GUILHERME ALVES LEPSKI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
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- Neuroscience Knowledge and Endorsement of Neuromyths among Educators: What Is the Scenario in Brazil?(2022) SIMOES, Estefania; FOZ, Adriana; PETINATI, Fernanda; MARQUES, Alcione; SATO, Joao; LEPSKI, Guilherme; AREVALO, AnaliaThe field of neuroscience has seen significant growth and interest in recent decades. While neuroscience knowledge can benefit laypeople as well as professionals in many different areas, it may be particularly relevant for educators. With the right information, educators can apply neuroscience-based teaching strategies as well as protect themselves and their students against pseudoscientific ideas and products based on them. Despite rapidly growing sources of available information and courses, studies show that educators in many countries have poor knowledge of brain science and tend to endorse education-related neuromyths. Poor English skills and fewer resources (personal, institutional and governmental) may be additional limitations in Latin America. In order to better understand the scenario in Latin America's largest country, we created an anonymous online survey which was answered by 1634 individuals working in education from all five regions of Brazil. Respondents stated whether they agreed with each statement and reported their level of confidence for each answer. Significant differences in performance were observed across regions, between educators living in capital cities versus the outskirts, between those teaching in private versus public schools, and among educators teaching different levels (pre-school up to college/university). We also observed high endorsement of some key neuromyths, even among groups who performed better overall. To the best of our knowledge, this is the first study to conduct a detailed analysis of the profile of a large group of educators in Brazil. We discuss our findings in terms of efforts to better understand regional and global limitations and develop methods of addressing these most efficiently.
- Neurosurgery(2022) LEPSKI, G. A.; NEPOMUCENO, T. B.The oncological treatment of intracranial tumors demands an experienced and multidisciplinary team able to manage vascular complications and perform reconstructive procedures when needed. Some brain tumors dislocate, enclose, and sometimes invade major arterial and venous structures of the brain, which if sacrificed may lead to unacceptable neurological deficits. Since the brain tumor treatment is a balance between preserving function and removing the greatest amount of tumor possible, the oncological neurosurgeon must also be trained to perform arterial and venous reconstruction and bypasses. In the present chapter, we address reconstructive strategies in the arterial and venous systems to preserve brain hemodynamics, either in the elective or emergent conditions. Brain tumors increase the risk of venous thromboembolism, which complicates the decision as to when to start anticoagulation (either before or after brain surgery). In addition, postoperative bleeding is a major complication, potentially culminating in death or serious neurological deficits. Nevertheless, many studies have demonstrated that thromboembolism risk overcomes the risk of postoperative bleeding in the neurosurgical oncology cohort, so that most protocols recommend early prophylaxis. This does not preclude the need for multifactorial and individual-based decision-making, paying careful attention to patient- and surgery-related risks. © Springer Nature Switzerland AG 2022.
- Editorial: How to improve neuroscience education for the public and for a multi-professional audience in different parts of the globe(2022) AREVALO, Analia; ABUSAMRA, Valeria; LEPSKI, Guilherme
- Laser-evoked potentials recover gradually when using dorsal root ganglion stimulation, and this influences nociceptive pathways in neuropathic pain patients(2022) MORGALLA, Matthias Hubert; ZHANG, Yi; BARROS FILHO, Marcos Fortunato de; LEPSKI, Guilherme; CHANDER, Bankim SubhashObjective Dorsal root ganglion stimulation (DRGS) is able to relieve chronic neuropathic pain. There seems evidence that DRGS might achieve this by gradually influencing pain pathways. We used laser-evoked potentials (LEP) to verify our hypothesis that the recovery of the LEP may reflect DRGS-induced changes within the nociceptive system. Methods Nine patients (mean age 56.8 years, range 36-77 years, two females) diagnosed with chronic neuropathic pain in the knee or groin were enrolled in the study. We measured each patient's LEP at the painful limb and contralateral control limb on the first, fourth, and seventh day after implantation of the DRGS system. We used the numeric rating scale (NRS) for the simultaneous pain assessment. Results The LEP amplitude of the N2-P2 complex showed a significant increase on day 7 when compared to day 1 (Z = -2.666, p = 0.008) and to day 4 (Z = -2.547, p = 0.011), respectively. There was no significant difference in the N2-P2 complex amplitude between ON and OFF states during DRGS. The patients' NRS significantly decreased after 1 day (p = 0.007), 4 days (p = 0.007), and 7 days (p = 0.007) when compared to the baseline. Conclusions The results show that with DRGS, the LEP recovered gradually within 7 days in neuropathic pain patients. Therefore, reduction of the NRS in patients with chronic neuropathic pain might be due to DRGS-induced processes within the nociceptive system. These processes might indicate neuroplasticity mediated recovery of the LEP.
- Near-Complete Remission of Glioblastoma in a Patient Treated with an Allogenic Dendritic Cell-Based Vaccine: The Role of Tumor-Specific CD4+T-Cell Cytokine Secretion Pattern in Predicting Response and Recurrence(2022) PINHO, Mariana P.; LEPSKI, Guilherme A.; REHDER, Roberta; CHAUCA-TORRES, Nadia E.; EVANGELISTA, Gabriela C. M.; TEIXEIRA, Sarah F.; FLATOW, Elizabeth A.; OLIVEIRA, Jaqueline V. de; FOGOLIN, Carla S.; PERES, Nataly; AREVALO, Analia; ALVES, Venancio; BARBUTO, Jose A. M.; BERGAMI-SANTOS, Patricia C.Immunotherapy has brought hope to the fight against glioblastoma, but its efficacy remains unclear. We present the case of CST, a 25-year-old female patient with a large right-hemisphere glioblastoma treated with a dendritic-tumor cell fusion vaccine. CST showed a near-complete tumor response, with a marked improvement in her functional status and simultaneous increases in tumor-specific CD8+ and CD4+ T cells. Two months before recurrence, the frequency of tumor-specific T cells decreased, while that of IL-17 and CD4+ T cells increased. CST passed away 15 months after enrollment. In this illustrative case, the tumor-specific CD4+ T-cell numbers and phenotype behaved as treatment efficacy biomarkers, highlighting the key role of the latter in glioblastoma immunotherapy.
- What Does the General Public Know (or Not) About Neuroscience? Effects of Age, Region and Profession in Brazil(2022) AREVALO, Analia; SIMOES, Estefania; PETINATI, Fernanda; LEPSKI, GuilhermeThe field of Neuroscience has experienced a growing interest in recent decades, which has led to an exponential growth in the amount of related information made available online as well as the market for Neuroscience-related courses. While this type of knowledge can be greatly beneficial to people working in science, health and education, it can also benefit individuals in other areas. For example, neuroscience knowledge can help people from all fields better understand and critique information about new discoveries or products, and even make better education- and health-related decisions. Online platforms are fertile ground for the creation and spread of fake information, including misrepresentations of scientific knowledge or new discoveries (e.g., neuromyths). These types of false information, once spread, can be difficult to tear down and may have widespread negative effects. For example, even scientists are less likely to access retractions of peer-reviewed articles than the original discredited articles. In this study we surveyed general knowledge about neuroscience and the brain among volunteers in Brazil, Latin America's largest country. We were interested in evaluating the prevalence of neuromyths in this region, and test whether knowledge/neuromyth endorsement differs by age, region, and/or profession. To that end, we created a 30-item survey that was anonymously answered online by 1128 individuals. While younger people (20-29-year-olds) generally responded more accurately than people 60 and older, people in the North responded significantly worse than those in the South and Southeast. Most interestingly, people in the biological sciences consistently responded best, but people in the health sciences responded no better than people in the exact sciences or humanities. Furthermore, years of schooling did not correlate with performance, suggesting that quantity may surpass quality when it comes to extension or graduate-level course offerings. We discuss how our findings can help guide efforts toward improving access to quality information and training in the region.
- Safety and Outcomes of Dentate Nucleus Deep Brain Stimulation for Cerebellar Ataxia(2022) CURY, Rubens Gisbert; FRANCA, Carina; DUARTE, Kleber Paiva; PARAGUAY, Isabela; DINIZ, Juliete Melo; CUNHA, Paulina; GALHARDONI, Ricardo; SILVA, Valquiria; IGLESIO, Ricardo; BISSOLI, Andre Bortolon; LEPSKI, Guilherme; BARBOSA, Egberto Reis; TEIXEIRA, Manoel Jacobsen; ANDRADE, Daniel Ciampi deCerebellar symptoms remain orphan of treatment options despite being prevalent and incapacitating. Investigate whether dentate nucleus deep brain stimulation (DN DBS) is safe and leads to improvements in cerebellar symptoms when compared to sham stimulation. This randomized double-blind crossover pilot trial enrolled five patients with spinocerebellar ataxia type 3 or post-lesion ataxia. Active or sham phases were randomly performed three months apart. The primary outcome was ataxia improvement as measured by the Scale for the Assessment and Rating of Ataxia (SARA) after the active compared to the sham period. Secondary outcome measures included safety and tolerability, the Fahn-Tolosa-Marin Tremor Rating Scale (FTMRS), quality of life measurements, and patients' global impression of change. The effects on ataxia were numerically better in four out of five patients after active versus sham stimulation. The composite SARA score did not change after comparing active to sham stimulation (8.6 +/- 3.6 versus 10.1 +/- 4.1; p = 0.223). The FTMRS showed significant improvement after active stimulation versus sham (18.0 +/- 17.2 versus 22.2 +/- 19.5; p = 0.039) as did patients' global impression of change (p = 0.038). The quality of life was not modified by stimulation (p = 0.337). DN DBS was well tolerated without serious adverse events. One patient had the electrode repositioned. DN DBS is a safe and well tolerated procedure that is effective in alleviating cerebellar tremor. In this small cohort of ataxic patients, DN DBS did not achieve statistical significance for ataxia improvement.