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| 1 | Video 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 | 2018 | World Journal of Gastrointestinal Endoscopy2018，10，12： | 10 |
| 2 | Endoscopic 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 | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，4： | 6 |
| 3 | Management of autoimmune hepatitis:Focus on pharmacologic treatments beyond corticosteroids显示文摘In autoimmune hepatitis, patients who are intolerant or with toxicity experience, non-responders, relapsers or refractory are challenging. Non-standard drugs are being tried to preemptively avoid corticosteroid-related side effects. Prognosis and quality of life of life rely on treatment optimization. Recently, emergence of powerful immunosuppressive agents, mainly from liver transplantation, challenged the supremacy of the corticosteroid regime and promise greater immunosuppression than conventional medications, offer site-specific actions and satisfactory patient tolerance. Successes in experimental models of related diseases have primed these molecular interventions. We performed a literature review on alternative treatments. Azatioprine intolerance is the principal indication for mycophenolate use butit can be used as a front-line therapy. Cyclosporine A and tacrolimus have been tested for non-responders or relapsers. Rituximab may be used as salvage therapy. Anti-tumor necrosis factor-alpha agents may be used for incomplete responses or non-responders. Methotrexate is possibly an alternative for induction of remission and maintenance in refractory patients. Cyclophosphamide has been included in the induction regimen with corticosteroids. Ursodeoxycholic acid action is mainly immunomodulatory. Non-standard treatments are coming slowly to the attention, but its use should be cautious performed by experienced centers. | Marta Casal Moura Rodrigo Liberal Hélder Cardoso Ana Maria Horta e Vale Guilherme Macedo | 2014 | World Journal of Hepatology2014，6，6： | 2 |
| 4 | Use of omental patch and endoscopic closure technique as an alternative to surgery after endoscopic full thickness resection of gastric intestinal stromal tumors: A series of cases显示文摘BACKGROUND Gastrointestinal stromal tumors(GISTs)originate from interstitial cells of Cajal.GISTs can occur anywhere along the gastrointestinal tract.Large lesions have traditionally been removed surgically.However,with recent innovations in advanced endoscopy,GISTs located within the stomach are now removed endoscopically.We describe a new innovative endoscopic technique to close large and hard to access defects after endoscopic full-thickness resection of gastric GISTs.CASE SUMMARY We present a series of three patients who were diagnosed with a gastric GIST.All patients underwent full-thickness endoscopic resection.In all cases,for closure of the surgical bed,conventional endoscopic techniques including hemoclips,endoloop and suturing were unsuccessful.We performed a new technique in which we pulled omental fat into the gastric lumen and completely closed the defect using endoscopic devices.All patients performed well post-procedure and computed tomography was carried out one day after the procedures which showed no extravasation of contrast.CONCLUSION The omental plug technique may be used as an alternative to surgery in selected cases of gastric perforation. | Amit H Sachdev Shahzad Iqbal Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura | 2020 | World Journal of Clinical Cases2020，8，1： | 2 |
| 5 | Excentral cleavage of beta- carotene in vivo in a healthy man显示文摘 | HO C C de MOURA F F KIM S H | 2007 | Clin Nutr2007，85，3： | 1 |
| 6 | Acute bleeding after argon plasma coagulation for weight regain after gastric bypass: A case report显示文摘Roux-en-Y gastric bypass(RYGB)is the most commonly performed surgical procedure used to treat obesity worldwide.Despite satisfactory results in terms of weight loss,over time many patients experience weight regain.There are many factors that contribute to weight regain after RYGB,including the diameter of the gastric-jejunal anastomosis(GJA).One of the most commonly performed endoscopic procedures for weight regain after RYGB is argon plasma coagulation(APC).We report a case of hematemesis after outlet revision with APC.We highlight several treatment modalities that can be used to treat this complication.CASE SUMMARY A 45-year-old female with a history of weight regain after RYGB was referred for possible endoscopic treatment for weight regain.On endoscopic evaluation,the diameter of the GJA was 22 mm.Due to the dilated GJA,treatment with APC was performed.Several months later she reported a return of poor satiety and an increased appetite.A repeat endoscopy was then performed.The GJA was approximately 15 mm and was incompetent.APC was performed.One day post procedure she had four episodes of hematemesis.An endoscopy was performed and a large ulcer with a visible arterial vessel was visualized at the GJA.Coagulation was attempted using a Coagrasper and after initial contact with the vessel,the vessel started oozing.Due to fibrosis and the depth of ulceration in the area,clips and repeat APC could not be used.Therefore,an attempt to inject epinephrine injection was made.However,persistent oozing was noted.As a result,hemostatic powder was applied to the region of the bleeding vessel.Subsequently,no more bleeding was observed.On follow-up,the patient remained hemodynamically stable and a second look endoscopy was not performed.The patient was discharged three days later.CONCLUSION APC revision of the GJA is known to be a relatively safe and effective strategy to manage weight regain post RYGB.Anastomotic site bleeding is an infrequent and potentially life-threatening complication associated with this therapy.Endoscopic management is the first line therapy used to achieve hemostasis in these cases. | Diogo Turiani Hourneaux de Moura Amit H Sachdev Po-Wen Lu Igor Braga Ribeiro Christopher C Thompson | 2019 | World Journal of Clinical Cases2019，7，15： | 1 |
| 7 | Isolation of Nosema algerae from cornea of an immunnocompetent patient显示文摘 | Visvesvara G S Belloso M Moura H | 1999 | J Eukaryot Microbiol1999，46，5： | 1 |
| 8 | The differential regulation of human telomerase reverse transcriptase and vascular endothelial growth factor may contribute to the clinically more aggressive behavior of p693-positive breast carcinomas 显示文摘 | Ribeiro-Silva A Becker de Moura H Ribeiro do Vale F | 2005 | Int J Biol Markers2005，20，4： | 1 |
| 9 | QD-Leaming:a collaborative distributed strategy for multi-agent reinforcement learning through consensus plus innovations显示文摘 | KAR S MOURA J M F POOR H V | 2013 | IEEE Transactions on Signal Processing2013，61，7： | 1 |
| 10 | Evaluation of electricalpotential difference across gastric mucosa in patiant with chronic gastritis according to site,histology,anddegree of inflammation显示文摘 | Gutin J Hause H Moura MA | 1987 | Dig Dis Sci1987，32，3： | 1 |
| 11 | Botulinum neurotoxin detection and differentiation by mass spectrometry显示文摘 | Barr JR Moura H Boyer AE | 2005 | Emer Infect Dis2005，11，10： | 1 |
| 12 | Energy and water balance measurements for water productivity analysis in irrigated mango trees, Northeast Brazil显示文摘 | Teixeira A H C Bastiaanssen W G M Moura M S B | 2008 | Agricultural and Forest Meteorology2008，，148： | 1 |
| 13 | Identification of pumpkin populations as resistance sources against the Zucchini yellow virus (ZYMV)显示文摘 | Moura M da C C L Zerbini E M da Silva D J H de Queiroz M A | 2005 | Horticultura Brasileira2005，23，： | 1 |
| 14 | Astochastic optimal control approach for powermanagement in plug-in hybrid electric vehicles显示文摘 | MOURA S J FATHY H K CALLAWAY D S | 2011 | Control Systems Technology IEEE Transactions on2011，19，3： | 1 |
| 15 | Structured low - density parity - check codes 显示文摘 | Moura J M F LU J ZHANG H T | 2004 | IEEE Signal Processing Magazine2004，，2： | 1 |
| 16 | Structured LDPC Codes with Large Girth 显示文摘 | Moura J M F Lu J Zhang H | 2004 | IEEE Signal Process Mag2004，21，1： | 1 |
| 17 | Energy and water balance measurements for water productivity analysis in irrigated mango trees ,Northeast Brazil显示文摘 | TEIXEIRA A H DE C BASTIAANSSEN W G M MOURA M S B SOARES J M AHMAD M D BOS M G | 2008 | Agricultural and Forest Meteorology2008，148，： | 1 |
| 18 | The human isolate of Brachiola algerae (Phylum Microspora):development in SCID mice and description of its fine structure features显示文摘 | Koudela B Visvesvara GS Moura H | 2001 | Parasitology2001，123，2： | 1 |
| 19 | Efficient use of Fe metal as an electron transfer agent in a heterogeneous Fenton system based on Fe0/Fe3O4composites显示文摘 | Moura F C C Araujo M H Costa R C C | 2005 | Chemosphere2005，60，： | 1 |
| 20 | Perinatal arrhythmias -- diagnosis and treatment显示文摘 | Moura C Vieira A Guimaraes H | 2002 | Rev Port Cardiol2002，21，1： | 1 |
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