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A systematic review of clinical practice guidelines and best practice statements for the diagnosis and management of varicocele in children and adolescents

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Asian Journal of Andrology 2016年第2期18卷 262-268,J0006页

作者： matheus roque Sandro C Esteves ORIGEN Center for Reproductive Medicine Rio de Janeiro Av. Rodolfo de Amoedo 140 Rio de Janeiro RJ 22620-330 Brazil ANDROFERT Center for Male Reproduction Av. Dr. Heitor Penteado 1464 Campinas SP 13075-460 Brazil.

A systematic review was conducted to identify and qualitatively analyze the methods as well as recommendations of Clinical Practice Guidelines （CPG） and Best Practice Statements （BPS） concerning varicocele in the pediatric and adolescent population. An electronic search was performed with the MEDLINE, EMBASE, Science Direct, and Scielo databases, as well as guidelines＇ Web sites until September 2015. Four guidelines were included in the qualitative synthesis. In general, the recommendations provided by the CPG/BPS were consistent despite the existence of some gaps across the studies. The guidelines issued by the American Urological Association （AUA） and American Society for Reproductive Medicine （ASRM） did not provide evidence-based levels for the recommendations given. Most of the recommendations given by the European Association of Urology （EAU） and European Society of Pediatric Urology （ESPU） were derived from nonrandomized clinical trials, retrospective studies, and expert opinion. Among all CPG/BPS, only one was specifically designed for the pediatric population. The studied guidelines did not undertake independent cost-effectiveness and risk-benefit analysis. The main objectives of these guidelines were to translate the best evidence into practice and provide a framework of standardized care while maintaining clinical autonomy and physician judgment. However, the limitations identified in the CPG/BPS for the diagnosis and management of varicocele in children and adolescents indicate ample opportunities for research and future incorporation of higher quality standards in patient care.

关键词： adolescent best practice statements child clinical practice guidelines varicocele systematic review

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Use of testicular sperm for intracytoplasmic sperm injection in men with high sperm DNA fragmentation： a SWOT analysis

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Asian Journal of Andrology 2018年第1期20卷 1-8页

作者： Sandro C Esteves matheus roque Nicolas Garrido ANDROFERT Andrology and Human Reproduction Clinic Referral Center for Male Reproduction Av. Dr. Heitor Penteado 1464 Campinas SP 13075-460 Brazil ORIGEN Center for Reproductive Medicine Rio de Janeiro Brazil Andrology Laboratory and Sperm Bank IVI Foundation Valencia Spain

Spermatozoa retrieved from the testis of men with high levels of sperm DNA fragmentation （SDF） in the neat semen tend to have better DNA quality. Given the negative impact of SDF on the outcomes of Assisted Reproductive Technology （ART）, an increased interest has emerged about the use of testicular sperm for intracytoplasmic sperm injection （Testi-ICSI）. In this article, we used a SWOT （strengths, weaknesses, opportunities, and threats） analysis to summarize the advantages and drawbacks of this intervention. The rationale of Testi-ICSI is bypass posttesticular DNA fragmentation caused by oxidative stress during sperm transit through the epididymis. Hence, oocyte fertilization by genomically intact testicular spermatozoa may be optimized, thus increasing the chances of creating a normal embryonic genome and the likelihood of achieving a live birth, as recently demonstrated in men with high SDF. However, there is still limited evidence as regards the clinical efficacy of Testi-ICSI, thus creating opportunities for further confirmatory clinical research as well as investigation of Testi-ICSI in clinical scenarios other than high SDF. Furthermore, Testi-ICSI can be compared to other laboratory preparation methods for deselecting sperm with damaged DNA. At present, the available literature supports the use of testicular sperm when performing ICSI in infertile couples whose male partners have posttesticular SDF. Due to inherent risks of sperm retrieval, Testi-ICSI should be offered when less invasive treatments for alleviating DNA damage have failed. A call for continuous monitoring is nonetheless required concerning the health of generated offspring and the potential complications of sperm retrieval.

关键词： intracytoplasmic sperm injection male infertility sperm DNA fragmentation sperm retrieval SWOT analysis testicular sperm

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Outcome of varicocele repair in men with nonobstructive azoospermia： systematic review and meta-analysis

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Asian Journal of Andrology 2016年第2期18卷 246-253,J0005,J0006页

作者： Sandro C Esteves Ricardo Miyaoka matheus roque Ashok Agarwal ANDROFERT Center for Male Reproduction Av. Dr. Heitor Penteado 1464 Campinas SP 13075-460 Brazil ORLGEN Center for Reproductive MedicineRio de Janeiro Aw Rodolfo de Amoedo 140 Rio de Janeiro RJ 22620-330 Brazil American Center for Reproductive Medicine 10681. Carnegie Avenue X-11Cleveland OH 44195 USA.

The objective of this systemic review was to evaluate the benefit of repairing clinical varicocele in infertile men with nonobstructive azoospermia （NOA）. The surgically obtained sperm retrieval rate （SRR） and pregnancy rates following assisted reproductive technology （ART） with the use of retrieved testicular sperm were the primary outcomes. The secondary outcomes included the presence of viable sperm in postoperative ejaculate to avoid the testicular sperm retrieval and pregnancy rates （both assisted and unassisted） using postoperative ejaculated sperm. An electronic search to collect the data was performed using the MEDLINE and EMBASE databases until April 2015. Eighteen studies were included in this systematic review and accounted for 468 patients who were diagnosed with NOA and varicocele. These patients were subjected to either surgical varicocele repair or percutaneous embolization. Three controlled studies evaluating sperm retrieval outcomes indicated that in patients who underwent varicocelectomy, SRR increased compared to those without varicocele repair （OR： 2,65; 95% Cl. 1.69-4.14; P 〈 0.001）. Although pregnancy rates with the use of testicular sperm favored the varicocelectomy group, results were not statistically significant （clinical pregnancy rate OR： 2.07; 95% CI： 0.92-4.65; P = 0.08; live birth rate OR： 2.19; 95% CI： 0.99-4.83; P = 0.05）. The remaining fifteen studies reported postoperative semen analysis results. In 43.9% of the patients （range： 20.8%-55.0%）, sperm were found in postoperative ejaculates. Pregnancy rates for unassisted and assisted （after IVF/ICSI） were 13.6% and 18.9% in the group of men with sperm in postoperative ejaculates, respectively. Our findings indicate that varicocelectomy in patients with NOA and clinical varicocele is associated with improved SRR. In addition, approximately 44% of the treated men will have enough sperm in the ejaculate to avoid sperm retrieval. Limited data on pregnancy outcomes with both postoperative

关键词： azoospermia male infertility meta-analysis sperm retrieval systematic review varicocele varicocelectomy

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Outcome of assisted reproductive technology in met with treated and untreated varicocele, systematic review and meta-analysis

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Asian Journal of Andrology 2016年第2期18卷 254-258,J0006页

作者： Sandro C Esteves matheus roque Ashok Agarwal ANDROFERT Center for Male Reproduction Av. Dr. Heitor Penteado 1464 Campinas SP 13075-460 Brazil ORIGEN Center for Reproductive Medicine Riode Janeiro Av. Rodoifo de Amoedo 140 Rio de Janeiro RJ 22620-330 Brazil American Center for Reproductive Medicine 10681 Carnegie Avenue X-11Cleveland OH 44195 USA.

Varicocele affects approximately 35%-40% of men presenting for an infertility evaluation. There is fair evidence indicating that surgical repair of clinical varicocele improves semen parameters, decreases seminal oxidative stress and sperm DNA fragmentation, and increases the chances of natural conception. However, it is unclear whether performing varicocelectomy in men with clinical varicocele prior to assisted reproductive technology （ART） improve treatment outcomes. The objective of this study was to evaluate the role of varicocelectomy on ART pregnancy outcomes in nonazoospermic infertile men with clinical varicocele. An electronic search was performed to collect all evidence that fitted our eligibility criteria using the MEDLINE and EMBASE databases until April 2015. Four retrospective studies were included, all of which involved intracytoplasmic sperm injection （ICSI）, and accounted for 870 cycles （438 subjected to ICSI with prior varicocelectomy, and 432 without prior varicocelectomy）. There was a significant increase in the clinical pregnancy rates （OR = 1.59, 95% CI. 1.19-2.12, 12 = 25%） and live birth rates （OR = 2.17, 95% CI： 1,55-3.06, I^2 = 0%） in the varicocelectomy group compared to the group subjected to ICSI without previous varicocelectomy. Our results indicate that performing varicocelectomy in patients with clinical varicocele prior to ICSI is associated with improved pregnancy outcomes.

关键词： assisted reproductive techniques meta-analysis pregnancy outcome systematic review varicocele varicocelectomy

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全胚冷冻策略：是时候了吗？

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生殖医学杂志 2018年第8期27卷 726-726页

作者： matheus roque Center for Reproductive Medicine Av Rodolfo de Arnoedo 140- Barra da Tijuca 22520 -350 Rio de Janeiro Rio de Janeiro Brazil

目的评估有关比较鲜胚移植（ET）和择期冻融胚眙移植（FET）的现有文献证据，探讨控制性卵巢刺激（COS）对胚胎植入及内膜容受性、IVF安全性、产科/围产结局可能的不良影响。方法回顾现有的比较择期FET（全胚冷冻）和鲜胚移植的文献证... 详细信息

目的评估有关比较鲜胚移植（ET）和择期冻融胚眙移植（FET）的现有文献证据，探讨控制性卵巢刺激（COS）对胚胎植入及内膜容受性、IVF安全性、产科/围产结局可能的不良影响。方法回顾现有的比较择期FET（全胚冷冻）和鲜胚移植的文献证据。结果冻存技术的改善使得对胚胎的有害影响降到极低，甚至是无害。冻融胚胎所产生的后代与鲜胚移植所获岳代比较无不良岳果。这让生殖医生有机会创立全胚冷冻策略（在新鲜周期冻存所有有活力的胚胎，择期移植）。IVF治疗中COS对于内膜环境及子宫环境的不良影响，以及COS对于鲜胚移植所获妊娠的安全性，越来越受到关注。COS可能引起子宫内膜的改变，并可能因此导致鲜胚移植的不良结局。证据提示，鲜胚移植所获妊娠的产科/围产结局要差于FET。在鲜胚移植周期中，仍有卵巢过度刺激综合征（OHSS）风险。结论越来越多的文献证据提示，以全胚冷冻策略替代鲜胚移植可带来更好的IVF结局，并减少产科/围产疾病。

关键词：全胚冷冻策略鲜胚移植冻融胚胎移植冷冻保存

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G protein-coupled estrogen receptor 1(GPER) activation triggers different signaling pathways on neurons and astrocytes

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Neural Regeneration Research 2019年第12期14卷 2069-2070页

作者： Claudio roque Graca Baltazar CICS-UBI - Health Sciences Research Centre University of Beira Interior Covilh. Portugal Faculty of Health Sciences University of Beira Interior Covilh. Portugal

Estradiol (E2) is the most potent and prevalent form of estrogen, a well-known hormone that regulates multiple tissues and functions in humans. In the brain, E2 regulates processes as diverse as learning, memory, cognition, mood, as well as neurodevelopment and neurodegeneration. The actions of E2 are mediated by classical estrogen receptors (ERs;α and β), and by the G protein-coupled estrogen receptor 1 (GPER or GPR30)(Prossnitz and Arterburn, 2015). Classical ER are predominantly present in the nucleus and cytoplasm, with less than 2% present on the plasma membrane, and mediate genomic cellular effects that occur in the time frame of hours to days (Prossnitz and Arterburn, 2015).

关键词： multiple tissues functions astrocytes

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Structural elucidation of SARS-CoV-2 vital proteins: Computational methods reveal potential drug candidates against main protease, Nsp12 polymerase and Nsp13 helicase

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Journal of Pharmaceutical Analysis 2020年第4期10卷 320-328页

作者： Muhammad Usman Mirza matheus Froeyen Department of Pharmaceutical and Pharmacological Sciences Rega Institute for Medical ResearchMedicinal ChemistryUniversity of LeuvenB-3000LeuvenBelgium

Recently emerged SARS-CoV-2 caused a major outbreak of coronavirus disease 2019(COVID-19)and instigated a widespread fear,threatening global health *** date,no licensed antiviral drugs or vaccines are available against COVID-19 although several clinical trials are under way to test possible *** this urgent situation,computational drug discovery methods provide an alternative to tiresome high-throughput screening,particularly in the hit-to-lead-optimization *** of small molecules that specifically target viral replication apparatus has indicated the highest potential towards antiviral drug *** this work,we present potential compounds that specifically target SARS-CoV-2 vital proteins,including the main protease,Nsp12 RNA polymerase and Nsp13 *** integrative virtual screening and molecular dynamics simulations approach has facilitated the identification of potential binding modes and favourable molecular interaction profile of corresponding ***,the identification of structurally important binding site residues in conserved motifs located inside the active site highlights relative importance of ligand binding based on residual energy decomposition *** the current study lacks experimental validation,the structural information obtained from this computational study has paved way for the design of targeted inhibitors to combat COVID-19 outbreak.

关键词： SARS-CoV-2 COVID-19 outbreak CoV-Mpro CoV-Nsp12 polymerase CoV-Nsp13 helicase

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Variational Calculus With Conformable Fractional Derivatives

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IEEE/CAA Journal of Automatica Sinica 2017年第2期4卷 340-352页

作者： matheus J.Lazo Delfim F.M.Torres Instituto de Matemática Estatística e Física-FURG Center for Research and Development in Mathematics and Applications (CIDMA) Department of MathematicsUniversity of Aveiro

Invariant conditions for conformable fractional problems of the calculus of variations under the presence of external forces in the dynamics are studied. Depending on the type of transformations considered, different necessary conditions of invariance are obtained. As particular cases, we prove fractional versions of Noether's symmetry theorem. Invariant conditions for fractional optimal control problems, using the Hamiltonian formalism, are also investigated. As an example of potential application in Physics, we show that with conformable derivatives it is possible to formulate an Action Principle for particles under frictional forces that is far simpler than the one obtained with classical fractional derivatives.

关键词： Conformable fractional derivative fractional calculus of variations fractional optimal control invariant variational conditions Noether’s theorem

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Determination of runoff coefficient(C)in catchments based on analysis of precipitation and flow events

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International Soil and Water Conservation Research 2022年第2期10卷 208-216页

作者： Ronalton Evandro Machado Tais Oliveira Cardoso matheus Henrique Mortene Unicamp(University of Campinas)-College of Technology LimeiraSPBrazil

Runoff coefficient(C)values are tabulated and enshrined in hydrological *** values are considered to be constant although they may not correspond to *** the same catchment,they may vary according to intensity,temporal and spatial distribution of precipitation events,humidity condi-tions,soil and land *** study aimed to analyze extreme events of precipitation and their corre-sponding flows to obtain experimental runoff coefficients(C)and compare them with the tabulated *** study was conducted in five experimental catchments in the state of S~ao Paulo,Brazil,with different land *** runoff coefficients(C)were obtained from the analysis of hydrograms and using a digital filter,which made it possible to separate the direct runoff from the total *** observed a different variation in runoff coefficient values between catchments compared to those obtained from the *** runoff coefficients had a high correlation with land *** catchments with original vege-tation cover,such as Cerrado and forest,they varied little among the events analyzed,unlike the catchments where land use is diversified,with predominantly agricultural and urban occupation.

关键词： Digital filter Hydrograms Hydrology Land use Watershed

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Immune thrombocytopenic purpura induced by intestinal tuberculosis in a liver transplant recipient

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World Journal of Gastroenterology 2014年第25期20卷 8304-8308页

作者： Renata dos Santos Lugao Marina Pamponet Motta matheus Freitas Cardoso de Azevedo roque Gabriel Rezende de Lima Flávia de Azevedo Abrantes Edson Abdala Flair José Carrilho Daniel Ferraz de Campos Mazo Hepatology Branch Clinical DivisionDepartment of GastroenterologyUniversity of S?o Paulo School of Medicine S?o Paulo 05403-000Brazil Liver and Gastrointestinal Transplant Division Department of GastroenterologyUniversity of S?o Paulo School of MedicineS?o Paulo 05403-000 Brazil Department of Infectious and Parasitic Diseases University of S?o Paulo School of Medicine S?o Paulo 05403-000 Brazil

A variety of clinical manifestations are associated directly or indirectly with tuberculosis. Among them, haematological abnormalities can be found in both the pulmonary and extrapulmonary forms of the disease. We report a case of immune thrombocytopenic purpura(ITP) associated with intestinal tuberculosis in a liver transplant recipient. The initial management of thrombocytopenia, with steroids and intravenous immunoglobulin, was not successful, and the lack oftuberculosis symptoms hampered a proper diagnostic evaluation. After the diagnosis of intestinal tuberculosis and the initiation of specific treatment, a progressive increase in the platelet count was observed. The mechanism of ITP associated with tuberculosis has not yet been well elucidated, but this condition should be considered in cases of ITP that are unresponsive to steroids and intravenous immunoglobulin, especially in immunocompromised patients and those from endemic areas.

关键词： Immune thrombocytopenic purpura Tuberculosis Liver transplant Thrombocytopenia Intestinal tuberculosis

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