JOAQUIM MAURICIO DA MOTTA LEAL FILHO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Peristomal variceal bleeding treated by coil embolization using a percutaneous transhepatic approach(2016) MACIEL, Macello Jose Sampaio; PEREIRA, Osvaldo Ignacio; LEAL FILHO, Joaquim Mauricio Motta; ZIEMIECKI JUNIOR, Enio; COSME, Susyanne Lavor; SOUZA, Moises Amancio; CARNEVALE, Francisco CesarPeristomal variceal bleeding due to portal hypertension is an entity that has rarely been reported with 3%-4% risk of death. A 68-year-old woman who had undergone a palliative colostomy (colorectal carcinoma) presented with a massive hemorrhage from the colostomy conduit. Considering her oncological status with medial and right hepatic veins thrombosis due to liver metastasis invasion, an emergency transhepatic coil embolization was successfully performed. Standard treatment modality for these cases has not been established. Percutaneous transhepatic coil embolization of varices is a safe and effective choice in patients who present with life threatening bleeding and exhibit contraindications to transjugular intrahepatic portosystemic shunt.
bookPart Radiologia intervencionalista e cirurgia endovascular(2016) NASSER, Felipe; AFFONSO, Breno Boueri; LEAL FILHO, Joaquim Maurício da Motta- Metabolomic characterization of renal ischemia and reperfusion in a swine model(2016) MALAGRINO, Pamella Araujo; VENTURINI, Gabriela; YOGI, Patricia Schneider; DARIOLLI, Rafael; PADILHA, Kallyandra; KIERS, Bianca; GOIS, Tamiris Carneiro; MOTTA-LEAL-FILHO, Joaquim Mauricio; TAKIMURA, Celso Kiyochi; GIRARDI, Adriana Castello Costa; CARNEVALE, Francisco Cesar; CANEVAROLO, Rafael; MALHEIROS, Denise Maria Avancini Costa; ZERI, Ana Carolina de Mattos; KRIEGER, Jose Eduardo; PEREIRA, Alexandre CostaAcute kidney injury (AKI) is a serious complication in hospitalized and transplanted patients, and is mainly caused by ischemia/reperfusion (I/R). However, the current diagnosis of AKI based on acute alterations in serum creatinine or urine output is late and unspecific. To identify new systemic biomarkers for AKI, we performed serum and urine metabolomic profile analyses during percutaneous unilateral renal I/R in a well-controlled swine model. For this, serial serum and urine samples obtained during the pre-ischemia, ischemia and reperfusion periods were analyzed by H-1 nuclear magnetic resonance at 600 MHz. Through the metabolic profiles over I/R, we identified eight serum metabolites that increased with ischemia and recovered to basal values after reperfusion, delineating the ischemic period. In addition, we identified 13 urinary metabolites that changed during the early reperfusion reflecting the ischemic kidney, being able to differentiate between pre-ischemia and post I/R periods. All selected metabolites are described in terms of disease pathophysiology (change of energetic pathway and oxidative stress), which suggest that these serum and urinary metabolites are candidate AKI biomarkers. Interestingly, the selected metabolites allowed us to identify, well described NF kappa B, leptin, INF-gamma and insulin pathways, and a new pathway (Huntingtin) that had not been previously implicated in renal I/R. Huntingtin showed different fragment patterns in ischemic versus non-ischemic kidneys. Therefore, the metabolomic profile found in renal I/R led to the identification of candidate disease biomarkers and a new pathway associated with renal injury.
conferenceObject Incidence of pulmonary embolism and upper-extremity deep venous thrombosis in patients submitted to lead extraction and upgrade procedures(2016) ALBERTINI, C. M. M.; SILVA, K. R.; AMAYA, I. C. M.; MELO, G. R. G.; CREVELARI, E. S.; LEAL, J. M. M.; LIMA, M. F.; CHATE, R. C.; HIGA, K.; NOMURA, C.; MARTINELLI FILHO, M.; COSTA, R.- Risk factors for infectious and noninfectious complications of totally implantable venous catheters in cancer patients(2016) ZERATI, Antonio Eduardo; FIGUEREDO, Tamires Rocha; MORAES, Richard Diego de; CRUZ, Amanda Monteiro da; MOTTA-LEAL FILHO, Joaquim Mauricio da; FREIRE, Maristela Pinheiro; WOLOSKER, Nelson; LUCCIA, Nelson deObjective: The aim of this study was to investigate the risk factors for complications of totally implantable catheters in a referral cancer center. Methods: This was a retrospective study of prospectively collected data of all consecutive cancer patients undergoing port placement, with a primary outcome of interest of major complication and subanalysis of the types of complications. Results: We studied 1255 nonvalved implanted port catheters inserted in 1230 patients, for a combined total of 469,882 catheter-days of use. Venous puncture was ultrasound (US) guided in 1049 cases (84%). Inadvertent arterial puncture occurred in 14 cases (1.1%) and was more frequent in procedures not guided by US (P = .045). Among the outpatients, 90 (9%) developed infection, and 75 (29%) of the hospitalized patients (P < .001) developed infections. Infection was diagnosed in 131 catheters (13%) implanted through the internal jugular vein (IJV), 23 catheters (14%) implanted in the subclavian vein (SCV), 1 catheter (5%) implanted in the external jugular vein, and 10 catheters (31%) implanted in the femoral vein (P = .044). In the multivariate analysis, only the hospitalization regimen maintained statistical significance, with hospitalization presenting as a risk factor for infection (P < .001). Regarding the introduction site, ambulatory patients in whom the femoral vein was the site of access had more infections than the others (28.6% vs 9.4% of the IJV, 4.8% of the SCV, and 4.8% of the external jugular vein; P = .019), which did not occur among the hospitalized patients (33.3% vs 26.5% of IJV and 39.5% of the SCV; P = .218). Conclusions: Not using US is a risk factor for iatrogenic arterial puncture. Port implantation in hospitalised patients and the use of femoral access are risk factors for infection.