FABIO ALBERTO CASTILLO BUSTAMANTE

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  • article 33 Citação(ões) na Scopus
    Obesity Treatment with Botulinum Toxin-A Is Not Effective: a Systematic Review and Meta-Analysis
    (2017) BUSTAMANTE, Fabio; BRUNALDI, Vitor Ottoboni; BERNARDO, Wanderley Marques; MOURA, Diogo Turiani H. de; MOURA, Eduardo Turiani H. de; GALVAO, Manoel; SANTO, Marco Aurelio; MOURA, Eduardo Guimares H. de
    The effectiveness of gastric injections of botulinum toxin-A (BTA) as primary treatment for obesity is not well known since results in literature are discrepant. Hence, we aimed to systematically review and meta-analyze the available data to assess the real effect of BTA therapy. We searched MEDLINE, Embase, Cochrane, SCOPUS, EBSCO, LILACS, and BVS. We considered eligible only randomized controlled trials enrolling obese patients comparing BTA versus saline injections. Our initial search identified 8811 records. Six studies fulfilled eligibility criteria. After critical appraisal, two articles were excluded and we meta-analyzed the remainder. The mean difference for absolute weight loss and BMI reduction were 0.12 [CI 95%, - 1.14, 1.38] and - 0.06 [95% CI, - 0.92, 0.81], respectively. Therefore, we concluded that treatment of obesity with BTA is not effective.
  • article
    Endoscopic palliative treatment versus surgical bypass in malignant low bile duct obstruction: A systematic review and meta-analysis
    (2015) LIMA, Silvia Lucia Alves de; BUSTAMANTE, Fabio Alberto Castillo; MOURA, Eduardo Guimaraes Hourneaux de; BERNARDO, Wanderley Marques; ARTIFON, Everson Luiz de Almeida; CHAVES, Dalton Marques; FRANZINI, Tomazo Antonio Prince; FURUYA JUNIOR, Carlos Kiyoshi
    Aims: Despite technological advances, only about 20% of periampullary tumors are found to be resectable at the time of presentation. Biliary tree obstruction and consequent jaundice occur in 70-90% of those patients and has important consequences for a patient's quality of life. Relief of biliary tree obstruction is the main goal for treatment, and few options for palliative therapy of biliary tree obstruction can be performed, including surgical bypass, percutaneous stenting, and endoscopic stenting. Objective: The aim of the present study was to acquire and analyze data to compare the success of procedures, procedure-related complication, mortality in 30 days, recurrent-jaundice rates in endoscopic, and surgical palliative techniques. Methods: Two independent reviewers searched the following electronic databases: Medline, EMBASE, Cochrane, LILACS, BVS, SCOPE, and CINAHL (EBSCO). Inclusion criteria included studies involving patients with distal biliary obstruction due to periampullary tumors who underwent endoscopic therapy or a surgical procedure for palliation. Results: No differences were observed for success of procedures; differences were observed with better outcomes for endoscopy therapy with regards to mortality associated with procedure, complication associated with procedure, and mortality in 30 days. Also, differences were observed with better outcomes for surgery therapy for recurrent-jaundice. Conclusion: Endoscopic palliative drainage is associated with a lower rate in complication, mortality associated with procedure, and mortality in 30 days. Recurrent-jaundice analysis demonstrated an overall lower rate in surgical bypass procedures. No differences were found for the success of procedures.