JOSE MARCIO NEVES JORGE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
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- Are Obese Patients at an Increased Risk of Pelvic Floor Dysfunction Compared to Non-obese Patients?(2017) CORREA NETO, Isaac Jose Felippe; PINTO, Rodrigo Ambar; JORGE, Jose Marcio Neves; SANTO, Marco Aurelio; BUSTAMANTE-LOPEZ, Leonardo Alfonso; CECCONELLO, Ivan; NAHAS, Sergio CarlosFactors associated with increased intra-abdominal pressure such as chronic cough, morbid obesity, and constipation may be related to pelvic floor dysfunction. In this study, we compared anorectal manometry values and clinical data of class II and III morbidly obese patients referred to bariatric surgery with that of non-obese patients. We performed a case-matched study between obese patients referred to bariatric surgery and non-obese patients without anorectal complaints. The groups were matched by age and gender. Men and nulliparous women with no history of abdominal or anorectal surgery were included in the study. Anorectal manometry was performed by the stationary technique, and clinical evaluation was based on validated questionnaires. Mean age was 44.8 +/- 12.5 years (mean +/- SD) in the obese group and 44.1 +/- 11.8 years in the non-obese group (p = 0.829). In the obese group, 65.4% of patients had some degree of fecal incontinence. Mean squeeze pressure was significantly lower in obese than in non-obese patients (155.6 +/- 64.1 vs. 210.1 +/- 75.9 mmHg, p = 0.004), and there was no significant difference regarding mean rest pressure in obese patients compared to non-obese ones (63.7 +/- 23.1 vs. 74.1 +/- 21.8 mmHg, p = 0.051). There were no significant differences in anorectal manometry values between continent and incontinent obese patients. The prevalence of fecal incontinence among obese patients was high regardless of age, gender, and body mass index. Anal squeeze pressure was significantly lower in obese patients compared to non-obese controls.
- Self-reported Fecal Incontinence in a Community-Dwelling, Urban Population in Southern Brazil(2014) SANTOS, Vera Lucia Conceicao de Gouveia; DOMANSKY, Rita de Cassia; HANATE, Cintia; MATOS, Danilo Soares; BENVENUTO, Carla Virginia Cordeiro; JORGE, Jose Marcio NevesPURPOSE: To assess the prevalence of self-reported fecal incontinence (FI) in a sample of community-dwelling adults residing in an urban area of southern Brazil. The study also aimed to determine the demographic and clinical factors associated with FI. DESIGN: This secondary data analysis used an exploratory, descriptive, and cross-sectional design to guide data collection and analysis. SUBJECTS AND SETTING: Two thousand one hundred sixty-two adults, including 1203 women (55.6%) and 979 men with a mean age of 40.6 years, were randomly selected from 390 census tracts in the city of Londrina (Parana, Brazil) using a stratified cluster sampling design. METHODS: Subjects were interviewed; the instrument was the culturally adapted and validated Brazilian-Portuguese version of the Bowel Function in the Community. Statistical analysis was performed using the Pearson chi-square test, the Fisher exact test, and forward stepwise logistic regression analysis. RESULTS: The prevalence of FI was 3.6% (n= 77; women 4%; men 3%); 70.1% (54/77) of the participants with FI reported liquid stool incontinence. Predictors of FI were aged between 40 and 60 years, anal fissure, previous colorectal or urogynecologic surgery, neurological diseases, cerebral vascular accident, and diarrhea or constipation. CONCLUSION: Our results revealed prevalence rates smaller than those reported in the Brazilian and international literature. The study broadens the knowledge on the epidemiology of FI in Brazil and the world. These results may be used to guide the implementation of public health policies for the prevention and early diagnosis of FI.
- Influence of perineal prostatectomy on anal continence(2011) GUILGER, Nadia Ricci; JORGE, Jose Marcio Neves; COSTA, Renato Prado; SALLA, Fernando Cesar; TEIXEIRA, Magaly Gemio; NAHAS, Sergio Carlos; CECCONELLO, IvanOBJECTIVE: Perineal prostatectomy has been proposed as a less invasive and safe procedure, but the risk of anal incontinence has been studied. This study aimed to evaluate the effects of perineal access on anal continence mechanisms after perineal prostatectomy. METHODS: From August 2008 to May 2009, twenty three patients underwent perineal prostatectomy. These patients were evaluated before surgery and eight months postoperatively using the Cleveland Clinic Anal Incontinence Score, the Fecal Incontinence Quality of Life Score, and anorectal manometry. RESULTS: The mean age of the subjects was 65 (range, 54-72) years, and the mean prostate weight was 34.5 (range, 24-54) grams. Gleason scores ranged from 6-7, and the mean Cleveland Clinic Anal Incontinence Score (mean +/- standard deviation) values were 0.9 +/- 1.9 and 0.7 +/- 1.2 (p>0.05) before and after surgery, respectively. The Fecal Incontinence Quality of Life Score did not change significantly after surgery. The mean values for anal manometric parameters before and after surgery were, respectively: Resting Pressures of 64 +/- 23 mmHg and 65 +/- 17 mmHg (p = 0.763), Maximum Squeezing Pressures of 130 +/- 41 mmHg and 117 +/- 40 mmHg (p = 0.259), High Pressure Zones of 3.0 +/- 0.9 cm and 2.7 +/- 0.8 cm (p = 0.398), Rectal Sensory Thresholds of 76 +/- 25 ml and 71 +/- 35 ml (p = 0.539), Maximum Tolerated Rectal Volumes of 157 +/- 48 ml and 156 +/- 56 ml (p = 0.836), and Sphincter Asymmetry Indexes 22.4 +/- 9% and 14.4 +/- 5% (p = 0.003). CONCLUSION: There was a significant decrease in the sphincter symmetry index after perineal prostatectomy. With the exception of the sphincter asymmetry index, perineal prostatectomy did not affect anal continence parameters.