ALFREDO LUIZ JACOMO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Deltoid muscle innervation in cadaveric specimens: A statistical analysis of the axillary nerve entering sites-preliminary results(2019) HARA, Lucas; AKAMATSU, Flavia Emi; LIMA, Larissa Barbosa; ITEZEROTE, Ana Maria; HOJAIJ, Flavio; ANDRADE, Mauro; JACOMO, Alfredo LuizconferenceObject Histopathologic changes in gastric mucosa after experimental gastric restriction(2017) MOTA FILHO, Guilherme; ITEZEROTE, Ana Maria; SALEH, Samir; HOJAIJ, Flavio; ANDRADE, Mauro; MARTINEZ, Carlos Augusto Real; AKAMATSU, Flavia Emi; JACOMO, Alfredo Luiz- Polyethylene Glycol fusion associated with anti-oxidants: A new promise in the treatment of traumatic paralysis (vol 40, pg 1489, 2018)(2018) SALOMONE, Raquel; JACOMO, Alfredo Luiz; BENTO, Ricardo F.; NASCIMENTO, Silvia Bona do; LEZIROVITZ, Karina; HOJAIJ, Flavio Carneiro; COSTA, Heloisa J. Z. R.
- Efficacy and safety of a device used to prevent fogging and residue buildup on surgical optics during video-assisted thoracic surgical procedures (LacrimaSurg): a pilot in vivo study in 30 patients(2022) ABREU, Igor Renato Louro Bruno de; SILVA, Alessandra Rodrigues; CHIOVATTO, Eduardo; ABRAO, Fernando Conrado; YOUNES, Riad N; JACOMO, Alfredo LuizIntroduction Nowadays the majority of the surgical procedures are video surgeries. Despite technological advances, some problems remain. The buildup of residues in front of the lens is an example of this problem. To solve it, Abreu et al. (Surg Technol Int 26:43-47, 2015) developed LacrimaSurg, which works as a lacrimal duct in the optics preventing fogging and residues buildup on it. This had 98.1% of efficiency in an experimental study. Objective Study feasibility and safety of the device under real surgical conditions. Materials and Methods A pilot study included 30 patients undergoing thoracic procedures using LacrimaSurg. Procedures were recorded for further analysis by investigators. The characteristics of patients (age, sex, body mass index, Charlton comorbidity index), data of environment (Temperatures variances), and data of procedures (type of surgery and duration of it) were recorded. The investigators watched the videos and recorded the residue buildup and fogging events that impaired surgeon's vision. The number of times the optics got dirty, need for further jets of crystalloid solution, and need for mechanical cleaning were collected to evaluate efficacy. Comparative serum measurements of electrolytes before and after surgery were studied. Data were organized and analyzed by simple linear correlations and t test for continuous variables and Fisher's test for categorical variables. Results The use of the device allowed 97% of the procedures to be performed without interruption. No characteristics inherent to the patients or to the procedures that lead to fogging or filth of the optics were identified. There were no statistically significant differences between pre- and postoperative serum ions, and no postoperative complications related to the use of the device were observed. Conclusion The device was effective in preventing interruption of surgical procedures due to dirt or fogging, its use was considered safe, and did not cause postoperative complications.
conferenceObject Colonic mucosa is affected by gastric restriction in an animal model(2017) FONTES, Luiz Gustavo; ITEZEROTE, Ana; SALEH, Samir; HOJAIJ, Flavio; ANDRADE, Mauro; MARTINEZ, Carlos Augusto Real; AKAMATSU, Flavia Emi; JACOMO, Alfredo Luiz- Anatomical Basis of the Myofascial Trigger Points of the Gluteus Maximus Muscle(2017) AKAMATSU, Flavia Emi; YENDO, Tatiana Mina; RHODE, Ciro; ITEZEROTE, Ana Maria; HOJAIJ, Flavio; ANDRADE, Mauro; HSING, Wu Tu; JACOMO, Alfredo LuizMyofascial pain syndrome is characterized by pain and limited range of motion in joints and caused by muscular contracture related to dysfunctional motor end plates and myofascial trigger points (MTrPs). We aimed to observe the anatomical correlation between the clinically described MTrPs and the entry point of the branches of the inferior gluteal nerve into the gluteus maximus muscle. We dissected twenty gluteus maximus muscles from 10 human adult cadavers (5 males and 5 females). We measured the muscles and compiled the distribution of the nerve branches into each of the quadrants of the muscle. Statistical analysis was performed by using Students f-test and Kruskal-Wallis tests. Although no difference was observed either for muscle measurements or for distribution of nerve branching among the subjects, the topography of MTrPs matched the anatomical location of the entry points into the muscle. Thus, anatomical substract of the MTrPs may be useful for a better understanding of the physiopathology of these disorders and provide basis for their surgical and clinical treatment.
bookPart Principais acessos em cirurgia inguinal(2019) MASSAROLO, Paulo; OTOCH, José Pinhata; JACOMO, Alfredo Luiz; HOJAIJ, Flávio Carneiro; ANDRADE, Mauro Figueiredo Carvalho de- Anatomical Study of the Innervation of the Masseter Muscle and Its Correlation with Myofascial Trigger Points(2020) PINHEIRO, Roberto Procopio; GAUBEUR, Matheus Aquesta; ITEZEROTE, Ana Maria; SALEH, Samir Omar; HOJAIJ, Flavio; ANDRADE, Mauro; JACOMO, Alfredo Luiz; AKAMATSU, Flavia EmiBackground and Purpose: Myofascial pain syndrome (MPS) is widely prevalent in the general population; some reports estimate its prevalence ranges from 9 to 85%. Among the different locations where MPS may arise, pain related to the masseter muscle is referred as masticatory myofascial pain. MPS is characterized by myofascial trigger points (MTPs), which represent tender anatomical areas of a muscle where painful symptoms are elicited whenever stimulated. Previous publications have found MTPs to coincide with neuromuscular junctions at the motor end plate, at the innervation zone (IZ). Our study aimed to describe the innervation of the masseter muscle and relate it to clinically described myofascial trigger points (MTPs). Materials and Methods: We mapped the nerve fiber distribution into the masseter muscles from 16 cadavers by anatomical dissection. We divided the muscle into six regions, three superior (I-III) and three inferior (IV-VI), and classified the nerve's branches distribution according to these predetermined areas. Statistical analyses was made by Poisson distribution and logarithm link function followed by Bonferroni multiple comparisons (P<0.05). Results: All six areas received branches from the masseteric nerve. Areas I and II (upper posterior and upper intermediate, respectively) had a significant higher number of nerve entries as compared to the remaining areas. Conclusion: The penetration areas of the masseteric nerve have been established and MTPs are found in the innervation zones, clinicians should focus initially on the regions of the penetration points, for diagnostics and therapeutic measures, such as injections, dry needling and soft tissue interventions. Anatomical study of nerve supply to the masseter muscle can provide useful additional knowledge to further understanding masticatory myofascial pain and to direct therapeutic interventions and diagnostic studies of temporomandibular junction dysfunction.
conferenceObject ABDUCTOR HALLUCIS MUSCLE HAS ONE MORE MUSCLE INSERTION POINT(2018) WADA, Juliano; AKAMATSU, Flavia Emi; ITEZEROTE, Ana Maria; HOJAIJ, Flavio; ANDRADE, Mauro; JACOMO, Alfredo Luiz- Lymph drainage of the upper limb and mammary region to the axilla: anatomical study in stillborns(2018) CUADRADO, Guilherme de Arruda; ANDRADE, Mauro Figueiredo Carvalho de; AKAMATSU, Flavia Emi; JACOMO, Alfredo LuizPurpose We studied the lymphatic drainage of the upper limb and mammary region directing to the axilla to investigate whether independent pathways can be observed or whether anastomoses and shared drainage occur between them. This analysis aimed to assess the safety of axillary reverse mapping (ARM) in breast cancer treatment and to understand the development of lymphedema after sentinel lymph node biopsy (SLNB) alone. Methods Seven unfixed stillborn fetuses were injected with a modified Gerota mass in the peri-areolar area, palm and dorsum of the hands, formalin fixed, and then submerged in 10% hydrogen peroxide solution. Microsurgical dissection was then performed on the subcutaneous cellular tissue of the upper limb, axillary region, and anterior thorax to expose the lymphatic vessels and lymph nodes. Results The dye injected into the upper limb reached either the lateral axillary group, known to be exclusively responsible for upper limb drainage, or the anterior group, which is typically related to breast drainage. There was great proximity among the pathways and lymph nodes. Communicating lymphatic vessels among these groups of lymph nodes were also found in all studied cases. Discussion Lymphedema remains a challenging morbidity in breast cancer treatment. ARM and SLNB aim to avoid unnecessary damage to the lymphatic drainage of the upper limb. However, our anatomical study suggests that ARM may have potential oncological risks because preserved lymph nodes may harbor malignant cells due their proximity, overlapping drainage pathways, and connecting lymph vessels among lymph nodes.