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DVCLCIR-62, Hospital Universitário

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Agora exibindo 1 - 9 de 9
  • article 4 Citação(ões) na Scopus
    Hypomagnesemia associated with hypocalcemia after total thyroidectomy: an observational study
    (2016) MAHMOUD, Renata Regina da Graca Lorencetti; ARAUJO NETO, Vergilius Jose Furtado de; ALVES, Wellington; LIN, Chin Shien; LEITE, Ana Kober Nogueira; MATOS, Leandro Luongo; ARAUJO FILHO, Vergilius Jose Furtado de; CERNEA, Claudio Roberto
    Introduction: Serum magnesium is frequently low in patients with hypocalcemia after total thyroidectomy. The aim of the present study was to analyze the variations in serum magnesium and calcium concentrations after total thyroidectomy, and the relationship between both ions. Materials and methods: We conducted an observational study of 142 patients who had undergone total thyroidectomy, measuring serum calcium and magnesium levels preoperatively and on the day following surgery. The incidence of postoperative hypocalcemia was compared with that of postoperative hypomagnesemia. Results: A total of 142, total thyroidectomies were performed: 54 patients (38%) presented with hypocalcemia on the first postoperative day. A marked decrease in blood magnesium in the group of patients with hypocalcemia was observed when compared to those with normal calcemia on the first postoperative day (mean variation respectively, 0.125 +/- 0.065 mmol/L versus 0.035 +/- 0.020 mmol/L; P = 0.0002). Conclusion: Hypomagnesemia is significantly associated with early hypocalcemia following thyroidectomy.
  • article 7 Citação(ões) na Scopus
    Biometric measurements involving the terminal portion of the thoracic duct on left cervical level IV: an anatomic study
    (2016) LOUZADA, Andressa Cristina Sposato; LIM, Soo Jin; PALLAZZO, Jaqueline Fabiano; SILVA, Viviane Passarelli Ramin; OLIVEIRA, Ruan Vitor Silva de; YOSHIO, Alvaro Masahiro; ARAUJO-NETO, Vergilius Jose Furtado de; LEITE, Ana Kober Nogueira; SILVEIRA, Andre; SIMOES, Cesar; BRANDAO, Lenine Garcia; MATOS, Leandro Luongo de; CERNEA, Claudio Roberto
    To determine the point of entrance of the thoracic duct in the venous system, as well as to evaluate some biometric measurements concerning its terminal portion, we conducted an anatomic study on 25 non-preserved cadavers. The termination of the thoracic duct occurred on the confluence between the left internal jugular vein and the left subclavian vein in 60 % of the individuals. The average results for the biometric measurements were: distance between the end of left internal jugular vein and omohyoid muscle 31.2 +/- A 2.7 mm; distance between the end of thoracic duct and the left internal jugular vein 0.0 +/- A 0.0 mm; distance between the end of thoracic duct and the left subclavian vein 3.6 +/- A 1.0 mm; distance between the end of thoracic duct and the left brachiocephalic vein 10.7 +/- A 3.1 mm. Moreover, it was identified that the left internal jugular vein length in level IV, measured between its entrance in the left subclavian vein and the omohyoid muscle, was able to predict the termination of the thoracic duct on the junction between the left internal jugular vein and the left subclavian vein (OR = 2.99) with high accuracy (79.3 %). In addition, the left internal jugular vein length at level IV was able to predict the localization of thoracic duct termination. Thus, this finding has practical value in minimizing the risk for a potential chyle leak during or after a left-sided neck dissection.
  • article 4 Citação(ões) na Scopus
    New method of sentinel lymph node biopsy in transoral robotic surgery for oropharyngeal squamous cell carcinoma
    (2018) KULCSAR, Marco Aurélio V.; CANOVAS, Natasha Sobreira; ARAUJO-NETO, Vergilius Jose Furtado de; KIM, Jorge Du Ub; CERNEA, Claudio Roberto
  • article 8 Citação(ões) na Scopus
    Cervical metastasis on level IV in laryngeal cancer
    (2014) ARAUJO NETO, V. J. Furtado De; CERNEA, C. R.; DEDIVITIS, R. Aparecido; PALAZZO, J. Fabiano; BRANDAO, L. Garcia
    The presence of cervical metastasis has substantial negative impact on survival of patients with laryngeal cancer. Bilateral elective selective neck dissection of levels II, II and IV is usually the chosen approach in these patients. However, there is significant morbidity associated with level IV dissection, such as phrenic nerve injury and lymphatic fistula. The objective of the present study was to evaluate the frequency of metastatic nodes in level IV in clinically T3/T4N0 patients with laryngeal cancer. The pathological reports of 77 patients with clinically T3/T4N0 laryngeal squamous cell carcinoma were reviewed. Patients underwent bilateral lateral neck dissection from January 2007 to November 2012. The surgical specimens were subdivided in levels before evaluation. There were 12 patients with neck metastasis (15.58%). In 3 cases (3.89%), there were metastatic lymph nodes in level IV, all T4 and with ipsilateral metastasis. In conclusion, the incidence of level IV metastasis was 3.89%, an in all patients was staged as T4.
  • article 17 Citação(ões) na Scopus
    Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB)
    (2018) MOSCA, Leticia; SILVA, Luiz Fernando Ferraz da; CARNEIRO, Paulo Campos; CHACON, Danielle Azevedo; ARAUJO-NETO, Vergilius Jose Furtado de; ARAUJO-FILHO, Vergilius Jose Furtado de; CERNEA, Claudio Roberto
    OBJECTIVES: Most thyroid diseases are nodular and have been investigated using ultrasound-guided fine needle aspiration biopsy (FNAB), the reports of which are standardized by the Bethesda System. Bethesda category III represents a heterogeneous group in terms of lesion characteristics and the malignancy rates reported in the literature. The objective of the present study was to evaluate the differences in the malignancy rates among Bethesda III subcategories. METHODS: Data from 1,479 patients who had thyroid surgery were reviewed. In total, 1,093 patients (89.6% female, mean age 52.7 (13-89) years) were included, and 386 patients were excluded. FNAB results (based on Bethesda Class) and histopathological results (benign or malignant) for coincident areas were collected. Bethesda III patients were subcategorized according to cytopathological characteristics (FLUS: follicular lesion of undetermined significance, Bethesda IIIA; AUS: atypia of undetermined significance, Bethesda IIIB). Data were correlated to obtain the malignancy rates for each Bethesda category and the newly defined subcategory. RESULTS: FNAB results for these patients were as follows: Bethesda I: 3.1%; Bethesda II: 18.6%; Bethesda III: 35.0%; Bethesda IV: 22.1%; Bethesda V: 4.1%; and Bethesda VI: 17.1%. The malignancy rates for Bethesda Class IIIB were significantly higher than those for Bethesda Class IIIA (p < 0.001) and Bethesda Class IV (p < 0.001). Bethesda Class IIIA showed significantly lower malignancy rates than Bethesda Class III overall (p < 0.001) CONCLUSIONS: Improvements of the Bethesda System should consider this subcategorization to better reflect different malignancy rates, which may have a significant impact on the decision-making process.
  • bookPart
    Hematoma cervical pós-tireoidectomia
    (2019) ARAúJO NETO, Vergilius José Furtado de; ARAúJO FILHO, Vergilius José Furtado de; CERNEA, Claudio Roberto
  • bookPart
    Doenças benignas da tireoide
    (2021) ARAUJO FILHO, Vergilius José Furtado de; MAHMOUD, Renata Regina da Graça Lorencetti; ARAUJO NETO, Vergilius José Furtado de
  • article 3 Citação(ões) na Scopus
    Incidental thyroid carcinoma: Correlation between FNAB cytology and pathological examination in 1093 cases
    (2022) RODRIGUES, Mariana Goncalves; SILVA, Luiz Fernando Ferraz da; ARAUJO-FILHO, Vergilius Jose Furtado de; MOSCA, Leticia de Moraes; ARAUJO-NETO, Vergilius Jose Furtado de; KOWALSKI, Luiz Paulo; CARNEIRO, Paulo Campos
    Objective: To investigate Incidental Thyroid Carcinoma (ITC) by comparing the results of Fine Needle Aspiration Biopsy (FNAB) cytology and the postoperative pathological findings. Methods: Data of 1479 patients who underwent total thyroidectomy were retrieved. Three hundred eighty-six patients were excluded due to insufficient data. Each surgical specimen studied received two histopathological diagnoses: the local diagnosis - for the same area in which the FNAB was performed; and the final diagnosis, which includes a study of the entire surgical specimen. Results: A thousand and ninety-three patients were investigated. FNAB result was malignant in 187 patients, benign in 204, suspicious or indeterminate in 668 cases, and inconclusive in 34 cases. The prevalence of ITC was 15.1%. Most of the ITC in this series was less than 0.5 cm. The incidence of ITC was higher in Bethesda III (17.5% ITC) and IV (19% ITC) than in Bethesda II cases (1.5% false negatives and 9% ITC). Conclusion: Although the incidence of false-negative results in Bethesda II nodules is only 1.5%, 9% of these patients had ITC in the thyroid parenchyma outside the nodule that underwent preoperative FNAB. The incidence of ITC in the same scenario was even higher in Bethesda III (17.5%) and Bethesda IV cases (19%). Ultrasonography-guided FNAB is an excellent method for the assessment of thyroid nodules. However, biopsy sites should be carefully selected. Despite the high incidence of incidentalomas, total thyroidectomy should not always be the treatment of choice due to its rare but potentially serious complications. The findings of the present study can assist future clinical decisions towards active surveillance strategies for the management of papillary thyroid carcinoma.
  • article 6 Citação(ões) na Scopus
    Substernal goiter and laryngopharyngeal reflux
    (2017) RODRIGUES, Mariana Gonçalves; ARAUJO FILHO, Vergilius José Furtado de; MATOS, Leandro Luongo de; HOJAIJ, Flávio Carneiro; SIMÕES, Cesar Augusto; ARAUJO NETO, Vergilius José Furtado de; RAMOS, Daniel Marin; MAHMOUD, Renata Lorencetti; MOSCA, Letícia de Moraes; MANTA, Gustavo Borges; VOLPI, Erivelto Martinho; BRANDÃO, Lenine Garcia; CERNEA, Claudio Roberto
    ABSTRACT Objective This study aims to compare the prevalence of laryngopharyngeal reflux signs between two groups of patients undergoing thyroidectomy for voluminous goiter: substernal goiters and voluminous cervical goiter without thoracic extension. Subjects and methods A retrospective case-control study was performed with data retrieved of the charts of the patients submitted to thyroidectomies occurred at a tertiary care center (Head and Neck Surgery Department, University of São Paulo Medical School) between 2010 and 2014. The selected thyroidectomies were allocated in two groups for study: patients with substernal goiters and patients with voluminous cervical goiter without thoracic extension. Cervical goiters were selected by ultrasonography mensuration. Clinical criterion was used to define substernal goiter. Results The average thyroid volume in patients with substernal goiter was significantly greater than the average volume in patients with only cervical goiter (p < 0.001). The prevalence of signs of reflux laryngitis at laryngoscopy was significantly greater in substernal goiter patients (p = 0.036). Moreover, substernal goiter was considered as the unique independent variable for high reflux laryngitis signs at laryngoscopy (OR = 2.75; CI95%: 1.05-7.20; p = 0.039) when compared to only cervical goiter patients. Conclusion This study shows a significant association between substernal goiters and signs of laryngopharyngeal reflux at preoperative laryngoscopy. Therefore, when compared with voluminous cervical goiters, the substernal goiters increase the chance of reflux laryngitis signs in patients.