LUIZ AUGUSTO CARNEIRO D ALBUQUERQUE

(Fonte: Lattes)
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Departamento de Gastroenterologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina - Líder

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  • article 6 Citação(ões) na Scopus
    THE EFFECT OF ILEOCECAL VALVE REMOVAL IN A MODEL OF SHORT BOWEL SYNDROME
    (2019) SOLER, Wangles Vasconcellos; LEE, Andre Dong; D'ALBUQUERQUE, Eugenia Machado Carneiro; CAPELOZZI, Vera; ALBUQUERQUE, Luiz Carneiro; CAPELHUCHNICK, Peretz; LANCELOTTI, Carmem Penteado; GALVAO, Flavio Henrique Ferreira
    Background: Short bowel syndrome is a harmful condition that needs experimental research. Aim: To assess the impact of the ileocecal valve removal in a model of short bowel syndrome, in order to investigate the evolution of the colon under this circumstance. Method: Fifteen Wistar rats were equitable divided into: Control (Sham), Group I (70% enterectomy preserving ileocecal valve) and Group II (70% enterectomy excluding ileocecal valve). After enterectomy was performed jejunoileal or jejunocecal anastomosis and sacrificed the animals on 30""' postoperative day for histomorphometric study of the colon. During this period, was observed the clinical evolution of the animals weekly including body weight measurement. Results: Group I and II presented progressive loss of weight. in Group I was observed diarrhea, perinea! hyperemia and purple color of the colon during autopsy. Histomorphometry assay showed hypertrophy and hyperplasia of colon mucosa in Group I. in Group II the colon wall was thicker due to hypertrophy and muscular hyperplasia, and in mucosa vascular proliferation and inflammatory infiltrate were intense. Conclusion: This short bowel syndrome model is relevant and achieve 100% of survival. Animal's weight loss was not altered by the presence or exclusion of the ileocecal valve. Animals with 70% of small bowel removal and presence of the ileocecal valve attained a better clinical evolution and histological colon adaptation than those without ileocecal valve.
  • article 3 Citação(ões) na Scopus
    Laparoscopically excised retroperitoneal presacral Schwannoma: atypical pre and postoperative manifestations - case report
    (2019) CARVALHO, Barbara Justo; MEDEIROS, Kayo Augusto de Almeida; MARTINES, Diego Ramos; NII, Fernanda; PIPEK, Leonardo Zumerkorn; MESQUITA, Gustavo Heluani Antunes de; D'ALBUQUERQUE, Luiz Augusto Carneiro; MEYER, Alberto; ANDRAUS, Wellington
    Background We are a reporting a rare case of retroperitoneal schwanomma with atypical pre and postoperative manifestations. Retroperitoneal schwannomas are rare tumors that are difficult to preoperatively diagnose. Case presentation This is a case report of a male patient, 41 years old, with symptoms of hipogastric and lower right member pain, as well as a history of a papilliferous thyroid tumor. Computerized tomography exams were inconclusive, showing a mass in the presacral region with dimensions of 4.4 x 3.9 x 3.4 cm. Removal was carried out by laparoscopic surgery, with self-limited postoperative complications. Diagnosis was carried out by anatomopathological examination, and syndromic hypotheses were discarded. Conclusions The postoperative complications of schwanomma are little reported in the literature. In the simultaneous occurrence of schwanomma and other endocrine tumors, further studies are warranted to better differentiate the cases that need investigation of syndromic causes.
  • article 6 Citação(ões) na Scopus
    Acute Liver Failure Secondary to Yellow Fever: A Challenging Scenario
    (2019) SONG, A.T.W.; D’ALBUQUERQUE, L.A. Carneiro
  • article 28 Citação(ões) na Scopus
    Sofosbuvir inhibits yellow fever virus in vitro and in patients with acute liver failure
    (2019) MENDES, Erica Araujo; PILGER, Denise Regina Bairros de; NASTRI, Ana Catharina de Seixas Santos; MALTA, Fernanda de Mello; PASCOALINO, Bruno dos Santos; D'ALBUQUERQUE, Luiz Augusto Carneiro; BALAN, Andrea; JR, Lucio Holanda Gondim de Freitas; DURIGON, Edison Luis; CARRILHO, Flair Jose; PINHO, Joao Renato Rebello
    Introduction and objectives: Direct antiviral agents (DAAs) are very efficient in inhibiting hepatitis C virus and might be used to treat infections caused by other flaviviruses whose worldwide detection has recently increased. The aim of this study was to verify the efficacy of DAAs in inhibiting yellow fever virus (YFV) by using drug repositioning (a methodology applied in the pharmaceutical industry to identify new uses for approved drugs). Materials and methods: Three DAAs were evaluated: daclatasvir, sofosbuvir and ledipasvir or their combinations. For in vitro assays, the drugs were diluted in 100% dimethyl sulfoxide. Vaccine strain 17D and a 17D strain expressing the reporter fluorescent protein were used in the assays. A fast and reliable cell-based screening assay using Vero cells or Huh-7 cells (a hepatocyte-derived carcinoma ell line) was carried out. Two patients who acquired yellow fever virus with acute liver failure were treated with sofosbuvir for one week as a compassionate use. Results: Using a high-content screening assay, we verified that sofosbuvir presented the best antiviral activity against YFV. Moreover, after an off-label treatment with sofosbuvir, the two female patients diagnosed with yellow fever infection displayed a reduction in blood viremia and an improvement in the course of the disease, which was observed in the laboratory medical parameters related to disease evolution. Conclusions: Sofosbuvir may be used as an option for treatment against YFV until other drugs are identified and approved for human use. These results offer insights into the role of nonstructural protein 5 (NS5) in YFV inhibition and suggest that nonstructural proteins may be explored as drug targets for YFV treatment. (C) 2019 Fundacion Clinica Medica Sur, A.C.
  • article 1 Citação(ões) na Scopus
    The liver injury following ischemia and reperfusion is worse in experimental knockout heterozygote mouse model for expression of connexin 43
    (2019) TREVISAN, Alexandre Maximiliano; COGLIATI, Bruno; HOMEM, Adriana Ribeiro; ALOIAV, Thiago Pinheiro Arrais; AQUINO NETO, Nelson de; MOREIRA, Jairo Marques; RENO, Leonardo da Cruz; NAUMANN, Alexandre Moulin; GALVAO, Flavio Henrique Ferreira; ANDRAUS, Wellington; D'ALBUQUERQUE, Luiz Augusto Carneiro
    Purpose: To evaluate that Connexin (Cx43) plays a role in lesions after hepatic ischemia/reperfusion (IR) injury. Methods: We use Cx43 deficient model (heterozygotes mice) and compared to a wild group. The groups underwent 1 hour ischemia and 24 hours reperfusion. The heterozygote genotype was confirmed by PCR. We analyzed the hepatic enzymes (AST, ALT, GGT) and histology. Results: The mice with Cx43 deficiency showed an ALT mean value of 4166 vs. 307 in the control group (p<0.001); AST mean value of 7231 vs. 471 in the control group (p<0.001); GGT mean value of 9.4 vs. 1.7 in the control group (p=0.001); histology showed necrosis and inflammation in the knockout group. Conclusions: This research demonstrated that the deficiency of Cx43 worses the prognosis for liver injury. The topic is a promising target for therapeutics advancements in liver diseases and procedures.
  • article 1 Citação(ões) na Scopus
    Livebirth After Uterus Transplantation From a Deceased Donor in a Recipient With Uterine Infertility
    (2019) EJZENBERG, Dani; ANDRAUS, Wellington; MENDES, Luana Regina Baratelli Carelli; DUCATTI, Liliana; SONG, Alice; TANIGAWA, Ryan; ROCHA-SANTOS, Vinicius; ARANTES, Rubens Macedo; SOARES JR., Jose Maria; SERAFINI, Paulo Cesar; HADDAD, Luciana Bertocco de Paiva; FRANCISCO, Rossana Pulcinelli; D'ALBUQUERQUE, Luiz Augusto Carneiro; BARACAT, Edmund Chada
    Infertility is common and affects about 10% to 15% of couples. In such couples, 1 in 500 women has infertility due to uterine causes, with uterine agenesis (Mayer-Rokitansky-Kuster-Hauser [MRKH] syndrome), or due to hysterectomy, malformation, or the sequelae of infection or surgery. Prior hysterectomy is the most common uterine cause of infertility, whereas MRKH syndrome is relatively uncommon and affects 1 in 4500 women. In the past, the only available option for these women to have a child was adoption or surrogacy, until the first uterine transplantation and successful livebirth was reported in Gothenburg, Sweden, in 2013. To date, only 1 Swedish center and 1 US center have published on livebirths from transplanted uteri, and these previous successful livebirths have been all involved live donors. The use of deceased donors would greatly broaden access to this treatment, but uncertainty regarding the feasible of uterine transplantation from a deceased donor arose after report of an unsuccessful pregnancy and subsequent miscarriage 2 years with use of a uterus from a deceased donor. The authors describe a case of uterine transplantation using a donated uterus from a deceased donor. In September 2016, a 32-year-old woman with congenital uterine absence (MRKH syndrome) underwent uterine transplantation in Hospital das Clinicas, University of Sao Paulo, Brazil, from a donor who died of subarachnoid hemorrhage. The 45-year-old donor had had 3 previous vaginal deliveries. The recipient underwent 1 in vitro fertilization cycle 4 months before transplant, which yielded 8 cryopreserved blastocysts. Based on their literature review, the authors believe this to be the first such successful livebirth following transplant from a deceased donor. The recipient showed satisfactory postoperative recovery and was discharged after 8 days' observation in hospital. Immunosuppression was induced with prednisolone and thymoglobulin and continued via tacrolimus and mycophenalate mofetil, until 5 months posttransplantation, at which time azathioprine replaced mycophenalate mofetil. First menstruation occurred 37 days posttransplantation and regularly (every 26-32 days) thereafter. Pregnancy occurred after the first single embryo transfer 7 months posttransplantation. No blood flow velocity waveform abnormalities were detected by Doppler ultrasound of uterine arteries, fetal umbilical, or middle cerebral arteries, nor any fetal growth impairments during pregnancy. No rejection episodes occurred after transplantation or during gestation. Cesarean delivery occurred onDecember 15, 2017, near gestational week 36. The female newborn weighed 2550 g at birth, appropriate for gestational age, with Apgar scores of 9 at 1 minute, 10 at 5 minutes, and 10 at 10 minutes, and along with the mother remains healthy and developing normally 7 months postpartum. The uterus was removed in the same surgical procedure as the livebirth and immunosuppressive therapy were suspended. The researchers concluded that the results establish proof-of-concept for treating uterine infertility by transplantation froma deceased donor, opening a path to healthy pregnancy for all women with uterine factor infertility, without need of living donors or live donor surgery.
  • article 13 Citação(ões) na Scopus
    Early detection of acute kidney injury in the perioperative period of liver transplant with neutrophil gelatinase-associated lipocalin
    (2019) LIMA, Camila; HADDAD, Luciana Bertocco de Paiva; MELO, Patricia Donado Vaz de; MALBOUISSON, Luiz Marcelo; CARMO, Lilian Pires Freitas do; D'ALBUQUERQUE, Luiz Augusto Carneiro; MACEDO, Etienne
    Background Acute kidney injury (AKI) is a common complication in patients undergoing liver transplant (LT) and is associated with high morbidity and mortality. We aim to evaluate the pattern of urine and plasma neutrophil gelatinase-associated lipocalin (NGAL) elevation during the perioperative period of LT and to assess it as a prognostic marker for AKI progression, need for dialysis and mortality. Methods We assessed NGAL levels before induction of anesthesia, after portal reperfusion and at 6, 18, 24, and 48 h after surgery. Patients were monitored daily during the first week after LT. Results Of 100 enrolled patients undergoing liver transplant, 59 developed severe AKI based on the KDIGO serum creatinine (sCr) criterion; 34 were dialysed, and 21 died within 60 days after LT. Applying a cut-off value of 136 ng/ml, UNGAL values 6 h after surgery was a good predictor of AKI development within 7 days after surgery, having a positive predictive value (PPV) of 80% with an AUC of 0.76 (95% CI 0.67-0.86). PNGAL at 18 h after LT was also a good predictor of AKI in the first week, having a PPV of 81% and AUC of 0.74 (95% CI 0.60-0.88). Based on PNGAL and UNGAL cut-off criteria levels, time to AKI diagnosis was 28 and 23 h earlier than by sCr, respectively. The best times to assess the need for dialysis were 18 h after LT by PNGAL and 06 h after LT by UNGAL. Conclusion In conclusion, the plasma and urine NGAL elevation pattern in the perioperative period of the liver transplant can predict AKI diagnosis earlier. UNGAL was an early independent predictor of AKI development and need for dialysis. Further studies are needed to assess whether the clinical use of biomarkers can improve patient outcomes.
  • conferenceObject
    NEW FRAGMENT OF BOVINE HEPARIN FBH001 DECREASES INTRACELLULAR CALCIUM IN HEPATOCYTES SUBMITTED TO CALCIUM OVERLOAD
    (2019) VASQUES, Enio R.; CUNHA, Jose Eduardo M.; NADER, Helena; TERSARIOL, Ivarne S.; LIMA, Marcelo A.; D'ALBUQUERQUE, Luiz Augusto C.; CHAIB, Eleazar; RODRIGUES, Tiago
  • article 45 Citação(ões) na Scopus
    Severe yellow fever in Brazil: clinical characteristics and management
    (2019) HO, Yeh-Li; JOELSONS, Daniel; LEITE, Gabriel F. C.; MALBOUISSON, Luiz M. S.; SONG, Alice T. W.; PERONDI, Beatriz; ANDRADE, Lucia C.; PINTO, Lecio F.; D'ALBUQUERQUE, Luiz A. C.; SEGURADO, Aluisio A. C.
    Background: Little is known about clinical characteristics and management of severe yellow fever as previous yellow fever epidemics often occurred in times or areas with little access to intensive care units (ICU). We aim to describe the clinical characteristics of severe yellow fever cases requiring admission to the ICU during the 2018 yellow fever outbreak in Sao Paulo, Brazil. Furthermore, we report on preliminary lessons learnt regarding clinical management of severe yellow fever. Methods: Retrospective descriptive cohort study. Demographic data, laboratory test results on admission, clinical follow-up, and clinical outcomes were evaluated. Results: From 10 January to 11 March 2018, 79 patients with laboratory confirmed yellow fever were admitted to the ICU in a tertiary hospital in Sao Paolo because of rapid clinical deterioration. On admission, the median AST was 7,000 IU/L, ALT 3,936 IU/L, total bilirubin 5.3 ml/dL, platelet 74 x 10(3)/mm(3), INR 2.24 and factor V 37%. Seizures occurred in 24% of patients, even without substantial intracranial hypertension. The high frequency of pancreatitis and rapidly progressive severe metabolic acidosis were notable findings. 73% of patients required renal replacement therapy. The in-hospital fatality rate was 67%. Patients with diabetes mellitus had a higher case fatality rate (CFR) of 80%, while patients without diabetes had a CFR of 65%. Leading causes of death were severe gastrointestinal bleeding, epileptic status, severe metabolic acidosis, necrohemorrhagic pancreatitis, and multiorgan failure. Conclusions: Severe yellow fever is associated with a high CFR. The following management lessons were learnt: Anticonvulsant drugs in patients with any symptoms of hepatic encephalopathy or arterial ammonia levels >70 mu mol/L was commenced which reduced the frequency of seizures from 28% to 17%. Other new therapy strategies included early institution of plasma exchange. Due to the high frequency of gastric bleeding, therapeutic doses of intravenous proton pump inhibitors should be administered.
  • article 2 Citação(ões) na Scopus
    Steatosis and steatohepatitis found in adults after death due to non-burn trauma
    (2019) REIS-JUNIOR, Paulo; TANIGAWA, Ryan; MESQUITA, Gustavo Heluani Antunes de; BASAN, Natalia; ALVES, Venancio; D'ALBUQUERQUE, Luiz Augusto Carneiro; ANDRAUS, Wellington
    OBJECTIVE: With the increasing prevalence of steatosis, the number of steatotic liver grafts from deceased donors is also increasing. Thus, determining the prevalence and the population risk factors of steatosis may assist in risk stratification. The aim of this study was to evaluate the prevalence and predictors of steatosis and steatohepatitis among livers from adults who died due to non-burn trauma. METHODS: Specimens were collected from 224 adults undergoing autopsy at a regional autopsy referral center from September 2011 to April 2013. Histopathological examination was performed on six samples obtained from different lobes of each liver. The outcomes of interest were the presence of steatosis, steatohepatitis, NASH inflammation and NASH fibrosis. The main predictors were body mass index, abdominal circumference, liver weight and volume, presence of cholelithiasis, and siderosis. Our modeling strategy made use of a series of generalized linear models with a binomial family. RESULTS: Our sample had a mean age of 40 years; steatosis was diagnosed in 48.2% of cases, and steatohepatitis was diagnosed in 2.7%. The presence of a high proportion of fatty changes was more prevalent among males and older individuals, with the most affected age group being 41-60 years. When evaluating the crude odds ratio for steatosis, the factors significantly associated with an increased risk of steatosis were greater abdominal circumference, BMI, and liver weight and the presence of siderosis. CONCLUSION: Our study reinforces the role of older age, obesity and hepatomegaly as predictors of fatty liver disease. These variables should be considered in the assessment of fatty changes in the livers of potential liver donors.