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1.
J Robot Surg ; 17(4): 1809-1816, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37083992

RESUMO

It is not established which factors impact the learning curve (LC) in robotic thoracic surgery (RTS), especially in emerging countries. The aim of this study is to analyze LC in RTS in Brazil and identify factors that can accelerate LC. We selected the first cases of two Brazilian surgeons who started their LC. We used CUSUM and the Lowess technique to measure LC for each surgeon and Poisson regression to assess factors associated with shorter console time (CT). 58 patients were operated by each surgeon and included in the analysis. Surgeries performed were different: Surgeon I (SI) performed 54 lobectomies (93.11%), whereas Surgeon II (SII) had a varied mix of cases. SI was proctored in his first 10 cases (17.24%), while SII in his first 41 cases (70.68%). The mean interval between surgeries was 8 days for SI and 16 days for SII. There were differences in the LC phases of the two surgeons, mainly regarding complications and conversions. There was shorter CT by 30% in the presence of a proctor, and by 20% with the Da Vinci Xi. Mix of cases did not seem to contribute to faster LC. Higher frequency between surgeries seems to be associated with a faster curve. Presence of proctor and use of bolder technologies reduced console time. We wonder if in phase 3 it is necessary to keep a proctor on complex cases to avoid serious complications. More studies are necessary to understand which factors impact the LC.


Assuntos
Procedimentos Cirúrgicos Robóticos , Cirurgiões , Cirurgia Torácica , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Curva de Aprendizado , Duração da Cirurgia , Estudos Retrospectivos
2.
Aesthet Surg J ; 39(7): 756-764, 2019 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-30107469

RESUMO

BACKGROUND: The endocrine-metabolic response to trauma is directly related to its magnitude, but little is known about the adverse effects of combined surgical procedures on morbidity. OBJECTIVES: The authors sought to evaluate risk factors by measuring the endocrine-metabolic response in patients who underwent multiple body-contouring surgeries after massive weight loss. METHODS: This prospective, randomized, interventional study included 46 massive weight loss patients who experienced a weight loss >30% of their body mass index (BMI) and were referred for body contouring surgery. Patients were randomly allocated to the control group (n = 10) or intervention group (n = 36), which in turn was divided into 3 subgroups (n = 12, each) according to BMI, surgical time, and scar length values. Blood samples were collected from all patients at different time points to assess biological stress markers. RESULTS: Levels of IL-6 in patients in the higher ranges of BMI and operating time and with more extensive scar length were significantly higher in the immediate postoperative period compared with baseline. Concentrations of noradrenaline were significantly higher 24 hours after surgery compared with baseline only in patients in the higher range of operating time. A higher level of IL-6 at 72 hours after surgery compared with baseline was associated with more extensive scar length. Levels of other biological stress markers did not significantly differ. CONCLUSIONS: The combination of surgical procedures did not significantly affect the concentrations of most biological stress markers. The variable of operating time most influenced increase in plasma concentrations of stress markers.


Assuntos
Contorno Corporal/efeitos adversos , Complicações Pós-Operatórias/metabolismo , Redução de Peso , Adulto , Biomarcadores/metabolismo , Contorno Corporal/métodos , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Adulto Jovem
3.
Rev Col Bras Cir ; 44(5): 498-504, 2017.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29019580

RESUMO

OBJECTIVE: to evaluate the effects of increasing pressures on the cutaneous blood flow in the skin of pigs. METHODS: we conducted an experimental study in pigs submitted to subcutaneous magnetic implants (n=30). After healing, were applied external magnets with varying magnetic forces to the skin, generating compression. We evaluated the cutaneous circulation of the skin under compression by the Laser Speckle Contrast Imaging (LSCI) technique. We measured the depth of the implants by ultrasonography, and applied computational simulations to the calculation of the different pressure values, considering the different distances between implants and external magnets. RESULTS: nineteen implants presented complications. The remaining 11 were submitted to different magnetic compression forces and perfusion analysis. Two linear regression models showed an inverse correlation between exerted pressure and cutaneous perfusion, with significant variation, mainly in the initial pressure increases, of up to 20mmHg. CONCLUSION: The main reduction in cutaneous blood flow resulted from initial increases of up to 20 mmHg. The results suggest that tissue ischemia can occur even in low-pressure regimes, which could contribute to the appearance of skin lesions, particularly ulcers related to medical devices.


Assuntos
Pressão/efeitos adversos , Pele/irrigação sanguínea , Animais , Fluxo Sanguíneo Regional , Suínos
4.
Rev. Col. Bras. Cir ; 44(5): 498-504, Sept.-Oct. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-896618

RESUMO

ABSTRACT Objective: to evaluate the effects of increasing pressures on the cutaneous blood flow in the skin of pigs. Methods: we conducted an experimental study in pigs submitted to subcutaneous magnetic implants (n=30). After healing, were applied external magnets with varying magnetic forces to the skin, generating compression. We evaluated the cutaneous circulation of the skin under compression by the Laser Speckle Contrast Imaging (LSCI) technique. We measured the depth of the implants by ultrasonography, and applied computational simulations to the calculation of the different pressure values, considering the different distances between implants and external magnets. Results: nineteen implants presented complications. The remaining 11 were submitted to different magnetic compression forces and perfusion analysis. Two linear regression models showed an inverse correlation between exerted pressure and cutaneous perfusion, with significant variation, mainly in the initial pressure increases, of up to 20mmHg. Conclusion: The main reduction in cutaneous blood flow resulted from initial increases of up to 20 mmHg. The results suggest that tissue ischemia can occur even in low-pressure regimes, which could contribute to the appearance of skin lesions, particularly ulcers related to medical devices.


RESUMO Objetivo: avaliar os efeitos de pressões crescentes exercidas sobre a pele de porcos no fluxo sanguíneo cutâneo. Métodos: estudo experimental em porcos submetidos a implantes magnéticos subcutâneos (n=30). Após a cicatrização, foram aplicados sobre a pele, ímãs externos com forças magnéticas variadas, gerando compressão. A circulação cutânea da pele submetida à compressão foi avaliada pela técnica Laser Speckle Contrast Imaging (LSCI). A profundidade dos implantes foi medida por ultrassonografia, e simulações computacionais foram aplicadas para o cálculo dos diferentes valores de pressão, considerando-se as variadas distâncias entre implantes e ímãs externos. Resultados: dezenove implantes apresentaram complicações. Os 11 restantes foram submetidos à diferentes compressões magnéticas e análise de perfusão. Dois modelos de regressão linear mostraram uma correlação inversa entre pressão exercida e perfusão cutânea com variação significativa principalmente nos acréscimos iniciais de pressão até 20mmHg. Conclusão: a principal redução do fluxo sanguíneo cutâneo resulta dos acréscimos iniciais de pressão de até 20mmHg. Os resultados sugerem que a isquemia tecidual pode ocorrer mesmo em regimes de baixa pressão, o que poderia contribuir para surgimento de lesões de pele, particularmente as úlceras relacionadas a dispositivos médicos.


Assuntos
Animais , Pressão/efeitos adversos , Pele , Fluxo Sanguíneo Regional , Suínos
5.
Aesthet Surg J ; 37(6): 654-661, 2017 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-28333173

RESUMO

BACKGROUND: Dual plane breast augmentation is a technical variation of the submuscular plane described as a technique that reduces contour deformities due to contraction of the pectoralis major muscle and lower risk of double-bubble deformity associated with breast ptosis. Despite improvement in the aesthetic aspect, there is still no consensus whether this technique affects the function of the pectoralis major muscle. OBJECTIVES: The aim of this study was to correlate functional with volumetric changes associated with dissection of the muscle origin in submuscular breast augmentation. METHODS: Thirty women who desired to undergo breast augmentation were selected prospectively and randomly allocated to 2 groups: 10 patients in the control group and 20 patients in the interventional group, who underwent submuscular breast augmentation. Magnetic resonance imaging and volumetric software were used to assess muscle volume and isokinetic dynamometry was used to assess function of the pectoralis major muscle. Preoperative measurements were compared with those at 3, 6, and 12 months after surgery. RESULTS: Magnetic resonance imaging revealed significant decrease in muscle volume at 6 and 12 months follow-up. The isokinetic test conducted during adduction showed a significant difference in muscle strength between groups from baseline to the 12-month follow-up, and between the 3- and 12-month follow-up. No significant differences in muscle strength during abduction were observed from baseline to the 3-, 6-, and 12-month follow-up. CONCLUSIONS: Submuscular breast augmentation reduced muscle strength during adduction 12 months after surgery, but without a significant correlation with volumetric muscle loss.


Assuntos
Implante Mamário/métodos , Dissecação , Imageamento por Ressonância Magnética , Força Muscular , Músculos Peitorais/cirurgia , Adolescente , Adulto , Brasil , Implante Mamário/efeitos adversos , Dissecação/efeitos adversos , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Músculos Peitorais/diagnóstico por imagem , Músculos Peitorais/fisiopatologia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/fisiopatologia , Estudos Prospectivos , Software , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
8.
Burns ; 42(4): 807-14, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26822695

RESUMO

Unfortunately burns are a common occurrence, leading to scarring or death. Platelet-rich plasma (PRP) contains many growth factors that can accelerate wound healing. We analyzed the use of PRP in deep second-degree (dSD), deep second-degree associated with diabetes mellitus (dSDD), and third-degree (TD) burns in rats. Sixty syngeneic rats divided into three groups (dSD, dSDD, and TD) were burned, half receiving topical PRP and half being used as control; 10 additional rats per group were used for PRP preparation. On day 21, the animals were sacrificed and skin biopsies were collected. dSD and dSDD wounds treated with PRP showed faster wound closure, reduction in CD31-, CD68-, CD163-, MPO-, and in TGF-ß-positive cells, and an increase in MMP2-positive cells. The neo-epidermis was thinner in the control of both the dSD and dSDD groups and granulation tissue was less reduced in the control of both the dSDD and TD groups. These results indicate that PRP can accelerate the healing process in dSD and dSDD, but not in TD burns.


Assuntos
Queimaduras/terapia , Plasma Rico em Plaquetas , Cicatrização , Animais , Antígenos CD/metabolismo , Biomarcadores/metabolismo , Queimaduras/metabolismo , Queimaduras/patologia , Cicatriz/patologia , Colágeno/análise , Citocinas/metabolismo , Diabetes Mellitus Experimental/complicações , Modelos Animais de Doenças , Tecido de Granulação/patologia , Masculino , Ratos , Ratos Wistar , Fator de Crescimento Transformador beta/metabolismo , Cicatrização/fisiologia
9.
Plast Reconstr Surg ; 137(1): 62-69, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26710008

RESUMO

BACKGROUND: Besides being a procedure with high level of patient satisfaction, one of the main causes for reoperation after breast augmentation is related to contour deformities and changes in breast volume. Few objective data are available on postoperative volumetric analysis following breast augmentation. The aim of this study was to evaluate volume changes in the breast parenchyma and pectoralis major muscle after breast augmentation with the placement of silicone implants in the subglandular and submuscular planes. METHODS: Fifty-eight women were randomly allocated either to the subglandular group (n = 24) or submuscular group (n = 24) and underwent breast augmentation in the subglandular or submuscular plane, respectively, or to a control group (n = 10) and received no intervention. Volumetric magnetic resonance imaging was performed at inclusion in all participants and either after 6 and 12 months in the control group or at 6 and 12 months after surgery in the intervention groups. RESULTS: Twelve months after breast augmentation, only the subglandular group had a significant reduction in glandular volume (mean, 22.8 percent), while patients in the submuscular group were the only ones showing significant reduction in muscle volume (mean, 49.80 percent). CONCLUSIONS: Atrophy of the breast parenchyma occurred after subglandular breast augmentation, but not following submuscular breast augmentation. In contrast, submuscular breast augmentation caused atrophy of the pectoralis major muscle. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.


Assuntos
Implantes de Mama , Contratura Capsular em Implantes/diagnóstico , Mamoplastia/métodos , Glândulas Mamárias Humanas/cirurgia , Músculos Peitorais/cirurgia , Adulto , Axila/cirurgia , Brasil , Estética , Feminino , Humanos , Estudos Longitudinais , Imageamento por Ressonância Magnética/métodos , Mamoplastia/efeitos adversos , Glândulas Mamárias Humanas/patologia , Pessoa de Meia-Idade , Satisfação do Paciente/estatística & dados numéricos , Músculos Peitorais/patologia , Estudos Prospectivos , Medição de Risco , Estatísticas não Paramétricas , Resultado do Tratamento , Adulto Jovem
10.
Aesthet Surg J ; 35(8): 929-35, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26508645

RESUMO

BACKGROUND: Despite being the cosmetic procedure most performed worldwide, there are still few objective measurements of postoperative volumetric analysis of breast augmentation available in the literature. OBJECTIVE: The aim of this study was to evaluate volumetric changes in the breast parenchyma after the placement of silicone implants in the subglandular plane. METHODS: Thirty-four women were randomly allocated to the intervention group (n = 24), who underwent breast augmentation in the subglandular plane, or to the control group (n = 10), who received no intervention. Volumetric magnetic resonance imaging was performed at inclusion, and after 6 and 12 months in all participants. The non-parametric Friedman's test was used for statistical analysis. RESULTS: There was a significant reduction in glandular volume (mean, 22%) at 12 months postoperatively in patients who underwent breast augmentation. CONCLUSIONS: Breast augmentation caused reduction in the volume of the breast parenchyma. LEVEL OF EVIDENCE: 3 Therapeutic.


Assuntos
Implante Mamário/métodos , Implantes de Mama/efeitos adversos , Mama/anatomia & histologia , Géis de Silicone/farmacologia , Adolescente , Adulto , Brasil , Implante Mamário/efeitos adversos , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Imageamento por Ressonância Magnética/métodos , Mamografia/métodos , Tamanho do Órgão/fisiologia , Cuidados Pré-Operatórios/métodos , Estudos Prospectivos , Desenho de Prótese , Falha de Prótese , Valores de Referência , Medição de Risco , Géis de Silicone/efeitos adversos , Fatores de Tempo , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Adulto Jovem
11.
Aesthet Surg J ; 35(3): 265-72, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25805280

RESUMO

BACKGROUND: Breast augmentation through incisions in the axillae is an option for patients who wish to avoid scars on the breasts. The axillary approach also preserves the mammary parenchyma and lactiferous ducts. The utility of video-assisted endoscopy during this procedure as a means to improve safety and aesthetic outcomes remains debatable. OBJECTIVES: The authors compared outcomes of transaxillary breast augmentation with and without video-assisted endoscopy. METHODS: Thirty-four women who underwent transaxillary breast augmentation with or without video-assisted endoscopy were evaluated in a prospective, randomized study. Patients received high-profile silicone implants in the subglandular plane and were monitored for an average of 25 months. Operating time, complication rates, postoperative pain, patient satisfaction, and aesthetic parameters were evaluated. RESULTS: Operative time were significantly longer for patients who underwent transaxillary breast augmentation with video-assisted endoscopy compared with patients who underwent nonendoscopic surgery. CONCLUSIONS: Video-assisted endoscopy increased operating time but did not improve the safety of transaxillary breast augmentation or yield better aesthetic outcomes. LEVEL OF EVIDENCE: 3 Therapeutic.


Assuntos
Implante Mamário/métodos , Implantes de Mama , Endoscopia/métodos , Complicações Pós-Operatórias/epidemiologia , Adulto , Axila , Feminino , Humanos , Duração da Cirurgia , Dor Pós-Operatória/epidemiologia , Satisfação do Paciente , Estudos Prospectivos , Géis de Silicone , Cirurgia Vídeoassistida , Adulto Jovem
12.
Plast Reconstr Surg ; 135(3): 533e-541e, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25719718

RESUMO

BACKGROUND: The gluteal muscles have been very important throughout the evolution of mankind for the adoption of the bipedal posture. Over the past 15 years, the intramuscular technique has become popular and has been improved, with enhanced results and reduced levels of postoperative complications. The insertion of gluteal implants within the musculature may be an intrinsic compression factor of these muscles. The objective of the present study was to evaluate the gluteus maximus function and its variation over a 12-month period after the insertion of the implant. METHODS: This was a prospective, controlled, clinical study. All subjects were female patients, with anthropometric characteristics and body mass index within preset limits to establish similar groups. Isokinetic test gluteus computed tomographic scans and clinical nutritional assessment were conducted in four stages during the study period: preoperatively and 3, 6, and 12 months after surgery. RESULTS: The study group presented 6.14 percent muscle atrophy to the left and 6.43 percent muscle atrophy to the right after the procedure. Muscle strength presented differences in hip flexion and adduction tests. CONCLUSIONS: The gluteus maximus muscle presents atrophy secondarily to gluteal augmentation surgery with implants. Variations in gluteus maximus muscle strength should not be attributed primarily to the surgical procedure or to the implants; physiologic and multifactorial variations should also be considered. Strength and volume variations did not show a significant correlation. Gluteal augmentation with implants was effective in improving the waist-to-hip ratio and in changing the anthropometric pattern from android to gynoid. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.


Assuntos
Nádegas/cirurgia , Contração Muscular/fisiologia , Músculo Esquelético/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Próteses e Implantes , Géis de Silicone , Tomografia Computadorizada por Raios X/métodos , Adulto , Nádegas/diagnóstico por imagem , Eletromiografia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/fisiologia , Estudos Prospectivos , Desenho de Prótese , Adulto Jovem
14.
Plast Reconstr Surg ; 131(2): 253e-259e, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23358021

RESUMO

BACKGROUND: New surgical techniques for gluteal augmentation have improved final results. It is estimated that more than 35,000 patients have undergone augmentation gluteoplasty using implants. The authors sought to determine and quantify the presence of muscle atrophy, and to evaluate implant positioning using the intramuscular technique. METHODS: Twenty-three female patients were selected prospectively for this study and underwent intramuscular gluteal augmentation using gluteal implants of a round or oval base. Computed tomographic scanning and three-dimensional volumetric reconstruction were used to investigate muscle atrophy and implant position, with comparison of the results between the preoperative scan and scans obtained 3, 6, and 12 months after surgery. RESULTS: Three-dimensional reconstruction and volumetric analysis showed muscular atrophy. After 12 months of follow-up, 34 gluteal muscles (17 patients) were analyzed, with 4.3 percent atrophy remaining on the right side and 2.6 percent on the left side. Twenty-three patients were studied regarding position (46 gluteal implants). All oval base implants introduced in a vertical direction (seven patients) turned to an oblique direction, following the direction of muscle fibers by 3 months after surgery. Two patients showed rotation of the implant. CONCLUSIONS: The presence of a gluteal implant caused muscle atrophy. However, it did not lead to clinical or physical limitations. It is not important whether the implants are positioned vertically or obliquely, provided that they are symmetric. The technique proved to be safe in maintaining the intramuscular position of the implant, with good satisfaction for the patients. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Assuntos
Nádegas/cirurgia , Músculo Esquelético/patologia , Procedimentos de Cirurgia Plástica/métodos , Radiologia Intervencionista , Tomografia Computadorizada por Raios X , Adulto , Atrofia , Feminino , Humanos , Estudos Prospectivos , Adulto Jovem
15.
Plast Reconstr Surg ; 130(5): 706e-713e, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23096624

RESUMO

BACKGROUND: Over the past 30 years, many techniques have been proposed for gluteal augmentation with implants. The intramuscular technique provided greatly improved results and a consequent increase in the number of such procedures performed in Brazil. However, the data available in the medical literature reveal high rates of wound complications, mostly seroma and dehiscence. The aim of this study was to present changes in the management of the wound of augmentation gluteoplasty with silicone implants in an attempt to reduce the rates of postoperative complications. METHODS: Twenty female candidates for augmentation gluteoplasty were selected prospectively and submitted to the procedure with a modified technique. The incidence of wound complications was compared with the data of the authors and of the literature. RESULTS: In the comparison between homogeneous groups of patients, the modified technique reduced the rate of wound complications from 35 percent to 5 percent. The most frequent complications were seroma and dehiscence. The combination of liposuction of the flanks was not a risk factor for the occurrence of these complications. CONCLUSIONS: Reduction of the undermined subcutaneous area, application of adhesion stitches, and maintenance of good vascularization in the sacral region are the keystones of the authors' proposal. The modifications of the technique presented here are simple and easy to perform, and have proved effective in reducing complications during augmentation gluteoplasty with silicone implants. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.


Assuntos
Nádegas/cirurgia , Procedimentos de Cirurgia Plástica/efeitos adversos , Próteses e Implantes , Infecção da Ferida Cirúrgica/prevenção & controle , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Implantação de Prótese/efeitos adversos , Procedimentos de Cirurgia Plástica/métodos , Seroma/prevenção & controle , Deiscência da Ferida Operatória/prevenção & controle
16.
Bol. Centro Pesqui. Process. Aliment ; 28(2): 247-254, jul.-dez. 2010. tab
Artigo em Português | LILACS | ID: lil-590837

RESUMO

A casca de ovo de galinha constitui subproduto utilizado no preparo de multimisturas alimentares distribuídas no Brasil. A carência de informações químicas sobre a casca de ovo motivou a realização deste trabalho que visou desenvolver tecnologia para obtenção desse produto na forma de pó e determinar o seu conteúdo de nutrientes com vistas a sua utilização como fonte de cálcio. Depois de higienizadas e desidratadas, as cascas foram transformadas em pó com auxílio de moinho, tendo sido obtido rendimento de 98,45 ± 0,70%. Determinações analíticas revelaram que 100 g desse produto continha baixo teor de umidade (1,3490 ± 0,0274 g), resíduo mineral fixo equivalente a 91,9600 ± 0,2218 g e baixo teor calórico (30,6823 ± 4,9069 Kcal), provenientes de 4,3693 ± 0,3977 g de proteínas, 0,7837 ± 0,0560 g de lipídios e 1,5379 ± 0,7029 g de carboidratos totais, além de 30.263,72 mg de cálcio. Considerando que a ingestão diária de cálcio recomendada para adultos saudáveis é de 1000 mg, apenas 3,30 g de casca de ovo em pó supririam essa necessidade. Os resultados obtidos sugerem que esse subproduto constitui potencial fonte de cálcio para a alimentação, sendo necessários maiores estudos sobre a sua biodisponibilidade em humanos.


Assuntos
Cálcio , Galinhas , Casca de Ovo/química
17.
Rev. bras. nutr. clín ; 24(4): 211-216, out.-dez. 2009. tab, ilus
Artigo em Português | LILACS | ID: lil-549034

RESUMO

Introdução: O cãncer colorretal (CCR) apresenta crescente incidência no mundo e a cirurgia é seu principal tratamento. Diante da forte associação entre estado nutricional (EN) e complicações no pós-operatório, evidencia-se a importância da avaliação adequada do EN. Objetivo: Verificar se o estadiamento do CCR de pacientes submetidos á cirurgia se correlaciona com um pior EN no momento da internação hospitalar. Método: Realizou-se um estudo retrospectivo com 100 pacientes portadores de CCR internandos e submetidos à cirurgia em um Hospital Universitário no Rio de Janeiro, entre 2003 e 2007. os indicadores do EN foram o ìndice de Massa Corporal (IMC) e o porcentual de perda de peso. O estadiamento seguiu os critérios do American Joint on Cancer (1997) fundamentado na classificação Tumor, Nodes and Metastasis. Para análise estatística, utilizaram-se os testes exato de Fisher e Kruskal-Wallis. Resultados: Na internação, 43% dos pacientes encontravam-se com sobrepeso ou obesidade, 53% eutróficos e 4% desnutridos. Do total, 36% relataram perda ponderal leve ou ausente, 17% significativa e 47% grave. O estadiamento mais avançado não se correlacionou com menor IMC (p=0,5624), nem com incidência (p=0,4037) e gravidade da perda ponderal 9p=0,6017). Porém, a gravidade da perda ponderal se correlacionou com uma alteração na ingestão alimentar (p<0,001, para ambos). Conclusão: Não houve correlação entre o estadiamento mais avançado do CCR e um pior estado nutricional no momento da internação hospitalar. Assim, novos estudos devem abordar outros métodos de avaliação nutricional e possíveis diferenças no metabolismo do cãncer de cólon e reto.


Introduction: Colorectal cancer (CRC) incidence is rising worldwide and its main treatment is surgery. Given the strong association between nutritional status (NS) and postoperative complications, highlights the importance of proper assessment of the EN. Objective: To determine whether the staging of CRC patients undergoing surgery correlates with a worse EN at the time of hospitalization. Method: We conducted a retrospective study of 100 patients with RCC internandos and underwent surgery at a university hospital in Rio de Janeiro, between 2003 and 2007. indicators of EN were the Body Mass Index (BMI) and percentage of weight loss. Staging followed the criteria of the American Joint on Cancer (1997) classification based on the Tumor, Nodes and Metastasis. Statistical analysis used the Fisher exact test and Kruskal-Wallis. Results: At baseline, 43% of patients were overweight or obese, 53% normal and 4% undernourished. Of the total, 36% reported weight loss is minimal or absent, a significant 17% and 47% severe. A more advanced stage was not correlated with lower BMI (p = 0.5624), nor with incidence (p = 0.4037) and severity of weight loss 9p = 0.6017). However, the severity of weight loss correlated with a change in food intake (p <0.001 for both). Conclusion: There was no correlation between more advanced stage of RCC and a poor nutritional status at the time of hospitalization. Thus, further studies should address other methods of nutritional assessment and possible differences in metabolism of the colon and rectum.


Introducción: El cáncer colorrectal (CCR) incidencia está aumentando en todo el mundo y su principal tratamiento es la cirugía. Dada la fuerte asociación entre el estado nutricional (NS) y las complicaciones postoperatorias, pone de relieve la importancia de la evaluación adecuada de la ES. Objetivo: determinar si la puesta en escena de los pacientes sometidos a cirugía de CRC se correlaciona con un peor ES en el momento de la hospitalización. Método: Se realizó un estudio retrospectivo de 100 pacientes con CCR internandos y se sometió a cirugía en un hospital universitario de Río de Janeiro, entre 2003 y 2007. indicadores de la norma fueron el Índice de Masa Corporal (IMC) y porcentaje de pérdida de peso. La estadificación seguido los criterios de la empresa común de América sobre el Cáncer (1997) clasificación basada en el tumor, nódulos y las metástasis. El análisis estadístico utilizó el test exacto de Fisher y Kruskal-Wallis. Resultados: Al inicio del estudio, el 43% de los pacientes con sobrepeso u obesidad, 53% normal y el 4% de desnutrición. Del total, 36% informó de la pérdida de peso es mínimo o ausente, un significativo del 17% y 47% graves. Una etapa más avanzada no se correlacionó con menor IMC (p = 0,5624), ni con la incidencia (p = 0,4037) y la severidad de la pérdida de peso 9p = 0,6017). Sin embargo, la severidad de la pérdida de peso relacionada con un cambio en la ingesta de alimentos (p <0,001 para ambos). Conclusión: No se encontró correlación entre más avanzado estado de CCR y un estado nutricional deficiente en el momento de la hospitalización. Así, los estudios, debería abordar otros métodos de valoración nutricional y las posibles diferencias en el metabolismo del colon y el recto.


Assuntos
Humanos , Masculino , Feminino , Estado Nutricional , Aumento de Peso/fisiologia , Neoplasias Colorretais/cirurgia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/dietoterapia , Índice de Massa Corporal , Qualidade de Vida
18.
Lipids ; 44(6): 537-43, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19415360

RESUMO

Experimental studies have suggested an important role of the spleen in lipid metabolism, although with controversial results. Our purpose was to analyze the effect of a nutritionally balanced (NB) diet and a diet containing pork fat (PF) as source of lipids on the lipid profile of rats submitted to splenic surgery. Sixty adult male Wistar rats were divided into six groups of 10 animals each: 1 sham-operated, NB diet; 2 sham-operated, PF diet; 3 total splenectomy (TS), NB diet; 4 TS, PF diet; 5 TS followed by splenic autotransplantation (SA), NB diet; and 6 SA, PF diet. Blood samples were collected at the beginning (D0) and after 12 weeks of the experiment (D + 12) for plasma lipid determination. Morphologic regeneration of splenic tissues was observed, with no differences between groups 5 and 6. When D + 12 plasma lipid levels were compared to D0 levels there were no differences in groups 1, 3, and 5, while in groups 2, 4, and 6 total cholesterol (TC), low density lipoprotein (LDL), very low density lipoprotein (VLDL), and triacylglycerols (TAG) increased, and high density lipoprotein (HDL) decreased. At D + 12, groups 2, 4, and 6 had lower HDL than group 3. In conclusion, regardless of the surgical procedure applied to the spleen, an NB diet maintained plasma lipid levels while a diet with PF as source of lipids changed the animals' lipid profile.


Assuntos
Ração Animal , Gorduras na Dieta/administração & dosagem , Gorduras na Dieta/farmacologia , Lipídeos/sangue , Baço/cirurgia , Animais , Lipídeos/administração & dosagem , Lipídeos/farmacologia , Masculino , Ratos , Ratos Wistar , Baço/metabolismo , Esplenectomia , Suínos
19.
Acta cir. bras ; 24(1): 69-74, Jan.-Feb. 2009.
Artigo em Inglês | LILACS | ID: lil-503110

RESUMO

The Brazilian scientific community claimed for a definitive systematization and for comprehensive and realistic national rules, to provide guidance and regulation, instead of sanctions, so that the question of scientific research involving animals could be better contemplated. This is beginning to occur now with Law n.º 11.794, sanctioned by the President of the Republic on November 8, 2008. PURPOSE: To describe the evolution of Brazilian regimentation for scientific use of animals and to analyze Law n.º 11.794. METHODS: The legislation about the use of animals in teaching and in scientific research in Brazil and in Rio de Janeiro State was identified and discussed. RESULTS: Until now, there was no updated general and systematizing rule regarding animal vivisection and experimentation for didactic or scientific purposes. The only specific law dates back to1979 and was not regimented. More recent laws equated the practice of scientific experiments to acts of abuse and mistreatment of animals, when alternative technology was available. Municipal laws that restricted the scientific practice of vivisection and experimentation with animals were created in the cities of Rio de Janeiro and Florianopolis. CONCLUSION: With the claim and collaboration of the scientific community, the sanction of Law n.º 11.794 regarding to the scientific use of animals represented an invaluable advance in spite of the presence of some points that eventually may require another type of treatment. The new Law states that it will be regimented within 180 (one-hundred-and-eighty) days, when some of these points could be better elucidated.


A comunidade científica brasileira clamava por uma norma federal abrangente e realista, mais orientadora e reguladora, e menos sancionadora, na qual a questão do uso científico dos animais pudesse ser mais bem contemplada. Isto agora começa a se materializar, com a Lei n.º 11.794, sancionada pelo Presidente da República no dia 8 de novembro de 2008. OBJETIVO: Relatar a evolução na regulamentação brasileira sobre o uso científico de animais e analisar a Lei n.º 11.794. MÉTODOS: Foi identificada e discutida a evolução na legislação existente no Brasil e em alguns municípios brasileiros acerca da utilização de animais no treinamento e na pesquisa científica, até a sanção da nova Lei. RESULTADOS: Até agora, não existia norma geral sistematizadora atualizada referente à vivissecção e experimentação com animais, nem para fins didáticos, nem científicos. A única lei referente a esse tópico datava de 1979 e não chegou a ser regulamentada. Leis mais recentes equiparavam a prática de experimentos científicos aos atos de abuso e maus tratos de animais, na presença de tecnologia alternativa. Nos municípios do Rio de Janeiro e de Florianópolis foram criadas Leis Municipais que cerceavam a prática científica da vivissecção e da experimentação com animais. CONCLUSÃO: A partir do clamor e da colaboração da comunidade científica nacional, a sanção da Lei n.º 11.794, que trata do uso científico dos animais, representou um avanço inestimável, a despeito da presença de alguns pontos que, eventualmente, merecessem outro tipo de tratamento. A nova Lei menciona que ela deverá ser regulamentada em até 180 (cento e oitenta) dias, quando alguns desses pontos poderão ser mais bem esclarecidos.


Assuntos
Animais , Experimentação Animal/legislação & jurisprudência , Pesquisa Biomédica/legislação & jurisprudência , Ensino/legislação & jurisprudência , Brasil , Pesquisadores , Ensino/métodos , Vivissecção
20.
Acta Cir Bras ; 24(1): 69-74, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19169547

RESUMO

UNLABELLED: The Brazilian scientific community claimed for a definitive systematization and for comprehensive and realistic national rules, to provide guidance and regulation, instead of sanctions, so that the question of scientific research involving animals could be better contemplated. This is beginning to occur now with Law no. 11.794, sanctioned by the President of the Republic on November 8, 2008. PURPOSE: To describe the evolution of Brazilian regimentation for scientific use of animals and to analyze Law no. 11.794. METHODS: The legislation about the use of animals in teaching and in scientific research in Brazil and in Rio de Janeiro State was identified and discussed. RESULTS: Until now, there was no updated general and systematizing rule regarding animal vivisection and experimentation for didactic or scientific purposes. The only specific law dates back to 1979 and was not regimented. More recent laws equated the practice of scientific experiments to acts of abuse and mistreatment of animals, when alternative technology was available. Municipal laws that restricted the scientific practice of vivisection and experimentation with animals were created in the cities of Rio de Janeiro and Florianopolis. CONCLUSION: With the claim and collaboration of the scientific community, the sanction of Law no. 11.794 regarding the scientific use of animals represented an invaluable advance in spite of the presence of some points that eventually may require another type of treatment. The new Law states that it will be regimented within 180 (one-hundred-and-eighty) days, when some of these points could be better elucidated.


Assuntos
Experimentação Animal/legislação & jurisprudência , Pesquisa Biomédica/legislação & jurisprudência , Ensino/legislação & jurisprudência , Animais , Brasil , Pesquisadores , Ensino/métodos , Vivissecção
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