TOMAS NAVARRO RODRIGUEZ
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
38 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 38
- Reply to Iovino and Ciacci: Respiratory physiotherapy in GERD: A proof-of-concept study on the increment of LES pressure(2013) CHAVES, R. C. de Miranda; NAVARRO-RODRIGUEZ, T.
- GUT MICROBIOTA, PREBIOTICS, PROBIOTICS, AND SYNBIOTICS IN GASTROINTESTINAL AND LIVER DISEASES: PROCEEDINGS OF A JOINT MEETING OF THE BRAZILIAN SOCIETY OF HEPATOLOGY (SBH), BRAZILIAN NUCLEUS FOR THE STUDY OF HELICOBACTER PYLORI AND MICROBIOTA (NBEHPM), AND BRAZILIAN FEDERATION OF GASTROENTEROLOGY (FBG)(2020) BARBUTI, Ricardo Correa; SCHIAVON, Leonardo Lucca; OLIVEIRA, Cláudia P; ALVARES-DA-SILVA, Mário Reis; SASSAKI, Lígia Yukie; PASSOS, Maria do Carmo F; FARIAS, Alberto Queiroz; BARROS, Luisa Leite; BARRETO, Bruno Paes; ALBUQUERQUE, Gisela Bandeira de Melo Lins de; ALVES, Amanda Mandarino; NAVARRO-RODRIGUEZ, Tomás; BITTENCOURT, Paulo LisboaABSTRACT Over the last years, there is growing evidence that microorganisms are involved in the maintenance of our health and are related to various diseases, both intestinal and extraintestinal. Changes in the gut microbiota appears to be a key element in the pathogenesis of hepatic and gastrointestinal disorders, including non-alcoholic fatty liver disease, alcoholic liver disease, liver cirrhosis, inflammatory bowel disease, irritable bowel syndrome, and Clostridium difficile - associated diarrhea. In 2019, the Brazilian Society of Hepatology (SBH) in cooperation with the Brazilian Nucleus for the Study of Helicobacter Pylori and Microbiota (NBEHPM), and Brazilian Federation of Gastroenterology (FBG) sponsored a joint meeting on gut microbiota and the use of prebiotics, probiotics, and synbiotics in gastrointestinal and liver diseases. This paper summarizes the proceedings of the aforementioned meeting. It is intended to provide practical information about this topic, addressing the latest discoveries and indicating areas for future studies.
conferenceObject Esophagogastroduodenal Mucosal Behavior after Bronchial Challenge with House Dust Mites in Allergic Asthmatic Patients(2015) AGONDI, Rosana C.; NAVARRO-RODRIGUEZ, Tomas; BARBUTI, Ricardo; BISACCIONI, Carla; AUN, Marcelo Vivolo; KALIL, Jorge; GIAVINA-BIANCHI, PedrobookPart Métodos de Avaliação Funcional do Trato Gastrintestinal(2016) SANTOS, Ivanna Beserra; QUEIROZ, Natália Sousa Freitas; Sá, Cláudia Cristina de; NAVARRO-RODRIGUEZ, Tomás- Ulcer and bleeding complications and their relationship with dyspeptic symptoms in NSAIDs users: a transversal multicenter study(2014) DIB, Ricardo Anuar; CHINZON, Decio; FONTES, Luiz Henrique de Souza; TEIXEIRA, Ana Cristina de Sa; NAVARRO-RODRIGUEZ, TomasObjectives. To evaluate the prevalence of lesions and digestive complications secondary to the use of non-steroidal anti-inflammatory drugs (NSAIDs), the clinical profile seen for digestive complaints and the relation with the endoscopic findings. Methods. Prospective, multicentric, open study, evaluating consecutively 1231 patients, divided as follows: group I NSAID and group II - non-NSAID. All patients answered questionnaire to evaluate the onset, the type of clinical complaint, the use of medication and possible complications associated to digestive bleeding. Results. A total of 1213 patients were evaluated. Among them, 65% were female and 13.1% were smokers; 15.6% mentioned they ingested alcoholic beverages. The main signs and symptoms reported were epigastralgy and pyrosis (67% and 62%, respectively). The upper gastrointestinal (UGI) endoscopy was normal in 3.9% in group I and in 10.7% in group II (p < 0.001). Patient who do not use NSAID will be 2.5 times more likely to have normal UGI endoscopy (p = 0.001). The presence of erosive or ulcer lesions in the stomach and duodenum was more frequent in group I. The incidence of lesions in the stomach when compared to the duodenum is observed (erosions: 49.12% vs. 13.60%, p = 0.001; ulcers: 14.04% vs. 11.84%, p = 0.05). The risk of digestive bleeding is 12 times higher (6.14% vs. 0.51%) in those who used NSAIDs, and the stomach is the site in which bleeding occurs more frequently. Conclusions. The frequency of gastric ulcer, duodenal ulcer and digestive bleeding was higher in patients who used NSAIDs. There was no connection found between endoscopic findings and dyspeptic symptoms.
- Efficacy of Early Optimization of Infliximab Guided by Therapeutic Drug Monitoring during Induction-A Prospective Trial(2023) GARCIA, Karoline Soares; AZEVEDO, Matheus Freitas Cardoso de; CARLOS, Alexandre de Sousa; BARROS, Luisa Leite; OBA, Jane; SOBRADO JUNIOR, Carlos Walter; SIPAHI, Aytan Miranda; ALVES, Olivia Duarte de Castro; NAVARRO-RODRIGUEZ, Tomas; PARRA, Rogerio Serafim; CHEBLI, Julio Maria Fonseca; CHEBLI, Liliana Andrade; FLORES, Cristina; VIEIRA, Andrea; CEARA, Christianne Damasceno Arcelino do; QUEIROZ, Natalia Sousa Freitas; DAMIAO, Aderson Omar Mourao CintraTherapeutic drug monitoring (TDM) during induction therapy with anti-tumor necrosis factor drugs has emerged as a strategy to optimize response to these biologics and avoid undesired outcomes related to inadequate drug exposure. This study aimed to describe clinical, biological, and endoscopic remission rates at six months in Brazilian inflammatory bowel disease (IBD) patients following a proactive TDM algorithm guided by IFX trough levels (ITL) and antibodies to IFX (ATI) levels during induction, at week six. A total of 111 IBD patients were prospectively enrolled, excluding those previously exposed to the drug. ITL & GE; 10 & mu;g/mL was considered optimal. Patients with suboptimal ITL (<10 & mu;g/mL) were guided according to ATI levels. Those who presented ATI & LE; 200 ng/mL underwent dose intensification in the maintenance phase, and patients with ATI > 200 ng/mL discontinued IFX. In our study, proactive TDM was associated with persistence in the IFX rate at six months of 82.9%. At that time, rates of clinical, biological, and endoscopic remission in patients under IFX treatment were 80.2%, 73.9%, and 48.1%, respectively. Applying a simplified TDM-guided algorithm during induction seems feasible and can help improve patients' outcomes in clinical practice.
- Atualização em doença do refluxo gastroesofágico (DRGE): tratamento não farmacológico(2012) CARVALHAES, Aloisio; EISIG, Jaime Natan; RODRIGUEZ, Tomas Navarro; BERNARDO, Wanderley Marques
bookPart 0 Citação(ões) na Scopus Acid indigestion: Causes, symptoms and treatment options(2014) CHAVES, R. C. M.; NAVARRO-RODRIGUEZ, T.Acid indigestion is a term commonly used by patients and physicians to indicate some form of gastrointestinal tract upset [1]. It includes a wide variety of symptoms, such as early satiety, nausea, bloating and abdominal discomfort. These vague upper gastrointestinal symptoms have been termed dyspepsia [2]. Functional dyspepsia, which is characterized by persistent or recurrent pain or discomfort centered in the upper abdomen based on Rome criteria, is accounted to be approximately 20% in the general population [3]. Occasionally, patients use the term indigestion to describe heartburn. However, it is defined more specifically as a burning sensation in the retroesternal area of variable intensity [4]. Likewise, this retroesternal burning, is the mainly symptom associated with gastroesophageal reflux disease (GERD) [5]. The epidemiological aspects of heartburn and GERD have been object of growing interest in the last decade because its increasing prevalence and the complications of the disease [6]. Population-based studies suggest that GERD is a common condition with a prevalence ranging between 10-20% in North America [4]. The impact of GERD extends beyond its economic burden, as it significantly impaired health-related quality of life [5]. Both dyspepsia and GERD are frequent chronic, often need long term treatment. Moreover, several studies have reported a higher prevalence of dyspeptic symptoms in patients with GERD [3]. In this chapter, we will review the cause, identify the symptoms and discuss treatment of patients with heartburn and acid indigestion. © 2014 by Nova Science Publishers, Inc. All rights reserved.bookPart Doença do refluxo gastresofágico(2013) MORAES-FILHO, Joaquim Prado Pinto de; CHAVES, Renata Carvalho de Miranda; DIB, Ricardo Anuar; NAVARRO-RODRIGUEZ, Tomás- Comparative study of two modes of gastroesophageal reflux measuring: conventional esophageal pH monitoring and wireless pH monitoring(2012) AZZAM, Rimon Sobhi; SALLUM, Rubens A. A.; BRANDÃO, Jeovana Ferreira; NAVARRO-RODRIGUEZ, Tomás; NASI, AryCONTEXT: Esophageal pH monitoring is considered to be the gold standard for the diagnosis of gastroesophageal acid reflux. However, this method is very troublesome and considerably limits the patient's routine activities. Wireless pH monitoring was developed to avoid these restrictions. OBJECTIVE: To compare the first 24 hours of the conventional and wireless pH monitoring, positioned 3 cm above the lower esophageal sphincter, in relation to: the occurrence of relevant technical failures, the ability to detect reflux and the ability to correlate the clinical symptoms to reflux. METHODS: Twenty-five patients referred for esophageal pH monitoring and with typical symptoms of gastroesophageal reflux disease were studied prospectively, underwent clinical interview, endoscopy, esophageal manometry and were submitted, with a simultaneous initial period, to 24-hour catheter pH monitoring and 48-hour wireless pH monitoring. RESULTS: Early capsule detachment occurred in one (4%) case and there were no technical failures with the catheter pH monitoring (P = 0.463). Percentages of reflux time (total, upright and supine) were higher with the wireless pH monitoring (P < 0.05). Pathological gastroesophageal reflux occurred in 16 (64%) patients submitted to catheter and in 19 (76%) to the capsule (P = 0.355). The symptom index was positive in 12 (48%) patients with catheter pH monitoring and in 13 (52%) with wireless pH monitoring (P = 0.777). CONCLUSIONS: 1) No significant differences were reported between the two methods of pH monitoring (capsule vs catheter), in regard to relevant technical failures; 2) Wireless pH monitoring detected higher percentages of reflux time than the conventional pH-metry; 3) The two methods of pH monitoring were comparable in diagnosis of pathological gastroesophageal reflux and comparable in correlating the clinical symptoms with the gastroesophageal reflux.