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1Acute calculous cholecystitis: Review of current best practices显示文摘Acute calculous cholecystitis(ACC) is the most frequent complication of cholelithiasis and represents one-third of all surgical emergency hospital admissions, many aspects of the disease are still a matter of debate. Knowledge of the current evidence may allow the surgical team to develop practical bedside decision-making strategies, aiming at a less demanding procedure and lower frequency of complications. In this regard, recommendations on the diagnosis supported by specific criteria and severity scores are being implemented, to prioritize patients eligible for urgency surgery. Laparoscopic cholecystectomy is the best treatment for ACC and the procedure should ideally be performed within 72h. Early surgery is associated with better results in comparison to delayed surgery. In addition, when to suspect associated common bile duct stones and how to treat them when found are still debated. The antimicrobial agents are indicated for high-risk patients and especially in the presence of gallbladder necrosis. The use of broad-spectrum antibiotics and in some cases with antifungal agents is related to better prognosis. Moreover, an emerging strategy of not converting to open, a difficult laparoscopic cholecystectomy and performing a subtotal cholecystectomy is recommended by adept surgical teams. Some authors support the use of percutaneous cholecystostomy as an alternative emergency treatment for acute Cholecystitis for patients with severe comorbidities.Carlos Augusto Gomes Cleber Soares Junior Salomone Di Saveiro Massimo Sartelli Michel Denis Kelly Camila Couto Gomes Felipe Couto Gomes Lívia Dornellas Correa Camila Brandao Alves Samuel de Fádel Guimaraes 2017World Journal of Gastrointestinal Surgery2017,9,5:18
2Characterization of monocarboxylate transporter activity in hepatocellular carcinoma显示文摘AIM: To assess the immunoexpression of hypoxiarelated markers in samples from cirrhosis and primary and metastatic hepatocellular carcinoma(HCC).METHODS: From a total of 5836 autopsies performed at the Pathology Department- University of Sao Paulo School of Medicine Hospital- from 2003 to 2009, 188 presented primary liver tumors. Immunohistochemical reactivity for monocarboxylate transporters(MCTs)-1, 2 and 4, CD147 and glucose transporter-1(GLUT1)was assessed in necropsies from 80 cases of HCC. Data were stored and analyzed using the IBM SPSS statistical software(version 19, IBM Company, Armonk, NY). All comparisons were examined for statistical significance using Pearson's χ2 test and Fisher's exact test(when n < 5). The threshold for significant P values was established as P < 0.05.RESULTS: Plasma membrane expression of MCT4 and overall expression of GLUT1 showed progressively higher expression from non-neoplastic to primary HCC and to metastases. In contrast, overall expression of MCT2 was progressively decreased from non-neoplastic to primary HCC and to metastases. MCT1(overall and plasma membrane expression), MCT2 and CD147 plasma membrane expression were associated with absence of cirrhosis, while plasma membrane expression of CD147 was also associated with absence of HBV infection. MCT2 overall expression was associated with lower liver weight, absence of metastasis and absence of abdominal dissemination. Additionally, MCT4 plasma membrane positivity was strongly associated with Ki-67 expression. CONCLUSION: MCT4 and GLUT1 appear to play a role in HCC progression, while MCT2 is lost during progression and associated with better prognosis.Venncio AF Alves Céline Pinheiro Filipa Morais-Santos Aloisio Felipe-Silva Adhemar Longatto-Filho Fátima Baltazar 2014World Journal of Gastroenterology2014,20,33:11
3Associations of sense of coherence with psychological distress and quality of life in inflammatory bowel disease显示文摘AIM:To investigate the relationship between sense of coherence,psychological distress and health related quality of life in inflammatory bowel disease(IBD).METHODS:This cross-sectional study enrolled a consecutive sample of 147 IBD(aged 45.1 ± 14.1 years; 57.1% female) patients recruited from a tertiary gastroenterology service.Sixty-four participants met diagnostic criteria for Crohn's disease,while eightythree patients had ulcerative colitis.Socio-demographic data(education,age,race,gender,gross monthly income and marital status),disease-related variables(illness activity,relapse rate in past 2 years,history of surgery and time since diagnosis),sense of coherence(Antonovsky's SOC scale),psychological distress symptoms(Hospital Anxiety and Depression Scale) and health-related quality of life(HRQo L; WHOQOLBref) were assessed.Hierarchical multiple regression analyses were performed to identify factors that are independently associated with psychological distress and HRQo L in patients with IBD and to provide indications for possible moderating or mediating effects.In addition,formal moderation and mediation analyses(Sobel tests) were performed to confirm potential moderators/mediators of the relationship between SOC,psychological distress symptoms and HRQoL.RESULTS:Lower SOC scores(std beta=-0.504; P < 0.001),female gender(std beta = 0.176; P = 0.021) and White race(std beta = 0.164; P = 0.033) were independently associated with higher levels of depressive symptoms,while lower levels of SOC(std beta =-0.438; P < 0.001) and higher relapse rate(std beta = 0.161; P = 0.033) were independently associated with more severe anxiety symptoms.A significant interaction between time since diagnosis and SOC was found with regard to the severity of depressive or anxiety symptoms,as the interaction term(time since diagnosis X SOC) had beta coefficients of-0.191(P = 0.009) and-0.172(P = 0.026),respectively.Lower levels of anxiety symptoms(std beta =-0.369; P < 0.001),higher levels of SOC(std beta = 0.231; P = 0.016) and non-White race(std beta =-0.229; P = 0.006),i.e.,mixed-race,which represented the reference category,were independently associated with higher levels of overall HRQoL.Anxiety symptoms were the most potent independent correlate of most aspects of HRQoL.In addition,anxiety mediated the association between SOC and satisfaction with health,as well as its relationship with physical,mental,and social relations HRQo L.Depressive symptoms also mediated the association between SOC and mental HRQoL.CONCLUSION:Our data indicated that SOC is an important construct,as it influences psychological distress and has significant albeit indirect effects on several HRQoL domains in IBD.Thiago H Freitas Elias Andreoulakis Gilberto S Alves Hesley LL Miranda Lúcia LBC Braga Thomas Hyphantis André F Carvalho 2015World Journal of Gastroenterology2015,21,21:10
4Open abdomen in gastrointestinal surgery:Which technique is the best for temporary closure during damage control?显示文摘AIM To compare the 3 main techniques of temporary closure of the abdominal cavity,vacuum assisted closure(vacuum-assisted closure therapy- VAC),Bogota bag and Barker technique,in damage control surgery.METHODS After systematic review of the literature,33 articles were selected to compare the efficiency of the three procedures.Criteria such as cost,infections,capacity of reconstruction of the abdominal wall,diseases associated with the technique,among others were analyzed.RESULTS The Bogota bag and Barker techniques present as advantage the availability of material and low cost,what is not observed in the VAC procedure.The VAC technique is the most efficient,not only because it reduces the tension on the boarders of the lesion,but also removes stagnant fluids and debris and acts at cellular level increasing cell proliferation and division.Bogota bag presents the higher rates of skin laceration and evisceration,greater need for a stent for draining fluids and wash-ups,higher rates of intestinal adhesion to the abdominal wall.The Barker technique presents lack of efficiency in closing the abdominal wall and difficulty on maintaining pressure on the dressing.The VAC dressing can generate irritation and dermatitis when the drape is applied,in addition to pain,infection and bleeding,as well as toxic shock syndrome,anaerobic sepsis and thrombosis.CONCLUSION The VAC technique,showed to be superior allowing a better control of liquid on the third space,avoiding complications such as fistula with small mortality,low infection rate,and easier capability on primary closure of the abdominal cavity.Marcelo A F Ribeiro Junior Emily Alves Barros Sabrina Marques de Carvalho Vinicius Pereira Nascimento José Cruvinel Neto Alexandre Zanchenko Fonseca 2016World Journal of Gastrointestinal Surgery2016,8,8:9
5Non-pharmacological cognitive intervention for aging and dementia:Current perspectives显示文摘In recent years, cognitive difficulties associated with normal aging and dementia have been receiving increased attention from both public and scientific communities. With an increase in overall lifespan, promoting healthy cognition has become a priority and a necessity for minimizing and preventing individual and societal burdens associated with cognitive dysfunctions in the elderly. The general awareness concerning the efficacy of preventive(e.g., lifestyles) and palliative treatment strategies of cognitive impairments, related to either healthy or unhealthy trajectories in cognitive aging, is continuously rising. There are several therapeutic strategies which can be broadly classified as either pharmacological or non-pharmacological/psychosocial. In face of the modest evidence for success of pharmacological treatments, especially for dementia related impairments, psychosocial interventions are progressively considered as a complementary treatment. Despite the relative spread of psychosocial interventions in clinical settings, research in this area is rather scarce with evidence for success of these therapies remaining controversial. In this work we provide an evidence based perspective on cognitive intervention(s) for healthy aging, pre-dementia(mild cognitive impairment), and dementia populations. Current evidence and future directions for improving cognitive functions in the elderly are discussed as well.Jorge Alves Rosana Magalh?es álvaro Machado óscar F Gon?alves Adriana Sampaio Agavni Petrosyan 2013World Journal of Clinical Cases2013,1,8:8
6Concordance of non-invasive mechanical and serum tests for liver fibrosis evaluation in chronic hepatitis C显示文摘AIM To determine the sensitivity and specificity of liver stiffness measurement(LSM) and serum markers(SM) for liver fibrosis evaluation in chronic hepatitis C.METHODS Between 2012 and 2014,81 consecutive hepatitis C virus(HCV) patients had METAVIR score from liver biopsy compared with concurrent results from LSM [transient elastography(TE) [FibroS can~/ARFI technology(Virtual Touch~)] and SM [FIB-4/aspartate aminotransferase-toplatelet ratio index(APRI)].The diagnostic performance of these tests was assessed using receiver operating characteristic curves.The optimal cut-off levels of each test were chosen to define fibrosis stages F ≥ 2,F ≥ 3 and F = 4.The Kappa index set the concordance analysis.RESULTS Fifty point six percent were female and the median age was 51 years(30-78).Fifty-six patients(70%) weretreatment-na?ve.The optimal cut-off values for predicting F ≥ 2 stage fibrosis assessed by TE were 6.6 kP a,for acoustic radiation force impulse(ARFI) 1.22 m/s,for APRI 0.75 and for FIB-4 1.47.For F ≥ 3 TE was 8.9 kP a,ARFI was 1.48 m/s,APRI was 0.75,and FIB-4 was 2.For F = 4,TE was 12.2 kP a,ARFI was 1.77 m/s,APRI was 1.46,and FIB-4 was 3.91.The APRI could not distinguish between F2 and F3,P = 0.92.The negative predictive value for F = 4 for TE and ARFI was 100%.Kappa index values for F ≥ 3 METAVIR score for TE,ARFI and FIB-4 were 0.687,0.606 and 0.654,respectively.This demonstrates strong concordance between all three screening methods,and moderate to strong concordance between them and APRI(Kappa index = 0.507).CONCLUSION Given the costs and accessibility of LSM methods,and the similarity with the outcomes of SM,we suggest that FIB-4 as well as TE and ARFI may be useful indicators of the degree of liver fibrosis.This is of particular importance to developing countries.Denise C Paranaguá-Vezozzo Adriana Andrade Daniel F C Mazo Vinicius Nunes Ana L Guedes Taisa G Ragazzo Renata Moutinho Lucas S Nacif Suzane K Ono Venancio A F Alves Flair J Carrilho 2017World Journal of Hepatology2017,9,8:7
7Embolization of splenorenal shunt associated to portal vein thrombosis and hepatic encephalopathy显示文摘Hepatic encephalopathy(HE)is a cognitive disturbance characterized by neuropsychiatric alterations.It occurs in acute and chronic hepatic disease and also in patients with portosystemic shunts.The presence of these portosystemic shunts allows the passage of nitrogenous substances from the intestines through systemic veins without liver depuration.Therefore,the embolization of these shunts has been performed tocontrol HE manifestations,but the presence of portal vein thrombosis is considered a contraindication.In this presentation we show a cirrhotic patient with severe HE and portal vein thrombosis who was submitted to embolization of a large portosystemic shunt.Case report:a 57 years-old cirrhotic patient who had been hospitalized many times for persistent HE and hepatic coma,even without precipitant factors.She had a wide portosystemic shunt and also portal vein thrombosis.The abdominal angiography confirmed the splenorenal shunt and showed other shunts.The larger shunt was embolized through placement of microcoils,and the patient had no recurrence of overt HE.There was a little increase of esophageal and gastric varices,but no endoscopic treatment was needed.Since portosystemic shunts are frequent causes of recurrent HE in cirrhotic patients,portal vein thrombosis should be considered a relative contraindication to perform a shunt embolization.However,in particular cases with many shunts and severe HE,we found that one of these shunts can be safely embolized and this procedure can be sufficient to obtain a good HE recovery.In conclusion,we reported a case of persistent HE due to a wide portosystemic shunt associated with portal vein thrombosis.As the patient had other shunts,she was successfully treated by embolization of the larger shunt.Letícia de Campos Franzoni Fábio Cardoso de Carvalho Rafael Gomes de Almeida Garzon Fábio da Silva Yamashiro Laís Augusti Lívia Alves Amaral Santos Mariana de Souza Dorna Júlio Pinheiro Baima Talles Bazeia Lima Carlos Antonio Caramori Giovanni Faria Silva Fernando Gomes Romeiro 2014World Journal of Gastroenterology2014,20,42:6
8Metabolic syndrome and colorectal neoplasms:An ominous association显示文摘AIM:To evaluate the association of metabolic syndrome(MS) and colorectal cancer and adenomas in a Western country,where the incidence of MS is over 27%.METHODS:This was a prospective study between March 2013 and March 2014.MS was diagnosed according to the National Cholesterol Education ProgramATP III.Demographic characteristics,anthropometric measurements,metabolic risk factors,and colonoscopic pathologic findings were assessed in patients with MS(group 1) who underwent routine colonoscopy at our department.This data was compared with consecutive patients without metabolic syndrome(group 2),with no differences regarding sex and age.Patients with incomplete colonoscopy,family history,or past history of colorectal neoplasm were excluded.Informed consent was obtained and the ethics committee approved this study.Statistical analysis was performed using Student's t-test and χ2 test,with a P value ≤ 0.05 being considered statistically significant.RESULTS:Of 258 patients,129 had MS;51% males;mean-age 67.1 years(50-87).Among the MS group,94% had high blood pressure,91% had increased waist circumference,60% had diabetes,55% had low high-density lipoprotein cholesterol level,50% had increased triglyceride level,and 54% were obese [body mass index(BMI) 30 kg/m2].51% presented 4 criteria of MS.MS was associated with increased prevalence of adenomas(43% vs 25%,P = 0.004) and colorectal cancer(13% vs 5%,P = 0.027),compared with patients without MS.MS was also positively associated with multiple(≥ 3) adenomas(35% vs 9%,P = 0.024) and sessile adenomas(69% vs 53%,P = 0.05).No difference existed between location(P = 0.086),grade of dysplasia(P = 0.196),or size(P= 0.841) of adenomas.In addition,no difference was found between BMI(P = 0.078),smoking(P = 0.146),alcohol consumption(P = 0.231),and the presence of adenomas.CONCLUSION:MS is positively associated with adenomas and colorectal cancer.However,there is not enough information in western European countries to justify screening in patients with MS.To our knowledge,no previous study has evaluated this association in Portuguese patients.Daniel Trabulo Suzane Ribeiro Cláudio Martins Cristina Teixeira Cláudia Cardoso Jo?o Mangualde Ricardo Freire élia Gamito Ana L Alves Fátima Augusto Ana P Oliveira Isabelle Cremers 2015World Journal of Gastroenterology2015,21,17:5
9Systematic review of noninvasive treatments to arrest dentin non-cavitated caries lesions显示文摘AIM: To systematically review the literature on the efficacy of noninvasive methods of arresting the progression of non-cavitated occlusal carious lesions in dentin.METHODS: The Medline/Pub Med,LILACS,Sci ELO and Scopus databases were searched to identify relevant publications through to November 2013.Only clinical trials evaluating the ability of noninvasive methods to arrest the progression of occlusal non-cavitated carious lesions in dentin were included.Screening,data extraction and quality assessment were conducted independently and in duplicate.RESULTS: Of 167 citations identified,nine full text articles were screened and five were included in the analysis.All papers reported on occlusal fissure sealing using a self-curing glass ionomer(n = 1) or resin-based(n = 4) sealant.Only the use of resin-based sealant to obliterate occlusal fissures arrested the progression of non-cavitated occlusal carious lesions in dentin.CONCLUSION: Occlusal fissure sealing with a resin-based sealant may arrest the progression of non-cavitated occlusal dentinal caries.Further clinical trials with longer follow-up times should be performed to increase scientific evidence.Isauremi Vieira de Assun??o Giovanna de Fátima Alves da Costa Boniek Castillo Dutra Borges 2014World Journal of Clinical Cases2014,2,5:3
10Association of nonalcoholic fatty liver disease and liver cancer显示文摘AIM:To investigate the association between nonalcoholic fatty liver disease(NAFLD) and liver cancer,and NAFLD prevalence in different liver tumors.METHODS:This is a retrospective study of the clinical,laboratory and histological data of 120 patients diagnosed with primary or secondary hepatic neoplasms and treated at a tertiary center where they underwent hepatic resection and/or liver transplantation,with subsequent evaluation of the explant or liver biopsy.The following criteria were used to exclude patients from the study:a history of alcohol abuse,hepatitis B or C infection,no tumor detected in the liver tissue examined by histological analysis,and the presence of chronic autoimmune hepatitis,hemochromatosis,Wilson's disease,or hepatoblastoma.The occurrence of NAFLD and the association with its known risk factors were studied.The risk factors considered were diabetes mellitus,impaired glucose tolerance,impaired fasting glucose,body mass index,dyslipidemia,and arterial hypertension.Presence of reticulin fibers in the hepatic neoplasms was assessed by histological analysis using slide-mounted specimens stained with either hematoxylin and eosin or Masson's trichrome and silver impregnation.Analysis of tumor-free liver parenchyma was carried out to determine the association between NAFLD and its histological grade.RESULTS:No difference was found in the association of NAFLD with the general population(34.2% and 30.0% respectively,95%CI:25.8-43.4).Evaluation by cancer type showed that NAFLD was more prevalent in patients with liver metastasis of colorectal cancer than in patients with hepatocellular carcinoma and intrahepatic cholangiocarcinoma(OR = 3.99,95%CI:1.78-8.94,P < 0.001 vs OR = 0.60,95%CI:0.18-2.01,P = 0.406 and OR = 0.70,95%CI:0.18-2.80,P = 0.613,respectively).There was a higher prevalence of liver fibrosis in patients with hepatocellular carcinoma(OR = 3.50,95%CI:1.06-11.57,P = 0.032).Evaluation of the relationship between the presence of NAFLD,nonalcoholic steatohepatitis,and liver fibrosis,and their risk factors,showed no significant statistical association for any of the tumors studied.CONCLUSION:NAFLD is more common in patients with liver metastases caused by colorectal cancer.Perla Oliveira Schulz Fabio Goncalves Ferreira Maria de Fátima Araújo Nascimento Andrea Vieira Mauricio Alves Ribeiro André Ibrahim David Luiz Arnaldo Szutan 2015World Journal of Gastroenterology2015,21,3:2
11Appropriateness of outpatient gastrointestinal endoscopy in a non-academic hospital显示文摘AIM:To assess the appropriate use and the diagnostic yield of upper gastrointestinal endoscopy and colonoscopy in this subgroup of patients.METHODS:In total,789 consecutive outpatients referred for gastrointestinal(GI) endoscopy [381 for esophagogastroduodenoscopy(EGD) and 408 for colonoscopy] were prospectively enrolled in the study.The American Society for Gastrointestinal Endoscopy(ASGE) guidelines were used to assess the relationship between appropriateness and the presence of relevant endoscopic f indings.RESULTS:The overall inappropriate rate was 13.3%.The indications for EGD and colonoscopy were,respectively,appropriate in 82.7% and 82.6% of the exams,uncertain in 5.8% and 2.4% and inappropriate in 11.5% and 15%.The diagnostic yield was signif icant higher forEGDs and colonoscopies judged appropriate and uncertain when compared with those considered inappropriate(EGD:36.6% vs 36.4% vs 11.4%,P = 0.004;Colonoscopy:24.3% vs 20.0% vs 3.3%,P = 0.001).Of the 25 malignant lesions detected,all but one was detected in exams judged appropriate or uncertain.CONCLUSION:This study shows a good adherence to ASGE guidelines by the referring physicians and a significant increase of the diagnostic yield in appropriate examinations,namely in detecting neoplastic lesions.It underscores the importance that the appropriateness of the indication assumes in assuring high-quality GI endoscopic procedures.Joo Mangualde Marie I Cremers Ana M Vieira Ricardo Freire lia Gamito Cristina Lobato Ana L Alves Fátima Augusto Ana P Oliveira 2011World Journal of Gastrointestinal Endoscopy2011,3,10:2
12NEW TOXOPLASMA GONDII GENOTYPES ISOLATED FROM FREE-RANGE CHICKENS FROM THE FERNANDO DE NORONHA, BRAZIL: UNEXPECTED FINDINGS显示文摘Dubey J P Rajendran C Costa D G C Ferreira L R Kwok O C H Qu D Su C Marvulo M F V Alves L C Mota R A Silva J C R 2010The Journal of Parasitology2010,,4:2
13The discoindin domain receptor tyrosine kinases are activated by collagen 显示文摘 Gish GD Alves F 1997Mol Cell1997,1,1:1
14Identification of molecular phenotypes in canine mammary carcinomas with clinical irnplications: application of the human classification 显示文摘Gama A Alves A Schmitt F 2008Virchows Arch2008,453,:1
15An expeditiousmethod for the determ ination of organochlorine pesticides resi-dues in estuarine sediments using microwave assisted pre-ex-traction an d automa ted headspace solid phase microextractioncoupled to gas chromatography-mass spectrometry显示文摘Carvalho P N Rodrigues P N R Alves F 2008Talan-ta2008,76,5:1
16Positive solu- tions for a quasilinear elliptic equations of Kirchhoff type显示文摘Alves C O Correa F J S A Ma T F 2005Comput Math Appl2005,4,:1
17Surface modification and characterization of thermoplastic polyurethane显示文摘ALVES P COELHO J F J HAACK J 0,,02:1
18A unified model for predicting flowing temperature distribution in wellbores and pipelines显示文摘Alves I N Alhanati F J S Shoham O 1992SPEPE1992,7,4:1
19Intraoral salivary duct carcinoma:case report with immunohistochemical observations显示文摘Lopes MA de Abreu Alves F Levy BA 2001Oral Surg Oral Med Oral Pathol Oral Radiol Endod2001,91,6:1
20RBS lattice site location and damage recovery studies in GaN 显示文摘Alves E DaSilva M F Soares J C 1999MRS Internet J Nitride Semiconductor Res1999,4,1:1
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