ELISANGELA PINTO MARINHO DE ALMEIDA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Acupuncture for chemotherapy-induced peripheral neuropathy: a randomised controlled pilot study(2022) D'ALESSANDRO, Eduardo Guilherme; NAGY, Daniela Ribeiro Nebuloni; BRITO, Christina May Moran de; ALMEIDA, Elisangela Pinto Marinho; BATTISTELLA, Linamara Rizzo; CECATTO, Rebeca BoltesChemotherapy-induced peripheral neuropathy (CIPN) can cause loss of independence and poor quality of life (QoL) due to severe disabilities, but in spite of its importance there is still a lack of data for the management of CIPN. Acupuncture has showed promising results and may be a cost-effective option for the treatment. Objectives To evaluate the effect of acupuncture treatment on neurological symptoms of CIPN and QoL of oncological patients. Methods We performed a clinical, single-centre, randomised and controlled pilot study that involved 33 adult patients with cancer and CIPN randomised into two groups (control and acupuncture treated with 10 sessions, two times per week). Both groups were subjected to a complete physical examination and clinical assessment with National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Scale V.2.0, FIM Scale, European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC QLQ-C30) Scale and Visual Analogue Scale for pain before and 5 weeks after treatment. Results There were no adverse events, and we found statistical differences in groups in physical (p=0.03) and function (p=0.04) domains of EORTC QLQ-C30 when comparing control and acupuncture groups. About NCI CTCAE Scale and neuropathy sensory symptoms, we found better results in acupuncture group, comparing pretreatment and post-treatment analyses (p=0.01). In control group, we have no differences after 5 weeks (p=0.11). Conclusion Although these results suggest an interesting effect of acupuncture on this patient population, the clinical significance has remained unclear. Given the tendency towards benefit and the lack of adverse effects, the authors recommend a follow-up acupuncture trial using higher follow-up time and better sample size.
- Liberal Versus Restrictive Transfusion Strategy in Critically Ill Oncologic Patients: The Transfusion Requirements in Critically Ill Oncologic Patients Randomized Controlled Trial(2017) BERGAMIN, Fabricio S.; ALMEIDA, Juliano P.; LANDONI, Giovanni; GALAS, Filomena R. B. G.; FUKUSHIMA, Julia T.; FOMINSKIY, Evgeny; PARK, Clarice H. L.; OSAWA, Eduardo A.; DIZ, Maria P. E.; OLIVEIRA, Gisele Q.; FRANCO, Rafael A.; NAKAMURA, Rosana E.; ALMEIDA, Elisangela M.; ABDALA, Edson; FREIRE, Maristela P.; FILHO, Roberto K.; AULER JR., Jose Otavio C.; HAJJAR, Ludhmila A.Objective: To assess whether a restrictive strategy of RBC transfusion reduces 28-day mortality when compared with a liberal strategy in cancer patients with septic shock. Design: Single center, randomized, double-blind controlled trial. Setting: Teaching hospital. Patients: Adult cancer patients with septic shock in the first 6 hours of ICU admission. Interventions: Patients were randomized to the liberal (hemoglobin threshold, < 9 g/dL) or to the restrictive strategy (hemoglobin threshold, < 7 g/dL) of RBC transfusion during ICU stay. Measurements and Main Results: Patients were randomized to the liberal (n = 149) or to the restrictive transfusion strategy (n = 151) group. Patients in the liberal group received more RBC units than patients in the restrictive group (1 [0-3] vs 0 [0-2] unit; p<0.001). At 28 days after randomization, mortality rate in the liberal group (primary endpoint of the study) was 45% (67 patients) versus 56% (84 patients) in the restrictive group (hazard ratio, 0.74; 95% CI, 0.53-1.04; p = 0.08) with no differences in ICU and hospital length of stay. At 90 days after randomization, mortality rate in the liberal group was lower (59% vs 70%) than in the restrictive group (hazard ratio, 0.72; 95% CI, 0.53-0.97; p = 0.03). Conclusions: We observed a survival trend favoring a liberal transfusion strategy in patients with septic shock when compared with the restrictive strategy. These results went in the opposite direction of the a priori hypothesis and of other trials in the field and need to be confirmed.
- Early mobilization programme improves functional capacity after major abdominal cancer surgery: a randomized controlled trial(2017) ALMEIDA, E. P. M. de; ALMEIDA, J. P. de; LANDONI, G.; GALAS, F. R. B. G.; FUKUSHIMA, J. T.; FOMINSKIY, E.; BRITO, C. M. M. de; CAVICHIO, L. B. L.; ALMEIDA, L. A. A. de; RIBEIRO- JR., U.; OSAWA, E. A.; DIZ, M. P. E.; CECATTO, R. B.; BATTISTELLA, L. R.; HAJJAR, L. A.Background: Major abdominal oncology surgery is associated with substantial postoperative loss of functional capacity, and exercise may be an effective intervention to improve outcomes. The aim of this study was to assess efficacy, feasibility and safety of a supervised postoperative exercise programme. Methods: We performed a single-blind, parallel-arm, randomized trial in patients who underwent major abdominal oncology surgery in a tertiary university hospital. Patients were randomized to an early mobilization postoperative programme based on supervised aerobic exercise, resistance and flexibility training or to standard rehabilitation care. The primary outcome was inability to walk without human assistance at postoperative day 5 or hospital discharge. Results: A total of 108 patients were enrolled, 54 into the early mobilization programme group and 54 into the standard rehabilitation care group. The incidence of the primary outcome was nine (16.7%) and 21 (38.9%), respectively (P = 0.01), with an absolute risk reduction of 22.2% [95% confidence interval (CI) 5.9-38.6] and a number needed to treat of 5 (95% CI 3-17). All patients in the intervention group were able to follow at least partially the exercise programme, although the performance among them was rather heterogeneous. There were no differences between groups regarding clinical outcomes or complications related to the exercises. Conclusions: An early postoperative mobilization programme based on supervised exercises seems to be safe and feasible and improves functional capacity in patients undergoing major elective abdominal oncology surgery. However, its impact on clinical outcomes is still unclear.
- Transfusion Requirements in Surgical Oncology Patients A Prospective, Randomized Controlled Trial(2015) ALMEIDA, Juliano Pinheiro de; VINCENT, Jean-Louis; GALAS, Filomena Regina Barbosa Gomes; ALMEIDA, Elisangela Pinto Marinho de; FUKUSHIMA, Julia T.; OSAWA, Eduardo A.; BERGAMIN, Fabricio; PARK, Clarice Lee; NAKAMURA, Rosana Ely; FONSECA, Silvia M. R.; CUTAIT, Guilherme; ALVES, Joseane Inacio; BAZAN, Mellik; VIEIRA, Silvia; SANDRINI, Ana C. Vieira; PALOMBA, Henrique; RIBEIRO JR., Ulysses; CRIPPA, Alexandre; DALLOGLIO, Marcos; DIZ, Maria del Pilar Estevez; KALIL FILHO, Roberto; AULER JR., Jose Otavio Costa; RHODES, Andrew; HAJJAR, Ludhmila AbrahaoBackground: Several studies have indicated that a restrictive erythrocyte transfusion strategy is as safe as a liberal one in critically ill patients, but there is no clear evidence to support the superiority of any perioperative transfusion strategy in patients with cancer. Methods: In a randomized, controlled, parallel-group, double-blind (patients and outcome assessors) superiority trial in the intensive care unit of a tertiary oncology hospital, the authors evaluated whether a restrictive strategy of erythrocyte transfusion (transfusion when hemoglobin concentration <7 g/dl) was superior to a liberal one (transfusion when hemoglobin concentration <9 g/dl) for reducing mortality and severe clinical complications among patients having major cancer surgery. All adult patients with cancer having major abdominal surgery who required postoperative intensive care were included and randomly allocated to treatment with the liberal or the restrictive erythrocyte transfusion strategy. The primary outcome was a composite endpoint of mortality and morbidity. Results: A total of 198 patients were included as follows: 101 in the restrictive group and 97 in the liberal group. The primary composite endpoint occurred in 19.6% (95% CI, 12.9 to 28.6%) of patients in the liberal-strategy group and in 35.6% (27.0 to 45.4%) of patients in the restrictive-strategy group (P = 0.012). Compared with the restrictive strategy, the liberal transfusion strategy was associated with an absolute risk reduction for the composite outcome of 16% (3.8 to 28.2%) and a number needed to treat of 6.2 (3.5 to 26.5). Conclusion: A liberal erythrocyte transfusion strategy with a hemoglobin trigger of 9 g/dl was associated with fewer major postoperative complications in patients having major cancer surgery compared with a restrictive strategy.