F Galas
University of São Paulo
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Featured researches published by F Galas.
Annals of Oncology | 2010
Ludhmila Abrahão Hajjar; Thais Mauad; F Galas; Anand Kumar; L. F. F. da Silva; Marisa Dolhnikoff; T. Trielli; João Alberto Pinheiro Pereira Almeida; M. R. L. Borsato; E. Abdalla; L. Pierrot; R. Kalil Filho; Joc Auler; P. H. Saldiva; Paulo M. Hoff
Background: The natural history and consequences of severe H1N1 influenza infection among cancer patients are not yet fully characterized. We describe eight cases of H1N1 infection in cancer patients admitted to the intensive care unit of a referral cancer center. Patients and methods: Clinical data from all patients admitted with acute respiratory failure due to novel viral H1N1 infection were reviewed. Lung tissue was submitted for viral and bacteriological analyses by real-time RT-PCR, and autopsy was conducted on all patients who died. Results: Eight patients were admitted, with ages ranging from 55 to 65 years old. There were five patients with solid organ tumors (62.5%) and three with hematological malignancies (37.5%). Five patients required mechanical ventilation and all died. Four patients had bacterial bronchopneumonia. All deaths occurred due to multiple organ failure. A milder form of lung disease was present in the three cases who survived. Lung tissue analysis was performed in all patients and showed diffuse alveolar damage in most patients. Other lung findings were necrotizing bronchiolitis or extensive hemorrhage. Conclusions: H1N1 viral infection in patients with cancer can cause severe illness, resulting in acute respiratory distress syndrome and death. More data are needed to identify predictors of unfavorable evolution in these patients.
Critical Care | 2010
Juliano J.P. Almeida; H Palomba; L Hajjar; V Torres; F Galas; Fa Duarte; D Nagaoka; Rosana Ely Nakamura; J Fukushima; L Yu
Fluid overload has recently been linked to adverse outcomes in critically ill patients, but its impact on the outcomes of cancer patients admitted to intensive care units (ICUs) has not been previously described.
BJA: British Journal of Anaesthesia | 2017
E.P.M. de Almeida; J.P. de Almeida; Giovanni Landoni; F Galas; J Fukushima; Evgeny Fominskiy; C.M.M. de Brito; Luciana Barrio Lara Cavichio; L.A.A. de Almeida; U. Ribeiro-Jr; E Osawa; M Pe Diz; Rebeca Boltes Cecatto; Linamara Rizzo Battistella; Ludhmila Abrahão Hajjar
Background Major abdominal oncology surgery is associated with substantial postoperative loss of functional capacity, and exercise may be an effective intervention to improve outcomes. The aim of this study was to assess efficacy, feasibility and safety of a supervised postoperative exercise programme. Methods We performed a single-blind, parallel-arm, randomized trial in patients who underwent major abdominal oncology surgery in a tertiary university hospital. Patients were randomized to an early mobilization postoperative programme based on supervised aerobic exercise, resistance and flexibility training or to standard rehabilitation care. The primary outcome was inability to walk without human assistance at postoperative day 5 or hospital discharge. Results A total of 108 patients were enrolled, 54 into the early mobilization programme group and 54 into the standard rehabilitation care group. The incidence of the primary outcome was nine (16.7%) and 21 (38.9%), respectively (P=0.01), with an absolute risk reduction of 22.2% [95% confidence interval (CI) 5.9-38.6] and a number needed to treat of 5 (95% CI 3-17). All patients in the intervention group were able to follow at least partially the exercise programme, although the performance among them was rather heterogeneous. There were no differences between groups regarding clinical outcomes or complications related to the exercises. Conclusions An early postoperative mobilization programme based on supervised exercises seems to be safe and feasible and improves functional capacity in patients undergoing major elective abdominal oncology surgery. However, its impact on clinical outcomes is still unclear. Clinical trial registration NCT01693172.
Critical Care | 2010
L Hajjar; F Galas; Juliano Pinheiro de Almeida; D Nagaoka; Fa Duarte; Rosana Ely Nakamura; C Simoes; R Kalil-Filho; Pm Hoff; Joc Auler
ICU admission of critically ill cancer patients was controversial until recently. In the past years, advances in the management of malignancies and organ failures have improved outcomes of patients, resulting in higher rates of survival in the ICU. The aim of this study is to prospectively evaluate the characteristics, short-term and mid-term outcomes of cancer patients requiring intensive care.
Critical Care | 2001
F Galas; Joc Auler
Pressure-controlled ventilation (PCV), is related to a better distribution of the inhaling flow and lower pressure peaks, when compared to volume-controlled ventilation (VCV). Nitric oxide (NO) promotes redistribution of blood flow to the ventilated areas and decreases the pulmonary shunt effect improving oxygenation.
Critical Care | 2011
João Alberto Pinheiro Pereira Almeida; F Galas; Jl Vincent; J Fukushima; Rosana Ely Nakamura; R. Kalil Filho; Fabio Biscegli Jatene; Joc Auler; L Hajjar
Red blood cell (RBC) transfusion is associated with a higher occurrence of clinical complications after cardiac surgery. However, the cause-effect relationship is confounded by other risk factors for worse outcomes as advanced age, valve or combined procedure, high EuroSCORE, redo surgery, longer bypass time and previous anemia. The objective of this study was to evaluate the effect of RBC transfusion in a propensity score-matched case-control analysis.
Critical Care | 2011
L Hajjar; Henrique Palomba; J Almeida; J Fukushima; Rosana Ely Nakamura; F Galas; V Torres; R. Kalil Filho; L Yu
Acute kidney injury (AKI) in cancer patients is a complication that causes substantial morbidity and mortality.
Archive | 2007
F Galas; Ludhmila Abrahão Hajjar; J Auler
Cardiovascular events are considered the main cause of death in the perioperative period. The most important events are acute myocardial infarction (MI), unstable angina, cardiac failure, severe arrhythmias, nonfatal cardiac arrest, and death. Patients experiencing an MI after noncardiac surgery have a hospital mortality rate of 15–25% [1, 2], and nonfatal perioperative MI is an independent risk factor for cardiovascular death and nonfatal MI during the 6 months following surgery. Patients who have a cardiac arrest after noncardiac surgery have a hospital mortality rate of 65%, and nonfatal perioperative cardiac arrest is a risk factor for cardiac death during the 5 years following surgery [3, 4]. The objectives of preoperative evaluation are: (a) performing an evaluation of the patient’s current medical status; (b) making recommendations concerning the evaluation, management, and risk of cardiac problems over the entire perioperative period; and (c) providing a clinical risk profile that the patient, primary physician, anesthesiologist, and surgeon can use in making treatment decisions that may influence short- and long-term outcomes. No test should be performed unless it is likely to influence patient treatment [5]. The cost of risk stratification cannot be ignored. Accurate estimation of a patient’s risk for postoperative cardiac events (MI, unstable angina, ventricular tachycardia, pulmonary edema, and death) after surgery can guide allocation of clinical resources, use of preventive therapies, and priorities for future research.
Arquivos Brasileiros De Cardiologia | 2011
R. Kalil Filho; L Hajjar; Fernando Bacal; Paulo M. Hoff; M del P Diz; F Galas
Critical Care | 2009
Ludhmila Abrahão Hajjar; T Yamaguti; F Galas; R. Kalil Filho; Marilde de Albuquerque Piccioni; Joc Auler