FERNANDO MORBECK ALMEIDA COELHO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
8 resultados
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conferenceObject Does F-18-FDG-PET/MRI Add Metabolic Information to Anatomic Image in Childhood-onset Takayasu's Arteritis Patients? A Multicenter Case Series(2021) CLEMENTE, Gleice; SOUZA, Alexandre; FILHO, Hilton Leao; COELHO, Fernando; BUCHPIGUEL, Carlos; LIMA, Marcos; PIOTO, Daniela Petry; FRAGA, Melissa; SAKAMOTO, Ana Paula; CARNEIRO, Camila; PEREIRA, Rosa; AIKAWA, Nadia; SILVA, Clovis Artur; CAMPOS, Lucia; ASTLEY, Camilla; GUALANO, Bruno; TERRERI, Maria- A New Insight into the Surgical Treatment of Primary Macronodular Adrenal Hyperplasia(2020) TANNO, Fabio Yoshiaki; SROUGI, Victor; ALMEIDA, Madson Q.; YAMAUCHI, Fernando Ide; COELHO, Fernando Morbeck Almeida; NISHI, Mirian Yumie; ZERBINI, Maria Claudia Nogueira; SOARES, Iracy Silvia Correa; PEREIRA, Maria Adelaide Albergaria; CHARCHAR, Helaine Laiz Silva; LACOMBE, Amanda Meneses Ferreira; BRONDANI, Vania Balderrama; SROUGI, Miguel; NAHAS, Willian Carlos; MENDONCA, Berenice B.; CHAMBO, Jose Luis; FRAGOSO, Maria Candida Barisson VillaresPurpose: This prospective study presents the results of a new approach in the treatment of primary macronodular adrenal hyperplasia (PMAII), with simultaneous total adrenalectomy of the larger adrenal gland and partial adrenalectomy of the contralateral adrenal gland (adrenal-sparing surgery). Materials and Methods: We performed a prospective study including 17 patients with PMAH treated surgically with adrenal-sparing surgery in a tertiary referral hospital, with a median follow-up of 41 months. Clinical, hormonal, and genetic parameters were evaluated before surgery and during follow-up. All patients had at least 1 radiological examination before and after the procedure. Results: Among the 17 patients, all but 1 patient had complete hypercortisolism control, and 12 recovered normal adrenal function after surgery. Significant improvement in clinical parameters was observed: weight loss (P = .004); reduction of both systolic (P = .001) and diastolic (P = .001) blood pressure; and reduction in the number of antihypertensive drugs (P < .001). Intra-, peri-, and postoperative complications were not observed. Conclusion: Adrenal-sparing surgery is a safe and feasible procedure to treat patients with PMAH, providing a substantial chance of hypercortisolism control without the disadvantages of lifetime corticosteroid replacement. (C) Endocrine Society 2020.
- Primary Adrenal Insufficiency Due to Bilateral Adrenal Infarction in COVID-19(2022) MACHADO, Iza F. R.; MENEZES, Isabel Q.; FIGUEIREDO, Sabrina R.; COELHO, Fernando M. A.; TERRABUIO, Debora R. B.; V, Davi Ramos; FAGUNDES, Gustavo F. C.; MACIEL, Ana Alice W.; LATRONICO, Ana Claudia; V, Maria Candida B. Fragoso; CANCADO, Eduardo L. R.; MENDONCA, Berenice B.; ALMEIDA, Madson Q.Context: Coronavirus disease 2019 (COVID-19) is a proinflammatory and prothrombotic condition, but its impact on adrenal function has not been adequately evaluated. Case report: A 46-year-old woman presented with abdominal pain, hypotension, and skin hyperpigmentation after COVID-19 infection. The patient had hyponatremia, serum cortisol <1.0 mu g/dL, adrenocorticotropin (ACTH) of 807 pg/mL, and aldosterone <3 ng/dL. Computed tomography (CT) findings of adrenal enlargement with no parenchymal and minimal peripheral capsular enhancement after contrast were consistent with bilateral adrenal infarction. The patient had autoimmune hepatitis and positive antiphospholipid antibodies, but no previous thrombotic events. The patient was treated with intravenous hydrocortisone, followed by oral hydrocortisone and fludrocortisone. Discussion: We identified 9 articles, including case reports, of new-onset adrenal insufficiency and/or adrenal hemorrhage/infarction on CT in COVID-19. Adrenal insufficiency was hormonally diagnosed in 5 cases, but ACTH levels were measured in only 3 cases (high in 1 case and normal/low in other 2 cases). Bilateral adrenal nonhemorrhagic or hemorrhagic infarction was identified in 5 reports (2 had adrenal insufficiency, 2 had normal cortisol levels, and 1 case had no data). Interestingly, the only case with well-characterized new-onset acute primary adrenal insufficiency after COVID-19 had a previous diagnosis of antiphospholipid syndrome. In our case, antiphospholipid syndrome diagnosis was established only after the adrenal infarction triggered by COVID-19. Conclusion: Our findings support the association between bilateral adrenal infarction and antiphospholipid syndrome triggered by COVID-19. Therefore, patients with positive antiphospholipid antibodies should be closely monitored for symptoms or signs of acute adrenal insufficiency during COVID-19.
conferenceObject A NEW INSIGHT FOR THE TREATMENT OF PRIMARY MACRONODULAR ADRENAL HYPERPLASIA: ADRENAL SPARING SURGERY EARLY OUTCOMES(2019) TANNO, Fabio; FRAGOSO, Maria Candida B. V.; SROUGI, Victor; ALMEIDA, Madson Queiroz; MENDONCA, Berenice Bilharinho; YAMAUCHI, Fernando Ide; MORBECK, Fernando; NAHAS, Willian Carlos; SROUGI, Miguel; CHAMBO, Jose LuisconferenceObject Association of primary tumor radiomic phenotypes and outcomes in patients (pts) with metastatic renal cell clear cell carcinoma (mRCC) treated with cytoreductive nephrectomy (CN).(2023) CUNHA, Mateus Trinconi; STANGLER, Lucas; FREIRE, Pedro; PINTO, Paulo Victor Alves; COELHO, Fernando Morbeck Almeida; VIANA, Publio; CORDEIRO, Mauricio; NAHAS, William Carlos; MOTA, Jose Mauricio- Is positron emission tomography/magnetic resonance imaging a reliable tool for detecting vascular activity in treated childhood-onset Takayasu's arteritis? A multicentre study(2022) CLEMENTE, Gleice; PEREIRA, Rosa M. R.; AIKAWA, Nadia; SILVA, Clovis A.; CAMPOS, Lucia M. A.; ALVES, Gabriel; BUCHPIGUEL, Carlos; LIMA, Marcos; CARNEIRO, Camila; FILHO, Hilton L.; MORBECK, Fernando; NETO, Guilherme; FILHO, Vicente O.; SOUZA, Alexandre W. D.; TERRERI, Maria TeresaObjectives Toassess whether F-18-fluordeoxiglucose (F-18-FDG) PET/MRI) with angiographic sequences can contribute to detecting vessel wall inflammation in patients with childhood-onset Takayasu's arteritis (c-TA) under immunosuppressive therapy. Methods A three-centre cross-sectional study was conducted. F-18-FDG PET/MRI scans were performed in c-TA patients and in oncologic patients, who served as the control group. Clinical and laboratory characteristics were also analysed. Results Seventeen c-TA patients (65% females) between the ages of 6 and 21 years with a mean disease duration of 9.4 years were recruited. Only one patient presented clinical disease activity and six (35.6%) had increased ESR and/or CRP levels. The most frequent magnetic resonance angiography (MRA) findings were stenosis and thickening, observed in 82.4 and 70.6% of c-TA patients, respectively. F-18-FDG PET revealed F-18-FDG uptake greater than the liver in at least one arterial segment in 15 (88.2%) patients in a qualitative analysis and a median maximum standardized uptake value (SUVmax) of 3.22 (interquartile range 2.76-3.69) in a semi-quantitative analysis. c-TA patients presented significantly higher SUVmax values than oncologic patients (P < 0.001). A positive correlation between SUVmax and CRP levels (rho = 0.528, P = 0.029) was seen. Conclusion A state-of-the-art imaging modality was used in c-TA patients and revealed a strong arterial FDG uptake even in patients in apparent remission. We suppose that this finding may represent silent activity in the vessel wall; however, we cannot exclude the possibility of arterial remodelling. Importantly, a negative imaging scan may help in immunosuppression withdrawal in daily clinical practice.
- Abdominal Imaging Findings after Radiation Therapy(2020) COELHO, Fernando Morbeck Almeida; RODRIGUES, Lidia Batista Quintino; PANIZZA, Pedro Sergio Brito; MEDICI, Carolina Trindade Mello; ANDO, Sabrina de Mello; MAURO, Geovanne Pedro; ROCHA, Manoel de Souza; YAMAUCHI, Fernando Ide; VIANA, Publio Cesar Cavalcante
- The effect of sirolimus on angiomyolipoma is determined by decrease of fat-poor compartments and includes striking reduction of vascular structures(2021) WATANABE, Elieser Hitoshi; COELHO, Fernando Morbeck Almeida; LEAO FILHO, Hilton; BALBO, Bruno Eduardo Pedroso; NEVES, Precil Diego Miranda de Menezes; FRANZIN, Fernanda Maria; YAMAUCHI, Fernando Ide; ONUCHIC, Luiz FernandoRenal angiomyolipomas hemorrhage is associated with their size and vascular constitution. The effects of sirolimus on different components of angiomyolipomas was analyzed in patients with tuberous sclerosis complex, sporadic lymphangioleiomyomatosis and multiple sporadic angiomyolipomas. Thirty angiomyolipomas from 14 patients treated with sirolimus were retrospectively evaluated. A Hounsfield-unit threshold was used to classify angiomyolipomas in fat-rich, fat-poor and intermediate-fat tumors, and to categorize tumor compartments in fat rich, fat poor, intermediate fat and highly vascularized. Diameter variations were measured to assess the effects on aneurysmatic/ectatic vascular formations. Volume reduction following treatment with sirolimus was higher in fat-poor than fat-rich angiomyolipomas. Tumor reduction was mainly determined by decrease of the fat-poor and highly-vascularized compartments while the volume of the fat-rich compartment increased. Broad liposubstitution was observed in some tumors. A median reduction of 100% (75 to 100) in the diameter of aneurysmatic/ectatic vascular structures was observed. Our study showed that sirolimus reduces the size of angiomyolipomas by decreasing primarily their highly-vascularized and fat-poor compartments. This effect is associated with a remarkable reduction of tumoral aneurysms/ectatic vessels, revealing the likely mechanism responsible for the risk-decreasing effect of mTOR inhibitors on angiomyolipoma bleeding. These findings support the role of mTOR in the development of angiomyolipoma blood vessels.