JOAO PAULO MOTA TELLES
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/12 - Laboratório de Pesquisa Básica em Doenças Renais, Hospital das Clínicas, Faculdade de Medicina
LIM/12 - Laboratório de Pesquisa Básica em Doenças Renais, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
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- The current clinical picture of cerebral proliferative angiopathy: systematic review(2020) YAMAKI, Vitor Nagai; SOLLA, Davi Jorge Fontoura; TELLES, Joao Paulo Mota; LIEM, Glaucia Lexy Jong; SILVA, Saul Almeida da; CALDAS, Jose Guilherme Mendes Pereira; TEIXEIRA, Manoel Jacobsen; PASCHOAL, Eric Homero Albuquerque; FIGUEIREDO, Eberval GadelhaBackground Cerebral proliferative angiopathy (CPA) is a rare subset of arteriovenous malformations (AVM). It has unique clinical presentation, angiographic characteristics, and pathophysiology which often brings challenges for the treatment. We aimed to define its epidemiology, pathophysiology are unknown, and best management strategies. Methods A systematic review was conducted according to the PRISMA guidelines. MEDLINE was searched for articles regarding CPA. Extracted data included epidemiological, clinical, and angiographical characteristics, treatment, and outcomes. Treatment was classified as conservative, radiosurgery, endovascular, decompression, and indirect vascularization. A meta-analytical approach was employed for description of the data as study-size adjusted percentages or weighted means, as appropriate. Results Thirty-three studies were analyzed, rendering a total 95 cases-half of which came from a single study. Patients were predominantly young (mean 23 years old) and female (60.0%) presenting with headaches (44.9%), seizures (37.1%), or transient ischemic attacks (33.7%). Hemorrhage was present in 18.0%, but rebleeding rates were as high as 67%. The majority of nidus were > 6 cm (52.5%) with hemispheric extension (73.0%). Capillary angioectatic appearance (85.7%), transdural supply (62.5%), and deep venous drainage (73.0%) were also frequent features. Most patients were treated conservatively (54.4%), followed by endovascular (34.2%). Indirect vascularization and radiosurgery were attempted in five and two patients, respectively. Mean follow-up was 110.8 patient-years. Neurological status improved in 50.7%, remained stable in 40.2%, and worsened in 9.0%. Conclusions Conservative and endovascular treatments seem adequate interventions, despite limited evidence. Complementary techniques can be used in patients throughout disease history, according to symptom-based, individualized approach. More studies are required for choosing interventions based on reliable long-term results.
- The impact of urgent neurosurgery on the survival of cancer patients(2020) TELLES, J.P.M.; YAMAKI, V.N.; YAMASHITA, R.G.; SOLLA, D.J.F.; PAIVA, W.S.; TEIXEIRA, M.J.; NEVILLE, I.S.Background: Patients with cancer are subject to all neurosurgical procedures of the general population, even if they are not directly caused by the tumor or its metastases. We sought to evaluate the impact of urgent neurosurgery on the survival of patients with cancer. Methods: We included patients submitted to neurosurgeries not directly related to their tumors in a cancer center from 2009 to 2018. Primary endpoints were mortality in index hospitalization and overall survival. Results: We included 410 patients, 144 went through elective procedures, functional (26.4%) and debridement (73.6%) and 276 urgent neurosurgeries were performed: one hundred and sixty-three ventricular shunts (59%), and 113 intracranial hemorrhages (41%). Median age was 56 (IQR = 24), 142 (51.4%) of patients were metastatic, with 101 (36.6%) having brain metastasis. In 82 (33.7%) of the urgent surgeries, the patient died in the same admission. Urgent surgeries were associated with mortality in index hospitalization (OR 3.45, 95% CI 1.93–6.15), as well as non-primary brain tumors (OR 3.13, 95% CI 1.48–6.61). Median survival after urgent surgeries was 102 days, compared to 245 days in the control group (Log rank, P < 0.01). Lower survival probability was associated with metastasis (HR 1.75, 95%CI 1.15–2.66) and urgent surgeries (HR 1.49, 95% CI 1.18–1.89). Within the urgent surgeries alone, metastasis predicted lower survival probability (HR 1.75, 95% CI 1.15–2.67). Conclusion: Conditions that require urgent neurosurgery in patients with cancer have a very poor prognosis. We present concrete data on the magnitude of several factors that need to be taken into account when deciding whether or not to recommend surgery. ©2020 Published by Scientific Scholar on behalf of Surgical Neurology International
- #Brainaneurysm: The Role of Hashtags(2020) TELLES, Joao Paulo Mota; TEIXEIRA, Manoel Jacobsen; FIGUEIREDO, Eberval Gadelha
- Hippocampal vascularization: Proposal for a new classification(2020) ISOLAN, G.R.; STEFANI, M.A.; SCHNEIDER, F.L.; CLAUDINO, H.A.; YU, Y.H.; CHOI, G.G.; TELLES, J.P.M.; RABELO, N.N.; FIGUEIREDO, E.G.Background: Anatomy of the hippocampal arterial supply is key to successful surgeries in this area. The goal of the current study is to present the results we obtained from our microsurgical dissections of the temporal lobe and to propose a new classification for the hippocampal arteries (HAs). Methods: Fifty-six brain hemispheres were analyzed. All dissections in this study were made using 3-40× at the surgical microscope. Results: The hippocampal arterial vasculature can be divided into six groups, according to their frequencies: Group A: mixed arterial vasculature originating from the anterior choroidal artery anterior choroidal artery, posterior cerebral artery (PCA), anterior infratemporal artery (AIA), and splenic artery (SA). Group B: Main origin at the temporal branches - main inferotemporal trunk, middle inferotemporal artery, posterior inferotemporal artery, AIA, or main branch of PCA. Group C: AIA as the main branch of the hippocampus. Group D: HAs originating from the main branch of PCA. Group E: A single hippocampal artery with the origin at the main branch of PCA. This single artery covered all of the structure and is named Ushimura's artery. Group F: The hippocampal vessels arose exclusively from the parieto-occipital artery, calcarine artery (CA), and the SA. Conclusion: This study proposes a new classification for the hippocampal vascularization, according to the origin of HAs. One of the groups has not yet been described in the literature - in which the HAs arise from the parieto-occipital artery, SA, and CA. © 2020 Published by Scientific Scholar on behalf of Surgical Neurology International