JOSE RIBAS MILANEZ DE CAMPOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina
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- Long-term results of the use of oxybutynin for the treatment of plantar hyperhidrosis(2015) WOLOSKER, Nelson; TEIVELIS, Marcelo P.; KRUTMAN, Mariana; PAULA, Rafael P. de; KAUFFMAN, Paulo; CAMPOS, Jose R. M. de; PUECH-LEAO, PedroBackgroundPlantar hyperhidrosis is a common illness with significant impact on quality of life. Oxybutynin presents good short-term results, but longer follow-up results are lacking. We evaluated oxybutynin effectiveness in patients who were not surgically treated and who had at least sixmonths of follow-up. MethodsFrom September 2007 to September 2013, 85 consecutive patients were enrolled in our institutional protocol for the pharmacological-first treatment of primary plantar hyperhidrosis with oxybutynin. Eight patients were lost to follow-up, 15 patients have not yet been under treatment for sixmonths, and data were available for 39 patients (all female) treated for at least sixmonths. Data at the start of the protocol, sixweeks after beginning treatment, and at their final visit were analyzed. ResultsTwenty-three of the 77 patients (29.87%) did not improve after pharmacological therapy. From the 39 patients with more than sixmonths of follow-up (median 16.9months, range 9-71), 79.5% reported moderate/great improvement in excessive plantar sweating after sixweeks of treatment, and this rate increased to 84.7% in the last follow-up visit; 82.85% showed improvement in other sites presenting hyperhidrosis. Dry mouth was the most common side effect; 51.6% of patients reported it to be moderate/severe at the last visit. ConclusionIn patients with good initial response to oxybutynin, more than 82% presented moderate or great improvement in plantar and other sites' excessive sweating; dry mouth was the most common side effect but was tolerable and did not lead any patient to interrupt treatment.
- A Simplified Method to Pass the Bar Through the Mediastinum in the Nuss Technique(2015) MESSINEO, Antonio; GHIONZOLI, Marco; PICCOLO, Roberto Lo; CAMPOS, Jose Ribas Milanez DeIn the minimally invasive repair of pectus excavatum, as reported by Nuss, the introducer is inserted into the thoracic cavity, making its way through the mediastinum, and emerges through a left intercostal space. Then, 2 umbilical tapes are tied to the introducer tip as a guide to pass into this tunnel the curved bar with the concave side up. When fat tissue is present in the anterior mediastinum or bars with notched ends are used, passage of the umbilical tape could be challenging and eventually lead to bleeding. In this report, we describe a different and simple technique to allow this passage, from left to right, in a very safe and effective way. (C) 2015 by The Society of Thoracic Surgeons
- Long-Term Efficacy of Oxybutynin for Palmar and Plantar Hyperhidrosis in Children Younger than 14 Years(2015) WOLOSKER, Nelson; TEIVELIS, Marcelo P.; KRUTMAN, Mariana; PAULA, Rafael P. de; SCHVARTSMAN, Claudio; KAUFFMAN, Paulo; CAMPOS, Jose R. M. de; PUECH-LEAO, PedroOxybutynin for treating hyperhidrosis in children has been evaluated only in short-term studies. We aimed to investigate the long-term effects of oxybutynin in treating children with palmar and plantar hyperhidrosis who had not undergone surgery and who were monitored for at least 6months (median 19.6mos). A cohort of 97 patients was evaluated retrospectively, with particular attention to 59 children (ages 4-14 yrs) who were treated for longer than 6months. Their quality of life (QOL) was evaluated using a validated clinical questionnaire before and after 6weeks of pharmacologic therapy. A self-assessment of hyperhidrosis was performed after 6weeks and after the last consultation. By their final office visit, more than 91% of the children with hyperhidrosis treated with oxybutynin experienced moderate or great improvement in their level of sweating and 94.9% experienced improvement in QOL. More than 90% of children reported improvement of hyperhidrosis at other sites. Dry mouth was the most common side effect. Oxybutynin appears to be an effective treatment option for children with hyperhidrosis, and positive results are maintained over the long term (median 19.6mos).