RUI IMAMURA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
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- Impact of the COVID-19 Pandemic on Physicians Working in the Head and Neck Field(2021) IMAMURA, Rui; BENTO, Ricardo F.; MATOS, Leandro L.; WILLIAM JR., William N.; MARTA, Gustavo N.; CHAVES, Aline L. F.; CASTRO JR., Gilberto de; KOWALSKI, Luiz P.Background With the COVID-19 pandemic, the clinical practice of physicians who work in the head and neck field in Brazil dropped dramatically. The sustained impact of the pandemic is not known. Methods An anonymous online survey was distributed to Brazilian otolaryngologists, head and neck surgeons, medical and radiation oncologists, asking about their clinical practice in the third to fourth months of the pandemic. Results The survey was completed by 446 specialists. About 40% reported reduction of more than 75% in outpatient care. A reduction of 90% to 100% in airway endoscopies was reported by 50% of the responders, and the same rate of reduction regarding surgeries (pediatric or nasosinusal) was reported by 80% of them. Family income decreased by 50%, and the psychological burden on physicians was considerable. The availability of personal protective equipment and safety precautions were limited, especially in the public sector. Conclusion COVID-19 is still impacting the head and neck field, and safety concerns may hinder the prompt resumption of elective care.
- Standardization of elective tracheostomies at the Central Institute of the Hospital das Clínicas in São Paulo during the COVID-19 pandemic(2020) MENEGOZZO, CARLOS AUGUSTO METIDIERI; ARAP, SÉRGIO SAMIR; MARIANI, ALESSANDRO WASUM; MINAMOTO, HÉLIO; IMAMURA, RUI; BENTO, RICARDO FERREIRA; PÊGO-FERNANDES, PAULO MANOEL; KOWALSKI, LUIZ PAULO; UTIYAMA, EDIVALDO MASSAZOABSTRACT The COVID-19 Pandemic has resulted in a high number of hospital admissions and some of those patients need ventilatory support in intensive care units. The viral pneumonia secondary to Sars-cov-2 infection may lead to acute respiratory distress syndrome (ARDS) and longer mechanical ventilation needs, resulting in a higher demand for tracheostomies. Due to the high aerosolization potential of such procedure, and the associated risks of staff and envoirenment contamination, it is necesseray to develop a specific standardization of the of the whole process involving tracheostomies. This manuscript aims to demonstrate the main steps of the standardization created by a tracheostomy team in a tertiary hospital dedicated to providing care for patients with COVID-19.
- Outcomes of Early Versus Late Tracheostomy in Patients With COVID-19: A Multinational Cohort Study(2022) SHRECKENGOST, C. S. Harrell; FOIANINI, J. E.; ENCINAS, K. M. Moron; GUARACHI, H. Tola; ABRIL, K.; AMIN, D.; BERKOWITZ, D.; CASTATER, C. A.; DOUGLAS, J. M.; GRANT, A. A.; KHULLAR, O. V.; LANE, A. N.; LIN, A.; NIROULA, A.; NIZAM, A.; RASHIED, A.; REITZ, A. W.; ROSER, S. M.; SPYCHALSKI, J.; ARAP, S. S.; BENTO, R. F.; CIARALO, P. P. D.; IMAMURA, R.; KOWALSKI, L. P.; MAHMOUD, A.; MARIANI, A. W.; MENEGOZZO, C. A. M.; MINAMOTO, H.; MONTENEGRO, F. L. M.; PêGO-FERNANDES, P. M.; SANTOS, J.; UTIYAMA, E. M.; SREEDHARAN, J. K.; KALCHIEM-DEKEL, O.; NGUYEN, J.; DHAMSANIA, R. K.; ALLEN, K.; MODZIK, A.; PATHAK, V.; WHITE, C.; BLAS, J.; EL-ABUR, I. Talal; TIRADO, G.; BENíTEZ, C. Yánez; WEISER, T. G.; BARRY, M.; BOECK, M.; FARRELL, M.; GREENBERG, A.; MILLER, P.; PARK, P.; CAMAZINE, M.; DILLON, D.; SMITH, R. N.OBJECTIVES: Timing of tracheostomy in patients with COVID-19 has attracted substantial attention. Initial guidelines recommended delaying or avoiding tracheostomy due to the potential for particle aerosolization and theoretical risk to providers. However, early tracheostomy could improve patient outcomes and alleviate resource shortages. This study compares outcomes in a diverse population of hospitalized COVID-19 patients who underwent tracheostomy either ""early""(within 14 d of intubation) or ""late""(more than 14 d after intubation). DESIGN: International multi-institute retrospective cohort study. SETTING: Thirteen hospitals in Bolivia, Brazil, Spain, and the United States. PATIENTS: Hospitalized patients with COVID-19 undergoing early or late tracheostomy between March 1, 2020, and March 31, 2021. INTERVENTIONS: Not applicable. MEASUREMENTS AND MAIN RESULTS: A total of 549 patients from 13 hospitals in four countries were included in the final analysis. Multivariable regression analysis showed that early tracheostomy was associated with a 12-day decrease in time on mechanical ventilation (95% CI, -16 to -8; p < 0.001). Further, ICU and hospital lengths of stay in patients undergoing early tracheostomy were 15 days (95% CI, -23 to -9 d; p < 0.001) and 22 days (95% CI, -31 to -12 d) shorter, respectively. In contrast, early tracheostomy patients experienced lower risk-adjusted survival at 30-day post-admission (hazard ratio, 3.0; 95% CI, 1.8-5.2). Differences in 90-day post-admission survival were not identified. CONCLUSIONS: COVID-19 patients undergoing tracheostomy within 14 days of intubation have reduced ventilator dependence as well as reduced lengths of stay. However, early tracheostomy patients experienced lower 30-day survival. Future efforts should identify patients most likely to benefit from early tracheostomy while accounting for location-specific capacity. Copyright © 2022 The Authors.
- Effect of the COVID-19 Pandemic on the Activity of Physicians Working in the Areas of Head and Neck Surgery and Otorhinolaryngology(2020) KOWALSKI, Luiz Paulo; IMAMURA, Rui; CASTRO JUNIOR, Gilberto de; MARTA, Gustavo Nader; CHAVES, Aline Lauda Freitas; MATOS, Leandro Luongo; BENTO, Ricardo FerreiraIntroduction Coronavirus disease 2019 (COVID-19) is an acute infection caused by the new coronavirus (SARS-CoV-2) and it is highly transmissible, especially through respiratory droplets. To prepare the health system for the care of these patients also led to a restriction in the activity of several medical specialties. Physicians who work with patients affected by diseases of the head and neck region constitute one of the populations most vulnerable to COVID-19 and also most affected by the interruption of their professional activities. Objective The aim of the present study was to assess the impact of the COVID-19 pandemic on the practice of head and neck surgeons and otorhinolaryngologists in Brazil. Methods An anonymous online survey of voluntary participation was applied, containing 30 questions regarding demographic aspects, availability of personal protective equipment (PPE), and impact on the routine of head and neck surgeons and otorhinolaryngologists, as well as clinical oncologists and radiation oncologists who work with head and neck diseases. Results Seven hundred and twenty-nine answers were received in a period of 4 days, similar to 40 days after the 1(st)confirmed case in Brazil. With professionals working in public and private services, there was a high level of concerns with the disease and its consequences, limited availability of PPE and a significant decrease in the volume of specialized medical care. Conclusion The study demonstrated a direct impact of the COVID-19 pandemic on the clinical practice of specialties related to the treatment of patients with diseases of the head and neck region already in the beginning of the illness management in Brazil.