AIRTON MOTA MOREIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- BRAZILIAN SOCIETY OF HEPATOLOGY UPDATED RECOMMENDATIONS FOR DIAGNOSIS AND TREATMENT OF HEPATOCELLULAR CARCINOMA(2020) CHAGAS, Aline Lopes; MATTOS, Angelo Alves de; CARRILHO, Flair José; BITTENCOURT, Paulo Lisboa; VEZOZZO, Denise Cerqueira Paranaguá; HORVAT, Natally; ROCHA, Manoel de Souza; ALVES, Venâncio Avancini Ferreira; CORAL, Gabriela Perdomo; ALVARES-DA-SILVA, Mario Reis; BARROS, Fabio Marinho do Rego; MENEZES, Marcos Roberto; MONSIGNORE, Lucas Moretti; COELHO, Fabricio Ferreira; SILVA, Renato Ferreira da; SILVA, Rita de Cássia Martins Alves; BOIN, Ilka de Fatima Santana Ferreira; D`ALBUQUERQUE, Luiz Augusto Carneiro; GARCIA, José Huygens Parente; FELGA, Guilherme Eduardo Gonçalves; MOREIRA, Airton Mota; BRAGHIROLI, Maria Ignez Freitas Melro; HOFF, Paulo Marcelo Gehm; MELLO, Vivianne Barretto de; DOTTORI, Mariana Fonseca; BRANCO, Tiago Pugliese; SCHIAVON, Leonardo de Lucca; COSTA, Thaisa de Fátima AlmeidaABSTRACT Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2015 its first recommendations about the management of HCC. Since then, new data have emerged in the literature, prompting the governing board of SBH to sponsor a single-topic meeting in August 2018 in São Paulo. All the invited experts were asked to make a systematic review of the literature reviewing the management of HCC in subjects with cirrhosis. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of updated recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present manuscript is the final version of the reviewed manuscript containing the recommendations of SBH.
- Improvements in Irritative Versus Obstructive Symptoms of the International Prostate Symptom Score After Prostatic Artery Embolization in 174 Patients, in a Single Center(2020) MOREIRA, Airton Mota; ASSIS, Andre Moreira de; CARNEVALE, Francisco Cesar; OLIVEIRA, Daniel Simoes; ANTUNES, Alberto AzoubelAim The aim of this study is to compare the improvements in irritative versus obstructive symptoms of the International Prostate Symptom Score (IPSS) after prostatic artery embolization (PAE) in patients with benign prostatic hyperplasia (BPH). Materials and Methods Between 2010 and 2018, 186 patients underwent PAE in a single center and 174 patients were retrospectively selected. The inclusion criteria were symptoms due to BPH, refractory to pharmacological treatment and IPSS >= 8. The mean age of the patients was 63.7 +/- 7.2 years, the mean prostate volume 89.5 +/- 42.5 cm(3), and the mean IPSS 19.0 +/- 6.2 points. Patient data were reviewed at baseline, 3, 12 and 24 months and compared using the ANOVA mixed models and the Tukey's multiple comparison test. Results Obstructive subscores dropped more significantly than irritative subscores (p < 0.0001). The mean decrease in each IPSS item was frequency 2.4 (83%); urgency 0.8 (87%); nocturia 1.3 (49%); incomplete emptying 2.6 (83%); intermittency 2.3 (91%); weak stream 2.9 (82%); straining 1.6 (91%). The area under the curve for baseline obstructive scores was 0.7 (p = 0.006) and 0.59 (p = 0.182) for irritative scores. The most common BPH clinical manifestations include irritative and/or obstructive symptoms, the latter usually more prevalent. The IPSS drop observed after PAE suggests that it acts predominantly over obstructive symptoms (p < 0.0001). Conclusion Although a predominant improvement in obstructive symptoms may be observed after PAE, nocturia complaints may require special attention. The severity of baseline obstructive symptoms may significantly predict clinical outcomes.
- Prostatic Artery Embolization: Equipment, Procedure Steps, and Overcoming Technical Challenges(2020) CARNEVALE, Francisco Cesar; ASSIS, Andre Moreira de; MOREIRA, Airton MotaIn the last decade, prostatic artery embolization (PAE) established itself as a safe and effective treatment option for lower urinary tract symptoms (LUTS) attributed to benign prostate hyperplasia (BPH), with reproducible results across multiple centers and endorsement by important international societies. However, PAE is also known to be a technically demanding procedure. Accompanying the prevalence of benign prostate hyperplasia, the procedure is usually performed in older patients, in whom atherosclerosis and comorbidities are common features. Also, prostatic vascular anatomy is described to be complex and variable, and pelvic structures are deeply interconnected by anastomosis. Thus, PAE demands a deep familiarization with materials and devices, intraprocedure imaging techniques, microcatetherization skills and with the pelvic vascular anatomy. Especially in the beginning of the learning curve, the procedure can be time-consuming and related to high radiation exposure for both medical team and the patient. In this article, the main points of technical concern during PAE are described and discussed, such as the equipment needed, the effect of different embolic materials, patient's preparation for the procedure, arterial access sites, identifying and catheterizing the prostatic arteries, the embolization techniques, among others. Finally, the most frequent technical challenges are presented, and the possible strategies to overcome them are exemplified and discussed.
- Prostatic Artery Embolization for the Treatment of Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: 10 Years' Experience(2020) CARNEVALE, Francisco Cesar; MOREIRA, Airton Mota; ASSIS, Andre Moreira de; ANTUNES, Alberto Azoubel; RODRIGUES, Vanessa Cristina de Paula; SROUGI, Miguel; CERRI, Giovanni GuidoBackground: Long-term experience with prostatic artery embolization (PAE) for benign prostatic hyperplasia remains limited. Purpose: To evaluate the efficacy, safety, and long-term results of PAE for benign prostatic hyperplasia. Materials and Methods: This retrospective single-center study was conducted from June 2008 to June 2018 in patients with moderate-to severe benign prostatic hyperplasia-related symptoms. International Prostate Symptom Score (IPSS), quality-of-life score, maximum urinary flow rate, postvoid residual volume, prostate-specific antigen (PSA), and prostate volume were assessed. PAE was performed with 100-500-mu m embolic microspheres. Mixed-model analysis of variance and Kaplan-Meyer method was accessed, as appropriate. Results: A total of 317 consecutive men (mean age 6 standard deviation, 65 years 6 8) were treated. Follow-up ranged from 3 months to 96 months (mean, 27 months). Bilateral and unilateral PAE was performed in 298 (94%) and 19 (6%) men, respectively. Early clinical failure occurred in six (1.9%) and symptom recurrence in 72 (23%) men at a median follow-up of 72 months. Mean maximum improvement was as follows: IPSS, 16 points +/- 7; quality-of-life score, 4 points +/- 1; prostatic volume reduction, 39 cm(3) +/- 39 (39% +/- 29); maximum urinary flow rate, 6 mL/sec +/- 10 (155% +/- 293); and postvoid residual volume, 70 mL +/- 6121 (48% +/- 81) (P < .05 for all). Unilateral PAE was associated with higher recurrence (42% vs 21%; P =.04). Baseline PSA was inversely related with recurrence (hazard ratio, 0.9 per nanograms per milliliter of PSA; 95% confidence interval [CI], 0.8, 0.9; P < .001). Embolization with combined particle sizes (100-500 mu m) did not relate to symptom recurrence (hazard ratio, 0.4; 95%CI: 0.2, 1.1 for 100-500-mu m group vs 300-500-mu m group and hazard ratio, 0.4; 95% CI: 0.1, 1.5 for 100-500-mu m group vs 100-300-mm group; P =.19). None of the patients presented with urinary incontinence or erectile dysfunction. Conclusion: Prostatic artery embolization was a safe and effective procedure for benign prostatic hyperplasia with good long-term results for lower urinary tract symptoms. (C) RSNA, 2020
- Management of Hepatocellular Carcinoma during the COVID-19 Pandemic - Sao Paulo Clinicas Liver Cancer Group Multidisciplinary Consensus Statement(2020) CHAGAS, Aline Lopes; FONSECA, Leonardo Gomes; COELHO, Fabricio Ferreira; SAUD, Lisa Rodrigues Cunha; ABADALA, Edson; ANDRAUS, Wellington; FIORE, Lucas; MOREIRA, Airton Mota; MENEZES, Marcos Roberto; CARNEVALE, Francisco Cesar; TANI, Claudia Megumi; ALENCAR, Regiane S. S. M.; D'ALBUQUERQUE, Luiz Augusto Carneiro; HERMAN, Paulo; CARRILHO, Flair JoseMore than 18 million people in 188 countries have been diagnosed as having coronavirus disease (COVID-19), and COVID-19 has been responsible for more than 600,000 deaths worldwide. Brazil is now the second most affected country globally. Faced with this scenario, various public health measures and changes in the daily routines of hospitals were implemented to stop the pandemic. Patients with hepatocellular carcinoma (HCC) are at an increased risk for severe COVID-19 as they present with two major diseases: cancer and concomitant chronic liver disease. The COVID-19 pandemic can significantly impact the management of HCC patients from diagnosis to treatment strategies. These patients need special attention and assistance at this time, especially since treatment for tumors cannot be delayed in most cases. The aim of this guideline was to standardize the management of HCC patients during the COVID-19 pandemic. This document was developed, on the basis of the best evidence available, by a multidisciplinary team from Instituto do Cancer do Estado de Sao Paulo (ICESP), and Instituto Central of the Hospital das Clinicas da Universidade de Sao Paulo (HC-FMUSP), which are members of the Sao Paulo Cli ' nicas Liver Cancer Group.