72 results match your criteria: "Hospital do Servidor Público Estadual - IAMSPE[Affiliation]"

Peritoneal chemotherapy delivery systems for ovarian cancer treatment: systematic review of animal models.

Front Oncol

January 2025

Departamento de Radiologia e Oncologia, Comprehensive Center for Precision Oncology (C2PO), Centro de Investigação Translacional em Oncologia (CTO), Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo (HCFMUSP), Sao Paulo, SP, Brazil.

Introduction: Intraperitoneal chemotherapy for ovarian cancer treatment has controversial benefits as most methodologies are associated with significant morbidity. We carried out a systematic review to compare tumor response, measured by tumor weight and volume, between intraperitoneal chemotherapy delivered via drug delivery systems (DDSs) and free intraperitoneal chemotherapy in animal models of ovarian cancer. The secondary aim was to assess the toxicity of DDS-delivered chemotherapy, based on changes in animal body weight.

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Article Synopsis
  • The study aimed to establish clear cutoff points for low, intermediate, and high doses of norepinephrine (noradrenaline), a key vasopressor in intensive care, to better assess patient mortality linked to cardiovascular support.
  • Researchers analyzed data from over 8,000 ICU patients in Finland and validated the findings with a larger dataset from the U.S., focusing on the highest norepinephrine doses administered within the first 24 hours.
  • The identified dose ranges were low (<0.2 μg/kg/min), intermediate (0.2-0.4 μg/kg/min), and high (>0.4 μg/kg/min), with increasing mortality rates correlating with higher doses, demonstrating a significant relationship between norepine
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Asbestos was largely used in Brazil. It is a mineral that induces pleural and pulmonary fibrosis, and it is a potent carcinogen. Our objective was to develop recommendations for the performance of adequate imaging tests for screening asbestos-related diseases.

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Cordotomy for pain control and opioid reduction in cancer patients: A cancer center 11-year experience.

Eur J Surg Oncol

October 2024

Postgraduate Program in Health Sciences, Instituto de Assistência Mêdica ao Servidor Público Estadual (IAMSPE), São Paulo, Brazil; Pain Department, AC Camargo Cancer Center, São Paulo, Brazil; Neurosurgery Department, Hospital do Servidor Público Estadual, São Paulo, Brazil.

Background: Percutaneous lateral cervical cordotomy (PLCC) is a treatment option for predominantly nociceptive pain of oncological origin that is refractory to conservative methods, with unilateral distribution, particularly in the lower trunk or lower limbs of patients with a life expectancy of less than one year.

Objective: The aim of this study was to assess the analgesic efficacy and opioid utilization alteration in patients undergoing PLCC.

Methods: We retrospectively collected data from patients undergoing PLCC between 2011 and 2021 at the AC Camargo Cancer Center in São Paulo, Brazil.

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Hemostasis plays a critical role in surgical procedures and is essential for a successful outcome. Advances in hemostatic agents offer new approaches to controlling bleeding thereby making surgeries safer. The appropriate choice of these agents is crucial.

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Autologous blood transfusion can be achieved through different techniques, including by the patient donating blood before surgery (pre-deposit), collecting blood from the patient immediately before the operation and replacing the volume with colloids or plasma expanders (acute normovolemic hemodilution) or through the salvage of lost blood, during or immediately after surgery, and its retransfusion after washing (intraoperative or postoperative recovery). We will focus on the two methods used intraoperatively that are of fundamental importance in the management and conservation of the patient's own blood.

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The use of strategies to reduce blood loss and transfusions is essential in the treatment of surgical patients, including in complex cardiac surgeries and those that use cardiopulmonary bypass. Antifibrinolytics, such as epsilon-aminocaproic acid (EACA) and tranexamic acid (TXA), are widely used in these procedures, as well as in other types of surgeries. These medicines are included in the World Health Organization (WHO) list of 'essential medicines'.

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The management of major bleeding is a critical aspect of modern healthcare and it is imperative to emphasize the importance of applying Patient Blood Management (PBM) principles. Although transfusion support remains a vital component of bleeding control, treating severe bleeding goes beyond simply replacing lost blood. A more comprehensive, multidisciplinary approach is essential to optimize patient outcomes and minimize the risks associated with excessive transfusions.

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Patient Blood Management (PBM) is a holistic approach to managing blood as a resource of each patient; it is a multimodal strategy that is implemented using a set of techniques that can be applied in individual cases. In fact, the overall result of the implementation of PBM cannot be fully appreciated or explained by simply summing up the effects of the individual strategies and techniques used, since they can only produce the expected ideal result if combined. Implementing a PBM program in healthcare offers several benefits including improved patient safety, better outcomes, cost savings, conservation of resources, evidence-based practice, transfusion alternatives, improved quality of care, compliance with accreditation standards, patient-centered care, and professional education and training.

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Cervical dorsal rhizotomy for upper limbs spasticity. Case report.

Acta Neurochir (Wien)

March 2024

Health Sciences Post-Graduation Program, Instituto de Assistência Médica ao Servidor Público Estadual - IAMSPE, São Paulo, Brazil.

Spasticity is a prevalent symptom of upper motor neuron syndrome, becoming debilitating when hindering voluntary movement and motor function and causing contractures and pain. Functional neurosurgery plays a crucial role in treating severe spasticity. Despite extensive literature on SDR for lower limb spasticity, there is a scarcity of papers regarding the procedure in the cervical region to alleviate upper limb spasticity.

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Managing the patient's blood and hematopoietic system is like managing any of the other organs and organ systems during patient care. Specialists control the heart, kidneys, endocrine system, etc. and the patient's blood requires similar clinical treatment.

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Patient Blood Management (PBM) is a multidimensional approach that seeks to optimize the use of blood and its components in patients. This matter emerged as a response to the need to reduce unnecessary exposure to blood transfusions and their potential risks. In the past, blood transfusion was often overused resulting in complications and high costs.

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The role of sphenoid bone in basilar invagination pathophysiology.

Neurosurg Rev

December 2023

Health Sciences Post-Graduation Program, Instituto de Assistência Médica ao Servidor Público Estadual - IAMSPE, Av. Ibirapuera, 91. 2nd Floor, Vila Clementino, São Paulo, SP, 04029-000, Brazil.

Basilar invagination (BI) is characterized by rostral dislocation of the cervical spine toward the skull base. The craniometrics of the skull base have shown significant differences among craniocervical junction malformations. The sphenoid bone is the center of the skull base; however, no study has evaluated this bone in cases of BI.

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Background: The effects of hernia repair on testicular function remain uncertain, regardless of the technique used. Studies that analyze testicular volume and flow after hernia repair or hormonal measurements are scarce and show contradictory results. This study aimed to evaluate the impact of bilateral inguinal hernia repair on male fertility in surgical patients in whom the Lichtenstein and laparoscopic transabdominal preperitoneal (TAPP) techniques were used.

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Article Synopsis
  • - Endometriosis is a chronic condition affecting women of reproductive age, often treated with hormone therapy to manage lesions.
  • - A study examined 330 patients on estrogen-progestin and progestin treatments, revealing that almost 54% discontinued their medication, with a higher risk linked to combined contraceptives.
  • - Key side effects leading to treatment discontinuation included ongoing pain, weight gain, and spotting, highlighting the challenges patients face with these therapies.
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Impact of the COVID-19 pandemic on the breast cancer early diagnosis program in Brazil.

Prev Med Rep

April 2023

CEDEP - Instituto de Assistência Médica ao Servidor Público Estadual (IAMSPE), Sao Paulo, Brazil.

During the COVID-19 pandemic, several screening exams were postponed, including mammograms. The aim of this study was to evaluate the impact of COVID-19 in mammographic screening in Brazil, considering 2015 to 2021. This was descriptive ecologic study based on the retrospective data of Brazil's mammographic screening program.

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Objective: To compare the measured odontoid tip violation above Chamberlain's line described in the literature to diagnose basilar invagination (BI) and to establish the normal placement of the dens tip defining individuals without BI (normal subjects).

Methods: A systematic literature review was performed to identify clinical or radiological studies that expressed the amount of odontoid violation above Chamberlain's line in patients with a BI diagnosis. In addition, a meta-analysis was performed to evaluate normal subjects' values of Chamberlain's line violation (CLV).

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Objective: This study aims to evaluate the impact of the Pink October Campaign on the increase in mammographic screening in Brazil.

Study Design: Ecological observational study, based on retrospective data.

Methods: Brazilian national screening database (DATASUS/SISMAMA/Information System on Breast Cancer) was used as a data source and is publicly available for download and analysis.

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Much More Than Just Women: Wonder Women.

Arq Bras Cardiol

August 2022

Pós-Graduação em Ciências da Saúde, Instituto de Assistência Médica do Servidor Público Estadual (IAMSPE), São Paulo, SP - Brasil.

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Intracapsular Femoral Neck Fractures in the Elderly.

Rev Bras Ortop (Sao Paulo)

June 2022

Serviço de Ortopedia e Traumatologia, Hospital do Servidor Público Estadual de São Paulo, Instituto de Assistência Médica ao Servidor Público Estadual (Iamspe), São Paulo, SP, Brasil.

Currently, intracapsular femoral neck fracture (IFNF) is still a great challenge for orthopedists. In spite of the progress that has been made, a high mortality rate persists in the first year, especially in Brazil, where there is no awareness that such fractures in elderly patients should be treated as a medical emergency. The present article seeks to provide an update on the preoperative, surgical, and postoperative approaches.

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Background: Cleaning workers represent a significant proportion of the active population worldwide, with poor remuneration, particularly in developing countries. Despite this, they remain a relatively poorly studied occupational group. They are constantly exposed to agents that can cause symptoms and respiratory problems.

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PERCUTANEOUS ENDOSCOPIC LUMBAR INTERBODY FUSION: RESULTS OVER 47 MONTHS OF FOLLOW-UP.

Acta Ortop Bras

January 2022

. Instituto de Assistência Médica ao Servidor Público Estadual (IAMSPE), Postgraduate Program, São Paulo, SP, Brazil.

Introduction: This study aims to investigate the clinical-functional results of a new surgical technique, Percutaneous Endoscopic Lumbar Interbody Fusion (PELIF), in patients with a clinical diagnosis of low back or sciatic pain and segmental instability who were submitted to surgery using this technique assisted by the attending physician.

Materials And Methods: Patients completed a consent form and were clinically and radiographically re-assessed by independent evaluators using the visual analog scale (VAS) for pain, the Oswestry Disability Index (ODI), and the SF-36 Quality of Life Score in the pre- and postoperative periods. Their medical records were also reviewed for surgical time, length of hospital stay, need for blood transfusion, return to work, and radiographic fusion evaluation.

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