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Search Results: 1 - 10 of 313952 matches for " Júlio Cezar Uili;Gomes "
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Tratamento colonoscópico de fístula colo-cutanea com plugue de colágeno
Coelho, Júlio Cezar Uili;Gomes, Guilherme Francisco;Macedo, Júlio Japiassu Marinho de;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2010, DOI: 10.1590/S0102-67202010000200016
Abstract: background: digestive fistulas remain as frequent complications after abdominal operations. when they occur, hospitalization time, cost, morbidity and post-operative mortality increase significantly. despite various treatment options, a significant number of patients require complex surgical procedures to close them. the development of interventional endoscopy has provided new treatment option for gastro-intestinal fistulas. case report: patient with colocutaneous fistula was successfully treated with a collagen plug. percutaneous injection of methylene-blue identified the internal orifice of the fistula in the transverse colon. previous clips application was unsuccessful. the fistula closed in few days after collagen plug introduction through a combined percutaneous-colonoscopic procedure. conclusion: the use of plugs of collagen by combined percutaneous and endoscopic procedure has the advantage of allowing reduced time for treatment of intestinal fistulae and may avoid surgical operations.
Tratamento laparoscópico de periapendicite causada por dispositivo intra-uterino
Coelho, Júlio Cezar Uili;Gon?alves, Carolina Gomes;Graf, Christie Michelle;
Arquivos de Gastroenterologia , 2003, DOI: 10.1590/S0004-28032003000100010
Abstract: background: intrauterine device may perforate the uterus and cause several complications. aim: to report a case of laparoscopic treatment of peri-appendicitis caused by intrauterine device. patient and method: a young female presented with pain in the right lower abdomen of 4 days of duration. on the physical examination, she had localized abdominal pain in the right lower abdomen with discrete guarding and pain on percussion and rebound tenderness. ultrasonography showed an intrauterine device outside of the uterus, in the right lower of the abdomen. results: at laparoscopy, an inflammatory mass that consisted of the intrauterine device blocked by the mesoappendix and the appendix was observed. appendectomy and removal of the intrauterine device were performed. conclusion: laparoscopy allows adequate treatment of peri-appendicitis caused by intrauterine device, inclusive with complete evaluation of the entire pelvic region to rule out associated complications
Obstru??o intestinal após uso de infliximab no tratamento de fístula êntero-cutanea na doen?a de Crohn
Gon?alves, Carolina Gomes;Coelho, Júlio Cezar Uili;Amarante, Heda Maria Braska dos Santos;
Revista do Colégio Brasileiro de Cirurgi?es , 2005, DOI: 10.1590/S0100-69912005000400015
Abstract: crohn's disease is often complicated by the development of fistulas. infliximab, a monoclonal antibody that binds tumor necrosis factor a have shown to be successful in the treatment of fistulizing crohn's disease. it's possible complications and side effects have not been completely elucidated. our objective is to report a case of a patient who developed intestinal obstruction after treatment of fistulizing crohn's disease with infliximab. a 50 years-old female with crohn's disease presented with spontaneous enterocutaneous fistula. she was successfully treated with the infusion of 5mg/kg infliximab at weeks 0, 2, and 6, with complete closure of the fistula after the first infusion. eight weeks after treatment she developed small bowel obstruction secondary to stenosis of the ileum. she was subjected to exploratory laparotomy and resection of the stenotic ileum. the patient had good recovery, with no complications, and was discharged on the 5th postoperative day. although a faster and complete healing of enterocutaneous fistula was induced by infliximab, this treatment may have caused intestinal obstruction in this case.
Tratamento laparoscópico de periapendicite causada por dispositivo intra-uterino
Coelho Júlio Cezar Uili,Gon?alves Carolina Gomes,Graf Christie Michelle
Arquivos de Gastroenterologia , 2003,
Abstract: RACIONAL: Dispositivo intra-uterino pode perfurar o útero e causar várias complica es. OBJETIVO: Descrever um caso de tratamento laparoscópico de periapendicite causada por dispositivo intra-uterino. MATERIAL E MéTODOS: Jovem do sexo feminino apresentou dor em fossa ilíaca direita de 4 dias de dura o. No exame físico, apresentava dor abdominal localizada em fossa ilíaca direita, com discreta renitência de parede e dor à percuss o e descompress o brusca na regi o. A ultra-sonografia evidenciou dispositivo intra-uterino fora do útero, na fossa ilíaca direita. RESULTADOS: à laparoscopia, observou-se massa inflamatória que consistia do dispositivo intra-uterino totalmente bloqueado pelo mesoapêndice e apêndice. Apendicectomia e retirada do dispositivo foram realizadas. CONCLUS O: A laparoscopia permite o tratamento adequado da periapendicite causada por dispositivo intra-uterino, inclusive com avalia o adequada de toda a regi o pélvica para excluir les es associadas.
Evaluation of the nonalcoholic fat liver disease fibrosis score for patients undergoing bariatric surgery
Pimentel, Silvania Klug;Strobel, Rodrigo;Gon?alves, Carolina Gomes;Sakamoto, Danielle Giacometti;Ivano, Flávio Heuta;Coelho, Júlio Cezar Uili;
Arquivos de Gastroenterologia , 2010, DOI: 10.1590/S0004-28032010000200010
Abstract: context: morbidly obese patients have an increased risk for nonalcoholic fat liver disease. its severe form, nonalcoholic steatohepatitis may cause liver fibrosis. the diagnosis of advanced fibrosis has great value during the pre operative evaluation for bariatric surgery. currently, liver biopsy is the gold standard for diagnosis of liver fibrosis. objective: to evaluate the nonalcoholic fat liver disease fibrosis score in morbidly obese patients undergoing roux-en-y gastric bypass in our population. methods: one hundred fifty-eight morbidly obese patients that had undergone bariatric surgery were included. age, body mass index, hyperglycemia, platelet count, albumin and ast/alt ratio were applied to the score formula. scores above 0.676 were indicative of advanced liver fibrosis and scores under -1,455 absence of advanced liver fibrosis. these scores were compared to liver biopsy findings. results: the presence of advanced fibrosis could be diagnosed with good accuracy, with a positive predictive value of 83.7%. the score had a higher accuracy to exclude advanced fibrosis with a negative predictive value of 97%. twenty-five patients (16%) had scores between the cutoffs points and were identified as indeterminate. the score sensibility and specificity was 83% and 97% respectively. conclusions: the nonalcoholic fat liver disease fibrosis score has high accuracy to identify and exclude advanced liver fibrosis in morbidly obese patients subjected to bariatric surgery.
Resultados do transplante de fígado na doen?a hepática alcoólica
Parolin, M?nica Beatriz;Coelho, Júlio Cezar Uili;Igreja, Mauro da;Pedroso, Maria Lúcia;Groth, Anne Karoline;Gon?alves, Carolina Gomes;
Arquivos de Gastroenterologia , 2002, DOI: 10.1590/S0004-28032002000300003
Abstract: background: liver transplantation is accepted as effective therapeutic option for end-stage liver disease, including alcoholic liver disease aim: to evaluate the outcome of liver transplantation for alcoholic liver disease in the liver transplantation program at "hospital de clínicas" of the federal university of paraná, curitiba, pr, brazil patients and methods: it was performed a retrospective study of the patients who underwent liver transplantation for alcoholic end-stage liver disease between september 1991 and january 2001. the minimum abstinence period required was 6 months before liver transplantation. identification of alcohol consumption after liver transplantation was determinated by information provided by patient or family and biochemical or histological anormalities results: twenty patients underwent liver transplantation for alcoholic liver disease in the study period, 95% (19/20) were men and the median age was 50 years (29-61 years). seventy-five percent of the patients (15/20) had severe liver disfunction (child c class) in the pre-transplant period. in six of them (30%) there was association with viral hepatitis and in one, with hepatocarcinoma. median abstinence period before liver transplantation was 24 months, varying from 9 to 120 months. one-year and 3-year survival rate were 75% and 50%, respectively. the main complications were: acute cellular rejection (40%), chronic rejection (5%), hepatic artery thrombosis (15%), biliary complications (15%), bacterial or fungal infections (45%), cytomegalovirus infection (20%). three patients returned to alcohol use after liver transplantation conclusion: the survival of patients who received liver transplant for alcoholic cirrhosis are satisfactory. in the present study there was a small index of alcohol use after liver transplantation.
Fatores de risco e conduta nas complica??es do trato biliar no transplante hepático
Freitas, Alexandre Coutinho Teixeira de;Coelho, Júlio Cezar Uili;Parolin, M?nica Beatriz;Matias, Jorge Eduardo Fouto;Zeni Neto, Clementino;Gon?alves, Carolina Gomes;
Revista do Colégio Brasileiro de Cirurgi?es , 2000, DOI: 10.1590/S0100-69912000000600001
Abstract: biliary reconstruction is a vulnerable step of liver transplantation, presenting an incidence of biliary complications between 10 to 35% in many studies. our aim is to present our incidence and treatment of biliary complications, in a total of 147 orthotopic liver transplantations, 88 males and 59 females, with an mean age of 37 years. biliary complications occurred in 27 transplants (18,36%) performed in 25 patients (two retransplants). cellular rejection and vascular complications were identified as risk factors for biliary complications. age, sex, etiology of cirrhosis and biliary reconstruction technique were not risk factors. fifty-two therapeutic courses were performed: 23 surgical treatments, 15 endoscopic treatments, seven retransplants, six external biliary drainage and one patient is waiting retransplantation. in conclusion, biliary complications are frequent after liver transplantation and vascular complications and cellular rejection are risk factors for them.
Complica??es vasculares pós-transplante hepático
Coelho, Júlio Cezar Uili;Matias, Jorge Eduardo Fouto;Parolin, M?nica Beatriz;Martins, Eduardo Lopes;Salvalaggio, Paolo Rogério de Oliveira;Gon?alves, Carolina Gomes;
Revista do Colégio Brasileiro de Cirurgi?es , 2000, DOI: 10.1590/S0100-69912000000600004
Abstract: background: the authors present the vascular complications observed in an academic brazilian hepatic transplantation division. methods: hospital charts of all patients who were submitted to a liver transplantation between of september 1991 and january 2000, were evaluated to determine vascular complications and to correlated them to clinical data and surgical procedures. results: of a total of 169 tranplantations performed, four were from living related donors and 9 retransplantations. twenty-four vascular complications (14,3%) were identified in 22 patients (13,0%), the most common being hepatic artery thrombosis (15 cases) and portal vein thrombosis (4 cases). complications of the infra and suprahepatic vena cava were observed in three cases (1,8%). vascular complications were more common in children (26,06%) than in adults (13,14%) (p<0,05). from the patients with hepatic artery thrombosis, one was submitted to an angioplasty, one to a thrombectomy, while eight underwent retransplantation and five died waiting for retransplantation. of the patients with portal vein thrombosis, two died, one submitted to an endovascular stent placement, and one to conservative treatment. patients with stenosis of the portal vein and of the infra and suprahepatic inferior vena cava received a conservative treatment, with good clinical recovery. conclusion: vascular complications are frequent after liver transplantation, mainly with children. they are associated with an elevated rate of morbidity, mortality and retransplantation.
Transplante hepático no Brasil: situa o atual Brazil liver transplantation: current situation
Eduardo Ramos,Júlio Cezar Uili Coelho
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2010, DOI: 10.1590/s0102-67202010000300001
Uso da mirtazapina no tratamento da náusea e v?mito refratários a terapia habitual após deriva??o gástrica em Y de Roux
Freitas, Alexandre Coutinho Teixeira de;Coelho, Júlio Cezar Uili;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2008, DOI: 10.1590/S0102-67202008000100009
Abstract: background: bariatric surgery is related to significant morbidity. mechanical complications such as stricture of the anastomotic sites are the most common causes of persistent nausea and vomiting. some patients present such symptoms in the absence of these complications. aim: to report the use of mirtazapine in a patient submitted to bariatric surgery, presenting persistent nausea and vomiting in the absence of mechanical complications, and unresponsive to conventional antiemetic drugs. case report: a morbidly obese patient submitted to laparoscopic roux-en-y gastric bypass presented persistent nausea and vomiting unresponsive to treatment with ondansetron, metoclopramide, and bromopride. no mechanical complications were identified. he was treated with an oral daily dose of 30 mg of mirtazapine for 60 days. after two days, the patient presented significant clinical improvement. mirtazapine is an effective drug most commonly used in the treatment of depression, presenting an antiemetic effect due to the blockade of 5-ht3 serotonin receptors in the brainstem. conclusion: mirtazapine can be useful in cases of roux-en-y gastric bypass that present nausea and vomiting unsuccessfully treated with conventional antiemetic drugs when mechanical causes are excluded.
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