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Use of the American Society of Anesthesiologists Classification as an Additional Planning Tool for Renal Cell Carcinoma Assessment

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Journal of Cancer Therapy 2013年第9期4卷 7-14页

作者： Daniel Beltrame Ferreira Stenio de Cassio Zequi Walter Henriques da Costa Diego Abreu Clavijo Ricardo Decia Deusdedit Cortez Neto Renato Rosa de Oliveira gustavo Cardoso Guimaraes Ademar Lopes Urology Division Department of Pelvic SurgeryA.C.Camargo Cancer CenterSao PauloBrazil Department of Urology Pasteur HospitalMontevideoUruguay

Objective: To determine the prognostic value of the American Society of Anesthesiologists (ASA) classification and of the main clinical pathologic variables in renal cell carcinoma (RCC) patients who underwent surgical treatment. Methods: In this international collaborative study, 376 RCC patients who underwent partial nephrectomy (PN) or radical nephrectomy (RN) during the period 1989-2009 were assessed. The pathological data were reviewed by a single pathologist, and all of the surgically treated patients had been previously evaluated by a team of anesthesiologists and classified as ASA 1, ASA 2, or ASA 3. Results: In total, 318 patients were included in the study, with a mean followup of 48 months. Incidental tumors represented 47% of the cases, while 11.6% presented with metastases at diagnosis. Among the patients assessed, 38 (11.9%) were classified as ASA 1, 213 (67%) as ASA 2, and 67 (21.1%) as ASA 3. An association between the ASA classification and the main clinicopathological variables of RCC was observed. The univariate analysis for overall survival (OS) revealed significant differences in the survival curves according to the ASA classification (p < 0.001). High-grade neoplasms, the presence of metastasis at diagnosis, clinical stage III/IV, and incidental tumors remained as independent predictors of survival. Moreover, the multivariate analysis revealed a negative impact of the ASA classification on OS (p = 0.001). Conclusions: The present study demonstrated a correlation between the ASA classification and the main prognostic factors of RCC and its impact on survival rates. ASA 3 patients had more aggressive tumors, increased risk of perioperative complications, and worse outcomes compared with ASA1 or ASA 2. Thus, the ASA classification may be considered an additional tool for assessing and planning the treatment of RCC patients.

关键词： Comorbidity Renal Cell Carcinoma ASA Prognosis Oncology

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Endoscopic stenting for inoperable malignant biliary obstruction: A systematic review and meta-analysis

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World Journal of Gastroenterology 2015年第47期21卷 13374-13385页

作者： Leonardo Zorrón Pu Eduardo Guimaraes Hourneaux de Moura Wanderley Marques Bernardo Felipe Iankelevich Baracat Ernesto Quaresma Mendonca AndréKondo gustavo Oliveira Luz Carlos Kiyoshi Furuya Júnior Everson Luiz de Almeida Artifon Gastrointestinal Endoscopy Division Department of GastroenterologyHospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo Guidelines Program Coordinator Brazilian Medical Association

AIM: To analyze through meta-analyses the benefits of two types of stents in the inoperable malignant biliary ***: A systematic review of randomized clinical trials(RCT) was conducted, with the last update on March 2015, using EMBASE, CINAHL(EBSCO), MEDLINE, LILACS/CENTRAL(BVS), SCOPUS, CAPES(Brazil), and gray literature. Information of the selected studies was extracted in sight of six outcomes: primarily regarding dysfunction, complication and reintervention rates; and secondarily costs, survival, and patency time. The data about characteristics of trial participants, inclusion and exclusion criteria and types of stents were also extracted. The bias was mainly assessed through the JADAD scale. This meta-analysis was registered in the PROSPERO database by the number CRD42014015078. The analysis of the absolute risk of the outcomes was performed using the software Rev Man, by computing risk differences(RD) of dichotomous variables and mean differences(MD) of continuous variables. Data on RD and MD for each primary outcome were calculated using the MantelHaenszel test and inconsistency was qualified and reported in χ2 and the Higgins method(I2). Sensitivity analysis was performed when heterogeneity was higher than 50%, a subsequent assay was done and other findings were compiled. Student's t-test was used for the comparison of weighted arithmetic means regarding secondary ***: Initial searching identified 3660 studies; 3539 were excluded through title, repetition, and/or abstract, while 121 studies were fully assessed and were excluded mainly because they did not compare self-expanding metal stents(SEMS) and plastic stents(PS), leading to thirteen RCT selected, with 13 articles and 1133 subjects meta-analyzed. The mean age was 69.5 years old, that were affected mostly by bile duct(proximal) and pancreatic tumors(distal). The preferred SEMS diameter used was the 10 mm(30 Fr) and the preferred PS diameter used was 10 Fr. In the metaanalysis

关键词： Biliary tract neoplasms Malignant biliaryobstruction Jaundice Palliative care Endoscopicretrograde cholangiopancreatography Stent Systematicreview Meta-analysis

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电影人之眼

电影人之眼

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作者： (美)古斯塔沃·默卡多(gustavo Mercado)

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Acute effects of physical exercise in type 2 diabetes: A review

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World Journal of Diabetes 2014年第5期5卷 659-665页

作者： Ricardo Yukio Asano Marcelo Magalhes Sales Rodrigo Alberto Vieira Browne José Fernando Vila Nova Moraes Hélio José Coelho Júnior Milton Rocha Moraes Hebert gustavo Simoes Universidade Mogi das Cruzes Center of Health Sciences Mogi das Cruzes 08770-490 Brazil Universidade Católica de Brasília School of Physical Education Brasília 72030-170 Brazil UDF-Centro Universitário School Health Brasilia 70390-045 Brazil Universidade Federal do Rio Grande do Norte Center of Health Sciences Natal 59078-970 Brazil Universidade Federal do Vale do So Francisco School of Physical Education Petrolina 56304205 Brazil Universidade Estadual de Campinas School of Physical Education Campinas 130883-851Brazil

The literature has shown the efficiency of exercise in the control of type 2 diabetes(T2D), being suggested as one of the best kinds of non-pharmacological treatments for its population. Thus, the scientific production related to this phenomenon has growing exponentially. However, despite its advances, still there is a lack of studies that have carried out a review on the acute effects of physical exercise on metabolic and hemodynamic markers and possible control mechanisms of these indicators in individuals with T2 D, not to mention that in a related way, these themes have been very little studied today. Therefore, the aim of this study was to organize and analyze the current scientific production about the acute effects of physical exercise on metabolic and hemodynamic markers and possible control mechanisms of these indicators in T2 D individuals. For such, a research with the following keywords was performed:-exercise; diabetes and post-exercise hypotension; diabetes and excess post-exercise oxygen consumption; diabetes and acute effects in PUBMED, SCIELO and HIGHWIRE databases. From the analyzed studies, it is possible to conclude that, a single exercise session can promote an increase in the bioavailability of nitric oxide and elicit decreases in postexercise blood pressure. Furthermore, the metabolic stress from physical exercise can increase the oxidation of carbohydrate during the exercise and keep it, in high levels, the post exercise consumption of O2, this phenomenon increases the rate of fat oxidation during recovery periods after exercise, improves glucose tolerance and insulin sensitivity and reduces glycemia between 2-72 h, which seems to be dependent on the exercise intensity and duration of the effort.

关键词： Metabolic diseases Hypertension Nitric oxide Blood glucose Oxygen consumption

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Hepatocarcinoma with metastasis to the anterior mediastinum

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Hepatoma Research 2016年第1期2卷 293-296页

作者： Rogerio Camargo Pinheiro Alves Lorena Sagrilo Auer Lisa Rodrigues da Cunha Saud Raquel Coris Arrelaro Aline Carboni Casado Bruno gustavo Ferreira Denis Szjenfeld Paula Bechara Poletti Department of Hepatology Instituto de Assistencia Medica ao Servidor Publico Estadual04028-000 Sao PauloBrazil Department of Gastroenterology Instituto de Assistencia Medica ao Servidor Publico Estadual04028-000 Sao PauloBrazil Department of Radiology Instituto de Assistencia Medica ao Servidor Publico Estadual04028-000 Sao PauloBrazil

Liver malignancies are the sixth leading cause of cancer worldwide,whereas hepatocellular carcinoma(HCC)is the most frequent histological type of liver *** metastasis,which rarely involves the mediastinum,is associated with poor *** 80-year-old male presenting with mild diffuse abdominal pain for 4 months,associated with hyporexia,increased abdominal volume,dry cough,and loss of 4 kg in 1 month,sought medical assistance due to hemoptysis and chest *** study revealed HCC with mediastinal metastasis,after which sorafenib therapy was *** progressed to death 4 months after the start of the treatment.

关键词： Hepatocellular carcinoma mediastinal metastasis sorafenib computed tomography

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Risk of colorectal polyps in patients with sporadic gastric polyps:A case-control study

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World Journal of Gastrointestinal Endoscopy 2013年第5期5卷 240-245页

作者： Daniel gustavo Cimmino José Manuel Mella Pablo Luna Raquel González Lisandro Pereyra Carolina Fischer Adriana Mohaidle Beatriz Vizcaino Mario Andres Medrano Adrián Hadad Silvia Pedreira Luis Boerr Digestive Endoscopy and Gastroenterology Units Internal Medicine DepartmentHospital AlemánBuenos AiresCP 1118Argentina

AIM:To assess the risk of colonic polyps,adenomas and advanced neoplastic lesions(ANL) in patients with sporadic gastric polyps,especially those with fundic gland polyps(FGP).METHODS:Clinical records of patients who had performed an upper and a lower digestive endoscopy between September 2007 and August 2008 were retrospectively analyzed.A case-control study was carried out,calling patients with gastric polyps as 'cases' and patients without gastric polyps as 'controls'.The risk of colonic polyps,adenomas and ANL(villous component ≥ 25%,size ≥ 10 mm,or high grade dysplasia) was assessed [odds ratio(OR) and its corresponding 95%CI].RESULTS:Two hundred and forty seven patients were analyzed:78 with gastric polyps(cases) and 169 without gastric polyps(controls).Among the cases,the majority of gastric polyps were FGP(80%,CI:69-88) and hyperplastic(20%,CI:12-31);25% had colonic polyps(25% hyperplastic and 68% adenomas,from which 45% were ANL).Among the controls,20% had colonic polyps(31% hyperplastic and 63% adenomas,from which 41% were ANL).The patients with sporadic FGP had an OR of 1.56(CI:0.80-3.04) for colonic polyps,an OR of 1.78(CI:0.82-3.84) for colonic adenomas,and an OR of 0.80(CI:0.21-2.98) for *** results were found in patients with gastric polyps in ***:The results of this study did not show more risk of colorectal adenomas or ANL neither in patients with sporadic gastric polyps nor in those with FGP.

关键词： Colorectal polyps Advanced neoplastic lesions Gastric polyps Fundic gland polyps gastric polyps Case-control study

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Synthesis and Biological Evaluation of a Highly Constrained Analogue of Methylthioadenosine (MTA)

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International Journal of Organic Chemistry 2012年第4期2卷 398-403页

作者： gustavo Senra G. de Carvalho Rafael Mafra de P. Dias Jean-Louis Fourrey Vania L. Silva Cláudio G. Diniz Adilson D. da Silva Departamento de Parasitologia Microbiologia e Imunologia Instituto de Ciências Biológicas (ICB) Universidade Federal de Juiz de Fora Juiz de Fora-MG Brasil Departamento de Química Instituto de Ciências Exatas (ICE) Universidade Federal de Juiz de Fora Juiz de Fora-MG Brasil Institut de Chimie des Substances Naturelles Gif-sur-Yvette Cedex France

We describe the synthesis and the antibacterial evaluation 2’,N3-cyclonucleoside 3 analogue of MTA that is characterized by the presence of an additional linkage between the heterocyclic ring and the sugar moiety.

关键词： Synthesis Biological Evaluation Antibacterial Analogue Methylthioadenosine

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In Silico Screening of Potential Drug with Antileishmanial Activty and Validation of their Activity by in Vitro and in Vivo Studies

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Journal of Chemistry and Chemical Engineering 2015年第6期9卷 375-402页

作者： Carol V. Mesa gustavo A. Blandon Diana L. Munoz Carlos E. Muskus Andres F. Florez Rodrigo Ochoa Ivan D. Velez Sara M. Robledo PECET Medical Research Institute School of Medicine University of Antioquia Medellin 050010 Colombia

The research on discovery and development of new treatments for cutaneous leishmaniasis has been declared as priority. Using bioinformatics approaches, this study aimed to identify antileishmanial activity in drugs that are currently used as anti-inflammatory and wound healing by such anti-Leishmania activity was validated by in vitro and in vivo assays. In silico analysis identified 153 compounds from which 87 were selected by data mining of DrugBank database, 22 and 44 were detected by PASS （http：//***） and BLAST （http：//***. gov/） alignment, respectively. The majority of identified drugs are used as skin protector, anti-acne, anti-ulcerative （wound healer） or anti-inflammatory and few of them had specific antileishmanial activity. The efficacy as antileishmanial was validated in vitro in 12/23 tested compounds and in all seven compounds that were evaluated in in vivo assays. Notably, this is the first report of antileishmanial activity for adapalene. In conclusion, bioinformatics tools not only can help to reduce time and cost of the drug discovery process but also may increase the chance that candidates identified in silico which have a validated antileishmanial activity by combining different biological properties.

关键词： Bioinformatic screening blast second uses antileishmanial activity leishmaniasis.

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Stage-Specific Changes on <i>Plasmodium yoelii yoelii </i>Following Treatment with <i>Hintonia latiflora</i>Stem Bark Extract and Phytochemical-Antioxidant Evaluation

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Pharmacology & Pharmacy 2017年第12期8卷 381-395页

作者： Elba Carrasco-Ramírez Perla Y. López-Camacho Armando Zepeda-Rodríguez Patricia Bizarro-Nevares Filiberto Malagón-Gutiérrez gustavo Basurto-Islas Norma Rivera-Fernández Laboratorio de Malariología Departamento de Microbiología y Parasitología Facultad de Medicina Universidad Nacional Autónoma de México CDMX México Departamento de Ciencias Naturales e Ingeniería Universidad Autónoma Metropolitana CDMX México Deparatmento de Biología Celular y Tisular Facultad de Medicina Universidad Nacional Autónoma de México CDMX México Departamento de Ingenierías Química Electrónica y Biomédica División de Ciencias e Ingeniería Universidad de Guanajuato Campus León Guanajuato México

Malaria endemic zones are mostly located on third world countries, where antimalarials are not easily found or patients cannot afford them, and in consequence, they must turn toward natural products or phytomedicines. In the present study, the effect of Hinotnia latiflora (Hl) methanolic stem bark extract (HlMeOHe) on the ultrastructure of the asexual intraerythrocytic stages of Plasmodium yoelii yoelii (Pyy) after a Peters’ four-day oral treatment was assessed by transmission electron microscopy (TEM), as well as the parasite development on blood smears, analyzed by light microscopy. Likewise, extract was subjected to qualitative tests adopting standard procedures for identification of phytoconstituents;its antioxidant activity was evaluated according to the method of Brand-Williams and by the radical cation decolorization assay. Results showed higher percentage of rings and lower percentage of trophozoites and schizonts in the treated animals, in comparison with those of the control groups, which demonstrated lower percentage of rings and trophozoites, and schizonts in higher number. Images of TEM showed in some treated parasites, mild parasite membranes, organelle swelling and ribosomal depletion. The phytochemical profile demonstrated that the extract contains alkaloids, tannis, steroids, terpenoids, flavonoids, phenolics and saponins. The obtained values of the half maximal inhibitory concentration (IC50) in μg/mL, for both antioxidant assays were of 423.83 and 202.95 respectively. It is concluded that HlMeOHe altered the development of the intraerythrocytic asexual stages and the ultrastructure of Pyy, and due to its phytochemical constituents, showed an in vitro antioxidant activity.

关键词： Hintonia latiflora Plasmodium yoelii yoelii Malaria Ultrastructural Changes Phytochemicals Antioxidant Natural Products

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Uniformity of Precipitation and Radial Profile of the Super 10 Sprinkler at Different Operating Pressures

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Journal of Water Resource and Protection 2014年第11期6卷 951-960页

作者： Paulo Eduardo S.Martins Elcides R.da Silva Juan Gabriel C.L.Ruiz gustavo R.Barbosa Jose Renato Zanini Marcilio V.Martins Filho Centro Universitário de Patos de Minas Patos de MinasBrazil Instituto Taquaritinguense de Ensino Superior TaquaritingaBrazil Sao Paulo State University JaboticabalBrazil

The study aimed to evaluate the effect of operating parameters of the sprinkler Super 10, manufactured by NaanDanJain, with green, yellow and blue nozzles on the hydraulic characterization, so that this information can contribute to a better dimensioning of systems and management of irrigated areas. For the determination of UC and UD the radial method was used and with the aid of computer application CATCH 3D the overlapping of water slides with ten spacings was calculated. The results demonstrate that the mechanism used for the fractionation of the water jet of sprinkler Super 10 is efficient because it presented good uniformity of water distribution and low amplitude of precipitation. For high uniformity of distribution of water in the larger wetting radii, it is recommended to work with Super 10 sprinkler using the green nozzle, with a pressure of 40 mH2O and spacing between sprinklers and lateral lines 12 × 12 m.

关键词： Hydraulic Performance Uniformity Irrigation Water Distribution Profile

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