Navegando por Palavras-chave "Pulmonary Embolism"

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    Aplicativo Para Estratificação De Risco E Prevenção De Tromboembolismo Venoso Em Cirurgia Plástica
    (Universidade Federal de São Paulo (UNIFESP), 2018-08-16) Favarin, Eduardo [UNIFESP]; Garcia, Elvio Bueno [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Venous thromboembolism (VTE), defined as deep venous thrombosis and/or pulmonary embolism, is an important safety-related topic in patients undergoing surgical procedures. All preoperative patients should be carefully evaluated for risk factors for venous thromboembolism and preventive strategies should be adopted. Medical applications can be used to monitor patients, improve their treatment and assist doctors’ decision making. There are only two applications intended for plastic surgeons for VTE risk assessment but both only consider the risk factors of the patient and abstain from taking into account the procedure to be performed. Objective: To develop an a mobile-health application to assist surgeons in VTE risk stratification and prevention thrombotic events in plastic surgery. Method: The Design Thinking tool was used to create application with full participation of plastic surgeons enrolled in a professional master's degree in the four phases of the process: Discover, Define, Develop and Deliver. The application was made by a company contracted under the supervision of the author. To validate the project was used the patent method Canvas. Result: The VTE plastic surgery application was developed following Caprine Risk Assessment Score and guidelines issued by the American Society of Plastic Surgeons. It takes into account the procedure to be performed and the 39 risk factors considered by the Caprine score. Conclusion: The VTE plastic surgery application and is ready to be launched to be used by plastic surgeons aiming to prevent of VTE as a result of surgical procedures.
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    Protocolo para avaliação do tromboembolismo pulmonar por tomografia computadorizada sincronizada com ECG
    (Universidade Federal de São Paulo (UNIFESP), 2020-04-30) Domingues, Antonio Donizeti [UNIFESP]; Szarf, Gilberto [UNIFESP]; Universidade Federal de São Paulo
    Objective: Evaluate whether there is a difference in the degree of pulmonar arterial opacification in the comparison between pulmonar angiotomographies performed in the usual way (without ECG coupling), versus those performed with synchronization of image acquisition with ECG. Also assess whether there is a significant increase in the patient’s exposure to ionizing radiation in the comparison between acquisitions without and with ECG coupling. Methods: 48 patients of both sexes and aged between 18 and 75 years, from de specialty outpatient clinic of the Federal University of São Paulo, São Paulo School of Medicine, were evaluated, for whom chest angiotomography was already clinically indicated. The study was carried out in a randomized manner, with regard to the coupling or not of the ECG. Patients with severe allergy to iodinated contrast, with renal failure (creatinine clearance below 50mg/dl), with a history of previous pulmonary artery manipulation (surgical or endovascular) and pregnant women were excluded. The contrast used was non- ionic iodine, 370 mg/ml. The Phillips Brilliance 64-channel computed tomography equipment was used for this study. Exam evaluations were performed by two radiologists, who assessed anatomical and quality criteria related to the contrast in the pulmonary arteries. All studies were carried out after patients signed the free and informed consent form. Results: Pulmonary circulation and right ventricular function could be evaluated in all cases in which electrocardiographic coupling was used for image acquisition. It was possible to evaluate the other pulmonary and thoracic parenchymal changes in these studies. The maintenance of image quality was confirmed in the assessment of the density of the pulmonary arteries. There was an increase in the radiation dose, estimated by up to 28% when the protocol with cardiac synchronization was used. Conclusions: The computed tomography protocol for the evaluation of pulmonary thromboembolism synchronized with electrocardiogram allows to assess the presence of thrombus in the pulmonary arterial circulation, allows the assessment of right ventricular function and maintains the quality and diagnostic capacity of the traditional angiotomography technique. However, it is associated with increased exposure to ionizing radiation.