维普中文期刊产品整合服务
131篇 您的检索式:作者名="Wanderley"
    题名 作者 年代 出处 被引量
1Endoscopy vs surgery in the treatment of early gastric cancer:Systematic review显示文摘AIM: To report a systematic review,establishing the available data to an unpublished 2a strength of evidence,better handling clinical practice.METHODS: A systematic review was performed using MEDLINE,EMBASE,Cochrane,LILACS,Scopus and CINAHL databases. Information of the selected studies was extracted on characteristics of trial participants,inclusion and exclusion criteria,interventions(mainly,mucosal resection and submucosal dissection vs surgical approach) and outcomes(adverse events,different survival rates,mortality,recurrence and complete resection rates). To ascertain the validity of eligible studies,the risk of bias was measured using the Newcastle-Ottawa Quality Assessment Scale. The analysis of the absolute risk of the outcomes was performed using the software Rev Man,by computingrisk differences(RD) of dichotomous variables. Data on RD and 95%CIs for each outcome were calculated using the Mantel-Haenszel test and inconsistency was qualified and reported in χ2 and the Higgins method(I2). Sensitivity analysis was performed when heterogeneity was higher than 50%,a subsequent assay was done and other findings were compiled.RESULTS: Eleven retrospective cohort studies were selected. The included records involved 2654 patients with early gastric cancer that filled the absolute or expanded indications for endoscopic resection. Threeyear survival data were available for six studies(n = 1197). There were no risk differences(RD) after endoscopic and surgical treatment(RD = 0.01,95%CI:-0.02-0.05,P = 0.51). Five-year survival data(n = 2310) showed no difference between the two groups(RD = 0.01,95%CI:-0.01-0.03,P = 0.46). Recurrence data were analized in five studies(1331 patients) and there was no difference between the approaches(RD = 0.01,95%CI:-0.00-0.02,P = 0.09). Adverse event data were identified in eight studies(n = 2439). A significant difference was detected(RD =-0.08,95%CI:-0.10--0.05,P < 0.05),demonstrating better results with endoscopy. Mortality data were obtained in four studies(n = 1107). There was no difference between the groups(RD =-0.01,95%CI:-0.02-0.00,P = 0.22).CONCLUSION: Three-,5-year survival,recurrence and mortality are similar for both groups. Considering complication,endoscopy is better and,analyzing complete resection data,it is worse than surgery.André Kondo Eduardo Guimaraes Hourneaux de Moura Wanderley Marques Bernardo Osmar Kenji Yagi Diogo Turiani Hourneaux de Moura Eduardo Turiani Hourneaux de Moura José Gon?alves Pereira Bravo Kendi Yamazaki Paulo Sakai 2015World Journal of Gastroenterology2015,21,46:12
2Video capsule endoscopy vs double-balloon enteroscopy in the diagnosis of small bowel bleeding:A systematic review and metaanalysis显示文摘AIM To compare the diagnostic accuracy of video capsule endoscopy(VCE) and double-balloon enteroscopy(DBE) in cases of obscure gastrointestinal bleeding(OGIB) of vascular origin.METHODS MEDLINE(via PubMed), LILACS(via BVS) and Cochrane/CENTRAL virtual databases were searched for studies dated before 2017. We identified prospective and retrospective studies, including observational, cohort, single-blinded and multicenter studies, comparing VCE and DBE for the diagnosis of OGIB, and data of all the vascular sources of bleeding were collected. All patients were subjected to the same gold standard method. Relevant data were then extracted from each included study using a standardized extraction form. We calculated study variables(sensitivity, specificity, prevalence, positive and negative predictive values and accuracy) and performed a meta-analysis using Meta-Disc software.RESULTS In the per-patient analysis, 17 studies(1477 lesions) were included. We identified3150 exams(1722 VCE and 1428 DBE) in 2043 patients and identified 2248 sources of bleeding, 1467 of which were from vascular lesions. Of these lesions, 864(58.5%) were diagnosed by VCE, and 613(41.5%) were diagnosed by DBE. The pretest probability for bleeding of vascular origin was 54.34%. The sensitivity of DBE was 84%(95%CI: 0.82-0.86; heterogeneity: 78.00%), and the specificity was92%(95%CI: 0.89-0.94; heterogeneity: 92.0%). For DBE, the positive likelihood ratio was 11.29(95%CI: 4.83-26.40; heterogeneity: 91.6%), and the negative likelihood ratio was 0.20(95%CI: 0.15-0.27; heterogeneity: 67.3%). Performing DBE after CE increased the diagnostic yield of vascular lesion by 7%, from 83% to90%.CONCLUSION The diagnostic accuracy of detecting small bowel bleeding from a vascular source is increased with the use of an isolated video capsule endoscope compared with isolated DBE. However, concomitant use increases the detection rate of the bleeding source.Hélcio Pedrosa Brito Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura Wanderley Marques Bernardo Dalton Marques Chaves Rogério Kuga Ethan Dwane Maahs Robson Kiyoshi Ishida Eduardo Turiani Hourneaux de Moura Eduardo Guimaraes Hourneaux de Moura 2018World Journal of Gastrointestinal Endoscopy2018,10,12:10
3Bartter's syndrome:clinical findings,genetic causes and therapeutic approach显示文摘Backgound Bartter's syndrome(BS)is a rare group of salt losing tubulopathies due to the impairment of transport mecha-nisms at the thick ascending limb of the Henle's loop.Data sources Literature reviews and original research articles were collected from database,including PubMed and Scopus.Results According to the time of onset and symptoms,BS can be classified into antenatal and classic BS.Molecular studies have identified different subtypes of BS.BS types Ⅰ,Ⅱ and Ⅲ are caused by mutations on genes encoding the luminal Na^(+)-K^(+)-2Cl^(-) co-transporter,the luminal K+ channel ROMK,and the basolateral chloride channel ClC-Kb(CLCNKB),respectively.Loss-of-function mutations of Barttin CLCNK type accessory beta subunit cause BS type Ⅳa.Simultaneous mutations of CLCNKB and CLCNKA cause BS type Ⅳb.BS type Ⅴ consists in a novel transient form characterized by antenatal presentation due to mutations in the MAGE family member D2.Severe gain-of-function mutations of the extracellular calcium sensing receptor gene can result in an autosomal dominant condition of BS.Main clinical and biochemical alterations in BS include polyuria,dehydration,hypokalemia,hypochloremic metabolic alka-losis,hyperreninemia,high levels of prostaglandins,normal or low blood pressure,hypercalciuria and failure to thrive.Treatment focuses mainly at correcting dehydration and electrolyte disturbances and in measures to reduce polyuria,including the use of nonsteroidal anti-inflammatory medications to control excessive renal prostaglandin E2 production.Conclusions Early diagnosis and treatment of BS may prevent long-term consequences such as growth failure,nephrocal-cinosis and end-stage renal disease.Flavia Cristina Carvalho Mrad Sílvia Bouissou Morais Soares Luiz Alberto Wanderley de Menezes Silva Pedro Versiani dos Anjos Menezes Ana Cristina Simoes-e-Silva 2021World Journal of Pediatrics2021,17,1:10
4Endoscopic stenting for inoperable malignant biliary obstruction: A systematic review and meta-analysis显示文摘AIM: To analyze through meta-analyses the benefits of two types of stents in the inoperable malignant biliary obstruction.METHODS: A systematic review of randomized clinical trials(RCT) was conducted, with the last update on March 2015, using EMBASE, CINAHL(EBSCO), MEDLINE, LILACS/CENTRAL(BVS), SCOPUS, CAPES(Brazil), and gray literature. Information of the selected studies was extracted in sight of six outcomes: primarily regarding dysfunction, complication and reintervention rates; and secondarily costs, survival, and patency time. The data about characteristics of trial participants, inclusion and exclusion criteria and types of stents were also extracted. The bias was mainly assessed through the JADAD scale. This meta-analysis was registered in the PROSPERO database by the number CRD42014015078. The analysis of the absolute risk of the outcomes was performed using the software Rev Man, by computing risk differences(RD) of dichotomous variables and mean differences(MD) of continuous variables. Data on RD and MD for each primary outcome were calculated using the MantelHaenszel test and inconsistency was qualified and reported in χ2 and the Higgins method(I2). Sensitivity analysis was performed when heterogeneity was higher than 50%, a subsequent assay was done and other findings were compiled. Student's t-test was used for the comparison of weighted arithmetic means regarding secondary outcomes.RESULTS: Initial searching identified 3660 studies; 3539 were excluded through title, repetition, and/or abstract, while 121 studies were fully assessed and were excluded mainly because they did not compare self-expanding metal stents(SEMS) and plastic stents(PS), leading to thirteen RCT selected, with 13 articles and 1133 subjects meta-analyzed. The mean age was 69.5 years old, that were affected mostly by bile duct(proximal) and pancreatic tumors(distal). The preferred SEMS diameter used was the 10 mm(30 Fr) and the preferred PS diameter used was 10 Fr. In the metaanalysis, SEMS had lower overall stent dysfunction compared to PS(21.6% vs 46.8%, P < 0.00001) and fewer re-interventions(21.6% vs 56.6%, P < 0.00001), with no difference in complications(13.7% vs 15.9%, P = 0.16). In the secondary analysis, the mean survival rate was higher in the SEMS group(182 d vs 150 d, P < 0.0001), with a higher patency period(250 d vs 124 d, P < 0.0001) and a lower cost per patient(4193.98 vs 4728.65 Euros, P < 0.0985).CONCLUSION: SEMS are associated with lower stent dysfunction, lower re-intervention rates, better survival, and higher patency time. Complications and costs showed no difference.Leonardo Zorrón Pu Eduardo Guimaraes Hourneaux de Moura Wanderley Marques Bernardo Felipe Iankelevich Baracat Ernesto Quaresma Mendonca AndréKondo Gustavo Oliveira Luz Carlos Kiyoshi Furuya Júnior Everson Luiz de Almeida Artifon 2015World Journal of Gastroenterology2015,21,47:10
5Clove(Syzygium aromaticum):a precious spice显示文摘Clove(Syzygium aromaticum) is one of the most valuable spices that has been used for centuries as food preservative and Tor many medicinal purposes.Clove is native of Indonesia but nowadays is cultured in several parts of the world including Brazil in the slate of Bahia.This plant represents one of the richest source of phenolic compounds such as eugenol,eugenol acetate and gallic acid and posses great potential for pharmaceutical,cosmetic,food and agricultural applications.This review includes the main studies reporting the biological activities of clove and eugennl.The antioxidant and antimicrobial activity of clove is higher than many fruits,vegetables and other spices and should deserve special attention.A new application of clove as larvicidal agent is an interesting strategy to combat dengue which is a serious health problem in Brazil and other tropical countries.Pharmacokinetics and lexicological studies were also mentioned.The different studies reviewed in this work confirm the traditional use of clove as food preservative and medicinal plant standing out the importance of this plant for different applications.Diego Francisco Cortés-Rojas Claudia Regina Fernandes de Souza Wanderley Pereira Oliveira 2014Asian Pacific Journal of Tropical Biomedicine2014,4,2:8
6Comparison between endoscopic sphincterotomy vs endoscopic sphincterotomy associated with balloon dilation for removal of bile duct stones:A systematic review and meta-analysis based on randomized controlled trials显示文摘AIM To compare gallstones removal rate and incidence of bleeding, pancreatitis, use of mechanical lithotripsy, cholangitis and perforation between isolated sphincterotomy vs sphincterotomy associated with balloon dilation of papilla in choledocholithiasis through the meta-analysis of randomized clinical trials. METHODS We conducted a systematic review according to the PRISMA guidelines. Literature search was restricted to randomized controlled trials(RCTs) on Med Line, Cochrane Library, LILACS, and EMBASE database platforms in July 2017. The manual search included references of retrieved articles. We extracted data focusing on outcomes: The primary endpoint was the stones removal rate; Secondary endpoints were rates of pancreatitis, bleeding, use of mechanical lithotripsy(ML), perforation and cholangitis. RESULTS Eleven RCTs with 1824 patients were included. EST was associated with more post-endoscopic retrograde cholangiopancreatography(ERCP) bleeding [FE RD-0.02, CI(-0.03,-0.00), I2 = 33%, P = 0.05] and more need of mechanical lithotripsy in general [RE RD-0.16, CI(-0.25,-0.06), I2 = 90%, P = 0.002] and in subgroup analysis of stones greater than 15 mm [RE RD-0.20, CI(-0.38,-0.02), I2 = 82%, P = 0.003]. Incidence of pancreatitis [FE RD-0.01, CI(-0.03, 0.01), I2 = 0, P = 0.36], cholangitis [FE RD-0.00, CI(-0.01, 0.01), I2 =0, P = 0.97] and perforation [FE RD-0.01, CI(-0.01, 0.00), I2 = 0, P = 0.23] was similar between the groups as well as similar stone removal rates in general [FE RD-0.01, CI(-0.01, 0.04), I2 = 0, P = 0.23] and pooled analysis of stones greater than 15 mm [FE RD-0.02, CI(-0.02, 0.07), I2 = 11%, P = 0.31]. CONCLUSION Through meta-analysis of randomized clinical trials we found that isolated sphincterotomy was associated with more post-ERCP bleeding and more need for mechanical lithotripsy. However, there was no statistical difference in the stone removal rate between isolated sphincterotomy and sphincterotomy associated with balloon dilation in the approach to remove gallstones.Cesar Capel de Clemente Junior Wanderley Marques Bernardo Tomazo Prince Franzini Gustavo Oliveira Luz Marcos Eduardo Lera dos Santos Jonah Maxwell Cohen Diogo Turiani Hourneaux de Moura Fábio Ramalho Tavares Marinho Martin Coronel Paulo Sakai Eduardo Guimaraes Hourneaux de Moura 2018World Journal of Gastrointestinal Endoscopy2018,10,8:8
7Endoscopic ultrasound-guided vs endoscopic retrograde cholangiopancreatography biliary drainage for obstructed distal malignant biliary strictures: A systematic review and meta-analysis显示文摘BACKGROUND For palliation of malignant biliary obstruction(MBO), the gold-standard method of biliary drainage is endoscopic retrograde cholangiopancreatography(ERCP)with the placement of metallic stents. Endoscopic ultrasound(EUS)-guided drainage is an alternative that is typically reserved for cases of ERCP failure.Recently, however, there have been robust randomized clinical trials(RCTs)comparing EUS-guided drainage and ERCP as primary approaches to MBO.AIM To compare EUS guidance and ERCP in terms of their effectiveness and safety in palliative biliary drainage for MBO.METHODS This was a systematic review and meta-analysis, in which we searched the MEDLINE, Excerpta Medica, and Cochrane Central Register of Controlled Trials databases. Only RCTs comparing EUS and ERCP for primary drainage of MBO were eligible. All of the studies selected provided data regarding the rates of technical and clinical success, as well as the duration of the procedure, adverse events, and stent patency. We assessed the risk of biases using the Jadad score and the quality of evidence using the Grading of Recommendations Assessment,Development and Evaluation criteria.RESULTS The database searches yielded 5920 records, from which we selected 3 RCTs involving a total of 222 patients(112 submitted to EUS and 110 submitted to ERCP). In the EUS and ERCP groups, the rate of technical success was 91.96%n and 91.81%, respectively, with a risk difference(RD) of 0.00%(95%CI:-0.07, 0.07;P = 0.97; I^2 = 0%). The clinical success was 84.81% and 85.53% in the EUS and ERCP groups, respectively, with an RD of-0.01%(95%CI:-0.12, 0.10; P = 0.90; I^2 =0%). The mean difference(MD) for the duration of the procedure was-0.12%(95%CI:-8.20, 7.97; P = 0.98; I^2 = 84%). In the EUS and ERCP groups, there were14 and 25 adverse events, respectively, with an RD of-0.06%(95%CI:-0.23, 0.12; P= 0.54; I^2 = 77%). The MD for stent patency was 9.32%(95%CI:-4.53, 23.18; P =0.19; I^2 = 44%). The stent dysfunction rate was significantly lower in the EUS t group(MD =-0.22%; 95 CI:-0.35,-0.08; P = 0.001; I^2 = 0%).CONCLUSION EUS represents an interesting alternative to ERCP for MBO drainage,demonstrating lower stent dysfunction rates compared with ERCP. Technical and clinical success, duration, adverse events and patency rates were similar.Fernanda P Logiudice Wanderlei M Bernardo Facundo Galetti Vitor M Sagae Carolina O Matsubayashi Antonio C Madruga Neto Vitor O Brunaldi Diogo T H de Moura Tomazo Franzini Spencer Cheng Sergio E Matuguma Eduardo G H de Moura 2019World Journal of Gastrointestinal Endoscopy2019,11,4:6
8Propofol vs traditional sedatives for sedation in endoscopy:A systematic review and meta-analysis显示文摘BACKGROUND Propofol is commonly used for sedation during endoscopic procedures.Data suggests its superiority to traditional sedatives used in endoscopy including benzodiazepines and opioids with more rapid onset of action and improved postprocedure recovery times for patients.However,Propofol requires administration by trained healthcare providers,has a narrow therapeutic index,lacks an antidote and increases risks of cardio-pulmonary complications.AIM To compare,through a systematic review of the literature and meta-analysis,sedation with propofol to traditional sedatives with or without propofol during endoscopic procedures.METHODS A literature search was performed using MEDLINE,Scopus,EMBASE,the Cochrane Library,Scopus,LILACS,BVS,Cochrane Central Register of Controlled Trials,and The Cumulative Index to Nursing and Allied Health Literature databases.The last search in the literature was performed on March,2019 with no restriction regarding the idiom or the year of publication.Only randomized clinical trials with full texts published were included.We divided sedation therapies to the following groups:(1)Propofol versus benzodiazepines and/or opiate sedatives;(2)Propofol versus Propofol with benzodiazepine and/or opioids;and(3)Propofol with adjunctive benzodiazepine and opioid versus benzodiazepine and opioid.The following outcomes were addressed:Adverse events,patient satisfaction with type of sedation,endoscopists satisfaction with sedation administered,dose of propofol administered and time to recovery post procedure.Meta-analysis was performed using RevMan5 software version 5.39.RESULTS A total of 23 clinical trials were included(n=3854)from the initial search of 6410 articles.For Group I(Propofol vs benzodiazepine and/or opioids):The incidence of bradycardia was not statistically different between both sedation arms(RD:-0.01,95%CI:-0.03–+0.01,I2:22%).In 10 studies,the incidence of hypotension was not statistically difference between sedation arms(RD:0.01,95%CI:-0.02–+0.04,I2:0%).Oxygen desaturation was higher in the propofol group but not statistically different between groups(RD:-0.03,95%CI:-0.06–+0.00,I2:25%).Patients were more satisfied with their sedation in the benzodiazepine+opioid group compared to those with monotherapy propofol sedation(MD:+0.89,95%CI:+0.62–+1.17,I2:39%).The recovery time after the procedure showed high heterogeneity even after outlier withdrawal,there was no statistical difference between both arms(MD:-15.15,95%CI:-31.85–+1.56,I2:99%).For Group II(Propofol vs propofol with benzodiazepine and/or opioids):Bradycardia had a tendency to occur in the Propofol group with benzodiazepine and/or opioidassociated(RD:-0.08,95%CI:-0.13–-0.02,I2:59%).There was no statistical difference in the incidence of bradycardia(RD:-0.00,95%CI:-0.08–+0.08,I2:85%),desaturation(RD:-0.00,95%CI:-0.03–+0.02,I2:44%)or recovery time(MD:-2.04,95%CI:-6.96–+2.88,I2:97%)between sedation arms.The total dose of propofol was higher in the propofol group with benzodiazepine and/or opiates but with high heterogeneity.(MD:70.36,95%CI:+53.11–+87.60,I2:61%).For Group III(Propofol with benzodiazepine and opioid vs benzodiazepine and opioid):Bradycardia and hypotension was not statistically significant between groups(RD:-0.00,95%CI:-0.002–+0.02,I2:3%;RD:0.04,95%CI:-0.05–+0.13,I2:77%).Desaturation was evaluated in two articles and was higher in the propofol+benzodiazepine+opioid group,but with high heterogeneity(RD:0.15,95%CI:0.08–+0.22,I2:95%).CONCLUSION This meta-analysis suggests that the use of propofol alone or in combination with traditional adjunctive sedatives is safe and does not result in an increase in negative outcomes in patients undergoing endoscopic procedures.Aureo Augusto de Almeida Delgado Diogo Turiani Hourneaux de Moura Igor Braga Ribeiro Ahmad Najdat Bazarbashi Marcos Eduardo Lera dos Santos Wanderley Marques Bernardo Eduardo Guimaraes Hourneaux de Moura 2019World Journal of Gastrointestinal Endoscopy2019,11,12:6
9Bone marrow-derived monocyte infusion improves hepatic fibrosis by decreasing osteopontin,TGF-β1,IL-13 and oxidative stress显示文摘AIM To evaluate the therapeutic effects of bone marrowderived CD11b+CD14+ monocytes in a murine model of chronic liver damage. METHODS Chronic liver damage was induced in C57BL/6 mice by administration of carbon tetrachloride and ethanol for 6 mo. Bone marrow-derived monocytes isolated by immunomagnetic separation were used for therapy. The cell transplantation effects were evaluated by morphometry,biochemical assessment,immunohistochemistry and enzyme-linked immunosorbent assay. RESULTS CD11b+CD14+ monocyte therapy significantly reduced liver fibrosis and increased hepatic glutathione levels. Levels of pro-inflammatory cytokines,including tumor necrosis factor-α,interleukin(IL)-6 and IL-1β,in addition to pro-fibrotic factors,such as IL-13,transforming growth factor-β1 and tissue inhibitor of metalloproteinase-1 also decreased,while IL-10 and matrix metalloproteinase-9 increased in the monocytetreated group. CD11b+CD14+ monocyte transplantation caused significant changes in the hepatic expression of α-smooth muscle actin and osteopontin. CONCLUSION Monocyte therapy is capable of bringing about improvement of liver fibrosis by reducing oxidative stress and inflammation,as well as increasing antifibrogenic factors.Veruska Cintia Alexandrino de Souza Thiago Almeida Pereira Valéria Wanderley Teixeira Helotonio Carvalho Maria Carolina Accioly Brelaz de Castro Carolline Guimaraes D’assuncao Andreia Ferreira de Barros Camila Lima Carvalho Virgínia Maria Barros de Lorena Vláudia Maria Assis Costa Alvaro Aguiar Coelho Teixeira Regina Celia Bressan Queiroz Figueiredo Sheilla Andrade de Oliveira 2017World Journal of Gastroenterology2017,23,28:6
10Green tea polyphenols inhibit testosterone production in rat Leydig cells显示文摘这研究调查了绿茶摘录(GTE ) 和它的多酚的尖锐效果成分,(-)-epigallocatechin-3-gallate (EGCG ) 和(-)-epicatechin (EC ) ,在由在 vitro 的老鼠 Leydig 房间的基础、刺激的睾丸激素生产上。在一个 Percoll 坡度净化的 Leydig 房间与 GTE, EGCG 或 EC 和睾丸激素先锋 androstenedione 为 3 h 被孵化,当面或任何一个蛋白质 kinase A (PKA ) 的缺席或蛋白质 kinase C (PKC ) 使活跃之物。效果的可逆性被 pretreating 房间与 GTE 或 EGCG 为 15 min 学习,允许他们为 1 h 恢复并且为有人的 chorionic 的 2 h 质问他们 gonadotropin (hCG ) , luteinizing 荷尔蒙释放荷尔蒙(LHRH ) , 22 (R)-hydroxycholesterol 或 androstenedione。GTE 和 EGCG,然而并非 EC,禁止了基础、刺激 kinase 的睾丸激素生产。在预告的处理条件下面, hCG/LHRH-stimulated 或 22 (R)-hydroxycholesterol-induced 睾丸激素生产上的 GTE/EGCG 的更高的集中的禁止的效果被维持,而支持 androstenedione 的睾丸激素生产回来了控制层次。在 GTE/EGCG 的更低的集中, 22 (R)-hydroxycholesterol-supported 睾丸激素生产上的这些多酚的禁止的效果被颠倒。GTE 的禁止的效果可以被它一个 gallate 组的主要部件, EGCG,和存在的行动在它的结构解释在禁止睾丸激素生产为它的高功效似乎重要。位于 GTE 和 EGCG 的效果下面的机制包含表明 P450 方面链劈开酶和 17-hydroxysteroid 脱氢酶功能的小径,以及抑制的 PKA/PKC 的抑制。Marina S. Figueiroa Juliany S. B. Cesar Vieira Disleide S. Leite Ruben C. O. Andrade Filho Fabiano Ferreira Patricia S. Gouveia Daniel P. Udrisar Maria I. Wanderley 2009Asian Journal of Andrology2009,11,3:4
11Propofol 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 2020World Journal of Gastrointestinal Endoscopy2020,12,8:4
12Treatment 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 2019World Journal of Gastrointestinal Endoscopy2019,11,3:2
13Molecular mechanisms underlying the neuroprotection of environmental enrichment in Parkinson’s disease显示文摘Parkinson’s disease is the most common movement disorder,affecting about 1%of the population over the age of 60 years.Parkinson’s disease is characterized clinically by resting tremor,bradykinesia,rigidity and postural instability,as a result of the progressive loss of nigrostriatal dopaminergic neurons.In addition to this neuronal cell loss,Parkinson’s disease is characterized by the accumulation of intracellular protein aggregates,Lewy bodies and Lewy neurites,composed primarily of the proteinα-synuclein.Although it was first described almost 200 years ago,there are no disease-modifying drugs to treat patients with Parkinson’s disease.In addition to conventional therapies,non-pharmacological treatment strategies are under investigation in patients and animal models of neurodegenerative disorders.Among such strategies,environmental enrichment,comprising physical exercise,cognitive stimulus,and social interactions,has been assessed in preclinical models of Parkinson’s disease.Environmental enrichment can cause structural and functional changes in the brain and promote neurogenesis and dendritic growth by modifying gene expression,enhancing the expression of neurotrophic factors and modulating neurotransmission.In this review article,we focus on the current knowledge about the molecular mechanisms underlying environmental enrichment neuroprotection in Parkinson’s disease,highlighting its influence on the dopaminergic,cholinergic,glutamatergic and GABAergic systems,as well as the involvement of neurotrophic factors.We describe experimental pre-clinical data showing how environmental enrichment can act as a modulator in a neurochemical and behavioral context in different animal models of Parkinson’s disease,highlighting the potential of environmental enrichment as an additional strategy in the management and prevention of this complex disease.Tamara Andrea Alarcón Sarah Martins Presti-Silva Ana Paula Toniato Simões Fabiola Mara Ribeiro Rita Gomes Wanderley Pires 2023Neural Regeneration Research2023,18,7:2
14Clonal relationships among avian Escherichia coli isolates determined by enterobacterial repetitive intergenic consensus (ERIC) - PCR显示文摘WANDERLEY D D S ALESSANDRA F MARCELO L 2002Veterinary Microbiology2002,89,:1
15Automated long-term total collection versus indicator method to estimate duodenal digesta flow in cattle 显示文摘WANDERLEY R C THEURER C B RAHNEMA S 1985Journal of Animal Science1985,61,:1
16Artificial neural networks used for ZnO arresters diagnosis显示文摘Wanderley Neto E T da Costa E G Mala M J A 2009IEEE Transactions on Power Delivery2009,24,3:1
17Vortex induced vibration of an elastically mounted circular cylinder using an upwind TVD two di- mensional numerical scheme显示文摘WANDERLEY J B V SOUZA G H B SPHAIER S H 2008Ocean Engineering2008,35,1415:1
18A Two-Dimensional Numerical Investigation of the Hysteresis Effect on Vortex Induced Vibration on an Elastically Mounted Rigid Cylinder显示文摘Wanderley JB V Sphaier S H Levi C 2012Journal of Offshore Mechanics and Arctic Engineering2012,134,02:1
19Biochemical characterization of alpha-amylase from the yeast Cryptococcus flavus显示文摘Wanderley KJ Torres FA Moraes LM 2004FEMS Microbiol Lett2004,231,2:1
20Effects of resistance and aerobic exercise on physical function,bone mineral density,OPG and RANKL in older women显示文摘MARQUES E A WANDERLEY F MACHADO L 2011Experimental gerontology2011,46,7:1
返回顶部 每页显示:
共7页 首页 上一页 第1页 下一页 末页 /7 跳转

网站首页 | 关于我们 | 联系我们 | 产品服务 | 客服中心 | 广告服务 | 版权声明 | 网站联盟 | 友情链接 | 售卡网点

版权所有© 渝B2-20050021-1 渝公网安备 50019002500403号 违法和不良信息举报中心

互联网出版许可证 新出网证(渝)字10号 全国400电话 - 免长途话费