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A comprehensive neuromonitoring approach in a large animal model of cardiac arrest

Animal Models and Experimental Medicine 2022年第1期5卷 56-60页

作者： Filippo Annoni Lorenzo Peluso Lucas Akira Hirai Giovanni Babini Amina Khaldi Antoine Herpain Lorenzo Pitisci Lorenzo Ferlini Bruno Garcia Fabio Silvio Taccone Jacques Creteur Fuhong Su Intensive Care Experimental Laboratory Intensive Care UnitErasme HospitalBrusselBelgium Intensive Care Unit São Domingos HospitalSão LuísBrazil Department of Pathophysiology and Transplants University of MilanMilanItaly Department of Anesthesiology Intensive Care and Emergency Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilanItaly

Background:Anoxic brain injuries represent the main determinant of poor outcome after cardiac arrest(CA).Large animal models have been described to investigate new treatments during CA and post-resuscitation phase,but a detailed model that includes extensive neuromonitoring is lacking.Method:Before an electrically-induced 10-minute CA and resuscitation,46 adult pigs underwent neurosurgery for placement of a multifunctional probe(intracranial pressure or ICP,tissue oxygen tension or PbtO_(2) and cerebral temperature)and a bolt-based technique for the placement and securing of a regional blood flow probe and two sEEG electrodes;two modified cerebral microdialysis(CMD)probes were also inserted in the frontal lobes and accidental misplacement was prevented using a perforated head support.Result:42 animals underwent the CA procedure and 41 achieved the return of spontaneous circulation(ROSC).In 4 cases(8.6%)an adverse event took place during preparation,but only in two cases(4.3%)this was related to the neurosurgery.In 6 animals(13.3%)the minor complications that occurred resolved after probe repositioning.Conclusion:Herein we provide a detailed comprehensive neuromonitoring approach in a large animal model of CA that might help future research.

关键词： anoxic injury heart arrest ischemiareperfusion post-arrest resuscitation

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Surgical risk for patients with Chagasic achalasia and its correlation with the degree of esophageai dilation

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World Journal of Gastroenterology 2005年第37期11卷 5840-5844页

作者： José garcia Neto Roberto de Cleva bruno Zilberstein Joaquim José Gama-Rodrigues Surgery Division Hospital das Clínicas Federal University of Goiás Medical School Goiás Brazil Gastroenterology Department Digestive Tract Surgery Division Hospital das Clínicas University of Sao Paulo Medical School So Paulo Brazil

AIM: To analyze the risk of cardiovascular complications in patients with indication for surgical treatment of Chagasic esophageal achalasia and to correlate the surgical risks with the degree of esophageal dilation,thereby proposing a risk scale index.METHODS: One hundred and twenty-four patients with Chagasic esophageal achalasia, who received surgical treatment at the Hospital das Clinicas of the Federal patients were mostly related to the postoperative complications due to the cardiovascular system. All the patients were submitted to: (1) clinical history to define the cardiac functional class (New York Heart Association);(2) conventional 12-lead electrocardiogram at rest; and (3) contrast imaging of the esophagus to determine esophageal dilatation according to Rezende's classification of Chagasic megaesophagus.RESULTS: An assessment of the functional classification (FC) of heart failure during the preoperative period determined that 67 patients (54.03%) were assigned functional class Ⅰ (FC Ⅰ), 46 patients (37.09%) were assigned functional class Ⅱ (FC Ⅱ), and 11 patients (8.87%) were assigned functional class Ⅲ (FC Ⅲ). None of the patients were assigned to functional class Ⅳ (FC Ⅳ). There was a positive correlation between the functional class and the postoperative complications (FC ⅠxFC Ⅱ: P＜0.001; FC ⅠxFC Ⅲ: P＜0.001). The ECG was normal in 44 patients (35.48%) and presented abnormalities in 80 patients (64.52%). There was a significant statistical correlation between abnormal ECG (arrhythmias and primary change in ventricular repolarization) and postoperative complications (P＜0.001).With regard to the classification of the Chagasic esophageal achalasia, the following distribution was observed: group Ⅱ, 53 patients (42.74%); group Ⅲ, 37 patients (29.83%);and group Ⅳ, 34 patients (27.41%). There was a positive correlation between the degree of esophageal dilation and the increase in postoperative complications (grade Ⅱxgrade Ⅲ achalasia: P＜0.001; grade Ⅱ×grade Ⅳ achalasia: P＜0.001; and grade Ⅲxgrade Ⅳ achalas

关键词：手术治疗食管扩张临床表现病理机制

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Employment of Waste from the Textile Industry for the Production of Nanocomposites Aiming at the Generation of Thermal Shrinkable Films and the Non-Formation of Microplastics

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Materials Sciences and Applications 2023年第8期14卷 426-438页

作者： Dian Souza garcia bruno de Paula Amantes Maria Inês bruno Tavares Instituto de Macromoléculas Professora Eloisa Mano Universidade Federal do Rio de Janeiro Centro de Tecnologia Rio de Janeiro Brasil

With the increase of incorrectly discarded materials in the environment, including clothes, the need for recycling and reusing them becomes one of the alternatives to work around this problem, following the law of the 3 Rs. However, these polymeric materials which are deposited in the marine environment and land generate microplastics, due to their degradation/fragmentation due to the action of the weather, in these regions, including being carried by the air and transported from various regions. With the aim of reducing the impact of this inappropriate disposal and obtaining a material that does not generate microplastics, this study used waste from the textile industry, which would be unusable, and a biodegradable polymer. The tissue residues were submitted to acid hydrolysis with sulfuric acid, in order to weaken the interactions between the cellulose fibrils and promote a better dispersion of the latter when processed with the polymer, during the extrusion process, generating biodegradable polymeric nanocomposites. The results showed that the samples submitted to acid hydrolysis presented a higher degree of crystallinity and a greater number of interactions and lower mobility of hydrogen atoms. In addition, the samples treated for a longer time showed a small release of fibrils, suggesting that this treatment can help in the production of nanocomposites during their extrusion.

关键词： Microplastic Nanotechnology Cellulose Textile Industry Biodegradable Polymer

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Stem cell therapy for retinal diseases

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World Journal of Stem Cells 2015年第1期7卷 160-164页

作者： Jose Mauricio garcia Luisa Mendonca Rodrigo Brant Murilo Abud Caio Regatieri bruno Diniz Department of Ophthalmology Universidade Federal de Goias Goiania 74001-970 Brazil Department of Ophthalmology Universidade Federal de Sao Paulo Sao Paulo 04023-062 Brazil

In this review, we discuss about current knowledge about stem cell(SC) therapy in the treatment of retinal degeneration. Both human embryonic stem cell and induced pluripotent stem cell has been growth in culture for a long time, and started to be explored in the treatment of blinding conditions. The Food and Drug Administration, recently, has granted clinical trials using SC retinal therapy to treat complex disorders, as Stargardt's dystrophy, and patients with geographic atrophy, providing good outcomes. This study 's intent is to overview the critical regeneration of the subretinal anatomy through retinal pigment epithelium transplantation, with the goal of reestablish important pathways from the retina to the occipital cortex of the brain, as well as the differentiation from pluripotent quiescent SC to adult retina, and its relationship with a primary retinal injury, different techniques of transplantation, management of immune rejection and tumorigenicity, its potential application in improving patients' vision, and, finally, approaching future directions and challenges for the treatment of several conditions.

关键词： Macular degeneration Human embryonic stem cell Induced pluripotent stem cell Retinal pigment epithelium Stargardt's disease

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Fluid and electrolyte overload in critically ill patients: An overview

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World Journal of Critical Care Medicine 2015年第2期4卷 116-129页

作者： bruno Adler Maccagnan Pinheiro Besen André Luiz Nunes Gobatto Lívia Maria garcia Melro Alexandre Toledo Maciel Marcelo Park Intensive Care Unit Department of Medical Emergencies Hospital das Clínicas University of Sao Paulo Medical School Imed Research Group Intensive Care Unit Hospital Sao Camilo Pompéia

Fluids are considered the cornerstone of therapy for many shock states, particularly states that are associated with relative or absolute hypovolemia. Fluids are also commonly used for many other purposes, such as renalprotection from endogenous and exogenous substances, for the safe dilution of medications and as "maintenance" fluids. However, a large amount of evidence from the last decade has shown that fluids can have deleterious effects on several organ functions, both from excessive amounts of fluids and from their non-physiological electrolyte composition. Additionally, fluid prescription is more common in patients with systemic inflammatory response syndrome whose kidneys may have impaired mechanisms of electrolyte and free water excretion. These processes have been studied as separate entities(hypernatremia, hyperchloremic acidosis and progressive fluid accumulation) leading to worse outcomes in many clinical scenarios, including but not limited to acute kidney injury, worsening respiratory function, higher mortality and higher hospital and intensive care unit lengthof-stays. In this review, we synthesize this evidence and describe this phenomenon as fluid and electrolyte overload with potentially deleterious effects. Finally, we propose a strategy to safely use fluids and thereafter wean patients from fluids, along with other caveats to be considered when dealing with fluids in the intensive care unit.

关键词： Fluid therapy Critically Ill Oliguria Waterelectrolyte balance Central venous pressure Resuscitation Acute kidney injury Diuretics Multiple organ dysfunction syndrome Systemic inflammatory response syndrome

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Fine mapping of genomic regions associated with female fertility in Nellore beef cattle based on sequence variants from segregating sires

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Journal of Animal Science and Biotechnology 2020年第2期11卷 303-315页

作者： Gerson A.Oliveira Júnior Daniel J.A.Santos Aline S.M.Cesar Solomon A.Boison Ricardo V.Ventura bruno C.Perez JoséF.garcia JoséBento S.Ferraz Dorian J.Garrick Department of Veterinary Medicine University of São Paulo(USP)Faculty of Animal Science and Food EngineerPirassunungaSPBrazil Department of Animal Bioscience Center for Genetic Improvement of LivestockUniversity of GuelphGuelphONCanada Department of Animal and Avian Sciences University of MarylandCollege ParkMarylandUSA Department of Animal Science University of São Paulo(USP)PiracicabaSPBrazil Department of Sustainable Agricultural Systems University of Natural Resources and Life SciencesViennaAustria Department of Animal Nutrition and Production School of Veterinary Medicine and Animal ScienceUniversity of São Paulo(USP)PirassunungaBrazil Department of Support Production and Animal HealthSchool of Veterinary MedicineSão Paulo State University(Unesp)AraçatubaSPBrazil School of Agriculture Massey UniversityRuakura Ag CentreHamiltonNew Zealand

Background:Impaired fertility in cattle limits the efficiency of livestock production systems.Unraveling the genetic architecture of fertility traits would facilitate their improvement by selection.In this study,we characterized SNP chip haplotypes at QTL blocks then used whole-genome sequencing to fine map genomic regions associated with reproduction in a population of Nellore(Bos indicus)heifers.Methods:The dataset comprised of 1337 heifers genotyped using a GeneSeek®Genomic Profiler panel(74677 SNPs),representing the daughters from 78 sires.After performing marker quality control,64800 SNPs were retained.Haplotypes carried by each sire at six previously identified QTL on BTAs 5,14 and 18 for heifer pregnancy and BTAs 8,11 and 22 for antral follicle count were constructed using findhap software.The significance of the contrasts between the effects of every two paternally-inherited haplotype alleles were used to identify sires that were heterozygous at each QTL.Whole-genome sequencing data localized to the haplotypes from six sires and 20 other ancestors were used to identify sequence variants that were concordant with the haplotype contrasts.Enrichment analyses were applied to these variants using KEGG and MeSH libraries.Results:A total of six(BTA 5),six(BTA 14)and five(BTA 18)sires were heterozygous for heifer pregnancy QTL whereas six(BTA 8),fourteen(BTA 11),and five(BTA 22)sires were heterozygous for number of antral follicles’QTL.Due to inadequate representation of many haplotype alleles in the sequenced animals,fine mapping analysis could only be reliably performed for the QTL on BTA 5 and 14,which had 641 and 3733 concordant candidate sequence variants,respectively.The KEGG“Circadian rhythm”and“Neurotrophin signaling pathway”were significantly associated with the genes in the QTL on BTA 5 whereas 32 MeSH terms were associated with the QTL on BTA 14.Among the concordant sequence variants,0.2%and 0.3%were classified as missense variants for BTAs 5 and 14,respectively,highlighting the genes MTERF2,RTMB,ENSBT

关键词： Antral follicles Causal variants Haplotype Heifer pregnancy WGS

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Imaging response predictors following drug eluting beads chemoembolization in the neoadjuvant liver transplant treatment of hepatocellular carcinoma

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World Journal of Hepatology 2020年第1期12卷 21-33页

作者： Francisco Leonardo Galastri Felipe Nasser Breno Boueri Affonso Leonardo Guedes Moreira Valle bruno Calazans Odísio Joaquim Mauricio Motta-Leal Filho Paolo Rogério Salvalaggio Rodrigo Gobbo garcia Márcio Dias de Almeida Ronaldo Hueb Baroni Nelson Wolosker Department of Interventional Radiology Hospital Israelita Albert EinsteinSão Paulo 05652-000Brazil Department of Diagnostic Radiology The University of Texas MD Anderson Cancer CenterHoustonTX 77230United States Radiology Department Radiology DepartmentHeart Institute(InCor)University of São PauloSão Paulo 05403-900Brazil Teaching and Research Institute São PauloBrazilHospital Israelita Albert EinsteinSão Paulo 05652-000Brazil Department of Liver Transplant Hospital Israelita Albert EinsteinSão Paulo 05652-900Brazil Department of Radiology Hospital Israelita Albert EinsteinSão Paulo 05652-000Brazil Department of Vascular Surgery Hospital Israelita Albert EinsteinSão Paulo 05652-000Brazil

BACKGROUND Drug-eluting bead transarterial chemoembolization(DEB-TACE)is an endovascular treatment to release chemotherapeutic agents within a target lesion,minimizing systemic exposure and adverse effects to chemotherapeutics.Therefore,identifying which patient characteristics may predict imaging response to DEB-TACE can improve treatment results while selecting the best candidates.Predictors of the response after DEB-TACE still have not been fully elucidated.This is the first prospective study performed with standardized DEBTACE technique that aim to identify predictors of radiological response,assessing patients clinical and laboratory characteristics,diagnostic imaging and intraprocedure data of the hepatocellular carcinoma treated in the neoadjuvant context for liver transplantation.AIM To identify pre-and intraoperative clinical and imaging predictors of the radiological response of drug-eluting bead transarterial chemoembolization(DEB-TACE)for the neoadjuvant treatment of hepatocellular carcinoma(HCC).METHODS This is prospective,cohort study,performed in a single transplant center,from 2011 to 2014.Consecutive patients with HCC considered for liver transplant who underwent DEB-TACE in the first session for downstaging or bridging purposes were recruited.Pre and post-chemoembolization imaging studies were performed by computed tomography or magnetic resonance.The radiological response of each individual HCC was evaluated by objective response using mRECIST and the percentage of necrosis.RESULTS Two hundred patients with 380 HCCs were examined.Analysis of the objective response(nodule-based analysis)demonstrated that HCC with pseudocapsules had a 2.01 times greater chance of being responders than those without pseudocapsules(P=0.01),and the addition of every 1mg of chemoembolic agent increased the chance of therapeutic response in 4%(P<0.001).Analysis of the percentage of necrosis through multiple linear regression revealed that the addition of each 1mg of the chemoembolic agent caused an average increase of

关键词： Hepatocellular carcinoma Liver transplantation Response evaluation criteria in solid tumors Neoadjuvant therapy Liver neoplasms

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Transcatheter mitral valve repair in nonagenarians

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Journal of Geriatric Cardiology 2022年第1期19卷 90-94页

作者： Pedro Luis Cepas-Guillén Isaac Pascual Eulogio garcia Pilar Jimenez-Quevedo Alfonso Jurado-Roman Tomás Benito-González Rodrigo Estevez-Loureiro Pedro Li Dabit Arzamendi bruno Melica Eduardo Infante de Oliveira Pedro Martín Lorenzo Felipe Fernández-Vázquez Guillermo Galeote Luis Nombela-Franco Leire Unzue Pablo Avanzas Manel Sabate Xavier Freixa Cardiology Department Cardiovascular Institute(ICCV)Hospital ClinicIDIBAPSUniversity of BarcelonaBarcelonaSpain Interventional Cardiology Unit Hospital Universitario Central de AsturiasDepartment of MedicineUniversity of OviedoOviedoSpain Servicio de Hemodinámica y Cardiología Intervencionista HM CIEC-Centro Integral de Enfermedades CardiovascularesHospital Universitario HM MontepríncipeHM HospitalesMadridSpain Facultad de Medicina Universidad CEU San PabloMadridSpain Cardiology Department Cardiovascular InstituteHospital Clínico San CarlosIdISSCMadridSpain Division of Interventional Cardiology University Hospital La PazIdiPAZCIBER-CVMadridSpain Department of Cardiology University Hospital of LeónLeónSpain Interventional Cardiology Unit HospitalÁlvaro CunqueiroVigoSpain Interventional Cardiology Unit Hospital Sant Pau i Santa CreuBarcelonaSpain Serviço de Cardiologia Centro Hospitalar de Vila Nova de Gaia/Espinho-EPEVila Nova de GaiaPortugal Serviço de Cardiologia Hospital de Santa MariaCentro Hospitalar Lisboa NorteCentro Académico Médico de LisboaLisboaPortugal Servicio de Cardiología Hospital Universitario de Gran Canaria Dr.NegrínLas Palmas de Gran CanariaSpain

Given the increase in life expectancy indeveloped countries,nonagenarian population will become clinically and numerically relevant in our daily routine practice in the near future.Age has been observed to exert a profound influence on the prevalence of severe mitral regurgitation (MR) in the population.[1]Mitral valve surgery remains the gold standard of care for patients with symptomatic severe MR.

关键词： mitral routine surgery

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Radioembolisation and portal vein embolization before resection of large hepatocellular carcinoma

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World Journal of Gastroenterology 2015年第32期21卷 9666-9670页

作者： Fikri Bouazza Arthur Poncelet Camilo Alejandro garcia Philippe Delatte Jean Luc Engelhom Maria Gomez Galdon Amélie Deleporte Alain Hendlisz bruno Vanderlinden Patrick Flamen Vincent Donckier Abdominal Surgery Institut Jules Bordet Université Libre de Bruxelles Nuclear Medicine Institut Jules Bordet Université Libre de Bruxelles Radiology Institut Jules Bordet Université Libre de Bruxelles Pathology Institut Jules Bordet Université Libre de Bruxelles Digestive Oncology Institut Jules Bordet Université Libre de Bruxelles Abdominal Surgery Institut Jules Bordet Centre de Chirurgie Hépato-Biliaire de l’ULB Université Libre de Bruxelles

Resectability of hepatocellular carcinoma in patients with chronic liver disease is dramatically limited by the need to preserve sufficient remnant liver in order to avoid postoperative liver insufficiency. Preoperative treatments aimed at downsizing the tumor and promoting hypertrophy of the future remnant liver may improve resectability and reduce operative morbidity. Here we report the case of a patient with a large hepatocellular carcinoma arising from chronic liver disease. Preoperative treatment, including tumor downsizing with transarterial radioembolization and induction of future remnant liver hypertrophy with right portal vein embolization, resulted in a 53% reduction in tumor volume and compensatory hypertrophy in the contralateral liver. The patient subsequently underwent extended right hepatectomy with no postoperativesigns of liver decompensation. Pathological examination demonstrated a margin-free resection and major tumor response. This new therapeutic sequence, combining efficient tumor targeting and subsequent portal vein embolization, could improve the feasibility and safety of major liver resection for hepatocellular carcinoma in patients with liver injury.

关键词： Hepatocellular carcinoma Chronic liver disease Rad

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Late onset acute Vogt-Koyanagi-Harada syndromechallenges on the way

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International Journal of Ophthalmology(English edition) 2018年第3期11卷 524-527页

作者： Sandra Rodrigues-Barros Jacqueline Martins Sousa bruno Carvalho Gabriel Andrade Heloisa Nascimento Department of Ophthalmology Hospital Garcia de Orta Avenida Torrado da Silva Almada 2801-951 Portugal Department of Ophthalmology and Visual Sciences Escola Paulista de Medicina Universidade Federal de Sao Paulo Rua Botucatu 821 Vila Clementino Sao Paulo SP 04023-062 Brazil Department of Ophthalmology Centro Hospitalar de Lisboa Central Alameda Santo Antonio dos Capuchos Lisboa 1169- 050 Portugal

Dear Editor,We would like to share some clinical cases of late onset acute Vogt-Koyanagi-Harada syndrome （VKH）, a rare diagnosis in this age range.

关键词： Late onset acute Vogt-Koyanagi-Harada syndromechallenges the way

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