RAPHAEL SALLES SCORTEGAGNA DE MEDEIROS
Índice h a partir de 2011
7
Projetos de Pesquisa
Unidades Organizacionais
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina
2 resultados
Resultados de Busca
Agora exibindo 1 - 2 de 2
- Leukoencephalopathy resolution after atypical mycobacterial treatment: a case report(2015) OLIVEIRA, Marcos C. B.; SATO, Douglas Kazutoshi; SOARES-NETO, Herval R.; LUCATO, Leandro T.; CALLEGARO, Dagoberto; NITRINI, Ricardo; MEDEIROS, Raphael S. S.; MISU, Tatsuro; FUJIHARA, Kazuo; CASTRO, Luiz H.Background: Association of leukoencephalopathy and atypical mycobacteriosis has been rarely reported. We present a case that is relevant for its unusual presentation and because it may shed further light on the pathogenic mechanisms underlying reversible encephalopathies. Case report: We report the case of a Hispanic 64-year-old woman with cognitive decline and extensive leukoencephalopathy. Magnetic resonance imaging revealed white-matter lesions with increased water diffusivity, without blood-brain-barrier disruption. Brain biopsy showed tissue rarefaction with vacuolation, mild inflammation, few reactive astrocytes and decreased aquaporin water-channel expression in the lesions. Six months later, she was diagnosed with atypical mycobacterial pulmonary infection. Brain lesions resolved after antimycobacterial treatment. Conclusion: We hypothesize leukoencephalopathic changes and vasogenic edema were associated with decreased aquaporin expression. Further studies should clarify if reversible leukoencephalopathy has a causal relationship with decreased aquaporin expression and atypical mycobacterial infection, and mechanisms underlying leukoencephalopathy resolution after antimycobacterial treatment. This article may contribute to the understanding of pathogenic mechanisms underlying magnetic resonance imaging subcortical lesions and edema, which remain incompletely understood.
- Endoscopic submucosal dissection versus transanal endoscopic microsurgery for the treatment of early rectal cancer(2014) KAWAGUTI, Fabio Shiguehissa; NAHAS, Caio Sergio Rizkallah; MARQUES, Carlos Frederico Sparapan; MARTINS, Bruno da Costa; RETES, Felipe Alves; MEDEIROS, Raphael Salles S.; HAYASHI, Takemasa; WADA, Yoshiki; LIMA, Marcelo Simas de; UEMURA, Ricardo Sato; NAHAS, Sergio Carlos; KUDO, Shin-ei; MALUF, FauzeEndoscopic submucosal dissection (ESD) and transanal endoscopic microsurgery (TEM) are minimally invasive procedures that can be used to treat early rectal cancer. The aim of this study was to compare clinical efficacy between ESD and TEM for the treatment of early rectal cancer. Between July 2008 and August 2011, 24 patients with early rectal cancers were treated by ESD (11) or TEM (13) at the Cancer Institute of So Paulo University Medical School (So Paulo, Brazil). Data were analyzed retrospectively according to database and pathological reports, with respect to en bloc resection rate, local recurrence, complications, histological diagnosis, procedure time and length of hospital stay. En bloc resection rates with free margins were achieved in 81.8 % of patients in the ESD group and 84.6 % of patients in the TEM group (p = 0.40). Mean tumor size was 64.6 +/- A 57.9 mm in the ESD group and 43.9 +/- A 30.7 mm in the TEM group (p = 0.13). Two patients in the TEM group and one patient in the ESD group had a local recurrence. The mean procedure time was 133 +/- A 94.8 min in the ESD group and 150 +/- A 66.3 min in the TEM group (p = 0.69). Mean hospital stay was 3.8 +/- A 3.3 days in the ESD group and 4.08 +/- A 1.7 days in the TEM group (p = 0.81). This was a non-randomized clinical trial with a small sample size and selection bias in treatment options. ESD and TEM are both safe and effective for the treatment of early rectal cancer.