PEDRO NOGUEIRA GIGLIO
Projetos de Pesquisa
Unidades Organizacionais
PAHC, Hospital das Clínicas, Faculdade de Medicina - Médico
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- AUTOLOGOUS CHONDROCYTE IMPLANTATION IN BRAZIL(2020) GIGLIO, Pedro Nogueira; LIZIER, Nelson Foresto; LEVY, Debora; SOBRADO, Marcel Faraco; GOBBI, Riccardo Gomes; PECORA, Jose Ricardo; BYDLOWSKI, Sergio Paulo; DEMANGE, Marco KawamuraObjective: To describe the first series of cases of autologous chondrocyte implantation (ACI) in collagen membrane performed in Brazil. Methods: ACI was performed in 12 knees of 11 patients, aged 32.1 +/- 10.9 years, with 5.3 +/- 2.6 cm(2) full-thickness knee cartilage lesions, with a six-month minimum follow-up. Two surgical procedures were performed: arthroscopic cartilage biopsy for isolation and expansion of chondrocytes, which were seeded onto collagen membrane and implanted in the lesion site; the characterization of cultured cells and implant was performed using immunofluorescence for type II collagen (COL2) for cell viability and electron microscopy of the implant. Clinical safety, KOOS and IKDC scores and magnetic resonance imaging were evaluated. We used repeated-measures ANOVA and post-hoc comparisons at alpha = 5%. Results: COL2 was identified in the cellular cytoplasm, cell viability was higher than 95% and adequate distribution and cell adhesion were found in the membrane. The median follow-up was 10.9 months (7 to 19). We had two cases of arthrofibrosis, one of graft hypertrophy and one of superficial infection as complications, but none compromising clinical improvement. KOOS and IKDC ranged from 71.2 +/- 11.44 and 50.72 +/- 14.10, in preoperative period, to 85.0 +/- 4.4 and 70.5 +/- 8.0, at 6 months (p = 0.007 and 0.005). MRI showed regenerated tissue compatible with hyaline cartilage. Conclusion: ACI in collagen membrane was feasible and safe in a short-term follow- up, presenting regenerated formation visualized by magnetic resonance imaging and improved clinical function.
- LEVER SIGN TEST FOR CHRONIC ACL INJURY: A COMPARISON WITH LACHMAN AND ANTERIOR DRAWER TESTS(2021) SOBRADO, Marcel Faraco; BONADIO, Marcelo Batista; RIBEIRO, Gabriel Fernandes; GIGLIO, Pedro Nogueira; HELITO, Camilo Partezani; DEMANGE, Marco KawamuraObjective: This study aims to evaluate the sensitivity and specificity of the lever sign test in patients with and without chronic Anterior Cruciate Ligament (ACL) injuries in an outpatient setting and the inter-examiner agreement of surgeons with different levels of experience. Methods: 72 consecutive patients with a history of previous knee sprains were included. The Lachman, anterior drawer, and Lever Sign tests were performed for all subjects in a randomized order by three blinded raters with different levels of experience. Sensitivity, specificity, positive predictive value, negative predictive value, and inter-rater agreement were estimated for all tests. Results: Among the 72 patients, the prevalence of ACL injuries was 54%. The lever test showed sensitivity of 64.1% (95% CI 0.47-0.78) and specificity of 100% (95% CI 0.87-1.00) for the senior examiner. For the less experienced examiner the sensitivity was 51.8% and the specificity was 93.7%. Positive predictive values (PPV) and negative predictive values (NPV) were 100% and 70.2%, respectively. Conclusion: Lever Sign test shows to be a maneuver of easy execution, with 100% specificity and 100% PPV. Moderate agreement between experienced examiners and low agreement among experienced and inexperienced examiners was found. This test may play a role as an auxiliary maneuver.
- ASSESSMENT OF THE USE OF TRANEXAMIC ACID AFTER TOTAL KNEE ARTHROPLASTY(2020) LEITE, Chilan Bou Ghosson; RANZONI, Lucas Verissimo; GIGLIO, Pedro Nogueira; BONADIO, Marcelo Batista; MELO, Lucas Da Ponte; DEMANGE, Marco Kawamura; GOBBI, Riccardo GomesObjective: To evaluate the profile of blood loss and blood transfusions after the introduction of Tranexamic acid (TXA) in a tertiary university hospital in Brazil. Methods: 173 patients were retrospectively divided into two groups: the ones who received TXA and the control group. Hemoglobin levels (Hb), drain output, transfusion rates, and thromboembolic events were measured. Results: Among the patients included in this study, 82 cases received TXA. Blood transfusion occurred in 3 cases of the TXA group (3.7%), and in 27 control group cases (29.7%; p < 0.001). The average Hb decrease was 2.7 g/dl (+/- 1.39) and the median drain output was 270 mL in the TXA group. In the control group, the values were 3.41 g/dl (+/- 1.34; p < 0.001) and 460 mL (p < 0.001), respectively. Thromboembolic events occurred in 2 TXA group cases (2.4%) and in 3 control group cases (3.3%; p > 0.999). Conclusion: TXA was effective in reducing blood transfusion rates, Hb decrease, and drain output on the 1st postoperative day without increasing thromboembolic events.
- NEGATIVE-PRESSURE WOUND THERAPY IN THE TREATMENT OF COMPLEX INJURIES AFTER TOTAL KNEE ARTHROPLASTY(2017) HELITO, Camilo Partezani; BUENO, Daniel Kamura; GIGLIO, Pedro Nogueira; BONADIO, Marcelo Batista; PECORA, Jose Ricardo; DEMANGE, Marco KawamuraObjective: To present an experience with negative-pressure wound therapy (NPWT) in the treatment of surgical wounds in patients treated for infections after total knee arthroplasty (TKA) with or without dehiscence and prophylaxis in wounds considered at risk of healing problems. Methods: We prospectively evaluated patients with TKA infection with or without surgical wound dehiscence and patients with risk factors for infection or surgical wound complications treated with Pico (R) device for NPWT in addition to standard treatment of infection or dehiscence in our institution. We considered as an initial favorable outcome the resolution of the infectious process and the closure of the surgical wound dehiscences in the treated cases and the good progression of the wound without complicating events in the prophylactic cases. Results: We evaluated 10 patients who used Pico (R) in our service. All patients had a favorable outcome according to established criteria. No complications were identified regarding the use of the NPWT device. The mean follow-up of the patients after the use of the device was 10.5 months. Conclusion: The NPWT can be safely used in wound infections and complications following TKA with promising results. Long-term randomized prospective studies should be conducted to prove its effectiveness.