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| 1 | Propofol vs midazolam sedation for elective endoscopy in patients with cirrhosis:A systematic review and meta-analysis of randomized controlled trials显示文摘BACKGROUND Patients with cirrhosis frequently require sedation for elective endoscopic procedures.Several sedation protocols are available,but choosing an appropriate sedative in patients with cirrhosis is challenging.AIM To conduct a systematic review and meta-analysis to compare propofol and midazolam for sedation in patients with cirrhosis during elective endoscopic procedures in an attempt to understand the best approach.METHODS This systematic review and meta-analysis was conducted using the PRISMA guidelines.Electronic searches were performed using MEDLINE,EMBASE,Central Cochrane,LILACS databases.Only randomized control trials(RCTs)were included.The outcomes studied were procedure time,recovery time,discharge time,and adverse events(bradycardia,hypotension,and hypoxemia).The risk of bias assessment was performed using the Revised Cochrane Risk-of-Bias tool for randomized trials(RoB-2).Quality of evidence was evaluated by GRADEpro.The meta-analysis was performed using Review Manager.RESULTS The search yielded 3,576 records.Out of these,8 RCTs with a total of 596 patients(302 in the propofol group and 294 in the midazolam group)were included for the final analysis.Procedure time was similar between midazolam and propofol groups(MD:0.25,95%CI:-0.64 to 1.13,P=0.59).Recovery time(MD:-8.19,95%CI:-10.59 to-5.79,P<0.00001).and discharge time were significantly less in the propofol group(MD:-12.98,95%CI:-18.46 to-7.50,P<0.00001).Adverse events were similar in both groups(RD:0.02,95%CI:0-0.04,P=0.58).Moreover,no significant difference was found for bradycardia(RD:0.03,95%CI:-0.01 to 0.07,P=0.16),hypotension(RD:0.03,95%CI:-0.01 to 0.07,P=0.17),and hypoxemia(RD:0.00,95%CI:-0.04 to 0.04,P=0.93).Five studies had low risk of bias,two demonstrated some concerns,and one presented high risk.The quality of the evidence was very low for procedure time,recovery time,and adverse events;while low for discharge time.CONCLUSION This systematic review and meta-analysis based on RCTs show that propofol has shorter recovery and patient discharge time as compared to midazolam with a similar rate of adverse events.These results suggest that propofol should be the preferred agent for sedation in patients with cirrhosis. | John Alexander Lata Guacho Diogo Turiani Hourneaux de Moura Igor Braga Ribeiro Alberto Machado da Ponte Neto Shailendra Singh Marina Gammaro Baldavira Tucci Wanderley Marques Bernardo Eduardo Guimarães Hourneaux de Moura | 2020 | World Journal of Gastrointestinal Endoscopy2020，12，8： | 4 |
| 2 | Treatment of high-grade dysplasia and intramucosal carcinoma using radiofrequency ablation or endoscopic mucosal resection + radiofrequency ablation: Meta-analysis and systematic review显示文摘BACKGROUND The progression of Barrett's esophagus(BE) to early esophageal carcinoma occurs sequentially; the metaplastic epithelium develops from a low-grade dysplasia to a high-grade dysplasia(HGD), resulting in early esophageal carcinoma and,eventually, invasive carcinoma. Endoscopic approaches including resection and ablation can be used in the treatment of this condition.AIM To compare the effectiveness of radiofrequency ablation(RFA) vs endoscopic mucosal resection(EMR) + RFA in the endoscopic treatment of HGD and intramucosal carcinoma.METHODS In accordance with PRISMA guidelines, this systematic review included studies comparing the two endoscopic techniques(EMR + RFA and RFA alone) in the treatment of HGD and intramucosal carcinoma in patients with BE. Our analysis included studies involving adult patients of any age with BE with HGD or intramucosal carcinoma. The studies compared RFA and EMR + RFA methods were included regardless of randomization status.RESULTS The seven studies included in this review represent a total of 1950 patients, with742 in the EMR + RFA group and 1208 in the RFA alone group. The use of EMR +RFA was significantly more effective in the treatment of HGD [RD 0.35(0.15,0.56)] than was the use of RFA alone. The evaluated complications(stenosis,bleeding, and thoracic pain) were not significantly different between the two groups.CONCLUSION Endoscopic resection in combination with RFA is a safe and effective method in the treatment of HGD and intramucosal carcinoma, with higher rates of remission and no significant differences in complication rates when compared to the use of RFA alone. | Mileine Valente de Matos Alberto Machado da Ponte-Neto Diogo Turiani Hourneaux de Moura Ethan Dwane Maahs Dalton Marques Chaves Elisa Ryoka Baba Edson Ide Rubens Sallum Wanderley Marques Bernardo Eduardo Guimar?es Hourneaux de Moura | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，3： | 2 |
| 3 | Features of In Vitro Ultrasound Biomicroscopic Imaging and Colonoscopy for Detection of Colon Tumor in Mice显示文摘 | Kelly Z. Alves Helena L. Borges Rossana C. Soletti Anália L.P. Viana Lorena I. Petrella M?nica Soldan Vera L. Chagas Alberto Schanaider Jo?o C. Machado | 2011 | Ultrasound in Medicine & Biology2011，，12： | 1 |
| 4 | Antimicrobial activity of alexidine alone and associated with N-acetylcysteine against Enterococcus faecalis biofilm显示文摘The purpose of this study was to assess the efficacy of alexidine(ALX),alone and combined with N-acetylcysteine(NAC),in eradicating two Enterococcus faecalis strain biofilms.The biofilms of E.faecalis ATCC 29212 and the clinical isolate E.faecalis D1 were grown in the MBEC-high-throughput device for 24 h and were exposed to five twofold dilutions of ALX(2%–0.007 8%)alone and combined with100 mg?mL21NAC,for 1 and 5 min.Eradication was defined as 100%kill of biofilm bacteria.The Student’s t-test was used to compare the efficacy of the associations of the two irrigants.After 1-min contact time,ALX eradicated the biofilms at all concentrations except for 0.007 8%and 0.015 6%–0.007 8%with E.faecalis ATCC 29212 and E.faecalis D1,respectively.Similar results for eradication and concentration were obtained when it was combined with 100 mg?mL21NAC.After 5 min of contact time,ALX alone and combined with NAC eradicated all enterococci biofilms.ALX showed antimicrobial properties against the two E.faecalis strain biofilms tested at very low concentrations,and its combined use with NAC was not seen to enhance its activity. | Luiz Fernando Machado Silveira Pilar Baca María Teresa Arias-Moliz Alberto Rodríguez-Archilla Carmen María Ferrer-Luque | 2013 | International Journal of Oral Science2013，5，3： | 1 |
| 5 | Aquaporins in the central nervous system显示文摘 | Venero JL Vizuete ML Alberto Machado | 2001 | Prog Neurobiol2001，63，3： | 1 |
| 6 | Primary bone lymphoma in 24 patients treated between 1955 and 1999显示文摘 | de Camargo Olavo Pires MD PhD dos Santos Machado Telma Murias MD Croci Alberto Tesconi MD PhD | 2002 | Clin Orthop2002，397，： | 1 |
| 7 | Endoluminal ultrasound biomicroscopy as a reliable tool for in vivo assessment of colonic inflammation in rats显示文摘 | Marcelo Alexandre Pinto Britto Rossana Colla Soletti Alberto Schanaider Kalil Madi Heitor Siffert Pereira Souza Jo?o Carlos Machado | 2013 | International Journal of Colorectal Disease2013，，12： | 1 |
| 8 | Zocor Forte? (simvastatin) has a neuroprotective effect against LPS striatal dopaminergic terminals injury, whereas against MPP + does not显示文摘 | Marti Santiago Mari Carmen Hernández-Romero Alberto Machado Josefina Cano | 2009 | European Journal of Pharmacology2009，，1： | 1 |
| 9 | Fecal microbiota transplantation in patients with metabolic syndrome and obesity:A randomized controlled trial显示文摘BACKGROUND Metabolic syndrome is a multifactorial disease,and the gut microbiota may play a role in its pathogenesis.Obesity,especially abdominal obesity,is associated with insulin resistance,often increasing the risk of type two diabetes mellitus,vascular endothelial dysfunction,an abnormal lipid profile,hypertension,and vascular inflammation,all of which promote the development of atherosclerotic cardiovascular disease.AIM To evaluate the outcomes of fecal microbiota transplantation(FMT)in patients with metabolic syndrome.METHODS This was a randomized,single-blind placebo-controlled trial comparing FMT and a sham procedure in patients with metabolic syndrome.We selected 32 female patients,who were divided into eight groups of four patients each.All of the patients were submitted to upper gastrointestinal endoscopy.In each group,two patients were randomly allocated to undergo FMT,and the other two patients received saline infusion.The patients were followed for one year after the procedures,during which time anthropometric,bioimpedance,and biochemical data were collected.The patients also had periodic consultations with a nutritionist and an endocrinologist.The primary end point was a change in the gut microbiota.RESULTS There was evidence of a postprocedural change in microbiota composition in the patients who underwent FMT in relation to that observed in those who underwent the sham procedure.However,we found no difference between the two groups in terms of the clinical parameters evaluated.CONCLUSION There were no significant differences in biochemical or anthropometric parameters,between the two groups evaluated.Nevertheless,there were significant postprocedural differences in the microbiota composition between the placebo group.To date,clinical outcomes related to FMT remain uncertain. | Alberto Machado da Ponte Neto Aniele Cristine Ott Clemente Paula Waki Rosa Igor Braga Ribeiro Mateus Pereira Funari Gabriel Cairo Nunes Luana Moreira Luiz Gustavo Sparvoli Ramon Cortez Carla Romano Taddei Márcio C Mancini Eduardo Guimarães Hourneaux de Moura | 2023 | World Journal of Clinical Cases2023，11，19： | 0 |
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