Navegando por Palavras-chave "Manometry"

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    Aspectos manométricos contributivos à Classificação de Chicago para categorização de pacientes como acalasia tipo I ou II
    (Universidade Federal de São Paulo (UNIFESP), 2020-06-25) Anefalos, Alexandre [UNIFESP]; Fernandes, Fernando Augusto Mardiros Herbella [UNIFESP]; Universidade Federal de São Paulo
    Background: Phenotypes of achalasia are based on esophageal body pressurization. The reasons that lead to wave pressurization are still unclear. This study aims to evaluate manometric parameters that may determine esophageal pressurization in patients with achalasia. Methods: 100 achalasia high resolution manometry tests were reviewed. We measured before each swallow: upper esophageal sphincter (UES) basal pressure, esophageal length, lower esophageal sphincter (LES) basal pressure, LES length, gastric and thoracic pressure, transdiaphragmatic pressure gradient (TPG) and LES retention pressure; during swallow: UES post-relaxation contraction pressure, UES residual pressure, UES recovery time, LES relaxation pressure, gastric and thoracic pressure, TPG and after swallow: esophageal length, LES length, wave amplitude, gastric and thoracic pressure and TPG. Results: Univariate analysis showed in pressurized waves before swallow: higher thoracic, UES and LES basal pressure, longer LES length, higher TPG and decrease of LES retention pressure; during swallow: higher thoracic, gastric and UES post-relaxation contraction pressure, higher UES and LES relaxation pressure and higher TPG; and after swallow: higher thoracic and gastric pressure and higher TPG. Multivariate analysis in pressurized waves showed as significant before swallow: thoracic and UES basal pressure; during swallow: thoracic, gastric and UES post-relaxation contraction pressure, UES residual pressure and UES recovery time; and after swallow: thoracic pressure. Conclusions: Manometric parameters that determined esophageal pressurization in patients with achalasia were: thoracic pressure (before, during and after swallow); UES basal pressure (before swallow); and UES post-relaxation contraction pressure, UES residual pressure and recovery time (during swallow).
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    Avaliação da motilidade faríngea pela manometria de alta resolução em pacientes submetidos a tireoplastia tipo I
    (Universidade Federal de São Paulo (UNIFESP), 2018-10-25) Pinna, Bruno de Rezende [UNIFESP]; Biase, Noemi Grigoletto de [UNIFESP]; Fernandes, Fernando Augusto Mardiros Herbella [UNIFESP]; http://lattes.cnpq.br/4035568020554599; http://lattes.cnpq.br/3156326658988323; http://lattes.cnpq.br/9966897407737956; Universidade Federal de São Paulo (UNIFESP)
    Objectives: This study aims to compare the motility of the pharynx and UES in patients with UVFI before and after thyroplasty type I. Methods: We prospectively studied 15 patients with UVFI that underwent thyroplasty type I. Subjects were divided according to the topography of vagal injury and presence of dysphagia. High resolution manometry (HRM) was performed before and 30 days after surgery. Time and pressure manometric parameters at the topography of the velopharynx, epiglottis and UES were recorded. Results: Dysphagia was present in 67% of patients. 73% had lower vagal injuries. Manometric parameters did not change after thyroplasty for the whole population. The group of dysphagic patients; however, had an increase in residual pressure at the UES after thyroplasty (1.2 vs. 5.2 mmHg - p=0.05). Patients with low vagal injury developed higher peak pressure (100 vs. 108.9 mmHg - p=<0.001); lower rise time (347 vs. 330 ms - p=0.04); and higher up stroke (260 vs. 266.2 mmHg/ms p= 0.04) at the topography of the velopharynx after thyroplasty. Conclusion: Pharyngeal motility is affected by thyroplasty type I in patients with dysphagia and low vagal injury.
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    Avaliação manométrica de alta resolução da faringe e do esfíncter esofagiano superior em pacientes com acalásia
    (Universidade Federal de São Paulo (UNIFESP), 2015-12-18) Menezes, Mariano de Almeida [UNIFESP]; Herbella Fernandes, Fernando Augusto Mardiros [UNIFESP]; http://lattes.cnpq.br/4035568020554599; http://lattes.cnpq.br/9401042136430137; Universidade Federal de São Paulo (UNIFESP)
    Introdução: A motilidade da faringe e do esfíncter esofágico superior ainda é pouco compreendida. Também não está claro se a motilidade desta área pode ser comprometida em pacientes com acalásia. Este estudo tem como objetivo avaliar a motilidade da faringe e do esfíncter esofagiano superior em pacientes com acalásia. Métodos: 60 pacientes com acalásia foram submetidos a manometria de alta resolução (52% do sexo feminino, com idade média de 54,2 anos). A dilatação do esôfago foi classificada de acordo com a classificação radiológica para a acalásia em grau I (<4 cm): 6%; grau II (4-7 cm): 36%; grau III (7-10 cm): 34%; e grau IV (> 10 cm): 24%. A manometria de alta resolução classificou os pacientes em acalásia tipo I de Chicago (43%) e tipo II (57%). Os parâmetros manométricos avaliados foram comparados aos valores normais obtidos a partir de um estudo prévio em voluntários. Resultados: A motilidade da faringe na região do véu palatino apresentou-se com contrações curtas, prematuras e hipertônicas. A motilidade da faringe na região da epiglote mostrou-se com contrações hipertônicas. O esfíncter esofagiano superior apresentou um déficit de relaxamento. Pacientes Chicago tipo II tiveram uma pressão residual do esfíncter esofagiano superior mais elevada que os pacientes tipo I (p = 0,028). O grau de dilatação do esôfago não se correlacionou com parâmetros manométricos avaliados. Conclusão: A acalásia pode afetar a motilidade do complexo faríngo-esofágico. As mudanças observadas podem representar alterações funcionais para impedir a aspiração, especialmente em pacientes classificados como tipo II de Chicago.
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    Avaliação manométrica e profilométrica computadorizada de pacientes portadores de anomalias anorretais intermediarias e altas, tratados cirurgicamente pelo princípio da anorretoplastia sagital posterior
    (Universidade Federal de São Paulo (UNIFESP), 2005) Vital Júnior, Pedro Felix [UNIFESP]; Martins, José Luiz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objetivo: Avaliar crianças portadoras de anomalias anorretais altas e intermediárias, submetidas à correção cirúrgica pela anorretoplastia sagital posterior quanto à sua continência fecal por meio da manometria anorretal e profilometria computadorizadas. Método: Entre 2001 e 2004 avaliamos 82 pacientes portadores de anomalias anorretais intermediárias e altas em pós-operatórios tardios (> 9 meses) de anorretoplastia sagital posterior, clinicamente quanto à continência fecal e através da manometria anorretal e profilometria computadorizadas. Foram agrupados em continentes, parcialmente continentes e incontinentes de acordo com princípios definidos por Martins em 1993. Estudamos a idade, o sexo, as malformações associadas e variáveis manométricas (pressão de repouso, resposta pressórica esfincteriana à tosse e à contração voluntária, pressão máxima na curva pressórica, resposta pressórica à estimulação peri-anal, reflexo reto-esfincteriano e profilometria, índices de assimetria total do segmento, comprimento do canal anal e volume retal). Os resultados foram analisados estatisticamente pela freqüência absoluta e relativa, teste Qui-quadrado, resíduo padronizado (Zres), Análises de Variâncias, teste de Tukey, teste de Kruskal-Wallis, t-Student e Mann-Whitney. Resultados: Dos 82 pacientes, 56,1 por cento eram meninos e 43,9 por cento meninas, com média de idade de 85,5 meses. Desses, 37,8 por cento eram continentes, 25,6 por cento parcialmente continentes e 36,6 por cento incontinentes. Dentre as malformações associadas predominaram as de coluna sacral (35,5 por cento). A média da pressão de repouso à manometria anorretal foi de 22 mmHg, sendo entre os continentes, parcialmente continentes e incontinentes respectivamente 30,7 mmHg, 23 mmHg e 14,7 mmHg. A média da resposta pressórica à contração voluntária foi de 56 mmHg, sendo entre os continentes 65,4 mmHg, parcialmente continentes 55,8 mmHg e incontinentes 46,6 mmHg. O reflexo reto-esfincteriano encontrava-se ausente em 82,9 por cento dos casos, estando presente em 35,3 por cento dos continentes. O comprimento do canal anal variou em média de 2,4 a 2,5 cm para todos os grupos. Encontramos médias de índices total e segmentar de assimetria de 29,8 e..(au).
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    Avaliação, através da tonometria gástrica, do efeito da dobutamina na perfusão esplancnica no pôs operatório de cirurgia cardíaca em pediatria
    (Universidade Federal de São Paulo (UNIFESP), 1996) Souza, Renato Lopes de [UNIFESP]; Carvalho, Werther Brunow de [UNIFESP]
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    Clinical, manometric and profilometric evaluation after surgery for Hirschsprung's disease: comparison between the modified Duhamel and the transanal rectosigmoidectomy techniques
    (Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2009-10-01) Martins, Elaine Cristina Soares [UNIFESP]; Peterlini, Fábio Luis [UNIFESP]; Fagundes, Djalma José [UNIFESP]; Martins, Jose Luiz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate fecal continence, anorectal manometry (AM) and profilometry (P), in patients operated for congenital megacolon, using either the modified Duhamel technique (MDT) or the modified transanal rectosigmoidectomy (MTR) technique. METHODS: 42 patients were evaluated clinically and via AM and P, for postoperative control. The resting, coughing, voluntary contraction, maintained voluntary contraction and perianal stimulation pressures were investigated. The rectosphincteric reflex was tested and the simple and enhanced pressure curves were evaluated. The three-dimensional profilometric outline was produced. Student's t, chi-squared and Fisher's exact tests were used for statistical analysis (p<0.05). RESULTS: AM showed mean resting pressures of 53.44 mmHg for MDT and 60.67 mmHg for MTR, and mean voluntary contraction pressures of 94.50 mmHg for MDT and 95.47 mmHg for MTR. There was no statistical difference between the groups. The shapes of the simple and enhanced pressure curves did not present any statistical difference, independent of the surgical technique used. CONCLUSION: The two surgical techniques were equivalent. MDT caused greater incidence of postoperative constipation that MTR did. AM and P were shown to be excellent tests for postoperative follow-up among these patients.
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    Comparison between perfusion and balloon techniques for performing anorectal manometry in children with intestinal constipation
    (Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2008-10-01) Marques, Geraldo Magela Nogueira [UNIFESP]; Martins, Jose Luiz [UNIFESP]; Nobre, Vânia Dolores Rodrigues Perdigão [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    INTRODUCTION: Two anorectal manometry techniques have commonly been utilized: the perfusion technique and the balloon technique. PURPOSE: To compare both techniques in children with intestinal constipation who had not undergone surgical treatment for its correction. METHODS: Thirty-nine children aged between four and fourteen years underwent anorectal manometry using both techniques at random. Resting pressure, pressure response to voluntary contraction, coughing and perianal stimulation, maximum pressure on the anal canal pressure curve, and presence of rectosphincteric reflex were registered and submitted to statistics. Vectorgraphy of the sphincter muscle complex was obtained by perfusion technique. RESULTS: The statistical comparison between the techniques revealed statistically significant differences in resting pressure (p=0.041), pressure response to voluntary contraction (p=0.026) and maximum pressure within the pressure curve (p=0.010). The rectosphincteric reflex was demonstrated in 21 patients by both techniques. CONCLUSIONS: The perfusion technique presented greater sensitivity in the following parameters: resting pressure, pressure response to voluntary contraction and maximum pressure within the pressure curve. The methods studied are equivalent regarding the measurement of pressure responses to coughing and perianal stimulation and the investigation of rectosphincteric reflex.
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    Efeito da nifedipina gel 0,2% nas pressões de canal anal e na dor pós-operatória: estudo após hemorroidectomia pela técnica aberta
    (Cidade Editora Científica Ltda, 2007-12-01) Cesar, Maria Auxiliadora Prolungatti; Klug, Wilmar Artur; Bassi, Deomir Germano [UNIFESP]; Paula, Pedro Roberto De [UNIFESP]; Cesar, Rosana Prolungatti; Ortiz, Jorge Alberto; Speranzini, Manilio Basilio; FCMSCSP; Universidade de Taubaté; Universidade Federal de São Paulo (UNIFESP); Hospital Universitário de Taubaté Serviço de Endoscopia e Motilidade Digestiva; Faculdade de Ciências Médicas da Santa Casa de São Paulo; Universidade de São Paulo (USP); Faculdade de Medicina do ABC
    INTRODUCTION: Hemorrhoids are very common and pain following their surgical treatment causes great suffering. Various alternatives have been studied for reducing postoperative pain. Among these is surgical sphincterotomy, which may in some cases cause some degree of fecal incontinence. For this reason, several studies have used chemical sphincterotomy, with nifedipine, diltiazem, glycerin trinitrate or botulinum toxin. The objective of the present study was to investigate the effects of topical nifedipine for reducing anal canal pressures and consequently reducing postoperative pain. MATERIAL AND METHOD: Topical gels of 0.2% nifedipine plus 2% lidocaine (Group 1) and 2% lidocaine alone (Group 2) were used following hemorrhoidectomy. Pressures were measured before the operation and on the first, fourth and seventh days after the operation. Pain was also evaluated on all of the first seven postoperative days using a visual analog scale. RESULTS: There were no differences in relation to anal canal pressures, but lower pain levels were reported in the group that received nifedipine. CONCLUSION: Nifedipine gel was efficient for postoperative analgesia, but did not alter anal canal pressures.
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    Eletromanometria esofágica e pHmetria de 24 horas na avaliação pós-operatória da hiatoplastia e válvula anti-refluxo total laparoscópica
    (Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2006-06-01) Pastore, Ricardo; Crema, Eduardo; Silveira, Mariana De Carvalho; Presoto, Adriana Ferreira; Herbella, Fernando Augusto Mardiros [UNIFESP]; Del Grande, José Carlos [UNIFESP]; Faculdade de Medicina do Triângulo Mineiro; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: The electromanometry and 24-hour esophageal pHmetry has been proposed as objective method in postoperative evaluation of antireflux surgery. AIM: Prospective evaluation of the results of cruroplasty and total fundoplication in the treatment of non-complicated gastroesophageal reflux disease based on comparative results of pre and post operative manometry and pHmetry findings. METHODS: Fifty-nine consecutive individuals with typical symptoms of gastroesophageal reflux disease were prospectively studied. All patients were submitted to a laparoscopic short floppy Nissen fundoplication between March, 2002 and August, 2003. All patients were submitted pre and postoperatively (3 months) to upper digestive endoscopy, manometry and pHmetry 24 hours. RESULTS: Eighteen (30.5%) patients were male and 41 (69.5%) female, their average age was 43.8 years. There were differences comparing the pre and post operative period in the manometrical findings in the following items: localization of the lower esophageal sphincter (41.2 cm and 42.3 cm). Extension o f the lower esophageal sphincter preoperative (2.0 cm and 2.5 cm), resting pressure of the lower esophageal sphincter (15.0 mm Hg and 21.5 mm Hg), and pressure of the esophageal body (78.0 mm Hg and 70.0 mm Hg). There were differences comparing the pre and post operative period in the pHmetrical findings in the following items: total number of acid refluxes (68.0 and 3.0), total number of acid refluxes more than 5 minutes (2.0 and 0.0), acid reflux more than 5 minutes in supine position (1.0 and 0.0), acid reflux more than 5 minutes in upright position (0.0 and 0.0), acidification period (5.5 and 0.1 min), DeMeester score (33.0 and 0.8). CONCLUSIONS: The esophageal manometry and pHmetry findings were improved in the post operative period with statistical significance when compared to the pre operative period. The exams were considered efficient in the evaluation of the surgical procedure.
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    High-Resolution Manometry Classifications for Idiopathic Achalasia in Patients with Chagas' Disease Esophagopathy
    (Springer, 2014-02-01) Vicentine, Fernando P. P. [UNIFESP]; Herbella, Fernando A. M. [UNIFESP]; Allaix, Marco E.; Silva, Luciana C. [UNIFESP]; Patti, Marco G.; Universidade Federal de São Paulo (UNIFESP); Univ Chicago
    Idiopathic achalasia (IA) and Chagas' disease esophagopathy (CDE) share several similarities. the comparison between IA and CDE is important to evaluate whether treatment options and their results can be accepted universally. High-resolution manometry (HRM) has proved a better diagnostic tool compared to conventional manometry. This study aims to evaluate HRM classifications for idiopathic achalasia in patients with CDE.We studied 98 patients: 52 patients with CDE (52 % females, mean age, 57 +/- 14 years) and 46 patients with IA (54 % females; mean age 48 +/- 19 years). All patients underwent a HRM and barium esophagogram.The Chicago classification was distributed in IA as Chicago I, 35 %; Chicago II, 63 %; and Chicago III, 2 %, and in CDE as Chicago I, 52 %; Chicago II, 48 %; and Chicago III, 0 % (p = 0.1, 0.1, and 0.5, respectively). All patients had the classic Rochester type. CDE patients had more pronounced degrees of esophageal dilatation (p < 0.002). the degree of esophageal dilatation did not correlate with Chicago classification (p = 0.08). in nine (9 %) patients, the HRM pattern changed during the test from Chicago I to II.Our results show that (a) HRM classifications for IA can be applied in patients with CDE and (b) HRM classifications did not correlate with the degree of esophageal dilatation. HRM classifications may reflect esophageal repletion and pressurization instead of muscular contraction. the correlation between manometric findings and treatment outcomes for CDE needs to be answered in the near future.
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    High-resolution Manometry Findings in Patients After Sclerotherapy for Esophageal Varices
    (Korean Soc Neurogastroenterology & Motility, 2016) Herbella, Fernando Augusto Mardiros [UNIFESP]; Colleoni, Ramiro [UNIFESP]; Bot, Luiz [UNIFESP]; Vicentine, Fernando Pompeu Piza [UNIFESP]; Patti, Marco G.
    Background/Aims Endoscopic therapy for esophageal varices may lead to esophageal dysmotility. High-resolution manometry is probably the more adequate tool to measure esophageal motility in these patients. This study aimed to evaluate esophageal motility using high resolution manometry following eradication of esophageal varices by endoscopic sclerotherapy. Methods We studied 21 patients (11 women, age 52 [45-59] years). All patients underwent eradication of esophageal varices with endoscopic sclerotherapy and subsequent high resolution manometry. Results A significant percentage of defective lower esophageal sphincter (basal pressure 14.3 [8.0-20.0] mmHg
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    Manometria De Alta Resolução Da Faringe E Do Esfíncter Esofagiano Superior Em Pacientes Submetidos À Aplicação De Toxina Botulínica Em Músculo Tireoaritenoideo
    (Universidade Federal de São Paulo (UNIFESP), 2018-12-20) Mororo, Welber Chaves [UNIFESP]; Biase, Noemi Grigoletto De [UNIFESP]; Fernandes, Fernando Augusto Mardiros Herbella [UNIFESP]; http://lattes.cnpq.br/4035568020554599; http://lattes.cnpq.br/3156326658988323; http://lattes.cnpq.br/5228061414625509; Universidade Federal de São Paulo (UNIFESP)
    Objective: To Evaluate The Motor Function Of The Pharynx And Upper Esophageal Sphincter In Patients Submitted To The Application Of Botulinum Toxin Type A In Thyroaritenoid Muscle Under The Light Of High-Resolution Manometry. Method: Twenty Female Patients With An Injection Of Botulinum Toxin In The Thyroarytenoid Were Studied Prospectively, With A Mean Age Of 61.9 Years. The High-Resolution Manometry Was Performed Before And After The Injection (7th To 14th Day) And Its Parameters In Topography Of Palatine Veil, Epiglottis And Upper Esophageal Sphincter Were Recorded. A Quality Of Life Questionnaire Was Used In Dysphagia To Divide The Sample Into Groups. Results: 11 (55%) Individuals Had Worse Quality Of Life. In The Analysis Of The Whole Sample, As Well As In Each Of The Two Groups, There Was An Increase In The Residual Pressure Of The Upper Esophageal Sphincter (P = 0.0012) And The Time Between Onset Of Pharyngeal Contraction In Topography Of The Palatine Veil And Relaxation Of The Esophageal Sphincter (P
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    Motilidade esofágica após derivação gástrica em Y-de-Roux para obesidade mórbida: achados à manometria de alta resolução
    (Colégio Brasileiro de Cirurgia Digestiva, 2013-01-01) Cassão, Bruna Dell'acqua [UNIFESP]; Herbella, Fernando Augusto Mardiros [UNIFESP]; Silva, Luciana C. [UNIFESP]; Vicentine, Fernando Pompeu P. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: Bariatric operations may alter esophageal motility; however, there is a paucity of studies of the esophageal motility with high resolution manometry. AIM: To study patients after Roux-en-Y gastric bypass for morbid obesity with high resolution motility. METHODS: Were included 18 asymptomatic patients (17 women, mean age 53 years) after undergoing to Roux-en-Y gastric bypass for morbid obesity. All patients underwent high resolution motility after a mean follow-up of three years after the operation. RESULTS: The mean pressure of the lower esophageal sphincter was 18±13 (range 0-51) mmHg. Seven (39%) patients had a hypotonic sphincter and one (5%) hypertonicity. Sphincter relaxation was abnormal in one patient. Total and abdominal lower esophageal sphincter length was 4±1 (1-7) cm e 2±1 (0-3) cm, respectively. Esophageal body distal amplitude (average measurements at 3 and 7 cm above the lower esophageal sphincter) was 77±22 (40-120) mmHg. One (5%) patient had hypocontractility. Peristaltic waves were found in 95±0% (60-100). The upper esophageal sphincter basal pressure was 118±82 (33 - 334) mmHg; one (5%) patient (5%) had a hypotonic upper sphincter and eight (44%) hypertonicity. CONCLUSION: After gastric bypass in Roux-en-Y occurs significant lower esophageal sphincter hypotonia and upper esophageal sphincter hypertonia.
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    Motilidade esofágica, sintomas, resultado alimentar e perda de peso após derivação gástrica em Y-de-Roux
    (Colégio Brasileiro de Cirurgia Digestiva, 2013-06-01) Valezi, Antonio Carlos; Herbella, Fernando [UNIFESP]; Mali-junior, Jorge; Marson, Antonio Cesar; Biazin, Claudio Clementino Camacho; Universidade Estadual de Londrina Departamento de Cirurgia; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Londrina Hospital Universitário
    BACKGROUND: Abnormal manometry findings can be found in the obese population. It is controversial if the manometry should be used to choose the adequate operation or if the motility status could predict symptomatic outcomes. AIM: To correlate the esophageal motility with postoperative symptoms, alimentary outcome and weight loss after Roux-en-Y gastric bypass. METHODS: One hundred and fourteen patients were submitted to the operation and were prospectively studied. They had no GERD symptoms or diseases that might interfere with esophageal motor function. One year after surgery patients were interviewed regarding current symptoms and eating habits. RESULTS: Excess weight loss was 66.2 %. Sixty (52.6%) patients had an abnormal manometry. Hypertensive lower esophageal sphincter was found in 18 (16%) patients and hypotonic sphincter in 31 (27%). Dumping syndrome was mentioned by 27 (23.6%) patients and 21 (18.4%) complained of regurgitation. Excellent, good, moderate and poor alimentary outcome was present in 32 (28%), 31 (27.2%), 39 (34.2%), 12 (11.6%) patients, respectively. Sphincter pressure and esophageal amplitude did not correlate with excess weight loss. Its average was significantly higher for patients with hypertensive esophageal amplitude. Regurgitation was more frequent in patients with a hypotensive sphincter. There is no correlation between dumping and sphincter pressure status; between dumping or regurgitation and esophageal amplitude; between alimentary outcomes and sphincter pressure status or esophageal amplitude. CONCLUSION: Esophageal manometry before Roux-en-Y gastric bypass is of limited clinical significance.
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    Novas técnicas ambulatoriais para avaliação da motilidade esofágica e sua aplicação no estudo do megaesôfago
    (Colégio Brasileiro de Cirurgiões, 2008-06-01) Herbella, Fernando A. M. [UNIFESP]; Del Grande, José Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Brazilian surgeons deal routinely with esophageal motility disorders, because achalasia is highly prevalent in Brazil due to Chagas' disease. In the last years new technologies for the evaluation of esophageal motility became available. High resolution manometry and the combination of barometric parameters and intraluminal impedance are the new frontiers on this topic. The authors reviewed current, national and international, literature about achalasia with multichannel intraluminal impedance and high resolution manometry studies. The new technologies described are promising, however few studies have been published and further studies are still expected for achalasia patients.
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    Pelvic floor muscle training to improve urinary incontinence in young, nulliparous sport students: a pilot study
    (Springer, 2012-08-01) Da Roza, Thuane; Araujo, Maita Poli de [UNIFESP]; Viana, Rui; Viana, Sara; Jorge, Renato Natal; Bo, Kari; Mascarenhas, Teresa; Univ Porto; Universidade Federal de São Paulo (UNIFESP); Univ Fernando Pessoa; Norwegian Sch Sport Sci
    Urinary incontinence (UI) is prevalent in sport students. We hypothesized that pelvic floor muscle training (PFMT) can improve pelvic floor muscle (PFM) strength and symptoms of UI in this group of physically active women.Sixteen sport students with UI participated in this pre-post test pilot study. However, only seven of them, mean age 20.0 +/- 0.8 years, completed the 8-week program. Activity level was measured by the International Physical Activity Questionnaire-Short Form (IPAQ-SF). the outcome measure was the International Consultation on Incontinence Questionnaire-Short Form (ICIQ UI SF). PFM strength was measured by manometry as maximum voluntary contraction (MVC).Vaginal resting pressure improved by 17.4 cmH(2)O (SD 6.7), p = 0.04 and MVC by 16.4 cmH(2)O (SD 5.8), p = 0.04. ICIQ UI SF score, frequency, and amount of leakage showed statistically significant improvement.PFMT increased PFM strength and reduced frequency and amount of UI episodes in sport students that completed an 8-week PFMT program. Randomized controlled trials are warranted to confirm these results.
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    A pictorial presentation of esophageal high resolution manometry current parameters
    (Colegio Brasileiro Cirurgia Digestiva-Cbcd, 2017) Lafraia, Fernanda M. [UNIFESP]; Herbella, Fernando A. M. [UNIFESP]; Kalluf, Julia R. [UNIFESP]; Patti, Marco G.
    Introduction: High resolution manometry is the current technology used to the study of esophageal motility and is replacing conventional manometry in important centers for esophageal motility with parameters used on esophageal motility, following the Chicago Classification. This classification unifies high resolution manometry interpretation and classifies esophageal disorders. Objective: This review shows, in a pictorial presentation, the new parameters established by the Chicago Classification, version 3.0, aimed to allow an easy comprehension and interpretation of high resolution manometry. Methods: Esophageal manometries performed by the authors were reviewed to select illustrative tracings representing Chicago Classification parameters. Results: The parameters are: Esophagogastric Morphology, that classifies this junction according to its physiology and anatomy
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    Posterior sagittal anorectoplasty in anorectal anomalies: clinical, manometric and profilometric evaluation
    (Associação Paulista de Medicina - APM, 2007-05-01) Vital Junior, Pedro Felix [UNIFESP]; Martins, Jose Luiz [UNIFESP]; Peterlini, Fábio Luís [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT AND OBJECTIVE: Anorectal malformations comprise a spectrum of anomalies that continue to be difficult to treat, even today. The aim was to evaluate the fecal continence of children who underwent posterior sagittal anorectoplasty due to anorectal malformations, via computerized anorectal manometry and profilometry. DESIGN AND SETTING: Prospective study at Universidade Federal de São Paulo (UNIFESP). METHOD: 82 patients (56.1% boys; 43.9% girls) of mean age 85.5 months were evaluated. They were divided into continent, partially continent and incontinent groups. Age, sex, manometric variables and profilometric parameters were studied. The results were statistically analyzed. RESULTS: Among the 82 patients, 37.8% were continent, 25.6% were partially continent and 36.6% were incontinent. The overall mean resting pressure was 22 mmHg, and the means for the continent, partially continent and incontinent groups were, respectively, 30.7 mmHg, 23 mmHg and 14.7 mmHg. The overall mean pressure response to voluntary contraction was 56 mmHg, and the means for the groups were 65.4 mmHg, 55.8 mmHg and 46.6 mmHg, respectively. The rectosphincteric reflex was absent in 82.9% of the cases. In the profilometry analysis for all patients together, blue (20 to 50 mmHg) and yellow (50 to 80 mmHg) were predominant, and there was a similar distribution for the continent and partially continent patients. However, among the incontinent patients, green (< 20 mmHg) and blue prevailed. CONCLUSIONS: Manometric and computerized profilometric analyses were an excellent method for postoperative evaluations on patients with intermediate and high anorectal anomalies, and for therapeutic planning.
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    Pressões do segmento faringoesofágico em diferentes tarefas fonatórias na manometria de alta resolução em cantores.
    (Universidade Federal de São Paulo (UNIFESP), 2018-11-08) Vaiano, Thays Cristina Garcia [UNIFESP]; Behlau, Mara Suzana [UNIFESP]; Herbella, Fernando [UNIFESP]; http://lattes.cnpq.br/4035568020554599; http://lattes.cnpq.br/2274436726620746; http://lattes.cnpq.br/5259159072433854; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Since air pressure provides energy for vocal fold vibration, the course of this pressure through the vocal tract is relevant to the study of vocal function. High-resolution manometry (HRM), a technology developed to measure esophageal intraluminal pressure using a catheter with a series of closely spaced sensors, represents a potential tool for measuring pharyngoesophageal phonation pressures. Methods: with HRM transnasal catheter in place, 12 (6 males, mean age 27) professional singers were asked to produce 4 different vocal tasks at low, medium and high vocal loudness: vowel /ae/, ascending 5 note scale, word /hey/ and word /go/. Pressures were measured at pharynx, upper esophageal sphincter (UES) and thorax. Results: Thoracic pressures are higher during vocalization than at rest and as vocal loudness increase, so does the pressure. Pressures at the UES do not increase significantly during vocalization, but muscle bundle recruitment differs according to vocal loudness. The pharynx does not present a linear pressure increment following an increase in vocal loudness. Pharyngoesophageal pressure magnitude does not change significantly among different vocal tasks. Conclusions: HRM is a valuable tool for measuring pharyngoesophageal pressures during phonation. Different from the UES and pharynx, thoracic pressures are higher during phonation than at rest and tend to increase with vocal loudness increment. The phonatory task nature does not significantly interfere with the pressure magnitude of the pharyngoesophageal segment. The topographic plot provides additional data about the physiology of phonation, especially at the UES region.
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    Reconstituição da válvula ileocecal em cães
    (Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2005-02-01) Maegawa, Felipe Antonio Boff; Souza, José Antônio De; Araújo, Edevard José De; Koh, Ivan Hong Jun [UNIFESP]; Acampora, Armando José D'; Farias, Débora Cadore De; Mengarda, Jackson; Volpato, Daniel; Silva, Luis Gustavo Ferreira Da; Córdova, Cleta Selva De; Universidade Federal de Santa Catarina Hospital Universitário; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: The importance of keeping the ileocecal valve in the intestinal ressections has been reported by several authors. When preserved, the ileocecal valve was related to a longer survival and prevention of the short bowel syndrome, due to its ability to block the colonic content reflux into the ileum and to avoid the rapid empting of the ileal content into the cecum. It was assessed a tecnique of ileocecal valve reconstitution, based on vesicoureteral anti-reflux tecniques. METHODS: Fourteen beagles were operated. Seven underwent ileocecal valve reconstitution following the tecnique proposed and in the other seven a simple end-to-end anastomosis was performed. To assess the new valve, it was done the clinical follow up, the microbiologic analysis and the manometric study. RESULTS: Clinically, during 45 days of follow up, there was no difference between the dogs with and without ileocecal reconstitution. In the aerobic bacteria analysis, the predominant bacterium was Escherichia coli. Quantitatively, the cultures grew in an irregular way, so that it was not able to compare the bacterial growth between the groups with or without ileocecal valve. The new valve had a colo-ileal reflux pressure similar to that of the physiological valve (P>0.05). However, when compared to the non valve group, the reflux pressures of the physiological valve and new valve were significantly higher, with P<0.05 and P<0.001, respectively. CONCLUSION: In this study, the reconstituted ileocecal valve served as a barrier to the colo-ileal reflux just as the physiological valve does.