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Diagnosis of pancreatic tumors by endoscopic ultrasound-guided fine-needle aspiration

World Journal of Gastroenterology 2007年第22期13卷 3112-3116页

作者： josé celso ardengh César Vivian Lopes Luiz Felipe Pereira de Lima Juliano Rodrigues de Oliveira Filadélfi o Venco Giulio Cesare Santo josé Luiz Pimenta Módena Echoendoscopy and Pathology Units from 9 de Julho Hospital and Ribeiro Preto Medical School-USP So Paulo Brazil

AIM： To evaluate the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration （EUS-FNA） for pancreatic solid tumors larger or smaller than 3 cm, and cystic lesions.METHODS： From January/1997 to December/2006, 611 patients with pancreatic tumors were subjected to EUSFNA. The final diagnosis was obtained either by surgery （356 cases） or after a mean clinical follow-up of 11.8 mo in the remaining patients.RESULTS： There were 405 solid tumors, 189 cystic lesions and 17 mixed. Pancreatic specimens for cytological assessment were successfully obtained by EUS-FNA in 595 （97.4%） cases. There were 352 （57.6%） malignancies and 259 （42.4%） benign tumors. Among the malignancies, pancreatic adenocarcinomas accounted for 67% of the lesions. Overall, the sensitivity, specificity, positive and negative predictive values, and accuracy of EUS-FNA were, respectively, 78.4%, 99.2%, 99.3%, 77.2% and 87.2%. Specifically for solid tumors, the same parameters for neoplasms larger and smaller than 3 cm were, respectively, 78.8% ys 82.4%, 100% ys 98.4%, 100% vs 99%, 54.8% vs 74.1% and 83.1% vs 87.8%. For cystic lesions, the values were, respectively, 72.2%, 99.3%, 97.5%, 91% and 92.2%.CONCLUSION： EUS-FNA can be used to sample pancreatic tumors in most patients. Even though the negative predictive value is inadequate for large solid tumors, the results are rather good for small solid tumors, especially concerning the sensitivity, negative predictive value and diagnostic accuracy. Among all pancreatic lesions, EUS-FNA for cystic lesions can reveal the best negative predictive value and diagnostic accuracy, both higher than 90%.

关键词： Diagnosis Endoscopic ultrasound Fineneedle-aspiration biopsy Pancreas cancer Pancreatic disease Sampling

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Yield of surgery in solid pseudopapillary neoplasms of the pancreas: A case series and literature review

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World Journal of Gastrointestinal Oncology 2021年第6期13卷 589-599页

作者： Flávio Silano Ricardo Bandeira de Melo Amaral Rodolfo Carvalho Santana Vanessa Costa Neves josécelso ardengh Paulo Cezar Galvão do Amaral Digestive Surgery Hospital São Rafael/Rede D’OrSalvador 40285000BahiaBrazil Department of Surgery of the Upper Digestive System São Rafael Hospital/Rede D’Or Hospital GroupSalvador 41253-190BahiaBrazil Surgery and Anatomy Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto-Universidade de São PauloSão Paulo 04611-000São PauloBrazil Endoscopy Service Hospital 9 de JulhoSão Paulo 04611-000São PauloBrazil Imaging and Diagnosis Escola Paulista de Medicina-São Paulo Federal UniversitySão Paulo 04611-000SPBrazil

BACKGROUND Solid pseudopapillary neoplasms(SPN)of the pancreas represents approximately 2%of non-endocrine tumors of the *** is described in the literature as a rare and predominant tumor in young *** To report a case series with SPN and analyzing clinical,surgical,anatomopathological characteristics,as well as the prognosis and review of *** Retrospective analysis of patients undergoing surgery,with histological diagnosis of SPN between 1998 and 2018,using standardized and prospectively completed forms,performed at the Surgery Service of the Upper Digestive System at Hospital São Rafael/Rede D’Or in *** of literature through a database search in MEDLINE/PubMed of retrospective *** Fourteen female patients with the average age of 31.6 years(range min-max)were *** patients(85.7%)were asymptomatic,being an incidental diagnosis or due to screening for other *** patient had abdominal pain due to gastric compression and another patient had *** 14 patients were staged with computerized tomography or magnetic resonance *** had evidence of *** 8 patients(57.1%),the tumor was in the tail and *** average size was 6.7 cm(range min-18).The type of surgery was according to the anatomical location of the *** was no lymph node *** two cases,vascular resection with the use of a prosthesis was required for *** surgical margins were *** all cases,postoperative immunohistochemistry confirmed that it was a solid pseudo-papillary neoplasia of the *** has been no disease recurrence in any case so *** The tumors had a benign,indolent and histopathological behavior compatible with the *** surgery is recommended in all cases.

关键词： Frantz tumor Malignancy Solid pseudo-papillary tumor Surgical treatment Survival Pancreas

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Conservative management of cholestasis with and without fever in acute biliary pancreatitis

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World Journal of Gastrointestinal Surgery 2012年第3期4卷 55-61页

作者： joséSebastio Santos Rafael Kemp josécelso ardengh Jorge Elias Jr Division of Digestive Surgery Department of Surgery and AnatomyFaculty of Medicine of Ribeiro PretoUniversity of So Paulo Department of Internal Medicine Faculty of Medicine of Ribeiro PretoUniversity of So Paulo

The presence of cholestasis in both mild and severe forms of acute biliary pancreatitis(ABP)does not justify,of itself,early endoscopic retrograde cholangiography(ERC)or endoscopic sphincterotomy(ES).Clinical support treatment of acute pancreatitis for one to two weeks is usually accompanied by regression of pancreatic edema,of cholestasis and by stone migration to the duodenum in 60%-88%of *** the other hand,in cases with both cholestasis and fever,a condition usually characterized as ABP associated with cholangitis,early ES is normally ***,in daily clinical practice,it is practically impossible to guarantee the coexistence of cholangitis and mild or severe acute ***,fever and cholestasis,as well as mental confusion and hypotension,may be attributed to inflammatory and necrotic events related to ABP. Under these circumstances,evaluation of the bile duct by endo-ultrasonography(EUS)or magnetic resonance cholangiography(MRC)before performing ERC and ES seems ***,it is necessary to assess the effects of the association between early and opportune access to the treatment of local and systemic inflammatory/infectious effects of ABP with cholestasis and fever, and to characterize the possible scenarios and the subsequent approaches to the common bile duct,directed by less invasive examinations such as MRC or EUS.

关键词： Biliary pancreatitis Cholestasis Endoscopic sphincterotomy Cholangitis Mortality Magnetic resonance cholangiopancreatography Endoscopic retrograde cholangiography Endoscopic ultrasonography Intensive care Health system regulation

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Different options of endosonography-guided biliary drainage after endoscopic retrograde cholangiopancreatography failure

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World Journal of Gastrointestinal Endoscopy 2018年第5期10卷 99-108页

作者： josécelso ardengh César Vivian Lopes Rafael Kemp jose Sebastiao dos Santos Division of Surgery and Anatomy Ribeirao Preto Medical SchoolUniversity of Sao PauloRibeirao PretoSao Paulo 14049-900Brazil Department of Gastroenterology and Digestive Endoscopy Santa Casa HospitalPorto Alegre 91410-000Brazil

AIM To investigate the success rates of endosonography(EUS)-guided biliary drainage(EUS-BD) techniques after endoscopic retrograde cholangiopancreatography(ERCP) failure for management of biliary *** From Feb/2010 to Dec/2016, ERCP was performed in 3538 patients, 24 of whom(0.68%) suffered failure to cannulate the biliary tree. All of these patients were initially submitted to EUS-guided rendez-vous(EUS-RV) by means of a transhepatic approach. In case of failure, the next approach was an EUS-guided anterograde stent insertion(EUS-ASI) or an EUS-guided hepaticogastrostomy(EUS-HG). If a transhepatic approach was not possible or a guidewire could not be passed through the papilla, EUS-guided choledochoduodenostomy(EUS-CD) was *** Patients were submitted to EUS-RV(7), EUS-ASI(5), EUS-HG(6), and EUS-CD(6). Success rates did not differ among the various EUS-BD techniques. Overall,technical and clinical success rates were 83.3% and 75%, respectively. Technical success for each technique was, 71.4%, 100%, 83.3%, and 83.3%, respectively(P = 0.81). Complications occurred in 3(12.5%) patients. All of these cases were managed conservatively, but one patient died after rescue percutaneous transhepatic biliary drainage(PTBD).CONCLUSION The choice of a particular EUS-BD technique should be based on patient's anatomy and on whether the guidewire could be passed through the duodenal papilla.

关键词： Cholestasis Drainage Endosonography Interventional procedures Jaundice Neoplasms

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Nonsteroidal anti-inflammatory drug effectivity in preventing postendoscopic retrograde cholangiopancreatography pancreatitis: A systematic review and meta-analysis

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World Journal of Gastrointestinal Endoscopy 2020年第11期12卷 469-487页

作者： Juan Pablo Román Serrano joséJukemura Samuel Galante Romanini Paúl Fernando Guamán Aguilar Juliana Silveira Lima de Castro Isabela Trindade Torres joséAndres Sanchez Pulla Otavio Micelli Neto Eloy Taglieri josécelso ardengh Department of Gastroenterology University of Sao PauloSão Paulo 05403-000São PauloBrazil Department of Gastrointestinal Endoscopy Service Hospital 9 de JulhoSão Paulo 01409002São PauloBrazil Department of Gastroinestinal Catholic University of CuencaCuenca 010101Ecuador Department of General Surgery Servidor Municipal HospitalSão Paulo 01532-001Brazil

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is the primary therapeutic procedure for the treatment of diseases affecting the biliary tree and pancreatic *** the therapeutic success rate of ERCP is high,the procedure can cause complications,such as acute pancreatitis[post-ERCP pancreatitis(PEP)],bleeding and *** To assess the efficacy of non-steroidal anti-inflammatory drugs(NSAIDs)in preventing PEP during *** Databases such as MEDLINE,EMBASE and Cochrane Central Library were *** randomized controlled trials(RCTs)comparing the efficacy of NSAIDs and placebo for the prevention of PEP were *** evaluated included the incidence of PEP,severity of pancreatitis,route of administration,types,dose,and timing of administration of *** Twenty-six RCTs were considered eligible with a total of 8143 patients ***,4020 patients used NSAIDs before ERCP and 4123 did not use NSAIDs(control group).Ultimately,298 cases of post-ERCP acute pancreatitis were diagnosed in the NSAID group and 484 cases in the placebo *** risk of PEP was lower in the NSAID group risk difference(RD):-0.04;95%confidence interval(CI):-0.07 to-0.03;number needed to treat(NNT),25;P<*** use effectively prevented mild pancreatitis compared to placebo use(2.5%vs 4.1%;95%CI:-0.05 to-0.01;NNT,33;P<0.05),but information on moderate PEP and severe PEP could not be fully *** rectal administration reduced the incidence of PEP with RD:-0.06;95%CI:-0.08 to-0.04;NNT,17;P<0.05).Furthermore,only the use of diclofenac or indomethacin was effective in preventing PEP,at a dose of 100 mg,which must be administered before performing *** Rectal administration of diclofenac and indomethacin significantly reduced the risk of developing mild *** RCTs are needed to compare the efficacy between NSAID routes of administration in preventing PEP.

关键词： Pancreatitis Endoscopic retrograde cholangiopancreatography Diclofenac Indomethacin Rectal

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Evaluation and modeling of runoff and sediment yield for different land covers under simulated rain in a semiarid region of Brazil

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International Journal of Sediment Research 2018年第2期33卷 117-125页

作者： Richarde Marques da Silva celso Augusto Guimares Santos josé Yure Gomes dos Santos Department of Geosaences Federal University of Paraíba Department of Civil and Environmental Engineering Federal University of Paraíba Federal University of Western Bahia Center for Humanities

This paper quantifies the runoff and sediment yield for four different land covers in a semiarid region of Brazil. The WESP model, a distributed, event-oriented runoff-erosion model, was applied and its physical parameters, NSand KR, were adjusted based on observed runoff and sediment yield data using simulated rainfall with an average intensity of 53 mm h-1. The sediment yield obtained was 53.02 kg ha-1(caatinga vegetation), 231.96 kg ha-1(bare soil), 309.75 kg ha-1(beans), and 847.38 kg ha-1(corn). The results showed that caatinga cover yields the lowest erosion and runoff when compared to the other *** results also show that the sediment yield and runoff values simulated with NS, KI, and KR parameters were well calibrated, within acceptable deviations. The caatinga vegetation was more effective in protecting the soil, when compared to the other types of coverage. The beans and corn covers had the highest values of runoff and sediment yield, even higher than those observed for bare soil.

关键词： Runoff Erosion Semiarid region WESP model

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Soil properties characterization for land-use planning and soil management in watersheds under family farming

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International Soil and Water Conservation Research 2022年第1期10卷 119-128页

作者： jose Miguel Reichert Paulo Ivonir Gubiani Danilo Rheinheimer dos Santos Dalvan jose Reinert celso Aita Sandro jose Giacomini Soils Department Universidade Federal de Santa Maria(UFSM)Santa MariaRSBrazil

Environmental monitoring of small,rural watersheds was one of the components of the Natural Re-sources Management and Rural Poverty Alleviation Program(RS-Rural)in southern *** purpose of the monitoring was to assess the impact of promoting soil conservation and environment manage-ment practices adopted by farmers and funded by the *** four small monitored watersheds,in a total of 95 plots representing distinct land use and soil management,surface soil was collected to characterize ground-zero of the Program by determining several soil physical,chemical and microbio-logical *** component analysis(PCA)shows soil physical,chemical and biological properties were decisive in defining the agricultural soils in the rural watersheds with family *** sensitivity to chemical properties provides an opportunity to improve soil quality if soil management focuses on altering those *** management practiced by tobacco farmers leads to rapid,intense degradation of some natural soil properties,especially those related to the dynamics of soil organic matter,compared with more conservationist uses(forest,regrowth,and grassland).Thus,soil management must be reoriented to avoid the progress of degradation and recover soil physical and biological *** crops and by land-abandonment to allow natural vegetation are important management strategies for the degraded soils used for tobacco production,increasing soil organic matter,nutrients and microbial activity and thus allowing further crop *** conclusion,wa-tersheds with tobacco cropping have soils with lower quality than when under no-tillage grain pro-duction,requiring changes in land use and soil management.

关键词： Natural resources management Environmental monitoring Soil conservation Soil quality Alleviating poverty

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Inflammatory bowel disease in an underdeveloped region of Northeastern Brazil

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World Journal of Gastroenterology 2015年第4期21卷 1197-1206页

作者： josé Miguel Luz Parente Claudio Saddy Rodrigues Coy Viriato Campelo Mírian Perpétua Palha Dias Parente Leonardo Araújo Costa Renata Mendes da Silva celso Stephan josé Murilo Robilotta Zeitune Center for Health Sciences Federal University of Piaui (Universidade Federal do Piauí - UFPI)TeresinaPiauí 64049-550Brazil Department of Surgery School of Medical SciencesState University of Campinas (Universidade Estadual de Campinas)CampinasS?o Paulo 13083-970Brazil Center of Health Sciences State University of Piaui (Universidade Estadual do Piauí - UESPI)TeresinaPiauí 64001-280Brazil Federal University of Piaui (Universidade Federal do Piauí - UFPI) TeresinaPiauí 64049-550Brazil Department of Public Health School of Medical SciencesState University of Campinas (Universidade Estadual de Campinas - Unicamp)CampinasS?o Paulo 13083-970Brazil Department of Internal Medicine School of Medical SciencesState University of Campinas (Universidade Estadual de Campinas - Unicamp)CampinasS?o Paulo 13083-970Brazil

AIM: To evaluate the demographic characteristics and clinical phenotypes of inflammatory bowel disease(IBD) in a geographic area in Northeastern ***: This retrospective study was conducted at the Hospital of the Federal University of Piauí in Northeastern Brazil. Demographic characteristics and clinical phenotypes of IBD were analyzed in relation to the time of diagnostic confirmation, which was defined as the date of disease onset. Data were collected between January 2011 and December 2012 and included all census patients 18 years of age or older during that period for whom there was diagnostic confirmation of Crohn's disease(CD), ulcerative colitis(UC), or unclassified colitis according to the Montreal criteria. We also analyzed the period of time between the onset of clinical manifestations and the diagnosis of IBD(delay in the diagnosis). Statistical analyses included means and standard deviations for numeric variables and the Pearson χ2 adherence test for nominal variables. The annual index occurrence and overall prevalence of IBD at our institution were also calculated, with P values < 0.05 indicating statistical significance. This study was approved by the Institutional Ethics and Research ***: A total of 252 patients with IBD were included, including 152(60.3%) UC patients and 100(39.7%) CD patients. The clinical and demographic characteristics of all patients with IBD showed a female to male ratio of 1.3:1.0 and a mean age of35.2(SD = 14.5) years. In addition, the majority of patients were miscegenated(171, 67.9%), had received higher education(157, 62.4%), lived in urban areas(217, 86.1%), and were under the age of 40 years(97, 62.5%). For patients with CD, according to the Montreal classification, the predominant features present from the onset of disease were an age between 17 and 40 years(A2); colonic disease location(L2); and nonstricturing, nonfistulizing disease behavior(B1). However, approximately one-quarter of all CD patie

关键词： Inflammatory bowel diseases Crohn’s disease Ulcera

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Increased hepatic expression of insulin-like growth factor-Ⅰreceptor in chronic hepatitis C

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World Journal of Gastroenterology 2006年第24期12卷 3821-3828页

作者： josé Tadeu Stefano Maria Lúcia Corr(e|^)a-Giannella Cristiane Maria Freitas Ribeiro Ven(a|^)ncio Avancini Ferreira Alves Paulo celso Bosco Massarollo Marcel Cerqueira Cesar Machado Daniel Giannella-Neto Laboratory for Cellular and Molecular Endocrinology University of Sao Paulo Medical School Brazil Laboratory for Cellular and Molecular Endocrinology University of Sao Paulo Medical School Diabetes UnitDivision of EndocrinologyBrazil Department of Pathology Santa Casa de Misericórdia de Sao Paulo Brazil Department of Pathology University of Sao Paulo Medical School Brazil Laboratory for Experimental Surgery University of Sao Paulo Medical School Brazil

AIM： Although increased insulin-like growth factor-I receptor （IGF-IR） gene expression has been reported in hepatocellular carcinoma, studies assessing IGF-IR in chronic hepatitis C （CHC） and cirrhosis are scarce. We therefore aimed to evaluate IGF-IR and IGF-I rnRNA expression in liver from patient with CHC. METHODS： IGF-IR and IGF-I rnRNA content were determined by semi-quantitative RT-PCR and IGF-IR protein expression was determined by immunohistochemistry in hepatic tissue obtained from patients with CHC before （34 patients） and after （10 patients） therapy with interferon-α and ribavirin. RESULTS： An increase of IGF-IR rnRNA content was observed in hepatic tissue obtained from all CHC patients as well as from 6 cadaveric liver donors following orthopic transplantation （an attempt to evaluate normal livers） in comparison to normal liver, while no relevant modifications were detected in IGF-I mRNA content. The irnrnunohistochemical results showed that the raise in IGF-IR rnRNA content was related both to ductular reaction and to increased IGF-IR expression in hepatocytes. A decrease in IGF-IR rnRNA content was observed in patients who achieved sustained virological response after therapy, suggesting an improvement in hepatic damage. CONCLUSION： The up-regulation of IGF-IR expression in hepatocytes of patients with CHC could constitute an attempt to stimulate hepatocyte regeneration. Considering that liver is the organ with the highest levels of IGF-I, our finding of increased IGF-IR expression after both acute and chronic hepatic damage highlights the need for additional studies to elucidate the role of IGF-I in liver regeneration.

关键词： Chronic hepatitis C Insulin-like growth factorI Insulin-like growth factor I receptor Ductular reaction Hepatocyte regeneration Ischemia-reperfusion

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Biomass-glycerol briquettes are not necessarily mechanically stable and energetically effective

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Waste Disposal and Sustainable Energy 2020年第4期2卷 291-303页

作者： Bruno Rafael de Almeida Moreira Ronaldo da Silva Viana Samuel Dias Moreira Monique dos Santos Lima Anderson Chagas Magalhães celso Tadao Miasaki joséClaudio Caraschi Department of Phytosanitary Rural Engineering and SoilsSchool of EngineeringSão Paulo State University(Unesp)Ilha SolteiraSão PauloBrazil Department of Plant Production College of Agricultural and Technological SciencesSão Paulo State University(Unesp)DracenaBrazil São Paulo State University(Unesp) ItapevaSão PauloBrazil

The re-use of glycerol from biodiesel industry as an alternative lubricant for making high-performance briquettes is ***,the technical performance of this agro-industrial residue is not *** study outlines,accordingly,the real risk of introducing glycerol into the co-briquetting of highly caloric by-products of *** production of hybrid briquettes consisted of pressing mixtures of residues of sugarcane and sorghum with the liquid additive at 10,20,and 30 wt.%in bench-scale hydraulic piston presser *** of the blend,briquettes containing the supplement at the highest level as part of their composition ended up being much more hygroscopic(20.10%)and less energetic(3.15 GJ m^(−3)).The explanation for the negative impact of glycerol on the thermomechanical behavior of briquettes would be overconcen-tration of additive capable of effectively defying compacting *** degree of compaction during co-briquetting has likely gone down quickly with a maximizing level of *** long as the additive is not able to lubricate the feedstock suitably,improbability of biomass particles to successfully bond together to form themselves into mechanically stable and energetically effective briquettes is *** lower density(273.80 kg m^(−3))and higher relaxation(22.75%),briquettes with glycerol at 30 wt.%generally were aesthetically ***,these products resisted no longer to handling,transportation,and *** lost their shape easily during emptying and shifting them,thus,releasing larger quanti-ties of biomass to the *** evidence of high-viscosity glycerol capable of limiting safe and effective production of high-performance briquettes for heating and power exists.

关键词： Additive Agro-residues Densification Biosolids Waste-to-energy

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