Publications by authors named "Rafael Pinheiro"

Introduction: Uterine transplantation was developed for the treatment of absolute uterine factor infertility. As it is a new modality of transplantation, there is still room for technical improvement. A factor that impacts graft survival in organ transplantation is the warm ischemia time.

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  • Direct Oral Anticoagulants (DOACs) are commonly used for treating non-valvular atrial fibrillation (NVAF), but Percutaneous Left Atrial Appendage Occlusion (LAAO) is a new treatment method with uncertain safety and effectiveness compared to DOACs.
  • A systematic review of ten studies involving over 18,500 patients found that LAAO is linked to lower all-cause and cardiovascular mortality rates, as well as a reduction in the composite outcomes of death, bleeding, and thromboembolic events.
  • While LAAO showed trends toward reduced stroke or TIA events and lower bleeding rates compared to DOACs, no significant differences in thromboembolic events were observed.
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Background: Simultaneous liver-kidney transplantation is indicated for patients with concomitant end-stage liver disease and end-stage renal disease. The traditional technique involves separate implantations of the liver and the kidney. In the en bloc approach, the liver is recovered en bloc with the right kidney and the donor renal artery is anastomosed to the donor splenic artery.

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  • The study aimed to estimate the levels of various metallic elements in the blood of people living near a Steel company in Santa Cruz, Brazil, and to see if living close to the company was linked to higher metal concentrations.
  • A total of 463 residents aged 18 and older were analyzed, measuring metals like Cadmium (Cd) and Lead (Pb) through blood samples, and distances from their homes to the Steel company were recorded using GPS.
  • The results showed that for every kilometer further from the Steel company, there was a 19% decrease in blood levels of harmful metals like Cd, Al, and Pb, suggesting lower exposure with increased distance, while no significant links were found for other metals after adjustments.
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Purpose: Gene expressions of vascular Endothelial Growth Factor Alpha (VEGFa), Nuclear Factor Kappa-Light-Chain-Enhancer of Activated B cells (NFkB) and cytokines could be useful for identifying potential therapeutic targets to alleviate ischemia-reperfusion injury after liver transplantation. Cytokine gene expressions, VEGFa and NFkB were investigated in a preclinical swine model of liver transplantation.

Methods: A total of 12 pigs were used as donors and recipients in liver transplantation without venovenous bypass or aortic clamping.

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Background: Liver adenomatosis is characterized by multiple adenomas diffusely distributed throughout the liver parenchyma. Studies addressing liver transplantation for those cases are scarce, and the criteria used to indicate transplantation are still debatable.

Objective: To report a single-center experience of liver transplantation for diffuse adenomatosis.

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Background: Hepatic artery thrombosis is the most common vascular complication of liver transplantation. When occurring late in the postoperative course, it may have no clinical repercussions, and conservative treatment may be implemented. Some patients, however, will develop severe biliary complications due to ischemic cholangiopathy and require retransplantation.

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Introduction: Polycystic liver disease and giant hepatic hemangioma may present with severe symptom burden and indicate orthotopic liver transplantation. The left-to-right piggyback approach is a useful technique for performing total hepatectomy of enlarged livers.

Objective: The purpose of this study is to analyze the results of liver transplantation in patients with benign massive hepatomegaly.

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  • Intrahepatic cholangiocarcinoma (iCC) is a serious liver disease and surgery is the only way to cure it, but not many patients can have surgery right away.
  • This study looked at using living donor liver transplants (LDLT) as a treatment for iCC, including a special case of a patient whose cancer couldn’t be removed by surgery.
  • While using liver transplants for this cancer used to have bad results, now it seems to be a better option, especially for certain patients, even though there are still not enough organ donors available.
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Background: Hepatic artery pseudoaneurysm after liver transplantation is a rare condition that can lead to spontaneous bleeding, depending on its extent and location. Treatment involves endovascular and surgical approaches in addition to liver retransplantation in cases of graft failure.

Case Report: A 42-year-old female underwent deceased donor liver transplantation due to cryptogenic cirrhosis and schistosomiasis with an uneventful postoperative course.

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Background: Perihilar cholangiocarcinoma (phCCC) is a dismal malignancy. There is no consensus regarding the best treatment for patients with unresectable phCCC. The present review aimed to gather the current pieces of evidence for liver transplantation and liver resection as a treatment for phCCC and to build better guidance for clinical practice.

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Intrahepatic cholangiocarcinoma (ICC) is a relatively uncommon but highly aggressive primary liver cancer that originates within the liver. The aim of this study is to review the molecular profile of intrahepatic cholangiocarcinoma and its implications for prognostication and decision-making. This comprehensive characterization of ICC tumors sheds light on the disease's underlying biology and offers a foundation for more personalized treatment strategies.

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Rationale And Objectives: Hepatocellular carcinoma (HCC) treatment often requires transarterial chemoembolization (TACE). However, TACE efficacy is controversial in the presence of portal vein thrombosis (PVT). Although transarterial radioembolization (TARE) benefit was previously documented in PVT, neither the objective tumor response (OTR) after TARE with Iodine-131-lipiodol (I-lipiodol) nor the PVT effect on the results of locoregional therapies was accurately measured in prospective clinical trials.

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Zoonotic viral infections continue to pose significant threats to global public health, as highlighted by the COVID-19 pandemic caused by the SARS-CoV-2 virus. The emergence of SARS-CoV-2 served as a stark reminder of the potential for zoonotic transmission of viruses from animals to humans. Understanding the origins and dynamics of zoonotic viruses is critical for early detection, prevention, and effective management of future outbreaks.

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Unlabelled: Reconstruction of the distal third of the tibia due to resection of a malignant tumor has some hindering factors, such as a thin subcutaneous layer, neurovascular bundles that cross compartments, prolonged operative duration, specific orthopedic material, and a trained multidisciplinary team. Allografting with material from tissue banks is part of this orthopaedic arsenal.

Objective: To describe the protocol used at Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad.

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Summary: People with cirrhosis of the liver are at risk for complications that can worsen their quality of life and increase morbidity and mortality. Contrary to previous beliefs, cirrhosis does not protect against the development of thromboembolic events, and cirrhotic patients may have higher rates of deep vein thrombosis (DVT).

Background And Aims: The study of chronic venous disease and its impact on patients with cirrhosis is unknown in the literature and may be an important fact since this condition also had impact on quality of life and morbidity.

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The present study aimed to evaluate the effect of E-VCO on the neurobehaviour and intestinal health parameters of obesity-induced rats, focusing on food consumption, body composition, bacterial and faecal organic acids and histological analyses in the hippocampus and colon. A total of 32 male Wistar rats were randomized into healthy (HG, = 16) and obese groups (OG, = 16), which consumed a control or cafeteria diet for eight weeks, respectively. After this period, they were subdivided into four groups: healthy (HG, = 8); healthy treated with E-VCO (HGCO, = 8); obese (OG, = 8); obese treated with E-VCO (OGCO, = 8), continuing for another eight weeks with their respective diets.

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Background: Lipid metabolism dysregulations have been associated with depressive and anxious behaviors which can affect pregnant and lactating individuals, with indications that such changes extend to the offspring. Therefore, the aim of this study was to evaluate the effect of a maternal high-fat diet on the neurobehavioral, biochemical and inflammatory parameters of their adult female offspring.

Methods: Wistar rats ± 90 days old were mated.

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Low rainfall in Northeast Brazil is a limiting factor for animal production. Forages that present crassulacean acid metabolism, such as forage cactus, are adapted to the edaphoclimatic conditions of this region, as they lose little water through the stomata. Thus, the objective was to evaluate the physical and chemical quality, fatty acid profile and sensory acceptance of the meat from goats fed forage cactus as a substitute for Tifton 85 hay.

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Unlabelled: The World Health Organization (WHO) estimates that by 2025 about 2.3 billion adults will be overweight, with more than 700 million obese. Obese patients with joint pain and reduced physical function represent a challenging group to treat effectively.

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Background: Isolated intestinal transplantation (IT) is indicated in cases of intestinal failure (IF) in the absence of severe liver dysfunction. Short bowel syndrome (SBS) is the most frequent IF etiology, and due to the absence or considerable reduction of intestinal loops in the abdominal cavity in these patients, there is atrophy and muscle retraction of the abdominal wall, leading to loss of the abdominal domain and elasticity and preventing the primary closure of the abdominal wall. This study aimed to describe a technique for the closure of the abdominal wall after IT without using prostheses.

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Introduction: Patients with liver cirrhosis are at a higher risk of hospitalization. The present review aimed to assess the risk of thromboembolism and its burden on hospitalized cirrhotic patients.

Materials And Methods: A systematic review (PROSPERO: CRD42021256869) was conducted in PubMed, Embase, Cochrane, Lilacs, and a manual search of references.

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In 2010, a steel company was established in Santa Cruz, Rio de Janeiro. In 2012, silver rain raised concerns about human and environmental impacts. In 2013, the steel company signed an Adjustment of Conduct Term (ACT).

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The aim of this study was to evaluate the effects of supplementing yellow mombin (YM) on the oxidative, somatic, and lipid parameters in rats fed a high-fat diet. A total of 24 adult Wistar rats were randomized into three groups: normal-fat diet (NF), high-fat diet (HF), and high-fat diet with YM supplementation (HFYM). Diets were administered for four weeks, and YM (400 mg/kg) was supplemented via gavage in the last two weeks of the experiment.

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Nestedness and modularity have been found in many species interaction networks. Despite being conceptually distinct, negatively correlated and having different causes, these patterns often co-occur. A realistic but seldom investigated alternative to these simple topologies is hierarchical compound networks, in which the entire network is modular, and modules are internally nested.

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