TOMAS NAVARRO RODRIGUEZ
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
24 resultados
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Agora exibindo 1 - 10 de 24
- 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.
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.
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, TomásconferenceObject High resolution manometry parameters to assess barrier function of the gastro-esophageal junction and to identify patients with gastro-esophageal reflux disease: a case-control study(2016) FREITAS-QUEIROZ, N.; JASPER, D.; HOLLENSTEIN, M.; MISSELWITZ, B.; LAYER, P.; NAVARRO-RODRIGUEZ, T.; FOX, M.; KELLER, J.- Probiotics intake and metabolic syndrome: A proposal (Retracted article. See vol. 39, pg. 85, 2014)(2011) BOGSAN, Cristina Stewart B.; FLORENCE, Ana Carolina R.; PERINA, Natalia; BARBUTI, Ricardo C.; NAVARRO-RODRIGUEZ, Tomas; EISIG, Jaime N.; OLIVEIRA, Marice N.Probiotics are practical tools to provide the modulation of microbiota. The ingestion of food or ingredients containing anti-inflammatory activity components as probiotics should be useful in obesity control and associated co-morbidities treatment. Metabolic syndrome is a metabolic dysfunction associated with visceral obesity and insulin resistance, in which the alterations in host microbiota interactions play an important role. Besides diet and physical activity, new strategies are necessary to control metabolic syndrome, and as consequence improving quality of life. This article revises the actual knowledge concerning probiotic intake and obesity as a proposal to control metabolic syndrome.
- Low levels of adherence with proton pump inhibitor therapy contribute to therapeutic failure in gastroesophageal reflux disease(2012) DAL-PAZ, K.; MORAES-FILHO, J. P.; NAVARRO-RODRIGUEZ, T.; EISIG, J. N.; BARBUTI, R.; QUIGLEY, E. M. M.To assess adherence to proton pump inhibitor (PPI) treatment and associated variables in patients with gastroesophageal reflux disease (GERD). Cross-sectional and prospective comprising 240 consecutive adult patients, diagnosed with GERD for whom continuous use of standard or double dose of omeprazole had been prescribed. Patients were ranked as ne-GERD (162: 67.5%) or e-GERD classified according to the Los Angeles classification as A (48:20.0%), B (21:8.6%), C (1:0.5%), D (1:0.5%), and Barrett's esophagus (7:2.9%). The Morisky questionnaire was applied to assess adherence to therapy and a GERD questionnaire to assess symptoms and their impact. Adherence was correlated with demographics, cotherapies, comorbidities, treatment duration, symptoms scores, endoscopic findings, and patient awareness of their disease. 126 patients (52.5%) exhibited high level of adherence and 114 (47.5%) low level. Youngers (P= 0.002) or married (O.R. 2.41, P= 0.03 vs. widowers) patients had lower levels of adherence; symptomatic patients exhibited lower adherence (P= 0.02). All other variables studied had no influence on adherence. Patients with GERD attending a tertiary referral hospital in Sao Paulo exhibited a high rate of low adherence to the prescribed PPI therapy that may play a role in the therapy failure. Age <60 years, marital status and being symptomatic were risk factors for low adherence.
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