JOSE PINHATA OTOCH
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
DVCLCIR-62, Hospital Universitário
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
DVCLCIR-62, Hospital Universitário
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Evaluation of the Maintained Effect of 3% Hypertonic Saline Solution in an Animal Model of Intracranial Hypertension(2016) SOUSA JR., Leonardo M.; ANDRADE, Almir F. de; BELON, Alessandro R.; SOARES, Matheus S.; AMORIM, Robson Luis; OTOCHI, Jose Pinhata; TEIXEIRA, Manoel J.; PAIVA, Wellingson S.Background: Current clinical treatment methods for refractory intracranial hypertension include elevation of the decubitus, ventilation adjustment, and use of hypertonic solutions such as hypertonic saline and mannitol solutions. Previous studies have shown that hypertonic solutions are particularly effective. Although several concentrations of saline solution have been proposed, a 3% solution is the most widely used. The aim of this study was to evaluate the maintained efficacy of a 3% hypertonic saline solution in an experimental model of intracranial hypertension. Material/Methods: A porcine model of reversible intracranial hypertension was created by inserting a balloon catheter into the brain parenchyma, which was inflated and deflated to simulate intracranial hypertension and its surgical correction. The experiment included 3 groups of animals (A, B, and C) with different balloon inflation volumes. In group B, balloons were inflated 2 times to simulate reexpansion. A 20 mL/kg bolus of 3% saline solution was infused using a pump 90 minutes after the start of balloon inflation, and the effects of intracranial pressure were evaluated 60 minutes after infusion. Results: No increases outside of the normal range were observed in mean serum sodium concentrations (p=0.09). In addition, we identified no differences within each group in serum sodium levels measured during hypertonic saline infusion (p=0.21). No significant reductions in intracranial pressure were observed in any of the 3 groups. Conclusions: Bolus infusion of 3% hypertonic saline solution with the aid of a pump does not significantly reduce intracranial pressure in an animal model of intracranial hypertension.
article 1 Citação(ões) na Scopus Local staging of rectal carcinoma: Systematic review of literature and meta-analysis(2016) GUENAGA, Katia F; OTOCH, Jose P; ARTIFON, Everson L. ANew surgical techniques in the treatment of rectal cancer have improved survival mainly by reducing local recurrences. A preoperative staging method is required to accurately identify tumor stage and planning the appropriate treatment. MRI and ERUS are currently being used for the local staging (T stage). In this review, the accuracy of MRI and ERUS with rigid probe was compared against the gold standard of the pathological findings in the resection specimens. Five studies met the inclusion criteria and were included in this meta-analysis. The accuracy was 91.0% to ERUS and 86.8% to MRI (p=0.27). The result has no statistical significance but with pronounced heterogeneity between the included trials as well as other published reviews. We can conclude that there is a clear need for good quality, larger scale and prospective studies- AN INNOVATIVE EX-VIVO MODEL FOR RAPID CHANGE OF THE PAPILLA FOR TEACHING ADVANCED ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY PROCEDURES(2016) ARTIFON, Everson L.A.; NAKADOMARI, Thaisa S.; KASHIWAGUI, Leandro Y.; BELMONTE, Emilio A.; SOLAK, Cláudio R.; CHENG, Spencer; FURUYA JR, Carlos K.; OTOCH, Jose P.ABSTRACT Background: Models for endoscopic retrograde cholangiopancreatography training allow practice with an expert feedback and without risks. A method to rapidly exchange the papilla can be time saving and accelerate the learning curve. Aim: To demonstrate a newly method of rapid exchange papilla in ex-vivo models to teach retrograde cholangiopancreatography advanced procedures. Methods: A new model of ex-vivo papilla was developed in order to resemble live conditions of procedures as cannulation, papilotomy or fistula-papilotomy, papiloplasty, biliary dilatation, plastic and metallic stentings. Results: The ex-vivo model of papilla rapid exchange is feasible and imitates with realism conditions of retrograde cholangiopancreatography procedures. Conclusion: This model allows an innovative method of advanced endoscopic training.
- Virtual and stereoscopic anatomy: when virtual reality meets medical education(2016) FARIA, Jose Weber Vieira de; TEIXEIRA, Manoel Jacobsen; SOUSA JUNIOR, Leonardo de Moura; OTOCH, Jose Pinhata; FIGUEIREDO, Eberval GadelhaOBJECTIVE The authors sought to construct, implement, and evaluate an interactive and stereoscopic resource for teaching neuroanatomy, accessible from personal computers. METHODS Forty fresh brains (80 hemispheres) were dissected. Images of areas of interest were captured using a manual turntable and processed and stored in a 5337-image database. Pedagogic evaluation was performed in 84 graduate medical students, divided into 3 groups: 1 (conventional method), 2 (interactive nonstereoscopic), and 3 (interactive and stereoscopic). The method was evaluated through a written theory test and a lab practicum. RESULTS Groups 2 and 3 showed the highest mean scores in pedagogic evaluations and differed significantly from Group 1 (p < 0.05). Group 2 did not differ statistically from Group 3 (p > 0.05). Size effects, measured as differences in scores before and after lectures, indicate the effectiveness of the method. ANOVA results showed significant difference (p < 0.05) between groups, and the Tukey test showed statistical differences between Group 1 and the other 2 groups (p < 0.05). No statistical differences between Groups 2 and 3 were found in the practicum. However, there were significant differences when Groups 2 and 3 were compared with Group 1 (p < 0.05). CONCLUSIONS The authors conclude that this method promoted further improvement in knowledge for students and fostered significantly higher learning when compared with traditional teaching resources.
article 0 Citação(ões) na Scopus Recurrent acute pancreatitis caused by pancreatic biliary maljunction due to long common channel(2016) FARIAS, Galileu F. A.; OTOCH, Jose P.; GUEDES, Hugo G.; ARTIFON, Everson L. A.The pancreatic biliary maljunction is a rare anomaly that affects mainly females, defined as an anatomical maljunction of the pancreatic duct and the biliary duct confluence, and may be a rare cause of recurrent acute pancreatitis. In order to early diagnosis and prompt treatment, ERCP has an important role in it- A Window on the Study of Aversive Instrumental Learning: Strains, Performance, Neuroendocrine, and Immunologic Systems(2016) OLIVEIRA, Caroline C. de; GOUVEIA, Flavia V.; CASTRO, Marina C. de; KUROKI, Mayra A.; SANTOS, Lennon C. T. dos; FONOFF, Erich T.; TEIXEIRA, Manoel J.; OTOCH, Jose P.; MARTINEZ, Raquel C. R.The avoidance response is present in pathological anxiety and interferes with normal daily functions. The aim of this article is to shed light on performance markers of active avoidance (AA) using two different rat strains, Sprague-Dawley (SD) and Wistar. Specifically, good and poor performers were evaluated regarding anxiety traits exhibited in the elevated plus maze (EPM) and corticosterone levels and motor activity in the open field test. In addition, the plasma levels of Interleukin-6 (IL-6), Interleukin-1 Beta (IL-1 beta), Nerve Growth Factor Beta (NGF-beta), Tumor Necrosis Factor-Alpha (TNF-alpha) and cytokine-induced neutrophil chemoattractant 1 (CINC-1) were compared in the good and poor performers to better understand the role of the immunologic system in aversive learning. Behavioral criteria were employed to identify subpopulations of SD and Wistar rats based on their behavioral scores during a two-way AA test. The animals were tested for anxiety-like behavior in the EPM and motor activity in the open-field test. Plasma corticosterone levels were measured at the end of the avoidance test. Cytokine levels of IL-6, IL-1 beta, NGF-beta, TNF-alpha, and CINC-1 were measured in the plasma of the Wistar rats. Sixty-six percent of the Wistar rats and 35% of the SD rats exhibited a poor performance. This feature was associated with a decrease in anxiety-like behavior in the EPM. The poor and good performers exhibited lower levels of corticosterone compared with the control animals, which suggests that training alters corticosterone levels, thereby leading to hypocortisolism, independent of the performance. The CINC-1 levels were increased in the poor performers, which reinforces the role of immunologic system activation in learning deficits. Our study provides a better understanding of the complex interactions that underlie neuroimmune consequences and their implications for performance.
- SEDATION IN COLONOSCOPY BY USING THREE DIFFERENT PROPOFOL INFUSION METHODS AND ANALYSIS OF PLASMA CONCENTRATION LEVELS: A PROSPECTIVE COMPARATIVE STUDY(2016) CARVALHO, Paulo Henrique Boaventura de; OTOCH, José Pinhata; KHAN, Mohamad Ali; SAKAI, Paulo; GUEDES, Hugo Gonçalo; ARTIFON, Everson Luiz de AlmeidaABSTRACT Background: The propofolemia becomes directly linked to the clinical effects of this anesthetic and is the focus for studies comparing propofol clinical use, in different administration methods routinely used in endoscopy units where sedation is widely administered to patients. Aim: To evaluate the effects of three different regimens of intravenous propofol infusion in colonoscopies. Methods: A total of 50 patients that underwent colonoscopies were consecutively assigned to three groups: 1) intermittent bolus infusion; 2) continuous manually controlled infusion; 3) continuous automatic infusion. Patients were monitored with Bispectral IndexTM (BIS) and propofol serum levels were collected at three different timepoints. The development of an original dilution of propofol and an inventive capnography catheter were necessary. Results: Regarding clinical outcomes, statistical differences in agitation (higher in group 1, p=0.001) and initial blood pressure (p=0.008) were found. As for propofol serum levels, findings were similar in consumption per minute (p=0.748) and over time (p=0.830). In terms of cost analysis, group 1 cost was R$7.00 (approximately US$2,25); group2, R$17.50 (approximately US$5,64); and group 3, R$112.70 (approximately US$36,35, p<0.001). Capnography was able to predict 100% of the oxygen saturation drop (below 90%). Conclusion: The use of propofol bolus administration for colonoscopies, through continuous manually controlled infusion or automatic infusion are similar regarding propofolemia and the clinical outcomes evaluated. The use of an innovative capnography catheter is liable and low-cost solution for the early detection of airway obstruction.
- Cachexia-associated adipose tissue morphological rearrangement in gastrointestinal cancer patients(2016) BATISTA JR., Miguel L.; HENRIQUES, Felipe S.; NEVES, Rodrigo X.; OLIVAN, Mireia R.; MATOS-NETO, Emidio M.; ALCANTARA, Paulo S. M.; MAXIMIANO, Linda F.; OTOCH, Jose P.; ALVES, Michele J.; SEELAENDER, MariliaBackground and aimsCachexia is a syndrome characterized by marked involuntary loss of body weight. Recently, adipose tissue (AT) wasting has been shown to occur before the appearance of other classical cachexia markers. We investigated the composition and rearrangement of the extracellular matrix, adipocyte morphology and inflammation in the subcutaneous AT (scAT) pad of gastrointestinal cancer patients. MethodsSurgical biopsies for scAT were obtained from gastrointestinal cancer patients, who were signed up into the following groups: cancer cachexia (CC, n=11), weight-stable cancer (WSC, n=9) and weight-stable control (non-cancer) (control, n=7). The stable weight groups were considered as those with no important weight change during the last year and body mass index <25kg/m(2). Subcutaneous AT fibrosis was quantified and characterized by quantitative PCR, histological analysis and immunohistochemistry. ResultsThe degree of fibrosis and the distribution and collagen types (I and III) were different in WSC and CC patients. CC patients showed more pronounced fibrosis in comparison with WSC. Infiltrating macrophages surrounding adipocytes and CD3 Ly were found in the fibrotic areas of scAT. Subcutaneous AT fibrotic areas demonstrated increased monocyte chemotactic protein 1 (MCP-1) and Cluster of Differentiation (CD)68 gene expression in cancer patients. ConclusionsOur data indicate architectural modification consisting of fibrosis and inflammatory cell infiltration in scAT as induced by cachexia in gastrointestinal cancer patients. The latter was characterized by the presence of macrophages and lymphocytes, more evident in the fibrotic areas. In addition, increased MCP-1 and CD68 gene expression in scAT from cancer patients may indicate an important role of these markers in the early phases of cancer.