ASCEDIO JOSE RODRIGUES
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
22 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 22
- A new technique for T-tube insertion in patients with subglottic stenosis(2011) TEDDE, Miguel Lia; RODRIGUES, Ascedio; SCORDAMAGLIO, Paulo Rogerio; MONTEIRO, Jackellyne SantosA silicone T tube is widely used for the management of airway problems. Montgomery described the way in which it is usually inserted, but this conventional insertion technique can fail in cases of subglottic stenosis due to the softness of the T tube, which kinks when forced against resistance. An adjunct to the traditional technique of Montgomery may help to insert a T tube in such patients.
- What is the optimal large airway size reduction value to determine malacia: exploratory bronchoscopic analysis in patients in Mounier-Kuhn syndrome(2021) LIMA, Evelise; GENTA, Pedro Rodrigues; ATHANAZIO, Rodrigo Abensur; RODRIGUES, Ascedio Jose; APARECIDA, Maria; NAKAMURA, Maria Aparecida Miyuki; RACHED, Samia Zahi; COSTA, Eduardo Leite Vieira; STELMACH, Rafael
- Flexible bronchoscopy as the first-choice method of removing foreign bodies from the airways of adults(2012) RODRIGUES, Ascedio Jose; OLIVEIRA, Eduardo Quintino; SCORDAMAGLIO, Paulo Rogerio; GREGORIO, Marcelo Gervilla; JACOMELLI, Marcia; FIGUEIREDO, Viviane RossiObjective: To determine the success rate of flexible bronchoscopy as the first-choice method of removing foreign bodies from the airways of adults. Methods: This was a retrospective study of all adult patients (over 18 years of age) with foreign body aspiration submitted to bronchoscopy between January of 2009 and January of 2011 at the University of Sao Paulo School of Medicine Hospital das Clinicas, located in Sao Paulo, Brazil. Results: The study sample comprised 40 adult patients, with a mean age of 52 years (range, 18-88 years). The median time of permanence of the foreign body in the airway was 15 days (range, 12 h to 10 years). All of the patients first underwent diagnostic flexible bronchoscopy. Foreign bodies were successfully removed with flexible bronchoscopy in 33 (82.5%) of the patients. In 1 patient, a metal object lodged in the distal bronchial tree required the use of fluoroscopy. Six patients (15%) required rigid bronchoscopy due to tracheal foreign body-induced dyspnea, in 2, and because the foreign body was too large for the flexible forceps, in 4. Bronchoscopy failed in 1 patient, who therefore required surgical bronchotomy. Conclusions: Although rigid bronchoscopy is considered the gold standard for the removal of foreign bodies from the airways, our experience showed that flexible bronchoscopy can be safely and effectively used in the diagnosis and treatment of stable adult patients.
- Tomografia de coerência óptica broncoscópica(2012) RODRIGUES, Ascedio Jose; TAKIMURA, Celso Kiyochi; LEMOS NETO, Pedro Alves; FIGUEIREDO, Viviane RossiObjective: To evaluate the feasibility of and the potential for using optical coherence tomography in conjunction with conventional bronchoscopy in the evaluation of the airways. Methods: This was a pilot study based on an ex vivo experimental model involving three animals: one adult New Zealand rabbit and two Landrace pigs. An optical coherence tomography imaging catheter was inserted through the working channel of a flexible bronchoscope in order to reach the distal trachea of the animals. images of the walls of the trachea were systematically taken along its entire length, from the distal to the proximal portion. Results: The imaging catheter was easily adapted to the working channel of the bronchoscope. High-resolution images of cross sections of the trachea were taken in real time, precisely delineating microstructures, such as the epithelium, submucosa, and cartilage, as well as the adventitia of the anterior and lateral tracheal walls. The corresponding layers of the epithelium, mucosa, and cartilage were clearly differentiated. The mucosa, submucosa, and trachealis muscle were clearly identified in the posterior wall. Conclusions: It is feasible to use an optical coherence tomography imaging catheter in combination with a flexible bronchoscope. Optical coherence tomography produces high-resolution images that reveal the microanatomy of the trachea, including structures that are typically seen only on images produced by conventional histology.
- Bronchoscopic closure of tracheoesophageal fistulas(2011) RODRIGUES, Ascedio Jose; SCORDAMAGLIO, Paulo Rogerio; TEDDE, Miguel Lia; MINAMOTO, Helio; MOURA, Eduardo Guimaraes Hourneaux de; PEDRA, Carlos A. C.
- Laryngeal and tracheobronchial involvement in Wegener's granulomatosis(2012) RODRIGUES, Ascedio Jose; JACOMELLI, Marcia; BALDOW, Renata Xavier; BARBAS, Carmen Valente; FIGUEIREDO, Viviane RossiIntroduction: Wegener's granulomatosis (WG) is a form of systemic vasculitis that involves primarily the upper and lower airways and the kidneys. The most frequent airway manifestations include subglottic stenosis and inflammation, and tracheal and bronchial stenoses. The endoscopic visualization of the airways is the best tool for assessing, diagnosing and managing those changes. Objectives: To describe the endoscopic abnormalities found in the airway mucosa of a group of patients with WG undergoing bronchoscopy at Hospital das Clinicas of the Faculdade de Medicina, Universidade de Sao Paulo (HC-FMUSP), and to report the therapeutic bronchoscopic interventions used in some cases. Methods: The study assessed 15 patients diagnosed with GW from the Vasculitis Outpatient Clinic of the Department of Pulmonology, HC-FMUSP, referred for bronchoscopy at the Service of Respiratory Endoscopy, HC-FMUSP, from 2003 to 2007. Results: Fifteen patients were studied [11 females (73.33%)]; mean age, 34 +/- 11.5 years. Airway changes were found in 80% of the patients, and the most frequent endoscopic finding was subglottic stenosis (n = 6). Therapeutic bronchoscopy was performed in three patients with subglottic stenosis and in other three patients with bronchial stenosis, all showing good results. Conclusion: Bronchoscopy allows for diagnosing, monitoring, and treating the airway lesions in WG, being a minimally invasive therapeutic option in selected cases.
article 13 Citação(ões) na Scopus Minimally invasive bronchoscopic resection of benign tumors of the bronchi(2011) RODRIGUES, Ascedio Jose; COELHO, David; DIAS JUNIOR, Servulo Azevedo; JACOMELLI, Marcia; SCORDAMAGLIO, Paulo Rogerio; FIGUEIREDO, Viviane RossiObjective: Primary benign tumors of the trachea and main bronchi are uncommon. Interventional bronchoscopy allows the diagnosis and the treatment of some of these lesions. Methods: We reviewed four cases endoscopically treated at our institution. Results: Two patients had hamartoma, and two patients had endobronchial lipoma. In all of the cases, the interventional technique for the resection was the use of a polypectomy snare and electrocautery. The only complication reported was one episode of bronchospasm. Conclusions: Minimally invasive bronchoscopic resection is a safe, effective method for treating selected benign tumors of the main airway and has a low complication rate.- Broncoscopia no diagnóstico de tuberculose pulmonar em pacientes com baciloscopia de escarro negativa(2012) JACOMELLI, Marcia; SILVA, Priscila Regina Alves Araujo; RODRIGUES, Ascedio Jose; DEMARZO, Sergio Eduardo; SEICENTO, Marcia; FIGUEIREDO, Viviane RossiObjective: To evaluate the diagnostic accuracy of bronchoscopy in patients with clinical or radiological suspicion of tuberculosis who were unable to produce sputum or with negative sputum smear microscopy results. Methods: A prospective cross-sectional study involving 286 patients under clinical or radiological suspicion of having pulmonary tuberculosis and submitted to bronchoscopy-BAL and transbronchial biopsy (TBB). The BAL specimens were submitted to direct testing and culture for AFB and fungi, whereas the TBB specimens were submitted to histopathological examination. Results: Of the 286 patients studied, 225 (79%) were diagnosed on the basis of bronchoscopic findings, as follows: pulmonary tuberculosis, in 127 (44%); nonspecific chronic inflammation, in 51 (18%); pneumocystis, fungal infections, or nocardiosis, in 20 (7%); bronchiolitis obliterans organizing pneumonia, alveolites, or pneumoconiosis, in 14 (5%); lung or metastatic neoplasms, in 7 (2%); and nontuberculous mycobacterium infections, in 6 (2%). For the diagnosis of tuberculosis, BAL showed a sensitivity and a specificity of 60% and 100%, respectively. Adding the TBB findings significantly increased this sensitivity (to 84%), as did adding the post-bronchoscopy sputum smear microscopy results (total sensitivity, 94%). Minor post-procedure complications occurred in 5.6% of the cases. Conclusions: Bronchoscopy is a reliable method for the diagnosis of pulmonary tuberculosis, with low complication rates. The combination of TBB and BAL increases the sensitivity of the method and facilitates the differential diagnosis with other diseases.
conferenceObject Cryobiopsy in the Diagnosis of Lung Allograft Rejection: Brazilian Case Series(2022) BELON, Carlos E. F.; OKUNO, Elissa A.; CAMPOS, Silvia V.; RODRIGUES, Ascedio J.; LIMA, Evelisse; SCORDAMAGLIO, Paulo R.; CAMARGO, Priscila C. L. B.; TEIXEIRA, Ricardo H. O. B.; CARRARO, Rafael M.; COSTA, Andre N.; PIRES, Juliana P.; REIS, Flavio P.; FERNANDES, Lucas M.; ABDALLA, Luis G.; FERNANDES, Paulo M. P.; FILHO, Mauro R.; SANTOS, Samuel L.bookPart Intubação endotraqueal guiada por broncoscopia flexível(2013) SAIJO, André Silva; RODRIGUES, Ascedio José; SCORDAMAGLIO, Paulo Rogério
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