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Search Results: 1 - 10 of 9664 matches for " Magaly Gemio;Scanavini Neto "
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Tratamento da doen?a de Crohn com infliximabe: primeira op??o?
Malheiros, Anna Paula Rocha;Teixeira, Magaly Gemio;Scanavini Neto, Arceu;Silva Filho, Edésio Vieira;Rodrigues, Leonardo Correa de Oliveira;Thierry, Roberta;Nahas, Sergio;Cecconello, Ivan;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2009, DOI: 10.1590/S0102-67202009000200007
Abstract: background: crohn′s disease is a chronic inflammatory disorder of the gastrointestinal tract with difficult management. infliximab is a chimeric igg1 monoclonal antibody against tumor necrosis factor and is indicated for refractory luminal and fistulization in crohn's disease. aim: to observe the outcome of 60 patients with diagnosis of crohn′s disease treated with infliximab. methods: prospective study with 60 patients with crohn′s disease in six years of observation. exclusion criteria were: clinical infection in at last three months; tuberculosis; intestinal occlusion; pregnancy. all patients were submitted to thorax x-rays, leukogram, tuberculosis cutaneous test. they were treated with infliximabe 5mg/kg each two months. they were divided into three groups according to the time of the diagnosis: 5 years, 6 to 10 and more than 10 years. the results were considered better, worse or unchanged. results: after the initial treatment, 76% of the patients achieved a response. at the first dose, the ones with 10 years and with associated abdominal surgery had good results and similar to the ones with less than 5 years with no operations. conclusion: the treatment with infliximab was effective and tolerable in the managing of symptoms in patients with active crohn′s disease, refractory to the conventional treatment and can be a reasonable approach to avoid the surgical treatment.
Pouchitis: extracolonic manifestation of ulcerative colitis?
Teixeira William Gemio Jacobsen,Silva José Hyppólito da,Teixeira Magaly Gemio,Almeida Maristela
Revista do Hospital das Clínicas , 1999,
Abstract: Pouchitis is the most frequent complication of ileal pouch-anal anastomosis for treatment of ulcerative colitis. There are several possible explanations. Among them, we focus on the one that considers pouchitis as an extracolonic manifestation of ulcerative colitis. The aim of this study was to investigate the association between pouchitis and extra-intestinal manifestations (EIM), which are frequent in these patients. Sixty patients underwent restorative proctocolectomy with an ileal J pouch (IPAA) from September 1984 to December 1998. Pouchitis was defined by clinical, endoscopic, and histologic criteria. The following extra-intestinal manifestations were studied: articular, cutaneous, hepatobiliary, ocular, genitourinary, and growth failure. Thirteen patients, of which 10 were female (76.9%), developed one or more episodes of pouchitis. Twelve patients of this group (92.3%) presented some kind of extra-intestinal manifestation, 4 pre-operatively (exclusively), 2 post-operatively (exclusively), and 6 both pre- and post-operatively (1.7 per patient). Twenty patients (42.7%) of the 47 without pouchitis did not present extra-intestinal manifestations; 10/35 (28.5%) of females had pouchitis, compared to 3/35 (12.0%) of men. Pouchitis was more frequent among females, though not statistically significant. EIM increases the risk of pouchitis. Pouchitis is related to EIM in 92.3 % of cases, corroborating the hypothesis that it could be an extracolonic manifestation of ulcerative colitis.
Blue rubber bleb nevus syndrome: case report
Teixeira Magaly Gemio,Perini Marcos Vinicius,Marques Carlos Frederico S.,Habr-Gama Angelita
Revista do Hospital das Clínicas , 2003,
Abstract: The case of a patient with blue rubber bleb nevus syndrome who is infected by acquired immunodeficiency syndrome virus due to multiple blood transfusions is presented. This case shows that although it is a rare systemic disorder, blue rubber bleb nevus syndrome has to be considered in the differential diagnosis of chronic anemia or gastrointestinal bleeding. Patients should be investigated by endoscopy, which is the most reliable method for detecting these lesions. The patient underwent gastroscopy and enteroscopy via enterotomy with identification of all lesions. Minimal resection of the larger lesions and string-purse suture of the smaller ones involving all the layers of the intestine were performed. The string-purse suture of the lesions detected by enteroscopy proved to be an effective technique for handling these lesions, avoiding extensive intestinal resection and stopping the bleeding. Effective management of these patients demands aggressive treatment and should be initiated as soon as possible to avoid risks involved in blood transfusions, as occurred in this case.
Inflammatory bowel diseases: principles of nutritional therapy
Campos Fábio Guilherme,Waitzberg Dan L.,Teixeira Magaly Gemio,Mucerino Donato Roberto
Revista do Hospital das Clínicas , 2002,
Abstract: Inflammatory Bowel Diseases - ulcerative colitis and Crohn's disease- are chronic gastrointestinal inflammatory diseases of unknown etiology. Decreased oral intake, malabsorption, accelerated nutrient losses, increased requirements, and drug-nutrient interactions cause nutritional and functional deficiencies that require proper correction by nutritional therapy. The goals of the different forms of nutritional therapy are to correct nutritional disturbances and to modulate inflammatory response, thus influencing disease activity. Total parenteral nutrition has been used to correct and to prevent nutritional disturbances and to promote bowel rest during active disease, mainly in cases of digestive fistulae with high output. Its use should be reserved for patients who cannot tolerate enteral nutrition. Enteral nutrition is effective in inducing clinical remission in adults and promoting growth in children. Due to its low complication rate and lower costs, enteral nutrition should be preferred over total parenteral nutrition whenever possible. Both present equal effectiveness in primary therapy for remission of active Crohn's disease. Nutritional intervention may improve outcome in certain individuals; however, because of the costs and complications of such therapy, careful selection is warranted, especially in patients presumed to need total parenteral nutrition. Recent research has focused on the use of nutrients as primary treatment agents. Immunonutrition is an important therapeutic alternative in the management of inflammatory bowel diseases, modulating the inflammation and changing the eicosanoid synthesis profile. However, beneficial reported effects have yet to be translated into the clinical practice. The real efficacy of these and other nutrients (glutamine, short-chain fatty acids, antioxidants) still need further evaluation through prospective and randomized trials.
Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis
Teixeira Magaly Gemio,Ponte Adauto C. Abreu da,Sousa Manuela,Almeida Maristela G. de
Revista do Hospital das Clínicas , 2003,
Abstract: Ileal pouch-anal anastomosis was an important advancement in the treatment of ulcerative colitis. The aim of this study was to determine whether early complications of ileal pouch-anal anastomosis in patients with ulcerative colitis are associated with poor late functional results. PATIENTS AND METHODS: Eighty patients were operated on from 1986 to 2000, 62 patients with ileostomy and 18 without. The early and late complications were recorded. Specific emphasis has been placed on the incidence of pouchitis with prolonged follow-up. RESULTS: The ileostomy was closed an average of 9.2 months after the first operation. Fourteen patients were excluded from the long-term evaluation; 6 patients were lost to regular follow-up, 4 died, and 4 patients still have the ileostomy. Of the 4 patients that died, 1 died from surgical complications. Early complications after operation (41) occurred in 34 patients (42.5%). Late complications (29) occurred in 25 patients as follows: 16 had pouchitis, 3 associated with stenosis and 1 with sexual dysfunction; 5 had stenosis; and there was 1 case each of incisional hernia, ileoanal fistula, hepatic cancer, and endometriosis. Pouchitis occurred in 6 patients (9.8%) 1 year after ileal pouch-anal anastomosis, 9 (14.8%) after 3 years, 13 (21.3%) after 5 years, and 16 (26.2%) after more than 6 years. The mean daily stool frequency was 12 before and 5.8 after operation. One pouch was removed because of fistulas that appeared 2 years later. CONCLUSIONS: Ileal pouch-anal anastomosis is associated with a considerable number of early complications. There was no correlation between pouchitis and severe disease, operation with or without ileostomy, or early postoperative complications. The incidence of pouchitis was directly proportional to duration of time of follow-up.
Pouchitis: extracolonic manifestation of ulcerative colitis?
Teixeira, William Gemio Jacobsen;Silva, José Hyppólito da;Teixeira, Magaly Gemio;Almeida, Maristela;Calache, Jo?o Elias;Habr-Gama, Angelita;
Revista do Hospital das Clínicas , 1999, DOI: 10.1590/S0041-87811999000500005
Abstract: pouchitis is the most frequent complication of ileal pouch-anal anastomosis for treatment of ulcerative colitis. there are several possible explanations. among them, we focus on the one that considers pouchitis as an extracolonic manifestation of ulcerative colitis. the aim of this study was to investigate the association between pouchitis and extra-intestinal manifestations (eim), which are frequent in these patients. sixty patients underwent restorative proctocolectomy with an ileal j pouch (ipaa) from september 1984 to december 1998. pouchitis was defined by clinical, endoscopic, and histologic criteria. the following extra-intestinal manifestations were studied: articular, cutaneous, hepatobiliary, ocular, genitourinary, and growth failure. thirteen patients, of which 10 were female (76.9%), developed one or more episodes of pouchitis. twelve patients of this group (92.3%) presented some kind of extra-intestinal manifestation, 4 pre-operatively (exclusively), 2 post-operatively (exclusively), and 6 both pre- and post-operatively (1.7 per patient). twenty patients (42.7%) of the 47 without pouchitis did not present extra-intestinal manifestations; 10/35 (28.5%) of females had pouchitis, compared to 3/35 (12.0%) of men. pouchitis was more frequent among females, though not statistically significant. eim increases the risk of pouchitis. pouchitis is related to eim in 92.3 % of cases, corroborating the hypothesis that it could be an extracolonic manifestation of ulcerative colitis.
Doen?a de Crohn em recém-nascido
Silveira, Rodrigo Cardoso;Baba, Renata Setsuko;Pereira, Ana Carolina S.;Paim, Sandra;Teixeira, Magaly Gemio;Habr-Gama, Angelita;
Revista Brasileira de Coloproctologia , 2008, DOI: 10.1590/S0101-98802008000300012
Abstract: crohn's disease occurs, mainly, in young adults. the incidence of this disease in other members of the same family is nearly 10%. nowadays the symptoms start precociously in children and teenagers. in the present case, the perianal disease was detected in three days old baby who developed different complications throughout his life. the child had two siblings with the same problems, but none of them survived after post-operative abdominal complications.
Intera??o da gesta??o na atividade da doen?a inflamatória intestinal e sua influência sobre o prognóstico gestacional e na fecundidade
Rodrigues, Leonardo Corrêa de Oliveira;Teixeira, Magaly Gemio;Arashiro, Roberta Thiery Godoy;Kiss, Desidério Roberto;
Revista Brasileira de Coloproctologia , 2009, DOI: 10.1590/S0101-98802009000300007
Abstract: introduction: most of women that develops inflammatory bowel disease (ibd) are in fertile age, concerning doctors and patients to understand this interaction. we evaluated the influence of ibd on fecundity and pregnancy and vice-versa. methods: the protocols of patients with crohn's disease (cd) and ulcerative colitis (uc), from 1984 and 2006, in fertile age, followed at the outpatient clinic were reviewed. patients were interviewed by the research medical doctor, to complete missing data not found in their protocols. patients with others colitis, incomplete investigation, not in fertile age or without cognitive capacity were excluded from this study. preterm delivery, low birth weight, congenital anomalies, stillbirth, miscarriages, types of delivery, disease topography in pregnant patients and drug administration during pregnancy were investigated. the statistic method adopted was the chi-square and fisher test, with significance level of 5%. no patient refused to participate in this study. results: 140 pregnancies in 104 patients with ibd were evaluated (uc in 63 and cd in 77 pregnancies). : a reduction of 41.6% in fecundity was observed after beginning of symptoms related to ibd, with influence of the disease in 20.6% (10.3% of patients did not want to have children because of fear related to disease; 6.5% because of medical orientation and 2.2% for poor medical conditions). there was no difference between cd and uc. most of patients did not want to become pregnant because they already had children, were "underage" or "alone" (53.3%) most of pregnancies did not altered clinic conditions in uc patients (77.8% / p=0.003). clinical conditions improved during pregnancies more in cd patients than uc patients (p=0.0007). the incidence of preterm delivery, low birth weight and stillbirth was higher when the whole colon was affected in uc (p < 0.037). the estimated rate of preterm delivery low birth weight was 83.3%[ic 95%: 10.29%; 100.00%]. there was no statistic diffe
Gumboro disease: evaluation of serological and anatomopathological responses in vaccinated broiler chickens challenged with very virulent virus strain
Bolis, DA;Paganini, FJ;Simon, VA;Zuanaze, MF;Scanavini Neto, H;Correa, ARA;Ito, NMK;
Revista Brasileira de Ciência Avícola , 2003, DOI: 10.1590/S1516-635X2003000200008
Abstract: this paper describes the effects of a strong type of vaccine - moulthrop g603 o and an intermediate-plus type of vaccine - 228e o in meat-type chickens challenged with a very virulent strain of infectious bursal disease virus (vvibdv). blood samples and bursa of fabricius were taken weekly up to 42 days of age. it was concluded that bursa of fabricius weight, bursa weight:body weight ratio, body weight and antibody titer evaluated before and after challenge with vvibdv were not enough to consistently and conclusively differentiate or estimate the protection given by vaccination. quantitative evaluation of injury intensity and the number of altered lymphoid follicles revealed that moulthrop g603 caused moderate microscopic lesions in one out of seven birds vaccinated at 14 days of age, while 228e vaccine did not induce ibd-typical microscopic lesions in the bursa of fabricius. good protection against bursal microscopic lesions was obtained when a strong type of vaccine was used before challenging with vvibdv. it was concluded that quantitative evaluation of microscopic lesions might be useful to measure the injury induced by vaccinal ibdv, as well as the level of protection and/or immunosuppression induced by ibdv challenge in vaccinated and non-vaccinated chickens.
Acesso vídeo-laparoscópico no tratamento cirúrgico da diverticulite aguda
Sousa Jr., Afonso Henrique da Silva e;Scanavini Neto, Arceu;Habr-Gama, Angelita;
Revista Brasileira de Coloproctologia , 2006, DOI: 10.1590/S0101-98802006000300018
Abstract: this review is based on standards of treatment for diverticular disease, both classical and new ones due to cumulated videolaparoscopic experience. the sequential double videolaparoscopic procedure for acute diverticulitis is discussed along with data from other studies supporting this novel modality of surgical treatment.
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