ROBSON LUIS OLIVEIRA DE AMORIM
Projetos de Pesquisa
Unidades Organizacionais
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
5 resultados
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Agora exibindo 1 - 5 de 5
- Evaluation of Head Computed Tomography Assessment of Brain Swelling after Acute Traumatic Brain Injury: A Pilot study(2019) AMORIM, Robson Luis; MORAIS, Barbara Albuquerque; PEREIRA, Francisco Otavio Camargo; OLIVEIRA, Matheus Fernandes; ANDRADE, Almir Ferreira; BOR-SENG-SHU, Edson; OLIVEIRA, Marcelo Lima; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson SilvaObjective To evaluate the interobserver reliability of a new scale created for quantitatively assessing brain swelling in traumatic brain injury (TBI) patients using the computed tomography (CT) findings in three levels. Methods Computed tomography scans of severe head injury patients were randomly selected from a tertiary hospital image database and evaluated by independent groups of neurosurgeons, neurosurgery residents, radiologists, and intensivists from the same hospital. Each specialist assessed the tomographic findings, applying zero to six points in a new scale. The Kappa coefficient was calculated to assess interobserver agreement. Results The highest reliability coefficient was obtained by the neurosurgeons group (0.791; 95% confidence interval [CI]: 0.975-0.607; p < 0.001), followed by the neurosurgery residents group (0.402; 95%CI: 0.569-0.236; p < 0.001) and by the radiologists group (0.301; 95%CI: 0.488-0.113; p < 0.002). The lowest coefficient was found among the intensivists (0.248; 95%CI: 0.415-0.081; p = 0.004). Conclusion The proposed scale showed good reliability among neurosurgeons, and moderate overall reliability. This tomographic classification might be useful to better assist severe TBI victims, allowing to identify the worsening or amelioration of brain swelling, which should be further investigated. The scale seems to be feasible, even in low income countries, where the cost of intracranial pressure (ICP) monitoring is higher than that of CTs.
- New Technique Seeking Prophylaxis in the Displacement of Distal Ventriculoperitoneal Shunt Catheter - Case Report(2023) MELO, Joao Victor Oliveira de; SILVA, Rebeca Brasil da; REIS, Franklin; AMORIM, Robson Luis Oliveira deIdiopathic intracranial hypertension is a comorbidity treated in neurosurgical practice today with the ventriculoperitoneal derivation technique. However, despite its great safety and efficacy, this technique is susceptible to infrequent failures, such as displacement of the catheter leading to the need for reoperation. In the present article, we report a case involving a peritoneal catheter tip retropulsion for subcutaneous tissue in an obese patient with posterior correction using an extending connector to the distal catheter, without harming the drainage flow. In our case report, the patient went on without complications and without the occurrence of new displacement after 8 months of surgery. The results obtained by this technique supported the idea that this alternative construction minimizes the risk of displacement of the peritoneal tip catheter in obese patients and with high intra-abdominal pressure, helping to reduce the need for reoperations. In addition, the present case report supports the need for further studies and clinical trials on the subject.
- Traumatic Brain Injury Research in Brazil: A Bibliometric Study(2016) AMORIM, Robson Luis; TEIXEIRA, Saulo Araujo; SILVA-NETO, Sergio Goncalves; ANGHINAH, Renato; TEIXEIRA, Manoel Jacobsen; ANDRADE, Almir Ferreira de; PAIVA, Wellingson SilvaTraumatic brain injury (TBI) is responsible for high rates of morbidity and mortality, constituting an important public health problem throughout the world. Improving medical research on systemic trauma is a critical issue to understand its impact and develop strategies for prevention and treatment. This paper presents an overview of medical research performed in Brazil about TBI comparing it with the production on the same topic with other countries and with publications about different neurological and non-neurological diseases. It is possible to notice that Brazil has a deficiency in the scientific production on TBI given its importance. Greater integration between the research centers could help meliorate the production and quality of the papers and encourage further studies on the theme, in the quest to minimize the shortage of publications that can be seen today.
- Intracranial Pressure Monitoring in Patients with Severe Traumatic Brain Injury: A Cohort Study with Paired Analysis(2023) TORRES, Gabriel Saboia de Araujo; PAIVA, Wellingson Silva; AMORIM, Robson Luis Oliveira deIntroduction Intracranial hypertension continues to be the most frequent cause of death in patients with traumatic brain injury (TBI). Thus, invasive monitoring of intracranial pressure (ICP) is a very important tool in neurointensivism. However, there is controversy regarding ICP monitoring and prognosis.Objectives To evaluate whether there is a difference in mortality between patients with severe TBI who underwent invasive ICP monitoring compared with those who did not undergo such procedure.Methodology This is a unicentric study in the prospective cohort mode. A total of 316 patients with severe TBI were evaluated and, out of these 316 individuals, 35 were submitted to ICP monitoring. All clinical data were evaluated by the Tertiary Hospital Neurosurgery team in the city of Sao Paulo.Results Of the total cohort, 35 (11%) patients underwent ICP monitoring, while 281 did not. Comparing the 2 groups, there was no difference in terms of early mortality between patients who were submitted to monitoring and those who were not (34.3 versus 14.3%; p = 0.09); there was also no difference in terms of hospital mortality (40 versus 28.5%; p = 0.31) or intensive care unit (ICU) length of stay (16.10 days, 95% confidence interval [CI]: 10.6-21.6; versus 20.60 days, 95%CI: 13.50-27.70; p = 0.31).Conclusions In this cohort, we did not identify differences in mortality or in duration of hospitalization between patients with ICP monitoring and those exclusively with clinical-radiological evaluation. However, further national co-operative studies of services using ICP monitoring are needed to achieve results with greater generalization power.
- Why Intracranial Pressure Monitoring is Important in Traumatic Brain Injury(2015) ANDRADE, Almir Ferreira de; PAIVA, Wellingson Silva; MORAIS, Barbara Albuquerque; AMORIM, Robson Luis; FIGUEIREDO, Eberval Gadelha; TEIXEIRA, Manoel JacobsenIntracranial hypertension (IH) remains the most frequent cause of death in patients with traumatic brain injury (TBI). Thus invasive monitoring of intracranial pressure is an important tool in these patients. Recently, results of a clinical trial questioned the application of this method. This paper presents a review of the literature about evidence and clinical concerns of invasive intracranial pressure monitoring.