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Dantas ACB, Coutinho JL, de Meira Junior JD, De Moura DTH, Pajecki D, Santo MA. Lots of reflux, but no Barrett's: real-world data on the incidence of Gastroesophageal Reflux on routine endoscopic follow-up more than five years after Sleeve Gastrectomy. J Gastrointest Surg 2024:S1091-255X(24)00434-7. [PMID: 38705371 DOI: 10.1016/j.gassur.2024.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/24/2024] [Accepted: 04/27/2024] [Indexed: 05/07/2024]
Affiliation(s)
- Anna Carolina Batista Dantas
- Unidade de Cirurgia Bariátrica e Metabólica, Disciplina de Cirurgia do Aparelho Digestivo e Coloproctologia, Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, BR.
| | - Jorge Landivar Coutinho
- Disciplina de Cirurgia do Aparelho Digestivo e Coloproctologia, Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, BR.
| | - José Donizeti de Meira Junior
- Disciplina de Cirurgia do Aparelho Digestivo e Coloproctologia, Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, BR.
| | - Diogo Turiani Hourneaux De Moura
- Serviço de Endoscopia Gastrointestinal, Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, BR.
| | - Denis Pajecki
- Unidade de Cirurgia Bariátrica e Metabólica, Disciplina de Cirurgia do Aparelho Digestivo e Coloproctologia, Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, BR.
| | - Marco Aurelio Santo
- Unidade de Cirurgia Bariátrica e Metabólica, Disciplina de Cirurgia do Aparelho Digestivo e Coloproctologia, Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, BR.
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Andraus W, Tustumi F, de Meira Junior JD, Pinheiro RSN, Waisberg DR, Lopes LD, Arantes RM, Rocha Santos V, de Martino RB, Carneiro D’Albuquerque LA. Molecular Profile of Intrahepatic Cholangiocarcinoma. Int J Mol Sci 2023; 25:461. [PMID: 38203635 PMCID: PMC10778975 DOI: 10.3390/ijms25010461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Intrahepatic cholangiocarcinoma (ICC) is a relatively uncommon but highly aggressive primary liver cancer that originates within the liver. The aim of this study is to review the molecular profile of intrahepatic cholangiocarcinoma and its implications for prognostication and decision-making. This comprehensive characterization of ICC tumors sheds light on the disease's underlying biology and offers a foundation for more personalized treatment strategies. This is a narrative review of the prognostic and therapeutic role of the molecular profile of ICC. Knowing the molecular profile of tumors helps determine prognosis and support certain target therapies. The molecular panel in ICC helps to select patients for specific therapies, predict treatment responses, and monitor treatment responses. Precision medicine in ICC can promote improvement in prognosis and reduce unnecessary toxicity and might have a significant role in the management of ICC in the following years. The main mutations in ICC are in tumor protein p53 (TP53), Kirsten rat sarcoma virus (KRAS), isocitrate dehydrogenase 1 (IDH1), and AT-rich interactive domain-containing protein 1A (ARID1A). The rate of mutations varies significantly for each population. Targeting TP53 and KRAS is challenging due to the natural characteristics of these genes. Different stages of clinical studies have shown encouraging results with inhibitors of mutated IDH1 and target therapy for ARID1A downstream effectors. Fibroblast growth factor receptor 2 (FGFR2) fusions are an important target in patients with ICC. Immune checkpoint blockade can be applied to a small percentage of ICC patients. Molecular profiling in ICC represents a groundbreaking approach to understanding and managing this complex liver cancer. As our comprehension of ICC's molecular intricacies continues to expand, so does the potential for offering patients more precise and effective treatments. The integration of molecular profiling into clinical practice signifies the dawn of a new era in ICC care, emphasizing personalized medicine in the ongoing battle against this malignancy.
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Affiliation(s)
| | - Francisco Tustumi
- Department of Gastroenterology, Transplantation Unit, Universidade de São Paulo, São Paulo 05403-000, Brazil
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Santiago LTC, Freitas NAD, Meira Junior JDD, Corrente JE, Paula VG, Damasceno DC, de Souza Rugolo LMS. Oxidative status in colostrum and mature breast milk related to gestational age and fetal growth. J Matern Fetal Neonatal Med 2023; 36:2183763. [PMID: 36852433 DOI: 10.1080/14767058.2023.2183763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
INTRODUCTION The effect of gestational age and fetal growth on the oxidant/antioxidant status of breast milk is poorly understood. OBJECTIVE To evaluate the oxidative stress biomarkers in colostrum and mature milk according to gestational age and fetal growth. METHOD A longitudinal study with mothers of premature and term infants, born in a tertiary referral hospital between 2014-2018. Inclusion criteria: postpartum women with a singleton pregnancy, who intended to exclusively breastfeed. Exclusion criteria: maternal diabetes, use of medication, drug addiction, congenital infection or malformation, mastitis, and failure to collect colostrum. Four groups were formed according to gestational age and birth weight (appropriate and small): Preterm small (n = 37), Preterm appropriate (n = 99), Full-term small (n = 65), and Full-term appropriate (control, n = 69). The colostrum samples were collected between 24-72 h and the mature milk was sampled in the 4th week of lactation for malondialdehyde (biomarker for lipid peroxidation) and Glutathione peroxidase, Catalase, and Superoxide dismutase measurements. The data were compared among groups using the Chi-square test or Fisher's exact test, one-way analysis of variance followed by Wald's Distribution test and repeated measures analysis of variance. RESULTS We found a lower malondialdehyde level in colostrum in preterm groups and term small for gestational age, and the antioxidant enzymes Superoxide dismutase and Catalase activities were higher for preterm compared to term groups. The malondialdehyde levels differed in mature milk samples (Full-term small > Full-term appropriate > Preterm small > Preterm appropriate). The malondialdehyde levels increased during lactation in all groups except Preterm appropriate, and the levels of Catalase decreased in preterm groups. CONCLUSION The oxidative status in breast milk is influenced by gestational age and fetal growth, which increased antioxidant defense for preterm infants and decreased oxidative stimuli for small for gestational age infants. These findings contribute to encouraging breastfeeding for newborns.
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Affiliation(s)
| | | | | | - José Eduardo Corrente
- Institute of Biosciences of Botucatu, UNESP_Univ Estadual Paulista, São Paulo State, Brazil
| | - Verônyca Gonçalves Paula
- Laboratory of Experimental Research on Gynecology and Obstetrics, Postgraduate Course on Tocogynecology, Univ Estadual Paulista_Unesp, Botucatu, São Paulo State, Brazil
| | - Debora Cristina Damasceno
- Laboratory of Experimental Research on Gynecology and Obstetrics, Postgraduate Course on Tocogynecology, Univ Estadual Paulista_Unesp, Botucatu, São Paulo State, Brazil
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Antonio Aissar Sallum R, Alexandre Fernandes F, Torres Branco L, Serena Arguelho Pereira L, Maria Arruda Vilanova de Câmara C, Beltrão Pereira Simões Í, Donizeti de Meira Junior J, Mello Mazepa M, Ervolino Corbi L, Nicida Garcia R, Takeda FR. Robotic Myotomy and Partial Fundoplication for Achalasia. J Vis Exp 2023. [PMID: 37590546 DOI: 10.3791/64822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
Laparoscopic Heller myotomy is currently considered the standard definitive treatment of achalasia. With the advancements in technology, robotic Heller myotomy has emerged as an alternative approach to traditional laparoscopy due to three-dimensional (3D) visualization, fine motor control, and improved ergonomics provided by the robot. Although there is a lack of randomized controlled trials, robotic-assisted Heller myotomy seems to be associated with lower rates of intraoperative perforations compared to the laparoscopic approach. A robotic approach may also improve surgical outcomes by providing a more complete myotomy. Here, we describe the detailed steps of robotic myotomy and partial fundoplication for achalasia.
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Boaron L, Facchin L, Bau M, Zacharias P, Ribeiro D, Miranda EF, Barcelos IFD, Ropelato RV, Steckert Filho Á, Meira Junior JDD, Sassaki L, Saad-Hossne R, Kotze PG. Postoperative complication rates between Crohn's disease and Colorectal cancer patients after ileocolic resections: a comparative study. Journal of Coloproctology 2021. [DOI: 10.1016/j.jcol.2017.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Abstract
Introduction Ileocolic resection (ICR) is the most common surgical procedure performed for Crohn's disease (CD). Similarly, right-sided Colorectal cancer (CRC) is treated by the same operation. The primary aim of this study was to analyze and compare the frequency and profile of early postoperative complications of ICR between patients with CD and CRC.
Methods Retrospective and observational study with patients submitted to ICR from two Brazilian tertiary referral units in colorectal surgery. We included patients with diagnosis of CD or CRC, treated with ICR, at any stage of follow-up. Variables analyzed: age at surgery, gender, diagnosis, surgical approach (open or laparoscopy), type of anastomosis (hand-sewn/stapled; end-to-end/side-to-side), presence and type of early postoperative complications (30 days) and mortality, among others.
Results 109 patients were included, 73 with CD (67%) and 36 with CRC (33%). CD patients were younger (42.44 ± 12.73 years vs. 66.14 ± 11.02 years in the CRC groups, p < 0.0001) and had more previous resections (20 ± 27.4 in CD and 0 in CCR, p = 0.001). There were no significant differences between the groups in terms of overall early postoperative complications [17/73 (23.3%) in the CD and 5/36 (13.9%) in the CRC groups (p = 0.250)]. There was no significant difference between the groups in relation to anastomotic leakage (p = 0.185), surgical site infections (p = 0.883), other complications (0.829) and deaths (p = 0.069).
Conclusions There was no significant difference in early postoperative complications in patients with CD or CRC submitted to ICR.
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Affiliation(s)
- Larissa Boaron
- Pontifícia Universidade Católica do Paraná (PUCPR), Hospital Universitário Cajuru, Serviço de Coloproctologia (SeCoHUC), Curitiba, PR, Brazil
| | - Luiza Facchin
- Pontifícia Universidade Católica do Paraná (PUCPR), Hospital Universitário Cajuru, Serviço de Coloproctologia (SeCoHUC), Curitiba, PR, Brazil
| | - Mariella Bau
- Pontifícia Universidade Católica do Paraná (PUCPR), Hospital Universitário Cajuru, Serviço de Coloproctologia (SeCoHUC), Curitiba, PR, Brazil
| | - Patricia Zacharias
- Pontifícia Universidade Católica do Paraná (PUCPR), Hospital Universitário Cajuru, Serviço de Coloproctologia (SeCoHUC), Curitiba, PR, Brazil
| | - Diogo Ribeiro
- Pontifícia Universidade Católica do Paraná (PUCPR), Hospital Universitário Cajuru, Serviço de Coloproctologia (SeCoHUC), Curitiba, PR, Brazil
| | - Eron Fábio Miranda
- Pontifícia Universidade Católica do Paraná (PUCPR), Hospital Universitário Cajuru, Serviço de Coloproctologia (SeCoHUC), Curitiba, PR, Brazil
| | - Ivan Folchini de Barcelos
- Pontifícia Universidade Católica do Paraná (PUCPR), Hospital Universitário Cajuru, Serviço de Coloproctologia (SeCoHUC), Curitiba, PR, Brazil
| | - Renato Vismara Ropelato
- Pontifícia Universidade Católica do Paraná (PUCPR), Hospital Universitário Cajuru, Serviço de Coloproctologia (SeCoHUC), Curitiba, PR, Brazil
| | | | | | - Ligia Sassaki
- Universidade Estadual Paulista (UNESP), Ambulatório de Doenças Inflamatórias Intestinais, Botucatu, SP, Brazil
| | - Rogério Saad-Hossne
- Universidade Estadual Paulista (UNESP), Ambulatório de Doenças Inflamatórias Intestinais, Botucatu, SP, Brazil
| | - Paulo Gustavo Kotze
- Pontifícia Universidade Católica do Paraná (PUCPR), Hospital Universitário Cajuru, Serviço de Coloproctologia (SeCoHUC), Curitiba, PR, Brazil
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Freitas NAD, Santiago LTC, Kurokawa CS, Meira Junior JDD, Corrente JE, Rugolo LMSDS. Effect of preeclampsia on human milk cytokine levels. J Matern Fetal Neonatal Med 2018; 32:2209-2213. [DOI: 10.1080/14767058.2018.1429395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Natália Alves de Freitas
- Department of Pediatrics, Botucatu School of Medicine, University Estadual Paulista (UNESP), Botucatu, Brazil
| | | | - Cilmery Suemi Kurokawa
- Department of Pediatrics, Botucatu School of Medicine, University Estadual Paulista (UNESP), Botucatu, Brazil
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