ANDRE OLIVEIRA PAGGIARO
Índice h a partir de 2011
4
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
LIM/04 - Laboratório de Microcirurgia, Hospital das Clínicas, Faculdade de Medicina
14 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 14
- Evaluation of Radiosterilized Glyercerolated Amniotic Membranes as a Substrate for Cultured Human Epithelial Cells(2020) PAGGIARO, Andre O.; MATHOR, Monica B.; TEODORO, Walcy R.; ISAAC, Cesar; CAPELOZZI, Vera L.; GEMPERLI, RolfHuman amniotic membrane (HAM) is a biomaterial with biological properties beneficial to tissue repair, serving as a substrate for cell cultivation. Irradiation is used for tissue sterilization, but can damage the HAM structure. The objective of this paper was to construct a skin substitute, composed of human keratinocytes cultured on glycerolated HAMs, and to evaluate the influence radiation on subsequent cell culture growth. Four batches of HAMs were glycerolated, and half of them were radio-sterilzed with 25 kGy. Non-irradiated glycerolated HAM (ni-HAM) and irradiated glycerolated HAM (i-HAM) samples were then de-epithelized and analyzed using optical microscopy (Picrossirius staining), immunofluorescence and electron microscopy. Subsequently, keratinocytes were cultured on ni- and i-HAMs, and either immersed or positioned at the air-liquid interface. The basement membranes of the ni-HAM group remained intact following de-epithelialization, whereas the i-HAM group displayed no evidence or remnant presence of these membranes. Concerning the keratinocyte cultures, the ni-HAM substrate promoted the growth of multi-layered and differentiated epithelia. Keratinocytes cultured on i-HAM formed epithelium composed of three layers of stratification and discrete cell differentiation. The glycerolated HAM was compatible with cultured epithelia, demonstrating its potential as a skin substitute. Irradiation at 25 kGy caused structural damage to the amnion.
- Estabelecimento de protocolo para armazenamento de pele autógena refrigerada(2017) CONCEIÇÃO, RENATA OLIVEIRA DA; PAGGIARO, ANDRÉ OLIVEIRA; POLO, EUGÊNIO FERRAMUNDO; MARTINES, KARINA; ISAAC, CESAR; CARVALHO, VIVIANE FERNANDES DE; GOMEZ, DAVID DE SOUZA; GEMPERLI, ROLFABSTRACT Introduction: Autologous skin grafts are used for treatment of burn patients. These grafts can be stored and preserved, as long as the storage process is performed with strict quality control to reduce the risk of infection. Methods: A retrospective cohort study was conducted in the Burn Unit of the Hospital das Clínicas de São Paulo from February 2015 to July 2016. During this period, a protocol was established to store refrigerated skin, with control of collection, preservation, and packaging, and recording of all processes. To ensure quality, graft biopsies were collected for preand poststorage microbiology testing and a cross-sectional study for contamination was performed. Results: Critical deficiencies included inadequate packaging, lack of processing records, lack of biopsies for microbiology testing, and failure to discard specimens. Most of the samples were contaminated before and after storage (84.2%). Only two samples were sterile before storage but became contaminated after storage, with growth of Gram-positive skin bacteria. Conclusion: A promising method for the storage of refrigerated skin was established, but requires minor adjustments in quality control.
conferenceObject POSITIVE EFFECTS OF MONOLAYER ELASTIC COMPRESSION IN PATIENTS WITH VENOUS ULCER IN PAIN AND SLEEP PATTERNS(2018) CARVALHO, Viviane; SZAMSZORYK, Michel; PAGGIARO, Andre O.- Posttraumatic stress disorder in burn patient: A systematic review(2022) PAGGIARO, Andre Oliveira; PAGGIARO, Patricia Bergantin Soares; FERNANDES, Rosa Aurea Quintela; FREITAS, Noelle Oliveira; CARVALHO, Viviane Fernandes; GEMPERLI, RolfSummary Introduction: Burns often cause severe physical and mental suffering and can become a trigger for the development of permanent psychological diseases, even after wound healing. Posttraumatic stress disorder (PTSD) is one such disorder, which involves the reexperiencing of many symptoms provoked by a previous traumatic situation. Method: This study is a systematic review of interventions used to reduce or prevent PTSD symptoms in burn victims. We included randomized clinical trials that described therapeutic interventions for the prevention of PTSD in burn patients. The search was conducted in the databases EMBASE and PUBMED/Medline between 2009 and 2020, and the main variables evaluated were%TBSA, age, number of hospitalization days, type of intervention, follow-up time and results. The analysis of the bias risk was carried out according to the guidance in the Cochrane Handbook for Bias Risk Assessment. Results: Eight clinical trials were selected: three of them were performed in children, and five involved adults. The most common bias risks were related to participant/researcher blinding and loss of follow-up. Two interventions were identified: a pharmacological intervention and a psychological intervention. Medications (sertraline and propanolol) were not effective in reducing stress symptoms. Four studies used cognitive-behavioral therapies, which achieved the best results for PTSD improvement in burn patients. Hypnosis and an informational education program were also evaluated and did not show success in reducing PTSD.
- Clinical Trial Comparing 3 Different Wound Dressings for the Management of Partial-Thickness Skin Graft Donor Sites(2011) CARVALHO, Viviane Fernandes de; PAGGIARO, Andre Oliveira; ISAAC, Cesar; GRINGLAS, Julio; FERREIRA, Marcus CastroPURPOSE: A review of the literature reveals a lack of consensus regarding local management of skin graft donor sites. This study was undertaken to determine the effects of 3 different dressings on healing of donor sites and patient discomfort related to donor sites. DESIGN: This study is a comparison cohort study. SUBJECTS AND SETTING: We recruited 34 burn patients scheduled for partial-thickness skin grafts; their mean age was 36 +/- 18 years (mean +/- SD, range 20 to 54 years), and 63% were male. All subjects were managed at Burn Unity Care, located in Sao Paulo, Brazil. MATERIALS AND METHODS: Subjects were randomly allocated to 1 of 3 groups: (1) a study group (group A) whose donor sites were dressed with a bovine collagen calcium-alginate dressing covered with transparent polyurethane film; (2) a second intervention group (group B), whose donor sites were dressed only with transparent polyurethane film dressing; and (3) a control group whose donor sites were dressed with rayon soaked in 0.9% saline (group C). Two independent observers assessed donor site wounds for epithelialization, scabbing, quantity and characteristics of exudate, and complications. Pain was measured using the visual analog scale, the brief pain inventory, and Index of Pain Management. RESULTS: Subjects managed with the bovine collagen calcium-alginate dressing covered with transparent polyurethane film (group A) achieved the greatest epithelialization (6.3 vs 8.2 for thin film dressing only P < .02 and 6.3 vs 11.7 days for control group P < .01). Patients managed with the bovine collagen calcium-alginate dressing covered with transparent polyurethane film also reported less pain that subjects allocated to the control (group C) or thin film only group (group B), (P < .05). Ninety percent of subjects allocated to the calcium alginate covered with thin film dressing reported mild pain intensity on the Visual Analog Scale, 85% of did not report pain localized to the donor site on the brief pain inventory, and scores on the Index of Pain Management ranged from 23 to 11. CONCLUSION: Study findings suggest that use of a collagen calcium-alginate dressing with a transparent film covering reduces the time for complete epithelialization and may reduce pain related to skin graft donor sites.
- Construção de substituto da pele composto por matriz de colágeno porcino povoada por fibroblastos dérmicos e queratinócitos humanos: avaliação histológica(2012) ISAAC, Cesar; REGO, Francinni M. P.; LADEIR, Pedro Ribeiro Soares de; ALTRAM, Silvana C.; OLIVEIRA, Renata C. de; ALDUNATE, Johnny L. C. B.; PAGGIARO, André O.; FERREIRA, Marcus CastroBACKGROUND: In the case of extensive lesions, the use of autologous grafts is limited by the extent of the donor area and the clinical condition of patients. Allografts collected from cadavers or volunteers are usually rejected after 1 to 2 weeks, thus serving only as temporary cover for these lesions. Treating major cutaneous lesions with reconstructed autologous skin is an attractive alternative, because it is possible to obtain cultures of cells that multiply rapidly and can be cryopreserved from a small fragment of the patient's skin, thereby facilitating its indefinite use in new treatments. This study evaluated the histological behavior of cultured human keratinocytes and fibroblasts on a collagen matrix derived from porcine small intestinal submucosa. METHODS: Cells from human epidermis and dermis were grown separately and seeded on porcine collagen matrix, which was maintained in a controlled environment for 21 days before being subjected to histological analysis. RESULTS: Fibroblasts invaded and colonized the collagen matrix, whereas keratinocytes were organized in laminated and stratified layers on the surface on which they were seeded. CONCLUSIONS: The use of porcine collagen matrix as a support for human skin cells is feasible, and the organization of these cells resembles the architecture of human skin.
- COVID-19 and risk management in a tissue bank(2020) PAGGIARO, Andre Oliveira; CONCEICAO, Renata Oliveira; BIANCHI, Mariana Parra; GEMPERLI, Rolf
conferenceObject DEVELOPMENT OF A BIOLOGIC DRESSING FOR THE TREATMENT OF SKIN ULCERS ASSOCIATED TO HLA CLASS I DEFICIENCY(2012) MORAES-VASCONCELOS, D.; PAGGIARO, A. O.; ISAAC, C.; RIBEIRO, R. L.; NICODEMO, A. C.Human leukocyte antigen class I (HLA-I) deficiency is a rare disease (less than 30 reported cases in the world) with remarkable clinical and biological heterogeneity. It presents a 90-99% reduction reduction in the expression of HLA-I molecules. This syndrome is caused by defects in TAP-1, TAP-2 and Tapasin (MIM 604571). Although asymptomatic cases have been described, HLA-I deficiencies are usually characterized by chronic bacterial infections of the upper and lower airways, evolving to bronchiectasis, and also necrotizing granulomatous skin lesions. Treatment is addressed to controlling infections. Early and prolonged use of antibiotics should be performed at the first sign of infection. Some patients have benefited from immunoglobulin therapy. The lack of adequate treatments for the cure of disease associated with the fact we do not have as well effective therapy for the necrotizing granulomatous lesions of the skin, directed us to look for alternatives for the treatment of these recalcitrant and disabling injuries. Considering the necessity of developing new skin substitutes for the treatment of major tissue loss in patients with deficiencies of MHC class I with large granulation tissue areas, it is proposed in this study the in vivo use of biological dressings made of denuded amniotic membranes as a substrate for the growth of a epidermal layer formed by keratinocytes of the patients, allowing the growth of epithelia from the recalcitrant wounds of granulomatous lesions presented by people with MHC class I deficiency.- Análise do atendimento clínico de portadores de úlceras crônicas em membros inferiores(2015) AGUIAR JR, ARMANDO COSTA; ISAAC, CESAR; NICOLOSI, JULIA TEIXEIRA; MEDEIROS, MARIO MUCIO MAIA DE; PAGGIARO, ANDRÉ OLIVEIRA; GEMPERLI, ROLFABSTRACT Introduction: Chronic ulcers of the lower limbs may have different etiologies, with the most frequent being venous, arterial, traumatic, infectious, and diabetic. The treatment of these wounds is dynamic and depends on the evolution of tissue repair. This treatment includes clinical and surgical methods, and dressings are the most frequently used. Dressings can range from inert covers to vehicles for actuation of active substances in the wound bed. The main indication for these substances is related to the effects of debridement and control of the bacterial population, enabling the preparation of wound beds for surgical or spontaneous resolution. Methods: This study is an observational, cross-sectional, retrospective study, with random sampling, aimed at assessing the care provided to patients with chronic ulcers of the lower limbs in the Outpatient Clinic for chronic wounds of the Plastic Surgery Division, HCFMUSP, between 2011 and 2013. Results: The clinical charts of 481 patients of both sexes, with a mean age 60 years, were analyzed; all had chronic ulcers in different stages of evolution. Comorbidities, underlying disease, size of the lesion, treatments, and evolution of wounds were evaluated. A predominance of vascular disease (69.2%) was the underlying cause. All patients were initially treated with dressings containing active agents, for preparation of the wound bed. Of these, 84% were referred for surgical management of wounds. There was no spontaneous closure in 1.5% of cases. The remaining patients (14.5%) showed worsening of lesions with topical treatment, and required other forms of preparation of the wound bed. Conclusion: Topical agents may be an effective outpatient/home method to prepare the wound bed of chronic ulcers for surgical management.
- Evaluation of the evidence level for the use of radiofrequency in aesthetic treatments: A systematic review and meta-analysis(2021) PAGGIARO, Andre Oliveira; PINHEIRO, Rafael; SOARES, Kaolanna; CARVALHO, Viviane Fernandes; GEMPERLI, RolfBackground Radiofrequency (RF) is a non-invasive or minimally invasive procedure with a low risk of complications. It has been employed for several aesthetic purposes. Aim This study aimed to conduct a systematic literature review on the use of RF for aesthetic applications and assess the level of accumulated evidence for each condition. Methods Using the MEDLINE/PubMed and EMBASE databases, we searched for articles published from 2009 to 2019 describing the use of RF treatment for aesthetic purposes. Results Our search approach identified 25 randomized clinical trials investigating the efficacy of RF in the following clinical situations: body contour improvement, facial rejuvenation, acne scar treatment, alopecia, and rosacea. There were problems with the quality of the studies, especially regarding selection, performance, and detection bias. Conclusion Our study revealed that RF treatment is potentially promising in all of the evaluated clinical situations; however, we were not able to identify a level of evidence that justifies its use over other therapeutic options currently available on the market.