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Search Results: 1 - 10 of 10333 matches for " Rodrigo Dolphini;Pracchia "
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é necessária a realiza??o de biópsia de medula óssea bilateral para o estadiamento do linfoma difuso de grandes células B?
Bellesso, Marcelo;Velasques, Rodrigo Dolphini;Pracchia, Luis Fernando;Beitler, Beatriz;Aldred, Vera Lúcia;Chamone, Dalton Alencar Fisher;Pereira, Juliana;
Jornal Brasileiro de Patologia e Medicina Laboratorial , 2009, DOI: 10.1590/S1676-24442009000200004
Abstract: this retrospective study aims to analyze the usefulness of bilateral bone marrow biopsy in bone marrow infiltration by diffuse large b-cell lymphoma (dlbcl). our objectives were to assess the incidence of unilateral bm involvement by dlbcl and compare fragment length obtained from positive and negative samples for infiltration. furthermore, we compared the differences between unilateral and bilateral infiltration correlating with lactic dehydrogenase (ldh) and computerized tomography (ct) staging. we evaluated 268 cases of dlbcl and observed medullary infiltration in 34 cases (13%). it was not possible to evaluate 6 out of 34 cases. 70 bm fragments were reviewed as to the presence or absence of infiltration and length. the mean number of fragments per case was 2.5; the mean bm fragment length was 11.01 mm (± 5.12 mm) and the mean bm fragment length per case was 27.53 mm. there was unilateral bm infiltration in six cases (21.4%). there were no differences in the mean fragment length as to the presence/absence of infiltration 10.95 mm (± 5.2 mm) versus 11.57 mm, p > 0.05, respectively. there were no differences in 23 cases between the comparison of unilateral medullary infiltration versus bilateral with lactic dehydrogenase and ct staging. we concluded that bilateral bone marrow biopsy was superior to unilateral because it may increase by 21.4% the detection of bm involvement by dlbcl.
Resultados da interven??o coronária percutanea primária em pacientes do Sistema único de Saúde e da saúde suplementar
Barreto, Rodrigo;Cantarelli, Marcelo José de Carvalho;Castello Jr., Hélio José;Gon?alves, Rosaly;Gioppato, Silvio;Guimar?es, Jo?o Batista de Freitas;Ribeiro, Evandro Karlo Pracchia;Vardi, Júlio César Francisco;Silva, Patricia Teixeira da;Gasperi, Ricardo de;Almeida, Leonardo Cao Cambra de;Coelho, Leonardo dos Santos;Almeida, Roberto Sim?es de;
Revista Brasileira de Cardiologia Invasiva , 2011, DOI: 10.1590/S2179-83972011000300010
Abstract: background: primary percutaneous coronary intervention (pci) is the most effective reperfusion technique in acute myocardial infarction (ami) and its success rate depends on many factors. this study aimed to assess the profile and to compare in-hospital outcomes of primary pci among patients from the public healthcare system (puhs) versus those from the private healthcare system (prhs). methods: from 2006 to 2010, 493 patients were submitted to primary pci, of which 220 were treated by the puhs and 273 by the prhs. procedure technique and materials were left to the operator's discretion. results: the puhs group had a larger number of killip > 1 patients. multivessel coronary disease, pre-procedure coronary flow timi 0/1 and the presence of collaterals for the treated vessel did not differ between groups. the prhs group used more thromboaspiration catheters (10% vs. 20.8%; p < 0.01) and glycoprotein iib/iiia inhibitors (24.1% vs. 36.6%; p < 0.01). there was no difference for door-to-balloon times (62.3 minutes vs. 64.2 minutes; p = 0.91). for patients referred from other hospitals, however, transportation times were higher for puhs patients (400.8 minutes vs. 262.4 minutes; p < 0.01). pci success rates and the occurrence of major adverse cardiovascular and cerebrovascular events (macce) did not differ between groups (6.3% vs. 6.2%; p = 0.1). age, killip iii/iv and transportation time were the variables that best explained the occurrence of macce. conclusions: differences in the clinical, angiographic and procedure profile of patients undergoing primary pci treated by the puhs and the prhs did not have an impact on macce. transportation times, however, high in both groups and higher in the puhs group, proved to be an independent predictor of adverse events.
Impacto do sexo feminino nos resultados da interven??o coronária percutanea contemporanea
Gasperi, Ricardo de;Cantarelli, Marcelo José de Carvalho;Castello Jr., Hélio José;Gon?alves, Rosaly;Gioppato, Silvio;Guimar?es, Jo?o Batista de Freitas;Ribeiro, Evandro Karlo Pracchia;Vardi, Júlio César Francisco;Silva, Patrícia Teixeira da;Barreto, Rodrigo;Almeida, Leonardo Cao Cambra de;
Revista Brasileira de Cardiologia Invasiva , 2011, DOI: 10.1590/S2179-83972011000200013
Abstract: background: prior studies have shown there are differences in the clinical outcomes of percutaneous coronary intervention (pci) between men and women. we tried to assess gender differences in clinical and angiographic presentation as well as in the in-hospital outcomes of patients undergoing contemporary pci. methods: from 2002 to 2009, 6,067 consecutive patients were submitted to pci, of these, 2,021 (33.3%) were women. the interventional strategy, including the type of stent implanted, was conducted at the operators discretion. results: the female gender was older and had a greater incidence of risk factors for atherosclerosis, except for smoking. acute coronary syndrome without st segment elevation was the most prevalent presentation in women. women had a higher number of single vessel lesions and a lower prevalence of b2/c lesions, thrombi, bifurcation lesions and moderate to severe ventricular dysfunction. patients were predominantly treated with bare metal stents and no differences were observed for the diameter and length of the stents. no differences were observed for the in-hospital incidence of major adverse cardiac and cerebrovascular events (1.5% vs. 1.4%; p = 0.76), death (0.9% vs. 0.6%; p = 0.15), stroke (0.05% vs. 0.05%; p > 0.99), acute myocardial infarction (0.7% vs. 1.1%; p = 0.16) and emergency myocardial revascularization surgery (0.1% vs. 0; p = 0.62). diabetes, multivessel coronary artery disease, b2/c type lesions and total occlusions were the variables that best explained the occurrence of in-hospital events. conclusions: women correspond to one third of the patients undergoing pci at our service and have a more severe clinical profile, but lower anatomic complexity than men. in our study, the female gender was not a predictor of in-hospital adverse clinical events.
Impacto da obesidade nos resultados hospitalares da interven??o coronária percutanea: resultados do registro do hospital Bandeirantes
Coelho, Leonardo dos Santos;Cantarelli, Marcelo José de Carvalho;Castello Jr., Hélio José;Gioppato, Silvio;Gon?alves, Rosaly;Guimar?es, Jo?o Batista de Freitas;Ribeiro, Evandro Karlo Pracchia;Silva, Patrícia Teixeira da;Almeida, Roberto Sim?es de;Vardi, Júlio Cesar Francisco;Barreto, Rodrigo;Gasperi, Ricardo de;
Revista Brasileira de Cardiologia Invasiva , 2011, DOI: 10.1590/S2179-83972011000400011
Abstract: background: obese patients may have better outcomes after percutaneous coronary intervention (pci) compared to those with normal body mass index (bmi), the so-called "obesity paradox". this study was aimed at evaluating whether this paradox is observed in our country. methods: this study included 4,957 consecutive patients submitted to pci. patients were classified as non-obese (bmi < 30 kg/m2) and obese (bmi > 30 kg/m2). major adverse cardiac and cerebrovascular events (macce) were recorded at hospital discharge. results: the obese group was three years younger, with a higher prevalence of risk factors for coronary artery disease, except for smoking. clinical presentation was similar, with a predominance of stable coronary patients. single vessel disease was the most frequent finding and the complexity of the lesions was not different between groups, except for calcified lesions, and left ventricular dysfunction was less frequent in the obese group. stent diameter and length were similar between groups. procedure success rate was high and similar for obese and non-obese patients. at hospital discharge, the incidence of macce (2.5% vs. 2.7%; p = 0.76), in-hospital death (1% vs. 1.1%; p = 0.88), stroke (0.1% vs. 0.1%; p = 0.79), acute myocardial infarction (1.6% vs. 1.8%; p = 0.74) and emergency cabg (0 vs. 0.1%; p = 0.35) was not different between groups. age, diabetes, hypertension and type b2/c lesions were the variables that best explained macce. conclusions: in patients with coronary artery disease undergoing pci, bmi > 30 kg/m2 did not influence the risk of procedure-related in-hospital clinical events.
Rodrigo á
Revista Cubana de Ortopedia y Traumatolog?-a , 1997,
Two Opposed Models of Approaching the Relationship between Art and Society and the Proposal of “Social-Aesthetic Constructs” as a Possibility of Mediation  [PDF]
Rodrigo Duarte
Art and Design Review (ADR) , 2018, DOI: 10.4236/adr.2018.61001
Abstract: The objective of this article is to investigate two opposed models of approaching the relationship between art and society. The first one—that of Jacques Rancière—stresses the idea of aesthetic autonomy as a result of a historical process that began with Kant’s Critique of Judgement, reaching its most developed form in contemporaneity, and the second model, represented here by Richard Shusterman (inspired by John Dewey pragmatist aesthetics), focuses on the deep roots that artistic phenomena have in society and culminates with his analysis of the hip hop culture. Taking into account as well their respectively fruitfulness as some of their limitations and inspired by Theodor Adorno, I propose the concept of “social-aesthetic construct”, which is meant to be a mediation between the aforementioned opposed models.
Gemcitabina e ifosfamida no tratamento do linfoma de Hodgkin refratário ou recidivado após múltiplas terapias
Pracchia, Luís Fernando;Linardi, Camila C.G.;Buccheri, Valeria;
Revista Brasileira de Hematologia e Hemoterapia , 2007, DOI: 10.1590/S1516-84842007000400021
Abstract: patients with hodgkin's lymphoma relapsed after or refractory to multiple therapies (rhl) have a dismal prognosis. monotherapy with gemcitabine can promote an overall response rate of about 40% in these patients and its association with alkylating agents can provide better results. we retrospectively evaluated 17 rhl cases. all were treated with the combination of gemcitabine (1.0 g/m2; d1 and d8) and ifosfamide (1.0 g/m2; d1 to d5) in a 21-day cycle. treatment response was evaluated according to the cotswolds criteria. toxicity was evaluated according to who criteria. the median age of all patients was 34 years (18-53). nine of them (53%) were men and eight (47%) had stage iii/iv. the median number of previous treatments was 2 (2-3); two patients had already been treated with autologous stem cell transplant. overall response rate to the combined regimen was 62.5% (95% ci = 38.8% - 86.2%) and the median progression-free survival was 15 months (95% ci = 4 - 24 months). fifty-six cycles were evaluated for toxicity. the most frequent toxicities observed by cycle were: hepatic grade i/ii in 48.2% of the cycles and grade iii/iv in 1.8%; anemia grade i/ii in 45%; neutropenia grade i/ii in 36% and grade iii/iv 16%. grade iii/iv renal toxicity on any degree of haematuria were not observed. combined therapy with gemcitabine and ifosfamide promoted responses in more than half of the evaluated patients with an acceptable toxicity profile.
Linfoma primário do sistema nervoso central
Bellesso, Marcelo;Bizzetto, Renata;Pereira, Juliana;Beitler, Beatriz;Pracchia, Luis Fernando;Chamone, Dalton A. S.;
Revista Brasileira de Hematologia e Hemoterapia , 2008, DOI: 10.1590/S1516-84842008000100013
Abstract: primary central nervous system lymphoma (pcnsl) is an extranodal non-hodgkin lymphoma in the brain, leptomeninges, spinal cord or eyes. the incidence of pcnsl increased approximately three-fold in the last decades. nowadays, it represents 0.4 case per 100,000 people and accounts for 4% of all primary brain tumors. although individuals infected with hiv have a 3,600-fold increased risk of developing pcnsl compared with the general population, the incidence has not increased only in aids group. recent data suggest that the incidence of pcnsl declined in the aids group after the introduction of anti-retroviral drugs. around 90% of pcnsl cases are classified as diffuse large b-cell lymphoma, 10% involve the eyes and 10% of patients are hiv positive. the clinical presentation depends on the location of the tumor with neurological rather than systemic symptoms. computed tomography (ct) and magnetic resonance imaging (rmi) are essential in diagnosis, however the gold standard is tumor biopsy. staging should be made with imaging and bilateral biopsy of bone marrow. the main poor prognosic parameters are performance status greater than 1, age older than 60 years, elevated dhl, high liquor protein concentration and tumor located within the deep regions of the brain. bcl-6 expression identified in the tumor confers a better prognosis. currently, a combined therapy with high doses of methotrexate and whole-brain radiotherapy is the therapy of choice. nowever, whole-brain radiotherapy should be carefully analyzed because neurotoxity is a frequent problem in the elderly and in relapsed and refractory patients.
Tratamento do linfoma de Hodgkin após falha do transplante autólogo
Santos, Fernanda M.;Pracchia, Luís F.;Linardi, Camila G. C.;Buccheri, Valeria;
Revista Brasileira de Hematologia e Hemoterapia , 2008, DOI: 10.1590/S1516-84842008000400007
Abstract: hodgkin's lymphoma (hl) is a lymphoid malignancy with excellent prognosis, however nearly 15% of the patients in early stages and 35% in advanced stages have progressive disease after initial treatment. autologous bone marrow or hematopoietic stem cell transplantation (abmt) are the treatments of choice in these cases. this report presents the therapeutic approach and the outcome of hl patients who experience relapse after or are refractory to abmt. of 38 patients with lh who underwent abmt between april 1996 and november 2005, 17 presented with relapsed/refractory disease and were included in this analysis. in these cases, the choice of rescue therapy varied upon the clinical conditions of each patient and was based on previously unused chemotherapy agents. after abmt, 10 (59%) of the 17 patients were in complete remission, one (6%) in partial remission and six (35%) were refractory. fourteen of the 17 patients received different schemes of rescue therapy at the time of abmt failure, one patient was treated exclusively with radiotherapy and two died before any treatment. we observed an overall response rate of 57.4% (95% ci: 23.2 - 90.7%). the median progression-free survival was 19 months and the median overall survival was 32 months. despite abtm, relapsed/refractory lh can not be cured with currently available chemotherapeutic agents, the patients had long survival times with frequent exacerbations of the diseas.
Diagnosis and treatment of polycythemia vera: Brazilian experience from a single institution
Linardi, Camila da Cruz Gouveia;Pracchia, Luís Fernando;Buccheri, Valeria;
Sao Paulo Medical Journal , 2008, DOI: 10.1590/S1516-31802008000100010
Abstract: context and objective: polycythemia vera (pv) is a chronic myeloproliferative disorder characterized by predominant proliferation of erythroid precursors. few data are available concerning brazilian patients with this condition. the aim of this study was to describe clinical and demographic characteristics of pv patients at diagnosis and analyze their long-term outcomes. design and setting: retrospective study at the division of hematology, faculdade de medicina da universidade de s?o paulo (fmusp), s?o paulo. methods: all consecutive patients with pv diagnosed according to world health organization criteria were eligible for this study. clinical and demographic characteristics, thrombotic events, transformation to acute leukemia, myelofibrosis and survival were evaluated. results: sixty-six patients were evaluated. thirty-six (54.5%) were females, with a median age at diagnosis of 61 years. at diagnosis, the median hemoglobin concentration was 18.8 mg/dl and the median platelet count was 593,000/mm3. fifty-eight patients (88.0%) were treated with hydroxyurea with or without phlebotomy. during a median follow-up of 77 months, 22 patients (33.3%) had new thrombotic events, mainly of arterial type. the overall incidence of leukemia and myelofibrosis was 0.42% per patient-year and 1.06% per patient-year, respectively. median overall survival was not reached and the seven-year survival rate was 77.8%. conclusion: the pv patients described here had long survival and arterial thrombotic events were the most important and common complication among this population.
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