DALTON DE ALENCAR FISCHER CHAMONE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
6 resultados
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conferenceObject Extracorporeal shockwave lithotripsy (ESWL) in a patient with congenital fator VII deficiency and von Willebrand disease(2013) VILLACA, P. R.; OKAZAKI, E.; ZEINAD-VALIM, A. K.; ROCHA, R. F.; SANDOVAL, E. P. N.; KATO, R. B.; CHEDID-NETO, E. A.; CHAMONE, D. A. F.; D'AMICO, E. A.conferenceObject Maintenance with rituximab is not associated with severe or uncommon infections in patients with follicular lymphoma: results from the phase IIIB MAXIMA study(2012) WITZENS-HARIG, M.; ROCCO, A. Di; HAZEL, G. van; CHAMONE, D.; RUFFERT, K.; ROWE, J.; ARCAINI, L.; PODDUBNAYA, I.; HO, A.; IVANOVA, V.; VRANOWSKY, A.; OERTEL, S.; THURLEY, D.; FOA, R.Clinical trial data support the efficacy of rituximab maintenance therapy, following rituximab-based chemoimmunotherapy, in patients with follicular lymphoma (FL). With safety as its primary objective, this phase IIIB study (clinicaltrials.gov identifier: NCT00430352) was the first large prospective evaluation of rituximab maintenance in clinical practice. Patients (n = 534) with first-line or relapsed FL who responded to ≥8 cycles of rituximab-based induction therapy (anthracycline 62%, alkylator 21%, purine analog 8%, rituximab monotherapy 5%, other 4%) received twelve 2-monthly rituximab infusions for 2 years. Overall, 422 infections occurred in 193 (36.1%) patients, most commonly nasopharyngitis (7.1%), bronchitis (4.7%), sinusitis (4.3%), upper respiratory tract infection (3.9%), and influenza (3.7%); and were grade 3/4/5 in 21 (3.9%), 2 (0.4%) and 1 (0.2%) patient(s), respectively. Fifty-one hematologic adverse events occurred in 35 (6.6%) patients, most commonly neutropenia (n = 18; 3.4%; grade 3 or 4 in 13 patients; 2.4%). Grade 3 or 4 hypogammaglobulinemia occurred in 5 (0.9%) patients. Rates and types of infections were similar in patients with or without prolonged neutropenia or hypogammaglobulinemia. Rituximab maintenance every 2 months for 2 years is not associated with uncommon or severe infections in clinical practice in FL. Prolonged neutropenia and hypogammaglobulinamia are rare, manageable events.conferenceObject Thrombelastography as screening test for the diagnosis of Scott syndrome(2012) VILLACA, P.; ROCHA, T.; OKAZAKI, E.; VALIM, A.; OLIVEIRA, V.; CHAMON, D.; DAMICO, E.Background: Scott syndrome (SS) is a rare bleeding disorder, characterized by impaired platelet procoagulant activity (PCA). The laboratory tests for its diagnosis are available in specialized laboratories, and sometimes only for research purposes. Case Report: A 35 year-old male patient was referred to our centre for diagnosis of hemostasis disorder. He had a history of bruises and hematomas since childhood. Blood transfusion was required after postectomy and crural hernioplasty. His family history for bleeding was negative. Laboratory investigation showed normal measurement of all coagulation factors, including VWF antigen/activity, normal evaluation of fibrinolytic system (alpha2-antiplasmin, plasminogen, and euglobulin lysis time), as well as plateletaggregometry (ADP, ADR, arachidonic acid, collagen, and ristocetin). Thrombelastography (TEG) was hypocoagulant (prolonged R and K; reduced angle MA, G, TG, MRTG, and TMRTG), which led us to consider abnormality of PCA. Then a series of TEGs was performed, mixing total blood (patient and control) with platelet-poor plasma (PPP) and platelet-rich plasma (PRP) of the patient and control. When PRP (control) was added to patient’s total blood, TEG was normalized, suggesting PCA dysfunction, and the hypothesis of SS was made. A PCA test was performed using washed platelet and activated prothrombinic complex, resulting in reduced PCA. After that, we performed the phosphatidylserin expression by flow cytometry, using annexin V and a thrombin generation assay (TGA) with control PRP, confirming the diagnosis of SS. Conclusion: SS is a rare disease, and usually confirmatory tests are not part of the routine, even in specialized laboratories. TEG using mixtures of total blood and PRP of patient and control can be a simple and less expensive alternative method for screening impaired PCA in patients with bleeding disorders. In this case, such an approach helped in elucidating the diagnosis when sophisticated tests such as annexin V and thrombin generation were not promptly available.conferenceObject Acquired factor VIII inhibitor associated to prostate cancer in elderly(2013) VILLACA, P. R.; OKAZAKI, E.; ZEINAD-VALIM, A. K.; ROCHA, R. F.; CHAMONE, D. A. F.; D'AMICO, E. A.conferenceObject Association of JAK2 V617F mutation and tromboembolic events among patients with essential thrombocytemia and idiopathic myelofibrosis in a Brazilian center: evidence of a retrospective study(2013) VILLACA, P. R.; ZEINAD-VALIM, A. K.; OKAZAKI, E.; LINARDI, C. G.; SUGANUMA, L. M.; SEGURO, F.; CHAMONE, D. A. F.; D'AMICO, E. A.conferenceObject Successful management of ITP during pregnancy: weekly IVIg is an option(2013) VILLACA, P. R.; OKAZAKI, E.; ZEINAD-VALIM, A. K.; CHAMONE, D. A. F.; D'AMICO, E. A.