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Search Results: 1 - 10 of 18043 matches for " Manlio Basílio;Fernandes "
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Cost-effectiveness analysis on spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure
Vaz, Filinto Aníbal Alagia;Abreu, Rone Ant?nio Alves;Soárez, Patrícia Coelho de;Speranzini, Manlio Basílio;Fernandes, Luís Cesar;Matos, Delcio;
Arquivos de Gastroenterologia , 2010, DOI: 10.1590/S0004-28032010000200008
Abstract: context: studies in the area of health economics are still poorly explored and it is known that the cost savings in this area is becoming more necessary, provided that strict criteria. objective: to perform a cost-effectiveness analysis of spinal anesthesia versus local anesthesia plus sedation for loop colostomy closure. methods: this was a randomized clinical trial with 50 patients undergoing loop colostomy closure either under spinal anesthesia (n = 25) or under local anesthesia plus sedation (n = 25). the duration of the operation, time spent in the post-anesthesia recovery room, pain, postoperative complications, length of hospital stay, laboratory and imaging examinations and need for rehospitalization and reoperation were analyzed. the direct medical costs were analyzed. a decision tree model was constructed. the outcome measures were mean cost and cost per local and systemic postoperative complications avoided. incremental cost-effectiveness ratios were presented. results: duration of operation: 146 ± 111.5 min. vs 105 ± 23.6 min. (p = 0.012); mean time spent in post-anesthesia recovery room: 145 ± 110.8 min. vs 36.8 ± 34.6 min. (p<0.001). immediate postoperative pain was lower with local anesthesia plus sedation (p<0.05). local and systemic complications were fewer with local anesthesia plus sedation (p = 0.209). hospitalization + rehospitalization: 4.5 ± 4.1 days vs 2.9 ± 2.2 days (p<0.0001); mean spending per patient: r$ 5,038.05 vs 2,665.57 (p<0.001). incremental cost-effectiveness ratio: r$ -474.78, indicating that the strategy with local anesthesia plus sedation is cost saving. conclusion: in the present investigation, loop colostomy closure under local anesthesia plus sedation was effective and appeared to be a dominant strategy, compared with the same surgical procedure under spinal anesthesia.
Tumor sólido-cístico pseudopapilar do pancreas multicêntrico submetido à gastroduodenopancreatectomia total: relato de caso e revis?o da literatura
Henriques, Alexandre Cruz;Costa, Sergio Renato Pais;Costas, Mauricio Campanelli;Waisberg, Jaques;Speranzini, Manlio Basílio;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2007, DOI: 10.1590/S0102-67202007000300016
Abstract: background: solid-cystic pseudopapillary pancreatic tumors are rare neoplasms. female young individuals are usually struck by this condition. this type of tumor has been considered to be a low-grade neoplasia, having an indolent biological behavior. surgical ressection has been the treatment of choice. this disease can also compromise the head, body as well as the tail of the pancreas. however, the presence of two simultaneous lesions, one in the cephalic portion and the other at the transition between the body and tail of the pancreas (multicentricity) is a very rare situation. case report: solid-cystic multicentric pseudopapillary pancreatic tumor (with two distinct lesions, one in the head and the other in the body-tail) in a 36 year old male was submitted to total gastroduodenopancreatectomy and splenectomy. histological tests revealed the presence of two distinct tumors, one in the head and the other in the body-tail of the pancreas, both of the same etiology (solid-cystic pseudopapillary tumor), receiving confirmation by immunohistochemical evaluation. the patient had a good post-operative development. five months after surgical treatment, the patient did not show any signs of recidive. conclusion: this tumors present a good prognosis and cure, so every effort should be taken to resect the tumor, even if it is necessary to perform total pancreatectomy.
Doen?a de Crohn isolada do apêndice cecal como causa de enterorragia
Lima Jr., Sizenando Ernesto de;Speranzini, Manlio Basílio;Guiro, Marcos Pacheco;
Arquivos de Gastroenterologia , 2004, DOI: 10.1590/S0004-28032004000100012
Abstract: background: crohn?s disease confined to the appendix is relatively rare as a sole primary manifestation of the disease. young people are more affected. the medical history and the physical examination are similar to the findings in acute appendicitis, but the manifestations are protracted. on physical examination there are signs of peritoneal irritation and an abdominal mass is palpable in the right iliac fossa. aims: to report a case of crohn?s disease confined to the appendix and presenting with enterorrhagia. the source of the bleeding was localized by colonoscopy. patient: a 16-year old caucasian male without past history of gastrointestinal symptoms, presented with two episodes of enterorrhagia within a period of one year. in the second episode colonoscopy identified the appendicular ostium as the source of bleeding. results: at operation the cecum and terminal ileum were normal in thickness and texture, and an inflammatory appendix adherent to the omentum was removed. microscopically there were non-caseating granulomas, intense infiltration of the wall with plasma cells, lymphocytes and macrophages. the patient has not suffered recurrence, and a colonoscopy realized 2 years after the operation did not show signs of crohn?s disease. conclusion: this case, like others in the literature, appendectomy is curative, but a 5-year follow-up is mandatory. when a young patient presents with enterorrhagia, this diagnosis has to be considered.
Neoplasia no sítio da colostomia: relato de três casos e revis?o da literatura
Salles, Valdemir José Alegre;Paula, Pedro Roberto de;Bassi, Deomir Germano;Speranzini, Manlio Basílio;
Revista Brasileira de Coloproctologia , 2006, DOI: 10.1590/S0101-98802006000100007
Abstract: carcinomas rarely occur at the site of a colostomy. colostomies are risk for malignancy, just as in any other portion of the colon. if the initial resection was for cancer, then the risk of metachronous colon adenocarcinoma is significantly higher than for the general population. metachronous colorectal carcinoma occurs from 0.1 to 3.6 percent of patients who undergo surgery for colorectal carcinoma and the recurrence of the primary bowel malignancy that necessitated the stoma may present with signs of bleeding or obstruction. we report three cases of this rare neoplasia occurring at the site of a colostomy, and we review the literature.
Duodenopancreatectomia e hemicolectomia direita em monobloco para tratamento de cancer de cólon direito localmente avan?ado
Henriques, Alexandre Cruz;Waisberg, Jaques;Possendoro, Karla de Andrade;Fuhro, Felipe Emanuel;Speranzini, Manlio Basílio;
Revista do Colégio Brasileiro de Cirurgi?es , 2010, DOI: 10.1590/S0100-69912010000300015
Abstract: this article reports the case of a patient whit a diagnosis of diarrhea and weight loss. subsidiary exams showed ulcerovegetant lesion in the second duodenal portion and duodenocolic fistula. an exploratory laparotomy was performed and a neoplasic lesion in the hepatic angle of the colon was observed invading the second duodenal portion. the patient then underwent a cephalic gastroduodenopancreatectomy associated with en bloc right hemicolectomy and improved well in the postoperative period. currently, 48 months after the surgery, he does not present any signs of the disease dissemination or recurrence. the consulted literature recommends that multivisceral resection must be considered if the patient is clinically able to undergo major surgery and does not present any signs of neoplasic dissemination, since the postoperative survival time is considerably longer in the resected group and some of these patients even achieve cure.
Veia paraumbilical pérvia: importancia hemodinamica na hipertens o portal por esquistossomose mans nica hepatoesplênica. (Estudo com ultra-sonografia Doppler)
WIDMAN Azzo,OLIVEIRA Ilka Regina Souza de,SPERANZINI Manlio Basílio,CERRI Giovanni Guido
Arquivos de Gastroenterologia , 2001,
Altera es morfológicas e hemodinamica tardias no território esplênico de pacientes com esquitomosse mans nica hepatoesplênica pós-anastomose esplenorrenal distal . (Estudo com ultra-som Doppler)
Widman Azzo,Oliveira Ilka Regina Souza de,Speranzini Manlio Basílio,Cerri Giovanni Guido
Arquivos de Gastroenterologia , 2002,
En-bloc pancreatoduodenectomy and right hemicolectomy for treating locally advanced right colon cancer (T4): a series of five patients
Costa, Sergio Renato Pais;Henriques, Alexandre Cruz;Horta, Sergio Henrique Couto;Waisberg, Jaques;Speranzini, Manlio Basílio;
Arquivos de Gastroenterologia , 2009, DOI: 10.1590/S0004-28032009000200014
Abstract: a series of five cases of right-colon adenocarcinoma that invaded the proximal duodenum is presented. all patients underwent successful en-bloc pancreatoduodenectomy plus right hemicolectomy by general surgery service of the teaching hospital of the abc medical school, santo andré, sp, brazil. the study was conducted between 2000 and 2007. there were two major complications but no mortality. three patients did not present any recurrence over the course of 15 to 54 months of follow-up. multivisceral resection with en-bloc pancreatoduodenectomy should be considered for patients who are fit for major surgery but do not present distant dissemination. long-term survival may be attained.
Hepatectomia para o tratamento de metástases colorretais e n?o-colorretais: análise comparativa em 30 casos operados
Costa, Sergio Renato Pais;Horta, Sérgio Henrique;Henriques, Alexandre Cruz;Waisberg, Jaques;Speranzini, Manlio Basílio;
Revista Brasileira de Coloproctologia , 2009, DOI: 10.1590/S0101-98802009000200009
Abstract: background: hepatectomy has presented the best curative therapeutic choice for hepatic metastatic colorectal cancer. more recently, hepatic resection has been performed for hepatic metastases from non-colorectal origin too. aim: to compare both early and long-term surgical outcomes on 20 patients' series of colorectal with 10 patients' series of non-colorectal hepatic metastases realized by general surgery service (discipline of tract digestive surgery) of abc medical school (santo andré - brazil). methods: complete follow-up data were available on 30 patients who underwent hepatectomy for metastatic methacronic cancer between january 2001 and september 2007. twenty patients presented colorectal liver metastases (group 1) were compared with ten patients presented non-colorectal metastases (group 2). results: there were twenty major hepatic resections and ten minor hepatic resections. overall morbidity rates were similar between groups 1 and 2 (p = ns). overall mortality in group 1 was higher than group 2 (5 % x 0 %), nevertheless there was no statistical significance (p=ns). both 3 and 5-year overall survival rates were comparable between groups (p=ns). both number of lesions and nodal disease were considered dismal prognostic factors. conclusion: in this sample, hepatic resection for liver metastasis from non-colorectal and nonneuroendocrine origin presents similar results to colorectal metastasis. multiple metastases and positive node were adverse prognostic factors.
Efeito da concentra??o da solu??o nutritiva no crescimento da alface em cultivo hidrop?nico-sistema NFT
Cometti, Nilton Nélio;Matias, Gean Carlos S;Zonta, Everaldo;Mary, Wellington;Fernandes, Manlio S;
Horticultura Brasileira , 2008, DOI: 10.1590/S0102-05362008000200027
Abstract: the growth of lettuce (lactuca sativa l.) cv 'vera' was evaluated in a nft hydroponic system with different nutrient solution concentrations. an experiment was carried out in a greenhouse from april to may, 2000 in rio de janeiro state, brazil. four treatments were used differing in macro nutrient concentration: 100; 50; 25 and 12.5% of the original concentration of the solution proposed by furlani (1997). using 50% of the original concentration with electric conductivity around 0,98 ds m-1, plants produced the same shoot dry mass as using 100% of the ionic strength. in this trial, the phytomass yield using 100 and 50% of the ionic strength was within the range of 90% of the maximum production, calculated at 75±1% of the ionic strength to the nutrient solution, simulated by a regression equation. however, the use of smaller concentrations resulted in reduction of the growth of 50% with the solution at 25% and 80% with the solution at 12.5% of the ionic strength, under the light and temperature conditions which the experiment was carried out. decreasing the nutrient solution concentration one can reduce up to 50% of the basic nutrient solution costs, if nutrient solution concentration is reduced and electric conductivity kept close to 1.00 ds m-1.
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