JOSE GUILHERME NOGUEIRA DA SILVA
Projetos de Pesquisa
Unidades Organizacionais
SVESAP-62, Hospital Universitário
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Potential of colonoscopy as a treatment for intussusception in children(2017) TAFNER, Edmar; TAFNER, Philipe; MITTLEDORF, Cornelius; PINHATA, Jose; SILVA, Ana Luisa; PILLI, Simone; SILVA, Jose Guilherme da; HASSEGAWA, Renato T.; MARUTA, Luis; CHRISTIANO, Celso; ANDRADA, LincolnBackground and study aims Invagination, which can occur in any part of the intestine, usually affects children and is the second most common cause of intestinal obstruction after pyloric stenosis. The cause of these intussusceptions in children is usually unknown and they typically occur within the ileocolic region. Management of pediatric patients with the condition often consists of surgical intervention. However, this retrospective study from the University Hospital of the University of Sao Paulo, Brazil, reports a series of cases of intussusception in children in whom a colonoscopy was used to reverse the intussusception. Patients and methods From April 2010 to January 2015, 30 pediatric patients underwent a colonoscopy as an noninvasive method for treatment of children's intestinal intussusception. Results Overall, treatment with colonoscopy was successful in reversing invagination in 66.7% of the patients. However, 33.3% of patients required surgery to resolve the intussusception. Conclusion Noninvasive colonoscopy is a potential treatment for intussusception in children.
- WHAT ARE THE MOST IMPORTANT FACTORS REGARDING ACCEPTANCE TO THE COLONOSCOPY?: Study of related tolerance parameters(2013) USSUI, Vivian Mayumi; SILVA, Ana Luiza Werneck da; BORGES, Luana Vilarinho; SILVA, José Guilherme Nogueira da; ZEITUNE, José Murilo Robilotta; HASHIMOTO, Cláudio LyoitiContext Colonoscopy plays an indubitable role in the setting of clinical practice, however, it is an invasive exam; complex, lengthy, embarrassing, not devoid of risks and discomfort that yields fear and anxiety in the majority of patients. In a new era of rising competition between health institutions, where the quality of health care and client satisfaction are praised, studies regarding tolerance-related colonoscopy issues yield great potential to be explored. In the present study, tolerance is defined as willingness to repeat the exam. Objectives Evaluate information associated to bowel preparation, the exam itself and post-examination period that might interfere with the tolerance to the colonoscopy. Methods Analysis of the tolerance to the colonoscopy at three stages (pre, post, and during) through a checklist: patient's questionnaire and a medical assessment form were used. Results In this present study, 91.2% of 373 patients exhibited positive tolerance to the colonoscopy. Aspects related to a negative level of tolerance were patient gender (12.9% of women versus 3.2% of men would not repeat the exam), age extremes (less than 20 years and greater than 80 years of age), and abdominal pain, both during the bowel preparation and after the procedure. Conclusions Gender, age, patient cooperation and abdominal pain were the decisive components regarding tolerance to the colonoscopy. Notably, in two phases of the exam, the abdominal pain was the most important feature associated to a lessened tolerance.
- Minimally Invasive Epicardial Pacemaker Implantation in Neonates with Congenital Heart Block(2017) COSTA, Roberto; SILVA, Katia Regina da; MARTINELLI FILHO, Martino; CARRILLO, RogerBackground: Few studies have characterized the surgical outcomes following epicardial pacemaker implantation in neonates with congenital complete atrioventricular block (CCAVB). Objective: This study sought to assess the long-term outcomes of a minimally invasive epicardial approach using a subxiphoid access for pacemaker implantation in neonates. Methods: Between July 2002 and February 2015,16 consecutive neonates underwent epicardial pacemaker implantation due to CCAVB. Among these, 12 (75.0%) had congenital heart defects associated with CCAVB. The patients had a mean age of 4.7 +/- 5.3 days and nine (56.3%) were female. Bipolar steroid-eluting epicardial leads were implanted in all patients through a minimally invasive subxiphoid approach and fixed on the diaphragmatic ventricular surface. The pulse generator was placed in an epigastric submuscular position. Results: All procedures were successful, with no perioperative complications or early deaths. Mean operating time was 90.2 +/- 16.8 minutes. None of the patients displayed pacing or sensing dysfunction, and all parameters remained stable throughout the follow-up period of 4.1 +/- 3.9 years. Three children underwent pulse generator replacement due to normal battery depletion at 4.0, 7.2, and 9.0 years of age without the need of ventricular lead replacement. There were two deaths at 12 and 325 days after pacemaker implantation due to bleeding from thrombolytic use and progressive refractory heart failure, respectively. Conclusion: Epicardial pacemaker implantation through a subxiphoid approach in neonates with CCAVB is technically feasible and associated with excellent surgical outcomes and pacing lead longevity.
- COLONOSCOPY COMPLICATIONS IN THE ELDERLY: the impact of age and multimorbidity(2013) STEIN, Francine de Cristo; HOJAIJ, Naira Hossepian Salles de Lima; SILVA, Jose Guilherme Nogueira da; BORGES, Luana Vilarinho; JACOB-FILHO, Wilson; HASHIMOTO, Claudio LyoitiContext Age has been considered an independent risk factor for colonoscopy complications, especially when associated with multimorbidity. Objectives The primary objective was to verify the relationships between age, multimorbidity and colonoscopy complications in the elderly. Methods A retrospective cohort including patients of 60 years or older who had undergone a colonoscopy. Data relating to age, multimorbidities according to the cumulative illness scale for geriatrics and the Charlson index and complications related to bowel preparation and procedure (sedation and exam) were collected. Results Of the 207 patients (mean age 70.47 ± 7.04) with appropriate indication for colonoscopy according to the American Society for Gastrointestinal Endoscopy, 43 (20.77%) patients had some colonoscopy complications: 1 (0.48%) with the sedation (apnea), 4 (1.93%) with the procedure (abdominal pain and bacteremia) and 38 (18.35%) with the bowel preparation (acute renal failure, hypotension). Individuals ≥80 years had an RR = 3.4 (1.2-10.1), P = 0.025, and those with a Charlson index 3 had an RR = 5.2 (1.6-16.8), P = 0.006, for complications. The cumulative illness rating scale for geriatrics was not associated with complications (P = 0.45). Conclusion There was a significant risk of complications in ≥80 years and in the group with a Charlson index 3. The cumulative illness rating scale for geriatrics was not a good predictor of risk in this sample.
bookPart Colites específicas(2013) SILVA, José Guilherme Nogueira; SILVA, Ana Luiza Werneck dabookPart Alterações Vasculares do Tubo Digestivo(2016) SILVA, José Guilherme Nogueira da; SILVA, Leonardo Soares da; COSTA, Fernando Gomes de Barros