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Search Results: 1 - 10 of 230603 matches for " Thomas Augusto;D'Albuquerque "
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The role of hilar lymphadenectomy in patients subjected to hepatectomy due to colorectal metastasis
Viana, Eduardo Freitas;Herman, Paulo;Coelho, Fabrício Ferreira;Taka, Thomas Augusto;D'Albuquerque, Luiz A. Carneiro;Cecconello, Ivan;
Arquivos de Gastroenterologia , 2011, DOI: 10.1590/S0004-28032011000300012
Abstract: context: hepatectomy is the treatment of choice for colorectal liver metastases, and several studies have shown good results, with 5-year survival rates ranging from 40% to 57%. several clinical and pathological predictive factors for survival after liver resection have been studied. involvement of the hepatic hilum lymph nodes, the incidence of which varies from 2% to 10%, indicates a poor long-term prognosis. results: despite variable results, some authors have reported a not-insignificant improvement in survival rate in liver-metastasis patients with hilar lymph node involvement who undergo combined liver resection and lymphadenectomy. due to the low rates of morbidity and mortality for liver-resection surgery, several specialized centers perform liver resections combined with lymphadenectomies in selected cases. it should be noted that the therapeutic value of systemic lymphadenectomy is not yet entirely understood, and only controlled studies comparing groups with and without lymphadenectomy can fully resolve the issue. conclusion: in any case, hilar lymph node dissection has been shown to be a useful tool for improving the accuracy of extra hepatic disease staging, regardless of its impact on survival.
Surgical management of spontaneous ruptured hepatocellular adenoma
Ribeiro Junior, Marcelo Augusto Fontenelle;Chaib, Eleazar;Saad, William Abr?o;D'Albuquerque, Luiz Augusto Carneiro;Cecconello, Ivan;
Clinics , 2009, DOI: 10.1590/S1807-59322009000800011
Abstract: aims: spontaneous ruptured hepatocellular adenoma (srha) is a rare life-threatening condition that may require surgical treatment to control hemorrhaging and also stabilize the patient. we report a series of emergency surgeries performed at our institution for this condition. methods: we reviewed medical records and radiology files of 28 patients (from 1989 to 2006) with a proven diagnosis of hepatocellular adenoma (ha). three (10.7%) of 28 patients had spontaneous ruptured hepatocellular adenoma, two of which were associated with intrahepatic hemorrhage while one had intraperitoneal bleeding. two patients were female and one was male. both female patients had a background history of oral contraceptive use. sudden abdominal pain associated with hemodynamic instability occurred in all patients who suffered from spontaneous ruptured hepatocellular adenoma. the mean age was 41.6 years old. the preoperative assessment included liver function tests, ultrasonography and computed tomography. results: the surgical approaches were as follows: right hemihepatectomy for controlling intraperitoneal bleeding, and right extended hepatectomy and non-anatomic resection of the liver for intrahepatic hemorrhage. there were no deaths, and the postoperative complications were bile leakage and wound infection (re-operation), as well as intraperitoneal abscess (re-operation) and pleural effusion. conclusion: spontaneous ruptured hepatocellular adenoma may be treated by surgery for controlling hemorrhages and stabilizing the patient, and the decision to operate depends upon both the patient's condition and the expertise of the surgical team.
Effect of Ageing on Systemic Inflammatory Response in Acute Pancreatitis
Marcel Cerqueira Cesar Machado,Ana Maria Mendon?a Coelho,Luiz Augusto Carneiro DAlbuquerque,Sonia Jancar
International Journal of Inflammation , 2012, DOI: 10.1155/2012/270319
Abstract: Elderly patients show increased incidence of multiple organ dysfunction in acute pancreatitis possibly due to bacterial translocation. This is associated with increased susceptibility to infections in older people. Several reports have related this increased susceptibility to a proinflammatory status called inflammaging, which decreases the capacity of the immunological system to respond to antigens. Cellular senescence also contributes to this low-grade chronic inflammation in older subjects. We discuss here the effect of ageing on systemic inflammation, focusing on that induced by acute pancreatitis and some of the mechanisms involved. It is important to understand the immunological changes in the elderly to adjust treatment strategies in order to reduce the morbidity and mortality associated with acute pancreatitis and other conditions that lead to systemic inflammation. 1. Introduction Several reports investigating ageing physiopathology have stated that old age is followed by a low-grade inflammatory process [1], which may be upregulated during sepsis, surgical procedures, and ischaemic/reperfusion injury. This low-grade inflammatory state is called inflammaging, a concept supported by several reports [2–4]. This is probably related to antigenic stress throughout life that may have caused exhaustion of immunological cells, thus decreasing the capacity of the immunological system to respond to antigens [5]. A concept that has been established is one of senescent cells being able to secrete many factors including growth factors, proteases, and cytokines that can induce inflammation [6]. Cellular senescence is a situation where the cell has an irreversible proliferative arrest due to potential oncogenic stress. This cellular state, limited to proliferative cells, has been recognized as a tumour suppressive mechanism. Senescent cells remain metabolically active, producing an array of tumour-suppressing and proinflammatory substances. Senescent cells probably contribute to the chronic inflammatory state related to ageing. This subject was extensively discussed in two important reviews, which also analyzed the molecular mechanisms and cellular pathways associated with cellular senescence [6, 7]. There is also clear evidence that elderly patients are more susceptible to infections after surgical procedures than young patients, and this could be related to the pro-inflammatory status of the elderly patients. This increased susceptibility to infections could be the reason for the increased postoperative morbidity and mortality observed in elderly patients
Sciatic Hernia Mimicking Perianal Abscess in a Cirrhotic Patient
Wellington Andraus,Luciana Bertocco de Paiva Haddad,Oscar Cavalcante Ferro,Luiz Augusto Carneiro D'Albuquerque
Case Reports in Medicine , 2012, DOI: 10.1155/2012/651472
Abstract: Abdominal hernias are very frequent in cirrhotic patients with ascites. The hernias usually present as umbilical, inguinal, incisional, or femoral. However, these patients can also develop uncommon hernias such as pelvic hernias because of pelvic floor weakness and high abdominal pressure due to ascites. We present the first case of a cirrhotic patient with ascites that developed a giant sciatic hernia mimicking a perianal abscess.
Agenesis of the Right Hepatic Lobe
Lucas Souto Nacif,Yuri dos Santos Buscariolli,Luiz Augusto Carneiro D'Albuquerque,Wellington Andraus
Case Reports in Medicine , 2012, DOI: 10.1155/2012/415742
Abstract: Introduction. Agenesis of the right lobe of the liver is a rare finding and was defined as the absence of liver tissue on the right side, with preservation of the middle hepatic vein, without previous disease or surgery. It is usually an incident finding reveled by imaging exams or during abdominal surgery. Case Report. A 32-year-old male patient was admitted to the hospital for abdominal discomfort and loss of appetite. Imaging studies revealed the absence of the right hepatic lobe and hypertrophied left hepatic segments. Discussion. Anomalies of hepatic morphology are rare and correspond to developmental defects during embryogenesis, are a rare diagnosis, and are generally diagnosed incidentally based on imaging. Agenesis or hypoplasia of the right lobe may predispose the patient to the development of portal hypertension and esophageal varices. Surgical knowledge of such anatomical agenesis is necessary for surgical planning, for the appropriate identification of intraoperative surgical findings, and for the design of the postoperative approach to therapy. Conclusion. Agenesis of the right hepatic lobe is a rare condition. We want to highlight the importance of understanding the condition. Surgeons must recognize the entity in order to deal appropriately with the findings.
Transplante de fígado no carcinoma hepatocelular: a escassez de órg os e resultados bem estabelecidos justificariam amplia o das indica es ou de novas modalidades técnicas?
D'ALBUQUERQUE Luiz Augusto Carneiro,OLIVEIRA e SILVA Adávio de,GARCIA Christian Evangelista
Arquivos de Gastroenterologia , 2001,
Abstract:
Tratamento da hipertens o portal: o caminho teve agora um novo e bom recome o, mas ainda será longo e árduo
DALBUQUERQUE Luiz Augusto Carneiro,OLIVEIRA e SILVA Adávio de
Arquivos de Gastroenterologia , 2000,
Abstract:
Sciatic Hernia Mimicking Perianal Abscess in a Cirrhotic Patient
Wellington Andraus,Luciana Bertocco de Paiva Haddad,Oscar Cavalcante Ferro,Luiz Augusto Carneiro D'Albuquerque
Case Reports in Medicine , 2012, DOI: 10.1155/2012/651472
Abstract: Abdominal hernias are very frequent in cirrhotic patients with ascites. The hernias usually present as umbilical, inguinal, incisional, or femoral. However, these patients can also develop uncommon hernias such as pelvic hernias because of pelvic floor weakness and high abdominal pressure due to ascites. We present the first case of a cirrhotic patient with ascites that developed a giant sciatic hernia mimicking a perianal abscess. 1. Introduction Pelvic hernias are very rare, and sciatic is the rarest between them [1]. These hernias occur in the sciatic foramina formed by the sacrospinous ligament. The rarity makes the diagnosis a challenge and also increases the chance of a misdiagnosis. On the other hand, abdominal hernias are frequent in cirrhotic patients with ascites. However, these patients can also develop uncommon hernias such as pelvic hernias because of pelvic floor weakness and high abdominal pressure due to ascites [2]. The presence of advanced cirrhosis, with ascites, other abdominal hernias, and cirrhotic signs can confuse the physician and makes the diagnosis even more difficult. We present a cirrhotic patient with ascites that developed a giant sciatic hernia mimicking a perianal abscess that was misdiagnosed. 2. Case Description We present a case of a 64-year-old woman with a history of secondary biliary cirrhosis after a cholecystectomy. In addition to the cholecystectomy, the patient underwent two attempts to surgically repair a bile duct stenosis using enteric anastomosis. However, she progressed to advanced cirrhosis and reached a child C and MELD (model for end stage liver disease) score of 31. Three months prior to hospital admission, the patient presented with a tender, hyperemic mass in the left perineum and left buttocks and progressed to partial skin necrosis in this region (Figure 1). Other findings at the time of the physical examination included severe malnutrition, jaundice, anemia, ascites, and an epigastric hernia. She reported pain in the perineum region and developed renal insufficiency after hospitalization. The patient had no history of fever or changes in bowel movements. At the time of admission, the patient had a white cell count of with a left shift, total bilirubin of 5.9?mg/dL, and an ascites culture positive for Escherichia coli and Candida tropicalis. Figure 1: Hyperemic mass in the left perineum and left buttocks, that progressed to skin necrosis and perforation. Computed tomography showed a sciatic hernia (Figure 2) on the left side with a large hernial sac filled with liquid (ascites). Unfortunately, this
O Brasil e os chamados blocos regionais
ALBUQUERQUE, JOSé AUGUSTO GUILHON;
S?o Paulo em Perspectiva , 2002, DOI: 10.1590/S0102-88392002000100004
Abstract: contrary to expectations, the formation of competing trade blocks has not become a reality. today, brazil has the opportunity to play a larger role in two regional associations ? the ftaa and mercosul ? as well as in the inter-regional arrangement between mercosul and the european union. ftaa membership is the most important of the three, providing as it would a point of reference from which brazil can define its role in the world.
Da crian a ao menor
José Augusto Guilhon Albuquerque
Psicologia: Ciência e Profiss?o , 1986, DOI: 10.1590/s1414-98931986000200012
Abstract:
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