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Hepatoma Research 2020年第4期6卷 60-69页

作者： Kathryn JFowler guilherme moura cunha Tae Kyoung Kim Department of Diagnostic Radiology University of California at San DiegoSan DiegoCA 92130USA University of Toronto Joint Department of Medical ImagingUniversity Health Network/Mount Sinai Hospital/Women’s College HospitalToronto M5G 2N2Canada

The Liver Imaging Reporting and Data System(LI-RADS)provides a stepwise algorithmic approach that is proven to be highly accurate in diagnosing hepatocellular carcinoma(HCC)in patients at *** essential and early step in the algorithm is the diagnosis of malignancies other than HCC,such as cholangiocarcinoma and combined tumors,by application of LR-M features and *** LR-M category captures most non-HCC malignancies and some atypical *** exclusion of non-HCC malignancies is important for maintaining the high specificity of the LR-5,definite HCC *** review provides an overview of the approach to diagnosing non-HCC malignancies using LI-RADS CT/MRI and contrast enhanced ultrasound algorithms.

关键词： Magnetic resonance imaging computer tomography contrast-enhanced ultrasound

Alternative approach of hepatocellular carcinoma surveillance: abbreviated MRI

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Hepatoma Research 2020年第9期6卷 39-54页

作者： Ryan L.Brunsing Kathryn J.Fowler Takeshi Yokoo guilherme moura cunha Claude B.Sirlin Robert M.Marks Department of Radiology Stanford UniversityStanfordCA 94305USA Liver Imaging Group Department of RadiologyUniversity of California San DiegoSan DiegoCA 92093USA Department of Radiology University of Texas Southwestern Medical CenterDallasTX 75390USA Department of Radiology Naval Medical Center San DiegoSan DiegoCA 92134USA Department of Radiology Uniformed Services University of the Health SciencesBethesdaMD 20892USA.

This review focuses on emerging abbreviated magnetic resonance imaging(AMRI)surveillance of patients with chronic liver disease for hepatocellular carcinoma(HCC).This surveillance strategy has been proposed as a high-sensitivity alternative to ultrasound for identification of patients with early-stage HCC,particularly in patients with cirrhosis or obesity,in whom sonographic visualization of small tumors may be *** general AMRI approaches have been developed and studied in the literature-non-contrast AMRI,dynamic contrast-enhanced AMRI,and hepatobiliary phase contrast-enhanced AMRI-each comprising a small number of selected sequences specifically tailored for HCC *** rationale,general technique,advantages and disadvantages,and diagnostic performance of each AMRI approach is ***,current gaps in knowledge and future directions are *** on emerging evidence,we cautiously recommend the use of AMRI for HCC surveillance in situations where ultrasound is compromised.

关键词： Abbreviated magnetic resonance imaging cirrhosis Hepatitis B hepatocellular carcinoma surveillance magnetic resonance imaging

Clinical outcomes after intrastromal corneal ring segments reoperation in keratoconus patients

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International Journal of Ophthalmology(English edition) 2013年第6期6卷 796-800页

作者： Lconardo Torquetti guilherme Ferrara Franklin Almeida Leandro cunha Paulo Ferrara Jesus Merayo-Lloves Ferrara Eye Clinic Fernandez-Vega Eye Institute Hilton Rocha Foundation

AIM:To evaluate the clinical outcomes after Ferrara intrastromal corneal ring segments(ICRS)reoperation in patients with ***:A total of 37 keratoconus eyes implanted with intrastromal corneal ring segments,which had an ICRS exchange,addition,reposition or removal were *** visual acuity(UCVA),best corrected visual acuity(BCVA),keratometry(K),asphericity(Q)and pachymetry at the thinnest point(PTP)of the cornea were evaluated using a corneal tomography(Oculus Pentacam,USA)RESULTS:The mean follow-up time after the reoperation was 30.5±9.7 *** mean UCVA improved from 20/300 to 20/80(P=0.005);the mean BCVA improved from 20/160 to 20/50(P=0.0002),the mean keratometry reduced from 49.33±4.19D to 46.16±3.90D(P=0.0001),the mean pachymetry at the thinnest point increased from 450±42.9μm to 469±40.8μm(P=0.0001).The asphericity increased from-0.84±0.74 to-0.35±0.81(P=0.15)and the spherical equivalent reduced from-4.64±4.87D to-3.04±3.45D(P=0.137).The changes in the asphericity and spherical equivalent were not statistically ***:Ferrara ICRS implantation showed to be a reversible and readjustable surgical procedure for keratoconus *** outcomes can be obtained even after removal,addition,reposition or exchange of ICRS.

关键词： keratoconus intrastromal corneal ring segments reoperation

Compatibility and stability studies involving polymers used in fused deposition modeling 3D printing of medicines

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Journal of Pharmaceutical Analysis 2022年第3期12卷 424-435页

作者： Ihatanderson A.Silva Ana Luiza Lima Tais Gratieri guilherme M.Gelfuso Livia L.Sa-Barreto Marcilio cunha-Filho Laboratory of Food Drugand Cosmetics(LTMAC)School of Health SciencesUniversity of Brasilia70910-900BrasíliaDFBrazil Faculty of Ceilandia University of Brasilia(UnB)72220-900BrasíliaDFBrazil

One of the challenges in developing three-dimensional printed medicines is related to their stability due to the manufacturing conditions involving high *** work proposed a new protocol for preformulation studies simulating thermal processing and aging of the printed medicines,tested regarding their morphology and thermal,crystallographic,and spectroscopic ***,despite the strong drug-polymer interactions observed,the chemical stability of the model drugs was preserved under such *** fact,in the metoprolol and Soluplus®composition,the drug's solubilization in the polymer produced a delay in the drug decomposition,suggesting a protective effect of the *** and polyvinyl alcohol mixture,in turn,showed unmistakable signs of thermal instability and chemical decomposition,in addition to physical *** the presented context,establishing protocols that simulate processing and storage conditions may be decisive for obtaining stable pharmaceutical dosage forms using three-dimensional printing technology.

关键词： Three-dimensional printing Preformulation Hot-melt extrusion Thermal analysis Drug-polymer compatibility

The influence of porosity on tablet subdivision

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Particuology 2020年第6期18卷 192-196页

作者： Maira T.Teixeira Livia L.Sa-Barreto Izabel C.Silva Tais Gratieri guilherme M.Gelfuso Ricardo N.Marreto Mariana Landin Marcilio cunha-Filho Laboratory of Food Drugs and Cosmetics(LTMAC)University of Brasilia(UnB)70910-900 BrasiliaDFBrazil Laboratory of Nanosystems and Drug Delivery Devices(NanoSYS) Federal University of GoiasGoianiaGO.Brazil Departamento de Farmacologia Farmacia y Tecnologia Farmaceutica1+D Farma Group(Gl-1645)Universidade de Santiago de CompostelaSpain

A tablet microstructure,especially the porosity,is a crucial parameter that influences the mechanical ***,tablet subdivisions were studied as a functi on of tablet *** tablets were manufactured in the presenee of different diluents,namely microcrystalline cellulose,LudipressR,or lactose ***,the add让ion of Camphor was investigated,which was thereafter sublimated with a view of obtaining tablets having varying degrees of *** assays were corre lated to the subdivision performs *** increase in porosity reduced the hardness and increased the tablet friability,adversely impacting the *** all the excipients,an increase in relative porosity>90%represented the threshold level from which an inadequate subdivision *** in crease in tablet porosity led to a reduction in mechanical resista nee,which,combined with a heterogeneous and disc on tinuous distribution of pores within the matrix,resulted in poor subdivision *** trolling tablet porosity is an important consideration when designing tablets having a subdivision purpose.

关键词： Tablet subdivision Porosity Mass variation Mass loss Friability Hardness

Human occupation explains species invasion better than biotic stability:evaluating Artocarpus heterophyllus Lam.(Moraceae;jackfruit)invasion in the Neotropics

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Journal of Plant Ecology 2018年第3期11卷 465-474页

作者： guilherme de Oliveira Laboratório de Biogeografia da Conservação Universidade Federal do Recôncavo da Bahia(UFRB)Centro de Ciências AgráriasAmbientais e Biológicas(CCAAB)Setor de Ciências BiológicasRua Rui Barbosa 710Centro 44380-000Cruz das AlmasBahiaBrasil

Aims Biological invasions are recognized to put native species in risk of *** this study,I tested whether the invasion of Artocarpus heterophyllus Lam.(Moraceae;jackfruit)in the Neotropics was explained by its biotic stability,an intrinsic force,or by human occupation,an extrinsic *** I used an ensemble framework combining 12 ecological niche models(ENMs)and 4 atmosphere-ocean general circulation *** were constructed for the pre-industrial time period in the Indo-Malaya biogeographic region,the native habitat of ***,and were then projected to past(last glacial maximum,21000 years ago and mid-Holocene,6000 years ago)and future(end of century,2080)*** ENMs were used to establish the biotic stability of ***-phyllus in areas where it was predicted to be present concomitantly within these four time *** biotic stability was projected onto the Neotropics,and then I used a null model and logistic regression to test what the main driver of *** *** Findings In general,the presence of *** in the Neotropics was not explained by biotic stability,tested by the null ***,human occupation explained much of its presence in the invaded habitat,once all standardized coefficients related to this driver was significant positive in the logistic *** on these results,humans sustained the presence of ***-erophyllus in the Neotropics,probably because of the additive influences of propagule pressure and habitat ***,the recommendation is that the cultivation of *** in the Neotropics must be regulated and supervised,primarily near reserve areas.

关键词： ecological niche models(ENMs) ensemble forecasting climate change habitat disturbance propagule pressure

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

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

Discontinuation of antiviral therapy in chronic hepatitis B patients

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World Journal of Clinical Cases 2021年第24期9卷 6979-6986页

作者： Renato Medas Rodrigo Liberal guilherme Macedo Department of Gastroenterology and Hepatology Centro Hospitalar Universitario de São JoãoPorto 4200-319Portugal

Nucleos(t)ide analogs(NUC)are the first-line therapy for patients with chronic hepatitis B(CHB)recommended by most current *** therapy decreases progression of liver disease,reduces the risk of liver-related complications,and improves the quality of life of patients with *** indefinite or long-term NUC therapy is usually recommended,this strategy raises several concerns,such as side-effects,adherence,costs,and patient willingness to stop *** data showed the feasibility,efficacy,and safety of stopping antiviral therapy in carefully selected CHB patients,leading to its incorporation in international *** who discontinue NUC have a higher likelihood of hepatitis B surface antigen(HBsAg)loss compared to patients who continue on *** pertaining endpoints allowing safety discontinuation of NUC therapy differ among international *** hepatitis B e antigen(HBeAg)-positive patients,durable HBeAg seroconversion is considered an acceptable treatment *** HBeAg-negative patients,some guidelines propose undetectability hepatitis B virus DNA for at least 2 or 3 years,while others consider HBsAg loss as the only acceptable *** patients who stop therapy should remain under strict clinical and laboratorial follow-up protocols to detect and manage relapses in a timely *** reliable predictor of relapse has been consistently identified to date,although quantitative HBsAg has been increasingly studied as a reliable biomarker to predict safe NUC discontinuation.

关键词： Chronic hepatitis B Finite therapy Hepatitis B surface antigen loss Relapse Retreatment

Conscience imperative of providing information and knowledge in hepatology:The Portuguese approach

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World Journal of Clinical Cases 2017年第1期5卷 24-26页

作者： guilherme Macedo Marco Silva Department of Gastroenterology the Centro Hospitalar São JoãoWGO Training CenterFaculty of MedicineUniversity of Porto4200-319 PortoPortugal

The last 25 years have been a thrilling time for the Portuguese hepatologists. Our national meetings have been providing the forum for the exchange of scientific ideas and the presentation of clinical research in clinical Hepatology, a growing world of knowledge in medical care. Bridging the gaps between technology and clinical daily practice, the latest development and the almost humble bedside care, has been a challenge for the increasing numbers of doctors devoted to the diagnostic and treatment of liver disease. We have been trying to be very persuasive among the Portuguese medical community in demonstrating that cultural vectors may influence the origin and pattern of liver disease among us. Viral hepatitis and alcoholic liver disease are paradigms of this assumption. Chronic liver disease is responsible for 3% of the deaths in Portugal, which accounts for the top ten causes of death in our country. The recognition by public health authorities of this fact along with the national net of hepatology outpatient consultation in public hospitals, has brought liver diseases under the lights of doctors concerns and an increased public awareness of its dimension.

关键词： Alcohol Cirrhosis Hepatology Liver Public health