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

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 University of Goiás, were included in this study. The 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 Ⅰ×FC Ⅱ： P〈0.001; FC Ⅰ×FC 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 compli

关键词： Postoperative Chagas' disease Surgical risk Chagasic achalasia Cardiovascular risk

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Fathal pulmonary hypertension after distal splenorenal shunt in schistosomal portal hypertension

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World Journal of Gastroenterology 2004年第12期10卷 1836-1837页

作者： Roberto de Cleva Paulo Herman Vincenzo Pugliese Bruno Zilberstein William Abro Saad joaquim joségama-rodrigues Gastroenterology Department Hospital Das Clinicas-University of Sao Paulo Medical School Digestive Tract Surgery Division Hospital Das Clinicas-University of Sao Paulo Medical School Digestive Tract Surgery Division Hospital Das Clincas-University of Sao Paulo Medical School

Mansonic schistosomiasis is the main cause of portal hypertension in Brazil. Hepatosplenic (HS) form is manifested by hepatomegaly mainly on the left hepatic lobe associated with large splenomegaly and bleeding due to... 详细信息

关键词： Adult Fatal Outcome Female Humans Hypertension, Portal Hypertension, Pulmonary Male Postoperative Complications Schistosomiasis mansoni Splenorenal Shunt, Surgical

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Preservation of the superior rectal artery in laparoscopic colectomy for slow transit constipation: Is it really associated with better outcomes?

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World Journal of Gastroenterology 2021年第38期27卷 6513-6514页

作者： Rogério Serafim Parra Omar Feres joséjoaquim Ribeiro Rocha Department of Surgery and Anatomy Ribeirao Preto Medical SchoolUniversity of São PauloRibeirao Preto 14048900Brazil

Few patients with slow-transit constipation refractory to conservative treatment can benefit with a subtotal colectomy with ileorectal anastomosis with the preservation of the superior rectal *** this letter to the editor some important issues were ***,the study did not include a comparison ***,they did not present the functional results in the short or long term related to the bowel function of these patients after ***,the authors showed that this surgical procedure was safe,and no cases of leakage were found.

关键词： Laparoscopy Colorectal surgery Constipation Colectomy

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Influence of a nucleotide oligomerization domain 1 (NOD1) polymorphism and NOD2 mutant alleles on Crohn's disease phenotype

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World Journal of Gastroenterology 2007年第41期13卷 5446-5453页

作者： Elisabet Cantó Elena Ricart David Busquets David Monfort Esther García-Planella Dolors González joaquim Balanzó josé L Rodríguez-Sánchez Sílvia Vidal Department of Immunology Sant Pau Hospital & Research Inst.Sant Pau HospitalBarcelona 08025Spain Department of Gastroenterology CIBER-EHD.Clinic HospitalBarcelona-08025Spain Department of Digestive Pathology Sant Pau HospitalBarcelona 08025Spain

AIM： To examine genetic variation of nucleotide oligomerization domain 1 （NOD/） and NOD2, their respective influences on Crohn＇s disease phenotype and gene-gene interactions. METHODS：（ND1＋32656＊1） NOD1 polymorphism and SNPS, SNP12 and SNP13 of NOD2 were analyzed in 97 patients and 50 controls. NOD2 variants were determined by reaction restriction fragment length polymorphism analysis. NOD1 genotyping and NOD2 variant confirmation were performed by specific amplification and sequencing. RESULTS： The distribution of NOD1 polymorphism in patients was different from controls （P = 0.045） and not altered by existence of NOD2 mutations. In this cohort, 30.92% patients and 6% controls carried at least one NOD2 variant （P 〈 0.001） with R702W being the most frequent variant. Presence of at least one NOD2 mutation was inversely associated with colon involvement （9.09% with colon vs 36.4% with ileal or ileocolonic involvement, P = 0.04） and indicative of risk of penetrating disease （52.63% with penetrating vs 25.64% with non-penetrating or stricturing behavior, P = 0.02）. L1007finsC and double NOD2 mutation conferred the highest risk for severity of disease （26.3% with penetrating disease vs 3.8% with non-penetrating or stricturing behavior presented L1007finsC, P = 0.01 and 21.0% with penetrating disease vs 2.5% with non-penentrating or stricturing behavior carried double NOD2 mutation, P = 0.007）. Exclusion of patients with NOD2 mutations from phenotype/NODl-genotype analysis revealed higher prevalence of ＊1＊1 genotype in groups of younger age at onset and colonic location.CONCLUSION： This study suggests population differences in the inheritance of risk NOD1 polymorphism and NOD2 mutations. Although no interaction between NOD1-NOD2 was noticed, a relationship between disease location and Nod-like receptor molecules was established.

关键词： Crohn's disease Nucleotide oligomerization domain 1 Nucleotide oligomerization domain 2

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Extrahepatic right hepatic duct diverticulum: a rare entity

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Hepatobiliary & Pancreatic Diseases International 2010年第2期9卷 213-215页

作者： Eduardo SM Fernandes Raquel L Bernardo Moacir M Fernandes Rogério MC Araújo Renato Sebbe Asterio Monte joséF Coelho Antonio AP Souza joaquim Ribeiro Filho Department of General Surgery Section of Hepatobiliary Surgery and TransplantationRio de Janeiro Federal University Department of Digestive Surgery and Gastroenterology Pio XII General Hospital

BACKGROUND:Douglas described choledochal cysts in 1852 and Todani proposed an anatomy-based classification in 1977. The classification is the most extensively used,but does not include some rare *** present a case of hepatic duct diverticulum,one of the variations,and discuss its diagnosis and treatment. METHODS:A 57-year-old woman presented with upper abdominal pain and discomfort associated with nausea and *** was finally diagnosed with cholelithiasis and right hepatic duct diverticulum. RESULT:The patient underwent resection of the hepatic duct diverticulum and cholecystectomy,and was asymptomatic 26 months after surgery. CONCLUSIONS:Hepatic duct diverticulum is a rare form of choledochal cyst,not included in Todani’s classification. Todani’s classification including this and other uncommon variations of choledochal cysts must be *** best diagnostic imaging methods and treatment for choledochal cysts must be defined.

关键词： choledochal cysts hepatic duct diverticulum Todani's classification intrahepatic diverticulum

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COVID-19 Downgraded Already Impaired Mental Health of Medical Undergraduates during the Pandemic Years

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Journal of Biosciences and Medicines 2023年第5期11卷 166-180页

作者： Rodrigo Corrêa Falcão rodrigues Alves Rodolffo da Silva Fossa Vinicius de Calasans Timaco josé Mariano Soares de Moraes Emilio Magalhães Martins Will Rinaldo Henrique Aguilar da Silva Luiz Antonio Vane joaquim Edson Vieira Matheus Fachini Vane Faculdade de Ciências Médicas de Sã o José dos Campos S&atildeo José dos Campos Brazil Department of Anesthesiology Juiz de Fora Federal University Juiz de Fora Brazil Department of Anesthesiology Clinics Hospital University of S&atildeo Paulo Medical School S&atildeo Paulo Brazil Discipline of Anesthesiology Department of Surgery University of S&atildeo Paulo Medical School S&atildeo José dos Campos Brazil

Background: Measures to contain the COVID-19 transmission reached teaching routines of universities worldwide with possible mental health consequences for anxiety. This study assessed prevalence and risk factors for stress, depression, and anxiety (SDA) in medical students during quarantine by COVID-19. Methods: A cross-sectional observational study of medical students by means of the DASS-21 questionnaire. Risk factors for SDA were assessed based on epidemiologic questions related to COVID-19. Receiver Operating Characteristics (ROC) curves were calculated for each predictor, as well as sensitivity and specificity. Results: This survey reached 1009 responses. A prevalence of 77.5% for some SDA disorder was found, 63% being severe. Previous diagnosis of psychiatric disorder was a factor of risk for anxiety (OR 2.78 CI95% 1.44 - 14.25, p = 0.044), as well as for depression (OR 3.37 CI95% 1.98 - 6.02, p Conclusion: Psychiatric conditions as well as chronic illnesses were risk factors for high prevalence of anxiety, depression and stress during the COVID-19 pandemic among medical students.

关键词： Mental Health COVID-19 Students Medical Surveys and Questionnaires

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Root Growth, Nutrition and Yield of Maize with Applied Different Limestone Particle Size in the Cerrado Soil

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American Journal of Plant Sciences 2014年第4期5卷 463-472页

作者： Rafael Felippe Ratke Hamilton Seron Pereira Joao de Deus Gomes dos Santos Junior joaquim joséFrazao Juliano Magalhaes Barbosa Bruno de Oliveira Dias Departamento de Engenharias AgronomiaCampus Professora Cinobelina ElvasUniversidade Federal do PiauíBom JesusBrazil Instituto de Ciencias Agrárias Universidade Federal de UberlandiaUberlandiaBrazil Embrapa Centro Nacional de Pesquisa no CerradoPlanaltinaBrazil Programa de Pós-Graduacao em Agronomia Universidade Federal de GoiásGoianiaBrazil

The limestone with smaller particle size provides rapid correction of soil acidity. However, the limestone with large particles can promote bigger root growth, and may still have a residual effect on the soil. The aim of this study was to evaluate the residual effect of the application and incorporation of different limestone with a particle size bigger than 0.30 mm in root growth, nutrition and yield of maize in Cerrado soil. A randomized completed block utilized in this experiment, with five treatments and four replications. The grain sizes of dolomitic limestone incorporated into the Oxisol were: 0 (control, no-lime), 2.00-0.82 mm, 0.82-0.56 mm, 0.56-0.30 mm, 0.30-0.20 mm, in doses of 6.5 t·ha-1, 3.9 t·ha-1, 2.6 t·ha-1 and 1.3 t·ha-1 respectively. The limestone applied in introduction no-tillage. The maize were evaluated of root attributes, nutrition and grain yield in two years 2009 and 2010. The use of limestone particle size of 2.00-0.82 mm, and the quantity of 6.5 t·ha-1 applied to the soil and incorporated showed elongation and root growth of maize thin depth of 20-40 cm in the soil. In that, same proposed management of the limestone was the highest maize grain yield in the first year. The rooting characteristics evaluated correlated with leaf Ca and Cu and maizegrain yield.

关键词： Limestone No-Tillage Zea Mays

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Root Growth, Nutrition and Yield of Maize with Applied Finely Limestone in Surface of Cerrado Soil

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American Journal of Plant Sciences 2014年第6期5卷 834-844页

作者： Rafael Felippe Ratke Hamilton Seron Pereira Joao de Deus Gomes dos Santos Junior joaquim joséFrazao Juliano Magalhaes Barbosa Bruno de Oliveira Dias Departamento de Engenharias AgronomiaCampus Professora Cinobelina ElvasUniversidade Federal do PiauíBom JesusBrazil Instituto de Ciencias Agrárias Universidade Federal de UberlandiaUberlândiaBrazil Embrapa Centro Nacional de Pesquisa no CerradoPlanaltinaBrazil Programa de Pós-graduacao em Agronomia Universidade Federal de GoiásGoianiaBrazil

The surface applies lime to correcting soil acidity in no-tillage and promotes root development and yield of maize. However, limestone with a particle size smaller than 0.30 mm cannot promote this effect. The aim of this study was to determine the root attributes, nutrition and productivity of maize with limestone ground in no-tillage. The experimental design was randomized blocks with five treatments and four replications. The treatments consisted of different particle sizes of limestone applying superficially to the soil under NT 0) control, without lime, 1) 0.30 mm to 0.20 mm 2) 0.20 mm to 0.10 mm, 3) 0, 10 mm to 0.05 mm 4) 0.05 mm to 0.01 mm. Attributes root, leaf nutrition and grain yield of maize were evaluated in two years 2009 and 2010. The elongation of roots in a 20-40 cm depth was greater when using limestone with particle size between 0.30 mm and 0.20 mm. The root length of maize plants correlated with the levels of Mn in maize leaves. The root development promoted by liming effect was not reflected in the productivity of maize.

关键词： Particle Size No-Tillage Limestone

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Development of Psychic Pain in the Context of Microcephaly and Abortion: Systematic Review and Meta-Analysis

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Health 2017年第2期9卷 376-391页

作者： Uilna Naté rcia Soares Feitosa Danilo Ferreira de Sousa Poliana Moreira de Medeiros Carvalho Raquel Guimarã es Kanda joaquim Alves Diniz Luis Clescivan Ferreira Nobre Dayse Christina rodrigues Pereira Luz Wilma josé Santana Cí cera Jaqueline Sobreira Andriola Né lio Barreto Vieira Antonio Souto Gouveia Alberto Olavo Advincula Reis Caio Parente Barbosa Modesto Leite Rolim Neto Programa de Pó s-Graduaç ã o em Ciê ncias da Saú de Faculdade de Medicina do ABC-FMABC Santo Andr&eacute S&atilde o Paulo Brazil Faculdade de Juazeiro do Norte FJN Juazeiro do Norte Cear&aacute Brazil Faculdade de Medicina Est&aacute cio/FMJ Juazeiro do Norte Cear&aacute Brazil Faculdade de Medicina Universidade Federal do Cariri-UFCA Barbalha Cear&aacute Brazil Programa de Pó s-Graduaç ã o em Saú de Pú blica Universidade de S&atilde o Paulo-USP S&atilde o Paulo Brazil

Background: In the year of 2015, evidence of a relation between Zika virus and the development of microcephaly in pregnant women who acquired the infection started to come up. Thus, it is extremely necessary that the analysis of the affliction affects these women in a biopsychosocial context, in order to discuss and comprehend in a more reliable manner the affection from the perception of the disease, origin, and psychic pain mechanisms. Methods: Systematic review with meta-analysis, using the PRISMA protocol. The study period was 2016 and the keywords included “microcephaly” and “abortion”, one at a time and then combined with the Boolean operator “AND.” The statistical analysis was done using the BioEstat 5.0 program. Calculation was based on an adjustment of Mantel-Haenszel random effect. Results: 41,046 registrations were found. Of this total, 40,992 articles were excluded because they only mentioned the fact or referred to spontaneous abortion, did not analyze abortion on the eyes of microcephaly, only treated with Zika virus, or were repeated. Limitations: Psychic pain and suffering need studies in the mother/son/disease relation, which were not found in the databases. The article was based on other sources. Conclusions: The pains vary in different areas of the female life, since internal conflicts, gender violence, stress, fear, insecurity, psychologic torture, grieve, loneliness, among other kinds of psychic suffering. More studies on psycho-emotional themes need to be promoted to discuss the female suffering on a wider vision, closer to the reality faced by these women.

关键词： Abortion Microcephaly Psychic Pain

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Peristomal variceal bleeding treated by coil embolization using a percutaneous transhepatic approach

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World Journal of Clinical Cases 2016年第1期4卷 25-29页

作者： Macello josé Sampaio Maciel Osvaldo Ignácio Pereira joaquim Maurício Motta Leal Filho Enio Ziemiecki Junior Susyanne Lavor Cosme Moisés Amancio Souza Francisco Cesar Carnevale Radiology Department of Heart Institute Hospital das ClínicasFaculdade de Medicina da Universidade de São Paulo

Peristomal variceal bleeding due to portal hypertension is an entity that has rarely been reported with 3%-4% risk of death.A 68-year-old woman who had undergone a palliative colostomy(colorectal carcinoma) presented with a massive hemorrhage from the colostomy *** her oncological status with medial and right hepatic veins thrombosis due to liver metastasis invasion,an emergency transhepatic coil embolization was successfully *** treatment modality for these cases has not been *** transhepatic coil embolization of varices is a safe and effective choice in patients who present with life threatening bleeding and exhibit contraindications to transjugular intrahepatic portosystemic shunt.

关键词： Ectopic variceal bleeding Stomal bleeding Percutaneous transhepatic embolization Colostomy Cirrhosis Hemostasis

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