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
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
- 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.
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.
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.- 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.
conferenceObject EVALUATION OF CUTANEOUS SENSIBILITY THRESHOLD ON THE FEET OF DIABETIC PATIENTS WITH THE SPECIFIED SENSORY DEVICE(2018) CARVALHO, Viviane; SANTOS, Vera Lucia Conceicao de Gouveia; PAGGIARO, Andre O.bookPart Queimaduras(2023) PAGGIARO, André Oliveira- Educational interventions on preventing pressure injuries targeted at nurses: systematic review and meta-analysis(2023) KITAMURA, J. C.; NICOLOSI, J. T.; PAGGIARO, A. O.; CARVALHO, V. F. deBackground: Although preventable, pressure injuries are commonly observed in the hospital setting and are estimated to be the third most costly condition, after cancer and cardiovascular disease. Aim: Nurses play a crucial role in the prevention and management of pressure injuries, however, published evidence on the effectiveness of educational interventions, directed specifically at nurses in the hospital environment, is scarce. Method: The authors retrieved published studies on the subject from selected databases (Pubmed/Medline, Embase, Web of Science and the Cochrane Library) in a number of languages (Portuguese, English, French and Spanish). The search yielded randomised controlled trials, as well as quasi-experimental and comparative studies. Findings: In total, 11 studies were selected. The outcomes analysed, following some type of educational intervention, included the attitudes and knowledge of the nursing professionals, as well as the incidence of pressure injuries. Conclusion: The present study demonstrated that different educational strategies can help prevent pressure injuries in the hospital environment.
- Effect of different human tissue processing techniques on SARS-CoV-2 inactivation-review(2021) PAGGIARO, Andre Oliveira; CARVALHO, Viviane Fernandes; GEMPERLI, RolfThe safety of the tissue transplant recipient is a top priority for tissue banks, and the emergence of the new coronavirus SARS-CoV-2 has raised significant concerns about the risks of releasing tissue for clinical use. In the present study, we conducted a literature review about the potential infectivity of SARS-CoV-2 in different biological tissues and the influence of various tissue processing and sterilization procedures on viral inactivation. The search revealed that SARS-CoV-2 binds to the human angiotensin-converting enzyme receptor to penetrate human cells. These receptors are present in skin cells, musculoskeletal tissue, amniotic membranes, cardiovascular tissue and ocular tissues, including the cornea. In general, we found that coronaviruses are stable at low temperatures, and inactivated upon exposure to extreme heat and pH. Notably, gamma irradiation, which has already been employed to inactivate SARS and MERS, could be useful for sterilizing skin, amnion and musculoskeletal tissues against SARS-CoV-2. We conclude that due to the limited information about the effects of physical and chemical tissue processing methods on viral neutralization, rigorous donor screening is still essential for tissue transplant recipient safety.