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J Gama-Rodrigues

Publications and source records attributed to J Gama-Rodrigues.

49 records · Page 3Linked to original sources

[Comparison of the subjective global nutrition assessment x objective nutrition evaluation].

OBJECTIVE: Nutritional Assessment methods (ONA) are traditionally employed in hospitalized patients (anthropometry, laboratorial exams and immunological tests). The Subjective Global Assessment (SGA) estimates weight loss and changes in dietetic intake as being allegedly efficient for protein-caloric malnutrition diagnosis of the hospitalized adult. PURPOSE: Compare the efficacy of SGA against the traditional ONA. METHODS: The prospective study was done with 100 hospitalized patients from 3/90-5/90 at the Hospital Beneficência Portuguesa de São Paulo. The Detsky et al. questionnaire was applied besides anthropometric measurements (body weight, triceps skinfold thickness-TSF, mirdam circumference MCA) and laboratorial examinations (serun albumin, hemoglobin, peripheral blood lymphocytes) all of them in the first 3 days of admission. SGA always preceded ONA, and was always done by the same observer. RESULTS: There was a significant reduction on the average values of anthropometric and laboratorial measurements with the progressive worsening of nutritional status assessed by SGA. There were significant associations (p < 0.05) between hypoalbuminemia (< 3.5 g/dL) loss of TSF (< 10 mm) and MAC (< 23.3 cm) in those patients classified as moderately and severely malnourished by SGA (14%). Hypoalbuminemia, low TSF and SGA malnutrition were all significantly associated to mortality (p < 0.05). CONCLUSION: SGA in our hospital is a reliable diagnostic method for the diagnosis of malnutrition of hospitalized adult patients and malnutrition of hospitalized adult patients and keeps prognostic association with mortality.

Adult↗

[Total regression of advanced gastric lymphoma after drug therapy].

Primary gastric lymphoma is a relatively rare entity that may have several different methods of treatment, including surgery, chemotherapy and radiotherapy. We describe a case of advanced primary gastric lymphoma treated with chemotherapy. A 51-year-old male patient underwent total gastrectomy after two cycles of chemotherapy. The histologic examination of the gross specimen revealed total regression of the lymphoma. Literature review of this condition and a discussion about the diagnosis and treatment are presented.

Antineoplastic Combined Chemotherapy Protocols↗

[Pseudotumor of the stomach: study of 10 cases and review of the literature].

Pseudotumoral form of gastric ulcer is an infrequent clinical presentation of peptic disease. We present the findings in ten patients with this variety of gastric peptic ulcer treated in the last five years. All records including preoperative radiological and endoscopic examinations are reviewed. Five patients were women and five were men. The median age of patients was 62.1 years (range, 45 to 79 years). Epigastric pain was the main symptom in 90% of patients and weight loss in 70%. Six patients underwent surgical treatment. There was no perioperative mortality. A review of literature of this condition and a discussion about the differential diagnosis are presented.

Adult↗

[The laparoscopy method in preoperative evaluation of patients with malignant stomach neoplasm].

In 190 patients with malignant gastric neoplasia the value of laparoscopy for diagnosing intra-abdominal metastases was investigated. At the laparoscopic examination the presence of tumoral tissue was appraised on the serosal coat of the stomach, epiploons, parietal and visceral peritoneum, and in the liver. On hand of laparoscopic findings (peritoneal or hepatic metastases) the surgical treatment was discarded in 34 patients (70.6%). In the remaining 29.4% of patients a bad general condition or concomitant diseases contra-indicated surgical intervention. A comparison of laparoscopic and surgical findings showed that correct diagnosis was established by laparoscopy in 61.4% of cases with tumoral invasion of gastric serosa, in 21.4% of cases with involvement of epiploon, in 27% of parietal peritoneum, and in 33.3% of the liver. Falsely positive findings were rare (5% of examinations).

Adult↗

[Effect of nutritional support on survival of AIDS-IV C patients].

Fifty-two patients with AIDS-IV C (opportunistic infections) received nutritional supplementation, (enteral diets or total parenteral nutrition) in 60 admission episodes. Most patients had lost more than 10% of their ideal weight; albumin serum level was inferior or equal to 3.0 g/dl at admission in 33.3% of cases, and low serum albumin had a positive correlation with mortality (p less than 0.05%). Lean body mass, indirectly evaluated by 24 hour urinary creatinine excretion was less than 30% of the ideal in 44.7% of cases, and had a positive correlation with death rate. Enteral nutrition was given in 16.7% of episodes, total parenteral nutrition in 35% and in the remaining episodes the patient received only oral supplements. Patients that received TPN spent more time in hospital than patients with enteral nutrition (23.1 more or less 21.3 days against 7.2 more or less 4.8 days). Patients with AIDS IV C are usually undernourished, have low serum albumin and important deficit of lean body mass. Weight loss and low lean body mass are associated positively with mortality. Nutritional support had no influence on mortality rate.

AIDS-Related Opportunistic Infections↗

[Colectomy and anterior resection with a video-laparoscopic approach. Initial experience-results].

Laparoscopic procedures are rapidly advancing. Laparoendoscopic colectomy appears to be an option the treatment of colonic disease and is increasingly being performed in selected patients. The purpose of this study is to review our initial experience with the method which initiated in 1992. Thirty-three patients underwent laparoscopic resection of colorectal segment. All the patient, charts were assessed and data were obtained about the diagnosis, operation performed, complications, conversion and postoperative course. Diverticular disease was the most frequent (54.5%) indication of laparoscopic colorectal procedure in our series followed by adenocarcinoma (27.3%). Left colectomy was performed in 19 (57.6%) patients. Anastomosis followed double-stapling technique in most of them. Conversion to open procedure occurred in six (18.2%) cases. There were 4 complications associated to the method resulting in an specifíc morbidity of 12.1% in this series. There were no complications related to the anastomosis and no death occurred. Postoperative course was favorable for the patients and all could take oral liquids in the day after the procedure. Colorectal surgery performed by video-laparoscopic access is feasible, safe and benefits all patients. Conversion and morbidity in our series are similar to those shown in literature. It must, however, be indicated in a selected basis and in centers of reference for treatment of colorectal disease.

Adult↗

Gastric emptying of 99mTc tagged solid food in gastric and duodenal ulceration.

This study is to analyze gastric emptying (GE) of 99mTc tagged solid meals in 43 gastric ulcer (GU), 16 duodenal ulcer (DU) patients, and 15 normal subjects. Diagnosis of active ulcers had been made through high gastrointestinal endoscopy. The patients with GU were divided into three groups according to Johnson's classification. Gastric contents were measured at 15 minute intervals over a period of 150 minutes, with the person standing in front of a gamma-counter. The GE curve was obtained from the mean percentile of radioactivity of all the groups measured at 15 minute intervals. Results were submitted to statistical analysis. Significant delay in GE in DU patients compared to normals, type II and Type III group. However, GE of type I GU was not statistically different from the DU group nor of types II and III GU, occupying an intermediate e position.

Adult↗

Site of peptic ulcer. comparison of hydrochloric acid output, pepsinogen and gastrin serum levels.

BACKGROUND/AIMS: Basal (BAO) and maximum (PAO) hydrochloric acid output after Histalog stimulation, basal pepsinogen (SPL-B), at 60 (SPL-60) and at 90 minutes (SPL-90), and basal gastrin (BG) levels were measured and compared in different gastric (GU) and duodenal (DU) ulcer sites. MATERIAL AND METHODS: Fifty nine patients with peptic ulcer were grouped according to Johnson's classification for gastric ulcers: type I (15), type II (16) type III (12) GU and (16) DU. Fifteen normal subjects were studied as controls. RESULTS: The BAO was greater in the DU than in the control or GU groups. No significant difference was noted in the production of hydrochloric acid after stimulation with Histalog. The SPL-B, at 60 and at 90 minutes was higher in type II GU than in the DU group and controls. The SPL-60 was higher in type II GU patients than in type III GU. Basal gastrin was higher in group DU and types II and III GU compared to the type I GU patients and controls. CONCLUSION: The topographic criteria for differentiating peptic ulcers has low discrimination capacity based on comparison of mean values of HCl acid production, pepsinogen and gastrin serum levels both basal and after stimulation with Histalog due to heterogeneity of these variables in group studies. In these studies, peptic ulcers from different sites should not be grouped as distinct entities except for type II gastric ulcers.

Betazole↗

Squamous cell carcinoma of the pancreas with gastric metastasis. Case report.

The squamous cell carcinoma of the pancreas is an uncommon form of pancreatic cancer, with a frequency in the range of 0.5-3.5%. A rare case of a primary squamous cell pancreatic carcinoma, with gastric invasion and upper digestive bleeding, requiring surgical control is reported. The surgical technique to treat the bleeding is also detailed.

Aged↗