ALFREDO LUIZ JACOMO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Suction versus slow-pull for endoscopic ultrasound-guided fine-needle aspiration of pancreatic tumors: a prospective randomized trial(2020) CHENG, Spencer; BRUNALDI, Vitor O.; MINATA, Mauricio K.; CHACON, Danielle A.; SILVEIRA, Eduardo B.; MOURA, Diogo T. H. de; SANTOS, Marcos E. L. Dos; MATUGUMA, Sergio E.; CHAVES, Dalton M.; FRANCA, Raony F.; JACOMO, Alfredo L.; ARTIFON, Everson L. A.Background: Suction (S) is commonly used to improve cell acquisition during endoscopic ultrasoundguided fine-needle aspiration (EUS-FNA). Slow-pull (SP) sampling is another technique that might procure good quality specimens with less bloodiness. We aimed to determine if SP improves the diagnostic yield of EUS-FNA of pancreatic masses. Methods: Patients with pancreatic solid masses were randomized to four needle passes with both techniques in an alternate fashion. Sensitivity, specificity, positive, and negative predictive values were calculated. Cellularity and bloodiness of cytological samples were assessed and compared according to the technique. Results: Sensitivity, specificity, and accuracy of suction vs. SP were 95.2% vs. 92.3%; 100% vs. 100; 95.7% vs. 93%, respectively. As to the association of methods, they were 95.6, 100 and 96%, respectively. Positive predictive values for S and SP were 100%. There was no difference in diagnostic yield between S and SP (p = 0.344). Cellularity of samples obtained with SP and Suction were equivalent in both smear evaluation (p = 0.119) and cell-block (0.980). Bloodiness of SP and suction techniques were similar as well. Conclusions: S and SP techniques provide equivalent sensitivity, specificity, and accuracy. Association of methods seems to improve diagnostic yield. Suction does not increase the bloodiness of samples compared to slow-pull.
- Anatomical basis of the temporal muscle trigger points(2020) AKAMATSU, Flavia; TEIXEIRA, Giulianna; ITEZEROTE, Ana; HOJAIJ, Flavio; ANDRADE, Mauro; JACOMO, Alfredo
- Anatomical Study of the Innervation of the Masseter Muscle and Its Correlation with Myofascial Trigger Points(2020) PINHEIRO, Roberto Procopio; GAUBEUR, Matheus Aquesta; ITEZEROTE, Ana Maria; SALEH, Samir Omar; HOJAIJ, Flavio; ANDRADE, Mauro; JACOMO, Alfredo Luiz; AKAMATSU, Flavia EmiBackground and Purpose: Myofascial pain syndrome (MPS) is widely prevalent in the general population; some reports estimate its prevalence ranges from 9 to 85%. Among the different locations where MPS may arise, pain related to the masseter muscle is referred as masticatory myofascial pain. MPS is characterized by myofascial trigger points (MTPs), which represent tender anatomical areas of a muscle where painful symptoms are elicited whenever stimulated. Previous publications have found MTPs to coincide with neuromuscular junctions at the motor end plate, at the innervation zone (IZ). Our study aimed to describe the innervation of the masseter muscle and relate it to clinically described myofascial trigger points (MTPs). Materials and Methods: We mapped the nerve fiber distribution into the masseter muscles from 16 cadavers by anatomical dissection. We divided the muscle into six regions, three superior (I-III) and three inferior (IV-VI), and classified the nerve's branches distribution according to these predetermined areas. Statistical analyses was made by Poisson distribution and logarithm link function followed by Bonferroni multiple comparisons (P<0.05). Results: All six areas received branches from the masseteric nerve. Areas I and II (upper posterior and upper intermediate, respectively) had a significant higher number of nerve entries as compared to the remaining areas. Conclusion: The penetration areas of the masseteric nerve have been established and MTPs are found in the innervation zones, clinicians should focus initially on the regions of the penetration points, for diagnostics and therapeutic measures, such as injections, dry needling and soft tissue interventions. Anatomical study of nerve supply to the masseter muscle can provide useful additional knowledge to further understanding masticatory myofascial pain and to direct therapeutic interventions and diagnostic studies of temporomandibular junction dysfunction.
- Is there something new regarding triceps brachii muscle insertion?(2020) AKAMATSU, Flavia Emi; NEGRAO, Jose Renato; RODRIGUES, Marcelo Bordalo; ITEZEROTE, Ana Maria; SALEH, Samir Omar; HOJAIJ, Flavio; ANDRADE, Mauro; JACOMO, Alfredo LuizPurpose: Previous studies have questioned whether the triceps brachii muscle tendon (TBMT) has a double or single insertion on the ulna. Aiming to provide an answer, we describe the anatomy of the TBMT and review a magnetic resonance imaging (MRI) series of the elbow. Methods: Forty-one elbows were dissected to assess the details of the triceps brachii insertion. Elbow plastination slices were analyzed to determine whether there was a space on the TBMT. Magnetic resonance imaging from the records of the authors were also obtained to demonstrate the appearance of the pre-tricipital space on MRI. Results: A virtual space on the medial aspect near the TBTM insertion site in the olecranon was consistently found on anatomic dissections. It was a distal pre-tricipital space. Magnetic resonance imaging demonstrated the appearance of the pre-tricipital space on MRI, and its extension was measured longitudinally either in elbow flexion or extension. There was no statistically significant difference between the measurements of this space in the right and left elbows or between flexion and extension (p > 0.05). The coefficient of variation was <10% for all measurements. Conclusion: Knowledge of this structure may be essential to avoid incorrect diagnosis and unnecessary therapeutic interventions.
- Morphometry and Frequency of the Pyramidalis Muscle in Adult Humans: A Pyramidalis Muscle's Anatomical Analysis(2020) HOJAIJ, Flavio Carneiro; KOGIMA, Rudolph Octaviano; MOYSES, Raquel Ajub; AKAMATSU, Flavia Emi; JACOMO, Alfredo LuizOBJECTIVES: To verify the pyramidalis muscle's frequency (bilaterality, unilaterality, or absence) and morphometry (length of the medial border and width of its origin/base) in a sample of the Brazilian population and the anthropometric influence. METHODS: Dissection of 30 cadavers, up to 24h post-mortem. RESULTS: The pyramidalis muscle was present bilaterally and unilaterally in 83.33% and 3.33% of the cadavers, respectively, and absent in 13.33%. The muscles on the right and left sides were symmetrical in length but not in width; the pyramidalis muscles of men were longer, while those of the women were wider. We also found that there was greater variation in the dimensions (length and width) of the men's muscles. Finally, in this sample of the Brazilian population, the pyramidalis muscle's unilaterality was more prevalent than in other populations, and its complete absence was less prevalent. CONCLUSIONS: There were no cases of muscle duplication in one or both sides, as described in some studies. Despite all of its morphometric variation, the pyramidalis muscle maintained its triangular shape with longitudinal fibers in every case. Furthermore, no statistically significant correlation was noted between the muscles' dimensions and person's age, height, weight, or gender.
- Colonic mucosae is affected by experimental gastric restriction(2020) AKAMATSU, Flavia; FONTES, Luiz; ITEZEROTE, Ana; SALEH, Samir; HOJAIJ, Flavio; ANDRADE, Mauro; PEREIRA, Jose; MARTINEZ, Carlos; JACOMO, Alfredo
- Ansa cervicalis and hypoglossal nerve topographical relation: anatomical study on cadavers(2020) BOOG, Gustavo Pereira; MEDEIROS, Vitor Brito; CHINELATTO, Lucas; HOJAIJ, Flavio; AKAMATSU, Flavia; JACOMO, Alfredo
conferenceObject Metabolic Duodenal Switch: Principles and Practice(2020) KAWAHARA, Nilton; KAWAHARA, Lucas; KOYAISHI, Akemi; BARROS, Cecilia; JACOMO, Alfredo; OTOCH, Jose- Nipple-sparing mastectomy for early breast cancer: the importance of intraoperative evaluation of retroareolar margins and intra-nipple duct removal(2020) HEINZEN, Rebeca Neves; BARROS, Alfredo Carlos Simoes Dornellas de; CARVALHO, Filomena Marino; AGUIAR, Fernando Nalesso; NIMIR, Cristiane da Costa Bandeira Abrahao; JACOMO, Alfredo LuizBackground: Nipple-sparing mastectomy (NSM) is increasingly performed for breast cancer (BC) treatment. To ensure local control with this procedure, it is important to obtain clear surgical margins. Here, we aimed to estimate the confidence in intraoperative evaluation of the retroareolar margin (IERM) and the necessity of removing the intra-nipple ducts. Methods: In this retrospective cohort study, we evaluated 224 BC (infiltrating carcinoma 178, ductal carcinoma in situ 46) patients, who underwent NSM. IERM was determined via cytology and frozen sections. Following gland removal, the intra-nipple ducts were excised and embedded in paraffin for analysis. The retroareolar tissue was also paraffin-embedded and reanalyzed for definitive evaluation of retroareolar margins (DERM). The IERM predictive capacity in relation to DERM and the frequency of intra-nipple duct involvement were estimated. Results: IERM classified the sub-nipple areolar complex area as cancer-free in 219 cases (97.8%). The condition of clear retroareolar margin was confirmed by DERM in 216 cases (98.6%). The IERM accuracy was estimated as 98.6%. Ductal carcinoma in situ was detected in intra-nipple ducts using paraffin sections in 1.8% of the cases, despite dear IERM (4/219). Conclusions: In conclusion, IERM affords high accuracy and its results are suitable to manage the nipple-areolar complex. Nevertheless, some patients may retain residual disease in the intra-nipple ducts; thus, these ducts should ideally be removed during NSM.
- Temporal behavior of weight loss in a rat model of gastric restriction(2020) AKAMATSU, Flavia; ITEZEROTE, Ana; SALEH, Samir; HOJAIJ, Flavio; ANDRADE, Mauro; MARTINEZ, Carlos; JACOMO, Alfredo