VIVIAN REGINA GUZELA
Projetos de Pesquisa
Unidades Organizacionais
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
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conferenceObject Prevalence association between HPV and fistulising perianal Crohn's disease(2020) BOARINI, L. Rodrigues; SOBRADO JR., C. W.; GUZELA, V. R.; GONCALVES, A. Pozzebon; VILLA, L. Lina; NADAL, S. R.; COSTA, A. Da Costa Lino; NAHAS, S. C.- Anorectal diseases in patients with Antiphospholipid syndrome: a cross-sectional study(2020) CUNHA, E.; GUZELA, V; BALBI, G. G. M.; SOBRADO, C.; ANDRADE, D.Background Hemorrhoid disease (HD) is one of the most common gastrointestinal complaints worldwide, affecting 4.4% of the general population in the United States. Since antiphospholipid syndrome (APS) may lead to intra-abdominal thrombosis, one may expect that this condition can impact the risk for HD development. Additionally, as APS patients are more prone to thrombosis and treatment with anticoagulants may increase risk of bleeding, one may also infer that rates of HD complications may be higher in this scenario. Nevertheless, no data in these regards have been published until now. The objective of the present study is to evaluate frequency of HD and describe its complications rates in antiphospholipid syndrome APS patients. Methods We consecutively invited patients who fulfilled APS criteria to undergo proctological examination. After examination, patients were divided in two groups, based on the presence of HD, and compared regarding different clinical manifestations and antiphospholipid profile. We performed the analysis of the data, using chi-square and Mann Whitney U when applicable and considering a significance level of 0.05. Multivariate regression analysis included age and variables withp < 0.10 in the bivariate analysis. Results Forty-one APS patients agreed to undergo proctological examination. All were female and overall median age was 43 (36-49). Seventeen (41.4%) patients were diagnosed with HD, with the following frequency distribution: 7 internal (41.2%), 4 external (23.5%) and 5 mixed hemorrhoids (29.4%). Of the internal hemorrhoids, 5 patients were classified as grade I (71.4%), 1 grade II (14.3%), and 1 grade IV (14.3%). Prior gestation (p = 0.067) and constipation (p = 0.067) correlated with a higher frequency of HD. In multivariate analysis, constipation remained as an important risk factor (OR 3.92,CI95% 1.03-14.2,p = 0.037). Five out of 17 patients (29.4%) reported anal bleeding, but it did not correlate with warfarin dose (p = 0.949). Surgical treatment was indicated for 10 patients (58.8%). Other anorectal findings were anal fissure, plicoma, condyloma and one chlamydial retitis. Conclusion We found an unexpected high frequency of hemorrhoids in APS patients, with a great proportion requiring surgical treatment.
- Local treatment of colostomy prolapse with the MESH STRIP technique: A novel and highly efficient day hospital technique(2020) SOBRADO JUNIOR, Carlos Walter; GUZELA, Vivian Regina; SOBRADO, Lucas Faraco; NAHAS, Sergio Carlos; CECCONELLO, IvanOBJECTIVE: Stoma prolapse is an intussusception of the bowel through a mature stoma. It can be caused by increased intra-abdominal pressure, excessively mobile bowel mesentery and/or a large opening in the abdominal wall at the time of stoma formation. It occurs predominantly in loop stomas, and correction methods include conservative modalities, such as local reduction to the prolapsed bowel, or surgical treatment. The purpose of this study was to describe our experience with the treatment of colostomy prolapse using a novel mesh strip technique. METHODS: Between February 2009 and March 2018, ten consecutive male patients underwent correction of colostomy prolapse under local anesthesia by peristomal placement of a polypropylene mesh strip. Operation time, short- and long-term complications, and recurrence rates were recorded and analyzed. RESULTS: No postoperative complications, morbidity or mortality were observed. The median length of the prolapse ranged from 6-20 cm, and the median operative time was 30 minutes. The median duration of follow-up was 25 months (range, 12-89 months). No relapse, mesh strip extrusion, local infection or granuloma formation were found. CONCLUSION: A simple, fast, and low-cost operation under local anesthesia using a mesh strip is a valuable option to treat colostomy prolapse.
conferenceObject Infection of the anal canal by human papillomavirus in Crohn's disease(2020) GUZELA, V.; SOBRADO JUNIOR, C.; NADAL, S.; NADAL, C. R.; VILLA, L. L.; GONCALVES, A. P.; BOARINI, L. R.; NAHAS, S. C.; CECCONELLO, I.