LEONARDO ZUMERKORN PIPEK
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Instrument to evaluate the knowledge of patient with cirrhosis on his disease: construction and validity(2021) STELMACH, Mariana; MEDEIROS, Kayo Augusto de Almeida; CARVALHO, Barbara Justo; PIPEK, Leonardo Zumerkorn; MESQUITA, Gustavo Heluani Antunes de; NII, Fernanda; MARTINES, Diego Ramos; IUAMOTO, Leandro Ryuchi; D'ALBUQUERQUE, Luiz Augusto Carneiro; MEYER, Alberto; ANDRAUS, WellingtonBackgroundThe application of measurement instruments is a strategy to evaluate the patient's knowledge about the disease. This study aims to build an instrument that evaluates the patient's knowledge about liver cirrhosis.MethodThis study includes three phases. The first one was the construction of the instrument based on a literature review. In the second phase, five experts were participated in the evaluation of the instrument, to check the validity of the content. Quantitative and qualitative analyzes were made. The tool used was the CVI (Content Validity Index) and it was used the semantic study of the questions. The third phase was the process of the restructuring the instrument.ResultsThe final version of the instrument consisted of 36 questions. The instrument was evaluated in 91.7 by the average CVI and 94.4% by the universal CVI.ConclusionsThe questions are properly structured and clear, therefore, understandable. Thus, the final instrument presented satisfactory content validity, so that, it reached the aim of this study.
- Comparison of SpO(2) and heart rate values on Apple Watch and conventional commercial oximeters devices in patients with lung disease(2021) PIPEK, Leonardo Zumerkorn; NASCIMENTO, Rafaela Farias Vidigal; ACENCIO, Milena Marques Pagliarelli; TEIXEIRA, Lisete RibeiroLung diseases have high mortality and morbidity, with an important impact on quality of life. Hypoxemic patients are advised to use oxygen therapy to prolong their survival, but high oxygen saturation (SpO(2)) levels can also have negative effects. Pulse oximeters are the most common way to assess oxygen levels and guide medical treatment. This study aims to assess whether wearable devices can provide precise SpO(2) measurements when compared to commercial pulse oximeters. This is a cross-section study with 100 patients with chronic obstructive pulmonary disease and interstitial lung disease from an outpatient pneumology clinic. SpO(2) and heart rate data were collected with an Apple Watch Series 6 (Apple) and compared to two commercial pulse oximeters. The Bland-Altman method and interclass correlation coefficient were used to compare their values. We observed strong positive correlations between the Apple Watch device and commercial oximeters when evaluating heart rate measurements (r = 0.995, p < 0.001) and oximetry measurements (r = 0.81, p < 0.001). There was no statistical difference in the evaluation of skin color, wrist circumference, presence of wrist hair, and enamel nail for SpO(2) and heart rate measurements in Apple Watch or commercial oximeter devices (p > 0.05). Apple Watch 6 is a reliable way to obtain heart rate and SpO(2) in patients with lung diseases in a controlled environment.
- Effects of ingested nanomaterials on tissue distribution of co-ingested zinc and iron in normal and zinc-deficient mice(2021) GONCALVES, Johnatan P.; PIPEK, Leonardo Z.; DONAGHEY, Thomas C.; DELOID, Glen M.; DEMOKRITOU, Philip; BRAIN, Joseph D.; MOLINA, Ramon M.Cellulose nanofibers (CNF) reduced serum triglyceride levels in rats when co-administered with heavy cream by gavage. Do CNF and other nanomaterials (NMs) alter the tissue distribution and retention of co-administered metal ions? We evaluated whether 5 different NMs affected tissue distribution of co-ingested Zn-65(++) and Fe-59(+++) in zinc-replete versus zinc-deficient mice. Male C57BL/6J mice were fed either zinc-replete or zinc-deficient diets for 3 weeks, followed by gavage with NM suspensions in water containing both (ZnCl2)-Zn-65 and (FeCl3)-Fe-59. Urine and feces were measured for 48 h post-gavage. Mice were euthanized and samples of 22 tissues were collected and analyzed for Zn-65 and Fe-59 in a gamma counter. Our data show that zinc deficiency alters the tissue distribution of Zn-65 but not of Fe-59, indicating that zinc and iron homeostasis are regulated by distinct mechanisms. Among the tested NMs, soluble starch-coated chitosan nanoparticles, cellulose nanocrystals, and TiO2 reduced Zn and Fe tissue retention in zinc-deficient but not in zinc-replete animals.
- Change in neoadjuvant chemotherapy could alter the prognosis of patients with pancreatic adenocarcinoma: A case report(2021) MEYER, Alberto; CARVALHO, Barbara J.; MEDEIROS, Kayo A. A.; PIPEK, Leonardo Z.; NASCIMENTO, Fernanda S.; SUZUKI, Milena O.; MUNHOZ, Joao V. T.; IUAMOTO, Leandro R.; CARNEIRO-D'ALBURQUERQUE, Luiz A.; ANDRAUS, WellingtonBACKGROUND Neoadjuvant treatment has become a standard of care for borderline or locally advanced pancreatic cancer and is increasingly considered even for up-front resectable disease. The aim of this article is to present the case of a 62-year-old patient with locally advanced pancreatic adenocarcinoma who was successfully treated with gemcitabine plus nab-paclitaxel after the failure of the first line treatment. CASE SUMMARY Computerized tomography scan and magnetic resonance imaging demonstrated a nodular lesion of ill-defined limits in the body of the pancreas, measuring approximately 4.2 cm x 2.7 cm, with an infiltrative aspect. The tumor had contact with the superior mesenteric vein, splenomesenteric junction and the proximal segment of the splenic artery, causing focal reduction of its lumens. Due to vascular involvement, neoadjuvant chemotherapy treatment with eight cycles of ""folinic acid, 5-fluorouracil, irinotecan and oxaliplatine"" (FOLFIRINOX) were performed. At the end of the cycles, surgery was performed, but the procedure was interrupted due to finding of lesions suspected of metastasis. Gemcitabine plus nab-paclitaxel was then successfully used for neoadjuvant treatment with subsequent R0 surgical resection. CONCLUSION Gemcitabine plus nab-paclitaxel may be effective as an alternative regimen when FOLFIRINOX fails as the first line of treatment, suggesting the need for further studies to identify which patients would benefit from each type of therapeutic approach.
- Inflammatory markers assessment in an animal model of intracranial hypertension: a randomized trial(2021) SANTO, Marcelo Prudente do Espirito; FARIA, Caroline Silverio; SOLLA, Davi Jorge Fontoura; PIPEK, Leonardo Zumerkorn; BELON, Alessandro Rodrigo; JENG, Brasil Ping; ANDRADE, Almir Ferreira de; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson SilvaBackground: Intracranial hypertension (ICH) is a common final pathway of most neurosurgical pathologies and leads to poor prognosis if not detected and treated properly. Inflammatory markers have been assessed in clinical scenarios of neurological injuries, in which systemic and brain tissue aggressions may introduce bias. There is a lack of studies under controlled settings to isolate the ICH effect on inflammation. This study aims to evaluate the effects of ICH on the serum concentration of cytokines as biomarkers of neuroinflammation in an experimental model which isolates ICH from potential confounding variables. Methods: An established model of ICH using an intracerebral pediatric bladder catheter and a multisensor intraparenchymal catheter was used in adult pigs (Sus domesticus). The animals were randomly allocated to 2 groups based on the catheter balloon volume used to simulate the ICP increase (4 ml or 7 ml). Cytokines were measured in 4 timepoints during the experiment: (1) 15 min before balloon insufflation; (2) 5 min after insufflation; (3) 125 min after insufflation; (4) 60 min after deflation. The following cytokines were measured IL-1 alpha; IL-1 beta; IL-1ra; IL-2; IL-4; IL-6; IL-8; IL-10; IL-12; IL-18; TNFa. Generalized estimating equations were modeled to compare the ICP and cytokines values between the groups along the experiment. The study sample size was powered to detect interactions between the groups and the study moments with an effect size (f) of at least 0.3. The ARRIVE checklist was followed. Results: A total of 20 animals were studied (10 in each group, 4 ml or 7 ml balloon volume insufflation). The animal model was successful in increasing the ICP along the moments of the experiment (p < 0,001) and in creating an ICP gradient between the groups (p = 0,004). The interaction term (moment x group) was also significant (p < 0,001). There was a significant association between ICP elevation and most cytokines variation. The cytokines IL-1 alpha, IL-1 beta, IL1-ra, IL-6, IL-12, and IL-18 increased, whereas IL-2, IL-4, and TNF-alpha decreased. IL-10 did not vary significantly in response to the ICP elevation. Conclusion: The serum concentration of cytokines varied in response to intracranial hypertension. The study demonstrated the specific changes in each cytokine afterintracranial hypertension and provides key information to guide neuroinflammation clinical research. The proposed experiment was successful as an animal model to the study of neuroinflammation biomarkers.
- The development of laparoscopic skills using virtual reality simulations: A systematic review(2021) TABA, Joao Victor; CORTEZ, Vitor Santos; MORAES, Walter Augusto; IUAMOTO, Leandro Ryuchi; HSING, Wu Tu; SUZUKI, Milena Oliveira; NASCIMENTO, Fernanda Sayuri do; PIPEK, Leonardo Zumerkorn; MATTOS, Vitoria Carneiro de; D'ALBUQUERQUE, Eugenia Carneiro; CARNEIRO-D'ALBUQUERQUE, Luiz Augusto; MEYER, Alberto; ANDRAUS, WellingtonBackground Teaching based on virtual reality simulators in medicine has expanded in recent years due to the limitations of more traditional methods, especially for surgical procedures such as laparoscopy. Purpose of review To analyze the effects of using virtual reality simulations on the development of laparoscopic skills in medical students and physicians. Data sources The literature screening was done in April 2020 through Medline (PubMed), EMBASE and Database of the National Institute of Health. Eligibility criteria Randomized clinical trials that subjected medical students and physicians to training in laparoscopic skills in virtual reality simulators. Study appraisal Paired reviewers independently identified 1529 articles and included 7 trials that met the eligibility criteria. Findings In all studies, participants that trained in virtual simulators showed improvements in laparoscopic skills, although the articles that also had a physical model training group did not show better performance of one model compared to the other. Limitations No article beyond 2015 met the eligibility criteria, and the analyzed simulators have different versions and models, which might impact the results. Conclusion Virtual reality simulators are useful educational tools, but do not show proven significant advantages over traditional models. The lack of standardization and a scarcity of articles makes comparative analysis between simulators difficult, requiring more research in the area, according to the model suggested in this review.
- The Development of Feeding and Eating Disorders after Bariatric Surgery: A Systematic Review and Meta-Analysis(2021) TABA, Joao Victor; SUZUKI, Milena Oliveira; NASCIMENTO, Fernanda Sayuri do; IUAMOTO, Leandro Ryuchi; HSING, Wu Tu; PIPEK, Leonardo Zumerkorn; CARNEIRO-D'ALBUQUERQUE, Luiz Augusto; MEYER, Alberto; ANDRAUS, WellingtonBackground: Patients in the postoperative period following bariatric surgery are at risk of developing eating disorders. This study aims to analyze the relation between bariatric surgery and the development and recurrence of eating disorders. Material and methods: A literature review was carried out on 15 November 2020. Fourteen studies that met the eligibility criteria were included for qualitative synthesis, and 7 studies for meta-analysis. Results: The prevalence of eating disorders in the postoperative period was 7.83%, based on the 7 studies in the meta-analysis. Binge eating disorder alone was 3.81%, which was the most significant factor, and addressed in 6 of these studies. Conclusion: The investigated studies have significant methodological limitations in assessing the relation between bariatric surgery and eating disorders, since they mostly present data on prevalence. PROSPERO CRD42019135614.