Biomedical subjects

Benedicto Oscar Colli

Publications and source records attributed to Benedicto Oscar Colli.

11 recordsLinked to original sources

PubMed2026

Short-term safety of dual versus single antiplatelet therapy in flow diversion for distal intracranial aneurysms: results from the DART trial.

BACKGROUND AND PURPOSE: Flow diverters (FDs) have become one of the primary treatments for intracranial aneurysms (IAs). However, their use in distal IA has been associated with higher complication rates compared with other techniques. The development of coated FDs, in combination with novel antiplatelet regimens, offers promising strategies to improve the safety profile of FDs in this context. This trial aimed to compare mono antiplatelet therapy (MAPT) using prasugrel versus dual antiplatelet therapy (DAPT) with aspirin and prasugrel for the treatment of distal IA using the p48 MW HPC FD (WallabyPhenox). METHODS: This was a multicenter, prospective, parallel-group, single-blind, non-inferiority randomized trial. Between February 2021 and February 2025, 140 patients were enrolled. After excluding 11 patients, 129 were included in the final analysis. The primary endpoint was the absence of new neurological deficits, defined as no shift in the modified Rankin Scale (mRS) score. The secondary endpoint was the incidence of any stroke. RESULTS: At the 30-day follow-up, 66 patients (98.5%) in the MAPT group and 59 patients (95.2%) in the DAPT group showed no new neurological deficits. With a predefined non-inferiority margin of 5%, the difference of 3.35% confirmed the non-inferiority of MAPT compared with DAPT (p=0.002). The incidence of any stroke was 4/67 (5.9%) in the MAPT group and 6/62 (9.6%) in the DAPT group (p=0.431). CONCLUSION: Prasugrel monotherapy for the treatment of distal IAs using the p48 MW HPC was non-inferior to DAPT within the first 30 days following treatment. CLINICAL TRIAL REGISTRATION: https://ensaiosclinicos.gov.br/rg/RBR-3q9zb73. UTN code: U1111-1290-2489. Research Ethics Committee of the Hospital das Clínicas de Ribeirão Preto - Universidade de São Paulo. CAAE number: 29848720.0.1001.5440.

Humans↗

PubMed2006

Midfacial translocation, a variation of the approach to the rhinopharynx, clivus and upper odontoid process.

OBJECTIVE: A surgical variation of the technique of facial translocation procedure is proposed, which has been called midfacial translocation for approach to the entire medial and lateral region of the middle third of the face, including the rhinopharynx, sphenoid sinus, pterygomaxillary fossa, odontoid process, and clivus. PATIENTS AND METHODS: The medical records of five treated patients accordingly were reviewed for an analysis of the surgical technique, the disease, the topography of the lesion, and the complications. RESULTS: The approach permitted ventral decompression of the bulbomedullary junction with resection of the C1 arch and the odontoid process in four patients and resection of a chordoma of the clivus located along the midline and extending intradurally in the fifth patient. Only one patient presented with dehiscence of the posterior half of the soft palate, this being the only complication observed following surgery in these patients. Three months postoperatively, no patient presented any aesthetic alteration of the face. Functionally, there was only infraorbital hypoaesthesia on the side of flap rotation. CONCLUSION: The technique of midfacial translocation provides both good surgical approach and access to the rhinopharynx, pterygomaxillary fossa, high odontoid process and clivus, with few adverse sequelae for the patient.

Chordoma↗

PubMed2006

Neurogenic thoracic outlet syndromes: a comparison of true and nonspecific syndromes after surgical treatment.

BACKGROUND: Neurogenic thoracic outlet syndrome (NTOS) is attributed to compression of the brachial plexus at the scalene hiatus. Patients with true NTOS (TNTOS) have typical clinical and electrophysiological changes and are considered to respond well to surgical treatment, but patients with nonspecific NTOS (NNTOS) have predominantly sensory signs, not well-defined electrophysiological changes, and are thought not to respond favorably to surgical treatment. The postsurgical outcome of patients with cervicobrachialgia diagnosed as TNTOS and as NNTOS is analyzed. METHODS: Seven patients with typical electrophysiological features of TNTOS and 11 with nonspecific signs (NNTOS--extraspinal compression of C5-T1) were treated from 1986 to 2001. Age, duration of symptoms, and follow-up were similar in both groups. All patients underwent unilateral (14) or bilateral (4) supraclavicular decompression of the brachial plexus, for a total of 22 procedures. Clinical outcome was evaluated based on sensory and motor signs and on functional capacity. The Mann-Whitney U test and Fisher exact test were used to compare demographic data and proportions, respectively. RESULTS: Improvement of pain/paresthesias, sensory loss, atrophy, and muscular weakness after surgery was similar in the two groups. Regarding functional capacity, 57.1% of patients with TNTOS and 63.6% of patients with NNTOS became normal or reacquired their previous condition with slight limitation. Surgery-related complications were paresthesias and paresis in the arm, sympathetic dystrophy, pneumothorax, and lymphatic collections, all in patients with NNTOS. CONCLUSIONS: Patients with NNTOS with electrophysiological signs of extraspinal radicular impairment had the same chances of improvement after surgical treatment as patients with TNTOS.

Activities of Daily Living↗

PubMed2006

Parasagittal meningiomas: follow-up review.

BACKGROUND: Parasagittal meningioma is one that fills the parasagittal angle, with no brain tissue between the tumor and the SSS. Invasion of the SSS is a challenge for complete removal and, consequently, for recurrence of these tumors. The objective of this study was to analyze the factors that influenced the clinical outcome of patients with parasagittal tumors surgically treated. METHODS: Review of data on 53 patients with diagnosis of parasagittal meningiomas surgically treated from 1984 to 2004. Thirty-four (64.2%) were female and 19 (35.8%) were male; age ranged from 18 to 81 years old (mean, 54.98 +/- 5.80). Follow-up ranged from 2 to 261 months (mean, 93.71 +/- 68.45). The patients were operated on using microsurgical techniques. Tumors in the anterior third (9) or occluding the SSS (5) were removed with the sinus; tumors touching/pouching the SSS (20) were removed and its dural attachment coagulated; tumors invading one sinus wall (10) were removed with partial excision and reconstruction of the sinus wall, and tumors invading more than one sinus wall in the posterior two thirds of the SSS (7) had a subtotal removal. No attempt at sinus resection and reconstruction was performed for tumors placed in the posterior two thirds of the SSS. Analysis of the patient outcome was done using survival and RFS Kaplan-Meier curves. The chi(2), Fisher exact, log-rank, Mann-Whitney, and Kruskall-Wallis ANOVA tests were used for comparing demographic data, survival curves, proportions, and medians, respectively. RESULTS: Total and subtotal resection were achieved in 85% and 13.1%, respectively. Males had better survival than females (P = .0252). Total RF rates were 10%, 25%, and 100% at 5 years and 100%, 50%, and 100% at 10 years for patients with meningiomas WHO grades I, II, and III, respectively. The RF survival curve was better for patients with grade I meningioma (grades I vs II vs III, P = .0001). There was no difference between the RF survival curves according to age, histopathologic WHO grade, location along or invasion of the SSS, and extent of resection. Males (P = .0401), WHO grade I (P < .0001), total resection (P = .0139), and less sinus invasion (P = .0308) had better RFS curves. Operative, surgery-related, and overall mortality were 1.9%, 5.4%, and 26.4%, respectively. CONCLUSIONS: Recurrence of parasagittal meningiomas predominated in males, in grades II/III tumors, after subtotal resection, and with more invasion of the SSS. Subtotal or total resections without sinus resection were considered adequate for treating these patients.

Adolescent↗

PubMed2005

Central nervous system paracoccidioidomycosis: diagnosis and treatment.

BACKGROUND: Paracoccidioidomycosis (PCM) is a systemic mycosis caused by Paracoccidioides brasiliensis. The involvement of the central nervous system (CNS) in paracoccidioidomycosis is higher than previously thought and 2 clinical presentations have been reported, meningitis and pseudotumoral. METHODS: Twenty medical records of patients with CNS paracoccidioidomycosis treated from 1986 to 2003 were analyzed. The follow-up ranged from 1 to 18 years (mean = 8.9 +/- 4.2). RESULTS: Besides CNS paracoccidioidomycosis, all patients but one had the chronic systemic form and the pseudotumoral clinical presentation was the most frequent. Based on computed tomography scan findings, 4 image patterns were identified: low-density lesion with ring enhancement, lesion with calcification and ring enhancement, multiloculated low-density lesion with ring enhancement, and diffuse subarachnoid enhancement. The magnetic resonance imaging was performed in 3 patients and showed subarachnoid enhancement in 1 patient and heterogeneous lesion with ring enhancement in 2 patients. Eleven patients were submitted to medical treatment and 9 needed neurosurgical treatment; ventriculoperitoneal shunts in 4 patients, brain lesions resection in 3 patients, and partial resection of spinal cord lesions in 2 patients. Eleven patients had excellent outcome, 4 patients died, 3 are in good clinical condition with residual pulmonary dysfunction, and 1 patient was lost to follow-up. CONCLUSIONS: The diagnosis of paracoccidioidomycosis with involvement of the CNS is difficult and clinical suspicion is a key point to achieve the correct diagnosis. Patients with early diagnosis have a favorable outcome with clinical or surgical treatment.

Adult↗

PubMed2004

Surgical management of axis' traumatic spondylolisthesis (Hangman's fracture).

OBJECTIVE: To evaluate the results of surgical treatment using pedicle screws going through C2 pedicles for fixating the spondylolisthesis of the axis in patients who presented pseudoarthrosis after clinical treatment, or who have no condition for fixation with "halo vest", due to serious head trauma. METHOD: Ten patients have been operated from June 1998 to April 2002, nine suffering from traumatic spondylolisthesis of the axis caused by car accident and one horse fall. Four of those patients have undergone clinical treatment and presented signs of pseudoarthrosis, suffering intense pain at the movement of the cervical spine. Two of them presented moderate head trauma with multiple fractures of the skull. Another one was submitted to a surgical treatment for an acute extradural hematoma. Three patients presented a serious dislocation of C2 over C3. The patients were submitted to arthrodesis of the fractures with two screws, placed on the C2 pedicles, which allowed a better approximation of the fractures with the alignment of C2-C3. Two other patients required additional fixation with a plate on the lateral masses of C3. RESULTS: Nine patients had a good post surgery evolution with satisfactory consolidation of the fractures and disappearance of the symptoms. One patient had a good evolution but still has cervical pain resulting from strain. CONCLUSION: The fixation of the traumatic spondylolisthesis of the axis using screws in C2 pedicles and through fractures traces is a good option for treating patients who present pseudoarthrosis after clinical treatment or who present contraindication to the "halo vest", such as skull fracture or great lacerations in the scalp.

Adult↗

PubMed2004

Experimental microaneurysms in rats: I. Model for induction.

BACKGROUND: Small aneurysms (lesser than 2 mm) in humans called sessile, baby aneurysms, or microaneurysms, generally are not able to be clipped or to be coil-packed through endovascular route. Among the modalities of treatment that have been used for treating microaneurysms, bipolar coagulation and wrapping of the lesion are outstanding. Nevertheless, demonstration of the efficacy of these treatments is difficult because most reported experimental models for inducting aneurysms are complex and difficult to be reproduced. This study aimed to develop a simple and reproducible model for inducing microaneurysms. METHODS: Microaneurysms were induced using a mechanical lesion of the bifurcation of the aorta in 72 rats. Three groups of 10 animals were sacrificed 7, 14, and 21 days after the lesion and 2 groups (35 and 7 animals) after 30 days. The aortic bifurcation was macro/microscopically analyzed in the first 4 groups and a resistance test was applied in the fifth group. RESULTS: Microaneurysms occurred in 77.8% of cases. Microscopically, degenerative changes were observed in the intima, media, and adventitia and in the internal elastic lamina. The bursting pressure ranged from 368 to 1,472 mm Hg during the resistance test in the fifth group. CONCLUSIONS: The presented model of experimental microaneurysm induction is simple, reproducible and gives a high rate of positivity.

Aneurysm, Ruptured↗

PubMed2004

Experimental microaneurysms in rats: II. Comparison between cotton wrapping and microbipolar coagulation.

BACKGROUND: Microsurgical aneurysm clipping is considered the best treatment for intracranial aneurysms, but often it cannot be used for microaneurysms. These aneurysms may require different type of treatment like bipolar coagulation or wrapping to reinforce the aneurysm wall, but these treatments have no experimentally proven efficacy. In this study the authors analyze the efficacy of 2 methods of treatment to prevent rupture of experimentally induced microaneurysms. METHODS: Microaneurysms were induced using mechanical compression of the wall of the aortic bifurcation in 60 rats. The animals were divided in three groups according to aneurysm treatment: Group 1-aneurysms treated using microbipolar coagulation; Group 2-aneurysms wrapped with cotton, and Group 3-no treatment. Four weeks after the treatment, the resistance of the microaneurysm was tested applying intraluminal hyperpressure (up to 2,427 mm Hg). After that, the vessels were microscopically analyzed. RESULTS: No rupture of the aneurysms was observed in Group 2 and all aneurysms ruptured in Groups 1 and 3 during the resistance test. Comparison between the mean bursting pressure of Groups 1 and 3 showed no significant difference (Student's t test, p > 0.05). The probability of rupture of the microaneurysms was significantly different between Groups 1 and 2, favoring Group 2 (Fisher exact test, p < 0.001). CONCLUSIONS: Wrapping of experimental microaneurysms with cotton was effective to protect aneurysm rupture under hyperpressure; and there was no protection using microbipolar coagulation.

Aneurysm, Ruptured↗

PubMed2004

Galectin-3 as an immunohistochemical tool to distinguish pilocytic astrocytomas from diffuse astrocytomas, and glioblastomas from anaplastic oligodendrogliomas.

The distinction of astrocytomas and oligodendrogliomas, mainly pilocytic astrocytomas (PILOs) from infiltrating astrocytomas and oligodendrogliomas (ODs), and high-grade oligodendrogliomas from glioblastomas (GBMs), poses a serious clinical problem. There is no useful immunohistochemical (IHC) marker to differentiate these gliomas, and sometimes the differential diagnosis between them is arbitrary. We identified galectin-3 (Gal-3) as a possible tool to differentiate them based on gene expression profiles of GBMs. We confirmed the differential expression in 45 surgical samples (thirteen GBMs; seven PILOs; 5 grade II ODs; 5 anaplastic oligodendrogliomas [AODs], including 2 Oligo-astrocytomas; 8 diffuse astrocytomas [ASTs], and 7 non-neoplastic samples) by quantification of Gal-3 gene expression by real-time quantitative PCR (rt-PCR). Higher expression of Gal-3 was observed in GBMs and PILOs than in OD, AODs and ASTs. The IHC expression of Gal-3 was evaluated in 90 specimens (fifteen PlLOs, fourteen ASTs, 10 anaplastic astrocytomas, fifteen GBMs, eleven ODs, fifteen AODs, and 10 dysembryoplastic neuroepithelial tumors). The mean labeling score for Gal-3 determined according to the percentage of labeled cells in the tumor bulk was significantly different in GBMs versus AODs and in PILOs versus ASTs. Hence, Gal-3 is differentially expressed in central nervous system tumors, making IHC detection of Gal-3 a useful tool in distinguishing between these gliomas.

Adolescent↗

PubMed2003

Functional evaluation of temporary focal cerebral ischemia: experimental model.

OBJECTIVE: Despite cerebral ischemia being a frequent clinical pathologic state, the tolerance of neural tissue to oxygen absence and to reperfusion is controversial. This study aims to evaluate the effects of focal cerebral ischemia/reperfusion, by analyzing the mitochondrial respiration. METHOD: Sixty-four adult rats underwent focal cerebral ischemia by middle cerebral artery occlusion, during 15, 30 and 60 minutes, followed by 10 minutes or 19 hours of reperfusion. The effects of ischemia were analyzed measuring the O2 consumption by mitochondria in the ischemic and non-ischemic areas. RESULTS: There was compromise of the mitochondrial respiration after 30 and 60 minutes of ischemia, followed by 10 minutes of reperfusion but there was no alteration in this function after 19 hours of reperfusion. CONCLUSION: Compromise of the mitochondrial function occurred after 30 minutes of ischemia but, until one hour of ischemia, if the reperfusion was prolonged there was no evidence of ischemic/reperfusion injuries.

Animals↗

PubMed2003

Meningioma of the internal auditory canal: case report.

Meningiomas limited to the internal auditory canal (IAC) are rare. Acoustic neuroma is usually the diagnosis made when a tumor is found in this location because of its higher frequency. We report on a 58 year-old woman with a meningioma arising from the IAC and the difficulty to establish the pre-surgical diagnosis, based on clinical and radiological features. The perioperative suspicion and confirmation are very important to deal with the dura and bone infiltration in order to reduce tumor recurrence.

Diagnosis, Differential↗