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
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
- 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.
- 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.
- 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.
- 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.
- Change in neoadjuvant chemotherapy could alter the prognosis of patients with pancreatic adenocarcinoma: A case report(2021) MEYER, Alberto; CARVALHO, Barbara J.; MEDEIROS, Kayo A. A.; PIPEK, Leonardo Z.; NASCIMENTO, Fernanda S.; SUZUKI, Milena O.; MUNHOZ, Joao V. T.; IUAMOTO, Leandro R.; CARNEIRO-D'ALBURQUERQUE, Luiz A.; ANDRAUS, WellingtonBACKGROUND Neoadjuvant treatment has become a standard of care for borderline or locally advanced pancreatic cancer and is increasingly considered even for up-front resectable disease. The aim of this article is to present the case of a 62-year-old patient with locally advanced pancreatic adenocarcinoma who was successfully treated with gemcitabine plus nab-paclitaxel after the failure of the first line treatment. CASE SUMMARY Computerized tomography scan and magnetic resonance imaging demonstrated a nodular lesion of ill-defined limits in the body of the pancreas, measuring approximately 4.2 cm x 2.7 cm, with an infiltrative aspect. The tumor had contact with the superior mesenteric vein, splenomesenteric junction and the proximal segment of the splenic artery, causing focal reduction of its lumens. Due to vascular involvement, neoadjuvant chemotherapy treatment with eight cycles of ""folinic acid, 5-fluorouracil, irinotecan and oxaliplatine"" (FOLFIRINOX) were performed. At the end of the cycles, surgery was performed, but the procedure was interrupted due to finding of lesions suspected of metastasis. Gemcitabine plus nab-paclitaxel was then successfully used for neoadjuvant treatment with subsequent R0 surgical resection. CONCLUSION Gemcitabine plus nab-paclitaxel may be effective as an alternative regimen when FOLFIRINOX fails as the first line of treatment, suggesting the need for further studies to identify which patients would benefit from each type of therapeutic approach.
- 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.
- A simple technique can reduce cardiopulmonary bypass use during lung transplantation(2016) SAMANO, Marcos N.; IUAMOTO, Leandro R.; FONSECA, Hugo V. S.; FERNANDES, Lucas M.; ABDALLA, Luis G.; JATENE, Fabio B.; PEGO-FERNANDES, Paulo M.Cardiopulmonary bypass causes an inflammatory response and consumption of coagulation factors, increasing the risk of bleeding and neurological and renal complications. Its use during lung transplantation may be due to pulmonary hypertension or associated cardiac defects or just for better exposure of the pulmonary hilum. We describe a simple technique, or open pericardium retraction, to improve hilar exposure by lifting the heart by upward retraction of the pericardial sac. This technique permits lung transplantation without cardiopulmonary bypass when bypass use is recommended only for better exposure.
- Burkholderia cepacia, cystic fibrosis and outcomes following lung transplantation: experiences from a single center in Brazil(2018) CARRARO, Danila de Souza; CARRARO, Rafael Medeiros; CAMPOS, Silvia Vidal; IUAMOTO, Leandro Ryuchi; BRAGA, Karina Andrighetti de Oliveira; OLIVEIRA, Lea Campos de; SABINO, Ester Cerdeira; ROSSI, Flavia; PEGO-FERNANDES, Paulo ManuelOBJECTIVES: To evaluate the impact of Burkholderia cepacia complex colonization in cystic fibrosis patients undergoing lung transplantation. METHODS: We prospectively analyzed clinical data and respiratory tract samples (sputum and bronchoalveolar lavage) collected from suppurative lung disease patients between January 2008 and November 2013. We also subtyped different Burkholderia cepacia complex genotypes via DNA sequencing using primers against the recA gene in samples collected between January 2012 and November 2013. RESULTS: From 2008 to 2013, 34 lung transplants were performed on cystic fibrosis patients at our center. Burkholderia cepacia complex was detected in 13 of the 34 (38.2%) patients. Seven of the 13 (53%) strains were subjected to genotype analysis, from which three strains of B. metallica and four strains of B. cenocepacia were identified. The mortality rate was 1/13 (7.6%), and this death was not related to B. cepacia infection. CONCLUSION: The results of our study suggest that colonization by B. cepacia complex and even B. cenocepacia in patients with cystic fibrosis should not be considered an absolute contraindication to lung transplantation in Brazilian centers.