BRUNO DA COSTA MARTINS
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Risk Stratification in Cancer Patients with Acute Upper Gastrointestinal Bleeding: Comparison of Glasgow-Blatchford, Rockall and AIMS65, and Development of a New Scoring System(2022) FRANCO, Matheus Cavalcante; JANG, Sunguk; MARTINS, Bruno da Costa; STEVENS, Tyler; JAIRATH, Vipul; LOPEZ, Rocio; VARGO, John J.; BARKUN, Alan; MALUF-FILHO, FauzeBackground/Aims: Few studies have measured the accuracy of prognostic scores for upper gastrointestinal bleeding (UGIB) among cancer patients. Thereby, we compared the prognostic scores for predicting major outcomes in cancer patients with UGIB. Secondarily, we developed a new model to detect patients who might require hemostatic care. Methods: A prospective research was performed in a tertiary hospital by enrolling cancer patients admitted with UGIB. Clinical and endoscopic findings were obtained through a prospective database. Multiple logistic regression analysis was performed to gauge the power of each score. Results: From April 2015 to May 2016, 243 patients met the inclusion criteria. The AIMS65 (area under the curve [AUC] 0.85) best predicted intensive care unit admission, while the Glasgow-Blatchford score best predicted blood transfusion (AUC 0.82) and the low-risk group (AUC 0.92). All scores failed to predict hemostatic therapy and rebleeding. The new score was superior (AUC 0.74) in predicting hemostatic therapy. The AIMS65 (AUC 0.84) best predicted in-hospital mortality. Conclusions: The scoring systems for prognostication were validated in the group of cancer patients with UGIB. A new score was developed to predict hemostatic therapy. Following this result, future prospective research should be performed to validate the new score.
conferenceObject PROPOSED CLINICAL MODEL FOR PREDICTION OF HEMOSTATIC THERAPY FOR UPPER GASTROINTESTINAL BLEEDING IN PATIENTS WITH CANCER(2018) FRANCO, Matheus C.; JANG, Sunguk; MARTINS, Bruno; STEVENS, Tyler; JAIRATH, Vipul; LOPEZ, Rocio; VARGO, John J.; BARKUN, Alan N.; MALUF-FILHO, Fauze- Risk factors for adverse events of colorectal endoscopic submucosal dissection: a systematic review and meta-analysis(2021) SANTOS, Juliana B.; NOBRE, Moacyr R. C.; OLIVEIRA, Cleyton Z.; SAFATLE-RIBEIRO, Adriana V.; KAWAGUTI, Fabio; MARTINS, Bruno; NAHAS, Sergio C.; RIBEIRO JR., Ulysses; ZHANG, Lanjing; MALUF-FILHO, FauzeColorectal endoscopic submucosal dissection (ESD) is already an established treatment for superficial colorectal tumors. However, its technical difficulty and high adverse events rates, compared to endoscopic piecemeal mucosal resection, are a concern to some specialists and have probably contributed to discouragement in its widespread adoption. The debate mentioned above stimulated us to perform a systematic review aiming to identify risk factors for colorectal ESD-related adverse events. We conducted this study following the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement and registered in the PROSPERO (University of York) international database (CRD42016042625). We searched MEDLINE, EMBASE, Cochrane Library and LILACS for the publications focused on risk factors for colorectal ESD-related adverse events from inception until April 2020. We included a total of 22 qualified studies in this analysis. We found that fibrosis had an odds ratio (OR) for perforation of 2.90 [95% confidence interval, (1.83-4.59)], right colon location of 2.35 (1.58-3.50), colonic location of 2.20 (1.44-3.35) and larger size of 2.17 (1.47-3.21), as well as one protective factor, the endoscopist experience OR = 0.62 (0.45-0.86). For bleeding, we considered rectal location a risk factor [OR = 3.55 (2.066.12)]. Through the several meta-analyses that we performed in this article, we could summarize the main risk factors for perforation and bleeding on colorectal ESD. Therefore, we provide insightful information for clinical judgment on regions where colorectal ESD is already widespread and help in the learning process of this challenging technique.
- Self-expandable metallic stent-induced esophagorespiratory fistulas in patients with advanced esophageal cancer(2023) JOSINO, Iatagan R.; MARTINS, Bruno C.; MACHADO, Andressa A.; LIMA, Gustavo R. de A.; CORDERO, Martin A. C.; POMBO, Amanda A. M.; SALLUM, Rubens A. A.; JR, Ulysses Ribeiro; BARON, Todd H.; MALUF-FILHO, FauzeBackground/Aims: Self-expandable metallic stents (SEMSs) are widely adopted for the palliation of dysphagia in patients with malignant esophageal strictures. An important adverse event is the development of SEMS-induced esophagorespiratory fistulas (SEMSERFs). This study aimed to assess the risk factors related to the development of SEMS-ERF after SEMS placement in patients with esophageal cancer. Methods: This retrospective study was performed at the Instituto do Cancer do Estado de Sao Paulo. All patients with malignant esophageal strictures who underwent esophageal SEMS placement between 2009 and 2019 were included in the study. Results: Of the 335 patients, 37 (11.0%) developed SEMS-ERF, with a median time of 129 days after SEMS placement. Stent flare of 28 mm (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.15-5.51; p=0.02) and post-stent chemotherapy (HR, 2.0; 95% CI, 1.01- 4.00; p=0.05) were associated with an increased risk of developing SEMS-ERF, while lower-third tumors were a protective factor (HR, 0.5; 95% CI, 0.26-0.85; p=0.01). No difference was observed in overall survival. Conclusions: The incidence of SEMS-ERFs was 11%, with a median time of 129 days after SEMS placement. Post-stent chemotherapy and a 28 mm stent flare were associated with a higher risk of SEMS-ERF.
conferenceObject Performance of Glasgow-Blacthford, Rockall and Aims65 Scores to Identify the Low-Risk Group After Upper Gastrointestinal Bleeding in Patients With Cancer(2017) FRANCO, Matheus C.; JANG, Sunguk; MARTINS, Bruno da Costa; STEVENS, Tyler; JAIRATH, Vipul; LOPEZ, Rocio; VARGO, John J.; BARKUN, Alan N.; MALUF-FILHO, FauzeconferenceObject Comparison of Glasgow-Blacthford, Rockall and Aims65 Scores for Predicting Upper GI Bleeding Outcomes in Patients With Cancer(2017) FRANCO, Matheus C.; JANG, Sunguk; MARTINS, Bruno da Costa; STEVENS, Tyler; JAIRATH, Vipul; LOPEZ, Rocio; VARGO, John J.; BARKUN, Alan N.; MALUF-FILHO, Fauze- Impact of COVID-19 on Endoscopy Training: Perspectives from a Global Survey of Program Directors and Endoscopy Trainers(2021) VIGNESH, Shivakumar; BUTT, Amna Subhan; ALBORAIE, Mohamed; MARTINS, Bruno Costa; PISCOYA, Alejandro; Quang Trung Tran; YEW, Damien Tan Meng; GHAZANFAR, Shahriyar; ALAVINEJAD, Pezhman; KAMAU, Edna; VERMA, Ajay M.; MENDELSOHN, Robin B.; KHOR, Christopher; MOSS, Alan; LIAO, David Wei Chih; HUANG, Christopher S.; TSAI, Franklin C.Background/Aims: The coronavirus disease of 2019 (COVID-19) pandemic has impacted the training of medical trainees internationally. The aim of this study was to assess the global impact of COVID-19 on endoscopy training from the perspective of endoscopy trainers and to identify strategies implemented to mitigate the impact on trainee education. Methods: Teaching faculty of gastroenterology (GI) training programs globally were invited to complete a 36-question web-based survey to report the characteristics of their training programs and the impact of COVID-19 on various aspects of endoscopy training, including what factors decisions were based on. Results: The survey response rate was 52.6% (305 out of 580 individuals); 92.8% reported a negative impact on endoscopy training, with suspension of elective procedures (77.1%) being the most detrimental factor. Geographic variations were noted, with European programs reporting the lowest percentage of trainee participation in procedures. A higher proportion of trainees in the Americas were allowed to continue performing procedures, and trainers from the Americas reported receiving the greatest support for endoscopy teaching. Conclusions: This study demonstrated that the COVID-19 pandemic has had a significant negative impact on GI endoscopy training internationally, as reported by endoscopy trainers. Focus-optimizing endoscopy training and assessment of competencies are necessary to ensure adequate endoscopy training.