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| 1 | Long-term outcomes of hepatocellular carcinoma that underwent chemoembolization for bridging or downstaging显示文摘BACKGROUND Prospective study of 200 patients with hepatocellular carcinoma(HCC)that underwent liver transplant(LT)after drug-eluting beads transarterial chemoembolization(DEB-TACE)for downstaging versus bridging.Overall survival and tumor recurrence rates were calculated,eligibility for LT,time on the waiting list and radiological response were compared.After TACE,only patients within Milan Criteria(MC)were transplanted.More patients underwent LT in bridging group.Five-year post-transplant overall survival,recurrence-free survival has no difference between the groups.Complete response was observed more frequently in bridging group.Patients in DS group can achieve posttransplant survival and HCC recurrence-free probability,at five years,just like patients within MC in patients undergoing DEB-TACE.AIM To determine long-term outcomes of patients with HCC that underwent LT after DEB-TACE for downstaging vs bridging.METHODS Prospective cohort study of 200 patients included from April 2011 through June 2014.Bridging group included patients within MC.Downstaging group(out of MC)was divided in 5 subgroups(G1 to G5).Total tumor diameter was≤8 cm for G1,2,3,4(n=42)and was>8 cm for G5(n=22).Downstaging(n=64)and bridging(n=136)populations were not significantly different.Overall survival and tumor recurrence rates were calculated by the Kaplan-Meier method.Additionally,eligibility for LT,time on the waiting list until LT and radiological response were compared.RESULTS After TACE,only patients within MC were transplanted.More patients underwent LT in bridging group 65.9%(P=0.001).Downstaging population presented:higher number of nodules 2.81(P=0.001);larger total tumor diameter 8.09(P=0.001);multifocal HCC 78%(P=0.001);more post-transplantation recurrence 25%(P=0.02).Patients with maximal tumor diameter up to 7.05 cm were more likely to receive LT(P=0.005).Median time on the waiting list was significantly longer in downstaging group 10.6 mo(P=0.028).Five-year posttransplant overall survival was 73.5%in downstaging and 72.3%bridging groups(P=0.31),and recurrence-free survival was 62.1%in downstaging and 74.8%bridging groups(P=0.93).Radiological response:complete response was observed more frequently in bridging group(P=0.004).CONCLUSION Tumors initially exceeding the MC down-staged after DEB-TACE,can achieve post-transplant survival and HCC recurrence-free probability,at five years,just like patients within MC in patients undergoing DEB-TACE. | Breno Boueri Affonso Francisco Leonardo Galastri Joaquim Mauricio da Motta Leal Filho Felipe Nasser Priscila Mina Falsarella Rafael Noronha Cavalcante Marcio Dias de Almeida Guilherme Eduardo Goncalves Felga Leonardo Guedes Moreira Valle Nelson Wolosker | 2019 | World Journal of Gastroenterology2019，25，37： | 21 |
| 2 | Endoscopic 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 | 2015 | World Journal of Gastroenterology2015，21，47： | 10 |
| 3 | Imaging of pancreatic ductal adenocarcinoma: State of the art显示文摘Significant advances in imaging technology have changed the management of pancreatic cancer. In computed tomography (CT), this has included development of multidetector row, rapid, thin-section imaging that has also facilitated the advent of advanced reconstructions, which in turn has offered new perspectives from which to evaluate this disease. In magnetic resonance imaging, advances including higher field strengths, thin-section volumetric acquisitions, diffusion weighted imaging, and liver specific contrast agents have also resulted in new tools for diagnosis and staging. Endoscopic ultrasound has resulted in the ability to provide high-resolution imaging rivaling intraoperative ultrasound, along with the ability to biopsy via real time imaging suspected pancreatic lesions. Positron emission tomography with CT, while still evolving in its role, provides whole body staging as well as the unique imaging characteristic of metabolic activity to aid disease management. This article will review these modalities in the diagnosis and staging of pancreatic cancer. | Eric Peter Tamm Priya Ranjit Bhosale Raghu Vikram Leonardo Pimentel de Almeida Marcal Aparna Balachandran | 2013 | World Journal of Radiology2013，5，3： | 3 |
| 4 | Imaging response predictors following drug eluting beads chemoembolization in the neoadjuvant liver transplant treatment of hepatocellular carcinoma显示文摘BACKGROUND Drug-eluting bead transarterial chemoembolization(DEB-TACE)is an endovascular treatment to release chemotherapeutic agents within a target lesion,minimizing systemic exposure and adverse effects to chemotherapeutics.Therefore,identifying which patient characteristics may predict imaging response to DEB-TACE can improve treatment results while selecting the best candidates.Predictors of the response after DEB-TACE still have not been fully elucidated.This is the first prospective study performed with standardized DEBTACE technique that aim to identify predictors of radiological response,assessing patients clinical and laboratory characteristics,diagnostic imaging and intraprocedure data of the hepatocellular carcinoma treated in the neoadjuvant context for liver transplantation.AIM To identify pre-and intraoperative clinical and imaging predictors of the radiological response of drug-eluting bead transarterial chemoembolization(DEB-TACE)for the neoadjuvant treatment of hepatocellular carcinoma(HCC).METHODS This is prospective,cohort study,performed in a single transplant center,from 2011 to 2014.Consecutive patients with HCC considered for liver transplant who underwent DEB-TACE in the first session for downstaging or bridging purposes were recruited.Pre and post-chemoembolization imaging studies were performed by computed tomography or magnetic resonance.The radiological response of each individual HCC was evaluated by objective response using mRECIST and the percentage of necrosis.RESULTS Two hundred patients with 380 HCCs were examined.Analysis of the objective response(nodule-based analysis)demonstrated that HCC with pseudocapsules had a 2.01 times greater chance of being responders than those without pseudocapsules(P=0.01),and the addition of every 1mg of chemoembolic agent increased the chance of therapeutic response in 4%(P<0.001).Analysis of the percentage of necrosis through multiple linear regression revealed that the addition of each 1mg of the chemoembolic agent caused an average increase of 0.65%(P<0.001)in necrosis in the treated lesion,whereas the hepatocellular carcinoma with pseudocapsules presented 18.27%(P<0.001)increased necrosis compared to those without pseudocapsules.CONCLUSION The presence of a pseudocapsule and the addition of the amount of chemoembolic agent increases the chance of an objective response in hepatocellular carcinoma and increases the percentage of tumor necrosis following drug-eluting bead chemoembolization in the neoadjuvant treatment,prior to liver transplantation. | Francisco Leonardo Galastri Felipe Nasser Breno Boueri Affonso Leonardo Guedes Moreira Valle Bruno Calazans Odísio Joaquim Mauricio Motta-Leal Filho Paolo Rogério Salvalaggio Rodrigo Gobbo Garcia Márcio Dias de Almeida Ronaldo Hueb Baroni Nelson Wolosker | 2020 | World Journal of Hepatology2020，12，1： | 2 |
| 5 | Induced pluripotent stem cells, a giant leap for mankind therapeutic applications显示文摘Induced pluripotent stem cells(iPSC)technology has propelled the field of stem cells biology,providing new cells to explore the molecular mechanisms of pluripotency,cancer biology and aging.A major advantage of human iPSC,compared to the pluripotent embryonic stem cells,is that they can be generated from virtually any embryonic or adult somatic cell type without destruction of human blastocysts.In addition,iPSC can be generated from somatic cells harvested from normal individuals or patients,and used as a cellular tool to unravel mechanisms of human development and to model diseases in a manner not possible before.Besides these fundamental aspects of human biology and physiology that are revealed using iPSC or iPSC-derived cells,these cells hold an immense potential for cell-based therapies,and for the discovery of new or personalized pharmacological treatments for many disorders.Here,we review some of the current challenges and concerns about iPSC technology.We introduce the potential held by iPSC for research and development of novel health-related applications.We briefly present the efforts made by the scientific and clinical communities to create the necessary guidelines and regulations to achieve the highest quality standards in the procedures for iPSC generation,characterization and long-term preservation.Finally,we present some of the audacious and pioneer clinical trials in progress with iPSC-derived cells. | JoséBraganca Joao AndréLopes Leonardo Mendes-Silva Joao Miguel Almeida Santos | 2019 | World Journal of Stem Cells2019，11，7： | 2 |
| 6 | Histological evaluation of the response of apical tissues to glass ionomer and zinc oxide-eogenol based sealers in dog teeth after root canal treatment显示文摘 | Leonardo MR Almeida WA Silva LAB | 1998 | Endod Dent Traumato1998，14，3： | 1 |
| 7 | Tissue response to an epoxy resin-based root canal sealer 显示文摘 | Leonardo MR Silva LA Almeida WA | 1999 | Endod Dent Traumatol1999，15，： | 1 |
| 8 | Joannesia princeps: Evaluation of Aqueous Extracts Genotoxicity Utilizing Allium cepa Assay and Micronucleus Test显示文摘 | Viviane Moreira de Lima Jessica Tamara dos Santos Teixeira Jennifer Vieira Gomes Lelio Kallut Almeida Netto Leonardo Oliveira Bastos Hataanderson Luiz Cabral dos Santos Lenicio Gongalves Francisco de Assis da Silva Bruno Pereira Berto Helcio Resende Borba | 2013 | Journal of Life Sciences2013，7，12： | 1 |
| 9 | Antioxidant and intestinal anti-inflammatory effects of plant-derived coumarin derivatives显示文摘 | Aline Witaicenis Leonardo Noboru Seito Alexandre da Silveira Chagas Luiz Domingues de Almeida Ana Carolina Luchini Patrícia Rodrigues-Orsi Silvia Helena Cestari Luiz Claudio Di Stasi | 2013 | Phytomedicine2013，，： | 1 |
| 10 | Tissue response to an epoxy resin - based root canal sealer 显示文摘 | LEONARDO M R DA SILVA L A Almeida W A | 1999 | Endo Dent Traumatol1999，15，1： | 1 |
| 11 | Microwave coagulation versus sclerotherapy after band ligation to prevent recurrence of high risk of bleeding esophageal varices in Child-Pugh’s A and B patients显示文摘 | Leonardo Trevizan Monici José Olympio Meirelles-Santos Elza Cotrim Soares Maria Aparecida Mesquita José Murilo Robilotta Zeitune Ciro Garcia Montes Jazon Romilson Souza Almeida Ademar Yamanaka Luis Alberto Magna | 2010 | Journal of Gastroenterology2010，，2： | 1 |
| 12 | Response surface methodology (RSM) as a tool for optimization in analytical chemistry显示文摘 | Marcos Almeida Bezerra Ricardo Erthal Santelli Eliane Padua Oliveira Leonardo Silveira Villar Luciane Amélia Escaleira | 2008 | Talanta2008，，5： | 1 |
| 13 | Response surface methodology (RSM) as a tool for optimization in analytical chemistry显示文摘 | Marcos Almeida Bezerra Ricardo Erthal Santelli Eliane Padua Oliveira Leonardo Silveira Villar Luciane Amélia Escaleira | 2008 | Talanta2008，，5： | 1 |
| 14 | Inactivation of formyltransferase (wbkC) gene generates a Brucella abortus rough strain that is attenuated in macrophages and in mice显示文摘 | Thaís Lourdes Santos Lacerda Patrícia Gomes Cardoso Leonardo Augusto de Almeida Ilana Lopes Baratella da Cunha Camargo Daniela Almeida Freitas Afonso Cyntia Cardoso Trant Gilson Costa Macedo Eleonora Campos Silvio L. Cravero Suzana P. Salcedo Jean-Pierre | 2010 | Vaccine2010，，34： | 1 |
| 15 | Response surface methodology (RSM) as a tool for optimization in analytical chemistry显示文摘 | Marcos Almeida Bezerra Ricardo Erthal Santelli Eliane Padua Oliveira Leonardo Silveira Villar Luciane Amélia Escaleira | 2008 | Talanta2008，，5： | 1 |
| 16 | Prediction of hospital mortality in intensive care unit patients from clinical and laboratory data: A machine learning approach显示文摘BACKGROUND Intensive care unit(ICU)patients demand continuous monitoring of several clinical and laboratory parameters that directly influence their medical progress and the staff’s decision-making.Those data are vital in the assistance of these patients,being already used by several scoring systems.In this context,machine learning approaches have been used for medical predictions based on clinical data,which includes patient outcomes.AIM To develop a binary classifier for the outcome of death in ICU patients based on clinical and laboratory parameters,a set formed by 1087 instances and 50 variables from ICU patients admitted to the emergency department was obtained in the“WiDS(Women in Data Science)Datathon 2020:ICU Mortality Prediction”dataset.METHODS For categorical variables,frequencies and risk ratios were calculated.Numerical variables were computed as means and standard deviations and Mann-Whitney U tests were performed.We then divided the data into a training(80%)and test(20%)set.The training set was used to train a predictive model based on the Random Forest algorithm and the test set was used to evaluate the predictive effectiveness of the model.RESULTS A statistically significant association was identified between need for intubation,as well predominant systemic cardiovascular involvement,and hospital death.A number of the numerical variables analyzed(for instance Glasgow Coma Score punctuations,mean arterial pressure,temperature,pH,and lactate,creatinine,albumin and bilirubin values)were also significantly associated with death outcome.The proposed binary Random Forest classifier obtained on the test set(n=218)had an accuracy of 80.28%,sensitivity of 81.82%,specificity of 79.43%,positive predictive value of 73.26%,negative predictive value of 84.85%,F1 score of 0.74,and area under the curve score of 0.85.The predictive variables of the greatest importance were the maximum and minimum lactate values,adding up to a predictive importance of 15.54%.CONCLUSION We demonstrated the efficacy of a Random Forest machine learning algorithm for handling clinical and laboratory data from patients under intensive monitoring.Therefore,we endorse the emerging notion that machine learning has great potential to provide us support to critically question existing methodologies,allowing improvements that reduce mortality. | Elena Caires Silveira Soraya Mattos Pretti Bruna Almeida Santos Caio Fellipe Santos Correa Leonardo Madureira Silva Fabricio Freire de Melo | 2022 | World Journal of Critical Care Medicine2022，11，5： | 0 |
| 17 | Diagnosis and management of hepatic artery in-stent restenosis after liver transplantation by optical coherence tomography:A case report显示文摘BACKGROUNDPercutaneous transluminal angioplasty and stenting represent an effectivetreatment for hepatic artery stenosis after liver transplantation. In the first yearafter stenting, approximately 22% of patients experience in-stent restenosis,increasing the risk of artery thrombosis and related complications, and 50%experience liver failure. Although angiography is an important tool for diagnosisand the planning of therapeutic interventions, it may raise doubts, especially insmall-diameter arteries, and it provides low resolution rates compared withnewer intravascular imaging methods, such as optical coherence tomography(OCT).CASE SUMMARYA 64-year-old male developed hepatic artery stenosis one year after orthotropicliver transplantation and was successfully treated with percutaneous transluminalangioplasty with stenting. Five months later, the Doppler ultrasound resultsindicated restenosis. Visceral arteriography confirmed hepatic artery tortuositybut was doubtful for significant in-stent restenosis (ISR) and intrahepatic flowreduction. To confirm ISR, identify the etiology and guide treatment, OCT wasperformed. OCT showed severe stenosis due to four mechanisms: Focal andpartial stent fracture, late stent malapposition, in-stent neointimal hyperplasia,and neoatherosclerosis.CONCLUSIONIntravascular diagnostic methods can be useful in evaluating cases in which initialangiography results are not sufficient to provide a proper diagnosis of significantstenosis, especially with regard to ISR. A wide range of diagnoses are provided byOCT, resulting in different treatment options. Interventional radiologists shouldconsider intravascular diagnostic methods as additional tools for evaluatingpatients when visceral angiography results are unclear. | Francisco Leonardo Galastri Guilherme Moratti Gilberto Breno Boueri Affonso Leonardo Guedes Moreira Valle Priscila Mina Falsarella Adriano Mendes Caixeta Camila Antunes Lima Marcela Juliano Silva Lucas Lembrança Pinheiro Conrado Dias Pacheco Annicchino Baptistella Márcio Dias de Almeida Rodrigo Gobbo Garcia Nelson Wolosker Felipe Nasser | 2020 | World Journal of Hepatology2020，12，7： | 0 |
| 18 | Governing Climate Change in Brazilian Coastal Cities" Risks and Strategies显示文摘 | Leila da Costa FerreiraI Rafael D'Almeida Martins Fabiana Barbi Lficia da Costa Ferreira Leonardo Freire de Mello Alberto Matenhauer Urbinattit Femanda Oliveira de Souza Thales Haddad Novaes de Andrade | 2011 | Journal of US-China Public Administration2011，8，1： | 0 |
| 19 | Development of New Macadamia Products显示文摘 | Thamires Canuto de Almeida e Silva Leonardo da Silva Arriechet Dermeval Jos6 Mazzini Sartori | 2013 | Journal of Chemistry and Chemical Engineering2013，7，8： | 0 |
| 20 | Large primary hepatic gastrinoma in young patient treated with trisegmentectomy: A case report and review of the literature显示文摘Primary hepatic gastrinoma is a rare disease, with fewer than 40 cases reported in the medical literature. Because it is located in an organ in which metastases are common, its diagnosis is difficult. We report a case of a 19 years old male patient with a history of gastric ulcers since the age of nine. Following gastric surgery, an antrectomy and a vagotomy, there was some alleviation of symptoms. Subsequently, the patient reported various intermittent episodes of diarrhea, diffuse abdominal pain, and vomiting. The patient underwent tomography, which revealed the presence of a hepatic mass measuring 19.5 cm × 12.5 cm × 17 cm. Primary hepatic gastrinoma was diagnosed based on laboratory examinations that indicated hypergastrinemia and a positron emission tomography/magnetic resonance study with somatostatin analogue that confirmed the liver as the primary site. After hepatic trisegmentectomy(Ⅱ, Ⅲ, Ⅳ, Ⅴ, Ⅷ), the patient's symptoms improved. The case is notable for the presence of a rare tumor with uncommon dimensions. | Leonardo Zumerkorn Pipek Yuri Justi Jardim Gustavo Heluani Antunes de Mesquita Fernanda Nii Kayo Augusto de Almeida Medeiros Bárbara Justo Carvalho Diego Ramos Martines Leandro Ryuchi Iuamoto Daniel Reis Waisberg Luiz Augusto Carneiro D'Albuquerque Alberto Meyer Wellington Andraus | 2018 | World Journal of Hepatology2018，10，7： | 0 |
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