Navegando por Palavras-chave "Embolia Pulmonar"
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- ItemAcesso aberto (Open Access)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.
- ItemSomente MetadadadosContribuicao para o estudo da embolia pulmonar com coagulos autologos: estudo experimental em caes(Universidade Federal de São Paulo (UNIFESP), 1978) Kasinski, Nelson [UNIFESP]
- ItemSomente MetadadadosContribuição para o estudo de alguns parâmetros para avaliação da função pulmonar na embolia gordurosa com ácido oléico: estudo experimental em cães(Universidade Federal de São Paulo (UNIFESP), 1977) Bogossian, Miguel [UNIFESP]; Ratto, Octávio Ribeiro [UNIFESP]
- ItemSomente MetadadadosIncidência de trombose venosa profunda dos membros inferiores no tratamento operatório da obesidade mórbida na vigência de profilaxia(Universidade Federal de São Paulo (UNIFESP), 2006) Brasileiro, Aldo Lacerda [UNIFESP]; Miranda Júnior, Fausto [UNIFESP]Contexto. A trombose venosa profunda dos membros inferiores e embolia \ pulmonar sao causas importantes de morbidade e mortalidade principalmente em pacientes submetidos a operacao. Em pacientes obesos submetidos a tratamento cirurgico essas complicacoes tem incidencia ainda maior em decorrencia da propria obesidade que e considerada um fator de risco para a trombose venosa, o tempo cirurgico geralmente longo e a imobilidade maior nestes pacientes podem, tambem, contribuir para esse maior risco. Apesar de existirem varios relatos de obitos apos operacao para tratamento da obesidade e incidencias variadas na literatura, nao existe consenso quanto a profilaxia da trombose venosa profunda nestes pacientes. Objetivo. Determinar a incidencia de trombose venosa profunda dos membros inferiores em pacientes submetidos a operacao para tratamento da obesidade morbida na vigencia de profilaxia com Enoxaparina 40 mg por quinze dias. A hipotese e que a incidencia de trombose venosa profunda, com uso de profilaxia farmacologica, seja de 6 por cento. Tipo de estudo. Estudo de incidencia. Local. Hospital geral privado de cuidados terciario (Hospital Sao Rafael, Salvador, BA). Amostra. Pacientes com indice de massa corporea maior ou igual a 35 kg/m2 submetidos a operacao para tratamento da obesidade morbida com septacao gastrica e derivacao em y de Roux por Laparotomia ou videolaparoscopia em uso de Enoxaparina 40 mg/dia por 15 dias. Foram excluidos pacientes com trombose venosa profunda previa e alergia a heparina. Variavel. Incidencia de trombose venosa profunda dos membros inferiores em pacientes submetidos a operacao para tratamento da obesidade morbida. Os pacientes da pesquisa foram avaliados por meio de eco-Doppler colorido para a pesquisa de trombose venosa profunda dos membros inferiores, sendo realizado um exame no pre-operatorio, na segunda e quinta semanas de pos-operatorio. Metodo estatistico. Foi estimada uma amostra de 122 pacientes para responder a questao principal. Os dados foram armazenados e analisados em planilha eletronica, o erro tipo alfa foi de 5 por cento e o intervalo de confianca de 95 por cento. Resultados. De 27 de outubro de 2004 a 20 de agosto de 2005 foram incluidos 136 pacientes, tendo concluido o protocolo 126. Destes, 79 por cento (100/126) pertenciam ao sexo feminino. A idade desses pacientes variou de 19 a 65 anos com media e desvio padrao de 40 (DP 10) anos. O indice de massa corporea variou de 35 a 61 kg/m2, com media de 43 (DP 5). kg/m2 Todos os pacientes foram submetidos a operacao para restricao gastrica (septacao gastrica) e para reducao de absorcao (derivacao gastro-intestinal em Y de Roux), sendo que 55 por cento (69/126) por video¬laparoscopia, e 45 por cento (57/126) por laparotomia. Ocorreu 1 por cento (1/126) de trombose venosa profunda de membros inferiores e zero por cento de embolia pulmonar. Conclusoes. A incidencia de trombose venosa profunda dos membros inferiores foi 1 por cento. Descritores. Trombose venosa, embolia pulmonar, obesidade morbida, eco¬Doppler colorido, prevencao do tromboembolismo venoso
- ItemSomente MetadadadosInfluencia dos corticosteroides e da respiracao com pressao positiva expiratoria na evolucao da embolia gordurosa pulmonar provocada pelo acido oleico: estudo experimental em caes(Universidade Federal de São Paulo (UNIFESP), 1977) Nery, Luiz Eduardo [UNIFESP]
- ItemSomente MetadadadosProtocolo 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 PauloObjective: 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.
- ItemSomente MetadadadosTromboembolismo pulmonar recorrente e uso da nifedipina endovenosa: estudo experimental em cães(Universidade Federal de São Paulo (UNIFESP), 1989) Póvoa, Rui Manuel dos Santos [UNIFESP]; Ferreira, Celso [UNIFESP]
- ItemAcesso aberto (Open Access)Validação de modelo de predição clínica para o diagnóstico de trombose venosa profunda dos membros inferiores(Universidade Federal de São Paulo (UNIFESP), 2001) De Souza, Edvaldo [UNIFESP]; Figueiredo, Luiz Francisco Poli de [UNIFESP]Introduction: The deep vein thrombosis (DVT) has as serious complications lung embolism, important cause of mortality, and post-thrombosis syndrome ,the most frequent cause of chronic vein stasis of the lower limbs. The signs and clinical symptoms of DVT present a high rate of false-positive and false-negative, when compared to objective methods of diagnosis. The correct diagnosis of DVT, confirmed by phlebography or other non-invasive methods , permits the appropriate treatment with anticoagulants, reducing the incidence of lung embolism and minimizing chronic vein stasis. It also avoids the unnecessary exposure to the risks of anticoagulant therapy in the negative cases. With the indiscriminate use of subsidiary exams, the incidence of negative exams has increased, reducing the cost-benefit of these diagnostic methods. Philip S. Wells, of the University of Ottawa, Canada, in 1995 and 1997, proposed a method of clinical prediction for the diagnosis of DVT, and he concluded that it is possible to stratify groups accurately into high, moderate and low probability, rationalizing the use of supplementary diagnostic methods, method that needs validation in other centers, as suggested by the author himself. Objective: To test the hypothesis that the model of clinical prediction proposed by Wells is capable of stratifying the patients into groups of high, moderate and low probability of DVT of the lower limbs. Method: Prospective study, including 111 consecutive patients, 114 members, with signs and symptoms of DVT in the lower limbs. Of these, 99 carried out phlebography, resulting in 102 extremities studied. The patients were examined according to the order of their arrival in the hospital or by the request of intra-hospital evaluation of patients admitted for other reasons. A postgraduate student of vascular surgery, a second year resident of General Surgery, and a second year medical student, who had never had contact with patients with DVT, filled out forms based on the proposal by Wells, and would not have further contact with the examined patient. The phlebography were carried out by doctors that didn`t know about the forms and were just interpreted at the end of the study, by three other assisting doctors that didn`t know the identity of the patients and had not participated in the treatment or previous evaluation. Results: In 65 (63,7%) of the 102 lower limbs the presence of DVT was proven by phlebography. The clinical model of Wells demonstrated a prevalence of DVT of 85,5% in the category of high probability, 50% in the group of moderate probability and 25% in the category of low probability. The location of DVT was proximal, starting from the popliteal vein, by 80,6%, 25% and 12,5%, while it was located exclusively in the veins of the calf by 4,8%, 25,0% and 12,5%, in the high, moderate and low probability groups, respectively. The coefficient of reproducibility of Cronbach among the postgraduate, the resident and the student was 86,3%. Conclusion: The model of clinical prediction of DVT proposed by Wells allows adequate identification of patients with high probability and with DVT proximal. However, the method is unsatisfactory for the identification of DVT in the patients allocated in the moderate and low probability groups.