ARTUR MARTINS NOVAES COUTINHO
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LIM/43 - Laboratório de Medicina Nuclear, Hospital das Clínicas, Faculdade de Medicina
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bookPart Dacriocintilografia(2017) COUTINHO, Artur Martins NovaesbookPart Cintilografia cerebral e estudos com tálio-201 e sestamibi(2017) COUTINHO, Artur Martins Novaes; ONO, Carla Rachel; BUCHPIGUEL, Carlos Alberto- Long-Term Lithium Treatment Reduces Glucose Metabolism in the Cerebellum and Hippocampus of Nondemented Older Adults: An [F-18]FDG-PET Study(2014) FORLENZA, Orestes V.; COUTINHO, Artur Martins Novaes; APRAHAMIAN, Ivan; PRANDO, Silvana; MENDES, Luciana Lucas; DINIZ, Breno S.; GATTAZ, Wagner F.; BUCHPIGUEL, Carlos A.Lithium modulates several intracellular pathways related to neuroplasticity and resilience against neuronal injury. These properties have been consistently reported in experimental models, and involve the up-regulation of neurotrophic response and autophagy, and down-regulation of apoptosis, oxidative stress, and inflammation. Clinical and epidemiological studies in bipolar disorder show that acute treatment with lithium increases plasma concentrations of brain-derived neurotrophic factor, and long-term treatment lowers the risk of dementia. Neuroimaging studies indicate that lithium use is further associated with increased cortical thickness and larger hippocampal volumes. The objective of the present study was to evaluate whether these neurobiological properties of lithium reflect in increased regional brain glucose metabolism, as shown by [F-18]FDG-PET. Participants (n = 19) were nondemented older adults recruited at the end point of a controlled trial addressing clinical and biological effects of lithium in a sample of patients with amnestic mild cognitive impairment. Twelve patients who had received low-dose lithium carbonate for 4 years were compared to seven matched controls. Chronic lithium treatment was not associated with any significant increase in brain glucose metabolism in the studied areas. Conversely, we found a significant reduction in glucose uptake in several clusters of the cerebellum and in both hippocampi. These findings were not associated with any clinical evidence of toxicity. The clinical implications of the present findings need to be clarified by future controlled studies, particularly in the light of the potential use of lithium as a disease-modifying treatment approach for certain neurodegenerative disorders, namely, Alzheimer's disease and amyotrophic lateral sclerosis.
bookPart Cintilografia com metaiodobenzilguanidina (MIBG)(2017) COUTINHO, Artur Martins Novaes- Changes in Neuropsychological Tests and Brain Metabolism After Bariatric Surgery(2014) MARQUES, Emerson Leonildo; HALPERN, Alfredo; MANCINI, Marcio Correa; MELO, Maria Edna de; HORIE, Ndia Celeste; BUCHPIGUEL, Carlos Alberto; COUTINHO, Artur Martins Novaes; ONO, Carla Rachel; PRANDO, Silvana; SANTO, Marco Aurelio; CUNHA-NETO, Edecio; FUENTES, Daniel; CERCATO, CintiaContext: The mechanisms by which obesity alters the cerebral function and the effect of weight loss on the brain have not been completely clarified. Objective: The objective of the study was to assess the effect of bariatric surgery on the cognitive function and cerebral metabolism. Design: Seventeen obese women were studied prior to and 24 weeks after bariatric surgery using neuropsychological tests and positron emission tomography. Setting: The study was conducted in a reference center for the treatment of obesity of a Brazilian public university. Participants: Thirty-three women paired by age and level of education made up two groups: 17 severely obese patients and 16 lean patients. They did not have diabetes mellitus or a family history of dementia. Main Outcome Measures: Comparison of performance in neuropsychological tests and cerebral metabolism of the obese women before and after bariatric surgery was measured. The results found at the two moments were compared with those of the women of normal weight. Results: Women with a mean age of 40.5 years and mean body mass index of 50.1 kg/m(2) when compared with women with mean body mass index of 22.3 kg/m(2) showed increased cerebral metabolism, especially in the posterior cingulate gyrus (P <.004). No difference was found between the groups for the neuropsychological tests. After 24 weeks the cerebral metabolism of the obese women was lower, similar to the lean women, and there was an improvement of executive function, accompanying changes of metabolic and inflammatory parameters. Conclusions: Obese women may have increased cerebral metabolism when compared with women of normal weight, and this appears to reverse after weight loss induced by bariatric surgery, accompanied by improved executive function.
bookPart Proteção radiológica e dosimetria(2017) COUTINHO, Artur Martins Novaes; GUIMARãES, Maria Inês Calil Cury- Paraneoplastic limbic encephalitis with prominent neuropsychiatric apathy(2014) PORTO, Fabio Hernique de Gobbi; COUTINHO, Artur Martins Novaes; LUCATO, Leandro Tavares; SPINDOLA, Livia; ONO, Carla Rachel; BRUCKI, Sonia Maria Dozzi; BUCHPIGUEL, Carlos Alberto; NITRINI, RicardoThe spectrum of paraneoplastic neurologic syndromes has increased with the description of encephalitis associated with antibodies against cell surface and synaptic proteins. Subacute cognitive impairment, movement disorders, late onset epilepsy and neuropsychiatric syndromes were recently linked to paraneoplastic encephalitis. Despite that, probably some syndromes and antibodies are yet to be reported. Herein we reported the clinical and neuroimaging pictures of a patient with late onset medial temporal lobe epilepsy, subtle cognitive impairment, psychosis and severe apathy diagnosed with antibody-negative paraneoplastic encephalitis due to colonic adenocarcinoma. The apathy markedly improved after removal of the tumor, without concomitant immunotherapy (steroids, intravenous immunoglobulins, immunosuppressants, plasmapheresis, etc). Our report highlights the importance of a full clinical and neurologic investigation in cases of atypical neuropsychiatric presentations, particularly in the elderly and with the concomitance of epilepsy and cognitive decline. Even chronic presentations must be considered. Neuroimaging is an important tool to demonstrate structural and functional brain dysfunction in these cases. Colonic adenocarcinoma should be searched for in cases in which a typical tumor related to paraneoplastic neurologic syndromes is not found.
- F-18-FDG PET/CT Osteometabolic Activity in Metastatic Parathyroid Carcinoma(2016) VALE, Romulo Hermeto Bueno do; QUEIROZ, Marcelo Araujo; COUTINHO, Artur Martins Novaes; BUCHPIGUEL, Carlos Alberto; MENEZES, Marcos Roberto deParathyroid cancer is an uncommon type of malignancy, which is frequently associated with poor prognosis. Clinical manifestations are caused by elevated serum calcium and parathyroid hormone (PTH). Diagnostic imaging studies as neck ultrasonography, technetium Tc Tc-99m-sestamibi whole body scintigraphy, CT, and MR are already established tools for this malignancy. Nevertheless, the role of F-18-FDG PET/CT remains unknown in this scenario, with few published studies in literature. Hence, in this article, we aimed to report an illustrative case of increased skeletal FDG uptake associated with high calcium and PTH levels.
- Joint Guideline on Venous Thromboembolism-2022(2022) ALBRICKER, Ana Cristina Lopes; FREIRE, Claudia Maria Vilas; SANTOS, Simone Nascimento dos; ALCANTARA, Monica Luiza de; SALEH, Mohamed Hassan; CANTISANO, Armando Luis; TEODORO, Jose Aldo Ribeiro; PORTO, Carmen Lucia Lascasas; AMARAL, Salomon Israel do; VELOSO, Orlando Carlos Gloria; PETISCO, Ana Claudia Gomes Pereira; BARROS, Fanilda Souto; BARROS, Marcio Vinicius Lins de; SOUZA, Adriano Jose de; SOBREIRA, Marcone Lima; MIRANDA, Robson Barbosa de; MORAES, Domingos de; VERRASTRO, Carlos Gustavo Yuji; MANCANO, Alexandre Dias; LIMA, Ronaldo de Souza Leao; MUGLIA, Valdair Francisco; MATUSHITA, Cristina Sebastiao; LOPES, Rafael Willain; COUTINHO, Artur Martins Novaes; PIANTA, Diego Bromfman; SANTOS, Alair Augusto Sarmet Moreira Damas dos; NAVES, Bruno de Lima; VIEIRA, Marcelo Luiz Campos; ROCHITTE, Carlos Eduardo
bookPart Cintilografia pulmonar(2017) COUTINHO, Artur Martins Novaes