ALEXANDRE DANILOVIC
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
7 resultados
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Agora exibindo 1 - 7 de 7
- Editorial Comment: Thulium fibre laser versus Holmium: YAG for ureteroscopic lithotripsy: outcomes from a prospective randomised clinical trial(2023) ULVIK, Oyvind; AESOY, Mathias Sorstrand; JULIEBO-JONES, Patrick; GJENGSTO, Peder; BEISLAND, Christian; DANILOVIC, Alexandre
- One week pre-operative oral antibiotics for percutaneous nephrolithotomy reduce risk of infection: a systematic review and meta-analysis(2023) DANILOVIC, Alexandre; TALIZIN, Thalita Bento; TORRICELLI, Fabio Cesar Miranda; MARCHINI, Giovanni S.; BATAGELLO, Carlos; VICENTINI, Fabio C.; NAHAS, Willaim C.; MAZZUCCHI, EduardoPurpose: The aim of this meta-analysis is to assess the efficacy of extended dose of preoperative antibiotics to reduce infectious risk in patients undergoing percutaneous nephrolithotomy (PCNL).Materials and Methods: A literature search for prospective case-control studies or randomized controlled trials was done. PICO framework was used.Population: adult patients that underwent to PCNL; Intervention: extended dose preoperative antibiotic prophylaxis before PCNL; Control: short dose preoperative antibiotic prophylaxis befo-re PCNL; and Outcome: systemic inflammatory response syndrome (SIRS) or sepsis, fe-ver after PCNL and positive intraoperative urine and stone culture. This meta-analysis was registered in PROSPERO database under the number: CRD42022359589.Results: Three RCT and two prospective studies (475 patients) were included. SIRS/ sepsis outcome was retrieved from all studies included. Seven days preoperative oral antibiotics for PCNL was a protective factor for developing SIRS/sepsis (OR 0.366, 95% CI 0.234 -0.527, p < 0.001). There was no statistical association between seven-day use of antibiotics and fever (OR 0.592, 95% CI 0.147 - 2.388, p = 0.462). Patients who received seven days preoperative antibiotics had lower positive intraoperative urine culture (OR 0.284, 95% CI 0.120 - 0.674, p = 0.004) and stone culture (OR 0.351, 95% CI 0.185 - 0.663, p = 0.001) than the control group.Conclusion: one week of prophylactic oral antibiotics based on local bacterial sensi-tivity pattern plus a dose of intravenous antibiotics at the time of surgery in patients undergoing PCNL reduces the risk of infection.
- Low Dose Fluoroscopy During Ureteroscopy Does Not Compromise Surgical Outcomes (vol 33, pg 527, 2019)(2023) DANILOVIC, Alexandre; NUNES, E.; LIPKIN, M. E.; FERREIRA, T.; TORRICELLI, F. C. M.; MARCHINI, G. S.; SROUGI, M.; NAHAS, W. C.; MAZZUCCHI, E.
conferenceObject POSTOPERATIVE ANTIBIOTIC PROPHYLAXIS FOR PERCUTANEOUS NEPHROLITHOTOMY AND RISK OF INFECTION: A SYSTEMATIC REVIEW AND META-ANALYSIS(2023) TALIZIN, Thalita; DANILOVIC, Alexandre; TORRICELLI, Fabio; MARCHINI, Giovanni; BATAGELLO, Carlos; VICENTINI, Fabio; NAHAS, William; MAZZUCCHI, EduardoconferenceObject ONE WEEK PREOPERATIVE ORAL ANTIBIOTICS FOR PERCUTANEOUS NEPHROLITHOTOMY REDUCE RISK OF INFECTION: A SYSTEMATIC REVIEW AND META-ANALYSIS(2023) DANILOVIC, Alexandre; TALIZIN, Thalita; TORRICELLI, Fabio; MARCHINI, Giovanni; BATAGELLO, Carlos; VICENTINI, Fabio; NAHAS, William; MAZZUCCHI, Eduardo- Pulsed Thulium:YAG laser - What is the lithotripsy ablation efficiency for stone dust from human urinary stones? Results from an in vitro PEARLS study(2023) KWOK, Jia-Lun; VENTIMIGLIA, Eugenio; CONINCK, Vincent De; PANTHIER, Frederic; BARGHOUTHY, Yazeed; DANILOVIC, Alexandre; SHRESTHA, Anil; SMYTH, Niamh; SCHMID, Florian Alexander; HUNZIKER, Manuela; POYET, Cedric; DAUDON, Michel; TRAXER, Olivier; EBERLI, Daniel; KELLER, Etienne XavierBackground The novel pulsed thulium:yttrium-aluminum-garnet (p-Tm:YAG) laser was recently introduced. Current studies present promising p-Tm:YAG ablation efficiency, although all are based on non-human stone models or with unknown stone composition. The present study aimed to evaluate p-Tm:YAG ablation efficiency for stone dust from human urinary stones of known compositions.Methods Calcium oxalate monohydrate (COM) and uric acid (UA) stones were subjected to lithotripsy in vitro using a p-Tm:YAG laser generator (Thulio (R), Dornier MedTech GmbH, Germany). 200 J was applied at 0.1 J x 100 Hz, 0.4 J x 25 Hz or 2.0 J x 5 Hz (average 10W). Ablated stone dust mass was calculated from weight difference between pre-lithotripsy stone and post-lithotripsy fragments > 250 mu m. Estimated ablated volume was calculated using prior known stone densities (COM: 2.04 mg/mm3, UA: 1.55 mg/mm(3)).Results Mean ablation mass efficiency was 0.04, 0.06, 0.07 mg/J (COM) and 0.04, 0.05, 0.06 mg/J (UA) for each laser setting, respectively. This translated to 0.021, 0.029, 0.034 mm(3)/J (COM) and 0.026, 0.030, 0.039 mm(3)/J (UA). Mean energy consumption was 26, 18, 17 J/mg (COM) and 32, 23, 17 J/mg (UA). This translated to 53, 37, 34 J/mm(3 )(COM) and 50, 36, 26 J/mm(3) (UA). There were no statistically significant differences for laser settings or stone types (all p > 0.05).Conclusion To our knowledge, this is the first study showing ablation efficiency of the p-Tm:YAG laser for stone dust from human urinary stones of known compositions. The p-Tm:YAG seems to ablate COM and UA equally well, with no statistically significant differences between differing laser settings.
- Comparison of the outcomes of flexible ureteroscopy and mini-percutaneous nephrolithotomy for the treatment of kidney stones: a matched-pair analysis(2022) RODRIGUES, Jose Eduardo Castro Matheus; VICENTINI, Fabio Carvalho; DANILOVIC, Alexandre; MARCHINI, Giovanni Scala; TORRICELLI, Fabio Cesar Miranda; BATAGELLO, Carlos Alfredo; MAZZUCCHI, Eduardo; NAHAS, William CarlosOBJECTIVE: Mini-percutaneous nephrolithotomy is a recent advancement in the field of kidney stone treatment; however, its role has not been completely established. We aimed to compare the outcomes of initial Mini-percutaneous nephrolithotomy and flexible ureteroscopy.METHODS: A retrospective review of consecutive mini-percutaneous procedures was performed. Inclusion criteria were as follows: all percutaneous nephrolithotomy procedures performed with an access sheath up to 24Fr, kidney stone burdens up to 1550 mm3; and the presence of postoperative computed tomography (for control). The data collected for Mini-percutaneous nephrolithotomy procedures were paired 1:2 with patients treated with flexible ureteroscopy for stones between 100 and 1550 mm3, and with postoperative computed tomography for control. A 14Fr Mini-percutaneous nephrolithotomy set was used. The stone-free rate was defined as the absence of fragments on the control computed tomography, whereas success was limited to 2-mm residual fragments. Statistical analysis was performed using SPSS version 19.RESULTS: A total of 63 patients met the inclusion criteria (42 with flexible ureteroscopy and 21 with mini-percutaneous nephrolithotomy). Demographic data were comparable. The stone-free rate and success were similar between the groups (76.2 vs. 66.7%, p=0.42 and 90.5 vs. 85.7%, p=0.57). The complication rate was also similar (26.1 vs. 9.6%, p=0.188), but Mini-percutaneous nephrolithotomy had longer hospitalization and fluoroscopy time (p=0.001 in both).CONCLUSIONS: Our initial study of Mini-percutaneous nephrolithotomy showed that it is a promising procedure, with outcomes similar to flexible ureteroscopy, but with higher inpatient numbers and fluoroscopy times. A larger study population size and better equipment may improve the outcomes of mini-percutaneous nephrolithotomy.