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Search Results: 1 - 10 of 223036 matches for " José de Jesus Peixoto;Felicetti "
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Bronquiectasias: aspectos diagnósticos e terapêuticos Estudo de 170 pacientes
Moreira José da Silva,Porto Nelson da Silva,Camargo José de Jesus Peixoto,Felicetti José Carlos
Jornal de Pneumologia , 2003,
Abstract: INTRODU O: Bronquiectasias s o freqüentemente encontradas na prática médica no Brasil, levando a significativa morbidez e comprometimento da qualidade de vida de seus portadores. OBJETIVOS: Analisar aspectos diagnósticos e terapêuticos em uma série de pacientes com bronquiectasias atendidos em um servi o de doen as pulmonares. MéTODO: Sinais, sintomas, achados radiográficos e microbiológicos, e resultados terapêuticos foram estudados em 170 pacientes portadores de bronquiectasias hospitalizados no período de 1978 a 2001 - 62,4% do sexo feminino, 37,6% do masculino, com idade média de 37 anos, variando entre 12 e 88 anos. RESULTADOS: Antecedente de pneumonia na infancia foi detectado em 52,5% dos pacientes, de tratamento tisiológico em 19,8%; 8,8% tinham asma br nquica, e dois tinham síndrome de Kartagener. Os sintomas mais comuns foram tosse (100%), expectora o (96%) e estertores pulmonares (66%). As les es eram unilaterais em 46,5% dos casos. Pneumococo, H. influenzae ou flora mista estiveram presentes em 85% das amostras de escarro examinadas. Os 170 pacientes receberam inicialmente tratamento clínico à base de antibióticos e fisioterapia respiratória; 88 deles (52%) mais jovens, com les es menores e boa reserva funcional foram submetidos à cirurgia de ressec o pulmonar (82 unilaterais e seis bilaterais). Ocorreram dois óbitos hospitalares entre os pacientes que receberam tratamento exclusivamente clínico. Os pacientes tratados cirurgicamente tiveram acentuada melhora dos sintomas, raramente necessitando ser reinternados. CONCLUS ES: Os prolongados sintomas broncopulmonares foram permanentemente aliviados na maioria dos pacientes com bronquiectasias que puderam ir à cirurgia de ressec o pulmonar, diferentemente dos que seguiram com o tratamento clínico.
Tratamento cirúrgico das malforma??es pulmonares congênitas em pacientes pediátricos
Ferreira, Hylas Paiva da Costa;Fischer, Gilberto Bueno;Felicetti, José Carlos;Camargo, José de Jesus Peixoto;Andrade, Cristiano Feijó;
Jornal Brasileiro de Pneumologia , 2010, DOI: 10.1590/S1806-37132010000200004
Abstract: objective: to determine the main congenital lung malformations treated and the principal diagnostic methods employed, as well as the indications for surgical treatment and the results obtained, at a referral facility for pediatric thoracic surgery. methods: we reviewed the medical charts of 52 patients anatomopathologically diagnosed with congenital lung malformations and who had been submitted to pulmonary resection between january of 1997 and december of 2006. exclusion criteria were age > 12 years and incomplete clinical data. the final sample comprised 35 patients. results: in this sample, the mean age was 31 months, and there was a predominance of males (n = 21). the anatomopathological findings were cystic adenomatoid malformation (n = 14), congenital lobar emphysema (n = 13), pulmonary sequestration (n = 8) and arteriovenous malformation (n = 1). the most common type of lung resection was left lower lobectomy (in 25.71%) followed by different types of segmentectomy (in 22.85%), left upper lobectomy (in 22.85%), right upper lobectomy (in 14.28%), right lower lobectomy (in 8.57%) and middle lobectomy (in 5.71%). of the 35 patients, 34 (97.14%) were submitted to closed pleural drainage, with a mean duration of thoracic drainage of 3.9 days. ten patients (28.5%) presented with postoperative complications. there were no deaths in our sample. conclusions: pulmonary resection for the treatment of congenital lung malformations is a safe procedure, presenting low morbidity and no mortality at a referral facility for pediatric thoracic surgery.
Abscesso pulmonar de aspira??o: análise de 252 casos consecutivos estudados de 1968 a 2004
Moreira, José da Silva;Camargo, José de Jesus Peixoto;Felicetti, José Carlos;Goldenfun, Paulo Roberto;Moreira, Ana Luiza Schneider;Porto, Nelson da Silva;
Jornal Brasileiro de Pneumologia , 2006, DOI: 10.1590/S1806-37132006000200009
Abstract: objective: to relate the experience of the staff at a health care facility specializing in the management of patients with aspiration lung abscess. methods: diagnostic aspects and therapeutic results of 252 consecutive cases of lung abscess seen in patients hospitalized between 1968 and 2004. results: of the 252 patients, 209 were male, and 43 were female. the mean age was 41.4 years, and 70.2% were alcoholic. cough, expectoration, fever and overall poor health were seen over 97% of patients. chest pain was reported by 64%, 30.2% presented digital clubbing, 82.5% had dental disease, 78.6% reported having lost consciousness at least once, and 67.5% presented foul smelling sputum. in 85.3% of the patients, the lung lesions were located either in the posterior segments of the upper lobe or in the superior segments of the lower lobe, and 96.8% were unilateral. concomitant pleural empyema was seen in 24 (9.5%) of the patients. mixed flora was identified in the bronchopulmonary or pleural secretions of 182 patients (72.2%). all patients were initially treated with antibiotics (mainly penicillin or clindamycin), and postural drainage was performed in 98.4% of cases. surgical procedures were performed in 52 (20.6%) of the patients (drainage of empyema in 24, pulmonary resection in 22 and drainage of the abscess in 6). cure was obtained in 242 patients (96.0%), and 10 (4.0%) died. conclusion: lung abscess occurred predominantly in male adults presenting dental disease and having a history of loss of consciousness (especially as a result of alcohol abuse). most of the patients were treated clinically with antibiotics and postural drainage, although some surgical procedure was required in one-fifth of the study sample.
Complica??es relacionadas à lobectomia em doadores de transplante pulmonar intervivos
Camargo, Spencer Marcant?nio;Camargo, José de Jesus Peixoto;Schio, Sadi Marcelo;Sánchez, Leticia Beatriz;Felicetti, José Carlos;Moreira, José da Silva;Andrade, Cristiano Feijó;
Jornal Brasileiro de Pneumologia , 2008, DOI: 10.1590/S1806-37132008000500003
Abstract: objective: to evaluate post-operative complications in living lobar lung transplant donors. methods: between september of 1999 and may of 2005, lobectomies were performed in 32 healthy lung transplant donors for 16 recipients. the medical charts of these donors were retrospectively analyzed in order to determine the incidence of postoperative complications and alterations in pulmonary function after lobectomy. results: twenty-two donors (68.75%) presented no complications. among the 10 donors presenting complications, the most frequently observed complication was pleural effusion, which occurred in 5 donors (15.6% of the sample). red blood cell transfusion was necessary in 3 donors (9.3%), and 2 donors underwent a second surgical procedure due to hemothorax. one donor presented pneumothorax after chest tube removal, and one developed respiratory infection. there were two intra-operative complications (6.25%): one donor required bronchoplasty of the middle lobe; and another required lingular resection. no intra-operative mortality was observed. post-operative pulmonary function tests demonstrated an average reduction of 20% in forced expiratory volume in one second (p < 000.1) compared to pre-operative values. conclusions: lobectomy in living lung transplant donors presents high risk of post-operative complications and irreversible impairment of pulmonary function. careful pre-operative evaluation is necessary in order to reduce the incidence of complications in living lobar lung transplant donors.
Bronquiectasias: aspectos diagnósticos e terapêuticos Estudo de 170 pacientes
Moreira, José da Silva;Porto, Nelson da Silva;Camargo, José de Jesus Peixoto;Felicetti, José Carlos;Cardoso, Paulo Francisco Guerreiro;Moreira, Ana Luiza Schneider;Andrade, Cristiano Feijó;
Jornal de Pneumologia , 2003, DOI: 10.1590/S0102-35862003000500003
Abstract: background: bronchiectasis is a frequently found disease in medical practice in brazil leading to significant morbidity and decrease in quality of life of the affected individuals. objectives: to study diagnostic and therapeutic aspects in a series of hospitalized patients with bronchiectasis in a department of pulmonary diseases. method: signs, symptoms, microbiological and radiographic data, and therapeutic results were studied in 170 hospitalized patients between 1978 and 2001 - females 62.4%, males 37.6%, and aged from 12 to 88 years (mean age 36.8 yrs). previous history of pneumonia in childhood was detected in 52.5% of the patients, tuberculosis in 19.8%; 8.8% had bronchial asthma, and 2 had kartagener's syndrome. results: the most common symptoms were cough (100.0%), expectoration (96.0%) and pulmonary rales (66.0%). the pulmonary lesions were unilateral in 46.5% of the cases. pneumococcus, h. influenzae or mixed flora were found in 85.0% of the examined sputa. all 170 patients received antibiotics and postural drainage, and 88 of them (younger and with a higher functional reserve) were also submitted to pulmonary resections (82 unilateral and 6 bilateral). two deaths occurred, and repetitive hospitalizations were more frequent among the clinically treated patients. the follow up showed that most of the surgically treated patients had significant symptoms improvement and rarely needed to be re-hospitalized. conclusions: in the majority of the patients, lung resection surgery improved permanently the prolonged bronchopulmonary symptoms of patients with bronchiectasis, differently from the patients who received only clinical treatment.
Lobectomia por carcinoma br?nquico: análise das co-morbidades e seu impacto na morbimortalidade pós-operatória
Sánchez, Pablo Gerardo;Vendrame, Giovani Schirmer;Madke, Gabriel Ribeiro;Pilla, Eduardo Sperb;Camargo, José de Jesus Peixoto;Andrade, Cristiano Feijó;Felicetti, José Carlos;Cardoso, Paulo Francisco Guerreiro;
Jornal Brasileiro de Pneumologia , 2006, DOI: 10.1590/S1806-37132006000600005
Abstract: objective: to analyze the impact that comorbidities have on the postoperative outcomes in patients submitted to lobectomy for the treatment of bronchial carcinoma. methods: a retrospective study of 493 patients submitted to lobectomy for the treatment of bronchial carcinoma was conducted, and 305 of those patients met the criteria for inclusion in the final study sample. the surgical technique used was similar in all cases. the torrington-henderson scale and the charlson scale were used to analyze comorbidities and to categorize patients into groups based on degree of risk for postoperative complications or death. results: the postoperative (30-day) mortality rate was 2.9%, and the postoperative complications index was 44%. prolonged air leakage was the most common complication (in 20.6%). the univariate analysis revealed that gender, age, smoking, neoadjuvant therapy and diabetes all had a significant impact on the incidence of complications. the factors found to be predictive of complications were body mass index (23.8 ± 4.4), forced expiratory volume in one second (74.1 ± 24%) and the ratio between forced expiratory volume in one second and forced vital capacity (0.65 ± 0.1). the scales employed proved efficacious in the identification of the risk groups, as well as in drawing correlations with morbidity and mortality (p = 0.001 and p < 0.001). in the multivariate analysis, body mass index and the charlson index were found to be the principal determinants of complications. in addition, prolonged air leakage was found to be the principal factor involved in mortality (p = 0.01). conclusion: reductions in forced expiratory volume in one second, in the ratio between forced expiratory volume in one second and forced vital capacity, and in body mass index, as well as a charlson score of 3 or 4 and a torrington-henderson score of 3, were associated with a greater number of postoperative complications in patients submitted to lobectomy for the treatment of bronchial carc
Prevalência de refluxo gastroesofágico em pacientes com doen?a pulmonar avan?ada candidatos a transplante pulmonar
Fortunato, Gustavo Almeida;Machado, Mirna Mota;Andrade, Cristiano Feijó;Felicetti, José Carlos;Camargo, José de Jesus Peixoto;Cardoso, Paulo Francisco Guerreiro;
Jornal Brasileiro de Pneumologia , 2008, DOI: 10.1590/S1806-37132008001000004
Abstract: objective: to assess the esophageal function profile and the prevalence of gastro-esophageal reflux (ger) in lung transplant candidates. methods: from july of 2005 to november of 2006, a prospective study was conducted involving 55 candidates for lung transplantation at the santa casa de misericórdia hospital in porto alegre, brazil. prior to transplantation, patients underwent outpatient stationary esophageal manometry and 24-h esophageal ph-metry using one and two electrodes. results: abnormal esophageal manometry was documented in 80% of the patients, and 24% of the patients presented pathological acid reflux. digestive symptoms presented sensitivity and specificity for ger of 50% and 61%, respectively. of the patients with chronic obstructive pulmonary disease, 94% presented abnormal esophageal manometry, and 80% presented lower esophageal sphincter hypotonia, making it the most common finding. patients with bronchiectasis presented the highest prevalence of ger (50%). conclusions: in patients with advanced lung disease, ger is highly prevalent. in the population studied, digestive symptoms of ger were not predictive of pathological acid reflux. the role that ger plays in chronic rejection should be examined and clarified in future studies.
Sobrevida de 12 anos do primeiro transplante pulmonar pediátrico intervivos do Brasil
Machuca, Tiago Noguchi;Sidney Filho, Luzielio Alves;Schio, Sadi Marcelo;Camargo, Spencer Marcantonio;Felicetti, José Carlos;Camargo, José de Jesus Peixoto;
Jornal de Pediatria , 2012, DOI: 10.2223/JPED.2222
Abstract: objective: to report the long-term follow-up of the first living-donor lobar lung transplantation performed in latin america. description: the patient was a 12-year-old boy with post-infectious obliterative bronchiolitis with end-stage pulmonary disease. he was on continuous oxygen support, presenting with dyspnea even during minimal activity. he underwent bilateral lobar lung transplantation with living donors. the procedure was performed with the left and right lower lobes of two different related donors. in the second side cardiopulmonary bypass was required. the transplant was uneventful, and the patient was extubated after 14 hours and discharged with 44 days, after resolution of infectious, immunological and drug-related complications. after 12 years of follow-up, he presents with adequate lung function and has resumed his habitual activities. comments: living-donor lobar lung transplantation is a complex procedure feasible for the treatment of selected pediatric end-stage pulmonary disease. this particular population might benefit from this approach since the availability of pediatric donors is very scarce and the clinical course of pediatric advanced pulmonary disease may be unpredictable.
Perfus?o pulmonar anterógrada "versus" retrógrada na preserva??o pulmonar para transplante em modelo canino de viabilidade pulmonar pós-morte
Kohmann, Jean Carlo;Silva, Ubirajara Lima e;Madke, Gabriel;Pilla, Eduardo Sperb;Felicetti, José Carlos;Camargo, José de Jesus Peixoto;Bittencourt, Paulo Ivo Homem de;Cardoso, Paulo Francisco Guerreiro;
Jornal de Pneumologia , 1999, DOI: 10.1590/S0102-35861999000200004
Abstract: lung retrieval following cardio-circulatory arrest has been studied experimentally, however severe ischemia/reperfusion injury requires improved methods of graft preservation. allograft perfusion with crystalloid solution delivered via pulmonary artery (antegrade perfusion) remains the standard procedure, however it does not provide adequate washout of the blood retained within the bronchial circulation which may trigger reperfusion injury. this has led the authors to test the impact of antegrade versus retrograde (via left atrium) perfusion of lung grafts submitted to 3 hours of warm ischemia after cardio-circulatory arrest in a dog model of left lung allotransplantation. twelve donor dogs were sacrificed with thiopental sodium and kept under mechanical ventilation at room temperature for 3 hours. they were randomized and the heart-lung blocks harvested after being perfused in a retrograde (group i, n = 6) or antegrade (group ii, n = 6) fashion with modified euro-collins solution. twelve recipient animals were submitted to a left lung transplant receiving the grafts from both groups and the assessment was performed during 6 hours. hemodynamic parameters were similar for animals in both groups. the gas exchange (arterial pao2 and paco2) in recipients of group i (retrograde perfusion) was significantly better when compared to recipients of grafts perfused via pulmonary artery. intracellular atp did not show difference between the groups, however there was a measurable drop in its values when samples obtained upon extraction were compared to those measured after reperfusion and at the end of the assessment. the authors concluded that retrograde perfusion yields better pulmonary function after 6 hours of reperfusion in this animal model of left lung allotransplantation following 3 hours of normothermic ischemia under mechanical ventilation.
Tratamento cirúrgico do enfisema Surgical treatment of emphysema
José de Jesus Peixoto Camargo
Jornal Brasileiro de Pneumologia , 2009, DOI: 10.1590/s1806-37132009000100001
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