WELLINGSON SILVA PAIVA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
232 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 232
- Traumatic brain injury pharmacological treatment: recommendations(2018) ANGHINAH, Renato; AMORIM, Robson Luis Oliveira de; PAIVA, Wellingson Silva; SCHMIDT, Magali Taino; IANOF, Jessica NatulineThis article presents the recommendations on the pharmacological treatment employed in traumatic brain injury (TBI) at the outpatient clinic of the Cognitive Rehabilitation after TBI Service of the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Brazil. A systematic assessment of the consensus reached in other countries, and of articles on TBI available in the PUBMED and LILACS medical databases, was carried out. We offer recommendations of pharmacological treatments in patients after TBI with different symptoms.
- Impact of a cell cycle and an extracellular matrix remodeling transcriptional signature on tumor progression and correlation with EZH2 expression in meningioma(2022) PEREIRA, Benedito Jamilson Araujo; LERARIO, Antonio Marcondes; SOLA, Paula Rodrigues; LAURENTINO, Talita de Sousa; MOHAN, Dipika R.; ALMEIDA, Antonio Nogueira de; AGUIAR, Paulo Henrique Pires de; PAIVA, Wellingson da Silva; WAKAMATSU, Alda; TEIXEIRA, Manoel Jacobsen; OBA-SHINJO, Sueli Mieko; MARIE, Suely Kazue NagahashiOBJECTIVE The authors searched for genetic and transcriptional signatures associated with tumor progression and recurrence in their cohort of patients with meningiomas, combining the analysis of targeted exome, NF2-LOH, transcrip-tome, and protein expressions. METHODS The authors included 91 patients who underwent resection of intracranial meningioma at their institution between June 2000 and November 2007. The search of somatic mutations was performed by Next Generation Sequenc-ing through a customized panel and multiplex ligation-dependent probe amplification for NF2 loss of heterozygosity. The transcriptomic profile was analyzed by QuantSeq 3 ' mRNA-Seq. The differentially expressed genes of interest were validated at the protein level analysis by immunohistochemistry.RESULTS The transcriptomic analysis identified an upregulated set of genes related to metabolism and cell cycle and downregulated genes related to immune response and extracellular matrix remodeling in grade 2 (atypical) meningio-mas, with a significant difference in recurrent compared with nonrecurrent cases. EZH2 nuclear positivity associated with grade 2, particularly with recurrent tumors and EZH2 gene expression level, correlated positively with the expres-sion of genes related to cell cycle and negatively to genes related to immune response and regulation of cell motility. CONCLUSIONS The authors identified modules of dysregulated genes in grade 2 meningiomas related to the activation of oxidative metabolism, cell division, cell motility due to extracellular remodeling, and immune evasion that were predic-tive of survival and exhibited significant correlations with EZH2 expression.
- Simplifying the use of prognostic information in patients with traumatic brain injury(2018) SOLLA, Davi J. Fontoura; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson Silva
article 3 Citação(ões) na Scopus Gunshot wound to the upper cervical spine leading to instability(2014) PAIVA, Wellingson Silva; AMORIM, Robson Luis; MENENDEZ, Djalma Felipe; BROCK, Roger Schmidt; ANDRADE, Almir Ferreira De; TEIXEIRA, Manoel JacobsenGunshot wounds (GSW) to the cervical spine leading to instability are rare. Also, the presence of vital vascular and neurological structures in the surround area lead to death or severe disability in the vast majority of cases. In this brief report, we present a rare case of C1 fracture due to GSW leading to instability of the atlanto-occipital joint in a neurologically intact patient.- Computed Tomography Angiography for Detection of Middle Meningeal Artery Lesions Associated with Acute Epidural Hematomas(2014) PAIVA, Wellingson Silva; ANDRADE, Almir Ferreira; AMORIM, Robson Luis Oliveira De; BOR-SENG-SHU, Edson; GATTAS, Gabriel; NEVILLE, Iuri Santana; CALDAS, Jose Guilherme; FIGUEIREDO, Eberval Gadelha; TEIXEIRA, Andmanoel JacobsenBackground. The natural history of traumatic aneurysms of the middle meningeal artery (MMA) is not well known, but patients with these lesions are more likely to have delayed bleeds. In this paper, we described a series of patients with epidural hematoma who underwent angiotomography (CTA) for MMA vascular lesion diagnosis. Methods. Eleven patients admitted to our emergency unit with small acute epidural hematoma were prospectively studied. All patients with temporal acute epidural hematomas underwent CTA and cerebral angiogram at our institution for diagnosis of posttraumatic lesions of middle meningeal artery. The findings of angiotomography and digital angiography were reviewed by radiologist and angiographers, respectively, to ensure that the lesions were readily diagnosed without knowing the results of angiotomography and to compare CTA findings with standard angiogram. Results. The causes of head injury were traffic accidents, falls, and aggression. Three of these patients presented traumatic MMA pseudoaneurysm. CT angiography was able to diagnose all of them, with dimensions ranging from 1.5 to 2.8 mm. Conventional angiography confirmed the findings of CT angiography, and the lesions presented with similar dimensions at both methods. Conclusions. We believe that angiotomography can be a useful technique for diagnosis of vascular lesion associated with small epidural hematoma.
- Laser interstitial thermal therapy as an adjunct therapy in brain tumors: A meta-Analysis and comparison with stereotactic radiotherapy(2020) FRANCA, S. A. De; TAVARES, W. M.; SALINET, A. S. M.; TEIXEIRA, M. J.; PAIVA, W. S.Background: Minimally invasive procedures are gaining widespread acceptance in difficult-To-Access brain tumor treatment. Stereotactic radiosurgery (SRS) is the preferred choice, however, laser interstitial thermal therapy (LITT) has emerged as a tumor cytoreduction technique. The present meta-Analysis compared current SRS therapy with LITT in brain tumors. Methods: A search was performed in Lilacs, PubMed, and Cochrane database. Patient s demographics, tumor location, therapy used, Karnofsky performance status score before treatment, and patient s outcome (median overall survival, progression-free survival, and adverse events) data were extracted from studies. The risk of bias was assessed by Cochrane collaboration tool. Results: Twenty-five studies were included in this meta-Analysis. LITT and SRS MOS in brain metastasis patients were 12.8 months versus 9.8 months (ranges 9.3-16.3 and 8.3-9.8; P = 0.02), respectively. In a combined comparison of adverse effects among LITT versus SRS in brain metastasis, we found 15% reduction in absolute risk difference (-0.16; 95% confidence interval P < 0.0001). Conclusion: We could not state that LITT treatment is an optimal alternative therapy for difficult-To-Access brain tumors due to the lack of systematic data that were reported in our pooled studies. However, our results identified a positive effect in lowering the absolute risk of adverse events compared with SRS therapy. Therefore, randomized trials are encouraged to ascertain LITT role, as upfront or postoperative/post-SRS therapy for brain tumor treatment. © 2021 National Electronic-Information Consortium (NEICON). All rights reserved.
- Cyclin E1 expression and malignancy in meningiomas(2020) PEREIRA, Benedito Jamilson Araujo; SANTANA JUNIOR, Pedro Augustto de; ALMEIDA, Antonio Nogueira de; CAVALCANTE, Stella Goncalves; MELO, Keyde Cristina Martins de; AGUIAR, Paulo Henrique Pires de; PAIVA, Wellingson da Silva; OBA-SHINJO, Sueli Mieko; MARIE, Suely Kazue NagahashiObjective: The aim of the present study was to analyze if the pathway Skp2-p27-cyclin El could also be a tumor progression marker for meningiomas. Patients and methods: We used quantitative real-time PCR to assess the relative expression levels of the genes coding for cyclin El (CCNE1), Skp2 (SKP2), and p27 (P27). The expression levels were compared in grades Ito III meningiomas and among different histological subtypes of grade I meningiomas. Results: Anaplastic meningiomas accounted for 4.9%, atypical meningiomas for 23.5% and grade I meningiomas for 71.6%.CCNE1 expression level was significantly higher in grade II compared to grade I meningiomas (p = 0.0027), and its expression level reliably predicts grade II meningiomas (ROC AUC = 0.731, p = 0.003). CCNE1 expression also correlated with SKP2 and P27 expression levels in grade I meningiomas (r = 0.539, p < 0.0001 and r = 0.687, p = < 0.0001, respectively for CCNE1/SKP2 and CCNE1/P27, Spearman's test). Fibrous subtype among grade I meningiomas presented the highest expression levels of CCNE1, SKP2 and P27. Higher expression of cyclin El protein was detected in the nuclei of atypical meningiomas compared to grade I meningiomas. Conclusions: CCNE1 expression level predicts meningioma malignancy, and the fibrous subtype presents the highest gene expression levels among grade I meningiomas.
- Assessment of selected quality fields of nursing care in neurosurgical wards(2015) VIEIRA, Rita Cassia; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson Silva
- Prediction of Early TBI Mortality Using a Machine Learning Approach in a LMIC Population(2020) AMORIM, Robson Luis; OLIVEIRA, Louise Makarem; MALBOUISSON, Luis Marcelo; NAGUMO, Marcia Mitie; SIMOES, Marcela; MIRANDA, Leandro; BOR-SENG-SHU, Edson; BEER-FURLAN, Andre; ANDRADE, Almir Ferreira De; RUBIANO, Andres M.; TEIXEIRA, Manoel Jacobsen; KOLIAS, Angelos G.; PAIVA, Wellingson SilvaBackground: In a time when the incidence of severe traumatic brain injury (TBI) is increasing in low- to middle-income countries (LMICs), it is important to understand the behavior of predictive variables in an LMIC's population. There are few previous attempts to generate prediction models for TBI outcomes from local data in LMICs. Our study aim is to design and compare a series of predictive models for mortality on a new cohort in TBI patients in Brazil using Machine Learning. Methods: A prospective registry was set in Sao Paulo, Brazil, enrolling all patients with a diagnosis of TBI that require admission to the intensive care unit. We evaluated the following predictors: gender, age, pupil reactivity at admission, Glasgow Coma Scale (GCS), presence of hypoxia and hypotension, computed tomography findings, trauma severity score, and laboratory results. Results: Overall mortality at 14 days was 22.8%. Models had a high prediction performance, with the best prediction for overall mortality achieved through Naive Bayes (area under the curve = 0.906). The most significant predictors were the GCS at admission and prehospital GCS, age, and pupil reaction. When predicting the length of stay at the intensive care unit, the Conditional Inference Tree model had the best performance (root mean square error = 1.011), with the most important variable across all models being the GCS at scene. Conclusions: Models for early mortality and hospital length of stay using Machine Learning can achieve high performance when based on registry data even in LMICs. These models have the potential to inform treatment decisions and counsel family members.
- Posttraumatic epilepsy: current and emerging treatment options(2014) PAIVA, Wellingson Silva; MELLO, Luiz Eugenio