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| 1 | Feasibility and safety of autologous bone marrow mononuclear cell transplantation in patients with advanced chronic liver disease显示文摘AIM: To evaluate the safety and feasibility of bone marrow cell (BMC) transplantation in patients with chronic liver disease on the waiting list for liver transplantation. METHODS: Ten patients (eight males) with chronic liver disease were enrolled to receive infusion of autologous bone marrow-derived cells. Seven patients were classified as Child-Pugh B and three as Child-Pugh C. Baseline assessment included complete clinical and laboratory evaluation and abdominal MRI. Approximately 50 ml of bone marrow aspirate was prepared by centrifugation in a ficoll-hypaque gradient. At least of 100 millions of mononuclear-enriched BMCs were infused into the hepatic artery using the routine technique for arterial chemoembolization for liver tumors. Patients were followed up for adverse events up to 4 mo. RESULTS: The median age of the patients was 52 years (range 24-70 years). All patients were discharged 48 h after BMC infusion. Two patients complained ofmild pain at the bone marrow needle puncture site. No other complications or specific side effects related to the procedure were observed. Bilirubin levels were lower at 1 (2.19 ± 0.9) and 4 mo (2.10 ± 1.0) after cell transplantation that baseline levels (2.78 ± 1.2). Albumin levels 4 mo after BMC infusion (3.73 ± 0.5) were higher than baseline levels (3.47 ± 0.5). International normalized ratio (INR) decreased from 1.48 (SD = 0.23) to 1.43 (SD = 0.23) one month after cell transplantation. CONCLUSION: BMC infusion into hepatic artery of patients with advanced chronic liver disease is safe and feasible. In addition, a decrease in mean serum bilirubin and INR levels and an increase in albumin levels are observed. Our data warrant further studies in order to evaluate the effect of BMC transplantation in patients with advanced chronic liver disease. | Andre Castro lyra Milena Botelho Pereira Soares luiz Flavio Maia da Silva Marcos Fraga Fortes André Goyanna Pinheiro Silva Augusto César de Andrade Mota Sheilla A Oliveira Eduardo lorens Braga Wilson Andrade de Carvalho Bernd Genser Ricardo Ribeiro dos Santos luiz Guilherme Costa lyra | 2007 | World Journal of Gastroenterology2007，13，7： | 21 |
| 2 | Computed tomography-guided percutaneous core needle biopsy in pancreatic tumor diagnosis显示文摘AIM: To evaluate the techniques, results, and complications related to computed tomography(CT)-guided percutaneous core needle biopsies of solid pancreatic lesions.METHODS: CT-guided percutaneous biopsies of solid pancreatic lesions performed at a cancer reference center between January 2012 and September 2013 were retrospectively analyzed. Biopsy material was collected with a 16-20 G Tru-Core needle(10-15 cm; Angiotech, Vancouver, CA) using a coaxial system and automatic biopsy gun. When direct access to the lesion was not possible, indirect(transgastric or transhepatic) access or hydrodissection and/or pneumodissection maneuvers were used. Characteristics of the patients, lesions, procedures, and histologic results were recorded using a standardized form. RESULTS: A total of 103 procedures included in the study were performed on patients with a mean age of 64.8 year(range: 39-94 year). The mean size of the pancreatic lesions was 45.5 mm(range: 15-195 mm). Most(75/103, 72.8%) procedures were performed via direct access, though hydrodissection and/or pneumodissection were used in 22.2%(23/103) of cases and indirect transhepatic or transgastric access was used in 4.8%(5/103) of cases. Histologic analysis was performed on all biopsies, and diagnoses were conclusive in 98.1%(101/103) of cases, confirming3.9%(4/103) of tumors were benign and 94.2%(97/103) were malignant; results were atypical in 1.9%(2/103) of cases, requiring a repeat biopsy to diagnose a neuroendocrine tumor, and surgical resection to confirm a primary adenocarcinoma. Only mild/moderate complications were observed in 9/103 patients(8.7%),and they were more commonly associated with biopsies of lesions located in the head/uncinate process(n =8), than of those located in the body/tail(n = 1) of the pancreas, but this difference was not significant.CONCLUSION: CT-guided biopsy of a pancreatic lesion is a safe procedure with a high success rate, and is an excellent option for minimally invasive diagnosis. | Chiang J Tyng Maria Fernanda A Almeida Paula NV Barbosa Almir GV Bitencourt José Augusto AG Berg Macello S Maciel Felipe JF Coimbra Luiz Henrique O Schiavon Maria Dirlei Begnami Marcos D Guimares Charles E Zurstrassen Rubens Chojniak | 2015 | World Journal of Gastroenterology2015，21，12： | 14 |
| 3 | Liver transplantation and alcoholic liver disease:History,controversies,and considerations显示文摘Alcohol consumption accounts for 3.8% of annual global mortality worldwide, and the majority of these deaths are due to alcoholic liver disease(ALD), mainly alcoholic cirrhosis. ALD is one of the most common indications for liver transplantation(LT). However, it remains a complicated topic on both medical and ethical grounds, as it is seen by many as a 'self-inflicted disease'. One of the strongest ethical arguments against LT for ALD is the probability of relapse. However, ALD remains a common indication for LT worldwide. For a patient to be placed on an LT waiting list, 6 mo of abstinence must have been achieved for most LT centers. However, this '6-mo rule' is an arbitrary threshold and has never been shown to affect survival, sobriety, or other outcomes. Recent studies have shown similar survival rates among individuals who undergo LT for ALD and those who undergo LT for other chronic causes of end-stage liver disease. There are specific factors that should be addressed when evaluating LT patients with ALD because these patients commonly have a high prevalence of multisystem alcohol-related changes. Risk factors for relapse include the presence of anxiety or depressive disorders, short pre-LT duration of sobriety, and lack of social support. Identification of risk factors and strengthening of the social support system may decrease relapse among these patients. Family counseling for LT candidates is highly encouraged to prevent alcohol consumption relapse. Relapse has been associated with unique histopathological changes, graft damage, graft loss, and even decreased survival in some studies. Research has demonstrated the importance of a multidisciplinary evaluation of LT candidates. Complete abstinence should be attempted to overcome addiction issues and to allow spontaneous liver recovery. Abstinence is the cornerstone of ALD therapy. Psychotherapies, including 12-step facilitation therapy, cognitive-behavioral therapy, and motivational enhancement therapy, help support abstinence. Nutritional therapy helps to reverse muscle wasting, weight loss, vitamin deficiencies, and trace element deficiencies associated with ALD. For muscular recovery, supervised physical activity has been shown to lead to a gain in muscle mass and improvement of functional activity. Early LT for acute alcoholic hepatitis has been the subject of recent clinical studies, with encouraging results in highly selected patients. The survival rates after LT for ALD are comparable to those of patients who underwent LT for other indications. Patients that undergo LT for ALD and survive over 5 years have a higher risk of cardiorespiratory disease, cerebrovascular events, and de novo malignancy. | Claudio Augusto Marroni Alfeu de Medeiros Fleck Jr Sabrina Alves Fernandes Lucas Homercher Galant Marcos Mucenic Mario Henrique de Mattos Meine Guilherme Mariante-Neto Ajacio Bandeira de Mello Brandao | 2018 | World Journal of Gastroenterology2018，24，26： | 7 |
| 4 | Prophylaxis for venous thromboembolism after resection of hepatocellular carcinoma on cirrhosis: Is it necessary?显示文摘AIM: To assess the safety and effectiveness of prophylaxis for venous thromboembolism (VTE) in a large population of patients with hepatocellular carcinoma (HCC) on cirrhosis.METHODS: Two hundred and twenty nine consecutive cirrhotic patients with HCC who underwent hepatic resection were retrospectively evaluated to assess whether there was any difference in the incidence of thrombotic or hemorrhagic complications between those who received and those who did not receive prophylaxis with low-molecular weight heparin.Differences and possible effects of the following parameters were investigated: age,sex,Child-Pugh and model for end-stage liver disease (MELD) score,platelet count,presence of esophageal varices,type of hepatic resection,duration of surgery,intraoperative transfusion of blood and fresh frozen plasma (FFP),body mass index,diabetes and previous cardiovascular disease.RESULTS: One hundred and fifty seven of 229 (68.5%) patients received antithromboembolic prophylaxis (group A) while the remaining 72 (31.5%) patients did not (group B).Patients in group B had higher Child-Pugh and MELD scores,lower platelet counts,a higher prevalence of esophageal varices and higher requirements for intraoperative transfusion of FFP.The incidence of VTE and postoperative hemorrhage was 0.63% and 3.18% in group A and 1.38% and 1.38% in group B,respectively;these differences were not significant.None of the variables analyzed including prophylaxis proved to be risk factors for VTE,and only the presence of esophageal varices was associated with an increased risk of bleeding.CONCLUSION: Prophylaxis is safe in cirrhotic patients without esophageal varices;the real need for prophylaxis should be better assessed. | Marco Vivarelli Matteo Zanello Chiara Zanfi Alessandro Cucchetti Matteo Ravaioli Massimo Del Gaudio Matteo Cescon Augusto Lauro Eva Montanari Gian Luca Grazi Antonio Daniele Pinna | 2010 | World Journal of Gastroenterology2010，16，17： | 6 |
| 5 | Propofol 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 | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，12： | 6 |
| 6 | 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 |
| 7 | Chemical composition of Rosmarinus officinalis essential oil and antioxidant action against gastric damage induced by absolute ethanol in the rat显示文摘Objective: To evaluate the antioxidant activity of the essential oil obtained from Rosmarinus officinalis(R. officinalis) in ethanol-induced gastric ulcer model in vivo.Methods: The antioxidant properties of the essential oil obtained from R. officinalis were evaluated against gastric injury induced by absolute ethanol. Gastric tissues were prepared to enzymatic assays. The levels of glutathione, lipid peroxides, and the activities of glutathione peroxidase, superoxide dismutase and myeloperoxidase were measured.Results: Ethanol produced severe hemorrhagic lesions in the stomach with ulcerative lesion of(140.2 ± 37.2) mm2. In animals pretreated with essential oil of R. officinalis(50 mg/kg, p.o.), a significant inhibition of mucosal injury of(21.2 ± 7.1) mm2(84%inhibition) was observed. The essential oil of R. officinalis protected the gastric mucosa probably by modulating the activities of the enzymes(superoxide dismutase and glutathione peroxidase) and increasing or maintaining the levels of glutathione. In addition,lipid peroxides levels were reduced. The essential oil of R. officinalis was analyzed by gas chromatography–mass spectrometer and the main constituents were cineole(28.5%),camphor(27.7%) and alpha-pinene(21.3%).Conclusions: We suggest that the monoterpenes present in the essential oil obtained from R. officinalis may be among the active principles responsible for the antioxidant activity shown by essential oil of R. officinalis. | Christiane Takayama Felipe Meira de-Faria Ana Cristina Alves de Almeida Ricardo Jose Dunder Luis Paulo Manzo Eduardo Augusto Rabelo Socca Leonia Maria Batista Marcos Jose Salvador Alba Regina Monteiro Souza-Brito Anderson Luiz-Ferreira | 2016 | Asian Pacific Journal of Tropical Biomedicine2016，6，8： | 3 |
| 8 | Development and Optimization of an Alternative Methodology for Detection of Milk Adulteration by Water显示文摘 | Wesley William Gongalves Nascimento Marcone Augusto Leal de Oliveira1 Marcone Augusto Leal de Oliveira Marco Antonio Moreira Furtado Virgilio de Carvalho dos Anjos Maria Jose Valenzuela Bell | 2013 | Journal of Food Science and Engineering2013，3，7： | 2 |
| 9 | Natural Orifice Translumenal Endoscopic Surgery (NOTES) Transvaginal Cholecystectomy in a Morbidly Obese Patient显示文摘 | Luis DeCarli Ricardo Zorron Alcides Branco Fernando Cirme Lima Marcos Tang Sergio Ricardo Pioneer Idilio Zanin Alfredo Augusto Schulte André Vicente Bigolin Michel Gagner | 2008 | Obesity Surgery2008，，7： | 2 |
| 10 | Liver Transplantation for Hepatocellular Carcinoma Under Calcineurin Inhibitors: Reassessment of Risk Factors for Tumor Recurrence显示文摘 | Marco Vivarelli Alessandro Cucchetti Giuliano La Barba Matteo Ravaioli Massimo Del Gaudio Augusto Lauro Gian Luca Grazi Antonio Daniele Pinna | 2008 | Annals of Surgery2008，，5： | 2 |
| 11 | Fetal DNA detection in maternal plasma throughout gestation显示文摘 | Silvia Galbiati Maddalena Smid Dania Gambini Augusto Ferrari Gabriella Restagno Elsa Viora Mario Campogrande Simona Bastonero Marco Pagliano Stefano Calza Maurizio Ferrari Laura Cremonesi | 2005 | Human Genetics (-)2005，，2： | 2 |
| 12 | Osteoarthritis: An Overview of the Disease and Its Treatment Strategies显示文摘 | Piercarlo Sarzi-Puttini Marco A. Cimmino Raffaele Scarpa Roberto Caporali Fabio Parazzini Augusto Zaninelli Fabiola Atzeni Bianca Canesi | 2005 | Seminars in Arthritis and Rheumatism2005，，1： | 2 |
| 13 | Detection of contaminants in cell cultures, sera and trypsin显示文摘 | Tatiana Flávia Pinheiro de Oliveira Ant?nio Augusto Fonseca Marcelo Fernandes Camargos Anapolino Macedo de Oliveira Ana Cláudia Pinto Cottorello Antonizete dos Reis Souza Iassudara Garcia de Almeida Marcos Bryan Heinemann | 2013 | Biologicals2013，，6： | 2 |
| 14 | Efficacy of the over-the-scope clip (OTSC) for treatment of colorectal postsurgical leaks and fistulas显示文摘 | Alberto Arezzo Mauro Verra Rossella Reddavid Francesca Cravero Marco Augusto Bonino Mario Morino | 2012 | Surgical Endoscopy2012，，11： | 2 |
| 15 | Prognostic factors in advancedcancer Patients: evidence-based clinical recommendations-a study bythe Steering Committee of the European Association for palliativecare显示文摘 | Marco M Augusto C Cinzia B | 2015 | J Clin Oncol2015，23，25： | 1 |
| 16 | Oxidative Stress, Nox Isoforms and Complications of Diabetes—Potential Targets for Novel Therapies显示文摘 | Mona Sedeek Augusto Montezano Richard Hebert Stephen Gray Elyse Marco Jay Jha Mark Cooper Karin Jandeleit-Dahm Ernesto Schiffrin Jennifer Wilkinson-Berka Rhian Touyz | 2012 | Journal of Cardiovascular Translational Research2012，，4： | 1 |
| 17 | Effect of Different Immunosuppressive Schedules on Recurrence-Free Survival After Liver Transplantation for Hepatocellular Carcinoma显示文摘 | Marco Vivarelli Alessandro Dazzi Matteo Zanello Alessandro Cucchetti Matteo Cescon Matteo Ravaioli Massimo Del Gaudio Augusto Lauro Gian Luca Grazi Antonio Daniele Pinna | 2010 | Transplantation2010，，2： | 1 |
| 18 | Microsurgical Clipping of Previously Coiled Aneurysms显示文摘 | Pablo Augusto Rubino Jorge Mura Martin Kitroser Juan Santiago Bottan Eduardo Salas Jorge Lambre Marcos Chiarullo Jorge Bustamante | 2014 | 2014 (1-2)2014，，1： | 1 |
| 19 | Low birth weight in Silo Luis, northeastern Brazil, trends and associated factors 显示文摘 | Helma Jane Ferreira Veloso Ant6nio Augusto Moura da Silva Helolsa Bettiol Marcelo Zubarin Goldani Fernando Lamy Filho Vanda Maria Ferreira Sim6es Rosgmgela Fernandes Lucena Batista Marco Ant6nio Barbieri | 2014 | BMC Pre Child2014，14，1： | 1 |
| 20 | Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC显示文摘 | Augusto Caraceni Geoffrey Hanks Stein Kaasa Michael I Ben- nett Cirmia Brunelli Nathan Chemy Ola Dale Franco De Conno Marie Fallon Magdi Hanna Dagny Faksvfig Haugen Gitte Juhl Samuel King PadKlepstad Eivor A Laugsand Marco Maltoni Se- bastiano Mercadante Maria Nabal Alessandra Pigni Lukas Rad- bmch Colette Reid Per Sjogren Patrick C Stone Davide Tassi- nail Giovambattista Zeppetella | 2012 | Lancet Oncol2012，13，2： | 1 |
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