PAULO MANUEL PEGO FERNANDES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina - Líder
318 resultados
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conferenceObject A Comparative Cost Analysis Study of Robotic and Video-Assisted Lobectomy: Results of Randomized Controlled Trial (Bravo Trial)(2021) TERRA, R.; TRINDADE, J.; CAMPOLINA, A.; ARAUJO, P. H. De; CAMPOS, J. R. De; PEGO-FERNANDES, P.- A New 3D CT Method to Analyze Bronchial Stenosis after Lung Transplantation(2019) DIAS, Y. T. Nunes; CHATE, R. C.; NOGUEIRA FILHO, J. M.; CIRILLO, G. G.; PEGO-FERNANDES, P. M.; SAMANO, M. N.
- Great expectations(2012) PEGO-FERNANDES, Paulo Manuel; BIBAS, Benoit Jacques
bookPart Derrame pericárdico(2019) ARAúJO, Pedro Henrique Xavier Nabuco de; PêGO-FERNANDES, Paulo ManuelbookPart Abordagem do derrame pleural e toracocentese(2015) DIAS, Olivia Meira; MARIANI, Alessandro; PêGO-FERNANDES, Paulo Manuel- Impact of gastroesophageal reflux in the pathogenesis of tracheal stenosis(2020) CARDOSO, Paulo Francisco Guerreiro; MINAMOTO, Helio; BIBAS, Benoit Jacques; PEGO-FERNANDES, Paulo ManuelBenign airway stenosis is a multifactorial and heterogeneous disease often occurring after tracheal intubation. Despite the frequent finding of pathological gastroesophageal reflux (GER) in benign tracheal stenosis, the cause-and-effect relationship between these two entities and its impact on the outcome of the stenosis itself have not been established. The altered ventilatory dynamics caused by an increased thoracoabdominal pressure gradient in such patients has been proposed as a central cause. The presence of GER in a setting of microaspiration can also induce changes in the local collagen proliferation response, as well as in the local microbiome of the tracheal stenosis site, which may potentially cause and enhance the harm imposed to the already diseased tracheal wall. Diagnosis of GER remains underestimated in the general population, thus making its accurate detection and treatment in central airway stenosis a matter of investigation. The high prevalence of GER in tracheal stenosis patients often occurs in the absence of typical upper digestive signs and symptoms, therefore requiring an objective assessment using a 24-hour ambulatory esophageal pH/impedance study that has shown abnormal results in more than half the patients. The impact of the treatment of GER in patients with benign tracheal has been scarcely reported. Our group showed recently that the surgical control of GER through laparoscopic fundoplication in selected patients with tracheal stenosis can improve substantially the chance of resolution of the tracheal stenosis as opposed to the medical management with high dose proton pump inhibitors. This chapter describes the impact of GER in the pathogenesis of tracheal stenosis with a focus on its mechanisms, diagnosis and treatment strategy.
- Adverse events after pleurodesis in patients with malignant pleural effusion(2020) TERRA, Ricardo Mingarini; COSTA, Priscila Berenice da; VEGA, Alberto Jorge Monteiro Dela; PEGO-FERNANDES, Paulo ManuelBackground: Malignant pleural effusion (MPE) is an important sign of advanced disease in metastatic cancer. Pleurodesis is one option to treat recurrent MPE. The Inflammatory response after pleurodesis may lead to important adverse events (AE) in a set of very ill patients. Methods: Retrospective analysis of patients submitted to pleurodesis (2009-2013). Clinical and laboratory data were collected. We compare the values in the day of pleurodesis, 2nd, 5th and 10th days after. Results: One hundred fourteen patients were undergone to pleurodesis with silver nitrate (46%), iodine (52%) and talc (2%). Female was the most frequent (86%) and the breast cancer was the most common primary site. The most frequent adverse event was low hemoglobin account (37), followed by pain (31). 68% of patients presented AEs and 28% had at least one AE with grade 3 or higher. The most altered was CRP that peaked in the 5th day after pleurodesis. Changes in CRP curve were less severe with the use of iodine when compared with the other two agents. Conclusions: Pleurodesis leads to important systemic inflammatory response detected by different serum markers. The occurrence of adverse events in this set of patients was great number of events with being marked as grade 3 or higher.
- Lung transplantation: overall approach regarding its major aspects(2015) CAMARGO, Priscila Cilene Leon Bueno de; TEIXEIRA, Ricardo Henrique de Oliveira Braga; CARRARO, Rafael Medeiros; CAMPOS, Silvia Vidal; AFONSO JUNIOR, Jose Eduardo; COSTA, Andre Nathan; FERNANDES, Lucas Matos; ABDALLA, Luis Gustavo; SAMANO, Marcos Naoyuki; PEGO-FERNANDES, Paulo ManuelO transplante pulmonar é uma terapia bem estabelecida para pacientes com doença pulmonar avançada.A avaliação do candidato para o transplante é uma tarefa complexa e envolve uma equipe multidisciplinar que acompanha o paciente para além do período pós-operatório.O tempo médio atual em lista de espera para transplante pulmonar é de aproximadamente 18 meses no estado de São Paulo. Em 2014, dados da Associação Brasileira de Transplante de Órgãos mostram que 67 transplantes pulmonares foram realizados no Brasil e que 204 pacientes estavam na lista de espera para transplante pulmonar.O transplante pulmonar é principalmente indicado no tratamento de DPOC, fibrose cística, doença intersticial pulmonar, bronquiectasia não fibrocística e hipertensão pulmonar.Esta revisão abrangente teve como objetivos abordar os aspectos principais relacionados ao transplante pulmonar: indicações, contraindicações, avaliação do candidato ao transplante, avaliação do candidato doador, gestão do paciente transplantado e complicações maiores. Para atingirmos tais objetivos, utilizamos como base as diretrizes da Sociedade Internacional de Transplante de Coração e Pulmão e nos protocolos de nosso Grupo de Transplante Pulmonar localizado na cidade de São Paulo.
article 5 Citação(ões) na Scopus An experimental rat model of ex vivo lung perfusion for the assessment of lungs after prostacyclin administration: inhaled versus parenteral routes(2011) CARDOSO, Paulo Francisco Guerreiro; PAZETTI, Rogerio; MORIYA, Henrique Takachi; PEGO-FERNANDES, Paulo Manuel; ALMEIDA, Francine Maria de; CORREIA, Aristides Tadeu; FECHINI, Karina; JATENE, Fabio BiscegliObjective: To present a model of prostaglandin I(2) (PGI(2)) administration (inhaled vs. parenteral) and to assess the functional performance of the lungs in an ex vivo lung perfusion system. Methods: Forty Wistar rats were anesthetized and placed on mechanical ventilation followed by median sterno-laparotomy and anticoagulation. The main pulmonary artery was cannulated. All animals were maintained on mechanical ventilation and were randomized into four groups (10 rats/group): inhaled saline (IS); parenteral saline (PS); inhaled PGI(2) (IPGI(2)); and parenteral PGI(2) (PPGI(2)). The dose of PGI(2) used in the IPGI(2) and PPGI(2) groups was 20 and 10 mu g/kg. respectively. The heart-lung blocks were submitted to antegrade perfusion with a low potassium and dextran solution via the pulmonary artery, followed by en bloc extraction and storage at 4 degrees C for 6 h. The heart-lung blocks were then ventilated and perfused in an ex vivo lung perfusion system for 50 min. Respiratory mechanics, hemodynamics, and gas exchange were assessed. Results: Mean pulmonary artery pressure following nebulization decreased in all groups (p < 0.001), with no significant differences among the groups. During the ex vivo perfusion, respiratory mechanics did not differ among the groups, although relative oxygenation capacity decreased significantly in the IS and PS groups (p = 0.04), whereas mean pulmonary artery pressure increased significantly in the IS group. Conclusions: The experimental model of inhaled PGI(2) administration during lung extraction is feasible and reliable. During reperfusion, hemodynamics and gas exchange trended toward better performance with the use of PGI(2) than that with the use of saline.- Tacrolimus impairs airway mucociliary clearance of rats(2024) SILVA, Maristela Prado E.; SOTO, Sonia de Fatima; ALMEIDA, Francine Maria de; CORREIA, Aristides Tadeu; PEGO-FERNANDES, Paulo Manuel; PAZETTI, RogerioObjectives: Tacrolimus (TAC) is the most widely used immunosuppressive agent after lung transplantation. Considering that the ciliary beat frequency (CBF) mainly depends on the cytoplasmic calcium concentration and that TAC can affect this due to its binding with the intracellular immunophilin FKBP12, we hypothesized that TAC could also impair the airway mucociliary clearance of rats. Methods: Sixty rats were divided into two groups (n = 30 each): Control = water; TAC = tacrolimus. After 7, 15 or 30 days of treatment, ten animals from each group were euthanized and the following parameters were studied: mucus transportability, CBF, mucociliary transport velocity (MCTV), and neutral and acid mucus production. Results: There was a significant decrease in CBF (Control vs TAC: 7 days, p = 0.008; 15 days, p = 0.007; 30 days, p = 0.001) and MCTV (Control vs TAC: 7 days, p = 0.004; 15 days, p < 0.001; 30 days, p < 0.001) in all immunosuppressed animals. TAC therapy also caused an increase in acid mucus production at all treatment times (Control vs TAC: 7 days, p = 0.001; 15 days, p = 0.043; 30 days, p = 0.001). Conclusions: TAC impairs airway mucociliary clearance of rats.