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Role of pancreatography in the endoscopic management of encapsulated pancreatic collections-review and new proposed classification

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World Journal of Gastroenterology 2020年第45期26卷 7104-7117页

作者： Igor Mendonca Proença marcos eduardo lera dos santos Diogo Turiani Hourneaux de Moura Igor Braga Ribeiro Sergio Eiji Matuguma Spencer Cheng Thomas R McCarty Epifanio Silvino do Monte Junior Paulo Sakai eduardo Guimaraes Hourneaux de Moura Gastrointestinal Endoscopy Unit Department of GastroenterologyHospital das ClinicasUniversity of Sao PauloSao Paulo 05403000Brazil Division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s Hospital-Harvard Medical SchoolBostonMA 02115United States

Pancreatic fluids collections are local complications related to acute or chronic pancreatitis and may require intervention when symptomatic and/or *** the last decade,endoscopic management of these collections via endoscopic ultrasound-guided transmural drainage has become the gold standard treatment for encapsulated pancreatic collections with high clinical success and lower morbidity compared to traditional surgery and percutaneous *** understanding of anatomic landmarks,including assessment of the main pancreatic duct and any associated lesions–such as disruptions and strictures-are key to achieving clinical success,reducing the need for reintervention or recurrence,especially in cases with suspected disconnected pancreatic duct ***,proper review of imaging and anatomic landmarks,including collection location,are pivotal to determine type and size of pancreatic stenting as well as approach using long-term transmural indwelling plastic *** to adequately assess the main pancreatic duct may be performed by two methods:Either non-invasively using magnetic resonance cholangiopancreatography or endoscopically via retrograde *** the critical need to understand anatomy via pancrea tography and assess the main pancreatic duct,a standardized approach or uniform assessment strategy has not been described in the ***,the aim of this review was to clarify the role of pancreatography in the endoscopic management of encapsulated pancreatic collections and to propose a new classification system to aid in proper assessment and endoscopic treatment.

关键词： Endoscopic retrograde cholangiopancreatography Endoscopy Endoscopic ultrasound Pseudocyst Endosonography Pancreatic ducts

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Deep sedation during gastrointestinal endoscopy: Propofol-fentanyl and midazolam-fentanyl regimens

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World Journal of Gastroenterology 2013年第22期19卷 3439-3446页

作者： marcos eduardo lera dos santos Fauze Maluf-Filho Dalton Marques Chaves Sergio Eiji Matuguma Edson Ide Gustavo de Oliveira Luz Thiago Ferreira de Souza Fernanda C Simoes Pessorrusso eduardo Guimares Hourneaux de Moura Paulo Sakai Department of Gastroenterology Hospital das Clínicas University of Sao Paulo Medical School Sao Paulo CEP 05403-900 Brazil Cancer Institute of Sao Paulo State Sao Paulo CEP 01246-000 Brazil

AIM: To compare deep sedation with propofol-fentanyl and midazolam-fentanyl regimens during upper gastrointestinal endoscopy. METHODS: After obtaining approval of the research ethics committee and informed consent, 200 patients were evaluated and referred for upper gastrointestinal endoscopy. Patients were randomized to receive propofol-fentanyl or midazolam-fentanyl (n = 100/group).We assessed the level of sedation using the observer's assessment of alertness/sedation (OAA/S) score and bispectral index (BIS). We evaluated patient and physician satisfaction, as well as the recovery time and complication rates. The statistical analysis was performed using SPSS statistical software and included the MannWhitney test, χ 2 test, measurement of analysis of variance, and the κ statistic. RESULTS: The times to induction of sedation, recovery, and discharge were shorter in the propofolfentanyl group than the midazolam-fentanyl group. According to the OAA/S score, deep sedation events occurred in 25% of the propofol-fentanyl group and 11% of the midazolam-fentanyl group (P = 0.014). Additionally, deep sedation events occurred in 19% of the propofol-fentanyl group and 7% of the midazolamfentanyl group according to the BIS scale (P = 0.039). There was good concordance between the OAA/S score and BIS for both groups (κ = 0.71 and κ = 0.63, respectively). Oxygen supplementation was required in 42% of the propofol-fentanyl group and 26% of the midazolam-fentanyl group (P = 0.025). The mean time to recovery was 28.82 and 44.13 min in the propofolfentanyl and midazolam-fentanyl groups, respectively (P < 0.001). There were no severe complications in either group. Although patients were equally satisfied with both drug combinations, physicians were more satisfied with the propofol-fentanyl combination. CONCLUSION: Deep sedation occurred with propofolfentanyl and midazolam-fentanyl, but was more frequent in the former. Recovery was faster in the propofol-fentanyl group.

关键词： Endoscopy Deep sedation Anesthetic administration Anesthetic dose Adverse effects

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Pancreatitis after endoscopic retrograde cholangiopancreatography:A narrative review

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World Journal of Gastroenterology 2021年第20期27卷 2495-2506页

作者： Igor Braga Ribeiro Epifanio Silvino do Monte Junior Antonio Afonso Miranda Neto Igor Mendonça Proença Diogo Turiani Hourneaux de Moura Mauricio Kazuyoshi Minata Edson Ide marcos eduardo lera dos santos Gustavo de Oliveira Luz Sergio Eiji Matuguma Spencer Cheng Renato Baracat eduardo Guimarães Hourneaux de Moura Department of Gastrointestinal Endoscopy Unit University of São Paulo School of MedicineSão Paulo 05403-010Brazil

Acute post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a feared and potentially fatal complication that can be as high as up to 30%in high-risk ***-examination measures,during the examination and after the examination are the key to technical and clinical success with a decrease in adverse *** studies have debated on the subject,however,numerous topics remain controversial,such as the effectiveness of prophylactic medications and the amylase dosage *** review was designed to provide an update on the current scientific evidence regarding PEP available in the literature.

关键词： Endoscopic retrograde cholangiopancreatography Pan-creatitis Postendoscopic retrograde cholangiopancreatography pancreatitis Adverse events Pancreatitis Prevention

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Propofol vs traditional sedatives for sedation in endoscopy:A systematic review and meta-analysis

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World Journal of Gastrointestinal Endoscopy 2019年第12期11卷 573-588页

作者： Aureo Augusto de Almeida Delgado Diogo Turiani Hourneaux de Moura Igor Braga Ribeiro Ahmad Najdat Bazarbashi marcos eduardo lera dos santos Wanderley Marques Bernardo eduardo Guimaraes Hourneaux de Moura Gastrointestinal Endoscopy Unit Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao PauloSao Paulo 05403000Brazil Division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115United States

BACKGROUND Propofol is commonly used for sedation during endoscopic *** suggests its superiority to traditional sedatives used in endoscopy including benzodiazepines and opioids with more rapid onset of action and improved postprocedure recovery times for ***,Propofol requires administration by trained healthcare providers,has a narrow therapeutic index,lacks an antidote and increases risks of cardio-pulmonary *** To compare,through a systematic review of the literature and meta-analysis,sedation with propofol to traditional sedatives with or without propofol during endoscopic *** A literature search was performed using MEDLINE,Scopus,EMBASE,the Cochrane Library,Scopus,LILACS,BVS,Cochrane Central Register of Controlled Trials,and The Cumulative Index to Nursing and Allied Health Literature *** last search in the literature was performed on March,2019 with no restriction regarding the idiom or the year of *** randomized clinical trials with full texts published were *** divided sedation therapies to the following groups:(1)Propofol versus benzodiazepines and/or opiate sedatives;(2)Propofol versus Propofol with benzodiazepine and/or opioids;and(3)Propofol with adjunctive benzodiazepine and opioid versus benzodiazepine and *** following outcomes were addressed:Adverse events,patient satisfaction with type of sedation,endoscopists satisfaction with sedation administered,dose of propofol administered and time to recovery post ***-analysis was performed using RevMan5 software version *** A total of 23 clinical trials were included(n=3854)from the initial search of 6410 *** Group I(Propofol vs benzodiazepine and/or opioids):The incidence of bradycardia was not statistically different between both sedation arms(RD:-0.01,95%CI:-0.03–+0.01,I2:22%).In 10 studies,the incidence of hypotension was not statistically difference between sedation arms(RD:0.01,95%CI

关键词： Sedation Digestive endoscopy Propofol Benzodiazepines Opioids Adverse events

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Comparison between endoscopic sphincterotomy vs endoscopic sphincterotomy associated with balloon dilation for removal of bile duct stones:A systematic review and meta-analysis based on randomized controlled trials

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World Journal of Gastrointestinal Endoscopy 2018年第8期10卷 130-144页

作者： Cesar Capel de Clemente Junior Wanderley Marques Bernardo Tomazo Prince Franzini Gustavo Oliveira Luz marcos eduardo lera dos santos Jonah Maxwell Cohen Diogo Turiani Hourneaux de Moura Fábio Ramalho Tavares Marinho Martin Coronel Paulo Sakai eduardo Guimaraes Hourneaux de Moura Gastrointestinal Endoscopy Unit Department of GastroenterologyUniversity of Sao Paulo Medical SchoolSao Paulo 05403-010Brazil Beth Israel Deaconess Medical Center Harvard Medical SchoolBostonMA 02215United States

AIM To compare gallstones removal rate and incidence of bleeding, pancreatitis, use of mechanical lithotripsy, cholangitis and perforation between isolated sphincterotomy vs sphincterotomy associated with balloon dilation of papilla in choledocholithiasis through the meta-analysis of randomized clinical trials. METHODS We conducted a systematic review according to the PRISMA guidelines. Literature search was restricted to randomized controlled trials(RCTs) on Med Line, Cochrane Library, LILACS, and EMBASE database platforms in July 2017. The manual search included references of retrieved articles. We extracted data focusing on outcomes: The primary endpoint was the stones removal rate; Secondary endpoints were rates of pancreatitis, bleeding, use of mechanical lithotripsy(ML), perforation and cholangitis. RESULTS Eleven RCTs with 1824 patients were included. EST was associated with more post-endoscopic retrograde cholangiopancreatography(ERCP) bleeding [FE RD-0.02, CI(-0.03,-0.00), I2 = 33%, P = 0.05] and more need of mechanical lithotripsy in general [RE RD-0.16, CI(-0.25,-0.06), I2 = 90%, P = 0.002] and in subgroup analysis of stones greater than 15 mm [RE RD-0.20, CI(-0.38,-0.02), I2 = 82%, P = 0.003]. Incidence of pancreatitis [FE RD-0.01, CI(-0.03, 0.01), I2 = 0, P = 0.36], cholangitis [FE RD-0.00, CI(-0.01, 0.01), I2 =0, P = 0.97] and perforation [FE RD-0.01, CI(-0.01, 0.00), I2 = 0, P = 0.23] was similar between the groups as well as similar stone removal rates in general [FE RD-0.01, CI(-0.01, 0.04), I2 = 0, P = 0.23] and pooled analysis of stones greater than 15 mm [FE RD-0.02, CI(-0.02, 0.07), I2 = 11%, P = 0.31]. CONCLUSION Through meta-analysis of randomized clinical trials we found that isolated sphincterotomy was associated with more post-ERCP bleeding and more need for mechanical lithotripsy. However, there was no statistical difference in the stone removal rate between isolated sphincterotomy and sphincterotomy associated with balloon dilation in the

关键词： Sphincterotomy Papillotomy Dilation Cholangiopancreatography Endoscopic retrograde Endoscopic retrograde cholangiopancreatography Cholangiography

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Diversity of filamentous fungi in leaf litter and aerial litter in semideciduous forest,Bahia,Brazil

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Journal of Forestry Research 2015年第2期26卷 479-485页

作者： marcos Fabio Oliveira Marques Edemir Barbosa dos santos Luis Fernando Pascholati Gusmaao Laborato rio de Biologia Molecular de Fungos Universidade do Estado da BahiaCampus VIIBr 407Km 127Rod.Lomanto JuoniorSenhor do BonfimBA 44230-000Brazil Laboratorio de Micologia (LAMIC) Universidade Estadual de Feira de SantanaCaixa Postal 252Feira de SantanaBA 44036-900Brazil

The fungi have wide distribution in ecosystems and can be found colonizing various substrates,where they act as efficient decomposers,participating in cycling of *** present study aimed to assess the diversity,richness and composition of filamentous fungi in leaf litter and aerial litter in a semi-deciduous forest in the Chapada Diamantina,Bahia,*** of leaf litter and aerial litter were collected monthly from October/2009 to September/2010 in eight installments in the studied *** samples were washed,placed in moist chambers and incubated.47 taxa were identified,37 in leaf litter and 35 in aerial litter,with 25 species common to both.A similarity of 69 % according to Sorensen *** similarity was considered low when the sample points were compared to the same *** fungi showed sporadic intervals.

关键词： Plant debris Species richness Tropical microfungi

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The use of Vis-NIR-SWIR spectroscopy in the prediction of soil available ions after application of rock powder

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Information Processing in Agriculture 2024年第1期11卷 26-44页

作者： Marlon Rodrigues Josiane Carla Argenta Everson Cezar Glaucio Leboso Alemparte Abrantes dos santos ÖnderÖzal Amanda Silveira Reis marcos Rafael Nanni Department of Agronomy State University of MaringáColombo AvenueMaringá87020900Brazil Department of Plant and Soil Sciences Mississippi State UniversityMS 39762USA International Agricultural Research and Training Center Izmir 35660Turkey

Some of the problems attributed to traditional laboratory analyses that limit the correct assessment of the nutrient contents in the soil are time requirements and high cost of the soil nutrient *** solve these problems,a study was carried out to evaluate the use of visible,near-infrared,and short-wave infrared(Vis-NIR-SWIR)spectroscopy in the prediction of soil available ions submitted to the application of rock *** study was carried out on an Arenosol in ParanavaíCity/***(rock powders)were arranged within a split-plot system designed in randomized blocks with four *** was cultivated for 14 months after the application of rock ***,96 soil samples were collected for measuring the pH and available ions P,K^(+),Ca^(2+),Mg^(2+),S-SO_(4)^(2-),Si,Cu^(2+),Fe^(2+),Mn^(2+),and Zn^(2+)as well as spectral reading through a Vis-NIR-SWIR spectroradiometer to predict the soil chemical attributes through the partial least square regression(PLS)*** results showed that the elements K^(+),Ca^(2+),Mg^(2+),Cu^(2+),and Fe^(2+)could be predicted with a reasonable rightness degree(R^(2)_(p)>0.50,RPDp>1.40)from spectral ***,for the attributes pH,P,S-SO_(4)^(2-),Si,Mn^(2+),and Zn^(2+),there were no satisfactory models(R^(2)_(p)<0.50,RPDp<1.40).Thus,the application of rock powder changed the spectral curves and,because of that,allows the building of PLS models to predict the elements K^(+),Ca^(2+),Mg^(2+),Cu^(2+),and Fe^(2+).Therefore,Vis-NIR-SWIR spectroscopy is a promising alternative to the routine analyses of soil fertility since it has advantages such as fast analytical speed,low cost,easy to operate,non-destructive,and environmentally friendly,because it does not use harmful chemicals.

关键词： Alternative inputs Available Ions Multivariate analysis Soil Spectroscopy

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Physical habitat condition as a key tool to maintain freshwater biodiversity in neotropical artificial ponds

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Water Biology and Security 2023年第3期2卷 30-35页

作者： Marden S.Linares Livia B.dos santos marcos Callisto Jean C.santos Universidade Federal de Minas Gerais Instituto de Ciencias BiologicasDepartamento de GeneticaEcologia e EvoluçaoLaboratorio de Ecologia de BentosAv.Antonio Carlos 6627CEP 31270-901PampulhaBelo HorizonteMGBrazil Laboratorio de Macroecologia e Conservaçao da Biodiversidade Departamento de Botanica e EcologiaUniversidade Federal do Mato GrossoAv.Fernando Correa da Costa2367Boa EsperançaCuiabaMato GrossoCEP 78060-900Brazil Programa de Pos-Graduaçao em Ciencias Ambientais Instituto de Ciencias NaturaisHumanas e SociaisUniversidade Federal do Mato GrossoAvenida Alexandre Ferronato1200SinopMTCEP 78550-728Brazil Universidade Federal de Sergipe Departamento de EcologiaCampus Sao Cristovao-Cidade Universitaria Prof.Jose Aloísio de CamposCEP 49100-000Sao CristovaoSergipeBrazil

In areas highly affected by anthropogenic disturbances,artificial(human-made)freshwater ecosystems can provide habitat for maintaining and conserving regional freshwater *** assessed how the physical habitat of artificial ponds affected the structure of benthic macroinvertebrate *** do so,we tested two hypotheses.(1)Physical habitat disturbances are not detrimental to the diversity of nearby artificial ponds,and(2)Physical habitat disturbances do not cause significant shifts in taxonomic *** results rejected both null hypotheses,i.e.,macroinvertebrate diversity metrics correlated significantly and positively with Physical Habitat Integrity index scores,and only sites with high habitat condition scores were significantly associated with sensitive indicator *** results highlight the importance of maintaining physical habitat conditions for sustaining the ecological health of artificial ponds.

关键词： Bioindicators Ecosystem management Lentic ecosystems

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Analysis of 12 variants in the development of gastric and colorectal cancers

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World Journal of Gastroenterology 2017年第48期23卷 8533-8543页

作者： Giovanna C Cavalcante marcos AT Amador Andre M Ribeiro dos santos Darlen C Carvalho Roberta B Andrade Esdras EB Pereira Marianne R Fernandes Danielle F Costa Ney PC santos Paulo P Assumpcao Andrea Ribeiro dos santos Sidney santos Laboratório de Genética Humana e Médica Universidade Federal do Pará Núcleo de Pesquisas em Oncologia Universidade Federal do Pará

AIM To evaluate the relation between 12 polymorphisms and the development of gastric cancer(GC) and colorectal cancer(CRC).METHODS In this study,we included 125 individuals with GC diagnosis,66 individuals with CRC diagnosis and 475 cancer-free individuals. All participants resided in the North region of Brazil and authorized the use of their samples. The 12 polymorphisms(in CASP8,CYP2 E1,CYP19 A1,IL1 A,IL4,MDM2,NFKB1,PAR1,TP53,TYMS,UGT1 A1 and XRCC1 genes) were genotyped in a single PCR for each individual,followed by fragment analysis. To avoid misinterpretation due to population substructure,we applied a previously developed set of 61 ancestryinformative markers that can also be genotyped by multiplex PCR. The statistical analyses were performed in Structure v.2.3.4,R environment and SPSS *** After statistical analyses with the control of confounding factors,such as genetic ancestry,three markers(rs79071878 in IL4,rs3730485 in MDM2 and rs28362491 in NFKB1) were positively associated with the development of GC. One of these markers(rs28362491) and the marker in the UGT1 A1 gene(rs8175347) were positively associated with the development of CRC. Therefore,we investigated whether the joint presence of the deleterious alleles of each marker could affect the development of cancer and we obtained positive results in all analyses. Carriers of the combination of alleles RP1 + DEL(rs79071878 and rs28361491,respectively) are at 10-times greater risk of developing GC than carriers of other combinations. Similarly,carriers of the combination of DEL + RARE(rs283628 and rs8175347) are at about 12-times greater risk of developing CRC than carriers of other *** These findings are important for the comprehension of gastric and CRC development,particularly in highly admixed populations,such as the Brazilian population.

关键词： Inflammatory processes Immune response Genomic and cellular stability Gastric cancer Colorectal cancer Amazon

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Chemical and microbiological characterization of tinctures and microcapsules loaded with Brazilian red propolis extract

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Journal of Pharmaceutical Analysis 2017年第5期7卷 280-287页

作者： Erika Tayse da Cruz Almeida Maria Cristina Delgado da Silva José marcos dos santos Oliveira Regianne Umeko Kamiya Rodolfo Elleson dos santos Arruda Danilo Abreu Vieira Valdemir da Costa Silva Pierre Barnabé Escodro Irinaldo Diniz Basílio-Júnior Ticiano Gomes do Nascimento Laboratório de Controle de Qualidade e Análise de Fármacos Medicamentos e AlimentosCurso de FarmáciaEscola de Enfermagem e FarmáciaUniversidade Federal de AlagoasCampus A.C.SimõesBR 104 Norte-Km 97MaceióAL.CEP:57072-970Brazil Laboratório de Controle de Qualidade Microbiológico de Alimentos Faculdade de NutriçãoUniversidade Federal de AlagoasCampus A.C.SimõesBR 104 Norte/Km 97MaceióAL.CEP:57072-970Brazil

The aim of this study was to characterize tinctures and microcapsules loaded with an ethanol extract of red propolis through chemical, physicochemical and microbiological assays in order to establish quality control tools for nutraceutical preparations of red propolis. The markers(isoflavonoids, chalcones, pterocarpans,flavones, phenolic acids, terpenes and guttiferones) present in the tinctures A and B were identified and confirmed using LC/ESI/FTMS/Orbitrap. Four compositions(A, B, C and D) were prepared to contain B tincture of the red propolis with some pharmaceutical excipients and submitted to two drying processes, i. ***-drying and freeze-drying to obtain microcapsules loaded with the red propolis extract. The tinctures and microcapsules of the red propolis were submitted to the total flavonoid content and antioxidant activity *** antibacterial activity and minimum inhibitory concentration(MIC) were tested using Staphylococcus aureus ATCC 25293 and Pseudomonas aeruginosa ATCC 27853 strains. The tinctures and microcapsules presented high flavonoid quantities from 20.50 to 40.79 mg/100 mg of the microcapsules. The antioxidant activity and IC50 were determined for the tinctures A and B(IC50: 6.95 μg/m L and 7.48 μg/m L), the spray-dried microcapsules(IC50: 8.89–15.63 μg/m L) and the freeze-dried microcapsules(IC50: 11.83–23.36 μg/m L). The tinctures and microcapsules were proved to be bioactive against gram-positive and gram-negative bacteria with inhibition halos superior to 10 mm at concentration of 200 μg/m L and MIC values of 135.87–271.74 μg/m L using gram-positive strain and 271.74–543.48 μg/m L using gram-negative strain. The tinctures and microcapsules of the red propolis have a potential application for nutraceutical products.

关键词： Red propolis Tinctures Microcapsules Isoflavonoids LC/ESI/FTMS/Orbitrap Antioxidant activity Antibacterial activity

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