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Potential approaches to improve the outcomes of donation after cardiac death liver grafts

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World Journal of Transplantation 2016年第2期6卷 314-320页

作者： Paria Mahboub Adel Bozorgzadeh Paulo N martins Department of Surgery Groningen Transplant CenterUniversity Medical Center GroningenUniversity of Groningen Depart-ment of Surgery Division of TransplantationUniversity of Massachusetts

There is a growing discrepancy between the supply and demand of livers for transplantation resulting in high mortality rates on the waiting list. One of the options to decrease the mortality on the waiting list is to optimize organs with inferior quality that otherwise would be discarded. Livers from donation after cardiac death(DCD) donors are frequently discarded because they are exposed to additional warm ischemia time, and this might lead to primary-non-function, delayed graft function, or severe biliary complications. In order to maximize the usage of DCD livers several new preservation approaches have been proposed. Here, we will review 3 innovative organ preservation methods:(1) different ex vivo perfusion techniques;(2) persufflation with oxygen; and(3) addition of thrombolytic therapy. Improvement of the quality of DCD liver grafts could increase the pool of liver graft's for transplantation, improve the outcomes, and decrease the mortality on the waiting list.

关键词： Biliarycomplications Donation after cardiac death Organ preservation methods

Development of Blast Chilling Method for Cooked Meat Dishes

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Journal of Life Sciences 2013年第5期7卷 553-558页

作者： martins Rucins viesturs Rozenbergs t Imants Skrupskis Department of Nutrition Latvia University of Agriculture Jelgava L V-3001 Latvia

In order to ensure hygienic end-product realization, it is necessary as soon as possible to chill it by using efficient methods, such as blast chilling. Blast chill equipment provides food chilling optimum for 90-120 min to ＋3 ℃, reaching an internal temperature of food particularly for the perishable ready-to-eat product groups, including meat dishes, which are used as a reference model in this study. The aim of the research is to reduce duration of the chilling process at the same time providing equipollent microbiological indices of the product to be chilled, which could enable carrying out its storage in a chilled condition for several days. For this study, two types of meat dishes were used---pork goulash and minced meat sauce. Research results show that by combining the food safety standards and cost-efficiency, chilling final temperature of blast chilling was in the range of ＋3 ℃-＋1 1 ℃, followed by further storage in refrigerator. It was recommended to stop the blast chilling at ＋7 ℃＋1 1 ℃ temperature range, depending on the required shelf life for the ready-to-eat product. It is therefore essential to encourage the blast chilling process, reducing its duration and enabling to optimize the overall process.

关键词： Chilling blast chillers ready-to-eat products.

Agroecosystems, Landscapes and Knowledge of Family Farmers from AramaçáIsland, Upper Solimões Region, Amazon

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Agricultural Sciences 2018年第10期9卷 1369-1387页

作者： Ayrton Luiz Urizzi martins Sandra do Nascimento Noda Hiroshi Noda Lúcia Helena Pinheiro martins Elisabete Brocki Faculdade de Ciências Agrárias (FCA) Universidade Federal do Amazonas (UFAM) Manaus Brazil Instituto Nacional de Pesquisas da Amazô nia (INPA) Manaus Brazil Núcleo de Etnoecologia da Amazô nia (NETNO) Universidade Federal do Amazonas (UFAM) Manaus Brazil Escola Superior de Tecnologia (EST) Universidade do Estado do Amazonas (UEA) Manaus Brazil

The family farmer’s knowledge about floodplains agroecosystems dynamics is part of agrobiodiversity conservation cognitive strategies. This is because the conservation in floodplains is conditioned by the ecophysiological adaptation to the period and flood gradient of the agricultural lands and by the transformations promoted in the environment by the waters pulse. The aim of this study was to understand the cognitive strategies expressed in the organized meaning of agroecosystems by local knowledge, related to the geomorphological dynamics of the Aramaçá Island, Amazonas, Brazil. In this research, the Case Study and Ethnoecology were adopted as approach, taking the systemic complexity paradigm as a theoretical framework. To do so, it was necessary to establish a dialogue with the local knowledge through multitemporal analyses of satellite images, historical series of hydrological data, as well as cartographic documents of the locality. The floodplains amphibian mark, as a living organism in permanent autopoietic process, seems to be imprinted in the family farmer’s knowledge. In order to live in the floodplains and of floodplains, it is necessary, above all, to develop a cognitive ability capable of understanding not only the rivers action on the lands, but also that of the lands on the rivers as well. Therefore, the geomorphological dynamics in the spaces managed by the family farmers impose on them, risks and uncertainties, demanding from them strategies that allow knowing and dealing with this complexity.

关键词： Geomorphological Dynamics Ethnoecology Floodplains Amazonia

Genetic variability of Pumpkin Landraces in Brazilian Amazon

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Agricultural Sciences 2016年第12期7卷 822-833页

作者： Lúcia Helena Pinheiro martins Hiroshi Noda Maria Teresa Gomes Lopes Maria Silvesnizia Paiva Mendonça Ayrton Luiz Urizzi martins Núcleo de Etnoecologia da AmazÔ nia (NETNO) Universidade Federal do Amazonas Manaus Brazil Instituto Nacional de Pesquisas da AmazÔ nia (INPA) Manaus Brazil Faculdade de Ciências Agrárias (FCA) Universidade Federal do Amazonas Manaus Brazil

The family farm of the Upper Solim?es region has maintained the great genetic variability of the pumpkin (Cucurbita maxima Duchesne) by the in situ conservation of the landraces which are widely used as human food. The aim of this study was to estimate the current level of genetic variability of pumpkin landraces by means of estimation techniques of genetic parameters. Landraces areas samples were the family farming production units located in floodplains ecosystems of Benjamin Constant (Upper Solim?es River) and Iranduba (Lower Solim?es River), Amazonas. The split-plot designs were adopted at the treatments where the main plots were the five pumpkin landraces and one commercial cultivar. Each landrace was obtained six half sib families distributed in the sub-plots. Among the results of this study, it can be concluded that the genetic variation within the each landrace is greater than the genetic variation among the landraces. The qualitative morphological characteristics bring together half-sib families collected in geographically distant locations. It can be concluded that, through the estimation of genetic parameters, there is genetic variability among local cultivars collected in family farming of Benjamin Constant and Iranduba, Amazonas.

关键词： Amazon Agriculture Crop Genetic variability Cucurbita maxima Duchesne Genetic Resource Local Cultivars

Quantitative scintigraphic analysis of the apical seal in Thermafil/Topseal and Real Seal 1/Realseal filled root canals

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World Journal of Stomatology 2013年第2期2卷 30-34页

作者： Manuel Marques Ferreira Margarida Abrantes Eunice virgínia Carrilho Maria Filomena Botelho Department of Dentistry Faculty of Medicine University of Coimbra3000 Coimbra Portugal Department of Biophysics and Biomathematics IBILI-Faculty of Medicine University of Coimbra 3000 Coimbra Portugal

AIM: To investigate the microleakage of two different root canal obturation systems, using the nuclear medicine ***: Twenty-six single-rooted extracted teeth were selected. The crowns were sectioned to obtain 15-mm long root segments and each tooth was prepared using rotary Pro File instruments. The roots were divided into 2 experimental groups using Real Seal 1 and Real Seal sealer or Thermafil and Top Seal sealer as well as two control groups. On the 7th and the 28 th day the apices were submersed in a solution of 99 m TcPertechnetate during 3 h. The radioactivity was counted using a γ camera. RESULTS: The present study showed that none of the root canal-filled teeth was leakage free. The statistical analyses were made using Kruskal-Wallis and statistical significance was assessed using α = 0.05. Although apical leakage measured in counts per minute(cpm) in the Thermafil/Top Seal group was lower than in the Real Seal/Real Seal group(363 916 ± 180 707.7 cpm vs533 427 ± 414 020.6 cpm) on 7th day and(1 678 200 ± 567 217.4 cpm vs 2 240 518 ± 383 356.7 cpm) on 28 th day, there was no statistical difference(P > 0.05). In the Thermafil/Top Seal group and Real Seal 1/Real Seal group it was found that over time, the number of counts increased between 7 d and 28 d(363 916 ± 180 707.7 cpm vs 1 678 200 ± 567 217.4 cpm) and(533 427 ± 414 020.6 cpm vs 2 240 518 ± 383 356.7 cpm), respectively, with statistically significant differences(Thermafil/Top Seal group, P = 0.015 and Real Seal 1/Real Seal group, P = 0.036).CONCLUSION:Both carrier-based Realseal 1 and Thermafil techniques showed a similar sealing effect,but none of the materials was leakage free.

关键词： Microleakage Nuclear medicine Obturation Thermafil Realseal

Peroxisome proliferator-activated receptor-alpha activation and dipeptidyl peptidase-4 inhibition target dysbiosis to treat fatty liver in obese mice

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World Journal of Gastroenterology 2022年第17期28卷 1814-1829页

作者： Flavia Maria Silva-veiga Carolline Santos Miranda Isabela Macedo Lopes vasques-Monteiro Henrique Souza-Tavares Fabiane Ferreira martins Julio Beltrame Daleprane vanessa Souza-Mello Department of Anatomy Institute of BiologyState University of Rio de JaneiroLaboratory of MorphometryMetabolism and Cardiovascular DiseasesRio de Janeiro 20551-030Brazil Department of Clinical and Toxicology Analysis State University of Rio de JaneiroNutrition InstituteState University of Rio de JaneiroNutrition InstituteUniversity of Sao PauloRio de Janeiro 20551-030Brazil

BACKGROUND Obesity and comorbidities onset encompass gut dysbiosis,altered intestinal permeability,and *** that target gut dysbiosis can cope with obesity and nonalcoholic fatty liver disease(NAFLD)*** proliferator-activated receptor(PPAR)-alpha activation and dipeptidyl-peptidase-4(DPP-4)inhibition alleviate NAFLD,but the mechanism may involve gut microbiota modulation and merits further *** To address the effects of PPAR-alpha activation and DPP-4 inhibition(isolated or combined)upon the gut-liver axis,emphasizing inflammatory pathways in NAFLD management in high-fat-fed C57BL/6J *** Male C57BL/6J mice were fed a control diet(C,10%of energy as lipids)or a highfat diet(HFD,50%of energy as lipids)for 12 wk,when treatments started,forming the groups:C,HF,HFA(HFD+PPAR-alpha agonist WY14643,2.5 mg/kg body mass),HFL(HFD+DPP-4 inhibitor linagliptin,15 mg/kg body mass),and HFC(HFD+the combination of WY14643 and linagliptin).RESULTS The HFD was obesogenic compared to the C *** treatments elicited significant body mass loss,and the HFC group showed similar body mass to the C *** treatments tackled oral glucose intolerance and raised plasma glucagon-like peptide-1 *** metabolic benefits restored Bacteroidetes/Firmicutes ratio,resulting in increased goblet cells per area of the large intestine and reduced lipopolysaccharides concentrations in treated *** the gene level,treated groups showed higher intestinal Mucin 2,Occludin,and Zo-1 expression than the HFD *** reduced endotoxemia suppressed inflammasome and macrophage gene expression in the liver of treated *** observations complied with the mitigation of liver steatosis and reduced hepatic triacylglycerol,reassuring the role of the proposed treatments on NAFLD *** PPAR alpha activation and DPP-4 inhibition(isolated or combined)tackled NAFLD in dietinduced obese mice by restoration of gut-liver axis

关键词： Nonalcoholic fatty liver disease High-fat diet Peroxisome proliferator-activated receptor-alpha Dipeptidyl-peptidase-4-inhibitor Dysbiosis Inflammation

Evolution of costs of cancer drugs in a Portuguese hospital

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World Journal of Clinical Oncology 2014年第2期5卷 164-169页

作者： v.nia Peixoto Ana Luísa Faria Márcia Gon?alves Joana Macedo Sónia Rego Emilio Macías Aldiro Magano Márcia Loureiro António Araújo Department of Medical Oncology Centro Hospitalar de Entre Douro e Vouga Pharmacy Department Centro Hospitalar de Entre Douro e Vouga

AIM:To analyze the costs of cancer drugs administered in a Portuguese Hospital compared with the Karolinska Institute ***:To evaluate spending on cancer drugs, we retrospectively analyzed data on the overall costs of cancer drugs, obtained at the Department of Medical Oncology of the Centro Hospitalar de Entre Douro e vouga, between 2004 and 2010. In this comparative study we selected only drugs belonging to the following groups:chemotherapy, targeted therapy, immunotherapy and endocrine therapy. The selected drugs were further grouped according to their market placement year:≤ 1998, 1999 to 2002, 2003 to 2005, and 2006 to 2010. Drugs used as supportive therapy and bisphosphonates were ***:The overall costs of cancer drugs increased gradually between 2004 and 2008(from €1911947 to €3666284), with an increase in the number of patients treated during this period. The expenditure decreased in 2009(€3438155) and increased again in 2010(€3673116), but the costs increment was not the same as in previous years. Chemotherapy and targeted therapy were responsible for most of the expenditure. Drugs placed on the national market before 1999 accounted for more than 50% of the expenditure up to 2007. From 2008, these drugs represented less than 50% of the total expenditure. Cancer drugs placed between 1999 and 2002 accounted for 25%-35% of the costs in all the years studied, while drugs placed between 2003 and 2005 accounted for less than 30%. Drugs placed between 2006 and 2010 were responsible for less than 10% of the ***:In this study, older drugs were responsible for most of the expenditure up to 2007, which is in agreement with the Karolinska study.

关键词： Cancer Costs Drugs Economy Treatment

Intestinal complications in Brazilian patients with ulcerative colitis treated with conventional therapy between 2011 and 2020

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World Journal of Gastroenterology 2023年第8期29卷 1330-1343页

作者： Adalberta Lima martins Rodrigo Galhardi Gasparini Ligia Yukie Sassaki Rogerio Saad-Hossne Alessandra Mileni versut Ritter Tania Biatti Barreto Taciana Marcolino Claudia Yang Santos Espirito Santo Health Office State Office for Pharmaceutical AssistanceEspirito Santos 29056-030Brazil Department of Gastroenterology Specialized Medical CenterMarília 17502-020Brazil Department of Gastroenterology Sao Paulo State UniversityMedical SchoolBotucatu 18618-687Brazil Real World Evidence IQVIA BrazilSao Paulo 04719-002Brazil Department of Gastroenterology Takeda Pharmaceuticals BrazilSao Paulo 04794-000Brazil

BACKGROUND This was an observational, descriptive, and retrospective study from 2011 to 2020 from the Department of Informatics of the Brazilian Healthcare System *** To describe the intestinal complications(IC) of patients with ulcerative colitis(UC) who started conventional therapies in Brazil’s public Healthcare *** Patients ≥ 18 years of age who had at least one claim related to UC 10th revision of the International Statistical Classification of Diseases and Related Health Problems(ICD-10) code and at least 2 claims for conventional therapies were included. IC was defined as at least one claim of: UC-related hospitalization, procedures code for rectum or intestinal surgeries, and/or associated disease defined by ICD-10 codes(malignant neoplasia of colon, stenosis, hemorrhage, ulcer and other rectum or anus disease, megacolon, functional diarrhea volvulus, intussusception and erythema nodosum). Descriptive statistics, annual incidence, and incidence rate(IR) [per 100 patient-years(PY)] over the available follow-up period were *** In total, 41229 UC patients were included(median age, 48 years;65% women) and the median(interquartile range) follow-up period was 3.3(1.8-5.3) years. Conventional therapy used during follow-up period included: mesalazine(87%), sulfasalazine(15%), azathioprine(16%) or methotrexate(1%) with a median duration of 1.9(0.8-4.0) years. Overall IR of IC was 3.2 cases per 100 PY. Among the IC claims, 54% were related to associated diseases, 20% to procedures and 26% to hospitalizations. The overall annual incidence of IC was 2.9%, 2.6% and 2.5% in the first, second and third year after the first claim for therapy(index date), respectively. Over the first 3 years, the annual IR of UC-related hospitalizations ranged from 0.8% to 1.1%;associated diseases from 0.9% to 1.2%-in which anus or rectum disease, and malignant neoplasia of colon were the most frequently reported;and procedure events from 0.6% to 0.7%, bein

关键词： Ulcerative colitis Brazil Conventional therapy Intestinal complications Real world Public healthcare

Management of liver transplantation biliary stricture: Results from a tertiary hospital

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World Journal of Gastrointestinal Endoscopy 2015年第7期7卷 747-757页

作者： Fernanda Prata martins Michel Kahaleh Angelo P Ferrari Endoscopy Unit Hospital Israelita Albert Einstein Division of Gastroenterology and Hepatology Department of Medicine Weill Cornell Medical College Division of Gastroenterology Universidade Federal de Sao Paulo

AIM: To review results of endoscopic treatment for anastomotic biliary strictures after orthotopic liver transplantation(OLT) during an 8-year period. METHODS: This is a retrospective review of all endoscopic retrograde cholangiopancreatographys(ERCPs) performed between May 2006 and June 2014 in deceased OLT recipients with anastomotic stricture at a tertiary care hospital. Patients were divided into 2 groups, according to the type of stent used(multiple plastic or covered self-expandable metal stents), which was chose on a case-by-case basis and their characteristics. The primary outcome was anastomotic stricture resolution rate determined if there was no more than a minimum waist at cholangiography and a 10 mm balloon could easily pass through the anastomosis with no need for further intervention after final stent removal. Secondary outcomes were technical successrate, number or ERCPs required per patient, number of stents placed, stent indwelling, stricture recurrence rate and therapy for recurrent anastomotic biliary stricture(AS). Stricture recurrence was defined as clinical laboratorial and/or imaging evidence of obstruction at the anastomosis level, after it was considered completely treated, requiring subsequent interventional ***: A total of 195 post-OLT patients were assessed for eligibility. One hundred and sixty-four(164) patients were diagnosed with anastomotic biliary stricture. ERCP was successfully performed in 157/164(95.7%) patients with AS, that were treated with either multiple plastic(n = 109) or metallic billiary stents(n = 48). Mean treatment duration, number of procedures and stents required were lower in the metal stent group. Acute pancreatitis was the most common procedure related complication, occurring in 17.1% in the covered self-expandable metal stents(c SEMS) and 4.1% in the multiple plastic stent(MPS) group. Migration was the most frequent stent related complication, observed in 4.3% and 5.5%(c SEMS and MPS respectively

关键词： Biliary stricture Benign Liver transplant Endoscopic retrograde cholangiopancreatographys Endoscopic treatment Plastic stent Self-expandablemetal stent