SERGIO SAMIR ARAP

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LIM/28 - Laboratório de Cirurgia Vascular e da Cabeça e Pescoço, Hospital das Clínicas, Faculdade de Medicina

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Revista / Livro: Revista do Colégio Brasileiro de Cirurgiões ×

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  • article 5 Citação(ões) na Scopus
    Standardization of elective tracheostomies at the Central Institute of the Hospital das Clínicas in São Paulo during the COVID-19 pandemic
    (2020) MENEGOZZO, CARLOS AUGUSTO METIDIERI; ARAP, SÉRGIO SAMIR; MARIANI, ALESSANDRO WASUM; MINAMOTO, HÉLIO; IMAMURA, RUI; BENTO, RICARDO FERREIRA; PÊGO-FERNANDES, PAULO MANOEL; KOWALSKI, LUIZ PAULO; UTIYAMA, EDIVALDO MASSAZO
    ABSTRACT The COVID-19 Pandemic has resulted in a high number of hospital admissions and some of those patients need ventilatory support in intensive care units. The viral pneumonia secondary to Sars-cov-2 infection may lead to acute respiratory distress syndrome (ARDS) and longer mechanical ventilation needs, resulting in a higher demand for tracheostomies. Due to the high aerosolization potential of such procedure, and the associated risks of staff and envoirenment contamination, it is necesseray to develop a specific standardization of the of the whole process involving tracheostomies. This manuscript aims to demonstrate the main steps of the standardization created by a tracheostomy team in a tertiary hospital dedicated to providing care for patients with COVID-19.
  • article 5 Citação(ões) na Scopus
    The deceptive concept of hypoparathyroidism and recurrence after parathyroidectomy in dialysis patients: are we offering a Procrustean bed to some patients?
    (2016) MONTENEGRO, FABIO LUIZ DE MENEZES; BRESCIA, MARILIA D'ELBOUX GUIMARAES; NASCIMENTO JÚNIOR, CLIMÉRIO PEREIRA; MASSONI NETO, LEDO MAZZEI; ARAP, SÉRGIO SAMIR; SANTOS, STÊNIO ROBERTO CASTRO LIMA; GOLDENSTEIN, PATRÍCIA TASCHNER; BUENO, RODRIGO OLIVEIRA; CUSTODIO, MELANI RIBEIRO; JORGETTI, VANDA; MOYSES, ROSA MARIA AFFONSO
    ABSTRACT Objective: to analyze the frequency of hypoparathyroidism and of its recurrence after parathyroidectomy in dialysis patients according to different existing classifications. Methods: we conducted a retrospective study of 107 consecutive dialysis patients undergoing total parathyroidectomy with immediate autograft in a tertiary hospital from 2006 to 2010. We studied the changes in PTH levels in the postoperative period over time. Were grouped patients according to different PTH levels targets recommended according to the dosage method and by the American and Japanese Nephrology Societies, and by an International Experts Consortium. Results: after parathyroidectomy, there was sustained reduction in serum calcium and phosphatemia. The median value of PTH decreased from 1904pg/ml to 55pg/ml in 12 months. Depending on the considered target level, the proportion of patients below the target ranged between 17% and 87%. On the other hand, the proportion of patients with levels above the target ranged from 3% to 37%. Conclusion: the application of different recommendations for PTH levels after parathyroidectomy in dialysis patients may lead to incorrect classifications of hypoparathyroidism or recurrent hyperparathyroidism and resultin discordant therapeutic conducts.