FERNANDO MENDES PASCHOAL JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina
23 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 23
conferenceObject Using color flow image to identify brain vessels during metastasis approach(2014) PASCHOAL JR., F. Mendes; OLIVEIRA, M. L. de; PICARELLI, H.; AZEVEDO, M. K.; LIMA, S. B.; BASTOS, M. F.; RIBAS, E. S. C.; TEIXEIRA, M. J.; BOR-SENG-SHU, E.- Transcranial Doppler: A Useful Tool to Predict Brain Death Still Not Confirmed by Clinical Assessment(2021) RONCONI, Karla de Almeida Lins; AMORIM, Robson Luis Oliveira de; JR, Fernando Mendes Paschoal; OLIVEIRA, Marcelo de Lima; NOGUEIRA, Ricardo de Carvalho; PAIVA, Wellingson Silva; GONCALVES, Daniel Buzaglo; FARIAS, Stephanie Ramos de; BRASIL, Sergio Paulo; TEIXEIRA, Manoel Jacobsen; BOR-SENG-SHU, EdsonBackground. Diagnosing brain death (BD) with accuracy and urgency is of great importance because an early diagnosis may guide the clinical management, optimize hospital beds, and facilitate organ transplantation. The clinical diagnosis of nonreactive and irreversible coma can be confirmed with additional tests. Among the complimentary exams that may testify brain circulatory arrest, transcranial Doppler (TCD) can be an option. It is a real-time, bedside, inexpensive, noninvasive method that assesses cerebral blood flow. In patients with suspected BD, especially those who are under sedative drugs, early diagnosis is imperative. The aim of the present study was to evaluate the role of TCD in predicting BD. Methods. One hundred consecutive comatose patients with a Glasgow Coma Scale score of less than 5, owing to different etiologies, were included. TCD was performed in all patients. The TCD operator was blinded for clinical and neurologic data. This study is in compliance with the Declaration of Helsinki. Results. Sixty-nine patients with TCD-brain circulatory collapse were diagnosed later with BD. Of the 31 patients with brain circulatory activity, 8 (25.8%) were clinically brain dead and 23 (74.2%) were alive. TCD showing brain circulatory collapse had a sensitivity of 89.6%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 74.2%. Conclusion. TCD is highly specific (100%) and sensitive (89.6%) as a method to confirm the clinical diagnosis of BD, even in patients under sedation. The possibility of patients presenting with cerebral circulatory activity and clinical diagnosis of BD was demonstrated to occur.
- Relationship between endothelial nitric oxide synthase (eNOS) and natural history of intracranial aneurysms: meta-analysis(2018) PASCHOAL, Eric Homero Albuquerque; YAMAKI, Vitor Nagai; TEIXEIRA, Renan Kleber Costa; PASCHOAL JUNIOR, Fernando Mendes; JONG-A-LIEM, Glaucia Suzanna; TEIXEIRA, Manoel Jacobsen; YAMADA, Elizabeth Sumi; RIBEIRO-DOS-SANTOS, Andrea; BOR-SENG-SHU, EdsonThe aneurysmal subarachnoid hemorrhage is a major public health problem described as a sudden drastic event with no warning symptoms and high morbidity and mortality rates. The role of the endothelial isoform of nitric oxide synthase gene polymorphism in intracranial aneurysms (IAs) is still a matter of controversy with divergent findings among European, American, and Asian populations. Our study purposed to test the association between intracranial aneurysms formation and nitric oxide gene polymorphisms through a systematic review and meta-analysis. Systematic search on Medline, Lilacs, and EMBASE was performed. The primary search resulted in 139 papers, out of which 9 met our inclusion criteria after a full text analysis. The dominant T786C model found a significant association with IA (OR 1.22, 95 % CI 1.04-1.44, p = 0.01), so did studies of the recessive T786C model (OR 0.37, 95 % CI 0.30-0.45, p < 0.0001) but with opposite effect. Our findings support the presence of the T786C polymorphism as a predictor for the development of intracranial aneurysm in the cerebral vascular system. More studies are necessary in order to elucidate the pathways of the endothelial nitric oxide synthase (eNOS) in cerebrovascular diseases and in defining how different allelic combinations of the eNOS gene single-nucleotide polymorphism (SNP) could favor this pathological process.
- Neck paraganglioma: Head rotation maneuver on transcranial Doppler ultrasonography(2015) PASCHOAL, Fernando Mendes; PASCHOAL, Eric Homero Albuquerque; ROGERIO, Ricardo Mendes; TEIXEIRA, Manoel Jacobsen; BOR-SENG-SHU, Edson
conferenceObject Severity of restless legs syndrome is inversely correlated with echogenicity of the substantia nigra in different neurodegenerative movement disorders: A preliminary observation(2014) PASCHOAL JR., F. Mendes; ALMEIDA, K. J.; PEDROSO, J. L.; OLIVEIRA, M. L. de; FERRRAZ, H. B.; BARSOTINE, O.; TEIXEIRA, M. J.; BOR-SENG-SHU, E.- Cerebral hemodynamic and metabolic changes in fulminant hepatic failure(2017) PASCHOAL JUNIOR, Fernando Mendes; NOGUEIRA, Ricardo de Carvalho; OLIVEIRA, Marcelo de Lima; PASCHOAL, Eric Homero Albuquerque; TEIXEIRA, Manoel Jacobsen; D'ALBUQUERQUE, Luiz Augusto Carneiro; BOR-SENG-SHU, EdsonIntracranial hypertension and brain swelling are a major cause of morbidity and mortality of patients suffering from fulminant hepatic failure (FHF). The pathogenesis of these complications has been investigated in man, in experimental models and in isolated cell systems. Currently, the mechanism underlying cerebral edema and intracranial hypertension in the presence of FHF is multi-factorial in etiology and only partially understood. The aim of this paper is to review the pathophysiology of cerebral hemodynamic and metabolism changes in FHF in order to improve understanding of intracranial dynamics complication in FHF.
- Detection of Cerebral Vasculopathy by Transcranial Doppler in Children With Neurofibromatosis Type 1(2016) PASCHOAL, Joelma Karin Sagica Fernandes; PASCHOAL JR., Fernando Mendes; LIMA, Fernanda Teresa de; PINHO, Ricardo Silva; VILANOVA, Luiz Celso Pereira; BOR-SENG-SHU, Edson; MASRUHA, Marcelo RodriguesNeurofibromatosis type 1 is characterized by nerve sheath neurofibromas associated with a number of additional clinical features, including cerebrovascular disease. The aim of this study was to use transcranial Doppler as a screening method for identifying cerebral vasculopathy in children with neurofibromatosis type 1. Forty children with neurofibromatosis type 1, aged 5 to 18 years old, were examined by transcranial Doppler. Patients presenting with hemodynamic features of arterial stenosis/occlusion on transcranial Doppler underwent magnetic resonance angiography to confirm the findings. Magnetic resonance angiography was performed on 4 children who exhibited a transcranial Doppler hemodynamic pattern indicative of cerebral vasculopathy. Among these cases, 2 presented internal carotid artery stenosis/occlusion, 1 had bilateral middle cerebral artery stenosis, and 1 presented a normal magnetic resonance angiography result. Transcranial Doppler can be used routinely in the investigation of cerebrovascular disease in neurofibromatosis type 1 patients, where magnetic resonance angiography can be subsequently applied to confirm the diagnosis, further contributing to the prevention of cerebrovascular events.
- Decompressive Craniectomy for Traumatic Brain Injury: Postoperative TCD Cerebral Hemodynamic Evaluation(2019) BOR-SENG-SHU, Edson; DE-LIMA-OLIVEIRA, Marcelo; NOGUEIRA, Ricardo Carvalho; ALMEIDA, Kelson James; PASCHOAL, Eric Homero Albuquerque; PASCHOAL JR., Fernando MendesBackground: There are no studies describing the cerebral hemodynamic patterns that can occur in traumatic brain injury (TBI) patients following decompressive craniectomy (DC). Such data have potentially clinical importance for guiding the treatment. The objective of this study was to investigate the postoperative cerebral hemodynamic patterns, using transcranial Doppler (TCD) ultrasonography, in patients who underwent DC. The relationship between the cerebral circulatory patterns and the patients' outcome was also analyzed. Methods: Nineteen TBI patients with uncontrolled brain swelling were prospectively studied. Cerebral blood circulation was evaluated by TCD ultrasonography. Patients and their cerebral hemispheres were categorized based on TCD-hemodynamic patterns. The data were correlated with neurological status, midline shift on CT scan, and Glasgow outcome scale scores at 6 months after injury. Results: Different cerebral hemodynamic patterns were observed. One patient (5.3%) presented with cerebral oligoemia, 4 patients (21%) with cerebral hyperemia, and 3 patients (15.8%) with cerebral vasospasm. One patient (5.3%) had hyperemia in one cerebral hemisphere and vasospasm in the other hemisphere. Ten patients (52.6%) had nonspecific circulatory pattern. Abnormal TCD-circulatory patterns were found in 9 patients (47.4%). There was no association between TCD-cerebral hemodynamic findings and outcome. Conclusion: There is a wide heterogeneity of postoperative cerebral hemodynamic findings among TBI patients who underwent DC, including hemodynamic heterogeneity between their cerebral hemispheres. DC was proved to be effective for the treatment of cerebral oligoemia. Our data support the concept of heterogeneous nature of the pathophysiology of the TBI and suggest that DC as the sole treatment modality is insufficient.
conferenceObject CORRELATION BETWEEN CHANGES IN GREY AND WHITE MATTER RADIODENSITY WITH PROGNOSIS AFTER CRANIOPLASTY(2014) OLIVEIRA, Arthur Maynart Pereira; AMORIM, Robson Luis Oliveira de; PAIVA, Wellingson Silva; ANDRADE, Almir Ferreira de; PASCHOAL JUNIOR, Fernando Mendes; BOR-SENG-SHU, Edson; COELHO, Fernanda; GATTAS, Gabriel Scarabotolo; ANGHINAH, Renato; TEIXEIRA, Manoel JacobsenbookPart Doenças Vasculares(2017) PASCHOAL, Joelma Karin Sagica Fernandes; JúNIOR, Fernando Mendes Paschoal; AMARAL, Lázaro Luís Faria do; CAMPOS, Christiane Monteiro de Siqueira
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