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Search Results: 1 - 10 of 2433 matches for " Giorgio Baretta "
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Sele??o e uso de antibióticos em infec??es intra-abdominais
Coelho, Júlio Cezar Uili;Baretta, Giorgio Alfredo Pedroso;Okawa, Luciano;
Arquivos de Gastroenterologia , 2007, DOI: 10.1590/S0004-28032007000100018
Abstract: background: intra-abdominal infections are common and are associated with elevated morbidity and mortality. the microorganisms that cause intra-abdominal infections are usually from the gastrointestinal flora, mainly e. coli and bacteroides fragilis. aim: to present a review of the selection and use of antibiotics in intra-abdominal infections. conclusions: appropriate use of antibiotics is essential to control infection and to reduce treatment failure. antibiotics are initiated whenever intra-abdominal infection is suspected and the antimicrobial agents are selected based on the most common microorganisms involved. in addition, efficacy, cost, safety, and posologic regimen are considered for an appropriated selection. antibiotic regimen is different whether the infection is acquired in the community or at hospital due to the more resistant flora in the latter.
Efeitos da cirurgia bariátrica na fun o do assoalho pélvico Effects of bariatric surgery on pelvic floor function
Larissa Araújo de Castro,Wagner Sobottka,Giorgio Baretta,Alexandre Coutinho Teixeira de Freitas
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2012,
Abstract: RACIONAL: A incontinência urinária é bem documentada como comorbidade da obesidade. Estudos demonstram resolu o ou atenua o da incontinência após a perda de peso. Porém, os mecanismos pelos quais isso ocorre ainda n o est o claros. OBJETIVO: Avaliar os efeitos da cirurgia bariátrica na fun o do assoalho pélvico em mulheres. MéTODOS: Foram avaliadas 30 mulheres que estavam em lista de espera para realizar a opera o. Foi verificada a prevalência de incontinência urinária no pré e no pós-operatório e seu impacto na qualidade de vida através do King's Health Questionnaire. A qualidade da contra o muscular do assoalho pélvico foi avaliada através da Escala de Oxford Modificada e da perineometria. RESULTADOS: Vinte e quatro mulheres finalizaram o estudo. O índice de massa corporal passou de 46,96±5,77 kg/m2 no pré-operatório para 29,97±3,48 kg/m2 no pós-operatório, e a perda percentual do excesso de peso média foi de 70,77±13,26%. A prevalência de incontinência urinária passou de 70,8% no pré-operatório para 20,8% no pós-operatório. Após um ano da cirurgia bariátrica, houve redu o do impacto da incontinência urinária na qualidade de vida em sete dos nove domínios avaliados no questionário. A mediana da Escala de Oxford Modificada aumentou de três no pré-operatório para quatro no pós-operatório. A perineometria apresentou aumento significativo na média das três contra es solicitadas, passou de 21,32±12,80 sauers para 28,83±16,17 sauers na compara o pré e pós-operatória. O pico de contra o também aumentou significativamente no pós-operatório em rela o ao pré-operatório, passou de 25,29±14,49 sauers para 30,92±16,20 sauers. CONCLUS O: A perda massiva de peso através da cirurgia bariátrica repercute positivamente na fun o do assoalho pélvico e na qualidade de vida das mulheres com obesidade mórbida. BACKGROUND: Urinary incontinence is well documented as a comorbidity of obesity. Studies demonstrate improvement of incontinency after weight loss. However, the mechanisms are still not clear. AIM: To analyze the effects of bariatric surgery on pelvic floor function in women. METHODS: Thirty women were invited to participate. They were waiting for bariatric surgery. Evaluations were done on pre-operative period and one year after surgery. It comprehended: body mass index, urinary incontinence prevalence, quality of life through the King's Health Questionnaire, quality of pelvic floor muscular contraction through the Oxford Modified Scale and perineometry. RESULTS: Twenty four women were included in the study. The body mass index reduced from 46.96±5.77 kg/m
Anemia pós-cirurgia bariátrica: as causas nem sempre s?o relacionadas à cirurgia
Baretta, Giorgio Alfredo Pedroso;Marchesini, Jo?o Batista;Marchesini, Jo?o Caetano Dallegrave;Brenner, Sérgio;Sanches, Maria Elize Rocha;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2008, DOI: 10.1590/S0102-67202008000200012
Abstract: background: iron deficiency anemia, pernicious and megaloblastic are common after gastric bypass and biliopancreatic diversion. the main causes are due to duodenal exclusion and anastomotic ulcers. however, low protein diet, vitaminic supplementation, medicines, alcohol and tumors must be remembered. cases report: the authors relate two cases of severe anemia after bariatric procedures that were diagnosed as metastatic melanoma in small bowel and a colorectal cancer treated surgically with good results. conclusion: anemias are common after bariatric surgery, however unusual causes like tumors must be suspected in the elderly and in those patients that clinical treatment didn't have good results.
Imunossupress?o com tacrolimus favorece a regenera??o hepática induzida por hepatectomia extensa em ratos
Gama Filho, Ozimo;Toderke, Edimar Leandro;Baretta, Giorgio Alfredo Pedroso;Sakamoto, Daniele Giacometti;Agulham, Miguel Angelo;Tambara, Elizabeth Milla;Matias, Jorge Eduardo Fouto;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2010, DOI: 10.1590/S0102-67202010000200003
Abstract: background: liver regeneration is the result of physiological responses that occur after loss of parenchyma, as a consequence of drug abuse-toxic, infection, trauma or surgical procedure. aim: to analyze, during two different moments of liver regeneration, the effect of the immunosuppressant tacrolimus on the 70% hepatectomy model-induced liver regeneration in adult rats. methods: forty wistar adult rats, weighing 510.08+11.66 g were randomly divided into two groups (study or control), each group divided into two subgroups according to the death day after 70% hepatectomy (24 hours or 7 days). according to the group of study, rats received 0.1mg/kg/day of tacrolimus or the same volume of saline solution, by gavage, daily, starting three days before hepatectomy until the end of observation (animal death′s day). after three days of pre-therapy, all animals were submitted to 70% hepatectomy by resection of median and left lateral hepatic lobes which were weighed for posterior calculation of liver regeneration by kwon′s formula. twenty four hours or seven days after hepatectomy 10 rats of each group were killed; the remaining liver (regenerated) was entirely resected, weighed and sampled for mitotic index on hematoxylin-eosin staining and immunohistochemical assays with pcna and ki-67 markers. data were statistically analyzed by mann-whitney or student "t" tests, with significance level of 5% (p<0.05). results: rats receiving tacrolimus showed statistically significant higher levels of liver regeneration when compared to placebo according to kwon's formula, mitotic index and pcna marker. identical trend was found with ki-67 marker, but without statistical significance. conclusion: tacrolimus-based immunossuppression has stimulatory effect on liver regeneration process induced by 70% hepatectomy in adult wistar rats.
Qualidade de vida do doador após transplante hepático intervivos
Coelho, Júlio Cezar Uili;Parolin, M?nica Beatriz;Baretta, Giorgio Alfredo Pedroso;Pimentel, Silvania Klug;Freitas, Alexandre Coutinho Teixeira de;Colman, Daniel;
Arquivos de Gastroenterologia , 2005, DOI: 10.1590/S0004-28032005000200004
Abstract: background: quality of life of the donor after living donor liver transplantation has not been evaluated in brazil yet. aim: to evaluate the quality of live of the donor after living donor liver transplantation. methods: of a total of 300 liver transplantations, 51 were of living donors. all donors with less than 6 months of follow-up and those who did not want to participate were excluded from the study. the donors answered a questionnaire contained 28 questions about several aspects of donation. demographic and clinical data from the donors were also evaluated. results: thirty-seven donors were included in the study. thirty-two were first or second degree relatives of the receptor. only one donor would not donate again. twenty-two donors (59%) experienced more postoperative pain than they had previously anticipated. return to regular activities occurred in less than 3 months for 21 donors (57%). twenty-one donors (57%) referred financial loss with the donation due to expenses with medications, exams, transportation or lost wages. thirty-three (89%) had no modification or limitation in their lives after donation. the most negative aspects of donation were postoperative pain and the presence of a surgical scar. most postoperative complications resolved with clinical treatment, but severe or potentially fatal complications occurred in two patients. conclusions: most donors had good recovery and returned to regular activities few months after donation. the most negative aspect of donation was postoperative pain.
Resultados do transplante hepático em pacientes com diagnóstico pré-operatório de hepatocarcinoma
Parolin, M?nica Beatriz;Coelho, Júlio Cezar Uili;Matias, Jorge Eduardo Fouto;Baretta, Giorgio A. P.;Ioshii, Sérgio Ossamu;Nardo, Hygor;
Arquivos de Gastroenterologia , 2006, DOI: 10.1590/S0004-28032006000400003
Abstract: backgroud: hepatocellular carcinoma is the most frequent malignant hepatic tumor in humans, and its association with cirrhosis makes the therapeutic approach still a challenge. liver transplantation is the treatment of choice for cirrhotic patients with unresectable early hepatocellular carcinoma aim: to evaluate the post-transplant outcome of a cohort of 15 cirrhotic patients with preoperative diagnosis of unresectable early hepatocellular carcinoma according the milan criteria who underwent liver transplantation between september 1991 and december 2003 methods: we retrospectively reviewed the clinical data from 15 liver transplant recipients and the explanted livers were assessed for the efficacy of preoperative therapy. patient survival and tumor recurrence were evaluated as primary outcome measures results: the mean age of the patients was 49.2 ± 14.3 years and hepatitis c was the etiology of the underlying liver disease in 60%. preoperative therapy, either chemoembolization or percutaneous ethanol injection, was performed in 12 (86%) patients. complete necrosis of all tumoral lesions were observed in 5 of 12 patients (44,66%); all others had variable amounts of viable tumor in the explanted liver. only 4 of the 15 (26.6%) explanted livers had microscopic vascular invasion. the median post-transplant follow-up was 33 months (range: 8-71months) and no tumor recurrence was detected during this period. the only death was an early event not related to the tumor. the recurrence-free survival rates at 1 and 3 years were 93% conclusion: liver transplantation has emerged as a good alternative for cirrhotic patients with early hepatocellular carcinoma not amenable to curative resection, offering excellent recurrence-free survival rates.
Complica??es biliares pós-transplante hepático intervivos
Coelho, Júlio C. U.;Matias, Jorge Eduardo Fouto;Baretta, Giorgio Alfredo Pedroso;Celli, Adriane;Pisani, Júlio Cesar;Yokochi, Jorge Massayukim;
Revista do Colégio Brasileiro de Cirurgi?es , 2005, DOI: 10.1590/S0100-69912005000400008
Abstract: background: biliary reconstruction in living donor liver transplantation is associated with an elevated rate of complications. the objective of the present study is to present our experience with biliary complications following living donor liver transplantation and their treatment. methods: of a total of 300 hepatic transplantations, 51 (17%) were of living donors. all receptors had identical abo blood group of the donors. electronic charts of the receptors were evaluated to determine the presence and type of biliary tree anomalies, presence of vascular and biliary complications and technique and results of the treatment of the complications. results: the biliary duct was double in 7 grafts (16.7%) and triple in 2 (4.8%) grafts of the right lobe. in the remaining, the duct was single. the most common reconstitution procedure was single or double hepaticohepaticostomy (n = 38; 75%). biliary complications occurred in 21 patients (41.2%) and included biliary fistula in 11 (21.6%), biliary stenosis in 6 (11.8%), and fistula with stenosis in 4 (7.8%). the fistula was at the biliary anastomosis in 11 patients (21.6%) and at the liver surface in 4 (7.8%). treatment consisted of biliary stent insertion in 8, papillotomy in 1, retransplantation in 2 who had hepatic artery thrombosis, and suture of the biliary duct in 1. fistula closed with conservative treatment in 3 patients. most biliary stenosis was treated with dilation followed by biliary stent insertion. conclusions: biliary complications are frequent after living donor liver transplantation and they are associated with elevated rates of morbidity and mortality.
Termocoagula??o endoscópica do es?fago de Barrett com plasma de arg?nio sob diferentes potências: análise histopatológica e de sintomas pós-procedimento
Dotti, Vanessa Puccinelli;Baretta, Giorgio Alfredo Pedroso;Yoshii, Sérgio Ossamu;Ivano, Flávio Heuta;Ribeiro, Hugo Daniel Welter;Matias, Jorge Eduardo Fouto;
Revista do Colégio Brasileiro de Cirurgi?es , 2009, DOI: 10.1590/S0100-69912009000200004
Abstract: objective: to establish the ideal power to be employed in order to get the effective ablation and the lowest rate of symptoms at argon plasma thermocoagulation in barrett's esophagus (be). methods: twenty-eight asymptomatic patients with be, were randomly divided in two groups of different ablation powers, 50w or 70w. after endoscopic ablation and biopsies from the treated area for histological analyses, symptoms were evaluated through a questionnaire answered by phone. results: thirteen patients without specialized columnar metaplasia were excluded and the remaining fifteen patients, seven men (46,7%) and eight women (53,3%), with an average age of 53 years +10,4, composed the two groups: 10 patients at the 70w power and 5 at the 50w power group. there was no significant difference between the groups regarding age, be extent, percentage of coagulated esophageal circumference and the duration of symptoms. pain was the most important symptom, with a mean duration of 10,3 + 9,7 days. when power was compared to symptoms, although not statistically significant, a moderate negative correlation was noted. endoscopic biopsies showed ablation restricted to the mucosa's superficial layer in 40% of the cases in the lower power group, and only 10% in the higher power group, although deeper layers of the mucosa were compromised. there were no statistical significant differences when comparing the different powers to the penetration through the mucosa's layers and the symptoms. conclusion: there are evidences that the 70w potency argon plasma coagulation for be leads to a lower incidence of residual specialized columnar metaplasia under the new scamous epithelium.
Imunossupress?o com tacrolimus favorece a regenera??o hepática induzida por hepatectomia ampla em ratos
Gama Filho, Ozimo;Toderke, Edimar Leandro;Baretta, Giorgio Alfredo Pedroso;Sakamoto, Daniele Giacometti;Agulham, Miguel Angelo;Tambara, Elizabeth Milla;Matias, Jorge Eduardo Fouto;
Revista do Colégio Brasileiro de Cirurgi?es , 2010, DOI: 10.1590/S0100-69912010000300010
Abstract: objective: to analyze, during two different moments of liver regeneration, the effect of the immunosuppressant tacrolimus on the 70% hepatectomy model-induced liver regeneration in adult rats. methods: forty wistar adult rats, weighing 510.08 + 11.66 g were randomly divided into two groups, each group divided into two subgroups according to the death day after 70% hepatectomy . according to the group of study, rats received 0.1mg/kg/day of tacrolimus or the same volume of saline solution, by gavage. after three days of pre-therapy, all animals were submitted to 70% hepatectomy by resection of median and left lateral hepatic lobes which were weighed for posterior calculation of liver regeneration by kwon′s formula. twenty four hours or seven days after hepatectomy ten rats of each group were killed; the remaining liver (regenerated) was entirely resected, weighed and sampled for mitotic index on hematoxylin-eosin staining and immunohistochemical assays with pcna and ki-67 markers. data were statistically analyzed by mann-whitney or student "t" tests, with significance level of 5% (p<0.05). results: rats receiving tacrolimus showed statistically significant higher levels of liver regeneration when compared to placebo according to kwon's formula, mitotic index and pcna marker. identical trend was found with ki-67 marker, but without statistical significance. conclusion: tacrolimus-based immunossuppression has stimulatory effect on liver regeneration process induced by 70% hepatectomy in adult wistar rats.
Fatores prognósticos relacionados à falha do tratamento n?o-operatório de les?es esplênicas no trauma abdominal fechado
Carvalho, Fábio Henrique de;Romeiro, Paula Christina Marra;Colla?o, Iwan Augusto;Baretta, Giorgio Alfredo Pedroso;Freitas, Alexandre Coutinho Teixeira de;Matias, Jorge Eduardo Fouto;
Revista do Colégio Brasileiro de Cirurgi?es , 2009, DOI: 10.1590/S0100-69912009000200006
Abstract: objective: identify prognostic factors related to treatment failure of blunt splenic injuries managed by non surgical treatment (nst). methods: fifty six adult patients submitted to nst were prospectively studied. the injuries were diagnosed by computed axial tomography scan and classified according to aast (american association for surgery of trauma) criteria. patients were divided in success and failure groups. nst failure was defined as the need for laparotomy for any reason. results: nst failures (19.6%) were due to: abdominal pain (45.4%), hemodinamic instability (36.4%), splenic haematoma associated to a fall in hematocrit (9.1%) and splenic abscess (9.1%). there were no failures in grade i and ii of the splenic injuries; failure rate was 17.5% in grade iii and iv injuries grouped, and 80% in grade v injuries (p = 0,0008). in the success group, 31.3% patients received red cell transfusions, versus 63.6% patients in the failure group (p = 0,05). failure rate in patients with iss = 8 was zero; 15.9% in patients with iss 9 to 25; and 50% in patients with iss = 26 (p = 0,05). there were no deaths or missed bowel injuries. conclusion: iss and splenic injury grade were related to failure of nst.
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