MANOEL DE SOUZA ROCHA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Radiologia, Faculdade de Medicina - Docente
6 resultados
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Agora exibindo 1 - 6 de 6
- PDX1-MODY and dorsal pancreatic agenesis: New phenotype of a rare disease(2018) CAETANO, L. A.; SANTANA, L. S.; COSTA-RIQUETTO, A. D.; LERARIO, A. M.; NERY, M.; NOGUEIRA, G. F.; ORTEGA, C. D.; ROCHA, M. S.; JORGE, A. A. L.; TELES, M. G.Maturity-Onset Diabetes of the Young (MODY) type 4 or PDX1-MODY is a rare form of monogenic diabetes caused by heterozygous variants in PDX1. Pancreatic developmental anomalies related to PDX1 are reported only in neonatal diabetes cases. Here, we describe dorsal pancreatic agenesis in 2 patients with PDX1-MODY. The proband presented with diabetes since 14 years of age and maintained regular glycemic control with low doses of basal insulin and detectable C-peptide levels after 38 years with diabetes. A diagnosis of MODY was suspected. Targeted next-generation sequencing identified a heterozygous variant in PDX1: c.188delC/p. Pro63Argfs*60. Computed tomography revealed caudal pancreatic agenesis. Low fecal elastase indicated exocrine insufficiency. His son had impaired glucose tolerance, presented similar pancreatic agenesis, and harbored the same allelic variant. The unusual presentation in this Brazilian family enabled expansion upon a rare disease phenotype, demonstrating the possibility of detecting pancreatic malformation even in cases of PDX1-related diabetes diagnosed after the first year of life. This finding can improve the management of MODY4 patients, leading to precocious investigation of pancreatic dysgenesis and exocrine dysfunction.
- Noninvasive mapping of fibrosis and inflammation in nonalcoholic fatty liver disease: isolating fibrogenesis in the Space of Disse with MRI R2 multicomponent relaxometry(2018) CLARK, P.; CHUA-ANUSORN, W.; OLIVEIRA, C.; ROCHA, M.; CARRILHO, F. J.; LIMA, F.; ALVES, V.; OLIVEIRA, B.; FILHO, H. L.
- Small-Volume, Fast-Emptying Gastric Pouch Leads to Better Long-Term Weight Loss and Food Tolerance After Roux-en-Y Gastric Bypass(2018) RICCIOPPO, Daniel; SANTO, Marco Aurelio; ROCHA, Manoel; BUCHPIGUEL, Carlos Alberto; DINIZ, Marcio Augusto; PAJECKI, Denis; CLEVA, Roberto de; KAWAMOTO, FlavioAnatomical and functional influences on gastric bypass (GBP) results are often poorly evaluated and not yet fully understood. The purpose of this study is to evaluate the influence of the gastric pouch volume and its emptying rate on long-term weight loss and food tolerance after GBP. Weight loss, food tolerance, pouch volumetry (V) by three-dimensional reconstruction, and pouch emptying rate by 4 h scintigraphy were evaluated in 67 patients. Cutoffs were identified for V and retention percentage (%Ret) at 1 h (%Ret1). From these parameters, the sample was categorized, looking for associations between V, %Ret, weight loss, and food tolerance, assessed by a questionnaire for quick assessment of food tolerance (SS). PO median follow-up time was 47 months; median V was 28 mL; %Ret at 1, 2, and 4 h were 8, 2, and 1%, respectively. There were associations between V <= 40 mL and higher emptying rates up to 2 h (V <= 40 mL: %Ret1 = 6, %Ret2 = 2, p = 0.009; V > 40 mL: %Ret1 = 44, %Ret2 = 13.5, p = 0.045). An association was found between higher emptying speed in 1 h and higher late weight loss (WL), represented by lower percentage of excess weight loss (%EWL) regain (p = 0.036) and higher %EWL (p = 0.033) in the group with %Ret1 <= 12%, compared to the group %Ret1 >= 25%. Better food tolerance (SS > 24), was associated with lower %Ret1 (p = 0.003). Smaller pouch size is associated with a faster gastric emptying, greater WL maintenance, and better food tolerance. These data suggest that a small pouch with rapid emptying rate is an important technical parameter for good outcomes in GBP.
- Iron-Overload Evaluation by Noninvasive Methods in Patients with Nonalcoholic Fatty Liver Disease, Overweight, and Hyperferritinemia(2018) BRANISSO, Paula P. F.; OLIVEIRA, Claudia P.; LEAO FILHO, Hilton M.; SANTOS, Aritania; LIMA, Fabiana R.; MANCINI, Marcio; CARRILHO, Flair Jose; ROCHA, Manoel; CERCATO, Cintia
- Insulinoma: A retrospective study analyzing the differences between benign and malignant tumors(2018) CAMARA-DE-SOUZA, A. B.; TOYOSHIMA, M. T. K.; GIANNELLA, M. L.; FREIRE, D. S.; CAMACHO, C. P.; LOURENCO JR., D. M.; ROCHA, M. S.; BACCHELLA, T.; JUREIDINI, R.; MACHADO, M. C. C.; ALMEIDA, M. Q.; PEREIRA, M. A. A.Background/objectives: Insulinoma is a rare pancreatic tumor and, usually, a benign disease but can be a malignant one and, sometimes, a highly aggressive disease. The aim of this study was to determine differences between benign and malignant tumors. Methods: Retrospective study of 103 patients with insulinoma treated in a tertiary center. It was analyzed demographic, clinical, laboratory, localization and histologic analysis of tumor and follow up data of subjects in order to identify differences between individuals benign and malignant disease. Results: Almost all patients (87%) had a benign tumor and survival rates of 100% following pancreatic tumor surgery. Those with malignant tumors (13%) have a poor prognosis, 77% insulinoma-related deaths over a period of 1-300 months after the diagnosis with a survival rate of 24% in five years. The following factors are associated with an increased risk of malignant disease: duration of symptoms < 24 months, fasting time for the occurrence of hypoglycemia < 8 h, blood plasma insulin concentration > 28 mu U/mL and C-peptide >= 4.0 ng/mL at the glycemic nadir and tumor size >= 2.5 cm. Conclusions: Our data help to base the literature about these tumors, reinforcing that although insulinoma is usually a single benign and surgically treated neoplasia, the malignant one is difficult to treat. We highlight the data that help predict a malignancy behavior of tumor and suggest a long follow up after diagnosis in these cases.
- Multimodality Screening of Hepatic Nodules in Patients With Congenital Heart Disease After Fontan Procedure: Role of Ultrasound, ARFI Elastography, CT, and MRI(2018) HORVAT, Natally; ROCHA, Manoel Souza; CHAGAS, Aline Lopes; OLIVEIRA, Brunna Clemente; PACHECO, Mariana Poltronieri; BINOTTO, Maria Angelica; IKARI, Nana Miura; PARANAGUA-VEZOZZO, Denise Cerqueira; LEAO-FILHO, Hilton Muniz; VICENTINI, Joao Rafael Terneira; SILVA FILHO, Mauricio Ricardo Moreira da; JATENE, Marcelo Biscegli; CARRILHO, Flair Jose; CERRI, Giovanni GuidoOBJECTIVE. Currently, there is no consensus in the literature regarding the screening of hepatic nodules in patients who have undergone the Fontan procedure. The objectives of this study are to evaluate in this population the frequency of hepatic nodules at ultrasound (US), CT, and MRI; to measure liver stiffness using acoustic radiation force impulse (ARFI) elastography; and to investigate predictive factors for hepatic nodules. SUBJECTS AND METHODS. In this cross-sectional study, 49 patients who underwent the Fontan procedure were prospectively recruited from August 2014 through June 2016. These patients underwent clinical evaluation for hepatic disorders, ARFI elastography, US, CT, and MRI. RESULTS. Most of the patients had no symptoms, and hepatic nodules were detected in three of 49 (6.1%) patients at US, 14 of 44 (31.8%) patients at CT, and 19 of 48 (39.6%) patients at MRI. Liver stiffness at ARFI elastography was significantly higher in patients with hepatic nodules than i n patients without such nodules (2.64 +/- 0.81 m/s vs 1.94 +/- 0.49 m/s; p = 0.002) and was a significant predictor of hepatic nodule (AUC, 0.767; p = 0.002). No clinical or laboratory data had any significant correlation with the existence of hepatic nodules, including time since Fontan procedure. CONCLUSION. In our study, more than one-third of patients had hepatic nodules at CT or MRI, but US did not detect most hepatic nodules. Liver stiffness at ARFI elastography was significantly higher in patients with hepatic nodules, and it may help guiding which patient should be further imaged with CT or MRI.