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Liver Transplantation in a Patient with Situs inversus Associated with Biliary Atresia, Polysplenia and Absence of Inferior Vena Cava: A Case Report

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Surgical Science 2016年第2期7卷 89-95页

作者： Henrique de aguiar Wiederkehr caroline Aragão de Carvalho Matheus Ruggeri Lucca Cajazeira campos Barbara de aguiar Wiederkehr Julio Cesar Wiederkehr School of Medicine Faculdade Evangélica do Paraná (FEPAR) Curitiba Brazil Department of Surgery Federal University (UFPR) Curitiba Brazil

Biliary atresia (BA) is the result of a process of unknown etiology which can occur as an isolated lesion or in association with several congenital abnormalities and remains the main indications of liver transplantation among infants. One of the malformations associated with biliary atresia is Situs inversus totalis, which is a rare congenital abnormality found in 10% - 20% of infants with biliary atresia and presents an incidence varying from 1:5000 to 1:20,000. This case report aims to present an extremely rare case of a patient with Situs inversus associated with biliary atresia, polysplenia and abscence of inferior vena cava that underwent liver transplantation. Case Report: A 10-month-old boy was referred to our hospital with the diagnosis of cirrhosis, due to biliary atresia. Abdominal ultrasound and Doppler scan showed the liver in the left upper quadrant as well as signs of chronic liver disease. In addition, we could notice that the spleen had several lobes, suggesting polysplenia, and was positioned in the right upper quadrant. The patient underwent living donor liver transplant. His mother was the donor and the graft, segment III, was positioned in the left upper quadrant associated with a Y en Roux reconstruction of the biliary tract. During the first post-operatory day, the patient presented signs of disseminated sepsis. Laboratory and imaging diagnostic tests were performed presenting a small intestinal malrotation associated with diffuse ischemia. The patient died at the third day of PO due to complications related to this condition. Conclusion: Any patient with Situs inversus with acute abdomen should be aggressively investigated for other structural and biochemical abnormalities. If liver transplant is indicated, the procedure can be successfully performed.

关键词： Liver Transplantation Situs inversus Polysplenia Biliary Atresia

Umbilical hernia in patients with liver cirrhosis: A surgical challenge

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World Journal of Gastrointestinal Surgery 2016年第7期8卷 476-482页

作者： Julio CU Coelho Christiano MP Claus Antonio CL campos Marco AR Costa caroline Blum Department of Surgery Federal University of Parana Chief Division of Gastrointestinal Surgery and Liver Transplantation Federal University of Parana Department of Surgery Positive University

Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites. Hernia repair is indicated in patients in whom medical treatment is effective in controlling ascites. Patients who have a good perspective to be transplanted within 3-6 mo, herniorrhaphy should be performed during transplantation. Hernia repair with mesh is associated with lower recurrence rate, but with higher surgical site infection when compared to hernia correction with conventional fascial suture. There is no consensus on the best abdominal wall layer in which the mesh should be placed: Onlay, sublay, or underlay. Many studies have demonstrated several advantages of the laparoscopic umbilical herniorrhaphy in cirrhotic patients compared with open surgical treatment.

关键词： Umbilical hernia Liver transplantation Liver cirrhosis Ascites Hernia repair Surgical site infection Mesh Ascites drainage

Disentangling spatial,environmental and historical effects on tropical forest tree species turnover

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Journal of Plant Ecology 2021年第4期14卷 717-729页

作者： Alisson Borges Miranda Santos Vinicius Andrade Maia Cleber Rodrigo de Souza Nathalle Cristine Alencar Fagundes Fernanda Moreira Gianasi Aurelio de Jesus Rodrigues Pais Natalia de aguiar-campos Gabriela Gomes Pires Diego Teixeira Girardelli Jean Daniel Morel Mariana caroline Moreira Morelli Felipe de Carvalho Araujo Rubens Manoel dos Santos Department of Forestry Sciences Federal University of LavrasUniversity CampusLavrasBrazil Biological Sciences University of the State of Minas GeraisItuiutaba UnitItuiutabaBrazil Department of Biology Federal University of LavrasUniversity CampusLavrasBrazil Faculty of Environmental Engineering and Natural Resources Zambeze UniversityChimoioMozambique

Aims We aimed at disentangling the effects of spatial distance,current and past environmental dissimilarity,and their combinations on tree community taxonomic and phylogenetic turnover by addressing the following questions:(i)Is tree community taxonomic and phylogenetic turnover related to the indirect effects of spatial distance via environmental dissimilarity?(ii)Does tree community taxonomic and phylogenetic turnover respond to paleoclimate(Last Glacial Maximum and Mid-Holocene)?Methods The study was carried out in 14 Atlantic rainforest sites in Brazil(20.4 ha sampled)containing 615 tree species from 83 plant *** obtained plot-level geographic coordinates and soil variables and site-level bioclimatic variables in the current,Mid-Holocene and Last Glacial *** used structural equation models with a distance-based approach to(i)test the direct effects of spatial distance and environmental dissimilarity and(ii)test the indirect effects of spatial distance via environmental dissimilarity on taxonomic(Bray–Curtis distance)and phylogenetic turnover(Comdist and Comdistnt distances).Important Findings Our results suggest a weak indirect effect of spatial distance via environmental dissimilarity on taxonomic and phylogenetic *** community turnover was driven by the direct effects of neutral,niche-based and historical ***,we inferred that the paleoclimate(historical processes)promoted the selection of the clades that gave rise to the current flora,while spatial distances(neutral processes)limited the dispersal range of species from the regional pool and environmental conditions(niche-based processes)locally selected the taxa that are able to persist.

关键词： assembly processes phylogenetic communities environmental filtering neutral communities phylogenetic turnover ecological niche paleoclimate effects

Comparison of morphological and functional outcomes of mouse sciatic nerve repair with three biodegradable polymer conduits containing poly (lactic acid)

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Neural Regeneration Research 2018年第10期13卷 1811-1819页

作者： Fernanda Marques Pestana Rui C.C.Domingues Júlia Teixeira Oliveira Daniela F.P.A.Durco Camila Oliveira Goulart Henrique Rocha Mendonca Anne caroline Rodrigues dos Santos Natália Tavares de campos Beatriz Theodoro da Silva Cristina Cardoso Pereira Cristiano Piacsek Borges Ana Maria Blanco Martinez Pós Graduacao em Ciências Morfológicas Instituto de Ciências Biomédicas-UFRJRio de Janeiro RJ Brazil Anatomia Patológica-Faculdade de Medicina-HUCFF-UFRJ Rio de Janeiro RJ Brazil Laboratório de Neurodegeneracao e Reparo-Faculdade de Medicina-HUCFF-UFRJ Rio de Janeiro RJ Brazil Programa de Eng. Química COPPE-UFRJRio de Janeiro Brazil Polo Universitário de Macaé Laboratório Integrado de Produtos Bioativos e BiociênciasMacaê UFRJ Brazil

Poly（lactic acid）（PLA）-containing nerve guidance conduits（NGCs） are currently being investigated for nerve repair as an alternative to autograft, which leads to permanent functional impairment in the territory innervated by the removed nerve. Combination of polymers modifies the physical properties of the conduits, altering their nerve-guidance properties. Conduits made from PLA-only or combined with other polymers have been used successfully for nerve repair, but their efficiency has not been compared. We compared the morphological and functional outcomes of peripheral nerve repair by using NGCs made of poly（lactic acid） and combined or not with polycaprolactone（PLA/PCL） or polyvinylpyrrolidone（PLA/PVP）. To assess the functional recovery, we employed a mechanical hyperalgesia analysis, sciatic functional index（SFI）, and electroneuromyography. The mechanical hyperalgesia analysis showed that the PLA group improved more rapidly than the PLA/PVP and PLA/PCL groups; similarly, in the electroneuromyography assay, the PLA group exhibited higher amplitude than the PLA/PCL and PLA/PVP groups. However, the SFI improvement rates did not differ among the groups. Morphologically, the PLA group showed more vascularization, while the nerve fiber regeneration did not differ among the groups. In conclusion, the PLA-only conduits were superior to the other NGCs tested for nerve repair.

关键词： sciatic nerve tubulization biodegradable conduit poly(lactic acid) regeneration

Temporal pattern of humoral immune response in mild cases of COVID-19

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World Journal of Biological Chemistry 2023年第2期14卷 40-51页

作者： Isadora Maria Pilati campos Milena Marques Gabrielle caroline Peiter Ana Paula Carneiro Brandalize Mauricio Bedim dos Santos Fabrício Freire de Melo Kádima Nayara Teixeira Campus Toledo Universidade Federal do ParanáToledo 85.919-899ParanáBrazil Setor Palotina Universidade Federal do ParanáPalotina 85.950-000ParanáBrazil Campus Anísio Teixeira Universidade Federal da BahiaVitória da Conquista 45029-094BahiaBrazil

BACKGROUND Understanding the humoral response pattern of coronavirus disease 2019(COVID-19)is one of the essential factors to better characterize the immune memory of patients,which allows understanding the temporality of reinfection,provides answers about the efficacy and durability of protection against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),and consequently helps in global public health and vaccination *** the patients who became infected with SARS-CoV-2,the majority who did not progress to death were those who developed the mild COVID-19,so understanding the pattern and temporality of the antibody response of these patients is certainly *** To investigate the temporal pattern of humoral response of specific immunoglobulin G(IgG)in mild cases of *** Blood samples from 191 COVID-19 real-time reverse transcriptase-polymerase chain reaction(RT-qPCR)-positive volunteers from the municipality of Toledo/Paraná/Brazil,underwent two distinct serological tests,enzyme-linked immunosorbent assay,and detection of anti-nucleocapsid *** samples and clinicoepidemiological data of the volunteers were collected between November 2020 and February *** assays were performed in duplicate and the manufacturers'recommendations were strictly *** data were statistically analyzed using multiple logistic regression;the variables were selected by applying the P<0.05 *** Serological tests to detect specific IgG were performed on serum samples from volunteers who were diagnosed as being positive by RT-qPCR for COVID-19 or had disease onset in the time interval from less than 1 mo to 7 *** time periods when the highest number of participants with detectable IgG was observed were 1,2 and 3 *** was observed that 9.42%of participants no longer had detectable IgG antibodies 1 mo only after being infected with SARS-CoV-2 and 1.57%were also IgG negative at less than 1 *** 5 mo,3.14%of volunteers were IgG n

关键词： Humoral response Immunoglobulin G antibody Immune memory Mild cases COVID-19 SARS-CoV-2 infection Serological test

Verification of Macro-and Micronutrient Intake in the First Year of Roux-En-Y Gastric Bypass Using MSM Method

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Food and Nutrition Sciences 2017年第4期8卷 392-401页

作者： caroline Frehner Marilia R.Zaparolli Magda R.R.da Cruz Antonio C.L.campos Maria Eliana M.Schieferdecker Alcides J.B.Filho Clinical Hospital of Federal University of Parana(UFPR) CuritibaBrazil Federal University of Parana(UFPR) CuritibaBrazil Pontifical Catholic University of Parana(PUCPR) CuritibaBrazil Cevip-ParanáLaparoscopy Center CuritibaBrazil

Background: Bariatric surgery is an alternative treatment for obesity. However, physicians need to be aware of the possible consequences of nutritional deficiencies with this type of surgery. This study aimed to determine the prevalence of inadequacy of macro- and micronutrients from the diet in patients undergoing Roux-en-Y gastric bypass after 3, 6, and 12 months postoperatively. Methods: We performed a longitudinal, observational, clinical study during preoperatively and 3-, 6-, and 12-month postoperatively (n = 95 patients). We collected information from medical records of patients in a Reference Clinic of Bariatric Surgery. Quantitative food intake was analyzed by ADS Nutri? and Multiple Source Method? software. The obtained data were compared with the daily-recommended intake in accordance with specific guidelines for bariatric surgery. Data were analyzed using t-tests, Mann-Whitney test, one-way analysis of variance (ANOVA), and Tukey’s test. Results: There was a high prevalence of inadequacy of macronutrients and micronutrients from food in the postoperatively period. However, only vitamin B12 intake was adequate based on the daily recommended intake. Conclusions: Our study suggests that the intake of nutrients by feeding is below current recommendations. Individual nutritional counseling with a therapeutic plan for adequate nutrition and prescription supplements are important to ensure that nutritional recommendations are adhered to.

关键词： Macronutrients Micronutrients Bariatric Surgery Gastric Bypass Food Intake

Assessment of Climate Change over South America under RCP 4.5 and 8.5 Downscaling Scenarios

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American Journal of Climate Change 2014年第5期3卷 512-527页

作者： Sin Chan Chou Andre Lyra caroline Mourao Claudine Dereczynski Isabel Pilotto Jorge Gomes Josiane Bustamante Priscila Tavares Adan Silva Daniela Rodrigues Diego campos Diego Chagas Gustavo Sueiro Gracielle Siqueira Jose Marengo National Institute for Space Research Cachoeira PaulistaBrazil Department of Meteorology Federal University of Rio de JaneiroRio de JaneiroBrazil National Center for Natural Disaster Monitoring and Warning Sao Jose dos CamposBrazil

Four sets of downscaling simulations based on the Eta Regional Climate Model forced by two global climate models, the HadGEM2-ES and the MIROC5, and two RCP scenarios—8.5 and 4.5, have been carried out. The objective of this work is to assess the climate change over South America based on the Eta simulations. The future changes are shown in timeslices of 30 years: 2011-2040;2041-2070 and 2071-2100. The climate change response of the Eta simulations nested in HadGEM2-ES is larger than the Eta nested in MIROC5. Major warming area is located in the central part of Brazil. In austral summer, the reduction of precipitation in the central part and the increase in the southeastern part of the continent are common changes in these simulations, while the EtaHadGEM2-ES intensifies the decrease of precipitation in central Brazil, the Eta-MIROC5 expands the area of increase of precipitation in southern Brazil toward the end of the century. In austral winter, precipitation decrease is found in the northern part of South America and in most of Central America, whereas the reduction in southeastern South America is limited to near coastal region. The time series of temperatures show that warming trends are larger in the Eta-HadGEM2-ES than in the Eta-MIROC5 simulations. Heavier precipitation rates are projected in the Central-South of Brazil toward the end of the century. Increase in the length of consecutive dry days (CDD) in Northeast of Brazil and the decrease of consecutive wet days (CWD) in the Amazon region are common features in these simulations.

关键词： South America Climate Downscaling Climate Change Assessment Climatic Extreme Indicators Eta Model

Evaluation of the Eta Simulations Nested in Three Global Climate Models

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American Journal of Climate Change 2014年第5期3卷 438-454页

作者： Sin Chan Chou André Lyra caroline Mourao Claudine Dereczynski Isabel Pilotto Jorge Gomes Josiane Bustamante Priscila Tavares Adan Silva Daniela Rodrigues Diego campos Diego Chagas Gustavo Sueiro Gracielle Siqueira Paulo Nobre José Marengo National Institute for Space Research Cachoeira PaulistaBrazil Department of Meteorology Federal University of Rio de JaneiroRio de JaneiroBrazil Centre for Monitoring and Warning of Natural Disasters Cachoeira PaulistaBrazil

To provide long-term simulations of climate change at higher resolution, Regional Climate Models (RCMs) are nested in global climate models (GCMs). The objective of this work is to evaluate the Eta RCM simulations driven by three global models, the HadGEM2-ES, BESM, and MIROC5, for the present period, 1961-1990. The RCM domain covers South America, Central America, and Caribbean. These simulations will be used for assessment of climate change projections in the region. Maximum temperatures are generally underestimated in the domain, in particular by MIROC5 driven simulations, in summer and winter seasons. Larger spread among the simulations was found in the minimum temperatures, which showed mixed signs of errors. The spatial correlations of temperature simulations against the CRU observations show better agreement for the MIROC5 driven simulations. The nested simulations underestimate precipitation in large areas over the continent in austral summer, whereas in winter overestimate occurs in southern Amazonia, and underestimate in southern Brazil and eastern coast of Northeast Brazil. The annual cycle of the near-surface temperature is underestimated in all model simulations, in all regions in Brazil, and in most of the year. The temperature and precipitation frequency distributions reveal that the RCM and GCM simulations contain more extreme values than the CRU observations. Evaluations of the climatic extreme indicators show that in general hot days, warm nights, and heat waves are increasing in the period, in agreement with observations. The Eta simulations driven by HadGEM2-ES show wet trends in the period, whereas the Eta driven by BESM and by MIROC5 show trends for drier conditions.

关键词： South America Climate Downscaling Model Evaluation Climatic Extreme Indicators Eta Model

Downscaling Climate Projections over La Plata Basin

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Atmospheric and Climate Sciences 2016年第1期6卷 1-12页

作者： caroline Mourão Sin Chan Chou José Marengo National Institute for Space Research Cachoeira Paulista Brazil National Center for Natural Disaster Monitoring and Early Warning S&#227o José dos Campos Brazil

Regional Climate Models are important tools, which are increasingly being used in studies of impacts and adaptation to climate change at local scale. The goal of this work is to assess the climate change over the La Plata Basin, using the Eta Regional model with a resolution of 10 km. Initial and boundary conditions used by the model are provided by the Eta-20 km model and the HadGEM2-ES Global model. The RCP 4.5 scenario was used for simulations of the future climate. The evaluation of the present climate (1961-1990) shows that the model represents well the spatial and temporal distribution of precipitation and temperature in the region. The model underestimates precipitation over large areas in summer, and overestimates in Southern Brazil in winter. Simulated temperature shows a good correlation with CRU data, with bias less than 1°C. The bias of temperature and precipitation in this simulation setup for the La Plata Basin is substantially reduced in comparison with previous literature using regional models. The climatic projections are shown in timeslices: 2011-2040, 2041-2070, and 2071-2099. In the three timeslices, the simulation project has a trend for an increase in precipitation during summer in Argentina, Uruguay, and southernmost Brazil. This increase is only projected in Southern Brazil during winter. The negative anomaly of precipitation appears in a large portion of the model domain during summer and is limited to some states in Southeast and Central-West Brazil in winter. The area with largest warming is projected in the northern portion of the domain. The projected increase in temperature reaches about 4°C in 2071-2099.

关键词： Regional Climate Model Climate Downscaling Climate Change Assessment La Plata Basin