JOCIELLE SANTOS DE MIRANDA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
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- Early assessment of bilateral inguinal hernia repair: A comparison between the laparoscopic total extraperitoneal and Stoppa approaches(2016) UTIYAMA, Edivaldo Massazo; DAMOUS, Sergio Henrique Bastos; TANAKA, Eduardo Yassushi; YOO, Jin Hwan; MIRANDA, Jocielle Santos de; USHINOHAMA, Adriano Zuardi; FARO JR., Mario Paulo; BIROLINI, Claudio Augusto ViannaBACKGROUND: The present clinical trial was designed to compare the results of bilateral inguinal hernia repair between patients who underwent the conventional Stoppa technique and laparoscopic total extraperitoneal repair ( LTE) with a single mesh and without staple fixation. PATIENTS AND METHODS: This controlled, randomised clinical trial was conducted at General Surgery and Trauma of the Clinics Hospital, Medical School, the University of Sao Paulo between September 2010 and February 2011. Totally, 50 male patients, with a bilateral inguinal hernia, older than 25 years were considered eligible for the study. The following parameters were analysed during the early post-operative period: ( 1) The intensity of surgical trauma, operation time, C-reactive protein ( CRP) levels, white blood cell count, bleeding and pain intensity; ( 2) quality of life assessment; and ( 3) post-operative complications. RESULTS: LTE procedure was longer than the Stoppa procedure ( 134.6 min +/- 38.3 vs. 90.6 min +/- 41.3; P < 0.05). The levels of CRP were higher in the Stoppa group ( P < 0.05) but the number of leucocytes, haematocrit, and haemoglobin were similar between the groups ( P > 0.05). There was no difference in pain during the 1st and 7th post-operative, physical functioning, physical limitation, the impact of pain on daily activities, and the Carolinas Comfort Scale during the 7th and 15th post-operative ( P > 0.05). Complications occurred in 88% of Stoppa group ( 22 patients) and 64% in LTE group ( 16 patients) ( P < 0.05). CONCLUSION: The comparative study between the Stoppa and LTE approaches for the bilateral inguinal hernia repair demonstrated that: ( 1) The LTE approach showed less surgical trauma despite the longer operation time; ( 2) Quality of life during the early post-operative period were similar; and ( 3) Complication rates were higher in the Stoppa group.
- Polypropylene and polypropylene/polyglecaprone (Ultrapro(r)) meshes in the repair of incisional hernia in rats(2015) UTIYAMA, Edivaldo Massazo; ROSA, Maria Beatriz Sartor de Faria; ANDRES, Marina de Paula; MIRANDA, Jocielle Santos de; DAMOUS, Sérgio Henrique Bastos; BIROLINI, Cláudio Augusto Vianna; DAMOUS, Luciana Lamarão; MONTERO, Edna Frasson de SouzaPURPOSE: To compare the inflammatory response of three different meshes on abdominal hernia repair in an experimental model of incisional hernia. METHODS: Median fascial incision and skin synthesis was performed on 30 Wistar rats. After 21 days, abdominal hernia developed was corrected as follows: 1) No mesh; 2) Polypropylene mesh; and, 3) Ultrapro(r) mesh. After 21 days, the mesh and surrounding tissue were submitted to macroscopic (presence of adhesions, mesh retraction), microscopic analysis to identify and quantify the inflammatory and fibrotic response using a score based on a predefined scale of 0-3 degrees, evaluating infiltration of macrophages, giant cells, neutrophils and lymphocytes. RESULTS: No significant difference was seen among groups in adherences, fibrosis, giant cells, macrophages, neutrophils or lymphocytes (p>0.05). Mesh shrinkage was observed in all groups, but also no difference was observed between polypropylene and Ultrapro mesh (7.0±9.9 vs. 7.4±10.1, respectively, p=0.967). Post-operatory complications included fistula, abscess, dehiscence, serohematic collection and reherniation, but with no difference among groups (p=0.363). CONCLUSION: There is no difference between polypropylene (high-density) and Ultrapro(r) (low-density) meshes at 21 days after surgery in extraperitoneal use in rats, comparing inflammatory response, mesh shortening, adhesions or complications.
- Great saphenous vein aneurysm: A differential diagnosis of femoral hernia and review(2015) MIRANDA, Jocielle Santos de; DAMOUS, Sergio Henrique Bastos; FARO JUNIOR, Mario Paulo; YOO, Jin Hwan; YASSUSHI, Eduardo Tanaka; ZUARDI, Adriano; MURAKAMI, Abel Hiroshi; BIROLINI, Claudio; UTIYAMA, Edivaldo MassazoINTRODUCTION: Venous aneurysms are unusual clinical entities that might be difficult to diagnose and usually appear as an asymptomatic incidental finding on physical examination or imaging study and discovered only during the surgical exploration. They are important differential diagnosis of groin and other subcutaneous mass. PRESENTATION OF CASE: We report a case of a 67-years-old woman who had a groin mass misdiagnosed as femoral hernia, which was subsequently diagnose as great saphena vein aneurysm in the intraoperative set and treated with ligature and resection. DISCUSSION: In conclusion, venous aneurysms of the superficial system are lesions that are important differential diagnosis of groin and other subcutaneous mass. CONCLUSION: Diagnosis is readily available by duplex ultrasonography; however, in most cases, the diagnosis is done only in the operative field. (C) 2015 The Authors.
- Does a bilateral polypropylene mesh alter the duct deferens morphology, testicular size and testosterone levels? Experimental study in rats(2020) DAMOUS, Sergio Henrique Bastos; DAMOUS, Luciana Lamarao; MIRANDA, Jocielle dos Santos; MONTERO, Edna Frasson de Souza; BIROLINI, Claudio; UTIYAMA, Edivaldo MassazoPurpose: To evaluate the effect of a PP mesh on duct deferens morphology, testicular size and testosterone levels. Methods: Forty adult male rats were distributed into groups: 1) no surgery; 2) inguinotomy; 3) mesh placed on the duct deferens; and 4) mesh placed on the spermatic funiculus. After 90 postoperative days, the inguinal region was resected, and blood samples were collected for the measurement of serum testosterone (pg/dl). The ducts deferens were sectioned in three axial sections according to the relationship with the mesh - cranial, medial and caudal. The wall thickness and duct deferens lumen area were measured. Results: The morphology of the duct deferens was preserved in all groups. The mesh placement did not alter this morphology in any of the analyzed segments. Surgery, with or without mesh placement, did not alter the morphology, wall thickness or lumen area (p>0.05). In all operated groups, serum testosterone levels were similar (p>0.05) but there was a decrease in testicle size (p<0.05). Conclusion: Surgery, with or without mesh placement, did not alter the morphology of the duct deferens and, although this treatment resulted in testicular size reduction, it did not affect serum testosterone levels.
- Pneumomediastinum complicating COVID-19: a case series(2021) DAMOUS, Sergio Henrique Bastos; SANTOS JUNIOR, Jones Pessoa dos; PEZZANO, alvaro Vicente Alvarez; CHAMS, Mohamad Abdul Majid; HARITOV, Nathaly; WAKSMAN, Ricardo; LIMA, Helber Vidal Gadelha; MIRANDA, Jocielle dos Santos; RASSLAN, Roberto; UTIYAMA, Edivaldo MassazoBackground Pneumomediastinum is a rare complication of COVID-19 pneumonia, which may or may not be associated with invasive ventilatory support. Therefore, the report and findings associated with its evolution can be of great contribution in the management of this unknown disease. Case presentation Here, we present a series of four patients with severe pneumomediastinum requiring intensive care unit. These patients developed pneumomediastinum before or during orotracheal intubation (OTI) or without OTI. The four patients were three men and one woman with a mean age of 60.5 years (48-74 years). No patients had a known history of lung disease or traumatic events, except for one patient who had a history of smoking, but who was without parenchymal disease. All intubations were performed without complications. No cases of pneumomediastinum occurred after tracheostomy, and none of the patients had tomographic or bronchoscopic evidence of tracheal injury. Although the pneumomediastinum observed in our cases was apparently not related to a violation of the aerodigestive track, this complication was associated with a worse prognosis. Conclusion Pneumomediastinum is a rare complication of COVID-19 pneumonia, and the most likely etiopathogenesis is severe pulmonary involvement, which may or may not be associated with invasive ventilatory support. Future studies with a greater number of cases should elucidate the relationship of pneumomediastinum to a probable prognostic factor.