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Ileal loop interposition:an alternative biliary bypass technique

Hepatobiliary & Pancreatic Diseases International 2010年第6期9卷 654-657页

作者： Felipe JF Coimbra Alessandro L Diniz Heber SC Ribeiro Wilson L Costa Jr. eduardo np lima AndréL Montagnini Abdominal Surgery Department Hospital do Cncer A.C.CamargoRua Professor Antnio Prudente 211LiberdadeSo PauloSP 01509-010Brazil Nuclear Medicine Imaging Department Hospital do Cncer A.C.CamargoRua Professor Antnio Prudente 211LiberdadeSo PauloSP 01509-010Brazil

BACKGROUND:Obstructive jaundice is a common condition in advanced digestive *** procedures can improve quality of life and allow patients to attempt a systemic *** anastomosis is still the procedure of choice for patients in many *** a surgical bypass is not possible,biliary drainage can be done by placing endoscopic or transparietal stents,which are less durable methods even when an expandable stent is employed. METHODS:A 47-year-old male with an excellent clinical status and a previous cholecystectomy and an exploratory laparotomy for advanced gastric cancer was referred with obstructive jaundice.A preoperative CT scan showed a dilated bile duct and a small mass at the distal hepatic *** other signs of metastasis were found.A surgical bilioenteric anastomosis was *** surgery,a distal choledochal obstruction and a mesenteric retraction by a lymph node mass prevented the jejunum to ascend for a bilioenteric anastomosis. Surgically,an alternative bilioenteric bypass was performed by means of an ileal loop interposition between the bile duct and the jejunum. RESULT:The recovery of the patient was uneventful and his bilirubin levels normalized after one *** patient was then referred for systemic chemotherapy. CONCLUSIONS:This alternative biliary bypass can be safely and easily performed,and may be a good alternative for patients already referred for surgery because of a better life expectancy and when the jejunum is not an alternative.

关键词： biliary bypass ileal loop interposition biliary cancer

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Iron-Deficiency Anemia Management in Gynecological Surgery: A Review of Current Evidence and Best Practices

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1223-1241页

作者： Aline Evangelista Santiago Artur lima Sendin Víctor Nilo Nogueira Rogério Adão Braga Admilson Lemos Costa Filho eduardo Batista Cândido Agnaldo Lopes Silva Filho Department of Gynecology and Obstetrics Faculty of Medicine Santo Amaro University (UNISA) So Paulo Brazil Department of Gynecology and Obstetrics Federal University of Minas Gerais (UFMG) Belo Horizonte Brazil Department of Gynecology and Obstetrics Faculty of Medicine So Paulo State University (UNESP) So Paulo Brazil

Purpose: Due to the high prevalence of iron deficiency anemia in women undergoing gynecological surgeries and its association with worse postoperative results, it is necessary to identify and treat anemia preoperatively. However, although anemia and iron deficiency are significant global health problems, there are still disparities in the recognition and implementation of “Patient Blood Management” (PBM) as a comprehensive approach to mitigating the risks associated with these diseases. The purpose of the study is to review best practices for the treatment of anemia based on the Enhanced Recovery After Surgery (ERAS) protocol and PBM recommendations. Methods: This study reviewed the literature on preoperative iron deficiency anemia in patients undergoing gynecological surgery. We identified references through searches in PubMed using relevant search terms. Results: Among the various strategies used in PBM, perhaps the most important is the early detection and management of anemia. In gynecological surgery, there are several approaches to reducing perioperative blood loss, highlighting the use of gonadotropin-releasing hormone (GnRH) agonists (aGnRh) and antifibrinolytics. Oral and intravenous iron supplementation can be performed in addition to blood transfusion to treat anemia. Conclusion: Addressing preoperative and postoperative anemia through systematic correction, following the guidelines of the ERAS protocol and PBM guidelines, is essential to improving perioperative outcomes in women undergoing gynecological surgery.

关键词： Anemia Gynecological Surgery Iron Supplementation Iron Deficiency

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Combined Oxidative Phosphorylation Deficiency-20-Exome as a Diagnostic Implement

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Journal of Biosciences and Medicines 2024年第6期12卷 7-12页

作者： Paulo Roberto Matos-Neto Lucas Antonissen lima Verde Airton Ferreira da Ponte-Filho Luís eduardo Oliveira Matos Amandha Espavier Trés Paulo Roberto Lacerda Leal Gerardo Cristino-Filho Regina Coeli de Carvalho Porto Carneiro Faculty of Medicine Federal University of Cear Sobral Cear Brazil Department of Neurosurgery Federal University of Cear Sobral Cear Brazil Department of Neuropediatrics Federal University of Cear Sobral Cear Brazil

Mitochondrial disorders are phenotypically varied, with serious clinical repercussions. Among them, there is the deficiency of combined oxidative phosphorylation of type 20, which occurs due to a defect in the VARS2 gene. This article presents a case of a 2-year-old female with progressive myoclonic epilepsy and psychomotor regression, with refractoriness to multiple anticonvulsants. The diagnosis was only made after the examination was carried out. Therefore, this article highlights the aspects of this rare disease and the importance of the exome for the diagnosis of rare conditions.

关键词： Oxidative Phosphorylation Epilepsy Exome Mitochondrial Defect VARS2

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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

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Uncontrolled hypertension in older patients： markers and associated factors to masked and white-coat effect

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Journal of Geriatric Cardiology 2016年第8期13卷 672-678页

作者： Nereida KC lima Julio C Moriguti eduardo Feniolli Division of General lnternal Medicine & Geriatrics Internal Medicine Department Ribeirao Preto Medical School Sao Paulo University Sao Paulo Brazil

Background Hypertension is the main risk factor for cardiovascular diseases, affecting more than half the elderly population. It is essential to know if they have proper control of hypertension. The aim of this study was to identify the associated factors to masked uncon- trolled hypertension and false uncontrolled hypertension in older patients. Methods Two-hundred seventy-three individuals （70.1±6.7 years-old） had blood pressure （BP） measured at the office and by ambulatory BP monitoring （ABPM）, with the definition of controlled group （C）, individuals with high office BP and adequate ABPM, called white-coat effect group （WCE）, uncontrolled （UC）, and subjects with ap- propriate office BP and elevated ABPM denominated masked effect group （ME）. Age, body mass index, diabetes, pulse pressure （PP） and BP dipping during sleep were evaluated （Kruskal-Wallis test and logistic regression models）. Results Age was higher in UC than in C and ME （P 〈 0.01）, and 24-h ABPM PP was lower in C （48± 7 mmHg） and WCE （51±6 mmHg） than in UC （67±12 mmHg） and ME （59±8 mmHg）（P 〈 0.01）. Sleep systolic BP dipping was lower in ME than in C （P = 0.03）. Female gender was associated with a greater chance of being of ME group, which showed a higher PP and lower BP dipping during sleep. Conclusions In older individuals, office BP measure- ments did not allow the detection of associated factors that would permit to differentiate WCE from UC group and C from ME group. ABPM favored the identification of a higher PP and a lower BP dipping during sleep in the masked effect and uncontrolled groups.

关键词： Ambulatory blood pressure monitoring Hypertension Masked effect The aged White coat effect

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From liver to hormones:The endocrine consequences of cirrhosis

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World Journal of Gastroenterology 2024年第9期30卷 1073-1095页

作者： Juan eduardo Quiroz-Aldave Elman Rolando Gamarra-Osorio María del Carmen Durand-Vásquez Luciana del Pilar Rafael-Robles Jhean Gabriel Gonzáles-Yovera María Alejandra Quispe-Flores Luis Alberto Concepción-Urteaga Alejandro Román-González José Paz-Ibarra Marcio José Concepción-Zavaleta Non-communicable Diseases Endocrinology Research LineHospital de Apoyo ChepénChepén 13871Peru Department of Endocrinology Hospital Víctor Lazarte EchegarayTrujillo 13006Peru Department of Endocrinology Clínica Javier PradoLima 15046Peru Department of Gastroenterology Hospital Nacional Guillermo Almenara IrigoyénLima 15018Peru Department of Endocrinology Hospital de Emergencias GrauLima 15001Peru Internal Medicine Hospital Regional Docente de TrujilloTrujillo 13011Peru Department of Endocrinology Hospital Universitario de San Vicente FundaciónMedellin 050010Colombia Internal Medicine Universidad de AntioquiaMedellín 050010Colombia School of Medicine Universidad Nacional Mayor de San MarcosLima 15081Peru Department of Endocrinology Hospital Nacional Edgardo Rebagliati MartinsLima 15072Peru Carrera de Medicina Humana Universidad Científica del SurLima 15067Peru

Hepatocrinology explores the intricate relationship between liver function and the endocrine *** liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis *** its importance,assessing endocrine issues in cirrhotic patients is frequently *** article provides a comprehensive review of the epidemiology,pathophysiology,diagnosis,and treatment of endocrine disturbances in liver *** review was conducted using the PubMed/Medline,EMBASE,and Scielo databases,encompassing 172 *** cirrhosis is associated with endocrine disturbances,including diabetes,hypoglycemia,sarcopenia,thyroid dysfunction,hypogonadotropic hypogonadism,bone disease,adrenal insufficiency,growth hormone dysfunction,and secondary *** optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system,*** can be assessed through imaging and functional tests,while other endocrine disorders are evaluated using hormonal assays and imaging *** options include metformin,glucagon-like peptide-1 analogs,sodium-glucose co-transporter-2 inhibitors,and insulin,which are effective and safe for diabetes *** standards are followed for managing hypoglycemia,and hormone replacement therapy is often necessary for other endocrine *** transplantation can address some of these problems.

关键词： Diabetes mellitus Hypoglycemia Thyroid diseases Hypogonadism Metabolic bone diseases Liver cirrhosis

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A comprehensive review of genetic causes of obesity

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World Journal of Pediatrics 2024年第1期20卷 26-39页

作者： Marcio Jose Concepcion-Zavaleta Juan eduardo Quiroz-Aldave Maria del Carmen Durand-Vasquez Elman Rolando Gamarra-Osorio Juan del Carmen Valencia de la Cruz Claudia Mercedes Barrueto-Callirgos Susan Luciana Puelles-Leon Elena de Jesus Alvarado-Leon Frans Leiva-Cabrera Francisca Elena Zavaleta-Gutierrez Luis Alberto Concepcion-Urteaga Jose Paz-Ibarra Universidad Cientifica del Sur Bolivar 2150 AvenuePueblo Libre15084LimaPeru Division of Medicine Hospital de Apoyo ChepénChepenPeru Division of Family Medicine Hospital de Apoyo ChepénChepenPeru Division of Endocrinology Hospital Victor Lazarte EchegarayTrujilloPeru Division of Pediatrics Hospital de Apoyo ChepenChepenPeru Division of Internal Medicine Hospital de Apoyo ChepenChepenPeru Division of Genetics Universidad Nacional de TrujilloTrujilloPeru Division of Neonatology Hospital Belen de TrujilloTrujilloPeru Division of Internal Medicine Universidad Nacional de TrujilloTrujilloPeru Department of Medicine School of MedicineUniversidad Nacional Mayor de San MarcosLimaPeru

Background Obesity is a multifactorial chronic disease with a high,increasing worldwide *** causes account for 7%of the cases in children with extreme *** sources This narrative review was conducted by searching for papers published in the PubMed/MEDLINE,Embase and SciELO databases and included 161 *** search used the following search terms:"obesity","obesity and genetics","leptin","Prader-Willi syndrome",and"melanocortins".The types of studies included were systematic reviews,clinical trials,prospective cohort studies,cross-sectional and prospective studies,narrative reviews,and case *** The leptin-melanocortin pathway is primarily responsible for the regulation of appetite and body ***,several important aspects of the pathophysiology of obesity remain *** causes of obesity can be grouped into syndromic,monogenic,and polygenic causes and should be assessed in children with extreme obesity before the age of 5 years,hyperphagia,or a family history of extreme obesity.A microarray study,an analysis of the melanocortin type 4 receptor gene mutations and leptin levels should be performed for this *** are three therapeutic levels:lifestyle modifications,pharmacological treatment,and bariatric *** Genetic study technologies are in constant development;however,we are still far from having a personalized approach to genetic causes of obesity.A significant proportion of the affected individuals are associated with genetic causes;however,there are still barriers to its approach,as it continues to be underdiagnosed.

关键词： Leptin Melanocortin Obesity Prader-Willi syndrome Precision medicine

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Multi-generational SIR modeling: Determination of parameters, epidemiological forecasting and age-dependent vaccination policies

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Infectious Disease Modelling 2021年第1期6卷 751-765页

作者： eduardo lima Campos Rubens Penha Cysne Alexandre L.Madureira Gelcio L.Q.Mendes EPGE Brazilian School of Economics and Finance(FGV EPGE) Rio de JaneiroRJBrazil ENCE-Escola Nacional de Ci^encias Estatísticas(ENCE/IBGE) Rio de JaneiroRJBrazil Laboratorio Nacional de Computaç~ao Científica PetropolisRJBrazil INCA-Brazilian National Cancer Institute Coordination of AssistanceRio de JaneiroRJBrazil

We use an age-dependent SIR system of equations to model the evolution of the *** that measure the amount of interaction in different locations(home,work,school,other)are approximated from in-sample data using a random optimization scheme,and indicate changes in social distancing along the course of the *** allows the estimation of the time evolution of classical and age-dependent reproduction *** those parameters we predict the disease dynamics,and compare our results with out-of-sample data from the City of Rio de ***,we provide a numerical investigation regarding age-based vaccination policies,shedding some light on whether is preferable to vaccinate those at most risk(the elderly)or those who spread the disease the most(the youngest).There is no clear upshot,as the results depend on the age of those immunized,contagious parameters,vaccination schedules and efficiency.

关键词： COVID-19 Epidemiology Vaccination Compartmental modeling SIR

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Photoluminescence emissions of Ca_(1-x)WO_(4):xEu^(3+):Bridging between experiment and DFT calculations

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Journal of Rare Earths 2022年第10期40卷 1527-1534页

作者： Amanda Fernandes Gouveia Marcelo Assis Lara Kelly Ribeiro Aline Estefany Brandao lima eduardo de Oliveira Gomes Daniele Souza Yara Gobato Galvao Ieda Lucia Viana Rosa Geraldo eduardo da Luz Jr Eva Guillamón Elson Longo Juan Andrés Miguel Angel San-Miguel Department of Physical and Analytical Chemistry University Jaume I(UJI)12071CastelloSpain Institute of Chemistry State University of Campinas(Unicamp)13083-970CampinasSPBrazil CDMF Federal University of S?o Carlos(UFSCar)P0.Box 67613565-905Sao CarlosSao PauloBrazil Departamento de Química Federal University of Piauí(UFPI)64049-550TeresinaPiautBrazil Physics Department Federal University of S?o Carlos(UFSCar)P.0.Box 67613565-905Sao CarlosSao PauloBrazil

In this work,the impact of the doping process on the photoluminescence emission of CaWO_(4) as a function of the concentration of Eu^(3+) cation(0.01 mol%,0.02 mol%,0.04 mol%,0.06 mol%,0.08 mol%,and 0.10 mol%) is discussed in ***_(1-x)WO~4:xEu^(3+) samples were successfully synthesized by a simple coprecipitation method followed by microwave *** blue shift in the absorption edge confirms the quantum confinement effect and the band gap energy covers the range from 3.91 to 4.18 eV,as the amount of Eu^(3+) cations *** experimental results are sustained by first-principles calculations,at the density functional theory level,to decipher the geometry and electronic properties,thereby enabling a more accurate and direct comparison between theory and experiment for the Ca_(1-x)WO_(4):xEu^(3+) structure.

关键词： Ca_(1-x)WO_(4):xEu^(3+) DFT calculations Photoluminescence emissions Rare earths

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Parametric Analysis of the Stability of Degraded Railroad Platforms

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Journal of Civil Engineering and Architecture 2014年第1期8卷 11-18页

作者： Paulo Roberto Aguiar Cassio eduardo lima de Paiva Geotechnical and Transportation Department Civil Engineering School Campinas University (UN1CAMP) Campinas 13000-000Brazil

The current study is developed based on one of the types of subgrade rupture risk suggested by Selig and Waters （1994）. It aims to evaluate subgrade stability railroad, which consists of the slope stability analysis of a railway yard embankment subjected to a wagon load type gondola parked on this track. This proposed analysis was taken into consideration because there are Brazilian railroads in high deterioration level. In some of these lines the tracks are submitted to increasing amount of load every year. The adopted model slope stability to the studied railroad embankments considers the rupture on circular line. It was applied the Geoslope-Slope/W software, version 6, to the evaluation of the platform-slope system. Several situations are adopted to reach the minimum safety slope, permitting to analyze the platform stability to keep railroad traffic under adequate safety level.

关键词： Rupture circle railway yard track tensions at subgrade degraded railway track.

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