RICHARD LOUIS VOEGELS
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina - Líder
7 resultados
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- Perivascular Innervation in the Nasal Mucosa and Clinical Findings in Patients with Allergic Rhinitis and Idiopathic Rhinitis(2023) CARVALHO, Thiago; JR, Joao Ferreira de Mello; CALDINI, Elia Tamaso Espin Garcia; SALGADO, Daniel Calduro; CARVALHO, Nicole Mary Garcia de; DAMACENO-RODRIGUES, Nilsa Regina; VOEGELS, Richard LouisIntroduction The nonspecific hyperreactivity of rhinitis has been attributed to neurotrophins activating sensory nerves and inflammatory cells. The relationship between these markers and the intensity of the symptoms is not well established and few studies have evaluated individuals with idiopathic rhinitis.Objective The present study aims to evaluate whether perivascular innervation and nerve growth factor (NGF) are related to the intensity of the clinical conditions in allergic rhinitis (AR) and idiopathic rhinitis (IR).Methods A total of 15 patients with AR and 15 patients with IR with the indication for inferior turbinectomy (associated or not with septoplasty) were selected. The patients received a score according to their signs and symptoms. After the surgery, we quantified eosinophils, mast cells, NGF, and nerve fibers in the nasal turbinate.Results The score of the signs and symptoms was higher in the AR group. Nerve growth factor was found in the cytoplasm of inflammatory cells in the submucosa in greater quantity in the AR group. The nerve fibers were distributed throughout the tissue, mainly in the subepithelial, glandular, and vascular regions, and there was no difference between the groups. Greater perivascular innervation was associated with a higher signs and symptoms score.Conclusions We concluded that these findings suggest that the NGF produced by submucosal inflammatory cells stimulates increased perivascular innervation in rhinitis, thus directly reflecting in more intense clinical conditions, especially in AR.
- Guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps (RSCwPN) in Brazil(2022) ANSELMO-LIMA, Wilma T.; TAMASHIRO, Edwin; ROMANO, Fabrizio R.; MIYAKE, Marcel M.; ROITHMANN, Renato; KOSUGI, Eduardo M.; NAKANISHI, Marcio; FORNAZIERI, Marco A.; BEZERRA, Thiago F. P.; MELLO, Joao F.; LESSA, Marcus M.; VOEGELS, Richard L.; PILTCHER, Otavio B.; SAKANO, Eulalia; VALERA, Fabiana C. P.Introduction: Severe uncontrolled chronic rhinosinusitis with nasal polyps has a negative impact on an individual's quality of life. Therefore, new biologics have emerged for use in specific phenotypes of chronic rhinosinusitis, changing the paradigms of its treatment. Objective: To review the current status of biologic treatment indications in chronic rhinosinusitis. Methods: The Brazilian Academy of Rhinology brought together different specialists to suggest a course of action, considering its particularities and aspects related to the national reality. Results: Of particular interest for decision making will be the identification of subgroups of patients refractory to pre-existing treatment options and the construction of a strategy that improves their quality of life, with the best cost-benefit ratio. Conclusion: The use of biologics is a valid option for treatment in more severe cases. This strategy must be better understood and improved in the future, with more studies and greater clinical experience.
- The Effect of Turbinate Injection of Botulinum Toxin A on The Symptoms of Idiopathic Rhinitis(2022) CARVALHO, Thiago; SALGADO, Daniel Calduro; MION, Olavo de Godoy; MELLO JUNIOR, Joao Ferreira de; VOEGELS, Richard LouisIntroduction Idiopathic rhinitis is a nonallergic and noninfectious rhinitis characterized mainly by nasal obstruction and rhinorrhea, resulting from an autonomic imbalance. Botulinum toxin type A (BTX-A) demonstrated its action in reducing rhinorrhea and nasal obstruction when injected into the nasal turbinates or septum. Objective To analyze the effects of intranasal BTX-A injection to control the symptoms of idiopathic rhinitis and its possible adverse effects. Method Patients with idiopathic rhinitis were divided into two groups. Group A had 15 participants (8 female and 6 male), of ages from 47 to 84 years (mean 66.57 years), and these received 60 U of Dysport (Ipsen Ltd, Maidenhead, Berkshire, UK) in each inferior nasal turbinate; group B had 12 participants (1 male and 11 female), of ages from 50 to 76 years (mean 60 years), and they received 1ml of 0.9% saline. The individuals were reevaluated in the 1st, 2nd, 4th, 8th, and 12th weeks after injection by a questionnaire, accompanied by nasal inspiratory peak flow and acoustic rhinometry. Results Group A showed significant improvement, mainly regarding the symptoms of sneezing/itching and nasal obstruction, over time and when compared to group B. Acoustic rhinometry confirmed the improvement in nasal obstruction. There was no relationship between the nasal peak flow data and the nasal obstruction score. No major adverse effects have been reported. Conclusion The injection of botulinum toxin in the inferior nasal turbinates of patients with idiopathic rhinitis reduces the symptoms of sneezing, itching, nasal obstruction, and runny nose without significant adverse effects, suggesting that it is an option in the treatment of these patients.
- Rhinosinusitis: evidence and experience. A summary(2015) ANSELMO-LIMA, Wilma T.; SAKANO, Eulalia; TAMASHIRO, Edwin; NUNES, Andre Alencar Araripe; FERNANDES, Atilio Maximino; PEREIRA, Elizabeth Araujo; ORTIZ, Erica; PINNA, Fabio de Rezende; ROMANO, Fabrizio Ricci; PADUA, Francini Grecco de Melo; MELLO JUNIOR, Joao Ferreira; TELES JUNIOR, Joao; DOLCI, Jose Eduardo Lutaif; BALSALOBRE FILHO, Leonardo Lopes; KOSUGI, Eduardo Macoto; SAMPAIO, Marcelo Hamilton; NAKANISHI, Marcio; SANTOS, Marco Cesar Jorge dos; ANDRADE, Nilvano Alves de; MION, Olavo de Godoy; PILTCHER, Otavio Bejzman; FUJITA, Reginaldo Raimundo; ROITHMANN, Renato; VOEGELS, Richard Louis; GUIMARAES, Roberto Eustaquio Santos; MEIRELES, Roberto Campos; NAKAJIMA, Victor; VALERA, Fabiana Cardoso Pereira; PIGNATARI, Shirley Shizue Nagata
- Brazilian academy of rhinology position paper on topical intranasal therapy (vol 79, pg 391, 2013)(2013) MELLO JUNIOR, Joao Ferreira de; MION, Olavo de Godoy; ANDRADE, Nilvano Alves de; ANSELMO-LIMA, Wilma Terezinha; STAMM, Aldo Eden Cassol; ALMEIDA, Washingthon Luiz de Cerqueira; CAVALCANTE FILHO, Pedro Oliveira; CASTRO, Fair de Carvalho e; PADUA, Francini Grecco de Melo; ROMANO, Fabrizio Ricci; SANTOS, Rodrigo de Paulo; ROITMANN, Renato; VOEGELS, Richard Louis; MEIRELLES, Roberto Campos; SA, Leonardo Conrado Barbosa; MOACYR, Moacyr Tabasnik; SANTOS, Marco Cesar Jorge dos; GUIMARAES, Roberto Eustaquio Santos
- Rhinosinusitis: evidence and experience. A summary (vol 81, pg 8, 2015)(2015) ANSELMO-LIMA, Wilma T.; SAKANO, Eulalia; TAMASHIRO, Edwin; NUNES, Andre Alencar Araripe; FERNANDES, Atilio Maximino; PEREIRA, Elizabeth Araujo; ORTIZ, Erica; PINNA, Fabio de Rezende; ROMANO, Fabrizio Ricci; PADUA, Francini Grecco de Melo; MELLO JUNIOR, Joao Ferreira de; TELES JUNIOR, Joao; DOLCI, Jose Eduardo Lutaif; BALSALOBRE FILHO, Leonardo Lopes; KOSUGI, Eduardo Macoto; SAMPAIO, Marcelo Hamilton; NAKANISHI, Marcio; SANTOS, Marco Cesar Jorge dos; ANDRADE, Nilvano Alves de; MION, Olavo de Godoy; PILTCHER, Otavio Bejzman; FUJITA, Reginaldo Raimundo; ROITHMANN, Renato; VOEGELS, Richard Louis; GUIMARAES, Roberto Eustaquio Santos; MEIRELES, Roberto Campos; SANTOS, Rodrigo de Paula; NAKAJIMA, Victor; VALERA, Fabiana Cardoso Pereira; PIGNATARI, Shirley Shizue Nagata
- Brazilian Academy of Rhinology position paper on topical intranasal therapy(2013) MELLO JUNIOR, Joao Ferreira de; MION, Olavo de Godoy; ANDRADE, Nilvano Alves de; ANSELINO-LIMA, Wilma Terezinha; STAMM, Aldo Eden Cassol; ALMEIDA, Washingthon Luiz de Cerqueira; CAVALCANTE FILHO, Pedro Oliveira; CASTRO, Jair de Carvalho e; PADUA, Francini Grecco de Melo; ROMANO, Fabrizio Ricci; SANTOS, Rodrigo de Paulo; ROITMANN, Renato; VOEGELS, Richard Louis; MEIRELLES, Roberto Campos; SA, Leonardo Conrado Barbosa; MOACYR, Moacyr Tabasnik; SANTOS, Marco Cesar Jorge dos; GUIMARAES, Roberto Eustaquio SantosThis documents aims at educating those who treat sinonasal diseases - both general practitioners and specialists - about topical nasal treatments. By means of scientific evidence reviews, the Brazilian Academy of Rhinology provides its practical and updated guidelines on the most utilized topical nasal medication, except for the drugs that have topical antibiotics in their formulas.