EDNA FRASSON DE SOUZA MONTERO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- EUS-guided Choledochoduodenostomy Versus Hepaticogastrostomy A Systematic Review and Meta-analysis(2018) UEMURA, Ricardo S.; KHAN, Muhammad Ali; OTOCH, Jose P.; KAHALEH, Michel; MONTERO, Edna F.; ARTIFON, Everson L. A.Background and Aims: Endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as an alternative in cases of endoscopic retrograde cholangiopancreatography (ERCP) failure. Two types of EUS-BD methods for achieving biliary drainage when ERCP fails are choledochoduodenostomy (CDS) or hepaticogastrostomy (HGS). However, there is no consensus if one approach is better than the other. Therefore, we conducted a systematic review and meta-analysis to evaluate these 2 main EUS-BD methods. Methods: We searched MEDLINE, Embase, Scopus, Cochrane database, LILACS from inception through April 8, 2017, using the following search terms in various combinations: biliary drainage, biliary stent, transluminal biliary drainage, choledochoduodenostomy, hepaticogastrostomy, endoscopic ultrasound-guided biliary drainage. We selected studies comparing CDS and HGS in patients with malignant biliary obstruction with ERCP failure. Pooled odds ratio (OR) were calculated for technical success, clinical success, and adverse events and difference of means calculated for duration of procedure and survival after procedure. Results: A total of 10 studies with 434 patients were included in the meta-analysis: 208 underwent biliary drainage via HGS and the remaining 226 via CDS. The technical success for CDS and HGS was 94.1% and 93.7%, respectively, pooled OR = 0.96 [95% confidence interval (CI) = 0.39-2.33, I-2 = 0%]. Clinical success was 88.5% in CDS and 84.5% in HGS, pooled OR = 0.76 (95% CI = 0.42-1.35, I-2 = 17%). There was no difference for adverse events OR = 0.97 (95% CI = 0.60-1.56), I-2 = 37%. CDS was about 2 minutes faster with a pooled difference in means of was -2.69 (95% CI = -4.44 to -0.95). Conclusion: EUS-CDS and EUS-HGS have equal efficacy and safety, and are both associated with a very high technical and clinical success. The choice of approach may be selected based on patient anatomy.
- Oxidative stress on ischemia/reperfusion injury in mice with non-alcoholic hepatic steatosis or steatohepatitis(2018) CAYUELA, Natalie Chaves; NEGRETI, Gabrielly Pascoa; RASSLAN, Roberto; KOIKE, Marcia Kiyomi; MONTEROV, Edna Frasson de SouzaPurpose: To evaluate the oxidative stress, resulting from ischemia and hepatic reperfusion, in mice with non-alcoholic hepatic steatosis and steatohepatitis. Methods: C57BL/6 male mice were used. Part of them were ob/ob mice, and the other part was fed with standard or MCD diets-this last used to develop steatohepatitis. The animals - MCD-I/R, ob/ob-I/R and I/R groups - were submitted to 30 minutes of partial hepatic ischemia, followed by reperfusion for 24 hours. The blood was collected, for biochemical analysis of AST, and the liver removed for assessment of TBARS and nitrite, and of histology. Results: After the I/R, the animal fed with MCD diet presented higher AST levels (MCD-I/R: 967 +/- 349U/L / ob/ob-I/R: 606 +/- 18 U/L / I/R: 311 +/- 172 U/L), TBARS (MCD-I/R: 7 +/- 1 nM/mg protein / ob/ob-I/R: 3 +/- 1 nM/mg protein / I/R: 3 +/- 1 nM/mg protein) and nitrite (MCD-I/R: 614 +/- 87 mu g/mL / ob/ob-I/R: 512 +/- 81 mu g/mL / I/R: 459 +/- 29 mu g/mL) than the ob/ob mice, when both groups were compared to animals fed with standard diet. Regarding histology, the steatosis level (azonal macrovesicular steatosis of level 3 - >66%) and hepatic fibrosis (periportal and perisinusoidal of level 2) was also more intense, but both animal models presented lobular inflammation of level 3 (>66%). Conclusions: The murine model fed with MCD diet is suitable for the assessment of oxidative stress in hepatic I/R injury associated with the nonalcoholic fatty liver disease. Although both murine models showed inflammatory infiltrate and macro and micro vesicular steatosis.