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
39 resultados
Resultados de Busca
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- Extracellular Matrix Composition of the Cricopharyngeus Muscle(2012) TAVARES, Raquel Aguiar; SENNES, Luiz Ubirajara; MAUAD, Thais; IMAMURA, Rui; SILVA, Luiz Fernando Ferraz da; CARRAU, Ricardo LuisThe aim of this study was to analyze the presence and distribution of total collagen, type I and type III collagen, elastic fibers, fibronectin, and versican in the endomysium of cricopharyngeus muscles from adults of various ages. The study was a cross-sectional analysis of human cricopharyngeus muscles. Twenty-seven muscles obtained from autopsies of men and women ranging in age from 28 to 92 years were analyzed with the Picrosirius method, oxidized Weigert resorcin-fuchsin, immunohistochemistry, and image analysis. Collagen had the highest density among the analyzed components. Elastic fibers surrounded each muscle cell; they were aligned longitudinally by their long axis and associated with traversing fibers, thereby forming a fiber network with embedded muscle cells. The fibronectin and versican contents varied widely among the specimens. We found no statistically significant differences between the proportion of extracellular matrix (ECM) components and factors such as gender and race. We conclude that the higher proportion of type I and type III collagen is compatible with the cricopharyngeus muscle's sphincteric behavior, and the arrangement of the elastic fibers may also contribute to the muscle's elasticity. We found no statistically significant correlation between the ECM components and age.
- Small cell lung carcinoma metastasis to palatine tonsils(2013) ARROYO, Helena Hotz; TAKEHARA, Jefferson; OGAWA, Allex Itar; FRIZZARINI, Ronaldo; IMAMURA, Rui; PAULA, Henrique Moura de
- Comparative study on liposomal amphotericin B and other therapies in the treatment of mucosal leishmaniasis: A 15-year retrospective cohort study(2019) SANTOS, Carolina Rocio; TUON, Felipe Francisco; CIESLINSKI, Juliette; SOUZA, Regina Maia de; IMAMURA, Rui; AMATO, Valdir SabbagaBackground Liposomal amphotericin B (L-AMB) has been used for mucosal leishmaniasis (ML), but comparative studies on L-AMB and other drugs used for the treatment of ML have not been conducted. The present study aimed to evaluate the outcome of patients with ML who were treated with L-AMB. Methods This is a 15-year retrospective study of Brazilian patients with a confirmed diagnosis of ML. The therapeutic options for the treatment of ML consisted of L-AMB, amphotericin B lipid complex (ABLC), deoxycholate amphotericin B (d-AMB), itraconazole, antimonial pentavalent, or pentamidine. Healing, cure rate and adverse effects (AEs) associated with the drugs used to treat this condition were analyzed. Results In 71 patients, a total of 105 treatments were evaluated. The outcome of the treatment with each drug was compared, and results showed that L-AMB was superior to other therapeutic regimens (P = 0.001; odds ratio [OR] = 4.84; 95% confidence interval [CI] = 1.78-13.17). d-AMB had worse AEs than other treatment regimens (P = 0.001, OR = 0.09; 95% CI = 0.09-0.43). Approximately 66% of the patients presented with AEs during ML treatment. Although L-AMB was less nephrotoxic than d-AMB, it was associated with acute kidney injury compared with other drugs (P <0.05). Conclusion L-AMB was more effective than other therapies for the treatment of ML. However, a high incidence of toxicity was associated with its use. Therapeutic choices should be reassessed, and the development of new drugs is necessary for the treatment of ML.
- Influence of international authorship on citations in Brazilian medical journals: a bibliometric analysis(2019) MONTEFUSCO, Adilson Marcos; NASCIMENTO, Felipe Parra do; SENNES, Luiz Ubirajara; BENTO, Ricardo Ferreira; IMAMURA, RuiThe challenge of increasing the impact of regional journals has received much attention. While funding and research agencies require the acceptance of papers from foreign authors as a means of increasing citations, Brazilian journal editors dispute the impact of this measure. This study aimed to evaluate, for Brazilian medical journals, whether the number of citations a document received was influenced by the authors' institutional affiliations or other predictive factors related to the paper or the journal. Sixty-one medical journals published in Brazil in 2012 were selected for analysis. SCImago and Scopus were used to extract the articles and their data. The number of citations a document received in 5years was analyzed according to the authors' affiliations, language, document type, SCImago Cites per Document, and journal subject category. After adjusting for covariates by multivariate analysis, documents with collaborative international affiliations showed a citation increase of 0.17 (95% CI: 0.084-0.216) over documents by Brazilian authors. Significant increases in citations were also observed for bilingual documents (0.329; 95% CI: 0.236-0.380), English-only documents (0.159; 95% CI: 0.078-0.203), articles (1.590; 95% CI: 1.363-1.714), reviews (2.752; 95% CI: 2.355-2.972), and those under the subject category of hematology (1.280; 95% CI: 0.756-1.604). In summary, while collaborative international authorship increased citations in the investigated journals, language, type of document, and subject category had a stronger impact on the number of citations.
- Effects of Superomedial Partial Arytenoidectomy on Incomplete Posterior Glottal Closure Caused by Arytenoid Positional Asymmetry in Excised Human Larynges(2023) ENOKI, A. M.; IMAMURA, R.; TSUJI, D. H.Objectives: To analyze the effects that arytenoid positional asymmetry has on posterior glottic closure and to determine whether superomedial partial arytenoidectomy (SPA) can provide a benefit in cases of such asymmetry. Methods: In this experimental study, we evaluated posterior glottic closure in 10 larynges freshly excised from human cadavers, measuring the distance between the vocal processes before and after artificially simulated positional asymmetry of the arytenoid cartilages. We then performed SPA, after which we again measured the distance between the vocal processes. Results: In all of the larynges studied, the posterior glottic closure went from complete to incomplete after simulation of arytenoid positional asymmetry, the median distance observed between the vocal processes being 1.74mm (interquartile range 0.22). The SPA performed after arytenoid asymmetry caused the posterior glottic closure to return from incomplete to complete in all of the larynges studied. Conclusion: Our results suggest that arytenoid positional asymmetry impairs posterior glottic closure and that SPA improves posterior glottic closure in such cases of arytenoid asymmetry. © 2021 The Voice Foundation
- Facial Structure Alterations and Abnormalities of the Paranasal Sinuses on Multidetector Computed Tomography Scans of Patients with Treated Mucosal Leishmaniasis(2014) CAMARGO, Raphael Abegao de; NICODEMO, Antonio C.; SUMI, Daniel Vaccaro; GEBRIM, Eloisa Maria Mello Santiago; TUON, Felipe Francisco; CAMARGO, Lazaro Manoel de; IMAMURA, Rui; AMATO, Valdir SabbagaBackground/Objectives: Mucosal leishmaniasis (ML) is a progressive disease that affects cartilage and bone structures of the nose and other upper respiratory tract structures. Complications associated with ML have been described, but there is a lack of studies that evaluate the structural changes of the nose and paranasal sinuses in ML using radiological methods. In this study, we aimed to assess the opacification of the paranasal sinuses in patients with treated ML and any anatomical changes in the face associated with ML using multidetector computed tomography scans (MDCT) of the sinuses. We compared the findings with a control group. Methodology/Principal Findings: We evaluated 54 patients with treated ML who underwent CT scans of the sinuses and compared them with a control group of 40 patients who underwent orbital CT scans. The degree of sinus disease was assessed according to the Lund-Mackay criteria. Forty of the 54 patients with a history of ML (74.1%) had a tomographic score compatible with chronic sinusitis (Lund-Mackay >= 4). CT scans in the leishmaniasis and control groups demonstrated significant differences in terms of facial structure alterations. Patients from the ML group showed more severe levels of partial opacification and pansinus mucosal thickening (42.6%) and a greater severity of total opacification. Patients from the ML group with a Lund-Mackay score >= 4 presented longer durations of disease before treatment and more severe presentations of the disease at diagnosis. Conclusion/Significance: CT scans of the sinuses of patients with ML presented several structural alterations, revealing a prominent destructive feature of the disease. The higher prevalence in this study of chronic rhinosinusitis observed in CT scans of patients with treated ML than in those of the control group suggests that ML can be considered a risk factor for chronic rhinosinusitis in this population (p<0.05).
- Identification of Leishmania species by next generation sequencing of hsp70 gene(2022) SOUZA, Regina Maia de; MARTINS, Roberta Cristina Ruedas; FRANCO, Lucas Augusto Moyses; TUON, Felipe Francisco; OLIVEIRA JUNIOR, Isael Gomes de; SILVA, Camila Alves Maia da; IMAMURA, Rui; AMATO, Valdir SabbagaLeishmaniasis is a major public health problem worldwide. Although next generation sequencing technology has been widely used in the diagnosis of infectious diseases, it has been scarcely applied in identification of Leishmania species. The aim of this study was to compare the efficiency of MinIONTM nanopore sequencing and polymerase chain reaction restriction fragment length polymorphism in identifying Leishmania species. Our results showed that the MinIONTM sequencer was able to discriminate reference strains and clinical samples with high sensitivity in a cost and time effective manner without the prior need for culture.
- Sensitivity and Specificity of Bedside Screening Tests for Detection of Aspiration in Patients Admitted to a Public Rehabilitation Hospital(2021) VELASCO, Leandro Castro; IMAMURA, Rui; REGO, Ana Paula Valeriano; ALVES, Priscilla Rabelo; PEIXOTO, Lorena Pacheco da Silva; SIQUEIRA, Jose de OliveiraEarly detection of dysphagia and specifically aspiration is essential to prevent and reduce complications of hospitalized patients in rehabilitation centers. Bedside screening test are often used to evaluate swallowing disorders, but their results may be questionable due to insufficient and inconsistent sensitivity and specificity. To compare the sensitivity and specificity of various bedside screening tests for detecting aspiration in hospitalized rehabilitation patients. A prospective observational study was performed in 150 consecutive patients of a tertiary rehabilitation hospital. Patients were evaluated regarding clinical predictors for aspiration, maximum phonation time (MPT), Eating Assessment Tool 10 (EAT-10) questionnaire, tongue strength and endurance (Iowa Oral Performance Instrument [IOPI]) and a swallowing test (Volume-Viscosity Swallow Test [V-VST]). Flexible Endoscopic Evaluation of Swallowing (FEES) was the reference test. Of the 144 patients included, 22% aspirated on FEES. Previous history of pneumonia, dysarthria, wet voice, and abnormal cough reflex were significantly associated with aspiration. The sensitivity, specificity and accuracy for V-VST (83.3%, 72.6%, 74.8%, respectively) and EAT-10 (82.8%, 57.7%, 62.8%, respectively) to detect aspiration were superior than those of other methods. Maximum tongue strength on IOPI and MPT presented high sensitivity but low specificity to detect aspiration. Clinical predictors of aspiration (previous history of pneumonia, dysarthria, wet voice, and abnormal cough reflex) associated with either V-VST or EAT-10 may be good screening methods to detect aspiration in patients hospitalized in a rehabilitation center.
- Bipedicled Vocal Fold Mucosal Flap Use in Phonomicrosurgery: Case Series(2021) TSUJI, Domingos Hiroshi; KINCHOKU, Vanessa Mika; IMAMURA, Rui; HACHIYA, Adriana; YAMASAKI, Rosiane; MARINHO, Guilherme Rodrigues; SENNES, Luiz UbirajaraObjectives. The objective of this study was to present a novel surgical technique involving the use of a ""bipedicled vocal fold mucosal flap"" to repair a mucosal defect and to evaluate the outcomes of patients in whom it was used. Material and methods. This was a retrospective study of 6 clinical cases. All patients underwent surgery between November 2000 and July 2018, and all procedures were performed by the same surgeon. For the auditory-perceptual assessment, the Grade-Roughness-Breathiness-Asthenia-Strain hoarseness scale was used. We based the stroboscopic evaluation on the European Laryngological Society protocol, analyzing the parameters glottal closure, mucosal wave, and phase symmetry. Results. Ages at the time of surgery ranged from 10 to 52 years, and all of the patients were male. Preexisting vocal fold lesions included polyps, cysts, a sulcus, and mucosal bridges. Among the stroboscopic parameters, only the mucosal wave differed significantly between the preoperative and postoperative periods (P = 0.046). There were also significant postoperative improvements in the overall grade of dysphonia (P = 0.025) and in the degree of breathiness (P = 0.025). Conclusions. The use of a bipedicled vocal fold mucosal flap appears to promote significant improvements in the mucosal wave and in voice quality. In the patients evaluated here, the technique was used without preoperative planning. However, it proved to be a safe and appropriate means of repairing mucosal defects in the vocal folds, with the potential to preserve rheological properties and promote healing with less chance of fibrosis.
- Management of laryngopharyngeal reflux in Brazil: a national survey(2022) LECHIENA, Jerome R.; PERAZZOE, Paulo S.; CECCONF, Fabio P.; ECKLEYG, Claudia A.; LOPESH, Karen de Carvalho; MAUNSELLI, Rebecca; AVELINOJ, Melissa A. G.; AKSTK, Lee M.; SANT'ANNAL, Geraldo D.; IMAMURAM, RuiIntroduction: Studies assessing the management of laryngopharyngeal reflux by otolaryngologists have reported an important heterogeneity regarding the definition, diagnosis, and treatment, which leads to discrepancies in the management of the patient. Information about the current knowledge and practices of Brazilian otolaryngologists in laryngopharyngeal reflux is lacking. Objective: To investigate the trends in management of laryngopharyngeal reflux disease among Brazilian otolaryngologists. Methods: A survey was sent by email to the members of the Brazilian Association of Otolaryngology-Head Neck Surgery. This survey has initially been conducted by the laryngopharyngeal reflux study group of young otolaryngologists of the International Federation of Otolaryngological Societies. Results: According to the survey responders, the prevalence of laryngopharyngeal reflux was estimated to be 26.8% of patients consulting in otolaryngology and the most common symptoms were globus sensation, throat clearing, cough and stomach acid reflux. Nasal obstruction, Eustachian tube dysfunction, acute and chronic otitis media, vocal fold nodules and hemorrhage were considered not associated with laryngopharyngeal reflux by the majority of responders. About 2/3 of Brazilian otolaryngologists based the diagnosis of laryngopharyngeal reflux on the assessment of both symptoms and findings and a positive response to empiric therapeutic trials. Proton pump inhibitor utilized once or twice daily, was the most commonly used therapeutic scheme. Only 21.4% of Brazilian otolaryngologists have heard about nonacid and mixed laryngopharyngeal reflux and the awareness about the usefulness of multichannel intraluminal impedance pH monitoring (MII-pH) was minimal; 30.5% of responders did not consider themselves as well-informed about laryngopharyngeal reflux. Conclusion: Although the laryngopharyngeal reflux-related symptoms, main diagnostic and treatment approaches referred by Brazilian otolaryngologists are consistent with the literature, the survey identified some limitations, such as the insufficient awareness of the role of laryngopharyngeal reflux in many otolaryngological conditions and of the possibility of non-acid or mixed reflux in refractory cases. Future studies are needed to establish international recommendations for the management of laryngopharyngeal reflux disease.