Omar Féres
University of São Paulo
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Featured researches published by Omar Féres.
BioMed Research International | 2014
Diego Oliveira Miranda; Taís Aparecida Soares de Lima; Lucas Ribeiro de Azevedo; Omar Féres; José Joaquim Ribeiro da Rocha; Gabriela Pereira-da-Silva
The objective of this study was to investigate whether serum cytokine levels correlate with depression and anxiety in colorectal cancer (CRC) patients. Twenty patients hospitalized for surgical resection of CRC were included in the study group and twenty healthy volunteers comprised the control group. Depression and anxiety were analyzed using the Hospital Anxiety and Depression Scale (HADS), and serum levels of IL-1β, IL-6, IL-8, IL-10, IL-12, TNF-α, and TGF-β were measured by Cytometric Bead Array. We found that more than half of CRC patients presented clinically significant levels of anxiety or depression, and 65% of them manifested a combination of severe anxiety and depression. CRC patients had increased serum levels of IL-1β, IL-6, IL-8, and TNF-α but lower IL-10 concentrations. Correlation analysis between HADS score and cytokine levels revealed a positive association of anxiety and/or depression with IL-1β, IL-6, IL-8, and TNF-α and a negative correlation with IL-10. These results indicate that circulating proinflammatory cytokines are involved in the pathophysiology of anxiety and depression in CRC patients. A better understanding of the molecular mechanisms involved in these psychological disorders will allow the design of therapeutic interventions that lead to an improved quality of life and overall survival of CRC patients.
Acta Cirurgica Brasileira | 2011
Rosemary Aparecida Furlan Daniel; V.K. Cardoso; Emanuel Góis Jr; Rogério Serafim Parra; Sérgio Britto Garcia; José Joaquim Ribeiro da Rocha; Omar Féres
PURPOSE Adequate tissue oxygenation is essential for healing. Hyperbaric oxygen therapy (HBOT) has potential clinical applications to treat ischemic pathologies, however the exact nature of any protective effects are unclear at present. We therefore investigated the potential role of HBOT in modulating the ischemia/reperfusion (I/R) injury response in intestinal model of I/R injury. METHODS Male Wistar rats were subjected to surgery for the induction of intestinal ischemia followed by reperfusion. HBOT was provided before and/or after intestinal ischemia. Cell viability in the intestinal tissue was assessed using the MTT assay and by measuring serum malondealdehyde (MDA). Microvascular density and apoptosis were evaluated by immunohistochemistry. RESULTS The results indicate that HBOT treatment pre- and post-ischemia reduces lesion size to the intestinal tissue. This treatment increases cell viability and reduces the activation of caspase-3, which is associated with increased number of tissue CD34 cells and enhanced VEGF expression. CONCLUSION The hyperbaric oxygen therapy can limit tissue damage due to ischemia/reperfusion injury, by inducing reparative signaling pathways.
Acta Cirurgica Brasileira | 2008
José Joaquim Ribeiro da Rocha; Omar Féres
PURPOSE The transanal procedure for rectal cancer surgery is one of the many techniques currently available. Different techniques for local excision of rectal tumors include: conventional transanal technique, posterior access surgery, therapeutic colonoscopy, transanal endoscopic surgery. METHODS The aim of the present study is to describe a new method of transanal endoscopic resection, transanal endoscopic operation (TEO), and performed with the aid of a surgical proctoscope especially designed for this purpose and report the results obtained in 32 patients submitted to the TEO and to compare these results with those obtained with other techniques currently available. The average proportions of recurrence, post-operation complications and posterior resections were analyzed by means of a metanalysis. Data on the distance and size of rectal lesions, the operative timing and hospitalization time were distributed in graphs according to authors and techniques. RESULTS The results were favorable and equivalent to those described in the literature. CONCLUSIONS The surgical proctoscope specially designed for this study is efficient and has a low cost; the TEO is easily performed with the aid of this equipment; the final results were favorable and similar to those obtained with other available techniques for endoscopic transanal intestinal resection, which are of high cost and less availability.
Acta Cirurgica Brasileira | 2002
Paulo Miki Junior; José Joaquim Ribeiro da Rocha; Francisco Aprilli; Omar Féres
Currently, colonoscopy has been a first choice exam to evaluate colon disease. This procedure also has had essencial role in the therapeutic approach of certain groups of pathologies. Colonic cleansing is a necessary and previous stage to do elective colonoscopy. The quality of the colon preparation has been found related directly to the sucess of procedure. Three solutions were compared as colonic cleansing agents in adult patients submitted to colonoscopy at ambulatory regimen. Sixty patients were randomized and then divided into three groups of twenty persons. Each one of these groups was submitted to a colonic cleansing with one of these studied solutions: 10% mannitol solution, sodium picosulphate and sodium phosphate. Taste, tolerance, associated side effects and quality of cleansing preparation were evaluated. Clinic parameters like standing pulse and blood pressure besides the assessment of sodium, potassium, calcium and phophate were also studied and compared with measurements taken before and after bow el preparation of each one of patients. The groups presented similar results when related to side effects. Electrolyte alterations were verified in these three studied groups without clinical signs. The variations related to cardiac frequency, blood pressure and hematocrit, though showing contraction of the intravascular volume, did not attend with clinic effects. The bad taste of sodium phosphate solution did not compromise its tolerance. The sodium phosphate and 10% mannitol solutions provide superior results in quality of colonic cleansing and as much as costs when compared to sodium picosulphate solution. When these three groups were compared all evaluated electrolytes presented significant differences and hyperphosphatemia of patients prepared with sodium phosphate solution was the most important of then. None of these differences was related to clinic effects.
Clinics | 2010
Rogério Serafim Parra; José Joaquim Ribeiro da Rocha; Omar Féres
Spontaneous evisceration through the vagina was first described in 1907 by McGregor.1 To date, only eighty-five cases of transvaginal small bowel evisceration have been documented worldwide.1,2 The primary risk groups for spontaneous vaginal evisceration include postmenopausal women,1,3–7 vaginal surgery cases,1,8–10 multiparae,11 and women of older age.2,3 In postmenopausal woman, transvaginal evisceration is frequently associated with increased abdominal pressure,1 vaginal ulceration due to severe atrophy, and straining at stool.6,8 Vaginal evisceration is a medical emergency that requires prompt recognition and immediate surgical intervention.1 The associated mortality rate is 5.6 percent; however, the incidence of morbidity is higher3,8 when the bowel has become strangulated through the vaginal defect. Here, we report a case of vaginal vault rupture with evisceration through the vagina and highlight the risk factors, clinical presentation, and treatment options for this rare gynecological emergency.
Acta Cirurgica Brasileira | 2016
Ana Luiza Normanha Ribeiro de Almeida; Mário Vinícius Angelete Alvarez Bernardes; Marley Ribeiro Feitosa; Fernanda Maris Peria; Daniela Tirapelli; José Joaquim Ribeiro da Rocha; Omar Féres
PURPOSE This paper describes the ability of miRNA value predict oncological outcomes in CRC patients and correlates to clinical and pathologic variables. METHODS We prospectively analyzed the serological expression of microRNA-21, microRNA-34a, and microRNA-126 in 37 stage II - IV CRC patients and correlate to seven fit counterparts. Serological microRNAs were extracted using the miRNeasy Mini Kit(r) (Qiagen, Hilden, Germany). Quantification of microRNAs was performed using TaqMan Master Mix(r) reagent (Applied Biosystems, USA). RESULTS We obtained serological underexpression microRNA-21, microRNA-34a, and microRNA-126 in CRC group. However, miRNAs serological values do not impact prognosis. Furthermore, miRNAs was not influenced by CEA values, TNM staging, and histological subtype. CONCLUSION Despite lower expression of miR-21, miR-34a and miR-126 in the CRC group, no association with poor prognosis was found.
Transplantation Proceedings | 2014
Daniele Moraes Losada; M.E. Jordani; Maria C. Jordani; M.A.N.C. Piccinato; Clarice Fleury Fina; Omar Féres; A.B. Chies; Paulo Roberto Barbosa Evora; O. de Castro e Silva
OBJECTIVES We designed studies to test the hypotheses that hyperbaric oxygen (HBO) therapy should protect liver against subsequent ischemia/reperfusion (I/R) injury are scarce and controversial. The purpose of this study was to clarify some questions about the association of HBO with the processes of liver I/R. METHODS We divided Wistar rats into 5 groups: (1) SHAM operation, (2) I/R, rats submitted to total pedicle ischemia for 30 minutes followed by 5 minutes of reperfusion; (3) HBO60I/R and (4) HBO120I/R, rats respectively submitted to 60 and 120 minutes of HBO therapy at 2 absolute atmospheres and immediately after submitted to the experimental protocol of I/R; (5) HBO120, rats submitted to 120 minutes of HBO therapy at 2 absolute atmospheres and then immediately after humanely killed. The experimental protocol included (1) serum levels of aspartate and alanine aminotransferase; (2) mitochondrial function; (3) tissue malondialdehyde (MDA); and (4) plasma nitrite/nitrate. Data were analyzed using the Mann-Whitney test and were considered significant P < 5%. RESULTS The processes of liver ischemia/reperfusion caused tissue injury with hepatic mitochondrial functional impairment. A single exposure to 120 minutes of HBO caused an increase of tissue MDA. The time of HBO exposure as preconditioning before hepatic I/R is critical in the prevalence of beneficial or deleterious effects. Sixty minutes of hyperoxic preconditioning before liver I/R presents systemic benefits, but no significant tissue preservation. One hundred twenty minutes of hyperoxic preconditioning tissue liver benefits predominate compared with systemic benefits. CONCLUSIONS The HBO preconditioning therapeutic benefits to liver I/R injury are time dependent, suggesting a therapeutic window that needs to be clearly defined in future studies.
Acta Cirurgica Brasileira | 2011
Silvana Marques e Silva; Vânia Maria Moraes Ferreira; Omar Féres; Paulo Gonçalves de Oliveira; João Batista de Sousa
PURPOSE To evaluate the effects of metoclopramide on the formation of adhesion and the healing of left colonic anastomoses in rats. METHODS Forty rats underwent sectioning of the left colon and end-to-end anastomosis and were divided into two groups of 20 animals for the administration of metoclopramide (experimental group - E) or saline solution (control group - C). Each group was divided into subgroups of 10 animals each to be killed on the third (E3 and C3) or seventh postoperative day (E7 and C7). Adhesion was assessed, and a colonic segment containing the anastomosis was removed for analysis of breaking strength and hydroxyproline concentration. RESULTS There were no deaths or dehiscence on the 3(rd) postoperative day. There was one death and one blocked anastomotic dehiscence in the E7 group. No significant differences between groups were found in the analysis of clinical outcome, intra-cavity adhesion, adhesion to the anastomosis or breaking strength on the 3(rd) and 7(th) postoperative day. Hydroxyproline concentration was higher in the control group on the 3(rd) (p=0.006) but not on the 7(th) postoperative day (p=0.241). CONCLUSION Metoclopramide did not have harmful effects on the healing of intestinal anastomoses in rats.
Acta Cirurgica Brasileira | 2008
Ricardo Luiz dos Santos Garcia; Bruna Meyer R. de Matos; Omar Féres; José Joaquim Ribeiro da Rocha
PURPOSE Surgical treatment of chagasic megacolon has suffered innumerable transformations over the years. Poor knowledge of the disease physiopathology is one of the reasons. METHODS From January 1977 to December 2003, 430 patients were submitted to surgical treatment for chagasic megacolon. Of these procedures, 351 were elective and 79 emergency operations carried out at the University Hospital of Ribeirão Preto. Four elective operations, most frequently used, should be singled out: anterior rectosigmoidectomy (52.71%), left hemicolectomy (18.23%), Duhamel-Haddad operation(15.95%), and total colectomy (5.98%). From the 79 exploratory laparotomies performed on an emergency basis, 53 (67.09%) required intestinal resection. From the 430 patients operated upon, 268 (62.33%) progressed without recurrence of intestinal constipation, and 71 (15.51%) had a recurrence. RESULTS AND DISCUSSION Based on the data collected, left hemicolectomy had the highest constipation recurrence rate compared to other operating procedures; anterior retosigmoidectomy had less complication episodes and a larger recurrence of intestinal constipation in comparison to the Duhamel-Haddad operation. Emergency operations, mainly for the treatment of volvulus and fecaloma, presented high morbidity and mortality and required extensive intestinal resections, stomas and reoperations.
Acta Cirurgica Brasileira | 2013
Diego Elias da Silva Caldeira; Maria Eliza Jordani de Souza; Maria Cecília Jordani Gomes; Maria Aparecida Neves Cardoso Picinato; Clarice Fleury Fina; Omar Féres; Orlando Castro e Silva
PURPOSE to assess the effect of hyperbaric oxygen (HBO) as pre-conditioning on periodic liver ischemia/reperfusion injury. METHODS Thirty-six male Wistar rats were divided into 4 groups (SHAM, I/R , HBO-I/R and CONTROL). The surgical technique consisted of total clamping of the hepatic pedicle for 15 min followed by twice repeated reperfusion for 5 min (unclamping). HBO was applied in a collective chamber (simultaneous exposure of 4 rats) directly pressurized with oxygen at 2 ATA for 60 min. Hepatic mitochondrial function was determined using samples of the median lobe obtained after exactly 5 min of reperfusion for the analysis of mitochondrial respiration based on the determination of states 3 and 4, the respiratory control ratio and the transition of mitochondrial permeability (mitochondrial swelling).Data were analyzed by the Mann-Whitney test and the level of significance was set at p < 0.05. RESULTS There was a statistically significant difference (p < 0.05) in state 3 between the CONTROL and I/R and HBO-I/R groups, in state 4 between the CONTROL and I/R and HBO-I/R groups; in respiratory control ratio (RCR) between the CONTROL and I/R and HBO-I/R groups and between the CONTROL and Sham groups, and in mitochondrial swelling between the CONTROL and I/R and HBO-/R groups and between the Sham and I/R and HBO-I/R groups. CONCLUSION In this process of periodic ischemia and reperfusion, hyperbaric pre-conditioning did not improve significantly hepatic mitochondrial function.