Negative neuromuscular and functional repercussion of forced swimming after axonotmesis

Júlia Araújo de Moura,Jaqueline de Morais,Samara Maria Neves Barbosa,Marcílio Coelho Ferreira,Ivo Vieira de Sousa Neto,Hércules Ribeiro Leite,Murilo Xavier Oliveira,Thaís Peixoto Gaiad,Ana Paula Santo 한국운동재활학회 2022 JER Vol.18 No.3

Endoscopic Ultrasound-Guided Fine Needle Aspiration and Endoscopic Retrograde Cholangiopancreatography-Based Tissue Sampling in Suspected Malignant Biliary Strictures: A Meta-Analysis of Same-Session Procedures

Diogo Turiani Hourneax de Moura,Marvin Ryou,Eduardo Guimarães Hourneaux De Moura,Igor Braga Ribeiro,Wanderlei Marques Bernardo,Christopher C. Thompson 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.4

Background/Aims: The diagnosis of biliary strictures can be challenging. There are no systematic reviews studying same-sessionendoscopic retrograde cholangiopancreatography (ERCP)-based tissue sampling and endoscopic ultrasound-guided fine needleaspiration (EUS-FNA) for the diagnosis of biliary strictures. Methods: A systematic review was conducted on studies analyzing same-session EUS and ERCP for tissue diagnosis of suspectedmalignant biliary strictures. The primary outcome was the accuracy of each method individually compared to the two methodscombined. The secondary outcome was the accuracy of each method in pancreatic and biliary etiologies. In the meta-analysis, we usedForest plots, summary receiver operating characteristic curves, and estimates of the area under the curve for intention-to-treat analysis. Results: Of the 12,132 articles identified, six were included, resulting in a total of 497 patients analyzed. The sensitivity, specificity,positive likelihood ratio, negative likelihood ratio, and accuracy of the association between the two methods were: 86%, 98%, 12.50,0.17, and 96.5%, respectively. For the individual analysis, the sensitivity, specificity and accuracy of EUS-FNA were 76%, 100%, and94.5%, respectively; for ERCP-based tissue sampling, the sensitivity, specificity, and accuracy were 58%, 98%, and 78.1%, respectively. For pancreatic lesions, EUS-FNA was superior to ERCP-based tissue sampling. However, for biliary lesions, both methods had similarsensitivities. Conclusions: Same-session EUS-FNA and ERCP-based tissue sampling is superior to either method alone in the diagnosis of suspectedmalignant biliary strictures. Considering these results, combination sampling should be performed when possible.

Agreement between two methods for assessment of maximal inspiratory pressure in patients weaning from mechanical ventilation

Ribeiro Emanuelle Olympia Silva,Gosselink Rik,Moura Lizandra Eveline da Silva,Correia Raissa Farias,Leite Wagner Souza,Araújo Maria das Graças Rodrigues de,Andrade Armele Dornelas de,Brandão Daniella 대한중환자의학회 2022 Acute and Critical Care Vol.37 No.4

Background: Respiratory muscle strength in patients with an artificial airway is commonly assessed as the maximal inspiratory pressure (MIP) and is measured using analogue or digital manometers. Recently, new electronic loading devices have been proposed to measure respiratory muscle strength. This study evaluates the agreement between the MIPs measured by a digital manometer and those according to an electronic loading device in patients being weaned from mechanical ventilation.Methods: In this prospective study, the standard MIP was obtained using a protocol adapted from Marini, in which repetitive inspiratory efforts were performed against an occluded airway with a one-way valve and were recorded with a digital manometer for 40 seconds (MIPDM). The MIP measured using the electronic loading device (MIPELD) was obtained from repetitively tapered flow resistive inspirations sustained for at least 2 seconds during a 40-second test. The agreement between the results was verified by a Bland-Altman analysis.Results: A total of 39 subjects (17 men, 55.4±17.7 years) was enrolled. Although a strong correlation between MIPDM and MIPELD (R=0.73, P<0.001) was observed, the Bland-Altman analysis showed a high bias of –47.4 (standard deviation, 22.3 cm H2O; 95% confidence interval, –54.7 to –40.2 cm H2O).Conclusions: The protocol of repetitively tapering flow resistive inspirations to measure the MIP with the electronic loading device is not in agreement with the standard protocol using one-way valve inspiratory occlusion when applied in poorly cooperative patients being weaned from mechanical ventilation.

Effects of different calcium-silicate based materials on fracture resistance of immature permanent teeth with replacement root resorption and osteoclastogenesis

de Souza Gabriela Leite,Freitas Gabrielle Alves Nunes,Ribeiro Maria Tereza Hordones,Lemus Nelly Xiomara Alvarado,Soares Carlos José,Moura Camilla Christian Gomes 대한치과보존학회 2023 Restorative Dentistry & Endodontics Vol.48 No.2

Objectives This study evaluated the effects of Biodentine (BD), Bio-C Repair (BCR), and mineral trioxide aggregate (MTA) plug on the fracture resistance of simulated immature teeth with replacement root resorption (RRR) and in vitro-induced osteoclastogenesis. Materials and Methods Sixty bovine incisors simulating immature teeth and RRR were divided into 5 groups: BD and BCR groups, with samples completely filled with the respective materials; MTA group, which utilized a 3-mm apical MTA plug; RRR group, which received no root canal filling; and normal periodontal ligament (PL) group, which had no RRR and no root canal filling. All the teeth underwent cycling loading, and compression strength testing was performed using a universal testing machine. RAW 264.7 macrophages were treated with 1:16 extracts of BD, BCR, and MTA containing receptor activator of nuclear factor-kappa B ligand (RANKL) for 5 days. RANKL-induced osteoclast differentiation was assessed by staining with tartrate-resistant acid phosphatase. The fracture load and osteoclast number were analyzed using 1-way ANOVA and Tukey’s test (α = 0.05). Results No significant difference in fracture resistance was observed among the groups (p > 0.05). All materials similarly inhibited osteoclastogenesis (p > 0.05), except for BCR, which led to a lower percentage of osteoclasts than did MTA (p < 0.0001). Conclusions The treatment options for non-vital immature teeth with RRR did not strengthen the teeth and promoted a similar resistance to fractures in all cases. BD, MTA, and BCR showed inhibitory effects on osteoclast differentiation, with BCR yielding improved results compared to the other materials. Objectives This study evaluated the effects of Biodentine (BD), Bio-C Repair (BCR), and mineral trioxide aggregate (MTA) plug on the fracture resistance of simulated immature teeth with replacement root resorption (RRR) and in vitro-induced osteoclastogenesis. Materials and Methods Sixty bovine incisors simulating immature teeth and RRR were divided into 5 groups: BD and BCR groups, with samples completely filled with the respective materials; MTA group, which utilized a 3-mm apical MTA plug; RRR group, which received no root canal filling; and normal periodontal ligament (PL) group, which had no RRR and no root canal filling. All the teeth underwent cycling loading, and compression strength testing was performed using a universal testing machine. RAW 264.7 macrophages were treated with 1:16 extracts of BD, BCR, and MTA containing receptor activator of nuclear factor-kappa B ligand (RANKL) for 5 days. RANKL-induced osteoclast differentiation was assessed by staining with tartrate-resistant acid phosphatase. The fracture load and osteoclast number were analyzed using 1-way ANOVA and Tukey’s test (α = 0.05). Results No significant difference in fracture resistance was observed among the groups (p > 0.05). All materials similarly inhibited osteoclastogenesis (p > 0.05), except for BCR, which led to a lower percentage of osteoclasts than did MTA (p < 0.0001). Conclusions The treatment options for non-vital immature teeth with RRR did not strengthen the teeth and promoted a similar resistance to fractures in all cases. BD, MTA, and BCR showed inhibitory effects on osteoclast differentiation, with BCR yielding improved results compared to the other materials.

Endoscopic Ultrasound Fine-Needle Aspiration versus Fine-Needle Biopsy for Lymph Node Diagnosis: A Large Multicenter Comparative Analysis

Diogo Turiani Hourneaux de Moura,Thomas R. McCarty,Pichamol Jirapinyo,Igor Braga Ribeiro,Galileu Ferreira Ayala Farias,Marvin Ryou,Linda S. Lee,Christopher C. Thompson 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.5

Background/Aims: Endoscopic ultrasound fine-needle aspiration (EUS-FNA) is preferred for sampling of lymph nodes (LNs) adjacentto the gastrointestinal wall; however, fine-needle biopsy (FNB) may provide improved diagnostic outcomes. This study aimed toevaluate the comparative effcacy and safety of FNA versus FNB for LN sampling. Methods: This was a multicenter retrospective study of prospectively collected data to evaluate outcomes of EUS-FNA and EUS-FNBfor LN sampling. Characteristics analyzed included sensitivity, specificity, accuracy, the number of needle passes, diagnostic adequacyof rapid on-site evaluation (ROSE), cell-block analysis, and adverse events. Results: A total of 209 patients underwent EUS-guided LN sampling. The mean lesion size was 16.22±8.03 mm, with similar sensitivityand accuracy between FNA and FNB ([67.21% vs. 75.00%, respectively, p=0.216] and [78.80% vs. 83.17%, respectively, p=0.423]). Thespecificity of FNB was better than that of FNA (100.00% vs. 93.62%, p=0.01). The number of passes required for diagnosis was notdifferent. Abdominal and peri-hepatic LN location demonstrated FNB to have a higher sensitivity (81.08% vs. 64.71%, p=0.031 and80.95% vs. 58.33%, p=0.023) and accuracy (88.14% vs. 75.29%, p=0.053 and 88.89% vs. 70.49%, p=0.038), respectively. ROSE was asignificant predictor for accuracy (odds ratio, 5.16; 95% confidence interval, 1.15–23.08; p=0.032). No adverse events were reported ineither cohort. Conclusions: Both EUS-FNA and EUS-FNB are safe for the diagnosis of LNs. EUS-FNB is preferred for abdominal LN sampling. EUS-FNA+ROSE was similar to EUS-FNB alone, showing better diagnosis for EUS-FNB than traditional FNA. While ROSE remained asignificant predictor for accuracy, due to its poor availability in most centers, its use may be limited to cases with previous inconclusivediagnoses.

Fingerprint and authenticity roasted coffees by ¹H-NMR: the Brazilian coffee case

Toci, Aline Theodoro,de Moura Ribeiro, Marcos Vinicius,de Toledo, Paulo Roberto Aparecido Bueno,Boralle, Nivaldo,Pezza, Helena Redigolo,Pezza, Leonardo 한국식품과학회 2018 Food Science and Biotechnology Vol.27 No.1

With globalization, it has become necessary to adopt policies to regulate the coffee market, addressing problems including the authenticity and traceability of products. It is therefore important to establish methodologies that can help to safeguard the interests of producer countries and add value to products. For this purpose, the use of NMR combined with multivariate statistical procedures can be an attractive option. The aim of this study was to develop a fast and effective technique, using $^1H$ NMR coupled with multivariate statistics, to create a fingerprint of roasted coffees, distinguishing them according to the main Brazilian producer regions. Several compounds suitable for differentiating roasted coffees were identified in the fingerprint. Discriminant analysis revealed good distinction among the samples. The compounds catechol, trigonelline, caffeine, and n-methylpyridine were most important for the differentiation. The findings should assist coffee-producing countries in adopting measures to protect their markets and to add value to coffee products.

Stent versus Balloon Dilation for the Treatment of Dominant Strictures in Primary Sclerosing Cholangitis: A Systematic Review and Meta-Analysis

Marina Tucci Gammaro Baldavira Ferreira,Igor Braga Ribeiro,Diogo Turiani Hourneaux de Moura,Thomas R. McCarty,Alberto Machado da Ponte Neto,Galileu Ferreira Ayala Farias,Antônio Afonso de Miranda Neto 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.6

Background/Aims: The endoscopic management of primary sclerosing cholangitis (PSC)-associated dominant strictures remainschallenging. This systematic review and meta-analysis aimed to compare balloon dilation and stent placement in the treatment ofdominant strictures among PSC patients. Methods: Literature searches on MEDLINE, EMBASE, Cochrane CENTRAL and Lilacs/Bireme were performed for studiespublished until December 2020. Measured outcomes included clinical efficacy, stricture recurrence, cumulative recurrencefree rate,transplant rate, 5-year survival rate, and adverse events (i.e., pancreatitis, cholangitis, bleeding, perforation and death). Results: A total of 5 studies (n=467) were included. Based on pooled analyses, there were no differences in clinical efficacy (riskdifference [RD], -0.13; 95% confidence interval [CI], -0.58 to 0.33; I2=93%) or transplant rates (RD, -0.09; 95% CI, -0.19 to 0.01;I2=0%); however, the risk of occurrence of adverse events was lower with balloon dilatation than with stent placement (RD,-0.34; 95% CI, -0.45 to -0.23; I2=61%). Among the types of adverse events reported, only the rates of cholangitis/bacteremia weresignificantly lower in balloon dilation patients (RD, -0.19; 95% CI, -0.25 to -0.13; I2=51%). Conclusions: Compared to balloon dilation, stent placement for dominant strictures in PSC appeared to have higher complicationrates without significant differences in efficacy.

Fingerprint and authenticity roasted coffees by 1H-NMR: the Brazilian coffee case

Aline Theodoro Toci,Marcos Vinı´cius de Moura Ribeiro,Paulo Roberto Aparecido Bueno de Toledo,Nivaldo Boralle,Helena Redigolo Pezza,Leonardo Pezza 한국식품과학회 2018 Food Science and Biotechnology Vol.27 No.1

With globalization, it has become necessary to adopt policies to regulate the coffee market, addressing problems including the authenticity and traceability of products. It is therefore important to establish methodologies that can help to safeguard the interests of producer countries and add value to products. For this purpose, the use of NMR combined with multivariate statistical procedures can be an attractive option. The aim of this study was to develop a fast and effective technique, using 1H NMR coupled with multivariate statistics, to create a fingerprint of roasted coffees, distinguishing them according to the main Brazilian producer regions. Several compounds suitable for differentiating roasted coffees were identified in the fingerprint. Discriminant analysis revealed good distinction among the samples. The compounds catechol, trigonelline, caffeine, and n-methylpyridine were most important for the differentiation. The findings should assist coffee-producing countries in adopting measures to protect their markets and to add value to coffee products.

Insufflation of Carbon Dioxide versus Air During Colonoscopy Among Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

John Alexander Lata Guacho,Diogo Turiani Hourneaux De Moura,Igor Braga Ribeiro,Bruna Furia Buzetti Hourneaux de Moura,Megui Marilia Mansilla Gallegos,Thomas McCarty,Ricardo Katsuya Toma,Eduardo Guimar 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.2

Background/Aims: Carbon dioxide is increasingly used in insufflation during colonoscopy in adult patients; however, air insufflationremains the primary practice among pediatric gastroenterologists. This systematic review and meta-analysis aims to evaluateinsufflation using CO2 versus air in colonoscopies in pediatric patients. Methods: Individualized search strategies were performed using MEDLINE, Cochrane Library, EMBASE, and LILACS databasesfollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Cochrane workingmethodology. Randomized control trials (RCTs) were selected for the present meta-analysis. Pooled proportions were calculated foroutcomes including procedure time and abdominal pain immediately and 24 hours post-procedure. Results: The initial search yielded 644 records, of which five RCTs with a total of 358 patients (CO2: n=178 versus air: n=180) wereincluded in the final analysis. The procedure time was not different between the CO2 and air insufflation groups (mean difference,10.84; 95% confidence interval [CI], -2.55 to 24.22; p=0.11). Abdominal pain immediately post-procedure was significantly lowerin the CO2 group (risk difference [RD], -0.15; 95% CI; -0.26 to -0.03; p=0.01) while abdominal pain at 24 hours post-procedure wassimilar (RD, -0.05; 95% CI; -0.11 to 0.01; p=0.11). Conclusions: Based on this systematic review and meta-analysis of RCT data, CO2 insufflation reduced abdominal pain immediatelyfollowing the procedure, while pain was similar at 24 hours post-procedure. These results suggest that CO2 is a preferred insufflationtechnique when performing colonoscopy in pediatric patients.

Cryotherapy versus radiofrequency ablation in the treatment of dysplastic Barrett’s esophagus with or without early esophageal neoplasia: a systematic review and meta-analysis

Igor Logetto Caetité Gomes,Diogo Turiani Hourneaux de Moura,Igor Braga Ribeiro,Sérgio Barbosa Marques,Alexandre de Sousa Carlos,Beanie Conceição Medeiros Nunes,Bruno Salomão Hirsch,Guilherme Henrique 대한소화기내시경학회 2024 Clinical Endoscopy Vol.57 No.2

Background/Aims: Radiofrequency ablation (RFA) is the first-line therapy for dysplastic Barrett’s esophagus (BE). Therefore, cryotherapy has emerged as an alternative treatment option. This study aimed to compare the efficacies of these two techniques based on the rates of complete eradication of intestinal metaplasia (CE-IM) and dysplasia (CE-D). Adverse events and recurrence have also been reported. Methods: An electronic search was conducted using the Medline (PubMed), Embase, LILACS, and Google Scholar databases until December 2022. Studies were included comparing cryotherapy and RFA for treating dysplastic BE with or without early esophageal neoplasia. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Three retrospective cohort studies involving 627 patients were included. Of these, 399 patients underwent RFA, and 228 were treated with cryotherapy. There was no difference in CE-IM (risk difference [RD], –0.03; 95% confidence interval [CI], –0.25 to 0.19; p=0.78; I2=86%) as well as in CE-D (RD, –0.03; 95% CI, –0.15 to 0.09; p=0.64; I2=70%) between the groups. The absolute number of adverse events was low, and there was no difference in the recurrence rate. Conclusions: Cryotherapy and RFA were equally effective in treating dysplastic BE, with or without early esophageal neoplasia.