FABIO CESAR MIRANDA TORRICELLI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
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- The skin-to-calyx distance measured by renal ct scan and ultrasound(2014) SHAN, Chen Jen; MAZZUCCHI, Eduardo; PAYAO, Fabio; GOMES, Andrea Cavalanti; BARONI, Ronaldo Hueb; TORRICELLI, Fabio Cesar; VICENTINI, Fabio Carvalho; SROUGI, MiguelPurpose: We developed a stereotactic device to guide the puncture for percutaneous nephrolithotripsy, which uses the distance from the target calyx to its perpendicular point on skin (SCD) to calculate the needle's entry angle. This study seeks to validate the use of measurements obtained by ultrasound (US) and computerized tomography (CT) for needle's entry angle calculation and to study factors that may interfere in this procedure. Materials and Methods: Height, weight, abdominal circumference, CT of the urinary tract in dorsal decubitus (DD) and ventral decubitus (VD), and US of the kidneys in VD were obtained from thirty-five renal calculi patients. SCD obtained were compared and correlated with body-mass index (BMI). Results: BMI was 28.66 +/- 4.6 Kg/m(2). SCD on CT in DD was 8.40 +/- 2.06cm, in VD was 8.32 +/- 1.95cm, in US was 6.74 +/- 1.68cm. SCD measured by US and CT were statistically different (p < 0.001), whereas between CT in DD and VD were not. SCD of the lower calyx presented moderate correlation with BMI. Conclusion: SCD obtained by CT in ventral and dorsal decubitus may be used for calculation of the needle's entry angle. SCD obtained by US cannot be used. A rule for the correlation between BMI and the SCD could not be determined.
bookPart Litotripsia extracorpórea por ondas de choque(2014) TORRICELLI, Fábio César Miranda; BRASIL, Elaine Cristina Barbosa; MARTINS, Renato Antônio- Predicting Urinary Stone Composition Based on Single-energy Noncontrast Computed Tomography: The Challenge of Cystine(2014) TORRICELLI, Fabio Cesar Miranda; MARCHINI, Giovanni Scala; DE, Shubha; YAMACAKE, Kleiton G. R.; MAZZUCCHI, Eduardo; MONGA, ManojOBJECTIVE To study several measurements from a single-energy noncontrast computed tomography (NCCT) that may distinguish calcium oxalate, uric acid, and cystine stones. METHODS Patients with pure urinary stones who had at least 1 single-energy NCCT before the stone composition analysis from January 2008 to December 2012 were enrolled in this study. The analyzed data comprised stone size, volume, core Hounsfield unit (HU), periphery HU, absolute and relative HU differences between core and periphery, and HU density. After these measurements, an NCCT bone window was subjectively evaluated to study the homogeneity of each stone from core to periphery. The Spearman correlation test was used to determine the correlation between HU values and stone size and volume for each group. RESULTS A total of 113 patients were found with pure urinary stones who also had a corresponding NCCT. There were 36, 47, and 30 patients in the calcium oxalate, uric acid, and cystine groups, respectively. The core HU, periphery HU, absolute and relative HU differences, and HU density were significantly different among the 3 groups (P <. 001). Stone size and volume had a positive correlation with core and periphery HUs only for calcium oxalate and cystine stones. The subjective evaluation of the urinary calculi revealed a different pattern for each stone composition. CONCLUSION Single-energy NCCT may predict calcium oxalate stones with a high degree of accuracy. There is an overlap in radiographic profiles of cystine and uric acid stones, making a definitive differentiation more challenging. (C) 2014 Elsevier Inc.
bookPart Videolaparoscopia no tratamento de cálculos urinários(2014) TORRICELLI, Fábio César Miranda; VICENTINI, Fabio Carvalho- Effects of ambient levels of traffic-derived air pollution on the ocular surface: Analysis of symptoms, conjunctival goblet cell count and mucin 5AC gene expression(2014) TORRICELLI, Andre Augusto Miranda; MATSUDA, Monique; NOVAES, Priscila; BRAGA, Alfesio Luiz Ferreira; SALDIVA, Paulo Hilario Nascimento; ALVES, Milton Ruiz; MONTEIRO, Mario Luiz RibeiroPurpose: To quantify ocular symptoms, goblet cells (GC) and mucin 5AC (MUC5AC) gene expression on the conjunctiva of healthy subjects exposed to ambient levels of traffic-derived air pollution and to estimate its correlation with NO2 and particulate matter smaller than 2.5 mu m (PM2.5) levels. Methods: Twenty-one taxi drivers or traffic controllers were assessed with the Ocular Surface Disease Index (OSDI) questionnaire and conjunctival impression cytology. MUC5AC mRNA levels were determined based on the cytology of the right eye, and GC density was assessed based on the cytology of the left eye. Mean individual levels of 24-h NO2 and PM2.5 exposure were assessed the day before examination. Possible associations between NO2 or PM2.5 levels, OSDI scores, GC densities and MUC5AC mRNA levels were verified. Results: The subjects were exposed to mean PM2.5 levels of 35 +/- 12 mu g/m(3) and mean NO2 levels of 189 +/- 47 mu g/m(3). OSDI scores were low (7.4 +/- 8) and GC densities were 521 +/- 257 and 782 +/- 322 cell/mm(2) on the bulbar and tarsal conjunctivas, respectively. The mean GC-derived MUC5AC mRNA expression was 14 +/- 7 fM/mu g of total RNA. A significant and positive correlation was observed between MUC5AC mRNA levels and tarsal GC density (p=0.018). A trend toward association between PM2.5 levels and tarsal GC cell density (p=0.052) was found. Conclusion: Exposure to ambient levels of air pollution impacts conjunctival GC density. An increase in MUC5AC mRNA levels may be part of an adaptive ocular surface response to long-term exposure to air pollution.
- Current management issues of immediate postoperative care in pediatric kidney transplantation(2014) TORRICELLI, Fabio Cesar Miranda; WATANABE, Andreia; DAVID-NETO, Elias; NAHAS, William CarlosThe number of pediatric kidney transplants has been increasing in many centers worldwide, as the procedure provides long-lasting and favorable outcomes; however, few papers have addressed the immediate postoperative care of this unique population. Herein, we describe the management of these patients in the early postoperative phase. After the surgical procedure, children should ideally be managed in a pediatric intensive care unit, and special attention should be given to fluid balance, electrolyte disturbances and blood pressure control. Antibiotic and antiviral prophylaxes are usually performed and are based on the recipient and donor characteristics. Thrombotic prophylaxis is recommended for children at high risk for thrombosis, although consensus on the optimum therapy is lacking. Image exams are essential for good graft control, and Doppler ultrasound must be routinely performed on the first operative day and promptly repeated if there is any suspicion of kidney dysfunction. Abdominal drains can be helpful for surveillance in patients with increased risk of surgical complications, such as urinary fistula or bleeding, but are not routinely required. The immunosuppressive regimen starts before or at the time of kidney transplantation and is usually based on induction with monoclonal or polyclonal antibodies, depending on the immunological risk, and maintenance with a calcineurin inhibitor (tacrolimus or ciclosporin), an anti-proliferative agent (mycophenolate or azathioprine) and steroids.
- Laparoscopic ureterocalicostomy for complicated upper urinary tract obstruction: mid-term follow-up(2014) ARAP, Marco Antonio; ANDRADE, Hiury; TORRICELLI, Fabio Cesar Miranda; DENES, Francisco Tibor; MITRE, Anuar Ibrahim; DUARTE, Ricardo Jordao; SROUGI, MiguelTo report on the largest series of laparoscopic ureterocalicostomies done for complicated upper urinary obstruction. We retrospectively reviewed the data from 6 transperitoneal laparoscopic ureterocalicostomies performed in our institution from January 2008 to January 2012. Symptomatic complicated upper urinary obstruction was the main reason for all the procedures. The recorded data included age, gender, clinical presentation, duration of symptoms, laterality, mean operative time, hospital stay, complications and clinical and functional outcomes. The median patient age was 20.1 (2-44) years, and all patients were females. Patients underwent laparoscopic ureterocalicostomy due to previous failed procedures (3 patients), anatomic abnormalities (2 patients) and a severe upper ureteral stenosis (1 patient). The median operative time was 215 (180-270) min. There were no major complications. There were no conversions to open surgery. In a median follow-up of 30 (8-56) months, all patients presented with clinical and radiological improvement with no signs of obstruction. In all cases, the postoperative renal scintigraphy revealed a T1/2 lower than 10 min. Laparoscopic ureterocalicostomy is feasible and associated with high success rate in well-selected cases with complicated upper urinary obstructions.
bookPart Nefrolitotomia anatrófica(2014) TORRICELLI, Fábio César Miranda; SROUGI, Miguel- Brazilian Abstracts Presented at the American Urological Association Annual Meetings: Contribution, Publication Rates, and Comparison with Oncology Abstracts(2014) ARAP, Marco A.; REIS, Rodolfo Borges dos; TORRICELLI, Fabio Cesar Miranda; MASSON, Andre L. S.; SAAD, Everardo D.Purpose: Scientific research originating from Brazil appears to be rising in several medical fields. Research results are often presented at scientific meetings before publication in peer-reviewed journals. We investigated the publication rate of Brazilian studies presented in American Urological Association (AUA) meetings and compared with the rate of publication of Brazilian oncological studies presented at the American Society of Clinical Oncology (ASCO) meetings. Materials and Methods: a hand search of 12,454 abstracts presented at aua meetings 2001-2007 was conducted. abstracts for which at least two-thirds of institutions were from brazil were considered as brazilian. final publication was searched in pubmed and lilacs databases. oncological abstracts were also hand searched in the asco meetings proceedings in the same years. Results: There was no significant temporal trend in the proportion of AUA studies originating from Brazil along those 7 years. A total of 195 abstracts (1.57%) were from Brazil. One hundred (51.3%) abstracts were published in full, and the estimated 5-year publication rate was 48.2%. There was a progressive increase in publication rates for studies categorized as video, poster, and podium presentations. Considering abstracts presented in years 2001-2005, urologic publication rate was significantly higher than for abstracts presented at the ASCO meeting. Conclusions: Our results suggest that the Brazilian contribution to AUA meetings is at a plateau and that the Brazilian literature contribution is greater in urology than in oncology. Efforts must be invested towards raising this plateau and understanding qualitative aspects of the urology scientific output from Brazil.
bookPart Pielolitotomia ampliada(2014) TORRICELLI, Fábio César Miranda; LUCON, Antonio Marmo