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
25 resultados
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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.
- Gastric fundus submucosa as a site for islets transplantation: An experimental study(2018) MESQUITA, Gustavo Heluani Antunes de; JARDIM, Yuri Justi; IUAMOTO, Leandro Ryuchi; SUGUITA, Fabio Yuji; ESSU, Felipe Futema; OLIVEIRA, Lucas Torres; MEYER, Alberto; CRESCENZI, Alessandra; ROCHA-SANTOS, Vinicius; GALVAO, Flavio H. F.; ANDRAUS, Wellington; CHAIB, Eleazar; D'ALBUQUERQUE, Luiz Augusto CarneiroBackground: Islets of Langerhans transplantation is a promising alternative for glycemic control in patients with type 1 diabetes. The graft site is a factor that has large impact on the functioning of this transplant, and the stomach appears to be a promising location. Our objective is to describe a new experimental model for the grafting of Islets of Langerhans in rat stomachs. Methodology: Islets of Langerhans were extracted from 45 isogenic male rats of the Lewis lineage and transplanted into 9 isogenic rats of the Wistar lineage; 5 in the gastric body submucosa, and 4 in the gastric fundus submucosa. Normoglycemia was defined as two successive measurements of < 250 mg/dL. No immunosuppression was used. The two groups glycemia control improvement were compared with t-student test. Results: The results obtained following the transplantation of the islets in 9 rats showed between 995 and 2310 islets transplanted (mean of 1367). The rats from the gastric submucosa group had a better glycemic level improvement, with a confidence equal to 83.94%. Conclusion: Islets graft into the gastric fundus submucosa is a viable model with potential for adequate glycemic control. This model gives potential for new perspectives and future studies in this area.
- Instrument to evaluate the knowledge of patient with cirrhosis on his disease: construction and validity(2021) STELMACH, Mariana; MEDEIROS, Kayo Augusto de Almeida; CARVALHO, Barbara Justo; PIPEK, Leonardo Zumerkorn; MESQUITA, Gustavo Heluani Antunes de; NII, Fernanda; MARTINES, Diego Ramos; IUAMOTO, Leandro Ryuchi; D'ALBUQUERQUE, Luiz Augusto Carneiro; MEYER, Alberto; ANDRAUS, WellingtonBackgroundThe application of measurement instruments is a strategy to evaluate the patient's knowledge about the disease. This study aims to build an instrument that evaluates the patient's knowledge about liver cirrhosis.MethodThis study includes three phases. The first one was the construction of the instrument based on a literature review. In the second phase, five experts were participated in the evaluation of the instrument, to check the validity of the content. Quantitative and qualitative analyzes were made. The tool used was the CVI (Content Validity Index) and it was used the semantic study of the questions. The third phase was the process of the restructuring the instrument.ResultsThe final version of the instrument consisted of 36 questions. The instrument was evaluated in 91.7 by the average CVI and 94.4% by the universal CVI.ConclusionsThe questions are properly structured and clear, therefore, understandable. Thus, the final instrument presented satisfactory content validity, so that, it reached the aim of this study.
- Laparoscopic totally extraperitoneal (TEP) hernioplasty using two trocars: anatomical landmarks and surgical technique(2015) IUAMOTO, Leandro Ryuchi; KATO, Juliana Mika; MEYER, Alberto; BLANC, PierreBACKGROUND: Among endoscopic hernioplasties, totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) approach are widely accepted alternatives to open surgery, both providing less postoperative pain, hospital length of stay and early return to work. Classical TEP technique requires three skin incisions for placement of three trocars in the midline or in triangulation. AIM: To describe a technique using only two trocars for laparoscopic total extraperitoneal for inguinal hernia repair. METHOD: Extraperitoneal access: place two regular trocars on the midline. The 10 mm is inserted into the subcutaneous in horizontal direction after a transverse infra-umbilical incision and then elevated at 60º angle. The 5 mm trocar is inserted at the same level of the pubis with direct vision. Preperitoneal space dissection: introduction 0º optical laparoscope through the infra-umbilical incision for visualization and preperitoneal dissection; insufflation pressure must be below 12 mmHg. Dissection of some anatomical landmarks: pubic bone, arcuate line and inferior epigastric vessels. Exposure of ""triangle of pain"" and ""triangle of doom"". Insertion through the 10 mm trocar polypropylene mesh of 10x15 cm to cover the hernia sites. Peritoneal sac and the dorsal edge of the mesh are repositioned in order to avoid bending or mesh displacement. It is also important to remember that the drainage is not necessary. RESULTS: The 2-port TEP required less financial costs than usual because it is not necessary an auxiliary surgeon to perform the technique. Trocars, suturing material and wound dressing were spared in comparison to the classical technique. Besides, there were only two incisions, which provides a better plastic result and less postoperative pain. CONCLUSION: The TEP technique using two trocars is an alternative technique which improves cosmetic and financial outcomes.
- 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.
- Cirrhosis and hernia repair in a cohort of 6352 patients in a tertiary hospital Risk assessment and survival analysis(2022) PIPEK, Leonardo Zumerkorn; CORTEZ, Vitor Santos; TABA, Joao Victor; SUZUKI, Milena Oliveira; NASCIMENTO, Fernanda Sayuri do; MATTOS, Vitoria Carneiro de; MORAES, Walter Augusto; IUAMOTO, Leandro Ryuchi; HSING, Wu Tu; CARNEIRO-D'ALBUQUERQUE, Luiz Augusto; MEYER, Alberto; ANDRAUS, WellingtonThe prevalence of hernias in patient with cirrhosis can reach up to 40%. The pathophysiology of cirrhosis is closely linked to that of the umbilical hernia, but other types are also common in this population. The aim of this study is to evaluate factors that influence in the prognosis after hernia repair in patients with cirrhosis. A historical cohort of 6419 patients submitted to hernia repair was gathered. Clinical, epidemiological data and hernia characteristics were obtained. For patient with cirrhosis, data from exams, surgery and follow-up outcomes were also analyzed. Survival curves were constructed to assess the impact of clinical and surgical variables on survival. 342 of the 6352 herniated patients were cirrhotic. Patient with cirrhosis had a higher prevalence of umbilical hernia (67.5% x 24.2%, P<.001) and a lower prevalence of epigastric (1.8% x 9.0%, P<.001) and lumbar (0% x 0.18%, P=.022). There were no significant differences in relation to inguinal hernia (P=.609). Ascites was present in 70.1% of patient with cirrhosis and its prevalence was different in relation to the type of hernia (P<.001). The survival curve showed higher mortality for emergency surgery, MELD>14 and ascites (HR 12.6 [3.79-41.65], 4.5 [2.00-10.34], and 6.1 [1.15-20.70], respectively, P<.05). Hernia correction surgery in patient with cirrhosis has a high mortality, especially when performed under urgent conditions associated with more severe clinical conditions of patients, such as the presence of ascites and elevated MELD.
- Analysis of biliary MICRObiota in hepatoBILIOpancreatic diseases compared to healthy people [MICROBILIO]: Study protocol(2020) NASCIMENTO, Fernanda Sayuri do; SUZUKI, Milena Oliveira; TABA, Joao Victor; MATTOS, Vitoria Carneiro de; PIPEK, Leonardo Zumerkorn; D'ALBUQUERQUE, Eugenia Machado Carneiro; IUAMOTO, Leandro; MEYER, Alberto; ANDRAUS, Wellington; PINHO, Joao Renato Rebello; MOURA, Eduardo Guimaraes Hourneaux de; SETUBAL, Joao Carlos; CARNEIRO-D'ALBUQUERQUE, Luiz AugustoBackground The performance of the microbiota is observed in several digestive tract diseases. Therefore, reaching the biliary microbiota may suggest ways for studies of biomarkers, diagnoses, tests and therapies in hepatobiliopancreatic diseases. Methods Bile samples will be collected in endoscopic retrograde cholangiopancreatography patients (case group) and living liver transplantation donors (control group). We will characterize the microbiome based on two types of sequence data: the V3/V4 regions of the 16S ribosomal RNA (rRNA) gene and total shotgun DNA. For 16S sequencing data a standard 16S processing pipeline based on the Amplicon Sequence Variant concept and the qiime2 software package will be employed; for shotgun data, for each sample we will assemble the reads and obtain and analyze metagenome-assembled genomes. Results The primary expected results of the study is to characterize the specific composition of the biliary microbiota in situations of disease and health. In addition, it seeks to demonstrate the existence of changes in the case of illness and also possible disease biomarkers, diagnosis, interventions and therapies in hepatobiliopancreatic diseases. Trial registration NCT04391426. Registered 18 May 2020, https://clinicaltrials.gov/ct2/show/NCT04391426.
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