Papers by Wanderley Bernardo
Neurorehabilitation and neural repair, Jan 10, 2018
Enhancement of sensory input in the form of repetitive peripheral sensory stimulation (RPSS) can ... more Enhancement of sensory input in the form of repetitive peripheral sensory stimulation (RPSS) can enhance excitability of the motor cortex and upper limb performance. To perform a systematic review and meta-analysis of effects of RPSS compared with control stimulation on improvement of motor outcomes in the upper limb of subjects with stroke. We searched studies published between 1948 and December 2017 and selected 5 studies that provided individual data and applied a specific paradigm of stimulation (trains of 1-ms pulses at 10 Hz, delivered at 1 Hz). Continuous data were analyzed with means and standard deviations of differences in performance before and after active or control interventions. Adverse events were also assessed. There was a statistically significant beneficial effect of RPSS on motor performance (standard mean difference between active and control RPSS, 0.67; 95% CI, 0.09-1.24; I = 65%). Only 1 study included subjects in the subacute phase after stroke. Subgroup anal...
Revista Da Associacao Medica Brasileira, Apr 1, 2004
BMJ Paediatrics Open, Apr 1, 2020
Revista Da Associacao Medica Brasileira, 2004
Cureus, Aug 6, 2023
Zenker's diverticulum treatment options range from endoscopic rigid or flexible procedures to sur... more Zenker's diverticulum treatment options range from endoscopic rigid or flexible procedures to surgery. There are limited studies available comparing these techniques. Frequently, the choice of treatment depends on the physician's preference or experience, as well as the institution's resources and capacity. Therefore, this study aims to define the best approach based on the highest efficacy and the lowest severe adverse events. In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search was performed. Only comparative studies were included, analyzing flexible endoscopy versus rigid endoscopy or surgery. The outcomes analyzed were clinical and technical success, severe adverse events, length of stay, and duration of the procedure. Analysis was performed using Review Manager 5.4.1 (RevMan 5.4, The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen, Denmark). Eight retrospective cohort studies met the inclusion criteria. A total of 1281 patients were identified, 492 underwent flexible endoscopy, 453 underwent rigid endoscopy, and 336 underwent surgery. There was no difference in clinical success [risk difference (RD), 0.07 (95% CI -0.05 to 0.19%); P = 0.26], technical success [RD, 0.07 (95% CI -0.03 to 0.16); P = 0.18], severe adverse events [RD, -0.03 (95% CI -0.13 to 0.07; P = 0.052), perforation [RD, 0.07 (95% CI -0.04 to 0.19); P = 0.22] or procedure time [mean difference (MD), -10.03 (95% CI -26.93 to 6.88); P = 0.24). There was lower length of stay with flexible endoscopy compared to the other approaches [MD, -1.98 (95% CI -3.56 to -0.40); P = 0.001]. Based on the current evidence, the three main techniques are effective for the treatment of Zenker's diverticulum. Although there was no significant difference in the safety of each technique in this meta-analysis, this result should be interpreted cautiously due to the limited data and the risk of vies between the techniques, considering that the results tend to favor flexible endoscopy, mainly explained by the newer and safer devices. Length of stay is lower with flexible endoscopy versus the other techniques, which can be beneficial considering the geriatric populations where Zenker's diverticulum mainly occurs.
Revista Da Associacao Medica Brasileira, Mar 1, 2020
Revista Da Associacao Medica Brasileira, 2010
Arquivos De Gastroenterologia, Feb 1, 2020
Revista Da Associacao Medica Brasileira, Sep 1, 2013
Revista da Associação Médica Brasileira
Journal of Surgical Oncology
There is no agreement whether prophylactic thoracic duct ligation (TDL), with or without resectio... more There is no agreement whether prophylactic thoracic duct ligation (TDL), with or without resection, during esophagectomy for patients with cancer is beneficial. The effects of these procedures on postoperative complications and overall survival remain unclear. This systematic review included 16 articles. TDL did not influence short‐ and long‐term outcomes. However, thoracic duct resection increased postoperative chylothorax and overall complications, with no improvement in survival.
Journal of Surgical Oncology
This study aims to estimate whether prophylactic cervical lymphadenectomy for esophageal cancer i... more This study aims to estimate whether prophylactic cervical lymphadenectomy for esophageal cancer influences the short‐ and long‐term results through a systematic literature review and meta‐analysis. Twenty‐eight articles were selected in this systematic review, encompassing 9180 patients. Prophylactic neck lymphadenectomy for esophageal cancer should be performed with caution, as it is associated with worse short‐term results compared to traditional two‐field lymphadenectomy and does not improve long‐term survival.
Journal of Surgical Oncology
There is no consensus on the timing of extubation after esophagectomy. There is a fear that prema... more There is no consensus on the timing of extubation after esophagectomy. There is a fear that premature extubation may result in a high risk of urgent reintubation. On the other hand, there is a risk of lung damage in prolonged intubation. The present systematic review compares early and late extubation. Five articles were selected. Early extubation after esophagectomy does not increase the risk of reintubation, mortality, complications, and length of stay.
Evidências em anestesiologia, 2017
Estimated pooled prevalence of HBsAg in individuals under 40Â years of age during the period from... more Estimated pooled prevalence of HBsAg in individuals under 40Â years of age during the period from 2007 to 2016 in Latin America and the Caribbean. (PDF 259Â kb)
Gastrointestinal Endoscopy, 2021
Diseases of the Esophagus, 2021
Gastroesophageal reflux disease (GERD) is a widely studied and highly prevalent condition. Howe... more Gastroesophageal reflux disease (GERD) is a widely studied and highly prevalent condition. However, few is reported about the exact efficacy and safety of fundoplication (FPT) compared to oral intake proton-pump inhibitors (PPI). This systematic review and meta-analysis of randomized clinical trials (RCT) aims to compare PPI and FPT in relation to the efficacy, as well as the adverse events associated with these therapies. Methods This systematic review was guided by PRISMA statement. Search carried out in June 2020 was conducted on Medline, Cochrane, EMBASE and LILACS. The inclusion criteria were (I) patients with GERD; (II) Randomized clinical trials, comparing oral intake PPI with FPT; (III) relevant outcomes for this review. The exclusion criteria were (I) reviews, case reports, editorials and letters (II) transoral or endoscopic FPT (III) studies with no full text. No restrictions were set for language or period. Certainty of evidence and risk of bias were assessed with GRADE...
Diseases of the Esophagus, 2021
Nowadays, there is still no consensus about the benefits of adding neck lymphadenectomy to the ... more Nowadays, there is still no consensus about the benefits of adding neck lymphadenectomy to the traditional two-fields esophagectomy. An extended lymphadenectomy could potentially increase operation time and the risks for postoperative complications. However, extended lymphadenectomy allows resection of cervical nodes at risk for metastases, potentially increasing long-term survival rates. This study aims to estimate whether cervical prophylactic lymphadenectomy for esophageal cancer influences short- and long-term outcomes through a systematic review of literature and meta-analysis. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library Central, and Lilacs (BVS). The inclusion criteria were: (1) studies that compare two-field vs. three-field esophagectomy; (2) adults (>18 years); (3) articles that analyze short- or long-term outcomes; and (4) clinical trials or cohort studies. The results were summarized by forest plots, with effect size (ES) or risk diff...
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Papers by Wanderley Bernardo