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Multimodal brain monitoring in fulminant hepatic failure

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World Journal of Hepatology 2016年第22期8卷 915-923页

作者： Fernando Mendes Paschoal Jr Ricardo Carvalho Nogueira Karla de Almeida Lins Ronconi marcelo de lima oliveira Manoel Jacobsen Teixeira Edson Bor-Seng-Shu Laboratory for Neurosonology and Cerebral Hemodynamics Department of Neurology Hospital das Clinicas Sao Paulo University Medical School department of Neurology Division of Neurosurgery Hospital das Clinicas Sao Paulo University Medical School

Acute liver failure, also known as fulminant hepatic failure(FHF), embraces a spectrum of clinical entities characterized by acute liver injury, severe hepatocellular dysfunction, and hepatic encephalopathy. Cerebral edema and intracranial hypertension are common causes of mortality in patients with FHF. The management of patients who present acute liver failure starts with determining the cause and an initial evaluation of prognosis. Regardless of whether or not patients are listed for liver transplantation, they should still be monitored for recovery, death, or transplantation. In the past, neuromonitoring was restricted to serial clinical neurologic examination and, in some cases, intracranial pressure monitoring. Over the years, this monitoring has proven insufficient, as brain abnormalities were detected at late and irreversible stages. The need for real-time monitoring of brain functions to favor prompt treatment and avert irreversible brain injuries led to the concepts of multimodal monitoring and neurophysiological decision support. New monitoring techniques, such as brain tissue oxygen tension, continuous electroencephalogram, transcranial Doppler, and cerebral microdialysis, have been developed. These techniques enable early diagnosis of brain hemodynamic, electrical, and biochemical changes, allow brain anatomical and physiological monitoring-guided therapy, and have improved patient survival rates. The purpose of this review is to discuss the multimodality methods available for monitoring patients with FHF in the neurocritical care setting.

关键词： Fulminant hepatic failure Cerebral edema Multimodality methods Intracranial hypertension Liver transplantation

Encephalic hemodynamic phases in subarachnoid hemorrhage:how to improve the protective effect in patient prognoses

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Neural Regeneration Research 2015年第5期10卷 748-752页

作者： marcelo de lima oliveira Daniel Silva de Azevedo Milena Krajnyk de Azevedo Ricardo de Carvalho Nogueira Manoel Jacobsen Teixeira Edson Bor-Seng-Shu Division of Neurological Surgery Hospital das ClinicasSchool of MedicineUniversity of Sao Paulo

Subarachnoid hemorrhage is frequently associated with poor prognoses. Three different hemo- dynamic phases were identified during subarachnoid hemorrhage： oligemia, hyperemia, and vasospasm. Each phase is associated with brain metabolic changes. In this review, we correlated the hemodynamic phases with brain metabolism and potential treatment options in the hopes of improving patient prognoses.

关键词： hemodynamic phases cerebral subarachnoid hemorrhage metabolic crises

Transcranial Doppler Ultrasonography to Prevent Cerebrovascular Accident in Children with Sickle-Cell Disease

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Neuroscience & Medicine 2019年第2期10卷 162-173页

作者： Giuliana Carpentieri-Pipolo marcelo de lima oliveira Fernando Mendes Paschoal Junior Edson Bor-Seng-Shu Brazilian Ministry of Health S&#227 o Paulo Brazil department of Neurosurgery Hospital das Clínicas School of Medicine of University of S&#227 o Paulo S&#227 o Paulo Brazil

Sickle-cell disease (SCD) is the most common cause of ischemic stroke in children and it happens in about 11% of patients between the age of 2 and 20 years old. About 7% of the world population is affected by hemoglobin disorders, mostly sickle cell anemia. SCD has a high prevalence in the population of African offspring and it is a public health problem in Brazil that affects more than 30,000 million people. Prevention of primary stroke might be feasible with a way to identify children at greatest risk. Transcranial Doppler Ultrasonography (TCD) to SCD patients can be a valuable service that results in a significant decrease of first stroke rates. In this work, we present a review about TCD as an effective strategy to detect children with SCD who are at risk for stroke.

关键词： Transcranial Doppler Sickle Cell Disease Stroke in Children Cerebrovascular Disease

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

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

Green Hydrogen: Perspectives and Challenges in Using the Natural Gas Network in Ceará/Brazil

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Journal of Geoscience and Environment Protection 2024年第3期12卷 70-94页

作者： Francisco Alfredo de Castro Mona Lisa Moura de oliveira Lutero Carmo de lima Daniel Silveira Serra Science and Technology Center State University of Ceará Ceará Brazil Av. Dr. Silas Munguba 1700 Fortaleza-Ceará Brazil

Climate change, mainly caused by the use of non-renewable fuels, has raised global concerns and led to the search for less polluting energy sources, making hydrogen a promising energy alternative with the potential to contribute to changes in the energy mix of various countries through the use of technologies that enable its production and use with low or zero carbon emissions. In this context, Brazil has aroused great interest from other countries in exploring its renewable resources for the production of hydrogen (green hydrogen). In this sense, the use of natural gas pipelines and the use of hydrogen in mixtures with natural gas have become the subject of studies due to their economically viable alternative for the immediate use of this energy vector. However, there are still technical and regulatory challenges regarding the integration of hydrogen into the existing natural gas pipeline network. In this context, the present study aims to address the effects of hydrogen interaction with the structure of natural gas pipeline steel and the regulatory barriers to the use of this network for the transportation of green hydrogen, particularly in the state of Ceará/Brazil. After extensive analysis of literature and regulatory documents, it was concluded that: 1) Ceará/Brazil has strong potential to meet the demand for green hydrogen through the use of solar and wind energy sources;2) there is feasibility for the adaptation or conversion of natural gas infrastructure for the transportation of green hydrogen;3) discussions regarding the regulatory competence of green hydrogen transportation and distribution through the natural gas network in Brazil are still incipient;4) the current regulation of the natural gas industry can serve as a subsidy for the regulation of green hydrogen and natural gas transportation.

关键词： decarbonization Natural Gas Green Hydrogen Pipelines

Antimicrobial and synergistic effects of lemongrass and geranium essential oils against Streptococcus mutans,Staphylococcus aureus,and Candida spp.

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World Journal of Critical Care Medicine 2024年第3期13卷 63-74页

作者： Patrícia Michelle Nagai de lima Thaís Cristine Pereira Lara Steffany de Carvalho Letícia Ferreira dos Santos Carlos Eduardo Rocha oliveira Lucas de Paula Ramos Maria Cristina Marcucci Amjad Abu Hasna Luciane Dias de oliveira department of Biosciences and Oral Diagnosis Institute of Science and TechnologySão Paulo State UniversitySão Josédos Campos 12245000SPBrazil Anhembi Morumbi University School of MedicineSão Josédos Campos 12230-002SPBrazil department of Restorative dentistry Endodontics DivisionInstitute of Science and TechnologySão Paulo State UniversitySão Josédos Campos 12245000São PauloBrazil

BACKGROUND The oral cavity harbors more than 700 species of bacteria,which play crucial roles in the development of various oral diseases including caries,endodontic infection,periodontal infection,and diverse oral *** To investigate the antimicrobial action of Cymbopogon Schoenanthus and Pelargonium graveolens essential oils against Streptococcus mutans,Staphylococcus aureus,Candida albicans,***,and *** Minimum microbicidal concentration was determined following Clinical and Laboratory Standards Institute *** synergistic antimicrobial activity was evaluated using the Broth microdilution checkerboard method,and the antibiofilm activity was evaluated with the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide *** were analyzed by one-way analysis of variance followed by the Tukey post-hoc test(P≤0.05).RESULTS *** and *** essential oils were as effective as 0.12%chlorhexidine against *** and *** monotypic biofilms after 24 *** 24 h *** essential oil at 0.25%was more effective than the nystatin group,and *** essential oil at 0.25%was as effective as the nystatin *** *** and *** essential oils are effective against ***,***,***,***,and *** at different concentrations after 5 min and 24 h.

关键词： Antifungal effect Lemongrass Geranium Candida albicans Candida dubliniensis Candida krusei Staphylococcus aureus Streptococcus mutans

Atmospheric Pollutants in a Commercial Region of Fortaleza, Ceará, Brazil: Integration of Health, Environment and Economy in Urban Planning to Improve Air Quality

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Journal of Geoscience and Environment Protection 2024年第5期12卷 92-112页

作者： Mônica Giovana Alves Cardoso Ratts Brenna Kessy Silva lima Gilvan Ribeiro dos Santos Fladimir de lima Gondim Rinaldo Santos Araújo Mona Lisa Moura de oliveira Francisco Sales Ávila Cavalcante Daniel Silveira Serra Science and Technology Center State University of Cear&#225 Cear&#225 Brazil department of Chemistry and Environment Federal Institute of Cear&#225 Cear&#225 Brazil Center of Technological Sciences State University of Cear&#225 Cear&#225 Brazil

The accelerated growth of the vehicular fleet, the modernization of large urban centers, and the few adjustments to the road network in Fortaleza have intensified the problems of traffic and emissions of atmospheric pollutants, highlighting the necessity for strategic urban planning initiatives to address the escalating issues of traffic and pollution. With the objective of analyzing the indices of concentrations of atmospheric pollutants and estimating how these levels can affect human health, this work consists of a study of the analysis of air quality in the intense trade region of Fortaleza. For this, the analysis zone was divided into three perimeters (Major - Medium - Minor), where each perimeter was analyzed at 7 am, 12 noon and 5 pm. Concentrations of the type of O3, particulate matter (PM2.5 and PM10), CO2 and HCHO were collected. Our results demonstrate that most of the analyses are within the limits of current legislation;however, at certain times and perimeters, the analyses of CO2 and HCHO exceeded the established limits. In view of the above, we conclude that public policies to control air quality are necessary to reduce the damage to human health and the environment caused by pollutants.

关键词： Air Quality Urban Planning Particulate Material Health Impacts

Immune pathway through endometriosis to ovarian cancer

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World Journal of Clinical Oncology 2024年第4期15卷 496-522页

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

Endometriosis is an estrogen-dependent inflammatory disease,defined by the presence of functional endometrial tissue outside of the uterine *** disease is one of the main gynecological diseases,affecting around 10%-15%women and girls of reproductive age,being a common gynecologic *** endometriosis is a benign disease,it shares several characteristics with invasive *** support that it has been linked with an increased chance of developing endometrial ovarian cancer,representing an earlier stage of neoplastic *** is particularly true for women with clear cell carcinoma,low-grade serous carcinoma and ***,the carcinogenic pathways between both pathologies remain poorly *** studies suggest a connection between endometriosis and endometriosis-associated ovarian cancers(EAOCs)via pathways associated with oxidative stress,inflammation,and *** article aims to review current data on the molecular events linked to the development of EAOCs from endometriosis,specifically focusing on the complex relationship between the immune response to endometriosis and cancer,including the molecular mechanisms and their *** recent developments in immunotherapy and their potential to boost the effectiveness of future treatments.

关键词： Ovarian neoplasms Endometriosis Endometriosis-associated ovarian cancers Immune response Immunotherapy