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Effects of intragastric balloon placement in metabolic dysfunctionassociated fatty liver disease: A systematic review and metaanalysis

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World Journal of Hepatology 2021年第7期13卷 815-829页

作者： João Remíde Freitas Júnior Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura Vitor Massaro Takamatsu Sagae Gabriel Mayo Vieira de Souza guilherme henrique peixoto de oliveira Sergio A Sánchez-Luna Thiago Ferreira de Souza Eduardo Turiani Hourneaux de Moura Cláudia Pinto Marques Souza de oliveira Wanderley Marques Bernardo Eduardo Guimarães Hourneaux de Moura Serviço de Endoscopia Gastrointestinal do Hospital das Clínicas HCFMUSP Departamento de GastroenterologiaFaculdade de MedicinaUniversidade de Sao PauloSao PauloSPBR Division of Gastroenterology and Hepatology Department of Internal MedicineBasil I.Hirschowitz Endoscopic Center of ExcellenceThe University of Alabama at BirminghamBirminghamAL 35294United States department of Gastroenterology Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 05403-010Brazil

BACKGROUND Metabolic dysfunction-associated fatty liver disease corresponds to a clinical entity that affects liver function triggered by the accumulation of fat in the liver and is linked with metabolic *** To evaluate the effects of the intragastric balloon(IGB)in patients with metabolic dysfunction-associated fatty liver disease through the assessment of liver enzymes,imaging and several metabolic *** A comprehensive search was done of multiple electronic databases(MEDLINE,EMBASE,LILACS,Cochrane and Google Scholar)and grey literature from their inception until February *** criteria involved patients with a body mass index>25 kg/m2 with evidence or previous diagnosis of hepatic *** analyzed before and after 6 mo of IGB removal were alanine aminotransferase(IU/L),gamma-glutamyltransferase(IU/L),glycated hemoglobin(%),triglycerides(mg/dL),systolic blood pressure(mmHg),homeostatic model assessment,abdominal circumference(cm),body mass index(kg/m2)and liver volume(cm3).RESULTS Ten retrospective cohort studies evaluating a total of 508 patients were *** 6 mo of IGB placement,this significantly reduced alanine aminotransferase[mean difference(MD):10.2,95%confidence interval(CI):8.12-12.3],gammaglutamyltransferase(MD:9.41,95%CI:6.94-11.88),glycated hemoglobin(MD:0.17%,95%CI:0.03-0.31),triglycerides(MD:38.58,95%CI:26.65-50.51),systolic pressure(MD:7.27,95%CI:4.79-9.76),homeostatic model assessment(MD:2.23%,95%CI:1.41-3.04),abdominal circumference(MD:12.12,95%CI:9.82-14.41)and body mass index(MD:5.07,95%CI:4.21-5.94).CONCLUSION IGB placement showed significant efficacy in improving alanine aminotransferase and gamma-glutamyltransferase levels in patients with metabolic dysfunctionassociated fatty liver disease as well as improving metabolic markers related to disease progression.

关键词： Intragastric balloon Metabolic dysfunction-associated fatty liver disease Homeostatic model assessment Abdominal circumference Body mass index

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Supercritical fluid technology as a sustainable alternative method for textile dyeing:An approach on waste,energy,and CO_(2)emission reduction

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Journal of Environmental Sciences 2024年第6期140卷 123-145页

作者： Carlos Rafael Silva de oliveira Patrícia Viera de oliveira Leandro Pellenz Catia Rosana Lange de Aguiar Afonso henrique da Silva Júnior Federal University of Santa Catarina Textile Engineering Department2514 João Pessoa St.BlumenauSC89036-004Brazil Federal University of Santa Catarina Chemical Engineering DepartmentS/n Biotério Central St.FlorianópolisSC88040-900Brazil

The clothing industry is considered one of the most polluting industries on the planet due to the high consumption of water,energy,chemicals/dyes,and high generation of solid waste and *** with environmental concerns,the textile ennoblement sector is the most critical of the textile production chain,especially the traditional dyeing *** an alternative to current problems,dyeing with supercritical CO_(2)(scCO_(2))has been presented as a clean and efficient process for a sustainable textile *** fluid dyeing(SFD)has shown a growing interest due to its significant impact on environmental preservation and social,economic,and financial *** main SFD benefits include economy and reuse of non-adsorbed dyes;reduction of process time and energy expenditure;capture of atmospheric CO_(2)(greenhouse gas);use and recycling of CO_(2)in SFD;generation of carbon credits;water-free process;effluent-free process;reduction of CO_(2)emission and auxiliary *** being still a non-scalable and evolving technology,SFD is the future of *** review presented a comprehensive overview of the environmental impacts caused by traditional processes and confronted the advantages of *** SFD technique was introduced,along with its latest advances and future *** and environmental gains were also discussed.

关键词： Textile industry Supercritical dyeing Sustainable processes Water free dyeing Energy saving Cleaner production

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Endoscopic ultrasound artificial intelligence-assisted for prediction of gastrointestinal stromal tumors diagnosis:A systematic review and meta-analysis

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World Journal of Gastrointestinal Endoscopy 2023年第8期15卷 528-539页

作者： Rômulo Sérgio Araújo Gomes guilherme henrique peixoto de oliveira Diogo Turiani Hourneaux de Moura Ana Paula Samy Tanaka Kotinda Carolina Ogawa Matsubayashi Bruno Salomão Hirsch Matheus de oliveira Veras João guilherme Ribeiro Jordão Sasso Roberto Paolo Trasolini Wanderley Marques Bernardo Eduardo Guimarães Hourneaux de Moura department of Gastroenterology Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 05403-010Brazil Division of Hepatology and Endoscopy Department of GastroenterologyHarvard Medical SchoolBrigham and Women’s HospitalBostonMA 02115United States

BACKGROUND Subepithelial lesions(SELs)are gastrointestinal tumors with heterogeneous malignant *** ultrasonography(EUS)is the leading method for evaluation,but without histopathological analysis,precise differentiation of SEL risk is *** intelligence(AI)is a promising aid for the diagnosis of gastrointestinal lesions in the absence of *** To determine the diagnostic accuracy of AI-assisted EUS in diagnosing SELs,especially lesions originating from the muscularis propria *** Electronic databases including PubMed,EMBASE,and Cochrane Library were *** of any sex and>18 years,with SELs assessed by EUS AIassisted,with previous histopathological diagnosis,and presented sufficient data values which were extracted to construct a 2×2 *** reference standard was *** primary outcome was the accuracy of AI for gastrointestinal stromal tumor(GIST).Secondary outcomes were AI-assisted EUS diagnosis for GIST vs gastrointestinal leiomyoma(GIL),the diagnostic performance of experienced endoscopists for GIST,and GIST vs *** sensitivity,specificity,positive,and negative predictive values were *** corresponding summary receiver operating characteristic curve and post-test probability were also *** Eight retrospective studies with a total of 2355 patients and 44154 images were included in this *** AI-assisted EUS for GIST diagnosis showed a sensitivity of 92%[95%confidence interval(CI):0.89-0.95;Pder the curve(AUC)of *** diagnosis of GIST vs GIL by AI-assisted EUS,specificity was 90%(95%CI:0.88-0.95;P=0.02)and AUC of *** experienced endoscopists’values were sensitivity of 72%(95%CI:0.67-0.76;P<0.01),specificity of 70%(95%CI:0.64-0.76;P<0.01),and AUC of 0.777 for *** GIST vs GIL,the experts achieved a sensitivity of 73%(95%CI:0.65-0.80;P<0.01)and an AUC of ***

关键词： Subepithelial lesions Ultrasound endoscopy Artificial intelligence

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Antibiotic prophylaxis to prevent complications in endoscopic retrograde cholangiopancreatography:A systematic review and meta-analysis of randomized controlled trials

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World Journal of Gastrointestinal Endoscopy 2022年第11期14卷 718-730页

作者： Maria Fernanda Shinin Merchan Diogo Turiani Hourneaux de Moura guilherme henrique peixoto de oliveira Igor Mendonça Proença Epifanio Silvino do Monte Junior Edson Ide Caroline Moll Sergio A Sánchez-Luna Wanderley Marques Bernardo Eduardo Guimarães Hourneaux de Moura department of Gastroenterology Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 05403-010Brazil department of Internal Medicine University of Alabama at Birmingham Heersink School of MedicineBirminghamAL 35233United States

BACKGROUND The prophylactic use of antibiotics in endoscopic retrograde cholangiopancreatography(ERCP)is still *** To assess whether antibiotic prophylaxis reduces the rates of complications in patients undergoing elective *** This systematic review and meta-analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines.A comprehensive search of multiple electronic databases was *** randomized controlled trials were *** outcomes analyzed included bacteremia,cholangitis,sepsis,pancreatitis,and *** risk of bias was assessed by the Cochrane revised Risk-of-Bias tool for randomized controlled *** quality of evidence was assessed by the Grading of Recommendation Assessment,development,and ***-analysis was performed using the Review Manager 5.4 *** Ten randomized controlled trials with a total of 1757 patients that compared the use of antibiotic and non-antibiotic prophylaxis in patients undergoing elective ERCP were *** was no significant difference between groups regarding incidence of cholangitis after ERCP[risk difference(RD)=-0.02,95%confidence interval(CI):-0.05,0.02,P=0.32,cholangitis in patients with suspected biliary obstruction(RD=0.02,95%CI:-0.08 to 0.13,P=0.66),cholangitis on intravenous antibiotic prophylaxis(RD=-0.02,95%CI:-0.05 to 0.01,P=0.25),septicemia(RD=-0.02,95%CI:-0.06 to 0.01,P=0.25),pancreatitis(RD=-0.02,95%CI:-0.06 to 0.01,P=0.19),and allcause mortality(RD=0.00,95%CI:-0.01 to 0.01,P=0.71).However,the antibiotic prophylaxis group presented a 7%risk reduction in the incidence of bacteremia(RD=-0.07,95%CI:-0.14 to-0.01,P=0.03).CONCLUSION The prophylactic use of antibiotics in patients undergoing elective ERCP reduces the risk of bacteremia but does not appear to have an impact on the rates of cholangitis,septicemia,pancreatitis,and mortality.

关键词： Endoscopy Antibiotics Endoscopic retrograde cholangiopancreatography Cholangitis Infection

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Tribologically induced nanostructural evolution of carbon materials: A new perspective

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Friction 2024年第1期12卷 144-163页

作者： guilherme oliveira NEVES Nicolás ARAYA Diego Berti SALVARO Thiago de Souza LAMIM Renan Oss GIACOMELLI Cristiano BINdeR Aloisio Nelmo KLEIN JoséDaniel Biasoli de MELLO Laboratório de Materiais Universidade Federal de Santa CatarinaSanta Catarina 88040-900Brazil departamento de Ingeniería Mecánica Facultad de IngenieríaUniversidad del Bío-BíoConcepcion 4070-386Chile Universidad de Concepción Concepcion 4070-386Chile SENAI Innovation Institute for Laser Processing Santa Catarina 89218-153Brazil Universidade Federal de Uberlândia Minas Gerais 38408-100Brazil

Carbon-based solid lubricants are excellent options to reduce friction and wear,especially with the carbon capability to adopt different allotropes *** the macroscale,these materials are sheared on the contact along with debris and contaminants to form tribolayers that govern the tribosystem *** a recently developed advanced Raman analysis on the tribolayers,it was possible to quantify the contactinduced defects in the crystalline structure of a wide range of allotropes of carbon-based solid lubricants,from graphite and carbide-derived carbon particles to multi-layer graphene and carbon *** addition,these materials were tested under various dry sliding conditions,with different geometries,topographies,and solid-lubricant application *** of the initial tribosystem conditions and allotrope level of atomic ordering,there is a remarkable trend of increasing the point and line defects density until a specific saturation limit in the same order of magnitude for all the materials tested.

关键词： carbon nanostructures tribology Raman spectroscopy defects quantification tribolayer solid lubrication

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New avenues for the treatment of immunotherapy-resistant pancreatic cancer

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1134-1153页

作者： Luis guilherme de oliveira Silva Fabian Fellipe Bueno Lemos Marcel Silva Luz Samuel Luca Rocha Pinheiro Mariana dos Santos Calmon Gabriel Lima Correa Santos Gabriel Reis Rocha Fabrício Freire de Melo Instituto Multidisciplinar em Saúde Universidade Federal da BahiaVitória da Conquista 45029-094BahiaBrazil

Pancreatic cancer(PC)is characterized by its extremely aggressive nature and ranks 14th in the number of new cancer cases ***,due to its complexity,it ranks 7th in the list of the most lethal cancers *** pathogenesis of PC involves several complex processes,including familial genetic factors associated with risk factors such as obesity,diabetes mellitus,chronic pancreatitis,and *** in genes such as KRAS,TP53,and SMAD4 are linked to the appearance of malignant cells that generate pancreatic lesions and,consequently,*** this context,some therapies are used for PC,one of which is immunotherapy,which is extremely promising in various other types of cancer but has shown little response in the treatment of PC due to various resistance mechanisms that contribute to a drop in immunotherapy *** is therefore clear that the tumor microenvironment(TME)has a huge impact on the resistance process,since cellular and non-cellular elements create an immunosuppressive environment,characterized by a dense desmoplastic stroma with cancerassociated fibroblasts,pancreatic stellate cells,extracellular matrix,and immunosuppressive *** to this are genetic mutations in TP53 and immunosuppressive factors that act on T cells,resulting in a shortage of CD8+T cells and limited expression of activation markers such as *** this way,finding new strategies that make it possible to manipulate resistance mechanisms is ***,techniques such as the use of TME modulators that block receptors and stromal molecules that generate resistance,the use of genetic manipulation in specific regions,such as microRNAs,the modulation of extrinsic and intrinsic factors associated with T cells,and,above all,therapeutic models that combine these modulation techniques constitute the promising future of PC ***,this study aims to elucidate the main mechanisms of resistance to immunotherapy in PC and new ways of manipulating thi

关键词： Pancreatic cancer Immunotherapy Resistance Tumor microenvironment manipulation Combined immunotherapy

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Histological Assessment of Bone Regeneration in the Maxilla with Homologous Bone Graft:A Feasible Option for Maxillary Bone Reconstruction

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Journal of Renewable Materials 2024年第1期12卷 131-148页

作者： Sergio henrique Gonçalves Motta Ana Paula Ramos Soares Juliana Campos Hasse Fernandes Gustavo Vicentis oliveira Fernandes Graduate Center of Faculdade Redentor CLIVORio de JaneiroBrazil Periodontics and Oral Medicine department University of Michigan School of DentistryAnn ArborMI48109USA Centre for Interdisciplinary Research in Health(CIIS) Universidade Católica PortuguesaViseu3504-505Portugal

Bone biomaterials have been increasingly used to reconstruct maxillary atrophic ***,the aim of this study was to evaluate bone reconstruction in the maxilla using a homologous cortico-cancellous FFB(lyophilized)graft and verify its *** individuals were included from 2014 to *** first surgery was performed to install homologous bone blocks in the *** period of the second intervention varied between 5 months and 15 days to 11 months(≈7.93 months).The biopsies were taken from the central region of the matured graft during the surgery for implant *** patients presented clinical and radiographic conditions for the installation of dental *** was a 100%of survival *** histological assessment showed that the homologous block bone graft was an osteoconductive biomaterial,with connective tissue present,and newly formed bone juxtaposed on its *** were bone trabeculae with osteocytes and active osteoblasts with connective tissue in the mineralization process;the remodeling process can be found through the reverse lines.A limited focus of necrosis with fibrosis was detected,with small resorption and areas of inflammatory infiltrate,but without clinical *** homologous block bone graft can be considered a feasible option to substitute the autogenous bone graft(gold standard),with predictable clinical and favorable histological *** patients had a shorter surgical period,low morbidity,and an unlimited amount of biomaterial available at an accessible cost.

关键词： Regeneration bone graft histology homologous allogenous autogenous

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Urea breath test for Helicobacter pylori infection in adult dyspeptic patients: A meta-analysis of diagnostic test accuracy

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World Journal of Gastroenterology 2024年第6期30卷 579-598页

作者： Fabian Fellipe Bueno Lemos Caroline Tianeze de Castro Marcel Silva Luz Gabriel Reis Rocha Gabriel Lima Correa Santos Luís guilherme de oliveira Silva Mariana Santos Calmon Cláudio Lima Souza Ana Carla Zarpelon-Schutz Kádima Nayara Teixeira Dulciene Maria de Magalhães Queiroz Fabrício Freire de Melo Instituto Multidisciplinar em Saúde Universidade Federal da BahiaVitória da Conquista 45029-094BahiaBrazil Instituto de Saúde Coletiva Universidade Federal da BahiaSalvador 40110040BahiaBrazil Campus Toledo Universidade Federal do ParanáToledo 85919-899ParanáBrazil Laboratory of Research in Bacteriology UFMGBelo Horizonte 30130-100Minas GeraisBrazil

BACKGROUND Helicobacter pylori(***)infection has been well-established as a significant risk factor for several gastrointestinal *** urea breath test(UBT)has emerged as a leading non-invasive method for detecting *** numerous studies confirming its substantial accuracy,the reliability of UBT results is often compromised by inherent *** findings underscore the need for a rigorous statistical synthesis to clarify and reconcile the diagnostic accuracy of the UBT for the diagnosis of *** *** To determine and compare the diagnostic accuracy of 13C-UBT and 14C-UBT for *** infection in adult patients with *** We conducted an independent search of the PubMed/MEDLINE,EMBASE,and Cochrane Central databases until April *** search included diagnostic accuracy studies that evaluated at least one of the index tests(^(13)C-UBT or ^(14)C-UBT)against a reference *** used the QUADAS-2 tool to assess the methodo-logical quality of the *** utilized the bivariate random-effects model to calculate sensitivity,specificity,positive and negative test likelihood ratios(LR+and LR-),as well as the diagnostic odds ratio(DOR),and their 95%confidence *** conducted subgroup analyses based on urea dosing,time after urea administration,and assessment *** investigate a possible threshold effect,we conducted Spearman correlation analysis,and we generated summary receiver operating characteristic(SROC)curves to assess ***,we visually inspected a funnel plot and used Egger’s test to evaluate publication *** both as reliable diagnostic tools in clinical *** In summary,our study has demonstrated that ^(13)C-UBT has been found to outperform the ^(14)C-UBT,making it the preferred diagnostic ***,our results emphasize the significance of carefully considering urea dosage,assessment timing,and measurement techniques for both tests to enh

关键词： Helicobacter pylori Urea breath test Diagnosis Diagnostic test accuracy Meta-analysis

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Endoscopic vs radiologic gastrostomy for enteral feeding:A systematic review and meta-analysis

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World Journal of Meta-Analysis 2023年第6期11卷 277-289页

作者： Evellin Souza Valentim dos Santos guilherme henrique peixoto de oliveira Diogo Turiani Hourneaux de Moura Bruno Salomão Hirsch Roberto Paolo Trasolini Wanderley Marques Bernardo Eduardo GuimarãesHourneaux de Moura department of Gastroenterology Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 05403-010Brazil department of Gastroenterology and Hepatology Hospital Harvard Medical SchoolBostonMA 02115United States

BACKGROUND Percutaneous endoscopic gastrostomy(PEG)and percutaneous radiological gastrostomy(PRG)are minimally invasive techniques commonly used for prolonged enteral *** safe,both techniques may lead to complications,such as bleeding,infection,pain,peritonitis,and tube-related *** literature is unclear on which technique is the *** To establish which approach has the lowest complication *** A database search was performed from inception through November 2022,and comparative studies of PEG and PRG were selected following the Preferred Reporting Items for Systematic Reviews and Meta-analyses *** included studies compared the two techniques directly and provided absolute values of the number of *** with pediatric populations were *** primary outcome of this study was infection and ***,peritonitis,pain,and mechanical complications were secondary *** risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials(RoB2)and we used The Risk of Bias in Nonrandomized Studies(ROBINS-I)to analyze the retrospective *** also performed GRAde analysis to assess the quality of *** on risk differences and 95%confidence intervals were obtained using the Mantel-Haenszel *** Seventeen studies were included,including two randomized controlled trials and fifteen retrospective cohort *** total population was 465218 individuals,with 273493 having undergone PEG and 191725 *** only outcome that showed a significant difference was tube related complications in retrospective studies favoring PEG(95%CI:0.03 to 0.08;P<0.00001),although this outcome did not show significant difference in randomized studies(95%CI:-0.07 to 0.04;P=0.13).There was no difference in the analyses of the following outcomes:infection in retrospective(95%CI:-0.01 to 0.00;P<0.00001)or randomized(95%CI:-0.06 to 0.04;P=0.44)studies;bleeding in retrospective(95%CI

关键词： Gastrostomy Adverse events Meta-analysis Percutaneous endoscopic Radiological gastrostomy

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In-Hospital Outcomes in Minimally Invasive Mitral Valve Surgery: First Results in a Brazilian Single Center

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Open Journal of Thoracic Surgery 2024年第1期14卷 17-28页

作者： Daniel de Magalhães Freitas João Alberto Pansani Max Weyler Nery Stanlley de oliveira Loyola Maurício Lopes Prudente Giulliano Gardenghi Artur henrique de Souza department of Cardiovascular Surgery Encore Hospital Aparecida de Goiania Brazil Anesthesia Clinic (Clianest) Goiania Brazil

Introduction: Treatments for cardiovascular diseases have increasingly evolved with the tendency to offer minimally invasive or transcatheter procedures instead of conventional sternotomy surgery. In this context, we highlight minimally invasive mitral valve surgery (MIMVS), which has been shown to be an increasingly solid option with some superior results when compared to the conventional technique: better pain control, shorter hospital stays, shorter recovery time, shorter readmission rate in the first postoperative year, better aesthetic results, and lower overall cost. Aim: This study aims to evaluate the stages of MIMVS, by primary mitral valve consultation, in our service and compare these results with data from the literature. Methods: All electronic medical records of patients who underwent MIMVS for primary mitral valve injury in the Encore Hospital from January 2020 to February 2023 were analyzed. Tabulation and statistical analysis were performed using the Microsoft Excel® program. Quantitative variables were presented as means, standard deviations. Results: 46 patients were enrolled in our study (Age: 59.1 ± 12.4 years old;60.8% Female, BMI: 26 ± 4.4 Kg/m2, Low risk STS score: 82.6%). The observed 30-day mortality was 2.1%, plastic rate of 23.9%, blood transfusion rate of 41.3%, length of stay in an intensive care bed (ICB) of 3.3 ± 3.3 days and hospital stay of 6.4 ± 5.1 days. Conclusions: We noticed that the MIMVS results carried out in our service agree with data from national and international literature with approximately 1.3 days more hospitalization in ICB.

关键词： Minimally Invasive Surgical Procedures Mitral Valve Outcome Assessment Health Care

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