CELSO DE OLIVEIRA BERNINI
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- Alcohol and drug involvement in motorcycle driver injuries in the city of Sao Paulo, Brazil: Analysis of crash culpability and other associated factors(2016) CARVALHO, Heraclito Barbosa de; ANDREUCCETTI, Gabriel; REZENDE, Marcelo Rosa; BERNINI, Celso; SILVA, Jorge Santos; LEYTON, Vilma; GREVE, Julia Maria D'AndreaBackground: Earlier studies have already identified that a greater proportion of injured drivers are under the effects of illicit drugs than alcohol in Brazil, but the crash risk attributable to each substance is still unknown. Methods: Injured motorcycle drivers who were involved in traffic accidents in the West Zone of the city of Sao Paulo were recruited for a cross-sectional study based on crash culpability analysis. Alcohol and drug positivity among drivers was evaluated according to their responsibility for the crash. Culpability ratios were generated based on the proportion of drivers who were deemed culpable in relation to those considered not culpable according to the use of drugs and alcohol. Results: Of the 273 drivers recruited, 10.6% tested positive for alcohol. Among those who were also tested for drugs (n=232), 20.3% had consumed either alcohol and/or other drugs, 15.5% of whom were positive only for drugs other than alcohol, specifically cannabis and cocaine. Drivers who tested positive for alcohol were significantly less likely to possess a valid driver's license and to report driving professionally, whereas those who had consumed only drugs were more likely to drive professionally. The culpability ratio estimated for alcohol-positive drivers was three times higher than that for alcohol-free drivers, showing a superior ratio than drivers who had consumed only drugs other than alcohol, who presented a 1.7 times higher culpability ratio than drug-free drivers. Conclusion: Substance use was overrepresented among culpable motorcycle drivers, with alcohol showing a greater contribution to crash culpability than other drugs.
- Can we respect the principles of oncologic resection in an emergency surgery to treat colon cancer?(2015) TEIXEIRA, Frederico; AKAISHI, Eduardo Hiroshi; USHINOHAMA, Adriano Zuardi; DUTRA, Tiago Cypriano; COUTO NETTO, Sergio Dias do; UTIYAMA, Edivaldo Massazo; BERNINI, Celso Oliveira; RASSLAN, SamirPatients with colorectal cancer admitted to the emergency room are generally at more advanced stage of the disease and are usually submitted to a resection with curative intent in a smaller scale. In such scenario, one of the aspects to be considered is whether the principles of oncologic resection are observed when those patients diagnosed with colon cancer are treated with surgery. We selected 87 patients with adenocarcinoma of colon and/or upper rectum submitted to an emergency surgical resection. The major variables reviewed retrospectively were: the extent of resection performed, the number of dissected regional lymph nodes and the overall survival rate. Intestinal obstruction was observed in 67 patients (77%) while perforation was found in 20 patients (23%). Seven (8%) specimens had circumferential compromised margins, all found in patients with T4 tumors combine with poor clinical status. The number of dissected regional lymph nodes was greater than, or equal to, 12 in 71% of patients. While the average days of stay in the ICU was 5.7 days, the median was 3 days. The morbidity and peri-operative mortality stood at 33.6% and 20%, respectively. The outcome of an emergency surgery of colorectal cancer observed in this study was similar to those found in the literature. The principles of oncologic resection were respected when considering and analyzing the extent of the resection, the surgical margins and the number of dissected lymph nodes.
bookPart Perfuração esofágica: observar, operar ou prótese endoscópica(2022) BERNINI, Celso de Oliveira; FACANALI JUNIOR, Marcio Roberto- Outcomes of Elderly Patients Undergoing Emergency Surgery for Complicated Colorectal Cancer: A Retrospective Cohort Study(2019) MENEGOZZO, Carlos Augusto Metidieri; TEIXEIRA-JUNIOR, Frederico; COUTO-NETTO, Sergio Dias do; MARTINS-JUNIOR, Octacilio; BERNINI, Celso de Oliveira; UTIYAMA, Edivaldo MassazoOBJECTIVE: Colorectal cancer is one of the most frequent types of malignant neoplasms. Age is a risk factor for this disease, with 75% of cases diagnosed in patients older than 65 years. Complications such as obstruction, hemorrhage, and perforation are present in more than one-third of cases and require emergency treatment. We aim to analyze the profile of elderly patients undergoing surgery for complicated colorectal cancer, and to evaluate factors related to worse short-term prognosis. METHODS: A retrospective analysis of patients who underwent emergency surgical treatment for complicated colorectal cancer was performed. Demographics, clinical, radiological and histological data were collected. RESULTS: Sixty-seven patients were analyzed. The median age was 72 years, and almost half (46%) of the patients were female. Obstruction was the most prevalent complication at initial presentation (72%). The most common sites of neoplasia were the left and sigmoid colon in 22 patients (32.8%), and the right colon in 17 patients (25.4%). Resection was performed in 88% of cases, followed by primary anastomosis in almost half. The most frequent clinical stages were II (48%) and III (22%). Forty-three patients (65.7%) had some form of postoperative complication. Clavien-Dindo grades 1, 2, and 4, were the most frequent. Complete oncologic resection was observed in 80% of the cases. The thirty-day mortality rate was 10.4%. Advanced age was associated with worse morbidity and mortality. CONCLUSION: Elderly patients with complicated colorectal cancer undergoing emergency surgery have high morbidity and mortality rates. Advanced age is significantly associated with worse outcomes.
bookPart Emergências anorretais(2019) BERNINI, Celso de Oliveira; MENEGOZZO, Carlos Augusto Metidieri- Laparoscopic Surgery in Abdominal Trauma: Retrospective Study in a Trauma Center in Brazil(2017) MENEGOZZO, Carlos Augusto M.; DAMOUS, Sergio H. B.; ALVES, Pedro H. F.; BERNINI, Celso O.; UTIYAMA, Edivaldo
bookPart Pneumotórax Espontâneo(2013) BERNINI, Celso de OliveiraconferenceObject Prevention of Fascial Dehiscence with Prophylactic Onlay Mesh in Emergency Laparotomy: A Randomized Trial(2019) LIMA, Helber V.; RASSLAN, Roberto; DAMOUS, Sergio H.; TIBERIO, Lima M.; BERNINI, Celso de Oliveira; MONTERO, Edna F.; UTIYAMA, Edivaldo M.- Predictive factors of mortality in patients with pelvic fracture and shock submitted to extraperitoneal pelvic packing(2022) FONSECA, VINICIUS CORDEIRO; MENEGOZZO, CARLOS AUGUSTO METIDIERI; CARDOSO, JULIANA MYNSSEN DA FONSECA; BERNINI, CELSO OLIVEIRA; UTIYAMA, EDIVALDO MASSAZO; POGGETTI, RENATO SÉRGIOABSTRACT Introduction: in recent decades, the extraperitoneal pelvic packing technique has been disseminated, but there are still few studies. Thus, it was decided to analyze the results of extraperitoneal pelvic tamponade, in patients with pelvic fracture and shock, in order to identify predictive factors for mortality. Methods: a retrospective review of medical records of patients submitted to extraperitoneal pelvic packing was conduced. We analyzed their characteristics, prehospital and emergency room data, pelvic fracture classification, associated and severity injuries, laboratory and imaging exams, data on packing, arteriography, and other procedures performed, complications, hemodynamic parameters, and amount of transfused blood products before and after packing. Results: data were analyzed from 51 patients, who showed signs of shock from prehospital care, presence of acidosis, with high base deficit and arterial lactate levels. Most patients underwent multiple surgical procedures due to severe associated injuries. The incidence of coagulopathy was 70.58%, and overall mortality was 56.86%. The group of non-surviving patients presented significantly higher age, prehospital endotracheal intubation, and lower Glasgow Coma Scale scores (p<0.05). The same group presented, before and after extraperitoneal pelvic packing, significantly worse hemodynamic parameters of mean arterial pressure, pH, base deficit, hemoglobin, and arterial lactate (p<0.05). The non-surviving group received significantly more units of packed red blood cells, fresh frozen plasma and platelets within 24 hours following extraperitoneal pelvic packing (p<0.05). Conclusion: age and base deficit are independent predictors of mortality in patients submitted to extraperitoneal pelvic packing.
bookPart Pancreatite Aguda(2013) STEINMAN, Milton; BERNINI, Celso de Oliveira; QUINTAS, Mário Luiz
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