Livros e Capítulos de Livros - ODS/03
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A coleção de Livros e Capítulos de Livros reúne capítulos e resumos de obras produzidas por autores do complexo Hospital das Clínicas - Faculdade de Medicina da Universidade de São Paulo.
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- Diabetic Foot(2022) GODOY-SANTOS, A. L.; SPOSETO, R. B.Diabetic foot syndrome is among the most serious complications of diabetes mellitus; it is increasing in worldwide prevalence despite advances in the clinical and metabolic control of diabetes mellitus. It represents great suffering for patients, their families, professionals, and health institutions and for society in general. It is a clinical situation associated with a high financial impact on health systems around the world. Treatment strategies are based on prevention, patient education, a multidisciplinary approach, and the principles of appropriate surgical and non-surgical treatment. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
- Charcot Neuroarthropathy(2022) SPOSETO, R. B.; GODOY-SANTOS, A. L.Charcot’s Neuroarthropathy (CN) is a serious pathology, with devastating impact on mobility and quality of life of the patient. Although its pathophysiology is not completely clear, it is related to sensory neuropathy, repetitive trauma, and increased expression of pro-inflammatory cytokines. Currently, Diabetes Mellitus (DM) is the disease most related to this pathology. The pathology begins with intense inflammation, associated with fractures and cumulative and progressive dislocations, mainly in the foot and ankle. At the end of the inflammatory phase, bone healing occurs, and the residual deformity is established. The objective of the treatment is to obtain a functional plantigrade foot at the end of the four clinical phases. The initial approach is to protect the foot in the inflammatory phase to avoid progression of the fractures and deformity. After the consolidation phase in case the patient does not adapt to the modification of footwear and orthotics, the surgical treatment for foot realignment should be indicated. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
- Oral Management of Patients Undergoing Antithrombotic Therapy(2023) TORREGROSSA, V. R.; SCARINI, J. F.; MONTANO, T. C. P.Antithrombotic therapy is considered one of the most prevalent treatment in contemporary medicine. Its objective is to reduce the risk of thromboembolism in patients with cardiovascular diseases and/or other disorders related to hypercoagulable states in the body. Several dental specialties, especially surgical specialties, were impacted by the need to treat these patients. This chapter provides evidence of the management guidelines of patients who are receiving anticoagulant or antiplatelet therapy and require an elective surgery or procedure. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.
- Hypertension in the Developing World(2023) KOCH, V. H.Hypertension is a major global chronic noncommunicable disease (NCD). Despite continued efforts to establish public policies to ensure surveillance and monitoring, the absolute numbers of patients affected by hypertension in low- and middle-income countries are likely to grow, as economic improvement favors longer life expectancy. Increasing longevity provides longer periods of exposure to the risk factors of cardiovascular disease (CVD), resulting in a greater probability of clinical manifestation of CVD events, especially because of the lack of awareness and insufficient treatment of the affected individuals. The survivors of an economic transition period are more likely to present the phenotype of lower birth weight coupled with either stunting or a higher body mass index in childhood or adulthood, which appears to be associated with the highest risks of morbid cardiovascular, renal, and metabolic outcomes into adulthood. The combination of population-wide and individual interventions may save millions of lives and considerably reduce human suffering from NCDs. © Springer Nature Switzerland AG 2023.
- Cancer Care Challenges for the LGBT Population in Brazil(2022) CRENITTE, M. R. F.; JUNIOR, A. L.; MELO, L. R. de; AVELINO-SILVA, T. J.Some improvements for the LGBT community have taken place in Brazil, such as the strengthening of progressive social movements and even the National Policy of Integral Healthcare for Lesbians, Gays, Bisexuals, Transsexuals, and Travestis (Travesti: Transfeminine person who identifies with a travesti gender identity, that has been marginalized throughout history. It is a predominantly Brazilian identity construction but is also found in other Latin American and European countries. As there is no consensus on the best translation of the term and its translation could sound pejorative, the authors of this chapter chose to keep its nomenclature in Portuguese. Travesti is not a pejorative term, and they want to be recognized as such by societys), in 2011. From there, it has been possible to consider public policies for caring for non-transmissible chronic diseases, such as cancer, and in barriers and inequalities in the access to the public healthcare system in the country. However, national healthcare has suffered ongoing budgetary cuts, stimulated by neoliberal policies, such as the constitutional amendment in 2016 that “froze” public investments for 20 years. Furthermore, our country has been the subject of worldwide scrutiny in view of escalating far-right conservative bids since the election of Jair Bolsonaro in 2018. The LGBT population already suffers with a lack of national data justifying the implementation of inclusive public policies, but in this context, it fears and dares to resist for the rights already fought for in the past. Thus, this chapter concerns the specificities of the Brazilian healthcare system and how the particulars that LGBT people face may interfere in the risk and follow-up of neoplasms. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
- Sexually Transmitted Infections(2022) MIOTTO, I. Z.; OLIVEIRA, W. R. P. deSexually transmitted infections (STIs) represent a significant global public health burden, with approximately 1 million new cases daily. Systematic serology screening for STIs is generally performed in transplant donors and recipients, which include testing for human immunodeficiency virus (HIV), viral hepatitis B and C, herpes simplex virus, and syphilis. Infection by human papillomavirus (HPV) should be properly recognized by clinical and histopathological examination, once lesions can undergo malignant transformation. STIs in solid organ transplant recipients (SOTRs) may have an atypical presentation and tricky diagnosis. Transplant caregivers must be aware of these peculiarities, and patients must be followed-up closely, in order to reduce associated morbidity. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
- Acromegaly: Preconception Management(2022) JALLAD, R. S.; BRONSTEIN, M. D.Family planning is an important component of the medical care for women with acromegaly. For women desiring fertility, preconception counseling should be offered to address the potential risks to the mother and fetus. The optimal time to conceive depends on disease control and the need for treatments used to manage acromegaly. Preconception evaluation also entails screening for comorbidities and managing them appropriately. We present a case of a woman with a growth hormone (GH)-secreting tumor who aims to conceive and summarize the pathophysiology and best standards regarding preconception management in this population of patients. © Springer Nature Switzerland AG 2022 This work is subject to copyright. All rights are reserved.
- Vascular Surgery in Oncology(2022)Circulatory conditions are involved both in the oncologic disease itself and in its treatment, with a direct impact on therapeutic planning for patients. At the same time, it goes without saying that cancer and its treatment affect the circulatory system, be it arterial, venous or lymphatic. This book explores the interface between vascular surgery and the various clinical and surgical oncological specialties, highlighting which types of neoplasm are most common and focusing on those that more frequently cause or are influenced by vascular diseases. The diagnostic procedures for these tumors and the most suitable types of treatment are also discussed. The content is divided into three sections: I - Surgical Oncology, II - Clinical Oncology and Oncohematology, and III - Vascular and Endovascular Surgery. The first section presents the most common types of tumor in each surgical oncology specialty, and the most frequent tumors associated with vascular complications. The diagnosis, staging, prognosis and oncological treatments are discussed, while associated vascular complications, such as vascular invasion, venous thrombosis, and arterial thrombosis, are described. The second section focuses on general aspects of Clinical Oncology and Oncohematology in addition to the most frequent vascular complications related to solid and hematological cancers and its treatment (chemotherapy, radiotherapy, bone marrow transplantation). The third section includes a more detailed approach to vascular events and diseases commonly found in cancer patients, in addition to technical discussions regarding vascular reconstructions associated with tumor resection, vascular access, among other topics. At the end of each chapter, the editors comment and highlight the most important challenges for vascular surgeons who dedicate their lives to treating cancer patients. Given its scope, the book offers a valuable resource for medical specialists and professionals in training in the fields of vascular surgery and angiology, clinical oncology, oncohematology and surgical oncology. © Springer Nature Switzerland AG 2022.
- Nuclear Medicine in Endocrine Disorders: Diagnosis and Therapy(2022)This book presents up-to-date information on the general principles of diagnostic and therapeutic nuclear medicine in the context of endocrinology. The content is divided into six parts. Section I examines general aspects of radiopharmaceuticals, scintigraphy, single-photon emission computed tomography (SPECT), positron emission tomography (PET), radionuclide therapies and radioguided surgery. Section II discusses diagnostic applications in benign thyroid diseases and evaluation of thyroid nodules. Section III gives an overview of the management of parathyroid diseases. Section IV presents diagnostic techniques in well-differentiated thyroid cancer. Section V addresses procedures and therapy in adrenal benign and malignant disorders (phaechromocytomas and paragangliomas). Lastly, the diagnosis and treatment of neuroendocrine tumors are featured in Section VI. Nuclear Medicine in Endocrine Disorders: Diagnosis and Therapy is intended for non-specialists in nuclear medicine working in the field of endocrinology, and is also a valuable resource for researchers and students. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
- Anesthesia for Vascular Surgery(2022) SIMõES, C. M.Anesthesia for vascular procedures in cancer patients can be challenging. In this chapter, we discuss some important aspects in preoperative evaluation and anesthesia planning, including risk stratification, medications, and also other patient potential risks. Onco-anesthesia has some specific aspects and should be considered an emerging subspecialty with critical competencies to be developed. Venous access, hemodynamic monitoring, blood and fluid management, analgesia, and also enhanced recovery bundles must be considered for all patients. Also, anesthesia technique may be an important factor to be studied. Postoperative care is also specific, and we must consider some situations more frequent in cancer patients-that will be discussed as analgesia and its adverse effects-that may be present and should be prevented. © Springer Nature Switzerland AG 2022.
- Management of Oral Lesions in COVID-19 Patients(2023) GUERRA, E. N. S.; SANTOS-SILVA, A. R.; NORMANDO, A. G. C.; SCARINI, J. F.; SANTOS, J. A. Dos; BRANDãO, T. B.In COVID-19 patients, the infection can lead to taste disturbances, xerostomia, halitosis, parotitis, and oral mucosal lesions. Usually, the lesions are symptomatic and have no sex predilection. Patients with older age and greater severity of the disease present more disseminated and severe lesions. This chapter sought to describe the clinical presentation and specificities of managing orofacial lesions in patients with COVID-19, based on the best evidence of clinical effectiveness. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.
- Older Adult Patients(2022) DESIDERI, I.; KARNAKIS, T.; BRAIN, E.Ageing is the most important risk factor for developing cancer. Breast cancer is not an exception to the rule, with a median age of 62 years at diagnosis, depending on the age distribution of the population at risk. In western countries, 40–50% of patients are being diagnosed at age 70 or older. Given the competing risks on mortality with multi-morbidities, a screening tool for frailty is recognized as the gateway to any treatment decision-making in patients aged 70 and older, for personalizing treatment. Indeed, treatment choice requires careful assessment of the benefit–risk ratio and guidance according to a general health status assessment, to avoid jeopardizing functional status and quality of life. This concept applies to any specific local or systemic treatment, showing the need for constant adjustment according to the degree of frailty reversibility. Hypofractionated schedules and partial breast irradiation are approaches increasing attractivity of radiation therapy strategies for older patients to avoid multiple burdensome transportations, while improving selection of cases for which chemotherapy is required, both in adjuvant and metastatic settings, is the main challenge for systemic treatments.
- Vascular Access(2022) SAES, G. F.; ZERATI, A. E.; WOLOSKER, M. B.; BARBOSA, J. A. S.; SILVA, T. C. do CampoIn this chapter, we deal with vascular accesses in cancer patients, complications associated with those devices, and nursery care. Long-term venous catheters, especially tunneled catheters, are essential for cancer treatment, with wide applicability in various stages of treatment. In addition to enabling the infusion of drugs and blood products, they also allow the collection of blood samples for laboratory analysis, the monitoring of hemodynamic parameters, parenteral nutrition, and the performance of essential procedures for maintaining life, such as hemodialysis sessions.The indications and types of catheters are discussed, taking into account the time of use, the compatibility of the drug with the peripheral venous system, and the risk of infection. Most frequent complications and how to avoid them are also a subject in this chapter. © Springer Nature Switzerland AG 2022.
- PET/CT in soft tissue sarcomas(2022) ETCHEBEHERE, E.; MUNHOZ, R. R.; CASALI, A.; ETCHEBEHERE, M.Soft tissue sarcomas are a diverse group of rare malignant tumors of mesenchymal origin. Clinical diagnosis of soft tissue sarcoma poses a dilemma since the differentiation of a benign from a malignant lesion might be challenging. In addition to the risk of local relapse, these tumors may metastasize, mainly to the lungs, but also to other tissues, and evaluation of the extent of disease and subsequent response to therapy may be difficult. Following local or systemic therapies, tumor fibrosis might occur and can be confounded with viable tumor tissue. FDG PET/CT is a molecular imaging modality that uses the tumor metabolism to evaluate aggressiveness, the extent of disease, treatment response, and differentiation of benign from malignant lesions. This chapter will discuss the potential added value of FDG PET/CT in soft tissue sarcomas. © 2022 Elsevier Inc. All rights reserved.
- FDG PET/CT in bone sarcomas(2022) CAMACHO, M.; CARVALHO, M.; MUNHOZ, R.; ETCHEBEHERE, M.; ETCHEBEHERE, E.Bone sarcomas are a rare and diverse group of malignant neoplasms composed by entities with distinct presentations, clinical courses and therapeutic approaches. Although bone sarcomas may affect all age groups, these tumors exhibit a bimodal distribution, with higher incidences in children and in the elderly. Imaging exams are a crucial step for an adequate evaluation of bone sarcomas and mandatory for treatment planning, and provide invaluable information regarding disease extent, prognostic information, treatment response, and disease relapse.Whole-body FDG PET/CT imaging may be a part of the diagnostic work-up of bone sarcomas. FDG PET/CT combines, in a single study, morphologic and metabolic information that may alter treatment strategies, help guide or avoid unnecessary biopsies, stage patients, determine the degree of tumor necrosis following neoadjuvant chemotherapy, detect local recurrence, and provide important prognostic information. This article will discuss the current and potential roles of FDG PET/CT in osteosarcoma, Ewing's sarcoma, chondrosarcoma, giant cell bone tumor, and chordoma. © 2022 Elsevier Inc. All rights reserved.
- Lymphadenectomy in Prostate Cancer: Technique and Outcomes(2022) LESTINGI, J. F. P.; SALAS, R. S.; YOSHIOKA, K.; COELHO, R. F.Despite recent advances in imaging, pelvic lymph node dissection (PLND) remains the gold standard modality for nodal staging in prostate cancer (PCa) patients. There remains significant debate about PLND: the odds of finding positive pelvic lymph nodes are proportional to the extent of the PLND; however, the therapeutic benefits of more extensive PLND remain an area of controversy, besides the increasing number of surgical risks. This chapter will review indications, techniques, and results of extended pelvic lymphadenectomy (ePLND) in the surgical treatment of PCa patients. Two recent randomized controlled trials comparing extended to limited PLND have not demonstrated differences in early biochemical recurrence. Limited lymphadenectomy significantly underestimates the actual incidence of lymph node metastasis and should no longer be performed for staging. EPLND is currently the gold standard in lymph node staging. It should be reserved for patients at higher risk of lymph node invasion. The oncological role of ePLND is not defined. It can help patients directly (up to two positive lymph nodes), indirectly (select for adjuvant treatments), or may benefit patients with ISUP Gleason Grade in biopsy 3-5. EPLND is also associated with significantly worse intra- and postoperative non-oncological outcomes, such as bleeding, lymphocele, and increased surgical time. The oncological role of salvage lymphadenectomy also is not clear. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
- Oral Management of Cancer Patients After Multimodality Therapy(2023) PRADO-RIBEIRO, A. C.; SANTOS-SILVA, A. R.; FONSECA, F. P.; SCARINI, J. F.; INNOCENTINI, L. M. A. R.; BRANDãO, T. B.No currently available anticancer treatment, whether radiotherapy or chemotherapy, can kill neoplastic cells without affecting normal cells. In this context, the oral mucosa epithelium is susceptible to acute and chronic toxicities of antineoplastic treatment. This chapter offers an update on the main oral toxic effects of radiotherapy and chemotherapy and how to adequate individualize treatment based on the recommendations of preventative and interventional treatments for these patients. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.
- Pancreatic Stem Cells and Regenerative Medicine of Endocrine Pancreas(2023) MANTOVANI, M. C.; SILVA, I. B. B.; LOJUDICE, F. H.; KOSSUGUE, P. M.; SOGAYAR, M. C.During embryogenesis, the first pancreatic cells arise from a region located in the posterior foregut. Different signals are important to induce the formation of both the ventral and dorsal buds of the pancreas, along with the differentiation of all kinds of pancreatic cells. Other factors are also important to maintain a proliferative pool of pancreatic progenitor cells within the embryonic ductal epithelium. After organogenesis, new beta cells can also be originated by expansion or neogenesis. Different stem cell populations have been described in the pancreas: ductal and acinar cells, nestin-positive cells, hepatocyte growth factor receptor-positive cells, c-Kit-positive cells, and DCAMKL-1-positive cells. Transdifferentiation or dedifferentiation followed by differentiation is also described as being present in the pancreas. Thus, other pancreatic cells that do not belong to the endocrine lineage are possible sources of new beta cells. Extra-pancreatic tissue may also be modified to express insulin, including the hepatic tissue, bone marrow, and monocytes. In addition, stem cells from several sources have been subjected to differentiation protocols, expecting to achieve insulin-producing cells with and without genetic manipulation. © 2024 Elsevier Inc. All rights reserved.
- Tackling Urbanicity and Pollution in Mental Health Prevention Strategies(2022) VENTRIGLIO, A.; CASTALDELLI-MAIA, J. M.; TORALES, J.; BERARDIS, D. De; BHUGRA, D.Globalization in the last decades has led to an increase of exchanges through the globe and an expansion of global markets as well as an increase of levels of urbanization through the continents. In particular, urbanization includes environmental, social, and economic changes and factors that may affect the mental health of the general population. In fact, emerging evidence reports higher rates of mental disorders in the urban settings than in rural areas, and social disparities and insecurity may impact on the mental health of the weaker groups of society. Also, the lack of contact with nature in the city and higher levels of pollution are associated with a remarkable rate of psychological distress. Pollution, in particular, is tightly related to the level of industrialization and employment of technology. It has been demonstrated that environmental pollutants (e.g., air pollutants, noise, ionizing radiations, etc.) may impact directly or indirectly on mental health: there may be a direct biological consequence of pollution on the human central nervous system as well as a range of psychological stress generated by the lasting exposure to pollutant agents. This chapter reports emerging evidence regarding the impact of urbanicity and pollution on public mental health and suggests further research and action in order to develop strategies of prevention of mental illness due to the burden of global urbanization. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
- ACE2/angiotensin-(1–7)/mas receptor axis in the central nervous system(2023) BRITO-TOSCANO, E. C.; ROCHA, N. P.; RACHID, M. A.; TEIXEIRA, A. L.; MIRANDA, A. S. deThe renin–angiotensin system (RAS) is classically conceived as a circulating hormonal system involved in cardiovascular and renal homeostasis. The discovery that RAS components are locally expressed in the brain tissue pointed out to a role for this system in the pathophysiology of neuropsychiatric diseases, including mood disorders and neurodegenerative and cerebrovascular illnesses. The RAS counterregulatory axis composed by the angiotensin-converting enzyme 2 (ACE2), angiotensin-(1–7) (Ang-(1–7)), and Mas receptor mediates, among others, antiinflammatory, antioxidant, and antiapoptotic processes, frequently opposing the classical RAS arm (ACE/Ang II/AT1 receptor) actions. Accumulating evidence has supported protective roles of the ACE2/Ang-(1–7)/Mas receptor axis in the brain. Herein, we will discuss emerging evidence regarding the role of RAS, mainly focusing in the ACE2-Ang-(1–7)-Mas receptor arm, in brain physiology and pathophysiology. We will also report current experimental and clinical evidence in relation to ACE2 stimulation and Mas receptor agonists as potential therapeutic targets for neuropsychiatric diseases. © 2023 Elsevier Inc. All rights reserved.