SUZANA MATAYOSHI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina - Docente
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
LIM/33 - Laboratório de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
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- Periocular basal cell carcinoma: cost of topical immunotherapy versus estimated cost of surgical treatment(2012) MACEDO, Erick Marcet Santiago de; CARNEIRO, Rachel Camargo; CARRICONDO, Pedro Carlos; MATAYOSHI, SuzanaPurpose: The objective of this study was to compare the estimated cost of clinical and surgical treatment for basl cell carcinoma of the eyelid. Methods: This was a pilot study of 12 patients with basal cell carcinoma receiving treatment with 5% imiquimod cream at the ocular plastic surgery center, medical school University of Sao Paulo (HC-FMUSP, Brazil). The cost of clinical treatment was estimated based on the time of treatment and amount of medication consumed by patients in the home setting. The cost of surgical treatment was estimated by ophthalmologists with experience in reconstructive plastic surgery based on analysis of images of the same patients. Surgeons responded to a questionnaire with four questions about surgical technique, surgical materials required, estimated duration of surgery and type of anesthesia. Results: Immunotherapy lasted from 8 to 12 weeks. All patients reported each cold-stored sachet with 5% imiquimod cream lasted 3 days. According to the institution, a box with 12 sachets costs BRL 480.00. Patients required 1.58-3.11 boxes for complete treatment, corresponding to a total cost of BRL 758.40-1,492.80. Based on image analysis, surgeons evaluated surgery would require 1-3 hours. The estimated cost of surgery room and staff was BRL 263.00, to which the cost of supplies was added. Thus, the total cost of surgical treatment was BRL 272.61-864.82. On the average, immunotherapy was 57,64% more costly than surgical treatment. Conclusions: Malignant eyelid tumors are a common finding in clinical ophthalmology. Surgery is still the treatment of choice at our institution, but immunotherapy with 5% imiquimod cream may be indicated for patients with multiple lesions or high surgical risk and for patients declining surgery for reasons of fear or esthetic concerns. The ability to estimate costs related to the treatment of malignant eyelid tumors is an important aid in the financial planning of health care institutions. Further studies should evaluate the possibility of institutions equating the cost of immunotherapy and surgical treatment by acquiring similar but less expensive medications.
- Reply re: ""Imiquimod 5% Cream for the Treatment of Periocular Basal Cell Carcinoma""(2011) MACEDO, Erick M. S. de; CARNEIRO, Rachel C.; MATAYOSHI, Suzana
- Acurácia do exame clínico no diagnóstico de lesões palpebrais(2014) ROSSATO, Luiz Angelo; CARNEIRO, Rachel Camargo; MIYAZAKI, Ahlys; MATAYOSHI, SuzanaObjective: To analyze the accuracy of the clinical examination in the diagnosis of eyelid lesions. Methods: From the observation of thirtyfive photos of benign and malignant eyelid tumors were presented to ophthalmologists, for each picture, it was asked 3 questions: 1) the lesion is malignant or not; 2) if considered malignant, the probably histological type; and 3) the tumor is aggressive or not. The phisicians were divided into 9 groups, according to academic degree (time since graduation and Oculoplastics specialty or not). Answers were compared with the results of the histopathologic study of the surgically resected tumor. Results: In total, one hundred and six ophthalmologists were interviewed. The professional experience influenced the diagnosis of malignancy of the tumor, as the Group 1 (first year residents) had the lowest accuracy (64.5%), with lower estimated agreement (kappa = 0.13), and Group 5 (graduated 5 years ago and with expertise in Oculoplastics) the highest accuracy (77.3%), with better agreement (Kappa = 0.45), and presented the best parameters for other analyzed items. For the histological type diagnosis, accuracy was lower: group 1 had the worst performance, with 51.1% accuracy, while the best was for group 6 (graduated over 5 years and with expertise in Oculoplastics, 77.2% ). As for the criterion of tumor aggressiveness, the results were closer among the different categories. Ophthalmologists trained longer and without expertise in Oculoplastics also showed a low diagnostic accuracy for malignancy and to determine the histological type of tumor. Conclusions: The low accuracy of clinical diagnosis of eyelid tumors in the groups above reinforces the need to improve ophthalmic oncology knowledge in these groups.
- Terapia fotodinâmica em carcinoma basocelular periocular: Relato de caso(2012) CARNEIRO, Rachel Camargo; MACEDO, Erick Marcet Santiago de; LIMA, Patricia Picciarelli de; MATAYOSHI, SuzanaThe authors report the use of photodynamic therapy with methyl aminolevulinate (Metvix (R)) in a patient with nodular and infiltrative basal cell carcinoma in the right lower eyelid. Side effects on the eye were evaluated weekly. After 12 weeks of treatment, to confirm cure the patient was submitted to a 2-mm punch biopsy, the anatomopathological findings of which were negative for neoplasia. Photodynamic therapy with methyl aminolevulinate was shown to be an attractive alternative to surgical excision(-)the current gold standard treatment worldwide.
- Is 2-mm Punch Biopsy Useful in the Diagnosis of Malignant Eyelid Tumors?(2012) CARNEIRO, Rachel Camargo; MACEDO, Erick Marcet Santiago de; LIMA, Patricia Picciarelli de; BONATTI, Rodolfo; MATAYOSHI, SuzanaPurpose: Two-millimeter punch biopsy is a swift and practical diagnostic tool in the outpatient setting. However, few studies have evaluated the efficacy of the method for diagnosis of malignant eyelid tumors. Methods: This was an observational study of patients with suspicion of malignant eyelid tumor attending the Ocular Plastic Surgery Center at Hospital das Clinicas, University of Sao Paulo School of Medicine. Following standard procedures, preoperative biopsies were taken with a 2-mm trephine and surgical excision was performed with safety margins, followed by reconstruction. Anatomopathologic analysis of the surgical specimen was used as gold standard to evaluate the accuracy of diagnosis by punch biopsy. Results: The study included 50 periocular tumors with suspicion of malignancy. The indicators of efficacy in the identification of malignancy by 2-mm punch biopsy were: sensitivity 88%, specificity 100%, positive predictive value 100%, and negative predictive value 64%. Accuracy was 90% for malignancy and 80% for histologic type. The. index of agreement between the diagnostic methods was 0.722 (p < 0.001). Conclusion: A positive result with 2-mm punch biopsy is a safe indication for surgical excision of the tumor, whereas a negative result does not necessarily imply benignity. In cases of high clinical suspicion, a second biopsy should be taken from a different part of the tumor to rule out malignancy. (Ophthal Plast Reconstr Surg 2012;28:282-285)