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Search Results: 1 - 10 of 137365 matches for " Jo?o Marcos Arantes Soares "
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Fatores clínicos e histológicos preditivos de metástase cervical em carcinomas epidermóides de língua e soalho de boca no estadio clínico II
Soares, Joo Marcos Arantes;Rapoport, Abr?o;Rosas, Marilene Paladino;Carvalho, Marcos Brasilino de;Fava, Ant?nio Sérgio;
Revista do Colégio Brasileiro de Cirurgi?es , 1998, DOI: 10.1590/S0100-69911998000100006
Abstract: the authors present a retrospective study of 54 patients with squamous cell carcinoma (scc) of the fongue and floor of the mouth in stage ii. the determination of clinical and hystological predictive factors of neck metastasis were the main proposal in t2 no cases submitted to surgical approach at the head and neck service of heliópolis hospital, hosphel, from 1977 till 1993. the clinical aspects (location, size, alcohol, tabacco, sex, race, age, complain) and histological (macroscopy, injlammatory infiltration, differenciation degree, desmoplasia, mitoses number, vascular and perineural invasion) factors were analysed, using the k square statistical method with 2 x 2 tables and p less than 0.05. concerning the outcomes for neck nodes metastases, 35.2% were positive coincident, 24.2% false negatives and 52.3% false positives. as conclusion, the main question of this paper were not obtained, due to the impossibility to determine the relation of predictive factors and natural history of the neoplasias of tongue and floor of the mouth.
Laringectomia de resgate: utiliza o do retalho miocutaneo de peitoral maior na preven o de fístula faringocutanea The usefulness of a pectoralis major myocutaneous flap in preventing salivary fistulae after salvage total laryngectomy
Alexandre Andrade Sousa,Sebasti?o Maurício de Oliveira Castro,José Maria Porcaro-Salles,Joo Marcos Arantes Soares
Brazilian Journal of Otorhinolaryngology , 2012, DOI: 10.1590/s1808-86942012000400019
Abstract: Laringectomias de resgate est o associadas a altas taxas de complica es pós-operatórias. O uso de retalhos na reconstru o do transito faríngeo poderia reduzir a incidência destas complica es. OBJETIVO: Avaliar a utilidade do retalho miocutaneo de músculo peitoral maior na preven o da fístula salivar no pós-operatório de laringectomia total de resgate. MéTODO: Estudo retrospectivo, realizado de abril/2006 a maio/2011, com 31 pacientes portadores de CCE de laringe recidivado, tratados previamente com quimiorradioterapia ou radioterapia isolada, submetidos à laringectomia de resgate. Destes 31 pacientes, a reconstru o da faringe foi realizada com utiliza o do retalho miocutaneo de músculo peitoral maior em 19 (61%) casos, enquanto o fechamento primário ocorreu em 12 pacientes (39%). RESULTADOS: Foi observada taxa de fistula salivar em (16%) dos pacientes em que se utilizou o retalho e 58% nos pacientes submetidos a fechamento primário da faringe (p < 0,02). N o foi observada diferen a estatisticamente significativa entre os grupos em rela o ao tempo médio de aparecimento de fistula e reintrodu o da dieta por via oral, bem como tempo de uso de cateter nasoentérico para alimenta o. CONCLUS O: O retalho miocutaneo do músculo peitoral maior mostrou-se como op o capaz de reduzir incidência de fistula salivar em laringectomias de resgate. Salvage laryngectomy in patients treated with organ preservation protocols is associated with high rates of postoperative complications. The use of non-irradiated tissue flaps in pharyngeal reconstruction could reduce the incidence of these complications. OBJECTIVE: This study aims to evaluate the usefulness of the pectoralis major myocutaneous flap in preventing salivary fistulae during the postoperative period of salvage total laryngectomy (TL). MATERIALS AND METHOD: This retrospective study enrolled 31 patients operated between April of 2006 and May of 2011. All patients had advanced cancer at the time of the salvage procedure and had been treated with chemoradiotherapy or radiotherapy alone. Pharyngeal reconstruction was performed using pectoralis major myocutaneous flap in 19 cases (61%); primary wound closure occurred in 12 patients (39%). RESULTS: Salivary fistulae occurred in 16% of the patients who received the flap and in 58% of the patients with primary closure of the pharynx (p < 0.02). No statistically significant differences were noted between the groups with respect to the mean time for fistula formation, reintroduction of an oral diet, or use of a nasoenteric tube for feeding. CONCLUSION: The pectorali
Hérnia perineal após disjun?ao da sínfise púbica: apresenta??o de caso e técnica para corre??o
Wainstein, Alberto Julius Alves;Soares, Joo Marcos Arantes;Belezia, Bruno de Freitas;Lima, Manoel Jacy Vilela;
Revista do Colégio Brasileiro de Cirurgi?es , 1998, DOI: 10.1590/S0100-69911998000100015
Abstract: traunatic perineal hernia remains a rare clinical entity despite an overall increase in blunt trauma. because of the incidence of other associated injuries, the mortality is high. most of the perineal defects are repaired during the orthopaedics surgery to reconstitute the pelvis and few patients develop a true perineal hernia without pelvic instability. a 80-year-old woman was involved in a running over accident with disjunction of pubic symphysis, dislocation of sacrum-iliac junction and fracture of pubis and ischium. the patient was submitted to an orthopaedic surgery and latter development an perineal hernia through the genitalia. the diagnosis could be established with physical examination alone. conventional radiology, computadorized tomography, and ultrasound should also be done to progran the surgery. the repair approach was performed using a marlex mesh, fixed in the pelvic bones, cooper ligament, and the abdominal wall. the mesh was stood in a retro- peritoneal position, rebuilding the pelvic floor without reconstruction the pelvic bones. we conclude that this is an efficient approach to repair of traumatic postoperative perineal hernia, mainly in patients with high operative risk, when the osseous repair is not necessary.
Fatores preditores para hipocalcemia pós-tireoidectomia Predictors factors for post-thyroidectomy hypocalcaemia
Alexandre de Andrade Sousa,José Maria Porcaro Salles,Joo Marcos Arantes Soares,Gustavo Meyer de Moraes
Revista do Colégio Brasileiro de Cirurgi?es , 2012,
Abstract: OBJETIVO: Avaliar a incidência e os fatores preditores da hipocalcemia e hipoparatireodismo definitivo pós-tireoidectomia. MéTODOS: Foi dosado cálcio i nico no pré e no pós-operatório (primeiro, segundo e 30odia) em 333 pacientes submetidos à tireoidectomia. Naqueles que apresentaram hipocalcemia, as dosagens foram feitas também aos 90 e 180 dias de pós-operatório, quando se dosou também o paratorm nio. Os pacientes foram agrupados segundo a presen a ou ausência de hipocalcemia e avaliados segundo idade, sexo, fun o tireoidiana, volume tireoidiano, número de paratireoides identificadas e necessidade de reimplante de paratireoides, tipo de opera o, tempo operatório e diagnóstico histopatológico. RESULTADOS: A incidência de hipocalcemia temporária foi de 40,8% (136 pacientes), e hipoparatireoidismo definitivo de 4,2% (14 pacientes). Tireoidectomia total ou reopera o, esvaziamento cervical, hipertireoidismo, tempo operatório e idade acima de 50 anos foram fatores determinantes de incidência significativamente maior de hipocalcemia e hipoparatireodismo definitivo (p<0,05). CONCLUS O: os fatores preditores da hipocalcemia pós-operatória incluem idade (>50 anos), tireoidectomia total, reopera o, esvaziamento cervical e tempo operatório. Os fatores preditores do hipoparatireoidismo definitivo pós-tireoidectomia incluíram tipo de opera o, diagnóstico histológico e hipertireoidismo. OBJECTIVE: To evaluate the incidence and predictors of post-thyroidectomy definitive hypocalcemia and hypoparathyroidism. METHODS: We assessed ionic calcium preoperatively and postoperatively (first, second and 30th day) in 333 patients undergoing thyroidectomy. In those presenting hypocalcemia, measurements were also made 90 and 180 days after surgery, when parathormone was also dosed. Patients were grouped according to the presence or absence of hypocalcemia and evaluated according to age, gender, thyroid function, thyroid volume, number of parathyroid glands identified and need to parathyroid reimplantation, type of operation, operative time, and histopathological diagnosis. RESULTS: The incidence of temporary hypocalcemia was 40.8% (136 patients), and of definitive hypoparathyroidism 4.2% (14 patients). Reoperation or total thyroidectomy, neck dissection, hyperthyroidism, operative time and age above 50 years were factors related to higher incidence of hypocalcemia and definitive hypoparathyroidism (p <0.05). CONCLUSION: predictors of postoperative hypocalcemia included age (> 50 years), total thyroidectomy, reoperation, neck dissection and operative time. The predictors of
Fatores preditores de fístula salivar pós-laringectomia total Predictors of salivary fistula after total laryngectomy
Alexandre de Andrade Sousa,José Maria Porcaro-Salles,Joo Marcos Arantes Soares,Gustavo Meyer de Moraes
Revista do Colégio Brasileiro de Cirurgi?es , 2013,
Abstract: OBJETIVO: Avaliar a incidência de fístula faringocutanea após laringectomia total e tentar identificar os fatores preditores. MéTODOS: No período de maio de 2005 a abril de 2010, 93 pacientes foram submetidos à laringectomia total. Foram avaliadas as complica es per e pós-operatórias e comparadas com as seguintes variáveis: sexo, estado nutricional, traqueostomia prévia, localiza o do tumor primário, tipo de opera o realizada, estadiamento de acordo com o TNM, tratamento prévio com quimioterapia e/ou radioterapia, utiliza o de retalhos para reconstru o e margem cirúrgica. Todos os pacientes apresentavam a neoplasia em estádio avan ado segundo o TNM. RESULTADOS: 14 (15,1%) pacientes evoluíram com fístula salivar no pós-operatório. O tempo médio de aparecimento da fístula salivar foi 3,5 dias, com desvio padr o de 13,7 dias. Comparando a fístula salivar com as variáveis TNM, tipo de opera o e esvaziamento cervical, traqueostomia prévia, utiliza o de retalho miocutaneo, rádio e quimioterapia pré-operatória e margem cirúrgica, n o foi observado diferen a estatisticamente significativa (p>0,05). CONCLUS O: A incidência de fístula salivar foi 15,1% e n o foi encontrado fator preditor para sua forma o. OBJECTIVE: To evaluate the incidence of pharyngocutaneous fistula after total laryngectomy and try to identify its predictors. METHODS: From May 2005 to April 2010, 93 patients underwent total laryngectomy. We evaluated complications during and after surgery and compared them with the following variables: gender, nutritional status, previous tracheotomy, tumor location, type of surgery, TNM staging, prior treatment with chemotherapy and/or radiotherapy, use of flaps for reconstruction and surgical margin. All patients presented with advanced neoplastic disease according to TNM. RESULTS: 14 (15.1%) patients developed postoperative salivary fistula. The mean time to onset of salivary fistula was 3.5 days, with a standard deviation of 13.7 days. Comparing salivary fistula with TNM variables, type of operation and neck dissection, prior tracheotomy, use of flap, preoperative radio and chemotherapy and surgical margin, there was no statistically significant difference (p> 0,05). CONCLUSION: The incidence of salivary fistula was 15.1% and no predictive factor for its formation was found.
Kikuchi-Fujimoto disease: three case reports
Sousa, Alexandre de Andrade;Soares, Joo Marcos Arantes;Santos, Marco Homero de Sá;Martins, Marcelo Portes Rocha;Salles, José Maria Porcaro;
Sao Paulo Medical Journal , 2010, DOI: 10.1590/S1516-31802010000400011
Abstract: context: kikuchi-fujimoto disease (kfd) manifests in most cases as unilateral cervical lymphadenomegaly, with or without accompanying fever. the disease mainly affects young women and has a self-limited course. it is more common in oriental countries, with few reports of its occurrence in brazil. kfd should be included in the differential diagnosis of suspected cases of viral infections, tuberculosis, reactive lymphadenitis, systemic lupus erythematosus and metastatic diseases. it can be histologically confused with lymphoma. the disease is benign and self-limiting and an excisional biopsy of an affected lymph node is necessary for diagnosis. there is no specific therapy. case reports: this study reports on three cases of non-asian female patients with kfd who were attended at our service between 2003 and 2006. a review of the literature was carried out, with a systematic search on this topic, with the aim of informing physicians about this entity that is manifested by cervical masses and fever.
Evolution of blood magnesium and phosphorus ion levels following thyroidectomy and correlation with total calcium values
Sousa, Alexandre de Andrade;Salles, José Maria Porcaro;Soares, Joo Marcos Arantes;Moraes, Gustavo Meyer de;Carvalho, Jomar Rezende;Savassi-Rocha, Paulo Roberto;
Sao Paulo Medical Journal , 2010, DOI: 10.1590/S1516-31802010000500005
Abstract: context and objective: magnesium ion concentration is directly related and phosphorus ion concentration is inversely related to calcemia. the aim of this study was to evaluate the evolution of magnesium and phosphorus ion levels in patients undergoing thyroidectomy and correlate these with changes to calcium concentration. design and setting: prospective study at the alpha institute of gastroenterology, hospital das clínicas, universidade federal de minas gerais. methods: the study included 333 patients, of both genders and mean age 45 ± 15 years, who underwent thyroidectomy between 2000 and 2005. total calcium, phosphorus and magnesium were measured in the blood preoperatively and 24 and 48 hours postoperatively. ionic changes were evaluated according to the presence or absence of postoperative hypocalcemia. results: there were statistically significant drops in blood phosphorus levels 24 and 48 hours after thyroidectomy, compared with preoperative values, in the patients without hypocalcemia. in the patients who developed hypocalcemia, there was a significant drop in plasma phosphorus on the first postoperative day and an increase (also statistically significant) on the second day, in relation to preoperative phosphorus levels. a significant drop in postoperative magnesium was also observed on the first and second days after thyroidectomy in the patients with hypocalcemia, in relation to preoperative levels. in the patients without hypocalcemia, the drop in magnesium was significant on the first day, but there was no difference on the second day. conclusion: despite the postoperative changes, neither magnesium nor phosphorus ion levels had any role in post-thyroidectomy calcemia.
Perioperative frozen section examination in parotid gland tumors
Carvalho, Marcos Brasilino de;Soares, Joo Marcos Arantes;Rapoport, Abr?o;Andrade Sobrinho, Josias de;Fava, Antonio Sérgio;Kanda, Jossi Ledo;Lehn, Carlos Neutzling;Walder, Fernando;Menezes, Marcelo Benedito;Negri, Sérgio Luiz Coelho;
Sao Paulo Medical Journal , 1999, DOI: 10.1590/S1516-31801999000600002
Abstract: context: the minimal recommended surgical approach to parotid tumors is partial parotidectomy with resection of the superficial lobe of the gland. histologic diagnosis prior to surgery is not possible, as incisional biopsies are contraindicated due to the possibility of facial nerve injury or incomplete tumor resection. thus, the biopsies tend to be perioperative. objective: to compare the results of frozen section examination with the definitive pathological diagnosis. design: accuracy study by retrospective analysis. setting: head and neck surgery service of heliópolis hospital, s?o paulo, brazil. sample: 153 cases of parotid gland tumors treated between 1977 and 1994. diagnostic test: frozen section and pathological diagnosis. main measurements: sensibility and specificity of the frozen section examination. results: frozen section study diagnosed 19 (12.4%) malignant and 127 (83.7%) benign tumors. sensitivity of the frozen sections for malignancy was 61.5% (95% ci 54 to 69%) and specificity was 98% (95% ci 94 to 100%), and this result is comparable to the literature. conclusions: we consider that frozen section examination for salivary gland tumors is not sufficient on its own for deciding on the best management. their interpretation must be correlated with clinical and intraoperative findings, in association with the surgeon's experience.
Atua o da fisioterapia na síndrome de fragilidade: revis o sistemática Physical therapy treatment on frailty syndrome: systematic review
Paula M. M. Arantes,Mariana A. Alencar,Rosangela C. Dias,Joo Marcos D. Dias
Brazilian Journal of Physical Therapy , 2009,
Abstract: OBJETIVO: Revisar sistematicamente a literatura sobre interven es fisioterapêuticas e seus efeitos em idosos frágeis da comunidade. MéTODOS: Revis o sistemática de estudos publicados até junho de 2008 nas bases de dados Medline, Embase, PEDro, SciELO, LILACS e Biblioteca Cochrane. Foram excluídos os artigos cuja amostra era constituída de idosos n o frágeis, institucionalizados e hospitalizados; aqueles cujas interven es propostas n o foram a fragilidade e n o eram específicos de fisioterapia. RESULTADOS: De acordo com os critérios de exclus o, dos 152 artigos encontrados no Medline, apenas 15 foram incluídos para análise; dos 71 artigos encontrados na base de dados PEDro, apenas um, uma vez que os outros 10 artigos encontrados já haviam sido selecionados pelo MEDLINE, e dos 461 artigos encontrados na base de dados Embase, apenas dois que n o haviam sido selecionados nas outras bases de dados foram incluídos neste estudo. Foi verificado um total de sete diferentes tipos de interven es: 1) fortalecimento muscular; 2) exercícios de fortalecimento muscular, equilíbrio, coordena o, flexibilidade, tempo de rea o e treinamento aeróbico; 3) treino funcional; 4) fisioterapia; 5) fisioterapia realizada no domicílio; 6) adapta o ambiental e prescri o de dispositivo e 7) exercício na água. Os resultados de alguns estudos foram contraditórios mesmo com interven es semelhantes. Os estudos analisados utilizaram formas distintas para definir fragilidade, o que dificultou as compara es dos resultados. CONCLUS O: Existem poucas evidências dos efeitos da interven o fisioterapêutica em idosos frágeis comunitários, dificultando estabelecer consenso ou conclus es sobre a eficácia das propostas terapêuticas nessa complexa síndrome. OBJECTIVE: To carry out a systematic review of the literature on physical therapy interventions and their effect on frail community-dwelling elders. METHODS: Systematic review of studies published until June 2008 in the databases Medline, Embase, PEDro, SciELO, LILACS and Cochrane Library. We excluded studies with samples composed of institutionalized, hospitalized and non-frail participants, studies not aimed at treating frailty, and studies that were not specifically related to physical therapy. RESULTS: In accordance with the exclusion criteria, out of the 152 Medline articles, only 15 were considered for analysis, out of the 71 PEDro articles only one was considered as the other ten had already been selected in Medline, and out of the 461 Embase articles only two that had not been selected in others databases were included in this st
Measuring the NBA Teams’ Cross-Efficiency by DEA Game  [PDF]
Luiz Aizemberg, Marcos Costa Roboredo, Thiago Gra?a Ramos, Joo Carlos C. B. Soares de Mello, Lidia Angulo Meza, Alessandro Martins Alves
American Journal of Operations Research (AJOR) , 2014, DOI: 10.4236/ajor.2014.43010
Abstract:

In this paper, we use DEA to measure the NBA basketball teams’ efficiency in seasons 2006-2007, 2007-2008, 2008-2009 and 2009-2010. In this context, each team is a DMU; we select the payroll and the average attendance to be the inputs while the wins and the average points per game to be the outputs. First, in order to obtain benchmarks, we measure the DMUs efficiency through classic DEA BCC model with an assurance region for each one of the four seasons individually and together. When we consider the four seasons together, we may analyse whether the performance of each team increases or decreases over time. Next, we evaluate the teams cross efficiency by DEA game to consider that there is no cooperation among DMUs. This approach also improves the efficiencies discrimination.

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