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Extrahepatic cholestasis associated with paracoccidioidomycosis:Challenges in the differential diagnosis of biliopancreatic neoplasia

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2531-2540页

作者： Jose Sebastiao dos Santos Vitor de Moura Arrais William Jose Rosseto Ferreira ricardo ribeiro correa filho Mariangela Ottoboni Brunaldi Rafael Kemp Ajith Kumar Sankanrakutty Jorge Elias Junior Fernando Bellissimo-Rodrigues Roberto Martinez Edson Zangiacomi Martinez Jose Celso Ardengh Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP) Departamento de Cirurgia e AnatomiaRibeirao Preto 14049-900Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de PatologiaRibeirao Preto 14048900Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Imagens MédicasHematologia e Oncologia ClínicaRibeirao Preto 14048900Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Medicina SocialRibeirao Preto 14015-010Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Clínica MédicaRibeirao Preto 14015-010Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Cirurgia e AnatomiaRibeirao Preto 14049-900Sao PauloBrazil and Hospital MoriahServico de Endoscopia DigestivaSao Paulo 04084-002Sao PauloBrazil

BACKGROUND Paracoccidioidomycosis(PCM)may involve the hepatic pedicle and peripan creatic lymph nodes,cause damage to the bile duct and manifest,exceptionally,in combination with extrahepatic cholestasis(EHC),making investigation and treatment *** To investigate the management of patients with visceral PCM admitted with *** All patients diagnosed with PCM treated in a public,tertiary teaching hospital between 1982 and 2020 were retrospectively *** also identified with EHC were allocated to two groups according to the treatment approach for the purpose of comparing clinical,laboratory,and imaging findings,resources used for etiological diagnosis,treatment results,and *** analyses were performed using the linear mixed-effects model(random and fixed effects),which was adjusted using the PROC MIXED procedure of the SAS®9.0 software,and Fisher’s exact *** Of 1645 patients diagnosed with PCM,40(2.4%)had *** these,20(50.0%)lived in the rural area and 29(72.5%)were men,with a mean age of 27.1 years(3-65 years).Jaundice as first symptom and weight loss of at least 10 kg were observed in 16 patients(40.0%),and a mass in the head of the pancreas was observed in 8(20.0%).The etiological diagnosis was made by tissue collection during surgery in 4 cases(10.0%)and by endoscopic methods in 3 cases(7.5%).Twenty-seven patients(67.5%)received drug treatment alone(Group 1),whereas 13(32.5%)underwent endoscopic and/or surgical procedures in combination with drug treatment(Group 2).EHC was significantly reduced in both groups(40.7% in Group 1,with a mean time of 3 months;and 38.4% in Group 2,with a mean time of 7.5 months),with no statistically significant difference between *** recurrence rates,associated mainly with treatment nonadherence,were similar in both groups:37% in Group 1 and 15.4% in Group *** mortality rate was 18.5% in Group 1 and 23% in Group 2,with survival estimates of 71.3% and 72.5%,respectively,with

关键词： Cholestasis Jaundice Obstructive Blastomycosis Paracoccidioides Diagnosis Treatment

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Mini-cutting technique for Khaya anthotheca: selection of suitable IBA concentration and nutrient solution for its vegetative propagation

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Journal of Forestry Research 2018年第1期29卷 73-84页

作者： Joamir Barbosa filho Maria Angélica Di Carvalho Leandro Silva de Oliveira Enéas ricardo Konzen Gilvano Ebling Brondani College of Forestry Federal University of Mato Grosso(UFMT) Institute of Agronomic Sciences Federal University of Minas Gerais (UFMG) Department of Forest Sciences Federal University of Lavras (UFLA)

Khaya anthotheca is a hardwood species from Africa and recently introduced to Brazil. This species yields high-quality wood for diverse applications, but little has been done toward an effective propagation method for large-scale production in nurseries. We evaluated the effects of different concentrations of macro and micronutrients（i.e., 100, 50 and 25% of the concentration of a referenced solution） combined with indole-3-butyric acid（IBA） at 0 and 2 g L-1 on the survival rate of mini-stumps and the survival and adventitious rooting of K. anthotheca mini-cuttings. The mini-stumps were grown from a source of seeds imported from Ghana, West Africa. The ministumps survived at a high rate（97%）. Consistently high shoot yields were obtained from the mini-stumps（average of 1.8 per mini-stump）. High survival percentage of minicuttings and adventitious rooting were observed when solutions with 100 and 50% of the nutrients concentration were combined with 2 g L-1 IBA. Histological sections analyzed through optical microscopy indicated the tissues from mini-cutting stems were juvenile, which might have stimulated adventitious rooting. These results have important implications for further work aimed at establishing propagation strategies for K. anthotheca, which are of prime importance for assisting breeding programs of this species.

关键词： African mahogany Seminal mini-garden Adventitious rooting Juvenile tissue Mini-stump

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Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease

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World Journal of Gastroenterology 2008年第40期14卷 6224-6227页

作者： Guilherme Eduardo Gonalves Felga Fernando Marcuz Silva ricardo correa Barbuti Tomás Navarro-Rodriguez Schlioma Zaterka Jaime Natan Eisig Department of Gastroenterology University of So PauloSchool of Medicine

AIM: To establish the efficacy and safety of a 7-d therapeutic regimen using omeprazole,bismuth subcitrate,furazolidone and amoxicillin in patients with peptic ulcer disease who had been previously treated with other therapeutic regimens without ***: Open cohort study which included patients with peptic ulcer who had previously been treated unsuccessfully with one or more eradication *** therapeutic regimen consisted of 20 mg omeprazole,240 mg colloidal bismuth subcitrate,1000 mg amoxicillin,and 200 mg furazolidone,taken twice a day for 7 *** were considered as eradicated when samples taken from the gastric antrum and corpus 12 wk after the end of treatment were negative for Helicobacter pylori (H pylori) (rapid urease test and histology).Safety was determined by the presence of adverse ***: Fifty-one patients were *** eradication rate was 68.8% (31/45).Adverse effects were reported by 31.4% of the patients,and these were usually considered to be slight or moderate in the majority of the *** patients had to withdraw from the treatment due to the presence of severe adverse ***: The association of bismuth,furazolidone,amoxicillin and a proton-pump inhibitor is a valuable alternative for patients who failed to respond to other eradication *** is an effective,cheap and safe option for salvage therapy of positive patients.

关键词： Gastric ulcer Duodenal ulcer Helicobacter pylori Retreatment Furazolidone

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Effectiveness of rotavirus vaccines against rotavirus infection and hospitalization in Latin America: systematic review and metaanalysis

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Infectious Diseases of Poverty 2016年第1期5卷 764-775页

作者： Victor S.Santos Daniella P.Marques Paulo R.S.Martins-filho Luis E.Cuevas ricardo Q.Gurgel Postgraduate Program in Health Sciences Federal University of SergipeRua Cláudio Batista s/nAracajuSergipe Zip code:49060-108Brazil Department of Medicine Federal University of SergipeAracajuSergipeBrazil Investigative Pathology Laboratory Federal University of SergipeAracajuSergipeBrazil Liverpool School of Tropical Medicine LiverpoolUK

Background:Rotavirus was the leading cause of childhood diarrhoea-related hospitalisations and death before the introduction of rotavirus ***:We describe the effectiveness of rotavirus vaccines to prevent rotavirus infections and hospitalizations and the main rotavirus strains circulating before and after vaccine introduction through a systematic review and meta-analysis of studies published between 1990 and 2014.203 studies were included to estimate the proportion of infections due to rotavirus and 10 to assess the impact of the vaccines.41 of 46 studies in the post-vaccination period were used for meta-analysis of genotypes,20 to calculate VE against infection,eight for VE against hospitalisation and seven for VE against severe ***:24.3%(95%CI 22.1–26.5)and 16.1%(95%CI 13.2–19.3)of cases of diarrhoea were due to rotavirus before and after vaccine introduction,*** most prevalent G types after vaccine introduction were G2(51.6%,95%CI 38–65),G9(14.5%,95%CI 7–23)and G1(14.2%,95%CI 7–23);while the most prevalent P types were P[4](54.1%,95%CI 41–67)and P[8](33%,95%CI 22–46).G2P[4]was the most frequent genotype combination after vaccine *** was 53%(95%CI 46–60)against infection,73%(95%CI,66–78)against hospitalisation and 74%(95%CI,68.0–78.0)against severe *** in hospitalisations and mortality due to diarrhoea were observed in countries that adopted universal rotavirus ***:Rotavirus vaccines are effective in preventing rotavirus-diarrhoea in children in Latin *** vaccines were associated with changes in genotype distribution.

关键词： Rotavirus vaccines Rotavirus vaccine effectiveness Rotavirus genotype Meta-analysis Latin America

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The influence of porosity on tablet subdivision

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Particuology 2020年第6期18卷 192-196页

作者： Maira T.Teixeira Livia L.Sa-Barreto Izabel C.Silva Tais Gratieri Guilherme M.Gelfuso ricardo N.Marreto Mariana Landin Marcilio Cunha-filho Laboratory of Food Drugs and Cosmetics(LTMAC)University of Brasilia(UnB)70910-900 BrasiliaDFBrazil Laboratory of Nanosystems and Drug Delivery Devices(NanoSYS) Federal University of GoiasGoianiaGO.Brazil Departamento de Farmacologia Farmacia y Tecnologia Farmaceutica1+D Farma Group(Gl-1645)Universidade de Santiago de CompostelaSpain

A tablet microstructure,especially the porosity,is a crucial parameter that influences the mechanical ***,tablet subdivisions were studied as a functi on of tablet *** tablets were manufactured in the presenee of different diluents,namely microcrystalline cellulose,LudipressR,or lactose ***,the add让ion of Camphor was investigated,which was thereafter sublimated with a view of obtaining tablets having varying degrees of *** assays were corre lated to the subdivision performs *** increase in porosity reduced the hardness and increased the tablet friability,adversely impacting the *** all the excipients,an increase in relative porosity>90%represented the threshold level from which an inadequate subdivision *** in crease in tablet porosity led to a reduction in mechanical resista nee,which,combined with a heterogeneous and disc on tinuous distribution of pores within the matrix,resulted in poor subdivision *** trolling tablet porosity is an important consideration when designing tablets having a subdivision purpose.

关键词： Tablet subdivision Porosity Mass variation Mass loss Friability Hardness

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Levels of Trihalomethanes in Stored Water from High and Fundamental Schools:Comparison between Two Temporal Data Sets

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Journal of Water Resource and Protection 2018年第6期10卷 577-586页

作者： ricardo Andreola Anny Rosi Mannigel Graciene de Souza Bido Thaise Moser Teixeira Edison Schmidt filho Jussara ricardo de Oliveira Andre ribeiro da Costa Rebecca Manesco Paixao Centro Universitário de Maringá(UNICESUMAR) MaringáBrazil Universidade Estadual de Maringá(UEM) MaringáBrazil

Epidemiological studies have been investigating the relationship between chlorination byproducts exposure and cancer. Studies showed the incidence of colon, rectum and bladder cancer in laboratory animals when halogenated byproducts were administered to them, such as trihalomethanes. Based on this fact, in this work, two data sets of water quality parameters were analyzed with focus on total trihalomethanes (THMt). These two data sets are from two different time periods (one in 2014 and other in 2017). All the samples were collected in the same months, in both data sets. The samples were taken from its same corresponding sampling points in both periods of time. Trihalomethanes (THMs) are undesired byproducts of chlorination and its formation occurs when the chlorine used in water treatment reacts with natural organic matter, which is present in natural waters, during the disinfection process. The aim of this research was to investigate the THMs levels in storage water from the chlorination performed by the Water Treatment Station (WTS) of the Maringá-Parana-Brazil;also, to compare the results obtained with the maximum allowable values (MAVs) established by the Consolidation Resolution n.05/2017, current law of water quality in Brazil. Water samples were collected in eight high and fundamental schools of Maringá-Paraná-Brazil and analyzed through the gas chromatography method by the use of mass spectrometry detector with purge-and-trap concentrator (GC-MS) for THM. Furthermore, parameters such as pH and residual chlorine were analyzed following the methodology proposed by the Standard Methods for the Examination of Water and Wastewater. The study results to THMt show that the maximum value of 21.5 μg/L obtained is within the MAV of 100 μg/L. Chloroform was the compound with higher concentrations in all samples in THMt analysis. Results of residual chlorine and pH also are within the MAVs. Studies like this are important to continuous monitoring of the water quality d

关键词： Water Treatment Chlorination Byproducts Cancer Tap Water

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Health production and risk of obesity among Chilean adolescents: Understanding health related behaviors in youth

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Health 2012年第12期4卷 1413-1419页

作者： Paulina correa-Burrows Raquel Burrows ricardo Uauy Cecilia Albala Department of Applied Economics II Rey Juan Carlos University Madrid Spain Institute of Nutrition and Food Technology University of Chile Santiago de Chile Chile

Background: Adolescent obesity is associated with high cardiovascular and metabolic risk. Western diet and reduced physical activity are strong environmental determinants. The “Health Production” model posits that individuals born with a certain amount of health stock, which depreciates over life, but can be augmented by individual behaviors, including exercise and dieting. Objective: To study the association between health production and obesity in a random sample of 1692 Chilean adolescents (14.8 ± 0.7 years old), and to study the effect of gender and socioeconomic characteristics on health production. Method: We used an indicator that considered the quality of food intake and physical activity, establishing three categories: good (GHP), intermediate (IHP) and poor health producers (PHP). Multivariate analysis was used to study the odds of obesity and good health production. Results: There was 31% of GHP, 32% of IHP and 38% of PHP. Obesity (Adj. OR: 1.59;95%CI: 1.04 - 2.42) and abdominal obesity (Adj. OR: 2.24;95%CI: 1.35 - 3.40) were significantly higher in the PHP group, compared to the GHP and IHP group. Health production was significantly associated with socioeconomic factors and gender. Female sex and coming from a less wealthy household significantly reduced the odds of good health production. Conclusions: Poor health production in adolescence, as defined by food intake and physical activity, depreciates individuals’ “health stock”, increasing the risk of obesity. In our sample, health production was strongly associated with socio-economic factors and gender.

关键词： Adolescent Health Adolescent Obesity Health Behavior Health Promotion Non-Communicable Diseases Chile

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Stability of Brazilian Seasonally Dry Forests under Climate Change: Inferences for Long-Term Conservation

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American Journal of Plant Sciences 2013年第4期4卷 792-805页

作者： Rosane G. Collevatti Matheus Souza Lima-ribeiro José Alexandre F. Diniz-filho Guilherme Oliveira ricardo Dobrovolski Levi Carina Terribile Departamento de Ecologia Instituto de Ciências Biológicas Universidade Federal de Goiás Goiania Brazil Laboratório de Genética & Biodiversidade Instituto de Ciências Biológicas Universidade Federal de Goiás Goiania Brazil Laboratório de Macroecologia Universidade Federal de Goiás Jataí Brazil

We identified climatically stable areas of seasonally dry forests (SDFs) from Central Brazil through time and assessed the effectiveness of the current reserves network in representing these climatically stable areas, as well as areas of high suitability in the present or in the future only. We used an ensemble approach based on several methods for ecological niche modelling (ENMs) to obtain potential distributions 16 SDF’ species for past (last glacial maximum), present, and future (end of XXI century) climate scenarios. We then computed how many current Brazilian reserves matched both stable areas (suitable areas for all time periods), present and future geographical ranges alone for each species, in a multi-level gap analysis. We found range shifts due to climate changes for SDF’ species. Although the future geographical range and stable areas for all analyzed species matched at least with one reserve, many protected areas will lose importance in protecting suitable areas for species in the future. Moreover, the current Brazilian reserves cover only a small amount of their climatically stable areas. However, some reserves will be suitable for many SDF’ species (90%) at the same time, but climatically stable for only half of them. Our findings show that vegetation community from SDFs may persist in Brazilian territories until the end of XXI century, and challenges about long-term conservation of the SDFs may be partially reached with already existing Brazilian reserve network, however the reserves should be connected to permit habitat tracking.

关键词： Cerrado Biome Ecological Niche Modelling Global Climate Change Quaternary Climate Change Gap Analysis

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A large epeiric methanogenic Bambuí sea in the core of Gondwana supercontinent?

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Geoscience Frontiers 2021年第1期12卷 203-218页

作者： Sergio Caetano-filho Pierre Sansjofre Magali Ader Gustavo M.Paula-Santos Cristian Guacaneme Marly Babinski Carolina Bedoya-Rueda Matheus Kuchenbecker Humberto L.S.Reis ricardo I.F.Trindade Universidade de Sao Paulo Instituto de GeocienciasRua do Lago562-Sao Paulo05508-080Brazil MNHN Sorbonne UniversiteCNRS UMR 7590Institut de Mineralogiede Physique des Materiaux et de Cosmochimie75005ParisFrance Universite de Paris Institut de Physique du Globe de ParisCNRSF-75005ParisFrance Universidade Estadual de Campinas Instituto de GeocienciasRua Carlos Gomes250-Campinas13083-855Brazil Universidade Federal dos Vales do Jequitinhonha e Mucuri Instituto de Ciencia e TecnologiaLaboratorio de Estudos TectonicosRodovia MGT 367Km 583-Diamantina39100-000Brazil Universidade Federal de Ouro Preto Departamento de Geologia-Escola de MinasLaboratiorio de Modelagem TectonicaCampus Morro do Cruzeiro-Ouro Preto35400-000Brazil Universidade de Sao Paulo Instituto de AstronomiaGeofísica e Ciencias AtmosfericasRua do Matao1226-Sao Paulo05508-090Brazil

Carbon isotope compositions of both sedimentary carbonate and organic matter can be used as key proxies of the global carbon cycle and of its evolution through time,as long as they are acquired from waters where the dissolved inorganic carbon(DIC)is in isotope equilibrium with the atmospheric ***,in shallow water platforms and epeiric settings,the influence of local to regional parameters on carbon cycling may lead to DIG isotope variations unrelated to the global carbon *** may be especially true for the terminal Neoproterozoic,when Gondwana assembly isolated waters masses from the global ocean,and extreme positive and negative carbon isotope excursions are recorded,potentially decoupled from global *** improve our understanding on the type of information recorded by these excursions,we investigate the pairedδ^13Ccarb andδ^13Corg evolution for an increasingly restricted late Ediacaran-Cambrian foreland system in the West Gondwana interior:the basal Bambui *** succession represents a 1~(st)-order sedimentary sequence and records two majorδ^13Ccarb excursions in its two lowermost lower-rank *** basal cap carbonate interval at the base of the first sequence,deposited when the basin was connected to the ocean,hosts antithetical negative and positive excursions forδ^13Ccarb andδ^13Corg,respectively,resulting inΔ^13C values lower than 25‰.From the top of the basal sequence upwards,an extremely positiveδ^13Ccarb excursion is coupled toδ^13Corg,reaching values of+14‰and-14‰,*** positive excursion represents a remarkable basin-wide carbon isotope feature of the Bambui Group that occurs with only minor changes inΔ^13C values,suggesting change in the DIC isotope *** argue that this regional isotopic excursion is related to a disconnection between the intrabasinal and the global carbon *** extreme carbon isotope excursion may have been a product of a disequilibria between the basin DIC and atmospheric CO2

关键词： Methanogenesis Ediacaran Cambrian Carbon isotopes Sao Francisco Basin Bambui Group

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Opinion: How to manage subepithelial lesions of the upper gastrointestinal tract?

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World Journal of Gastrointestinal Endoscopy 2015年第18期7卷 1262-1267页

作者： Matheus Cavalcante Franco ricardo Teles Schulz Fauze Maluf-filho Digestive Endoscopy Unit Cancer Institute of Sao Paulo University

Subepithelial lesions(SELs) in the upper gastrointestinal(GI) tract are relatively frequent findings in patients undergoing an upper GI endoscopy. These tumors, which are located below the epithelium and out of reach of conventional biopsy forceps, may pose a diagnostic challenge for the gastroenterologist, especially when SELs are indeterminate after endoscopy and endoscopic ultrasound(EUS). The decision to proceed with further investigation should take into consideration the size, location in the GI tract, and EUS features of SELs. Gastrointestinal stromal tumor(GIST) is an example of an SEL that has a well-recognized malignant potential. Unfortunately, EUS is not able to absolutely differentiate GISTs from other benign hypoechoic lesions from the fourth layer, such as leiomyomas. Therefore, EUS-guided fine needle aspiration(EUS-FNA) is an important tool for correct diagnosis of SELs. However, small lesions(size < 2 cm) have a poor diagnostic yield with EUS-FNA. Moreover, studies with EUS-core biopsy needles did not report higher rates of histologic and diagnostic yields when compared with EUS-FNA. The limited diagnostic yield of EUS-FNA and EUS-core biopsies of SELs has led to the development of more invasive endoscopic techniques for tissue acquisition. There are initial studies showing good results for tissue biopsy or resection of SELs with endoscopic submucosal dissection, suck-ligate-unroof-biopsy, and submucosal tunneling endoscopic resection.

关键词： Gastrointestinal neoplasm Gastrointestinal endosco

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