Procedures and Exams
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Pre and
Post-transplant
of bone marrow
Bone marrow transplantation is a therapeutic modality that uses hematopoietic stem cells obtained from bone marrow, peripheral blood or umbilical cord blood, for bone marrow recovery after high-dose chemotherapy. The transplant can be autologous (the patient's own cells) or allogeneic (cells from a compatible donor).
Indicated in the treatment of malignant hematological diseases (lymphoma, myeloma, leukemia, myelodysplastic syndrome) and non-malignant (spinal aplasia, hemoglobinopathies), immunological diseases (acquired and inherited immunodeficiencies, Systemic Lupus Erythematosus) is another therapeutic option, in addition to conventional treatment.
The Honcord medical team is a pioneer in this treatment in the state of Goiás, having performed since 1998, at Hospital Araújo Jorge, more than 800 transplants.
Honcord has a trained team accredited by the Ministry of Health, providing adequate pre- and post-transplant care.
Stem Cell Freezing
One of the great advances in modern medicine is, without a doubt, the treatment made from hematopoietic stem cells, those capable of originating blood cells. Hematopoietic stem cells are commonly found in umbilical cord, bone marrow, peripheral blood.
When compared to bone marrow, umbilical cord blood has some advantages, such as ease of collection, prolonged storage time, less graft-versus-host disease induction, and immediate availability of cells.
How is the collection and freezing done?
The collection is performed right after delivery, whether normal or cesarean, through the puncture of the umbilical cord and placenta. The entire process takes just over 10 minutes, with no risk for the mother and baby.
After collection, the umbilical cord blood is sent to the Honcord laboratory, where the stem cells are separated, quantified and stored at -196º C.
Blood tests from the mother and the umbilical cord, in addition to the viability test, guarantee the quality of the collected material.
For storage monitoring, new viability tests are carried out, by sampling and annually, which will be sent on your child's birthday.
How is the Cryopreservation process?
Honcord has a liquid nitrogen storage and distribution system based on the most advanced and used techniques.
To maintain the integrity of the stored material we have:
Continuous monitoring via internet and by telephone of cold chain equipment (nitrogen tanks at -196°C and freezer at -80°C);
Automated nitrogen filling from storage tank;
Reserve storage tank with a capacity of 3 thousand liters of nitrogen;
No-break safety of electrical equipment;
Power generator with a autonomy of 20 hours.
Biopsies
Biopsy is a fundamental step in the treatment of bone and soft tissue neoplasms, indispensable for the definitive diagnosis and for identifying the histological pattern of the tumor. Only after the biopsy result can the appropriate treatment be indicated.
Some biopsies performed:
High endoscopic biopsy (esophagus, stomach, duodenum) or low (rectum, sigmoid, colon);
Thyroid biopsy;
Percutaneous breast fragment biopsy with USG-guided core biopsy needle;
Cervical biopsy;
Skin and subcutaneous cell tissue biopsy;
Ganglion biopsy;
Biopsy of the oral mucosa, larynx and pharynx;
Prostatic and seminal vesicle biopsy;
Endoscopic bladder biopsy;
Urethral endoscopic biopsy;
Lung and bronchi biopsy by needle aspiration;
Liver, pancreatic, renal imaging guided needle biopsy.
Bronchoscopy
Bronchoscopy is an essential tool, established and continually expanding in the
respiratory medicine. It is a test that helps in the investigation and diagnosis of roadway diseases.
lower airways and allows viewing the structures for performing diagnostic procedures and
therapeutic, and can be performed in children and adults.
The procedure is performed under
sedation or general anesthesia with continuous monitoring lasting from about 30 to
40 minutes.
It helps in the diagnosis of different diseases of the larynx, trachea and bronchi, through the collection of
biopsies or cytological examination. It can also be used for minimally invasive treatment of
diseases that cause airway obstruction and foreign body removal.
Some bronchoscopies performed:
Bronchoscopy with transbronchial biopsy;
Bronchoscopy with or without aspirate;
Bronchoscopy with bilateral bronchial lavage;
Bronchoscopy with foreign body removal.
Our endoscopic devices have NBI Technology - Narrow Band Imaging, which enhances the analyzed tissue, making the exam faster and more assertive to identify the point with alteration and thus perform the biopsy.
Upper digestive endoscopy - EDA
Endoscopy is an exam capable of analyzing the mucosa of the esophagus, stomach and duodenum (first part of the small intestine). It is made through a flexible tube (known as an endoscope) that has a chip responsible for capturing images of the digestive system through a camera. Carrying out this examination is a medical prerogative, but it requires nursing attention and performance at all times.
How is it performed:
It is necessary to go on a diet the day before, according to the doctor's recommendations, keeping an 8 to 12 hour fast. The stomach must be completely empty so that it is possible to have a complete view of the organs. Upper digestive endoscopy (OED) is performed with intravenous sedatives, as the procedure can cause nausea and vomiting. The sedation time only lasts until the exam is completed.
The procedure is safe and a mouth guard (mouthpiece) is placed to prevent the endoscope from being bitten.
At all times, the patient's oxygenation and heart rate are monitored. Images are captured and transmitted in real time to a monitor. Many injuries can be treated or removed on the spot, without the need for any further surgical procedure.
The procedure lasts for approximately 20 to 30 minutes.
When areas with abnormalities are found, a biopsy is performed using instruments that are placed in the endoscope. A biopsy consists of collecting a sample of tissue taken from the esophagus, stomach or duodenum.
Some EDAs performed:
Upper digestive endoscopy esophagogastroduodenoscopy;
Upper digestive endoscopy with biopsy and/or cytology.
Our endoscopic devices have the NBI - Narrow Band Imaging Technology, which enhances the analyzed tissue, making the exam faster and more assertive to identify the point with alteration and thus perform the biopsy.
Colonoscopy
THE colonoscopy is a test that allows a doctor to look at the inner lining of the large intestine and part of the small intestine, in an area that corresponds to the rectum, colon, and terminal ileum. The procedure is to find polyps, tumors, inflammations, ulcers and other organ changes, currently being one of the main screening methods for colorectal cancer.
How do you do:
The exam is only performed after a thorough preparation (cleaning) of the colon, which includes the use of laxatives, diet and large intake of water. The effectiveness of bowel preparation is a critical factor related to the safety, diagnostic accuracy, quality, difficulty, and speed of the exam. If the patient uses a cardiac pacemaker, he should advise the physician and the nursing team before starting the procedure.
The examination is performed by introducing a long flexible colonoscope with a camera at the tip, through the anus, passing through the rectum and reaching the intestine. Generally, this exam is painless and is performed on an outpatient basis, with no need for hospitalization, but a period of observation at the site is recommended. The degree of sedation is decided according to the patient's level of anxiety, their ability to cooperate during the examination, and the condition of their clinical condition. It lasts approximately 20 to 30 minutes.
Some small intestinal polyps or lesions, when present in the upper layers of the digestive tract, can be removed or treated during the colonoscopy itself.
Some types of colonoscopy performed
Colonoscopy with biopsy and/or cytology.
Our endoscopic devices have the NBI - Narrow Band Imaging Technology, which enhances the analyzed tissue, making the exam faster and more assertive to identify the point with alteration and thus perform the biopsy.
Doppler
The Doppler tool combined with ultrasound provides real-time information on vascular architecture and hemodynamic aspects of vessels in various organs. It is always indicated for detecting thrombosis, diagnosing and evaluating varicose veins, identifying aneurysms or dilations in blood vessels, narrowing or occlusions of veins and arteries, measuring the blood flow from the mother to the fetus, through the placenta during pregnancy and among others.
The detection of the vascular architecture, with determination of the blood flow pattern, in addition to the observation of the direction and velocity of the blood, makes it possible to guide tissue biopsies more safely, avoiding large vessels or areas of intense vascularization. The technique also helps in the characterization of tumor masses and provides information on the hemodynamics of various vital organs.
How do you do:
Doppler ultrasound examination is simple and painless, requiring only lying down on the gurney while the doctor performs the examination. Fasting is not usually necessary, except for tests performed in the abdominal region, such as aortic Doppler or renal arteries. Thus, Doppler is performed using a device capable of emitting sound waves, which reach the tissue and return as an echo, which is converted into images. Images are created when the transducer is pressed against the skin and moved along the arm or leg.
The transducer sends sound waves through your skin and other body tissues to blood vessels. Sound waves echo through blood vessels and send the information to a computer to be processed and recorded. The computer will produce graphs or images that show the flow of blood through the arteries and veins. The transducer will be moved to different areas for comparison. You may hear a sound when blood flow is detected.
Some types of Doppler performed
Aortic and iliac color Doppler;
Color Doppler of the aorta and renal arteries;
Color Doppler of isolated organ or structures;
Color Doppler of a vase;
Two-vessel color Doppler;
Color Doppler of visceral vessels – arterial and venous;
Lower limb arterial color Doppler – unilateral;
Arterial color Doppler of upper limbs – unilateral;
Lower limb venous color Doppler – unilateral;
Upper limb venous color Doppler – unilateral;
Bilateral cervical arterial vessel color Doppler – carotid and vertebral.
Ultrasonography - USG
Ultrasonography is a technique that does not use ionizing radiation for image formation. It uses high-frequency sound waves, which when they hit organs and tissues produce echoes. These echoes are converted into real-time images of the body's organs, tissues, and blood flow, which can be viewed on a computer screen.
Ultrasound is mainly used in diagnosis for monitoring diseases, in addition to being used in some specialized surgical procedures.
How do you do:
Usually no preparation is needed; however, this will depend on the area being studied. However, the patient will be instructed on any preparation needed for the exam. For ultrasound of breast, thyroid, joints, scrotum, salivary glands, eyes, chest, transcranial, carotid, lower limb, and obstetric color Doppler (after first trimester), no prior preparation is required.
With the patient lying on a stretcher, the doctor will place a gel on the skin where the transducer will be manipulated. This gel lubricates the skin and helps to conduct sound waves. The gel is cold and slippery. If a probe is used, it will be covered with gel and placed inside some hole in the body. This can cause pressure and discomfort.
During the exam, the radiologist moves the transducer while pressing it firmly against the skin. The duration depends on the type of examination and the possible difficulty in detecting any alterations in the studied organs.
Some types of colonoscopy performed
USG of upper abdomen – liver, biliary tract, pancreas and spleen;
lower abdominal total USG – kidneys, retro, peritoneum and bladder;
urinary tract USG;
thyroid USG;
USG of manas - bilateral;
USG of superficial organs and structures – scrotum, penis, muscles, craniocervical tendon, salivary glands, cervical or armpits;
prostate USG – abdominal route;
prostate USG - transrectal with biopsy;
transvaginal pelvic USG
Mohs surgery
Mohs Micrographic Surgery is a highly effective and specialized technique for removing major types of skin tumors. It is a meticulous surgical procedure for the treatment of skin or mucous membrane cancer.
Mohs micrographic surgery can be considered the most refined, accurate and effective technique for the treatment of the most frequent types of skin cancer. Through it, it is possible to identify and remove the entire tumor, preserving as much healthy skin around the lesion. The procedure consists of removing the cancer from the skin, in stages and with the examination of each one under the microscope, until all free margins are obtained, that is, until the complete removal of the tumor (the level of precision and accuracy can reach 99%).
Cytoscopy
Cystoscopy is an exam for the diagnosis of vesical (bladder) pathology, including bladder cancer, inflammation or stones (lithiasis), among others.
Colposcopy
Colposcopy is an extremely important gynecological exam to assess the female lower genital tract: the vulva, vagina and cervix.
Spirometry
Spirometry is a non-invasive and painless test of the respiratory system, which lasts about half an hour, performed to assess whether there is any abnormality in pulmonary ventilation, screening and quantifying the presence of pulmonary diseases restrictive and obstructive.
hysteroscopy
Hysteroscopy examination allows the internal visualization of the uterus through an instrument called a hysteroscope, which is inserted through the vagina and cervix. The device has a built-in camera that films and transmits the images in real time to a TV monitor.
Hysteroscopy is usually ordered after an ultrasound of the pelvis and is not old enough to be performed.
Rhinopharyngoscopy
Rhinopharyngoscopy or nasofibroscopy is an exam that identifies changes in the nasal cavity, such as nasal septum deviation, inferior turbinate hypertrophy, adenoid hypertrophy, sinusitis and tumors.