UENIS TANNURI
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Pediatria, Faculdade de Medicina - Docente
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/30 - Laboratório de Investigação em Cirurgia Pediát, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/30 - Laboratório de Investigação em Cirurgia Pediát, Hospital das Clínicas, Faculdade de Medicina - Líder
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bookPart Malformações do sistema respiratório(2019) TANNURI, Uenis; VELHOTE, Manoel Carlos Prieto; CARVALHO, Thiago Caldi de; RODRIGUES, Joaquim Carlos- Extensive Hepatectomy as an Alternative to Liver Transplant in Advanced Hepatoblastoma: A New Protocol Used in a Pediatric Liver Transplantation Center(2019) PAGANOTI, G. de Freitas; TANNURI, A. C. A.; MARQUES, A. C. Dantas; TORRES, R. R.; GIBELLI, N. E. Mendes; TANNURI, U.Background. Surgery is a key factor in the treatment of hepatoblastoma, but choosing between an aggressive resection and liver transplant may be an extremely difficult task. The aim of this study was to describe the outcomes of patients with advanced hepatoblastoma: pretreatment extent of disease (PRETEXT)/post-treatment extent of disease (POST-TEXT) III and IV undergoing aggressive resections or living donor liver transplant in cases involving the entire liver. Based on this experience, a new protocol for the treatment of these patients was proposed. Methods. A retrospective study included patients with advanced hepatoblastoma (POST-TEXT III and IV) who were referred for a liver transplant from 2010 to 2017. Results. A total of 24 children were included: 13 (54.2%) were male, with a median age at diagnosis of 42 months (range, 15-120 months), and a history of prematurity was identified in 20.8% of the patients. Ten cases (41.7%) were staged as PRETEXT/POST-TEXT III, and 12 cases (50.0%) were staged as PRETEXT/POST-TEXT IV. Two patients were referred after posthepatectomy recurrence. Five patients underwent a liver transplant, with recurrence and death in 2 patients (40.0%) within a mean period of 6 months. In the extensive hepatectomy group, there was recurrence in 6 patients (31.6%), with disease-free outcomes and overall survival in 63.2% and 94.7% of patients, respectively. Conclusion. In cases of advanced hepatoblastoma, an extensive surgical approach is a valuable option. The fact that the team was fully prepared to proceed with living donor liver transplant allowed the surgeon to be more aggressive and to switch to transplantation when resection was not possible.
bookPart Vias de acesso vascular(2019) TANNURI, Ana Cristina Aoun; TANNURI, Uenis- Does Biliodigestive Anastomosis Have Any Effect on the Reversal of Hepatopulmonary Syndrome in a Biliary Cirrhosis Experimental Model?(2019) CORBI, Leonardo Ervolino; TANNURI, Ana Cristina Aoun; BRAZ, Maria Julia de Aro; PAES, Vitor Ribeiro; SBRAGIA, Lourenco; FIGUEIRA, Rebeca Lopes; COSTA, Karina Miura da; COELHO, Maria Cecilia Mendonca; GONCALVES, Josiane Oliveira; SERAFINI, Suellen; TANNURI, UenisBackground Biliary cirrhosis is associated with hepatopulmonary syndrome (HPS), which is related to increased posttransplant morbidity and mortality. Aims This study aims to analyze the pathophysiology of biliary cirrhosis and the onset of HPS. Methods Twenty-one-day-old Wistar rats were subjected to common bile duct ligation and were allocated to two groups: group A (killed 2, 3, 4, 5, or 6 weeks after biliary obstruction) and group B (subjected to biliodigestive anastomosis 2, 3, 4, 5, or 6 weeks after the first procedure and killed 3 weeks later). At the killing, arterial blood was collected for the analyses, and samples from the liver and lungs were collected for histologic and molecular analyses. The gasometric parameters as well as the expression levels of ET-1, eNOS, and NOS genes in the lung tissue were evaluated. Results From a total of 42 blood samples, 15 showed hypoxemia-(pO(2) < 85 mmHg) and 17 showed an increased oxygen gradient [p (A-a)-O-2 > 18 mmHg]. The liver histology revealed increased ductular proliferation after common bile duct ligation, and reconstruction of bile flow promoted decreased ductular proliferation 5 and 6 weeks post-common bile duct ligation. Pulmonary alterations consisted of decreased parenchymal airspace and increased medial wall thickness. Biliary desobstruction promoted transitory improvements 5 weeks after biliary obstruction (increased parenchymal airspace and decreased MWT-p = 0.003 and p = 0.004, respectively) as well as increased endothelin expression levels (p = 0.009). Conclusions The present model showed lung tissue alterations promoted by biliary obstruction. The biliodigestive anastomosis had no clear direct effects on these alterations.
- Biochemical profile in an infant with neonatal hemochromatosis shows evidence of impairment of mitochondrial long-chain fatty acid oxidation(2019) BASTOS, Karina Lucio de Medeiros; QUAIO, Caio Robledo; LIMA, Fabiana Roberto; ARAUJO, Iana Manuelle; ARAUJO, Candice Alves Tavares; PIAZZON, Flavia Balbo; SILVA, Ismael Dale Cotrim Guerreiro da; BENEVIDES, Gabriel Nuncio; TANNURI, Ana Cristina; TANNURI, Uenis; AZEVEDO, Ramiro Anthero; KIM, Chong Ae
- Mortality in adolescents and young adults with chronic diseases during 16 years: a study in a Latin American tertiary hospital(2019) RAMOS, Gabriel F.; RIBEIRO, Vanessa P.; MERCADANTE, Mariana P.; RIBEIRO, Maira P.; DELGADO, Artur F.; FARHAT, Sylvia C. L.; LEAL, Marta M.; MARQUES, Heloisa H.; ODONE-FILHO, Vicente; TANNURI, Uenis; CARVALHO, Werther B.; GRISI, Sandra J.; CARNEIRO-SAMPAIO, Magda; SILVA, Clovis A.Objectives: To evaluate mortality in adolescents and young adult patients with chronic diseases followed in a Latin American tertiary hospital. Methods: A cross-sectional retrospective study was performed in a tertiary/academic hospital in the state of Sao Paulo, Brazil. Death occurred in 529/2850 (18.5%) adolescents and young adult patients with chronic diseases, and 25/529 (4.7%) were excluded due to incomplete medical charts. Therefore, 504 deaths were evaluated. Results: Deaths occurred in 316/504 (63%) of early adolescent patients and in 188/504 (37%) of late adolescent/young adult patients. Further comparisons between early adolescents (n=316) and late adolescent/young adult patients (n= 188) with pediatric chronic diseases at the last hospitalization showed that the median disease duration (22.0 [0-173] vs. 43.0 [0-227] months, p < 0.001) was significantly lower in early adolescents vs. late adolescent/young adult patients. The median number of previous hospitalizations was significantly lower in the former group (4.0 [1-45] vs. 6.0 [1-52], p < 0.001), whereas the last hospitalization in intensive care unit was significantly higher (60% vs. 47%, p= 0.003). Regarding supportive measures, palliative care was significantly lower in the younger group compared to the older group (33% vs. 43%, p= 0.02). The frequencies of renal replacement therapy (22% vs. 13%, p = 0.02), vasoactive agents (65% vs. 54%, p= 0.01), and transfusion of blood products (75% vs. 66%, p = 0.03) were significantly higher in the younger group. The five most important etiologies of pediatric chronic diseases were: neoplasias (54.2%), hepatic diseases/transplantation (10%), human immunodeficiency virus (5.9%), and childhood-onset systemic lupus erythematosus and juvenile idiopathic arthritis (4.9%). Autopsy was performed in 58/504 (11%), and discordance between clinical and postmortem diagnoses was evidenced in 24/58 (41.3%). Conclusions: Almost 20% of deaths occurred in adolescents and young adults with distinct supportive care and severe disease patterns. Discordance between clinical diagnosis and autopsy was frequently observed. (C) 2018 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Pediatria.