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  • 1
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    Online Resource
    Effect of Duodenal–Jejunal Bypass Surgery on Glycemic Control in Type 2 Diabetes: A Randomized Controlled Trial
    Wiley ; 2015
    In:  Obesity Vol. 23, No. 10 ( 2015-10), p. 1973-1979
    Details
    In: Obesity, Wiley, Vol. 23, No. 10 ( 2015-10), p. 1973-1979
    Abstract: To determine whether upper gastrointestinal tract (UGI) bypass itself has beneficial effects on the factors involved in regulating glucose homeostasis in patients with type 2 diabetes (T2D). Methods A 12‐month randomized controlled trial was conducted in 17 overweight/obese subjects with T2D, who received standard medical care (SC, n  = 7, BMI = 31.7 ± 3.5 kg/m 2 ) or duodenal–jejunal bypass surgery with minimal gastric resection (DJBm) ( n  = 10; BMI = 29.7 ± 1.9 kg/m 2 ). A 5‐h modified oral glucose tolerance test was performed at baseline and at 1, 6, and 12 months after surgery or starting SC. Results Body weight decreased progressively after DJBm (7.9 ± 4.1%, 9.6 ± 4.2%, and 10.2 ± 4.3% at 1, 6, and 12 months, respectively) but remained stable in the SC group ( P   〈  0.001). DJBm, but not SC, improved: (1) oral glucose tolerance (decreased 2‐h glucose concentration, P  = 0.039), (2) insulin sensitivity (decreased homeostasis model assessment of insulin resistance, P  = 0.013), (3) early insulin response to a glucose load (increased insulinogenic index, P  = 0.022), and (4) overall glycemic control (reduction in HbA1c with fewer diabetes medications). Conclusions DJBm causes moderate weight loss and improves metabolic function in T2D. However, our study cannot separate the benefits of moderate weight loss from the potential therapeutic effect of UGI tract bypass itself on the observed metabolic improvements.
    Type of Medium: Online Resource
    ISSN: 1930-7381 , 1930-739X
    URL: Issue
    URL: Article
    DOI: 10.1002/oby.v23.10
    DOI: 10.1002/oby.21190
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2027211-X
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  • 2
    Online Resource
    Online Resource
    Cachexia causes time‐dependent activation of the inflammasome in the liver
    Wiley ; 2023
    In:  Journal of Cachexia, Sarcopenia and Muscle Vol. 14, No. 4 ( 2023-08), p. 1621-1630
    Details
    In: Journal of Cachexia, Sarcopenia and Muscle, Wiley, Vol. 14, No. 4 ( 2023-08), p. 1621-1630
    Abstract: Cachexia is a wasting syndrome associated with systemic inflammation and metabolic disruption. Detection of the early signs of the disease may contribute to the effective attenuation of associated symptoms. Despite playing a central role in the control of metabolism and inflammation, the liver has received little attention in cachexia. We previously described relevant disruption of metabolic pathways in the organ in an animal model of cachexia, and herein, we adopt the same model to investigate temporal onset of inflammation in the liver. The aim was thus to study inflammation in rodent liver in the well‐characterized cachexia model of Walker 256 carcinosarcoma and, in addition, to describe inflammatory alterations in the liver of one cachectic colon cancer patient, as compared to one control and one weight‐stable cancer patient. Methods Colon cancer patients (one weight stable [WSC] and one cachectic [CC] ) and one patient undergoing surgery for cholelithiasis (control, n  = 1) were enrolled in the study, after obtainment of fully informed consent. Eight‐week‐old male rats were subcutaneously inoculated with a Walker 256 carcinosarcoma cell suspension (2 × 10 7 cells in 1.0 mL; tumour‐bearing [T]; or phosphate‐buffered saline—controls [C] ). The liver was excised on Days 0 ( n  = 5), 7 ( n  = 5) and 14 ( n  = 5) after tumour cell injection. Results In rodent cachexia, we found progressively higher numbers of CD68 + myeloid cells in the liver along cancer‐cachexia development. Similar findings are described for CC, whose liver showed infiltration of the same cell type, compared with both WSC and control patient organs. In advanced rodent cachexia, hepatic phosphorylated c‐Jun N‐terminal kinase protein content and the inflammasome pathway protein expression were increased in relation to baseline ( P   〈  0.05). These changes were accompanied by augmented expression of the active interleukin‐1β (IL‐1β) form ( P   〈  0.05 for both circulating and hepatic content). Conclusions The results show that cancer cachexia is associated with an increase in the number of myeloid cells in rodent and human liver and with modulation of hepatic inflammasome pathway. The latter contributes to the aggravation of systemic inflammation, through increased release of IL‐1β.
    Type of Medium: Online Resource
    ISSN: 2190-5991 , 2190-6009
    URL: Issue
    URL: Article
    DOI: 10.1002/jcsm.v14.4
    DOI: 10.1002/jcsm.13236
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2586864-0
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  • 3
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    Online Resource
    Activation of the Adipose Tissue NLRP3 Inflammasome Pathway in Cancer Cachexia
    Frontiers Media SA ; 2021
    In:  Frontiers in Immunology Vol. 12 ( 2021-9-23)
    Details
    In: Frontiers in Immunology, Frontiers Media SA, Vol. 12 ( 2021-9-23)
    Abstract: Cachexia is a paraneoplastic syndrome that accompanies and compromises cancer treatment, especially in advanced stages, affecting the metabolism and function of several organs. The adipose tissue is the first to respond to the presence of the tumor, contributing to the secretion of factors which drive the systemic inflammation, a hallmark of the syndrome. While inflammation is a defensive innate response, the control mechanisms have been reported to be disrupted in cachexia. On the other hand, little is known about the role of NLRP3 inflammasome in this scenario, a multiprotein complex involved in caspase-1 activation and the processing of the cytokines IL-1β and IL-18. Aim based on the evidence from our previous study with a rodent model of cachexia, we examined the activation of the NLRP3 inflammasome pathway in two adipose tissue depots obtained from patients with colorectal cancer and compared with that another inflammatory pathway, NF-κB. Results For CC we found opposite modulation in ScAT and PtAT for the gene expression of TLR4, Caspase-1 (cachectic group) and for NF-κB p50, NF-κB p65, IL-1β. CD36, expression was decreased in both depots while that of NLRP3 and IL-18 was higher in both tissues, as compared with controls and weight stable patients (WSC). Caspase-1 basal protein levels in the ScAT culture supernatant were higher in WSC and (weight stable patients) CC, when compared to controls. Basal ScAT explant culture medium IL-1β and IL-18 protein content in ScAT supernatant was decreased in the WSC and CC as compared to CTL explants. Conclusions The results demonstrate heterogeneous responses in the activation of genes of the NLRP3 inflammasome pathway in the adipose tissue of patients with cancer cachexia, rendering this pathway a potential target for therapy aiming at decreasing chronic inflammation in cancer.
    Type of Medium: Online Resource
    ISSN: 1664-3224
    URL: Article
    DOI: 10.3389/fimmu.2021.729182
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 2606827-8
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  • 4
    Online Resource
    Online Resource
    Comparative anatomical analysis of the transcallosal-transchoroidal and transcallosal-transforniceal-transchoroidal approaches to the third ventricle
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2016
    In:  Journal of Neurosurgery ( 2016-11), p. 1-10
    Details
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), ( 2016-11), p. 1-10
    Abstract: Access to the third ventricle is a veritable challenge to neurosurgeons. In this context, anatomical and morphometric studies are useful for establishing the limitations and advantages of a particular surgical approach. The transchoroidal approach is versatile and provides adequate exposure of the middle and posterior regions of the third ventricle. However, the fornix column limits the exposure of the anterior region of the third ventricle. There is evidence that the unilateral section of the fornix column has little effect on cognitive function. This study compared the anatomical exposure afforded by the transforniceal-transchoroidal approach with that of the transchoroidal approach. In addition, a morphometric evaluation of structures that are relevant to and common in the 2 approaches was performed. METHODS The anatomical exposure provided by the transcallosal-transchoroidal and transcallosal-transforniceal-transchoroidal approaches was compared in 8 fresh cadavers, using a neuronavigation system. The working area, microsurgical exposure area, and angular exposure on the longitudinal and transversal planes of 2 anatomical targets (tuber cinereum and cerebral aqueduct) were compared. Additionally, the thickness of the right frontal lobe parenchyma, thickness of the corpus callosum trunk, and longitudinal diameter of the interventricular foramen were measured. The values obtained were submitted to statistical analysis using the Wilcoxon test. RESULTS In the quantitative evaluation, compared with the transchoroidal approach, the transforniceal-transchoroidal approach provided a greater mean working area (transforniceal-transchoroidal 150 ± 11 mm 2 ; transchoroidal 121 ± 8 mm 2 ; p 〈 0.05), larger mean microsurgical exposure area (transforniceal-transchoroidal 101 ± 9 mm 2 ; transchoroidal 80 ± 5 mm 2 ; p 〈 0.05), larger mean angular exposure area on the longitudinal plane for the tuber cinereum (transforniceal-transchoroidal 71° ± 7°; transchoroidal 64° ± 6°; p 〈 0.05), and larger mean angular exposure area on the longitudinal plane for the cerebral aqueduct (transforniceal-transchoroidal 62° ± 6°; transchoroidal 55° ± 5°; p 〈 0.05). No differences were observed in angular exposure along the transverse axis for either anatomical target (tuber cinereum and cerebral aqueduct; p 〉 0.05). The mean thickness of the right frontal lobe parenchyma was 35 ± 3 mm, the mean thickness of the corpus callosum trunk was 10 ± 1 mm, and the mean longitudinal diameter of the interventricular foramen was 4.6 ± 0.4 mm. In the qualitative assessment, it was noted that the transforniceal-transchoroidal approach led to greater exposure of the third ventricle anterior region structures. There was no difference between approaches in the exposure of the structures of the middle and posterior region. CONCLUSIONS The transforniceal-transchoroidal approach provides greater surgical exposure of the third ventricle anterior region than that offered by the transchoroidal approach. In the population studied, morphometric analysis established mean values for anatomical structures common to both approaches.
    Type of Medium: Online Resource
    ISSN: 0022-3085 , 1933-0693
    URL: Article
    DOI: 10.3171/2016.8.JNS16403.test
    RVK:
    XA 10000
    RVK:
    XA 55270
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2016
    detail.hit.zdb_id: 2026156-1
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  • 5
    Online Resource
    Online Resource
    Biliary Drainage in Patients With Unresectable, Malignant Obstruction Where ERCP Fails : Endoscopic Ultrasonography-Guided Choledochoduodenostomy Versus Percutaneous Drainage
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Journal of Clinical Gastroenterology Vol. 46, No. 9 ( 2012-10), p. 768-774
    Details
    In: Journal of Clinical Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. 9 ( 2012-10), p. 768-774
    Type of Medium: Online Resource
    ISSN: 0192-0790
    URL: Article
    DOI: 10.1097/MCG.0b013e31825f264c
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
    detail.hit.zdb_id: 2041558-8
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  • 6
    Online Resource
    Online Resource
    Comparative anatomical analysis of the transcallosal-transchoroidal and transcallosal-transforniceal-transchoroidal approaches to the third ventricle
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2017
    In:  Journal of Neurosurgery Vol. 127, No. 1 ( 2017-07), p. 209-218
    Details
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 127, No. 1 ( 2017-07), p. 209-218
    Abstract: Access to the third ventricle is a veritable challenge to neurosurgeons. In this context, anatomical and morphometric studies are useful for establishing the limitations and advantages of a particular surgical approach. The transchoroidal approach is versatile and provides adequate exposure of the middle and posterior regions of the third ventricle. However, the fornix column limits the exposure of the anterior region of the third ventricle. There is evidence that the unilateral section of the fornix column has little effect on cognitive function. This study compared the anatomical exposure afforded by the transforniceal-transchoroidal approach with that of the transchoroidal approach. In addition, a morphometric evaluation of structures that are relevant to and common in the 2 approaches was performed. METHODS The anatomical exposure provided by the transcallosal-transchoroidal and transcallosal-transforniceal-transchoroidal approaches was compared in 8 fresh cadavers, using a neuronavigation system. The working area, microsurgical exposure area, and angular exposure on the longitudinal and transversal planes of 2 anatomical targets (tuber cinereum and cerebral aqueduct) were compared. Additionally, the thickness of the right frontal lobe parenchyma, thickness of the corpus callosum trunk, and longitudinal diameter of the interventricular foramen were measured. The values obtained were submitted to statistical analysis using the Wilcoxon test. RESULTS In the quantitative evaluation, compared with the transchoroidal approach, the transforniceal-transchoroidal approach provided a greater mean working area (transforniceal-transchoroidal 150 ± 11 mm 2 ; transchoroidal 121 ± 8 mm 2 ; p 〈 0.05), larger mean microsurgical exposure area (transforniceal-transchoroidal 101 ± 9 mm 2 ; transchoroidal 80 ± 5 mm 2 ; p 〈 0.05), larger mean angular exposure area on the longitudinal plane for the tuber cinereum (transforniceal-transchoroidal 71° ± 7°; transchoroidal 64° ± 6°; p 〈 0.05), and larger mean angular exposure area on the longitudinal plane for the cerebral aqueduct (transforniceal-transchoroidal 62° ± 6°; transchoroidal 55° ± 5°; p 〈 0.05). No differences were observed in angular exposure along the transverse axis for either anatomical target (tuber cinereum and cerebral aqueduct; p 〉 0.05). The mean thickness of the right frontal lobe parenchyma was 35 ± 3 mm, the mean thickness of the corpus callosum trunk was 10 ± 1 mm, and the mean longitudinal diameter of the interventricular foramen was 4.6 ± 0.4 mm. In the qualitative assessment, it was noted that the transforniceal-transchoroidal approach led to greater exposure of the third ventricle anterior region structures. There was no difference between approaches in the exposure of the structures of the middle and posterior region. CONCLUSIONS The transforniceal-transchoroidal approach provides greater surgical exposure of the third ventricle anterior region than that offered by the transchoroidal approach. In the population studied, morphometric analysis established mean values for anatomical structures common to both approaches.
    Type of Medium: Online Resource
    ISSN: 0022-3085 , 1933-0693
    URL: Article
    DOI: 10.3171/2016.8.JNS16403
    RVK:
    XA 10000
    RVK:
    XA 55270
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2017
    detail.hit.zdb_id: 2026156-1
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  • 7
    Online Resource
    Online Resource
    Myokines in treatment-naïve patients with cancer-associated cachexia
    Elsevier BV ; 2021
    In:  Clinical Nutrition Vol. 40, No. 4 ( 2021-04), p. 2443-2455
    Details
    In: Clinical Nutrition, Elsevier BV, Vol. 40, No. 4 ( 2021-04), p. 2443-2455
    Type of Medium: Online Resource
    ISSN: 0261-5614
    URL: Article
    DOI: 10.1016/j.clnu.2020.10.050
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2009052-3
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  • 8
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    Online Resource
    276: Implications of Urinary Reflux in a Continent Urinary Diversion: an Experimental Model
    Ovid Technologies (Wolters Kluwer Health) ; 2005
    In:  Journal of Urology Vol. 173, No. 4S ( 2005-04), p. 76-76
    Details
    In: Journal of Urology, Ovid Technologies (Wolters Kluwer Health), Vol. 173, No. 4S ( 2005-04), p. 76-76
    Type of Medium: Online Resource
    ISSN: 0022-5347 , 1527-3792
    URL: Article
    DOI: 10.1016/S0022-5347(18)34541-5
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2005
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  • 9
    Online Resource
    Online Resource
    Photodynamic Therapy (PDT), Radiofrequency Ablation (RFA) With Biliary Stents in Palliative Treatment of Unresectable Extrahepatic Cholangiocarcinoma : A Systematic Review and Meta-analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Journal of Clinical Gastroenterology Vol. 56, No. 2 ( 2022-02), p. e153-e160
    Details
    In: Journal of Clinical Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 56, No. 2 ( 2022-02), p. e153-e160
    Abstract: Extrahepatic unresectable cholangiocarcinoma carries a dismal prognosis. In addition to biliary drainage by stent placement; photodynamic therapy (PDT) and radiofrequency ablation (RFA) have been tried to prolong survival. In this meta-analysis, we appraise the current known data on the use of PDT, RFA in the palliative treatment of extrahepatic unresectable cholangiocarcinoma. Methods: We searched multiple databases from inception through July 2020 to identify studies that reported on PDT and RFA. Pooled rates of survival, stent patency, 30-, 90-day mortality, and adverse events were calculated. Study heterogeneity was assessed using I 2 % and 95% prediction interval. Results: A total of 55 studies (2146 patients) were included. A total of 1149 patients underwent treatment with PDT (33 studies), 545 with RFA (22 studies), and 452 patients with stent-only strategy. The pooled survival rate with PDT, RFA, and stent-only groups was 11.9 [95% confidence interval (CI): 10.7-13.1] months, 8.1 (95% CI: 6.4-9.9) months, and 6.7 (95% CI: 4.9-8.4) months, respectively. The pooled time of stent patency with PDT, RFA, and stent-only groups was 6.1 (95% CI: 4.2-8) months, 5.5 (95% CI: 4.2-6.7) months, and 4.7 (95% CI: 2.6-6.7) months, respectively. The pooled rate of 30-day mortality with PDT was 3.3% (95% CI: 1.6%-6.7%), with RFA was 7% (95% CI: 4.1%-11.7%) and with stent-only was 4.9% (95% CI: 1.7%-13.1%). The pooled rate of 90-day mortality with PDT was 10.4% (95% CI: 5.4%-19.2%) and with RFA was 16.3% (95% CI: 8.7%-28.6%). Conclusion: PDT seemed to demonstrate better overall survival and 30-day mortality rates than RFA and/or stent-only palliation.
    Type of Medium: Online Resource
    ISSN: 0192-0790
    URL: Article
    DOI: 10.1097/MCG.0000000000001524
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2041558-8
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  • 10
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    Online Resource
    FULL-THICKNESS ENDOSCOPIC GASTRIC RESECTION USING A STAPLER AND GASTROSTOMY: A FEASIBILITY STUDY
    FapUNIFESP (SciELO) ; 2018
    In:  ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) Vol. 31, No. 3 ( 2018-08-16)
    Details
    In: ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), FapUNIFESP (SciELO), Vol. 31, No. 3 ( 2018-08-16)
    Abstract: RESUMO Racional: A gastrectomia vertical laparoscópica (LSG) é atualmente o procedimento bariátrico mais frequentemente realizado na Turquia. O objetivo da operação de redução de peso não é apenas diminuir o excesso de peso, mas também melhorar as comorbidades e a qualidade de vida relacionadas à obesidade (QoL). Objetivo: Avaliar o impacto do LSG na qualidade de vida dos pacientes, perda de peso e comorbidades associadas à obesidade mórbida de acordo com os critérios BAROS atualizados. Métodos: Estudo não-randomizado de intervenção comportamental e de saúde pública. Um total de 1138 pacientes adultos foram submetidos a LSG entre janeiro de 2013 e janeiro de 2016. Um questionário (The Bariatric Analysis and Reporting Outcome System - BAROS foi utilizado. Os dados sobre complicações pós-operatórias foram coletados do banco de dados hospitalar. Resultados: Responderam ao questionário 562 (49,4%) pacientes. Seis de 1138 pacientes (0,5%) tiveram deiscência e todos estes responderam a pesquisa. A taxa geral de complicações foi de 7,7%. Após período médio de 7,4±5,3 meses (1-30), a perda média de excesso de peso foi de 71,3±27,1% (10,2-155,4). Os questionados relataram 772 comorbidades. Destes, 162 (30,0%) foram melhorados e 420 (54,4%) foram resolvidos.Os escores médios de QoL foram significativamente aumentados após LSG (p 〈 0,05 a 〈 0,001). Dentre os resultados dos 562 pacientes, 26 (4,6%) foram classificadas como falhas; 86 (15,3%) regular; 196 (34,9%) bom;144 (25,6%) muito bom; e 110 (19,6%) excelente de acordo com para o sistema de pontuação BAROS atualizado. Conclusão: O LSG é procedimento bariátrico altamente efetivo para controle de peso, melhora nas comorbidades e aumento da QoL em curto e meio prazos.
    Type of Medium: Online Resource
    ISSN: 2317-6326 , 0102-6720
    URL: Article
    DOI: 10.1590/0102-672020180001e1386
    Language: Unknown
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2018
    detail.hit.zdb_id: 2560235-4
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