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Epidemiological and clinical characteristics of COVID-19 in a Brazilian public hospital

World Journal of Clinical Cases 2023年第8期11卷 1761-1770页

作者： Fillipe Dantas Pinheiro Luana Weber Lopes Rafael Santos Dantas Miranda Dórea Glauber Rocha Lima Araújo Filipe Antônio França da Silva Breno Bittencourt de Brito Maria Luísa Cordeiro Santos Geovani Moreno Santos Júnior Maria Teresa Araújo de Lorenzo Barcia Renata de Amorim Marques AndréBezerra Botelho Anna Carolina Saúde Dantas Davi Tanajura Costa Adriano Fernandes Teixeira Cláudio Lima Souza Lucas Miranda Marques guilherme barretos campos Márcio Vasconcelos Oliveira Dulciene Maria de Magalhães Queiroz Fabrício Freire de Melo Instituto Multidisciplinar em Saúde Universidade Federal da BahiaVitória da Conquista 45029-094BahiaBrazil Hospital Geral de Vitória da Conquista Vitória da Conquista 45030-160BahiaBrazil Departamento de Ciências da Saúde Universidade Estadual do Sudoeste da Bahia(UESB)Vitória da Conquista 45083-900BahiaBrazil Faculdade de Medicina Universidade Federal de Minas GeraisBelo Horizonte 31270-901Minas GeraisBrazil

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has become a major health concern *** that context,the understanding of epidemiological and clinical features associated with the disease and its severity is crucial for the establishment of strategies aimed at disease control and *** To describe epidemiological features,signs,symptoms,and laboratory findings among severely ill COVID-19 patients from an inten-sive care unit in northeastern Brazil as well as to evaluate predictor factors for disease *** This is a prospective single-center study that evaluated 115 patients admitted to the intensive care unit in a northeastern Brazilian *** The patients had a median age of 65.60±15.78 *** was the most frequent symptom,affecting 73.9%of the patients,followed by cough(54.7%).Fever was reported in approximately one-third of patients and myalgia in 20.8%of the *** least two comorbidities were found in 41.7%of the patients,and hypertension was the most prevalent(57.3%).In addition,having two or more comorbidities was a predictor of mortality,and lower platelet count was positively associated with *** and vomiting were two symptoms that were predictors of death,and the presence of a cough was a protective *** This is the first report of a negative correlation between cough and death in severely ill severe acute respiratory syndrome coronavirus 2-infected *** associations between comorbidities,advanced age,and low platelet count and the outcomes of the infection were similar to the results of previous studies,highlighting the relevance of these features.

关键词： COVID-19 Epidemiology Symptoms Comorbidities Laboratory parameters

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Surgical treatment of familial adenomatous polyposis: Dilemmas and current recommendations

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World Journal of Gastroenterology 2014年第44期20卷 16620-16629页

作者： Fábio guilherme campos Department of Gastroenterology Colorectal Surgery Division Hospital das Clínicas University of So Paulo Medical School

Familial adenomatous polyposis (FAP) is an autosomal dominant inherited syndrome characterized by multiple adenomatous polyps (predisposing to colorectal cancer development) and numerous extracolonic manifestations. The underlying genetic burden generates variable clinical features that may influence operative management. As a precancerous hereditary condition, the rationale of performing a prophylactic surgery is a mainstay of FAP management. The purpose of the present paper is to bring up many controversial aspects regarding surgical treatment for FAP, and to discuss the results and perspectives of the operative choices and approaches. Preferably, the decision-making process should not be limited to the conventional confrontation of pros and cons of ileorectal anastomosis or restorative proctocolectomy. A wide discussion with the patient may evaluate issues such as age, genotype, family history, sphincter function, the presence or risk of desmoid disease, potential complications of each procedure and chances of postoperative surveillance. Therefore, the definition of the best moment and the choice of appropriate procedure constitute an individual decision that must take into consideration patient’s preferences and full information about the complex nature of the disease. All these facts reinforce the idea that FAP patients should be managed by experienced surgeons working in specialized centers to achieve the best immediate and long-term results.

关键词： Familial adenomatous polyposis Surgical treatment Restorative proctocolectomy Ileal pouch-anal anastomosis Ileorectal anastomosis Adenocarcinomas

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Colorectal cancer in young adults: A difficult challenge

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World Journal of Gastroenterology 2017年第28期23卷 5041-5044页

作者： Fábio guilherme campos division of colorectal surgery department of gastroenterologyhospital das clínicasuniversity of sao paulo

Sporadic colorectal cancer(CRC) is traditionally diagnosed after the sixth decade of life,and current recommendations for surveillance include only patients older than 50 years of age. However,an increasing incidence of CRC in patients less than 40 years of age has been reported. This occurrence has been attributed to different molecular features and low suspicion of CRC in young symptomatic individuals. When confronting young-onset CRC with older patients,issues such as biological aggressiveness,stage at diagnosis and clinical outcomes seem to differ in many aspects. In the future,the identification of the molecular profile underlying the early development of sporadic CRC will help to plan tailored screening recommendations and improve management. Besides that,differential diagnosis with CRC linked with hereditary syndromes is necessary to provide adequate patient treatment and family screening. Until we find the answers to some of these doubts,doctors should raise suspicion when evaluating an young adult and be aware of this risk and consequences of a late diagnosis.

关键词： Colorectal cancer Young age Hereditary Prognosis

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Doppler-guided hemorrhoidal dearterialization/transanal hemorrhoidal dearterialization: Technical evolution and outcomes after 20 years

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World Journal of Gastrointestinal Surgery 2016年第3期8卷 232-237页

作者： Marleny Novaes Figueiredo Fábio guilherme campos Department of Gastroenterology University of S?o Paulo Medical School Department of Gastroenterology Hospital das Clínicas University of S?o Paulo Medical School

In the setting of Hemorrhoidal Disease treatment, the option of conventional hemorrhoidectomy is highly effective, but it is still associated with postoperative pain and discomfort. For this reason, technical alternatives have been developed in order to reduce complications and to provide better postoperative recovery. To accomplish this aim, non-excisional techniques such as stapled hemorrhoidectomy and Doppler-guided hemorrhoidal ligation have been introduced into clinical practice with high expectations. The aim of this article is to revise the literature about transanal hemorrhoidal dearterialization technique in the treatment of hemorrhoidal disease, looking into its evolution, results and possible benefits over other modalities of surgical treatment. The literature review showed that Dopplerguided hemorrhoidal dearterialization is a safe and effective method to treat grades II to IV hemorrhoidal disease. Outcomes in patients presenting prolapse are satisfactory and the association of anopexy is an important aspect of this operation. Anal physiology disturbances are rarely observed and mainly transitory. This technique is an excellent option for every patient, especially in those with previous anal surgeries and in patients with previous alterations of fecal continence, when an additional procedure might represent a risk of definitive incontinence.

关键词： Doppler-guided hemorrhoidal dearterialization Hemorrhoids Transanal hemorrhoidal dearterialization

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Colorectal cancer risk in hamartomatous polyposis syndromes

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World Journal of Gastrointestinal Surgery 2015年第3期7卷 25-32页

作者： Fábio guilherme campos Marleny Novaes Figueiredo Carlos Augusto Real Martinez Surgery at University of São Paulo Medical SchoolSão Paulo SP 01411-000Brazil Colorectal Surgery Division Gastroenterology DepartmentHospital das ClínicasUniversity of São PauloMedical SchoolSão Paulo SP 01411-000Brazil Colorectal Surgery Division University of São PauloMedical SchoolSão Paulo SP 01411-000Brazil Surgery at University of Campinas Medical School(UNICAMP)São Paulo 01411-000Brazil Colorectal Surgery Division Gastrocentro HospitalUniversity of CampinasMedical SchoolSão Paulo 01411-000Brazil

Colorectal cancer(CRC) is a major cause of morbidity and mortality around the world, and approximately 5% of them develop in a context of inherited mutations leading to some form of familial colon cancer syndromes. Recognition and characterization of these patients have contributed to elucidate the genetic basis of CRC. Polyposis Syndromes may be categorized by the predominant histological structure found within the polyps. The aim of the present paper is to review the most important clinical features of the Hamartomatous Polyposis Syndromes, a rare group of genetic disorders formed by the peutz-Jeghers syndrome, juvenil polyposis syndrome and PTEN Hamartoma Tumor Syndrome(Bannayan-Riley-Ruvalacaba and Cowden Syndromes). A literature search was performed in order to retrieve the most recent and important papers(articles, reviews, clinical cases and clinical guidelines) regarding the studied subject. We searched for terms such as "hamartomatous polyposis syndromes", "Peutz-Jeghers syndrome", "juvenile polyposis syndrome", "juvenile polyp", and "PTEN hamartoma tumour syndrome"(Cowden syndrome, Bananyan-Riley-Ruvalcaba). The present article reports the wide spectrum of disease severity and extraintestinal manifestations, with a special focus on their potential to develop colorectal and other neoplasia. In the literature, the reported colorectal cancer risk for Juvenile Polyposis, Peutz-Jeghers and PTEN Hamartoma Tumor Syndromes are 39%-68%, 39%-57% and 18%, respectively. A review regarding cancer surveillance recommendations is also presented.

关键词： Hereditary GI cancer syndromes Peutz-Jeghers Juvenile polyposis Cowden syndrome PTENtumor

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Duodenal adenoma surveillance in patients with familial adenomatous polyposis

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World Journal of Gastrointestinal Endoscopy 2015年第10期7卷 950-959页

作者： Fábio guilherme campos Marianny Sulbaran Adriana Vaz Safatle-Ribeiro Carlos Augusto Real Martinez Gastroenterology Department Hospital das Clínicas University of Sao Paulo Medical School Gastroenterology Department University of Sao Paulo Medical School Colorectal Division State University of Campinas (UNICAMP Sao Paulo) Postgraduate Program in Health Sciences at San Francisco University

Familial adenomatous polyposis(FAP) is a hereditary disorder caused by Adenomatous Polyposis Gene mutations that lead to the development of colorectal polyps with great malignant risk throughout life. Moreover, numerous extracolonic manifestations incorporate different clinical features to produce varied individual phenotypes. Among them, the occurrence of duodenal adenomatous polyps is considered an almost inevitable event, and their incidence rates increase as a patient's age advances. Although the majority of patients exhibit different grades of duodenal adenomatosis as they age, only a small proportion(1%-5%) of patients will ultimately develop duodenal carcinoma. Within this context, the aim of the present study was to review the data regarding the epidemiology, classification, genetic features, endoscopic features, carcinogenesis, surveillance and management of duodenal polyps in patients with FAP.

关键词： Familial adenomatous polyposis Adenoma Duodenum Surveillance Endoscopy Digestive system

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Short-term outcomes after laparoscopic colorectal surgery in patients with previous abdominal surgery: A systematic review

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World Journal of Gastrointestinal Surgery 2016年第7期8卷 533-540页

作者： Marleny Novaes Figueiredo Fabio guilherme campos Luiz Augusto D'Albuquerque Sergio Carlos Nahas Ivan Cecconello Yves Panis Department of Gastroenterology University of S?o Paulo Medical School Division of Colorectal Surgery Department of Gastroenterology Hospital das Clínicas University of S?o Paulo Medical School Department of Gastroenterology Hospital das Clínicas University of S?o Paulo Medical School Department of Colorectal Surgery P?le des Maladies de l’Appareil Digestif (PMAD)

AIM: To perform a systematic review focusing on shortterm outcomes after colorectal surgery in patients with previous abdominal open surgery(PAOS).METHODS: A broad literature search was performed with the terms "colorectal", "colectomy", "PAOS", "previous surgery" and "PAOS". Studies were included if their topic was laparoscopic colorectal surgery in patients with PAOS, whether descriptive or comparative. Endpoints of interest were conversion rates, inadvertent enterotomy and morbidity. Analysis of articles was made according to Preferred Reporting Items for Systematic Reviews and ***: From a total of 394 citations, 13 full-texts achieved selection criteria to be included in the study. Twelve of them compared patients with and without PAOS. All studies were retrospective and comparative and two were case-matched. The selected studies comprised a total of 5005 patients, 1865 with PAOS. Among the later, only 294(16%) had history of a midline incision for previous gastrointestinal surgery. Conversion rates were significantly higher in 3 of 12 studies and inadvertent enterotomy during laparoscopywas more prevalent in 3 of 5 studies that disclosed this event. Morbidity was similar in the majority of studies. A quantitative analysis(meta-analysis) could not be performed due to heterogeneity of the studies. CONCLUSION: Conversion rates were slightly higher in PAOS groups, although not statistical significant in most studies. History of PAOS did not implicate in higher morbidity rates.

关键词： Previous abdominal surgery Laparoscopic surgery Colorectal surgery Previous abdominal surgery Laparoscopy

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CDX2 Overexpression in Barrett’s Esophagus and Esophageal Adenocarcinoma

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Journal of Cancer Therapy 2014年第7期5卷 657-663页

作者： Leandro Almeida Streher Vinicius campos guilherme da Silva Mazzini Marcelo Binato Luise Meurer Maria Isabel Edelweiss Richard Ricachenevsky Gurski Gastrointestinal Surgery Department Hospital de Clínicas de Porto Alegre Porto Alegre Brazil School of Medicine Universidade Federal do Rio Grande do Sul Porto Alegre Brazil

Background: Patients with Barrett’s esophagus have an increased risk of developing esophageal adenocarcinoma. Our purpose was to determine CDX2 expression in esophageal mucosa and establish a correlation between this marker and the progression of disease. Methods: We analyzed biopsies and surgical specimens from 150 patients who were divided into five groups according to histopathological diagnosis: G1, normal mucosa (n = 29);G2, esophagitis (n = 19);G3, columnar epithelium without intestinal metaplasia (n = 26);G4, Barrett’s esophagus (n = 32), and G5, adenocarcinoma (n = 44). Immuno-histochemical determination of CDX2 expression was considered positive in the presence of nuclear staining. Results: No CDX2 expression was detected in the G1 or G3 groups;5% of G2, 62.5% of G4 and 70.5% of G5 patients were CDX2 positive. There was a statistically significant difference between the G4 and G5 groups compared to the G1, G2 and G3 (p < 0.05). Conclusions: CDX2 expression was observed among patients with Barrett’s esophagus and adenocarcinoma compared to other groups. CDX2 was not expressed in the phases preceding Barrett’s esophagus, but there was no linear correlation between CDX2 expression and metaplasia-adenocarcinoma progression.

关键词： CDX2 Barrett’s Esophagus Intestinal Metaplasia Esophageal Adenocarcinoma Immunohistochemistry

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Estimation of dusk time F-region electron density vertical profiles using LSTM neural networks:A preliminary investigation

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Artificial Intelligence in Geosciences 2023年第1期4卷 209-219页

作者： Lucas Alves Salles Paulo Renato Pereira Silva guilherme Schwinn Fagundes Jonas Sousasantos Alison Moraes Instituto Tecnol´ogico de Aeron´autica-ITA Sao Jos´e Dos CamposBrazil William B.Hanson Center for Space Sciences University of Texas at Dallas-UT DallasRichardsonTXUSA Instituto de Aeron´autica e Espaço-IAE S˜ao Jos´e Dos CamposSP12228-904Brazil

The vertical profile of the ionosphere density plays a significant role in the development of low-latitude Equatorial Plasma Bubbles(EPBs),that in turn lead to ionospheric scintillation which can severely degrade precision and availability of critical users of the Global Navigation Satellite System(GNSS).Accurate estimation of ionospheric delays through vertical electron density profiles is vital for mitigating GNSS errors and enhancing location-based *** objective of this study is to propose a neural network,trained with radio occultation data from the COSMIC-1 mission,that generates average ionospheric electron density profiles during dusk,focusing on the pre-reversal enhancement of the zonal electric *** show that the estimated profiles exhibit a clear seasonal pattern,and reproduce adequately the climatological behavior of the ionosphere,thus presenting strong appeal on ionospheric error attenuation.

关键词： Ionosphere density Equatorial plasma bubbles(EPBs) Ionospheric scintillation Global navigation satellite system(GNSS) Neural network modeling

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Heart Valve Injury Induced by Mediastinum Radiotherapy in Cancer Treatment

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Journal of Pharmacy and Pharmacology 2018年第6期6卷 578-586页

作者： Patricia Fraga Paiva Alice Assumpcao Soares guilherme Sotto Maior do Valle Pinheiro Carolina Fraga Paiva Gisele Maria campos Fabri Emanoel Guimaraes Paiva Carlos M. campos Jose Fabfi Junior Medicine School Faculty of Medical Sciences and Health of Juiz de Fora Suprema/Therezinha de Jesus Hospital and Maternity33 Dirceu de Andrade St. Juiz de Fora MG 36025-140 Brazil Nursing School Faculty of Medical Sciences and Health of Juiz de Fora Suprema/Therezinha de Jesus Hospital and Maternity 33Dirceu de Andrade St. Juiz de Fora MG 36025-140 Brazil Dentistry School Juiz de Fora Federal University Jose Lourengo Kelmer St. s/n Martelos Juiz de Fora MG 36036-330 Brazil Intensive Care and Emergency Rooms Santa Casa de Misericordia Hospital 3353 Barao do Rio Branco Ave Juiz de Fora MG36021-630 Brazil Department of lnterventional Cardiology Heart Institute (InCor) Sao Paulo University Sao Paulo SP 05403-000 Brazil Hospital Israelita Albert Einstein 44 Doctor Eneas de Carvalho Aguiar St Cerqueira Cesar Sao Paulo SP 05403-000 Brazil

Radiotherapy as monotherapy or in combination with chemotherapy, has contributed to the drop in mortality rates related to neoplasms in the last 60 years. However, irradiation may promote heart damage and involvement is very common. As a result, VHD （valvular heart disease） is one of the earliest cardiovascular events post-radiotherapy. What it concerns to valve disease induced by chemotherapeutics, there are still only few studies. However, patients treated with chemotherapy in combination with radiotherapy had twice the risk of developing the disease when compared to those treated by radiotherapy alone. The heart injury caused by radiotherapy begins with damage to the endothelium and results in fibrosis and diffuses calcification primarily of the mitral and aortic valves. The echocardiography is the tool of choice to the patient’s assessment and follow-up after exposure. Prevention is the best option to face the valve damage induced by radiation.

关键词： Radiation induced valvular disease radiation cardiotoxicity chemotherapy cardiotoxicity cancer related valvular disease.

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