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| 1 | Acute 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 | 2017 | World Journal of Gastrointestinal Surgery2017，9，5： | 18 |
| 2 | Phase angle obtained by bioelectrical impedance analysis independently predicts mortality in patients with cirrhosis显示文摘AIM To evaluate the prognostic value of the phase angle(PA)obtained from bioelectrical impedance analysis(BIA) for mortality prediction in patients with cirrhosis. METHODS In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker(PA ≤ 4.9°) in Kaplan-Meier curves and multivariate Cox regression models. RESULTS The patients were divided into two groups according to the PA cutoff value(PA > 4.9°, n = 73; PA ≤ 4.9°, n = 61). Weight, height, and body mass index were similar in both groups, but patients with PAs > 4.9° were younger and had higher mid-arm muscle circumference, albumin, and handgrip-strength values and lower severe ascites and encephalopathy incidences, interleukin(IL)-6/IL-10 ratios and C-reactive protein levels than did patients with PAs ≤ 4.9°(P ≤ 0.05). Forty-eight(35.80%) patients died due to cirrhosis, with a median of 18 mo(interquartile range, 3.3-25.6 mo) follow-up until death. Thirty-one(64.60%) of these patients were from the PA ≤ 4.9° group. PA ≤ 4.9° significantly and independently affected the mortality model adjusted for Model for End-Stage Liver Disease score and age(hazard ratio = 2.05, 95%CI: 1.11-3.77, P = 0.021). In addition, Kaplan-Meier curves showed that patients with PAs ≤ 4.9° were significantly more likely to die. CONCLUSION In male patients with cirrhosis, the PA ≤ 4.9° cutoff was associated independently with mortality and identified patients with worse metabolic, nutritional, and disease progression profiles. The PA may be a useful and reliable bedside tool to evaluate prognosis in cirrhosis. | Giliane Belarmino Maria Cristina Gonzalez Raquel S Torrinhas Priscila Sala Wellington Andraus Luiz Augusto Carneiro D'Albuquerque Rosa Maria R Pereira Valéria F Caparbo Graziela R Ravacci Lucas Damiani Steven B Heymsfield Dan L Waitzberg | 2017 | World Journal of Hepatology2017，9，7： | 11 |
| 3 | Metabolic 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 | 2015 | World Journal of Gastroenterology2015，21，17： | 5 |
| 4 | Percutaneous radiofrequency ablation for early hepatocellular carcinoma: Risk factors for survival显示文摘AIM: To evaluate outcomes of radiofrequency ablation(RFA) therapy for early hepatocellular carcinoma(HCC) and identify survival- and recurrence-related factors. METHODS: Consecutive patients diagnosed with early HCC by computed tomography(CT) or magnetic resonance imaging(MRI)(single nodule of ≤ 5 cm, or multi-(up to 3) nodules of ≤ 3 cm each) and who underwent RFA treatment with curative intent between January 2010 and August 2011 at the Instituto do Cancer do Estado de S o Paulo, Brazil were enrolled in the study. RFA of the liver tumors(with 1.0 cm ablative margin) was carried out under CT-fluoro scan and ultrasonic image guidance of the percutaneous ablation probes. Procedure-related complications were recorded. At 1-mo post-RFA and 3-mo intervals thereafter, CT and MRI were performed to assess outcomes of complete response(absence of enhancing tissue at the tumor site) or incomplete response(enhancing tissue remaining at the tumor site). Overall survival and diseasefree survival rates were estimated by the Kaplan-Meier method and compared by the log rank test or simple Cox regression. The effect of risk factors on survival was assessed by the Cox proportional hazard model. RESULTS: A total of 38 RFA sessions were performed during the study period on 34 patients(age in years: mean, 63 and range, 49-84). The mean follow-up time was 22 mo(range, 1-33). The study population showed predominance of male sex(76%), less severe liver disease(Child-Pugh A, n = 26; Child-Pugh B, n = 8), and single tumor(65%). The maximum tumor diameters ranged from 10 to 50 mm(median, 26 mm). The initial(immediately post-procedure) rate of RFAinduced complete tumor necrosis was 90%. The probability of achieving complete response was significantly greater in patients with a single nodule(vs patients with multi-nodules, P = 0.04). Two patients experienced major complications, including acute pulmonary edema(resolved with intervention) and intestinal perforation(led to death). The 1- and 2-year overall survival rates were 82% and 71%, respectively. Sex, tumor size, initial response, and recurrence status influenced survival, but did not reach the threshold of statistical significance. Child-Pugh class and the model for end-stage liver disease score were identified as predictors of survival by simple Cox regression, but only Child-Pugh class showed a statistically significant association to survival in multiple Cox regression analysis(HR = 15; 95%CI: 3-76 mo; P = 0.001). The 1-and 2-year cumulative disease-free survival rates were 65% and 36%, respectively. CONCLUSION: RFA is an effective therapy for local tumor control of early HCC, and patients with preserved liver function are the best candidates. | Luciana Kikuchi Marcos Menezes Aline L Chagas Claudia M Tani Regiane SSM Alencar Marcio A Diniz Venncio AF Alves Luiz Augusto Carneiro D’Albuquerque Flair José Carrilho | 2014 | World Journal of Gastroenterology2014，20，6： | 5 |
| 5 | Low-level laser therapy enhances the number of osteocytes in calvaria bone defects of ovariectomized rats显示文摘Background : Osteoporosis can make bone repair difficult. Low-level laser therapy( LLLT) has been shown to be a promising tool for bone neoformation. This study aimed to analyze the effect of LLLT on calvaria bone defects of ovariectomized rats using stereology. Methods : Fifty-four Wistar rats were subjected to bilateral ovariectomy, and bone defects were created in calvaria after 150 days. The animals were divided into nine groups(n = ?6 per group), and 24 hours after the bone defects were created they received three, six or 12 sessions of LLLT at 0, 20 or 30 J/cm 2, using a 780-nm low-intensity GaAlAs laser. One-way ANOVA followed by Tukey ' s post hoc test was used for data processing. A difference of P < 0.05 was considered statistically significant. The parameters evaluated were osteocyte density( Nv_(ost)), total osteocyte number( Nto ost), trabecular surface density( Sv_t), and trabecular surface area( Sa_t). Results : Data obtained showed that Nto ost, Sv t, and Sa t in group G2 rats were significantly different from G1(0 J/cm^2)( P < 0.05). Compared to group G4, G5 presented higher values for the parameters Sv t and Sa t, and G6 presented significantly higher values for almost all the analyzed parameters( Nv _(ost), Nto_(ost), Sv_t, and Sa t)( P < 0.05). Compared to group G7, G8 showed a higher value only for the parameter Sa t, and G9 showed significantly higher values for parameters Nv ost, Nto ost, Sv_t, and Sa_t. Conclusion : We conclude that LLLT stimulated bone neoformation and contributed to an increase in the total number of osteocytes, especially with a laser energy density of 30 J/cm^2 given for six and 12 sessions. | Priscilla Hakime Scalize Luiz Gustavo de Sousa Lígia Maria Napolitano Goncalves Dimitrius Leonardo Pitol Marcelo Palinkas Antonio Augusto Coppi Mariah Acioli Righeti Vitória Ricardo Karina Fittipaldi Bombonato-Prado Simone Cecílio Hallak Regalo Selma Siessere | 2019 | Animal Models and Experimental Medicine2019，2，1： | 2 |
| 6 | Appropriateness 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. | Joo Mangualde Marie I Cremers Ana M Vieira Ricardo Freire lia Gamito Cristina Lobato Ana L Alves Fátima Augusto Ana P Oliveira | 2011 | World Journal of Gastrointestinal Endoscopy2011，3，10： | 2 |
| 7 | Effect of propranolol on the splanchnic and peripheral renin angiotensin system in cirrhotic patients显示文摘AIM:To evaluate the effect of β-blockade on angiotensins in the splanchnic and peripheral circulation of cirrhotic patients and also to compare hemodynamic parameters during liver transplantation according to propranolol pre-treatment or not. METHODS:Patients were allocated into two groups:outpatients with advanced liver disease(LD) and during liver transplantation(LT). Both groups were subdivided according to treatment with propranolol or not. Plasma was collected through peripheral venipuncture to determine plasma renin activity(PRA),Angiotensin(Ang) Ⅰ,Ang Ⅱ,and Ang-(1-7) levels by radioimmunoassay in LD group. During liver transplantation,hemodynamic parameters were determined and blood samples were obtained from the portal vein to measure renin angiotensin system(RAS) components.RESULTS:PRA,Ang Ⅰ,Ang Ⅱ and Ang-(1-7) were signifi cantly lower in the portal vein and periphery in all subgroups treated with propranolol as compared to non-treated. The relationships between Ang-(1-7) and Ang Ⅰ levels and between Ang Ⅱ and Ang Ⅰ were significantly increased in LD group receiving propranolol. The ratio between Ang-(1-7) and Ang Ⅱ remained unchanged in splanchnic and peripheral circulation in patients under β-blockade,whereas the relationship between Ang Ⅱ and Ang Ⅰ was significantly increased in splanchnic circulation of LT patients treated with propranolol. During liver transplantation,cardiac output and index as well systemic vascular resistance and index were reduced in propranolol-treated subgroup. CONCLUSION:In LD group,propranolol treatment reduced RAS mediators,but did not change the ratio between Ang-(1-7) and Ang Ⅱ in splanchnic and peripheral circulation. Furthermore,the modification of hemodynamic parameters in propranolol treated patients was not associated with changes in the angiotensin ratio. | Walkíria Wingester Vilas-Boas Antnio Ribeiro-Oliveira Jr Renata da Cunha Ribeiro Renata Lúcia Pereira Vieira Jerusa Almeida Ana Paula Nadu Ana Cristina Sim■es e Silva Robson Augusto Souza Santos | 2008 | World Journal of Gastroenterology2008，14，44： | 2 |
| 8 | Market power assessment and mitigation in hydrothermal systems显示文摘 | KELMAN R AUGUSTO L BARROSO N | 2001 | IEEE Transactions on Power Systems2001，16，3： | 1 |
| 9 | Association of hemolytic activity of Pseudomonas entomophila, a versatile soil bacterium, with cyclic lipopeptide production显示文摘 | Vallet-Gely I Novikov A Augusto L | 2010 | Applied and Environmental Microbiology2010，76，3： | 1 |
| 10 | Potential contribution of the seed bank in coniferous plantations to the restoration of native deciduous forest vegetation显示文摘 | AUGUSTO L DUPOUEY J L PICARD J F | 2001 | Acta Oecologica2001，22，： | 1 |
| 11 | Decreased arginine and nitrite levels in nitrate reductasedeficient Arabidopsis thaliana plants impair nitric oxide synthesis and the hypersensitive response to Pseudomonas syringae显示文摘 | Modolo L V Augusto O Almeida I M G | 2006 | Plant Science2006，171，1： | 1 |
| 12 | In vitro mutation of Chrysanthemum with ethyl methane sulphonate in immature floral pedicels显示文摘 | RODRIGO R L ALVIS H A AUGUSTO T N | 2004 | Plant Cell Tissue Organ Cult2004，，77： | 1 |
| 13 | Lung function in type 2 diabetes:the Normative Aging Study显示文摘 | AUGUSTO A ROSS L DAVID S | 2005 | Respiratory Medicine2005，99，： | 1 |
| 14 | Impact of tree spe cies on forestsoil acidification显示文摘 | Augusto L Bonnaud P Ranger J | 1998 | Forest Ecology and Management1998，105，13： | 1 |
| 15 | Operating theatre sched- uling with patient recovery in both operating rooms and re- covery beds 显示文摘 | Augusto V Xie X L Perdomo V | 2010 | Computers & Industrial Engineering2010，58，2： | 1 |
| 16 | Potential contribution of the seed bank in coniferous plantations to the restoration of native deciduous forest vegetation显示文摘 | Augusto L Dupouey J L Picard J F | 2001 | Acta Oecologica2001，22，2： | 1 |
| 17 | Microbial reduction of cyclohexanones显示文摘 | de Conti R M Porto A L M Augusto J | 2001 | Journal of Molecular Catalysis B:Enzymatic2001，11，4： | 1 |
| 18 | A modified direct power control strategy allowing the connection of three-phase inverters to the grid through LCL filters显示文摘 | Augusto Serpa L Ponnaluri S Mantovanelli Barbosa P | 2007 | IEEE Transactions on Industrial Applications2007，43，5： | 1 |
| 19 | Impact of several common tree species of European temperate forest on soil fertility 显示文摘 | Augusto L Ranger J Binkley D | 2002 | Annals of Forest Science2002，59，3： | 1 |
| 20 | Autoreduetion of promoted Ni/γAl2O3 during autothermal reforming of methane显示文摘 | l Joelmir Augusto Costa Dias Jose Mansur Assaf | 2005 | Journal of Power Sources2005，139，： | 1 |
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