PATRICIA MORENO GRANGEIRO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
10 resultados
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- MODIFIED DEGA OSTEOTOMY IN TREATING DEVELOPMENTAL DYSPLASIA OF THE HIP (vol 26, pg 30, 2018)(2018) GUARNIERO, Roberto; SANCHEZ, Fernando Barbosa; MASSA, Bruno Sergio Ferreira; MONTENEGRO, Nei Botter; GRANGEIRO, Patricia Moreno; ANGELI, Luiz Renato Agrizzi De
- EXPERIMENTAL MODEL STUDY OF ISCHEMIC NECROSIS INDUCTION OF THE GROWING FEMORAL HEAD(2022) GORIOS FILHO, Antonio; SANTOS, Gustavo Bispo Dos; GUARNIERO, Jose Roberto Bevilacqua; ANGELI, Luiz Renato Agrizzi De; GRANGEIRO, Patricia Moreno; GUARNIERO, RobertoMany experimental models exist to better understand the necrosis of the femoral head etiology, both in terms of the species variety in which necrosis is induced and in the operative techniques used for treatment. Objective: This study has two main objectives, the first is to review the literature concerning experimental models of avascular necrosis of the growing femoral head, the second, to demonstrate the experimental pig model's reproducibility using a pilot study. Methods: This was a bibliographic review to describe the attempts over time to find the best species and technique for induction that would reproduce ischemic necrosis of the growing femoral head in humans. Simultaneously, a pilot study was performed to verify the replication of induction in pigs, the species that has more similarities with the human hip. The pilot's methodological analysis consists of conventional radiology and verification of possible anatomical, pathological changes. Results: In imaging exams; lateral sub-dislocation of the femur head and triangular appearance of the head were observed, characterizing its flattening; in macroscopic examination, the femoral head flattening with femoral neck widening and shortening was identified; in histology, the proliferation of articular cartilage with the presence of vascular granulation regenerative tissue, with osteoclasts and fibrocartilaginous tissue in the metaphyseal femoral neck region was identified. Conclusion: The experimental pig model can be used as a valuable tool for the reproducibility of anatomical, pathological changes in ischemic necrosis of the growing femoral head. The model is reproducible and feasible and can be beneficial for future studies on the anatomical pathology of necrosis of the growing femoral head. Level of Evidence III, Literature Review.
- Congenital Clubfoot - Is the Ponseti Method the Definitive Solution?(2021) CORDEIRO, Felippi Guizardi; MACEDO, Rodrigo Sousa; MASSA, Bruno Sérgio Ferreira; GRANGEIRO, Patricia Moreno; GODOY-SANTOS, Alexandre Leme; FERNANDES, Túlio DinizAbstract Congenital clubfoot is one of the most common deformities at birth. The inadequacy or absence of treatment causes serious limitations for people with this condition. The initial treatment using the Ponseti method ensures functional results superior to other treatment modalities previously proposed. However, recurrences and neglected feet are still a challenge today. An understanding of the pathophysiology of the disease, as well as of the anatomy and local biomechanics and a thorough clinical and radiological evaluation of patients are essential to understanding the limits of the method and choosing the best treatment.
- REPRODUCIBILITY OF MODIFIED WALDENSTROM CLASSIFICATION IN PERTHES DISEASE(2021) CORDEIRO, Felippi Guizardi; GRANGEIRO, Patricia Moreno; MASSA, Bruno Sergio Ferreira; MONTENEGRO, Nei Botter; GUARNIERO, RobertoObjective: The purpose of our study is to evaluate intraobserver and interobserver reliability of modified Waldenstrom classification system for Legg-Calve-Perthes disease and assess the influence of the professional's area of expertise in the assessment. Methods: Twelve evaluators assessed 40 pairs of pelvic radiographs of patients with Legg-Calve-Perthes disease. After two weeks, a new evaluation was performed by the same evaluators. Kappa and Kendall's W indexes were used to evaluate both intraobserver and interobserver reliability and determine the influence of the evaluators' experience and area of expertise. Results: The average intraobserver kappa value was 0.394, with a reasonable agreement level. The interobserver Kappa value was 0.243 in the first evaluation (95% CI, 0.2270.259 and p < 0.0001) and 0.245 in the second evaluation (95% CI, 0.229-0.260 and p < 0.0001). The Kendall's W values obtained for pediatric orthopedists, radiologists and resident physicians were 0.686, 0.630 and 0.529 ( p < 0.0001), respectively. Conclusion: The modified Waldenstrom classification presented both moderate and reasonable levels of intraobserver agreement, and reasonable level of interobserver agreement. The evaluators' degree of experience and area of expertise influenced the concordance level found.
- The knee in congenital femoral deficiency and its implication in limb lengthening: a systematic review(2021) LEITE, Chilan Bou Ghosson; GRANGEIRO, Patricia Moreno; MUNHOZ, Diego Ubrig; GIGLIO, Pedro Nogueira; CAMANHO, Gilberto Luis; GOBBI, Riccardo GomesCongenital femoral deficiency (CFD) is a rare disorder with several limb anomalies including limb shortening and knee cruciate ligament dysplasia. Limb lengthening is usually performed to correct lower limb discrepancy. However, complications, such as knee subluxation/dislocation, can occur during this treatment. Here, we explore CFD knee abnormalities and knee dislocation during limb elongation, discussing when and whether knee ligament reconstruction prior to the lengthening would be necessary to reduce the risk of knee dislocation. There is not enough support in the literature for the routine reconstruction of cruciate ligaments in CFD patients. Of note, in cases of severe anteroposterior or posterolateral rotatory instability, cruciate ligament reconstruction might be considered to decrease the risk of knee subluxation/dislocation during the lengthening treatment.
- Impact of COVID-19 on physical and mental functioning in adolescents with disabilities in a sports nongovernmental organization(2023) LAURENTINO, Moises de Freitas; LINDOSO, Livia; ASTLEY, Camilla; LAVORATO, Sofia Simao Martins; IHARA, Bianca Pires; LIMA, Dandara Carvalho Casado de; GUALANO, Bruno; QUEIROZ, Ligia Bruni; PEREIRA, Rosa Maria Rodrigues; POLANCZYK, Guilherme Vanoni; CAMARGO, Olavo Pires de; SILVA, Clovis Artur; GRANGEIRO, Patricia MorenoObjective:This study aimed to assess physical and mental health, and health-related quality of life (HRQL) parameters in adolescents with physical disabilities enrolled in a sports nongovernmental organization (NGO) versus adolescents without disabilities during coronavirus disease 2019 (COVID-19) pandemic. Methods: This cross-sectional study included 30 adolescents with disabilities and 86 adolescents without disabilities who responded to an online questionnaire with sociodemographic data and self-rated healthcare routine information during the COVID-19 quarantine. Validated self-report versions of the Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Outcome Data Collection Instrument (PODCI) were also applied. Results: The median of emotional [4 (0-10) vs. 5 (0-10), p=0.018] and prosocial [7 (0-10) vs. 9 (3-10), p=0.006] problems was lower in adolescents with disabilities versus adolescents without disabilities. Adolescents with disabilities had significantly lower global function [68 (21-99) vs. 94 (67-100), p<0.001] and higher happiness scores in the PODCI scale [90 (65-100) vs. 80 (0-100), p=0.016] compared to controls. Logistic regression analysis demonstrated that physical activity/week (OR=1.03; 95%CI 1.01-1.05, p=0.002) was higher in adolescents with disabilities compared to adolescents without disabilities. However, housework activities (OR=0.14; 95%CI 0.04-0.43, p=0.001) and screen time >= 3 h/day (OR=0.09; 95%CI 0.02-0.38, p=0.001) were lower in adolescents with disabilities compared to adolescents without disabilities. Conclusion: Adolescents with disabilities attending a sports NGO were not at higher risk of adverse health-related indicators; despite showing reduced physical function, they reported more physical activity, higher happiness, and less screen time compared to adolescents without disabilities during the COVID-19 pandemic.
- Physical and mental health impacts during COVID-19 quarantine in adolescents with preexisting chronic immunocompromised conditions(2022) LINDOSO, Livia; ASTLEY, Camilla; QUEIROZ, Ligia Bruni; GUALANO, Bruno; PEREIRA, Rosa Maria Rodrigues; TANNURI, Uenis; CAMPOS, Lucia Maria Mattei de Arruda; LOURENCO, Benito; TOMA, Ricardo Katsuya; MEDEIROS, Karina; WATANABE, Andreia; GRANGEIRO, Patricia Moreno; BARROS, Vera da Penha Martellini Ferrari Rego; CASELLA, Caio Borba; FARHAT, Sylvia; POLANCZYK, Guilherme Vanoni; SILVA, Clovis ArturObjective: To evaluate physical and mental health indicators in adolescents with preexisting chronic immunocompromised conditions during coronavirus disease 2019 (COVID-19) quarantine. Methods: A cross-sectional study included 355 adolescents with chronic conditions and 111 healthy adolescents. An online self-rated survey was used to investigate socio-demographic features, healthcare routine, and the quarantine impact on physical and mental health. The validated self-reported version of the Strengths and Difficulties Questionnaire (SDQ) was also applied. Results: The median of age [14 (10-18) vs. 15 (10-18) years, p = 0.733] and frequencies of female (61% vs. 60%, p = 0.970) were similar between adolescents with preexisting chronic conditions and healthy adolescents during quarantine of COVID-19 pandemic. The frequencies of abnormal total difficulties score of SDQ were similar in patients and controls (30% vs. 31%, p = 0.775). Logistic regression analysis showed that being female (OR = 1.965; 95% CI = 1.091-3.541, p = 0.024), fear of underlying disease activity/complication (OR = 1.009; 95%CI = 1.001-1.018, p = 0.030) were associated with severe psychosocial dysfunction in adolescents with chronic conditions, whereas school homework (OR = 0.449; 95% CI = 0.206-0.981, p = 0.045) and physical activity (OR = 0.990; 95% CI = 0.981-0.999, p = 0.030) were protective factors. Further analysis of patients with chronic immunocompromised conditions and previous diagnosis of mental disorders (9%) compared with patients without diagnosis showed higher median of total difficulties score (p = 0.001), emotional (p = 0.005), conduct (p = 0.007), peer problems (p = 0.001) and hyperactivity (p = 0.034) in the former group. Conclusion: Adolescents with preexisting chronic immunocompromised conditions during COVID-19 quarantine were not at higher risk of adverse health indicators. Being female, fear of underlying disease activity/complication, and household members working outside of the home were relevant issues for adolescents with preexisting chronic conditions. This study reinforces the need to establish mental health strategies for teens with chronic conditions, particularly during the pandemic. (C) 2021 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Pediatria.
- MODIFIED DEGA OSTEOTOMY IN TREATING DEVELOPMENTAL DYSPLASIA OF THE HIP(2018) GUARNIEIRO, Roberto; SANCHEZ, Fernando Barbosa; MASSA, Bruno Sergio Ferreira; MONTENEGRO, Nei Botter; GRANGEIRO, Patricia Moreno; ANGELI, Luiz Renato Agrizzi DeObjective: To retrospectively evaluate the preliminary postoperative results of modified Dega-type acetabular osteotomy to treat developmental dysplasia of the hip, confirming the efficacy and reproducibility of this technique. Methods: This retrospective study included patients older than 18 months. A total of 19 hips underwent modified Dega osteotomy. Results: Satisfactory results were obtained, with an average decrease of the acetabular index from 39.2 to 20.6 degrees. The final average center edge angle was 29.6 degrees. Hip joint congruence was reestablished in all cases, and as of this writing, only one case developed necrosis in the femoral head during follow-up. Conclusion: Modified Dega osteotomy demonstrated good initial results, as well as the potential for use in treating developmental dysplasia of the hip.
- Double femoral osteotomy fixed with a Puddu plate and a retrograde intramedullary nail to treat biapical deformity of the femur(2018) GRANGEIRO, Patrícia Moreno; REZENDE, Márcia Uchoa de; HELITO, Camilo Partezani; FELIX, Alessandro Monterroso; OCAMPOS, Guilherme Pereira; GUARNIERO, RobertoABSTRACT Biapical femoral deformities are challenging to treat. In order to correct concomitant metaphyseal and diaphyseal deformities of the femur, the authors propose a double femoral controlled osteotomy with combined internal fixation, consisting of a Puddu plate and an intramedullary nail. The method was described in two patients. Results were analyzed using a visual analog scale (VAS), the Lysholm score, and SF-36. No complications were found. Complete consolidation of the osteotomies and radiographic alignment correction were achieved. Results were obtained with a minimum follow-up of 66 months. Both patients had improved for pain (VAS from 60 to 40 and from 50 to 20 at reassessment), function (Lysholm score from 78 to 93 and from 55 to 73) and quality of life (SF-36, both mental – from 40.7 to 57.1 in case one and from 24.7 to 59.7 in case two – and physical – from 27.7 to 45.6 and from 28.2 to 46.8). The authors have found that this technique is a reliable, accurate, and reproducible solution for biapical deformities of the femur.
- Emotional, hyperactivity and inattention problems in adolescents with immunocompromising chronic diseases during the COVID-19 pandemic(2023) CAMPOS, Reinan T.; LINDOSO, Livia; SOUSA, Renan A. de; HELITO, Alberto C.; IHARA, Bianca P.; STRABELLI, Claudia A. A.; PARADELAS, Levi M. V.; CARNEIRO, Beatriz O. L.; CARDOSO, Maria Paula R.; SOUZA, Jean Paulo V. de; FREIRE, Marianna R. de M.; ASTLEY, Camilla; LAURENTINO, Moises F.; BUSCATTI, Izabel M.; KOZU, Katia; AIKAWA, Nadia E.; SALLUM, Adriana M. E.; FERREIRA, Juliana C. O.; SIMON, Juliana R.; VIANA, Vivianne S. L.; QUEIROZ, Ligia B.; GUALANO, Bruno; ROSCHEL, Hamilton; PEREIRA, Rosa Maria R.; TOMA, Ricardo K.; WATANABE, Andreia; GRANGEIRO, Patricia M.; CASELLA, Caio B.; FARHAT, Sylvia C.; V, Guilherme Polanczyk; CAMPOS, Lucia Maria A.; SILVA, Clovis A.Objective: To assess factors associated with emotional changes and Hyperactivity/Inattention (HI) motivated by COVID-19 quarantine in adolescents with immunocompromising diseases.Methods: A cross-sectional study included 343 adolescents with immunocompromising diseases and 108 healthy adolescents. Online questionnaires were answered including socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and validated surveys: Strengths and Difficulties Questionnaire (SDQ), Pitts-burgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0).Results: The frequencies of abnormal emotional SDQ scores from adolescents with chronic diseases were similar to those of healthy subjects (110/343 [32%] vs. 38/108 [35%], p = 0.548), as well as abnormal hyperactivity/inat-tention SDQ scores (79/343 [23%] vs. 29/108 [27%], p = 0.417). Logistic regression analysis of independent var-iables associated with abnormal emotional scores from adolescents with chronic diseases showed: female sex (Odds Ratio [OR = 3.76]; 95% Confidence Interval (95% CI) 2.00-7.05; p < 0.001), poor sleep quality (OR = 2.05; 95% CI 1.08-3.88; p = 0.028) and intrafamilial violence during pandemic (OR = 2.17; 95% CI 1.12-4.19; p = 0.021) as independently associated with abnormal emotional scores, whereas total PedsQL score was inversely associated with abnormal emotional scores (OR = 0.95; 95% CI 0.93-0.96; p < 0.0001). Logistic regression analysis associated with abnormal HI scores from patients evidenced that total PedsQL score (OR = 0.97; 95% CI 0.95-0.99; p = 0.010], changes in medical appointments during the pandemic (OR = 0.39; 95% CI 0.19-0.79; p = 0.021), and reliable COVID-19 information (OR = 0.35; 95% CI 0.16-0.77; p = 0.026) remained inversely associated with abnormal HI scores.Conclusion: The present study showed emotional and HI disturbances in adolescents with chronic immunosuppres-sive diseases during the COVID-19 pandemic. It reinforces the need to promptly implement a longitudinal pro-gram to protect the mental health of adolescents with and without chronic illnesses during future pandemics.