ARALDO AYRES MONTEIRO JUNIOR
Índice h a partir de 2011
2
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
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- Complicação grave do uso irregular de silicone industrial em paciente transexual: relato de caso(2020) MENDES, MONIQUE; MONTEIRO, GUSTAVO GOMES RIBEIRO; BASTOS, EMILLY FREIRE BARBOSA; MILCHESKI, DIMAS ANDRÉ; MONTEIRO JUNIOR, ARALDO AYRES; GEMPERLI, ROLFABSTRACT The use of industrial liquid silicone as a material for aesthetic modification of body contour is a practice that has been carried out clandestine for about 60 years. Currently, most reports come from countries in Asia and South America, and the victims are mainly women and transsexuals. Due to the large number of cases with complications, the use of industrial silicone for aesthetic purposes has never been approved. However, it continues to be applied alone or associated with other products, determining severe local and systemic complications. We report a case of death of a transsexual patient after injecting industrial silicone in the thighs and buttocks.
- Opções de tratamento cirúrgico em lesões cutâneas por extravasamento acidental de drogas: experiência do Hospital das Clínicas da Faculdade de Medicina da USP.(2018) MILCHESKI, Dimas André; MOTA, Wellington Menezes; LOBATO, Rodolfo Costa; MONTEIRO JÚNIOR, Araldo Ayres; GEMPERLI, RolfABSTRACT Objective: to report the experience of the Division of Plastic Surgery of the Hospital das Clínicas of the Medical School of the University of São Paulo in the treatment of cutaneous lesions due to accidental extravasation of drugs. Methods: we included patients with lesions due to extravasation of drugs over a period of 18 months. We retrospectively evaluated the following parameters: age, diagnoses during hospitalization and comorbidities, serum levels of albumin and hemoglobin, place of hospitalization, drug involved, anatomic segment affected, therapeutic management and death during hospitalization. Results: we followed-up 14 patients. The main drug involved was noradrenaline (21%). All patients underwent debridement of tissue necrosis. Three patients were submitted to flaps after preparation of the wound bed with negative pressure therapy, with good results. Seven patients had no definitive treatment of their lesions due to lack of clinical conditions. Conclusion: in patients with favorable clinical conditions, the definitive treatment with flaps was adequate for cases of wounds due to extravasation of drugs in the subcutaneous tissue when there was exposure of noble structures.
- Complicação grave do uso irregular do PMMA: relato de caso e a situação brasileira atual(2019) KURIMORI, KLEBER TETSUO; MENDES, MONIQUE; MILCHESKI, DIMAS ANDRÉ; MONTEIRO JUNIOR, ARALDO AYRES; GEMPERLI, ROLF▪ ABSTRACT Introduction: Use of permanent fillers can lead to significant complications. In Brazil, polymethylmethacrylate (PMMA)is a product approved by the Agência Nacional de VigilânciaSanitária (ANVISA), but its use exceeds its indications, leadingto serious complications. Recommendations for restricteduse have been in place for more than a decade, but caseswith serious consequences due to inappropriate use are stillseen. Objective: To report a serious complication due to inappropriate use of PMMA and discuss the current status of PMMA use in Brazil based on recommendations of medical societies and regulatory agencies. Methods: This report describes a case of extensive necrosis of the gluteal region after injection of PMMA by a non-qualified practitioner; the report also reviews the literature on the current status of PMMA use in Brazil. Discussion Despite the efforts of medical societies, acute and chronic complications are still reported in the Brazilian literature. In 2016, more than 17,000 PMMArelated complications were reported; nevertheless, reliable epidemiological data remain unavailable because the number of treatments, the quality of the product, and the training of practitioners remain unregulated. Conclusion A significant number of repair procedures are performed in Brazil to correct complications resulting from the use of PMMA. The severity of the reported case highlights the need to combat bad practice by untrained professionals, as well as the need for greater control of PMMA marketing by regulatory agencies.
- Brief hospitalization protocol for pressure ulcer surgical treatment: outpatient care and one-stage reconstruction(2017) MILCHESKI, Dimas André; MENDES, Rogério Rafael da Silva; FREITAS, Fernando Ramos de; ZANINETTI, Guilherme; MONEIRO JÚNIOR, Araldo Ayres; GEMPERLI, RolfABSTRACT Objective: to evaluate a brief hospitalization protocol for the treatment of pressure ulcers, proposed by the Complex Wound Group of Clinical Hospital of University of Sao Paulo Medical School, particularly in regard to selection of patients, hospitalization time, cutaneous covering, complications and sore recurrence. Methods: retrospective cohort of 20 consecutive patients with 25 pressure lesions Grade IV. All patients were ambulatorily prepared and were hospitalized for surgical one time procedure for pressure lesion closing. Results: in total, 27 flaps were performed to close 25 wounds. Three patients showed minor dehiscence (11.1%). There was no recurrence during the post-surgical follow-up period. No patient suffered a new surgery and no flap showed partial or total necrosis. Median time of hospitalization was 3.6 days (2-6 days) and median follow-up was 91 months (2-28 months). All patients maintained their lesions closed, and there was no recurrence during follow-up. Conclusion: the brief hospitalization protocol was considered adequate for the resolution of pressure wounds, showing an average time of hospitalization of 3.6 days and rate of minor surgical wound dehiscence of 11.1%.
- Experiência inicial com terapia por pressão negativa por instilação em feridas complexas(2017) MILCHESKI, Dimas André; PORTOCARRERO, Marcelo Lima; ALVAREZ, Daniel Mamere; MAZUCA, Luiz Guilherme de Moraes Prado; MONTEIRO JUNIOR, Araldo Ayres; GEMPERLI, RolfABSTRACT Objective: to report the initial experience with Negative-Pressure Wound Therapy with instillation in infected or contaminated complex wounds. Methods: the negative-pressure wound therapy with instillation used was V.A.C. Ulta with Veraflo instillation (Kinetic Concepts, Inc). The mode of operation was continuous with negative pressure set at 125 mmHg for two hours and instillation between the pauses. The instillation time was 20 minutes (contact time of the topical agent with the wound) and the instilled substance was 0.9% normal saline. After adequate preparation of the wound, it was covered with graft or flap. Results: ten patients with complex or contaminated wounds were operated on. The mean number of NPWTi changes was 1.4, the mean number of surgeries was 2.4, the interval until complete wound coverage was 6.3 days, and the interval up to the time of discharge was 11.4 days. Conclusion: the comparison of the negative-pressure wound therapy with instillation with two previous studies (historical control) evidenced a shorter hospitalization time, favoring TPNi. This study had an initial character, making it necessary to conduct a randomized and controlled trial to confirm the efficacy of this therapy and verify its cost-effectiveness.