LEANDRO RYUCHI IUAMOTO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
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- The impact of properly diagnosed sarcopenia on postoperative outcomes after gastrointestinal surgery: A systematic review and meta-analysis(2020) PIPEK, Leonardo Zumerkorn; BAPTISTA, Carlos Guilherme; NASCIMENTO, Rafaela Farias Vidigal; TABA, Joao Victor; SUZUKI, Milena Oliveira; NASCIMENTO, Fernanda Sayuri do; MARTINES, Diego Ramos; NII, Fernanda; IUAMOTO, Leandro Ryuchi; CARNEIRO-D'ALBUQUERQUE, Luiz Augusto; MEYER, Alberto; ANDRAUS, WellingtonBackground Sarcopenia is defined as the loss of muscle mass combined with loss of muscle strength, with or without loss of muscle performance. The use of this parameter as a risk factor for complications after surgery is not currently used. This meta-analysis aims to assess the impact of sarcopenia defined by radiologically and clinically criteria and its relationship with complications after gastrointestinal surgeries. Materials and methods A review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO registration number: CRD42019132221). Articles were selected from the PUBMED and EMBASE databases that adequately assessed sarcopenia and its impact on postoperative complications in gastrointestinal surgery patients. Pooled estimates of pre-operative outcome data were calculated using the odds ratio (OR) and 95% confidence interval (CI). Subgroup analysis were performed to assess each type of surgery. Results The search strategy returned 1323, with 11 studies meeting the inclusion criteria. A total of 4265 patients were analysed. The prevalence of sarcopenia between studies ranged from 6.8% to 35.9%. The meta-analysis showed an OR for complications after surgery of 3.01 (95% CI 2.55-3.55) and an OR of 2.2 (95% CI 1.44-3.36) for hospital readmission (30 days). Conclusion Sarcopenia, when properly diagnosed, is associated with an increase in late postoperative complications, as well as an increase in the number of postoperative hospital readmissions for various types of gastrointestinal surgery. We believe that any preoperative evaluation should include, in a patient at risk, tests for the diagnosis of sarcopenia and appropriate procedures to reduce its impact on the patient's health.
- Comparing dextrose prolotherapy with other substances in knee osteoarthritis pain relief: A systematic review(2022) CORTEZ, Vitor Santos; MORAES, Walter Augusto; TABA, Joao Victor; CONDI, Alberto; SUZUKI, Milena Oliveira; NASCIMENTO, Fernanda Sayuri do; PIPEK, Leonardo Zumerkorn; MATTOS, Vitoria Carneiro de; TORSANI, Matheus Belloni; MEYER, Alberto; HSING, Wu Tu; IUAMOTO, Leandro RyuchiThe objective of this study is to compare the effectiveness of dextrose-prolotherapy with other substances for pain relief in patients with primary knee osteoarthritis. The literature screening was done in January 2021 through Medline (PubMed), EMBASE, and Database of the National Institute of Health based on the following criteria: ran-domized clinical trials that subjected patients with primary knee osteoarthritis who underwent treatment with dextrose-prolotherapy and other substances for pain relief. Paired reviewers independently identified 3381 articles and included 8 trials that met the eligibility criteria. According to the findings of this review, participants that underwent dextrose-prolotherapy showed improvements between baseline and posterior assessments and when compared to saline injections, but when compared to other substances, the results were not clear. Although dextrose-prolotherapy is a useful treatment method by itself, it is still not possible to clearly affirm that it is supe-rior or inferior to its counterparts. There is an urgent need for further studies to bring more evidence to the field.
- Parameters involved and viability of immunosuppression on islet allotransplantation procedure in rodents(2014) IUAMOTO, Leandro R.; MEYER, Alberto; CHAIB, Eleazar; D'ALBUQUERQUE, Luiz ACINTRODUCTION: Autoimmunity and rejection after transplantation must still be overcome in the technical development of islet transplantation for the treatment of type 1 diabetes. It is therefore necessary to inhibit rejection of islet grafts while maintaining the graft's ability to secrete insulin. Although the use of immunosuppressants reduces the acute rejection rate in transplant patients, long-term side effects must be prevented. OBJECTIVES: The aim of the present study is to organize and analyze the parameters of immunosuppression involved in experimental attempts of allotransplantation in rodents. METHODOLOGY: This review was performed using the Pubmed database to search for published articles containing the keywords ""rodent islet transplantation"". The inclusion criteria involved allotransplantation with rodents' islets and the reference lists of the publications retrieved that were eligible. The exclusion criteria involved isotransplantation, autotransplantation, and xenotransplantation such as transplantation in other species. RESULTS: Twenty studies related to allotransplantation were selected for this systematic review based on immunosuppression. CONCLUSION: New immunosuppressive drugs increased the survival rates of allotransplantation in rodents by reducing the side effects. The advances in immunosuppression raise the possibility of overcoming autoimmunity and rejection after allotransplantation.
- Human islet xenotransplantation in rodents: A literature review of experimental model trends(2017) IUAMOTO, Leandro Ryuchi; FRANCO, Andre Silva; SUGUITA, Fabio Yuji; ESSU, Felipe Futema; OLIVEIRA, Lucas Torres; KATO, Juliana Mika; TORSANI, Matheus Belloni; MEYER, Alberto; ANDRAUS, Wellington; CHAIB, Eleazar; D'ALBUQUERQUE, Luiz Augusto CarneiroAmong the innovations for the treatment of type 1 diabetes, islet transplantation is a less invasive method of treatment, although it is still in development. One of the greatest barriers to this technique is the low number of pancreas donors and the low number of pancreases that are available for transplantation. Rodent models have been chosen in most studies of islet rejection and type 1 diabetes prevention to evaluate the quality and function of isolated human islets and to identify alternative solutions to the problem of islet scarcity. The purpose of this study is to conduct a review of islet xenotransplantation experiments from humans to rodents, to organize and analyze the parameters of these experiments, to describe trends in experimental modeling and to assess the viability of this procedure. In this study, we reviewed recently published research regarding islet xenotransplantation from humans to rodents, and we summarized the findings and organized the relevant data. The included studies were recent reports that involved xenotransplantation using human islets in a rodent model. We excluded the studies that related to isotransplantation, autotransplantation and allotransplantation. A total of 34 studies that related to xenotransplantation were selected for review based on their relevance and current data. Advances in the use of different graft sites may overcome autoimmunity and rejection after transplantation, which may solve the problem of the scarcity of islet donors in patients with type 1 diabetes.
- Effects of neuroplasticity in people with knee osteoarthritis A systematic review of the literature(2022) IUAMOTO, Leandro Ryuchi; ITO, Fabio Luis Kenji; TOME, Thales Augusto; HSING, Wu Tu; MEYER, Alberto; IMAMURA, Marta; BATTISTELLA, Linamara RizzoBackground: Knee osteoarthritis (OA) is associated with chronic inflammation in somatic structures, which alters sensory afferents and leads to plastic changes in the nervous system. Methods: A systematic literature review was carried out, without language restrictions, period, or status of publication. The database used were Medline, EMBASE, Cochrane Library and clinicaltrials.gov. Extra bibliographic references were extracted through the discussion with specialists, and through scientific researches in conference papers. Results: The electronic search found 938 articles. When excluding duplicates and applying the inclusion/exclusion criteria, 5 studies were considered: 2 using EEG and 3 using TMS. Significant reduction of EEG activity in the cingulate medium cortex, reduction of conditioned pain modulation (CPM) in studies with EEG, as well as the occurrence of an association between pain and motor response threshold/intracortical pain facilitation in studies with TMS were observed. Conclusions: The study contributes to a better understanding of the neurophysiological changes seen in the cingulate medium cortex, decrease in CPM and motor response threshold/intracortical pain facilitation. Advances in neuroplasticity studies may aid in the screening for early diagnosis of knee OA in the future. However, more studies are necessary.
- MICRObiota on BILIOpancreatic malignant diseases [MICROBILIO]: A systematic review(2022) MATTOS, Vitoria Carneiro de; NASCIMENTO, Fernanda Sayuri do; SUZUKI, Milena Oliveira; TABA, Joao Victor; PIPEK, Leonardo Zumerkorn; MORAES, Walter Augusto Fabio; CORTEZ, Vitor Santos; KUBRUSLY, Marcia Saldanha; TORSANI, Matheus Belloni; IUAMOTO, Leandro; HSING, Wu Tu; CARNEIRO-D'ALBUQUERQUE, Luiz Augusto; MEYER, Alberto; ANDRAUS, WellingtonIntroduction: The increase in the incidence of pancreatic and biliary cancers has attracted the search for methods of early detection of diseases and biomarkers. The authors propose to analyze new findings on the association between microbiota and Pancreatic Ductal Adenocarcinoma (PDAC) or Cholangiocarcinoma (CCA). Methods: This systematic review was carried out according to the items of Preferred Reports for Systematic Reviews and Protocol Meta-Analysis (PRISMA-P). This study was registered by the Prospective Register of Systematic Reviews (PROSPERO), identification code CRD42020192748 before the review was carried out. Articles were selected from the PUBMED, EMBASE, and Cochrane databases.Results: Most studies (86.67%) used 16s rRNA as a sequencing method. The main comorbidities found were diabe-tes mellitus, systemic arterial hypertension, and dyslipidemia. Many studies were limited by the small number of participants, but the biases were mostly low. There was very little concordance about the composition of the microbiome of different sites, for both case and control groups when compared to other studies' results. Bile sam-ple analysis was the one with a greater agreement between studies, as three out of four studies found Escherichia in cases of CCA.Conclusion: There was great disagreement in the characterization of both the microbiota of cases and control groups. Studies are still scarce, making it difficult to adequately assess the data in this regard. It was not possible to specify any marker or to associate any genus of microbiota bacteria with PDAC or CCA.
- The development of laparoscopic skills using virtual reality simulations: A systematic review(2021) TABA, Joao Victor; CORTEZ, Vitor Santos; MORAES, Walter Augusto; IUAMOTO, Leandro Ryuchi; HSING, Wu Tu; SUZUKI, Milena Oliveira; NASCIMENTO, Fernanda Sayuri do; PIPEK, Leonardo Zumerkorn; MATTOS, Vitoria Carneiro de; D'ALBUQUERQUE, Eugenia Carneiro; CARNEIRO-D'ALBUQUERQUE, Luiz Augusto; MEYER, Alberto; ANDRAUS, WellingtonBackground Teaching based on virtual reality simulators in medicine has expanded in recent years due to the limitations of more traditional methods, especially for surgical procedures such as laparoscopy. Purpose of review To analyze the effects of using virtual reality simulations on the development of laparoscopic skills in medical students and physicians. Data sources The literature screening was done in April 2020 through Medline (PubMed), EMBASE and Database of the National Institute of Health. Eligibility criteria Randomized clinical trials that subjected medical students and physicians to training in laparoscopic skills in virtual reality simulators. Study appraisal Paired reviewers independently identified 1529 articles and included 7 trials that met the eligibility criteria. Findings In all studies, participants that trained in virtual simulators showed improvements in laparoscopic skills, although the articles that also had a physical model training group did not show better performance of one model compared to the other. Limitations No article beyond 2015 met the eligibility criteria, and the analyzed simulators have different versions and models, which might impact the results. Conclusion Virtual reality simulators are useful educational tools, but do not show proven significant advantages over traditional models. The lack of standardization and a scarcity of articles makes comparative analysis between simulators difficult, requiring more research in the area, according to the model suggested in this review.
- The Development of Feeding and Eating Disorders after Bariatric Surgery: A Systematic Review and Meta-Analysis(2021) TABA, Joao Victor; SUZUKI, Milena Oliveira; NASCIMENTO, Fernanda Sayuri do; IUAMOTO, Leandro Ryuchi; HSING, Wu Tu; PIPEK, Leonardo Zumerkorn; CARNEIRO-D'ALBUQUERQUE, Luiz Augusto; MEYER, Alberto; ANDRAUS, WellingtonBackground: Patients in the postoperative period following bariatric surgery are at risk of developing eating disorders. This study aims to analyze the relation between bariatric surgery and the development and recurrence of eating disorders. Material and methods: A literature review was carried out on 15 November 2020. Fourteen studies that met the eligibility criteria were included for qualitative synthesis, and 7 studies for meta-analysis. Results: The prevalence of eating disorders in the postoperative period was 7.83%, based on the 7 studies in the meta-analysis. Binge eating disorder alone was 3.81%, which was the most significant factor, and addressed in 6 of these studies. Conclusion: The investigated studies have significant methodological limitations in assessing the relation between bariatric surgery and eating disorders, since they mostly present data on prevalence. PROSPERO CRD42019135614.
- Large primary hepatic gastrinoma in young patient treated with trisegmentectomy: A case report and review of the literature(2018) PIPEK, Leonardo Zumerkorn; JARDIM, Yuri Justi; MESQUITA, Gustavo Heluani Antunes de; NII, Fernanda; MEDEIROS, Kayo Augusto de Almeida; CARVALHO, Barbara Justo; MARTINES, Diego Ramos; IUAMOTO, Leandro Ryuchi; WAISBERG, Daniel Reis; D'ALBUQUERQUE, Luiz Augusto Carneiro; MEYER, Alberto; ANDRAUS, WellingtonPrimary hepatic gastrinoma is a rare disease, with fewer than 40 cases reported in the medical literature. Because it is located in an organ in which metastases are common, its diagnosis is difficult. We report a case of a 19 years old male patient with a history of gastric ulcers since the age of nine. Following gastric surgery, an antrectomy and a vagotomy, there was some alleviation of symptoms. Subsequently, the patient reported various intermittent episodes of diarrhea, diffuse abdominal pain, and vomiting. The patient und-erwent tomography, which revealed the presence of a hepatic mass measuring 19.5 cm x 12.5 cm x 17 cm. Primary hepatic gastrinoma was diagnosed based on laboratory examinations that indicated hypergastrinemia and a positron emission tomography/magnetic resonance study with somatostatin analogue that confirmed the liver as the primary site. After hepatic trisegmentectomy (II, III, IV, V, VIII), the patient's symptoms improved. The case is notable for the presence of a rare tumor with uncommon dimensions.
- Perioperative management of drugs commonly used in patients with rheumatic diseases: a review(2017) FRANCO, Andre Silva; IUAMOTO, Leandro Ryuchi; PEREIRA, Rosa Maria RodriguesRheumatic diseases are very prevalent, affecting about 7 million people in North America; they affect the musculoskeletal system, often with systemic involvement and potential for serious consequences and limitation on quality of life. Clinical treatment is usually long-term and includes drugs that are considered either simple or complex and are occasionally unknown to many health professionals who do not know how to manage these patients in emergency units and surgical wards. Thus, it is important for clinicians, surgeons and anesthesiologists who are involved with rheumatic patients undergoing surgery to know the basic principles of therapy and perioperative management. This study aims to do a review of the perioperative management of the most commonly used drugs in rheumatologic patients. Manuscripts used in this review were identified by surveying MEDLINE, LILACS, EMBASE, and COCHRANE databases and included studies containing i) the perioperative management of commonly used drugs in patients with rheumatic diseases: and ii) rheumatic diseases. They are didactically discussed according to the mechanism of action and pharmacokinetics; and perioperative management. In total, 259 articles related to the topic were identified. Every medical professional should be aware of the types of drugs that are appropriate for continuous use and should know the various effects of these drugs before indicating surgery or assisting a rheumatic patient postoperatively. This information could prevent possible complications that could affect a wide range of patients.