LAPAROSCOPIC BARIATRIC SURGERY IN ADOLESCENTS: EARLY AND FIVE- YEAR CLINICAL AND LABORATORY ASSESSMENT.

BACKGROUND: Obesity has reached epidemic proportions among adolescents. Methods, such as bariatric surgery, have become the most effective treatment for patients with classes III and IV obesity. AIM: To evaluate weight loss, comorbidity remission, and long-term results of bariatric surgery in adolescents. METHODS: Study with adolescent patients undergoing bariatric surgery, evaluating laboratory tests, comorbidities, and the percentage of excess weight loss in the preoperative period and at one, two, and five years postoperatively. RESULTS: A total of 65 patients who met the inclusion criteria, with a mean age of 18.6 years, were included in the analysis. In the preoperative period, 30.8% of hypercholesterolemia, 23.1% of systemic arterial hypertension, and 18.4% of type 2 diabetes were recorded, with remission of these percentages occurring in 60, 66.7 and 83.4%, respectively. The mean percentage of excess weight loss was 63.48% after one year of surgery, 64.75% after two years, and 57.28% after five years. The mean preoperative total cholesterol level was 180.26 mg/dL, and after one, two, and five years, it was 156.89 mg/dL, 161.39 mg/dL, and 150.97 mg/dL, respectively. The initial mean of low-density lipoprotein was 102.19mg/dL and after five years the mean value reduced to 81.81 mg/dL. The mean preoperative glycemia was 85.08 mg/dL and reduced to 79.13 mg/dL after one year, and to 76.19 mg/dL after five years. CONCLUSIONS: Bariatric surgery is safe and effective in adolescents, with low morbidity, resulting in a loss of excess weight and long-term stability, improving laboratory tests, and leading to remission of comorbidities, such as diabetes mellitus, hypercholesterolemia, and systemic arterial hypertension.

Laparoscopic bariatric surgery in adolescents: early and five- year clinical and laboratory assessment / Cirurgia bariátrica videolaparoscópica em adolescentes: avaliação clínica e laboratorial precoce e após cinco anos

ABSTRACT BACKGROUND: Obesity has reached epidemic proportions among adolescents. Methods, such as bariatric surgery, have become the most effective treatment for patients with classes III and IV obesity. AIM: To evaluate weight loss, comorbidity remission, and long-term results of bariatric surgery in adolescents. METHODS: Study with adolescent patients undergoing bariatric surgery, evaluating laboratory tests, comorbidities, and the percentage of excess weight loss in the preoperative period and at one, two, and five years postoperatively. RESULTS: A total of 65 patients who met the inclusion criteria, with a mean age of 18.6 years, were included in the analysis. In the preoperative period, 30.8% of hypercholesterolemia, 23.1% of systemic arterial hypertension, and 18.4% of type 2 diabetes were recorded, with remission of these percentages occurring in 60, 66.7 and 83.4%, respectively. The mean percentage of excess weight loss was 63.48% after one year of surgery, 64.75% after two years, and 57.28% after five years. The mean preoperative total cholesterol level was 180.26 mg/dL, and after one, two, and five years, it was 156.89 mg/dL, 161.39 mg/dL, and 150.97 mg/dL, respectively. The initial mean of low-density lipoprotein was 102.19mg/dL and after five years the mean value reduced to 81.81 mg/dL. The mean preoperative glycemia was 85.08 mg/dL and reduced to 79.13 mg/dL after one year, and to 76.19 mg/dL after five years. CONCLUSIONS: Bariatric surgery is safe and effective in adolescents, with low morbidity, resulting in a loss of excess weight and long-term stability, improving laboratory tests, and leading to remission of comorbidities, such as diabetes mellitus, hypercholesterolemia, and systemic arterial hypertension.

RESUMO RACIONAL: A obesidade tomou proporções epidêmicas entre adolescentes, e procedimentos como a cirurgia bariátrica tornou-se o tratamento mais efetivo em pacientes com obesidade grau III e IV. OBJETIVOS: Avaliar a perda peso, a remissão de comorbidades, e resultados a longo prazo da cirurgia bariátrica em adolescentes. MÉTODOS: Estudo com pacientes adolescentes submetidos à cirurgia bariátrica, avaliando exames laboratoriais, comorbidades e o percentual de perda de excesso de peso, nos períodos pré-operatório e com 1, 2 e 5 anos de pós-operatório. RESULTADOS: Foram incluídos no estudo 65 pacientes que preencheram os critérios de inclusão, com a média de idade de 18,6 anos. No pré-operatório foram registrados: 30,8% hipercolesterolemia, 23,1% hipertensão arterial sistêmica e 18,4% diabetes tipo 2, ocorrendo remissão destes porcentuais em 60, 66,7 e 83,4%, respectivamente. O percentual médio de perda de excesso de peso após 1 ano foi de 63,48%, após 2 anos foi de 64,75% e após 5 anos foi 57,28%. O valor médio do colesterol total no pré-operatório era de 180,26mg/dL, e após 1 ano, 2 anos e 5 anos foram de 156,89mg/dL,161,39mg/dL e de 150,97mg/dL, respectivamente. A média inicial de lipoproteína de baixa densidade era 102,19mg/dL e após 5 anos o valor médio reduziu para 81,81 mg/dL. O valor médio da glicose pré-operatório era 85,08 mg/dL, após um ano uma média 79,13mg/dL, e com 5 anos 76,19 mg/dL. CONCLUSÕES: A cirurgia bariátrica é segura e eficaz em adolescentes, com baixa morbidade, resultando em uma perda do excesso de peso e estabilidade a longo prazo, melhorando exames laboratoriais e levando a remissão de comorbidades como diabetes mellitus, hipercolesterolemia e hipertensão arterial sistêmica.

Clinical and immunological allergy assessment in cancer patients.

Cancer is associated with immunodeficiency, while allergies result from immune system hyperactivity mediated by cytokines and immunoglobulins. The purpose of this study was to determine the relationship between immune environment of specific cancers and allergies, emphasizing cytokines related to Th1 and Th2 responses associated with IgE. 80 adults were distributed into two groups: control (n = 20) and cancer (n = 60), distributed in three subgroups (n = 20), head and neck, stomach, and prostate cancers. This study compared Th1 (IL-2) and Th2 (IL-4) parameters, anti-inflammatory, pro-inflammatory, or regulatory profile regarding both IgE levels and reported allergies, by means of clinical manifestations and IgE, IL-1ß, IL-2, IL-4, IL-17, and TGF-ß serum concentration. Clinically allergies were observed in 50% of the control group and in 20% of the cancer group (p = 0.009). IL-2 cytokine and TGF-ß concentrations were higher in the patients with cancer as compared to the control (p < 0.005). However, there were IL-4, IL-17, and IL-1ß decreases in the patients with cancer (p < 0.05). No correlation was observed between the cytokines studied and IgE and clinically proven allergies in both investigated groups. There was an inverse association between cancer and clinical allergy manifestations. In head and neck, stomach, and prostate cancers, an immunosuppressive serum tumor environment was predominant. There was no difference in cytokines related to Th1 and Th2 parameters in relation to IgE. No correlation was found between clinically proved allergies and immunity markers related to the same allergens.

Characteristics of motorcyclists involved in accidents between motorcycles and automobiles.

INTRODUCTION: traffic accidents are one of the main causes of death and disability, with motorcyclists representing the great majority of both the victims and the perpetrators. OBJECTIVE: this work studied the characteristics of motorcyclists injured in accidents involving motorcycles and automobiles. METHOD: this study sought to interview 100 motorcyclists who had been injured in collisions between motorcycles and automobiles, and who were undergoing emergency hospital treatment in the region of Belo Horizonte, Brazil. The questionnaires included demographic information (age, gender, skin color, education level, profession) and questions about years of licensed driving practice, how often they would drive an automobile, how long they had had a motorcycle driver's license, how often they would ride a motorcycle, the number of prior accidents involving a car, and the number of prior accidents not involving a car. RESULTS: of the 100 consecutive accidents studied, 91 occurred with men and 9 with women, aged between 16 and 79 (m = 29 ± 11) years. Regarding their reason for using a motorcycle, 83% reported using it for transport, 7% for work, and 10% for leisure. Most of these accident victims had secondary or higher education (47%). Of the motorcyclists who held a car driver's license, 68.3% drove the vehicle daily or weekly and held the license for more than one year. Sixty-seven percent of the accident victims used a motorcycle daily and had a motorcycle driver's license for at least one year. CONCLUSION: among the motorcyclists injured, most were men aged 20 years or older, with complete secondary education, and experienced in driving both motorcycles and cars, indicating that recklessness while driving the motorcycle is the main cause of traffic accidents.

Characteristics of motorcyclists involved in accidents between motorcycles and automobiles / Características dos motociclistas envolvidos em acidentes entre motocicleta e automóvel

Introduction: traffic accidents are one of the main causes of death and disability, with motorcyclists representing the great majority of both the victims and the perpetrators. Objective: this work studied the characteristics of motorcyclists injured in accidents involving motorcycles and automobiles. Method: this study sought to interview 100 motorcyclists who had been injured in collisions between motorcycles and automobiles, and who were undergoing emergency hospital treatment in the region of Belo Horizonte, Brazil. The questionnaires included demographic information (age, gender, skin color, education level, profession) and questions about years of licensed driving practice, how often they would drive an automobile, how long they had had a motorcycle driver’s license, how often they would ride a motorcycle, the number of prior accidents involving a car, and the number of prior accidents not involving a car. Results: of the 100 consecutive accidents studied, 91 occurred with men and 9 with women, aged between 16 and 79 (m = 29 ± 11) years. Regarding their reason for using a motorcycle, 83% reported using it for transport, 7% for work, and 10% for leisure. Most of these accident victims had secondary or higher education (47%). Of the motorcyclists who held a car driver’s license, 68.3% drove the vehicle daily or weekly and held the license for more than one year. Sixty-seven percent of the accident victims used a motorcycle daily and had a motorcycle driver’s license for at least one year. Conclusion: among the motorcyclists injured, most were men aged 20 years or older, with complete secondary education, and experienced in driving both motorcycles and cars, indicating that recklessness while driving the motorcycle is the main cause of traffic accidents. .

Introdução: os acidentes de trânsito são uma das principais causas de morte e invalidez, sendo os motociclistas a maior parte de suas vítimas e seus causadores. Objetivo: estudar as características dos motociclistas envolvidos em acidentes entre motocicletas e automóveis. Métodos: foram entrevistados 100 motociclistas feridos em colisões entre motocicleta e automóvel que se encontravam em tratamento hospitalar de urgência no município de Belo Horizonte. O questionário continha sua identificação (idade, sexo, cor da pele, escolaridade, profissão) e perguntas sobre tempo de habilitação para dirigirem automóvel, frequência com que dirigiam automóvel, tempo de habilitação para conduzirem motocicleta, frequência com que dirigiam motocicleta, número de acidentes prévios envolvendo automóvel e número de acidentes prévios sem relação com automóvel. Resultados: dos 100 acidentados consecutivos estudados, 91 eram homens e 9 eram mulheres com idade de 16 a 79 anos (M=29±11). Quanto à finalidade do uso da motocicleta, 83% a empregavam para transporte, 7% para trabalho e 10% para lazer, tendo a maior parte dos acidentados pelo menos o ensino médio completo (47%). Dos motociclistas que possuíam habilitação para automóvel, 68,3% dirigiam o veículo diária ou semanalmente e possuíam a habilitação por período superior a 1 ano; 67% dos acidentados conduziam motocicleta diariamente e tinham pelo menos 1 ano de habilitação para motocicleta. Conclusão: entre os 100 acidentados, predominaram homens com idade superior a 20 anos, ensino médio completo, experiência em conduzir motocicletas e automóveis, indicando que a imprudência ao conduzir a motocicleta tenha sido a principal causa de acidentes de trânsito. .

Autologous and allogeneic ovarian orthotopic transplantation: morphologic, endocrinologic and natural pregnancy assessment.

PURPOSE: To assess pregnancy of rabbits submitted to bilateral ovariectomy and orthotopic allogeneic or autologous intact and sliced ovarian transplantation without a vascular pedicle and to determine the morphofunctional aspects of the transplanted ovaries. METHODS: Fifty-six female rabbits were studied. The ovaries were removed and orthotopically transplanted or replaced without vascular anastomoses: Group 1 (n=8), only laparotomy and laparorrhaphy, Group 2A (n=8) intact ovaries were transplanted on both sides, Group 2B (n=8) both ovaries were sliced and orthotopically transplanted, Group 2C (n=8), an intact ovary was transplanted on one side and a sliced ovary on the other side. In Group 3 the ovaries were reimplanted according to the procedure and subgroups described for Group 2. Three months later, the animals were paired with males for copulation. Estradiol, progesterone, FSH and LH hormone levels were assessed. A histologic study was carried out, and the number of pregnancies and litters were also determined. Chi-square test compared the number of pregnancies and litters. One-way ANOVA and the Tukey-Kramer tests compared the hormonal dosages. RESULTS: Pregnancies occurred in seven (87.5%) rabbits of Group 1, in three rabbits (37.5%) of Groups 2A and 3A, in four rabbits (50%) of groups 2B, 3B and 3C, and in five (62.5%) of group 2C. Normal hormone serum levels and histology confirmed the vitality of all ovaries. CONCLUSION: Orthotopic allogeneic and autologous ovarian transplantation without a vascular pedicle is viable in rabbits, and preserves their hormonal levels and fertile functions.

Autologous and allogeneic ovarian orthotopic transplantation: morphologic, endocrinologic and natural pregnancy assessment

PURPOSE: To assess pregnancy of rabbits submitted to bilateral ovariectomy and orthotopic allogeneic or autologous intact and sliced ovarian transplantation without a vascular pedicle and to determine the morphofunctional aspects of the transplanted ovaries. METHODS: Fifty-six female rabbits were studied. The ovaries were removed and orthotopically transplanted or replaced without vascular anastomoses: Group 1 (n=8), only laparotomy and laparorrhaphy, Group 2A (n=8) intact ovaries were transplanted on both sides, Group 2B (n=8) both ovaries were sliced and orthotopically transplanted, Group 2C (n=8), an intact ovary was transplanted on one side and a sliced ovary on the other side. In Group 3 the ovaries were reimplanted according to the procedure and subgroups described for Group 2. Three months later, the animals were paired with males for copulation. Estradiol, progesterone, FSH and LH hormone levels were assessed. A histologic study was carried out, and the number of pregnancies and litters were also determined. Chi-square test compared the number of pregnancies and litters. One-way ANOVA and the Tukey-Kramer tests compared the hormonal dosages. RESULTS: Pregnancies occurred in seven (87.5%) rabbits of Group 1, in three rabbits (37.5%) of Groups 2A and 3A, in four rabbits (50%) of groups 2B, 3B and 3C, and in five (62.5%) of group 2C. Normal hormone serum levels and histology confirmed the vitality of all ovaries. CONCLUSION: Orthotopic allogeneic and autologous ovarian transplantation without a vascular pedicle is viable in rabbits, and preserves their hormonal levels and fertile functions.

Avaliação do estresse psíquico em pacientes submetidos a operações de grande porte sob anestesia geral / Assessment of psychic stress in patients submitted to big surgical procedures under general anaesthesia

INTRODUÇÃO: Estudo realizado em clínicas cirúrgicas de dois hospitais de Belo Horizonte com 100 pacientes adultos de ambos os sexos, distribuídos em dois grupos: Grupo 1 - 22 pacientes sem experiência com cirurgia; Grupo 2 - 78 pacientes submetidos previamente a outras operações de médio e grande porte. OBJETIVO: Avaliar o impacto do estresse psíquico em pacientes submetidos a operações de grande porte sob anestesia geral, relacionando suas reações físicas e psíquicas com as diferentes fases do estresse. MÉTODO: Para investigação do estresse, utilizou-se o Inventário de Sintomas de Stress para Adultos, desenvolvido por Lipp, um dia antes e dois dias e sete dias após a operação. A comparação dos grupos quanto às variáveis "sexo", "dor" e "percentual de estresse" foi realizada pelo teste do qui ao quadrado e para a variável idade foi utilizado o teste t de Student. As diferenças foram consideradas significativas para p < 0,05. RESULTADOS: Os grupos não foram homogêneos quanto ao percentual geral de estresse nas três mensurações. O Grupo 1 diminuiu e o Grupo 2 aumentou o estresse no pós-operatório. Prevaleceram sintomas psíquicos do estresse em ambos os grupos. CONCLUSÃO: O fato de ter sido operado previamente reduziu a tensão pré-operatória, porém não interferiu nos distúrbios emocionais pós-operatórios.

INTRODUCTION: One hundred adult patients hospitalized in the surgical wards of two hospitals of Belo Horizonte city, Brazil, were separated into two groups: group 1, 22 patients who had no previous experience with surgeries; and group 2, 78 patients who had been previously submitted to major surgical procedures. OBJECTIVE: To evaluate the impact of psychical stress on patients submitted to major operations under general anesthesia and to correlate physical and psychological reactions to different stages of stress. METHOD: The Stress Symptoms Inventory for Adults was used one day before and two and seven days after the operation. The groups were compared with regard to sex, level of pain and stress percentage with the chi-square test and for age with the Student t test. The level of significance was set at p < 0.05. RESULTS: The groups were not homogeneous regarding the general percentage of stress on the occasion of the three measurements. The level of stress was decreased in Group 1 and increased in Group 2. Psychic stress symptoms prevailed in both groups. CONCLUSION: Previous experience with surgery under general anesthesia reduces preoperative stress, but does not affect postoperative stress.

[Assessment of immunossupresion induced by thalidomide, cyclosporine and diclofenac on skin allograft survival in rabbits]. / Estudo comparativo dos efeitos da talidomida, da ciclosporina e do diclofenaco na sobrevida de aloenxertos cutâneos em coelho.

OBJECTIVE: Allografting is one of the therapeutic alternatives for extensive burn victims without sufficient skin donor areas. This research studied the effects of cyclosporine, as an immunosuppressor model, and thalidomide and dyclofenac as anti-inflammatory drugs on an experimental skin allograft research. METHODS: Forty-two rabbits were divided in the following groups (n=6): Group 1 - autografting control; Group 2 - allografting control; Group 3 - allografts under thalidomide effect (100 mg/kg/day); Group 4 - allografts under sodium dyclofenac effect (2 mg/kg/day); - Group 5 -allografts under cyclosporine effect (10 mg/kg/day); Group 6 - allografts under cyclosporine effect (5 mg/kg/day); Group 7- allografts under cyclosporine (5 mg/kg/day) plus thalidomide (100 mg/kg/day) effect. Drugs were given via orogastric tube since the day before transplantation and daily during the postoperative period. Circular total skin grafts of the ear were exchanged between California and White New Zealand rabbits. RESULTS: Cyclosporine 10 mg/kg/day increased allograft survival and this effect was comparable to the association of cyclosporine 5 mg/kg/day with thalidomide 100 mg/kg/day. Thalidomide as an isolated drug and dyclofenac had a minimum effect on the average survival of the skin allografts. The number of eosinophils around the necrotic skin was higher in the dyclofenac group and lower in the group receiving cyclosporine associated with thalidomide. CONCLUSION: This study showed that thalidomide may be an useful drug when associated with subtherapeutic doses of cyclosporine for treatment of skin allografts.

Estudo comparativo dos efeitos da talidomida, da ciclosporina e do diclofenaco na sobrevida de aloenxertos cutâneos em coelho / Assessment of immunossupresion induced by thalidomide, cyclosporine and diclofenac on skin allograft survival in rabbits

OBJETIVO: Verificar se a talidomida é capaz de evitar a rejeição de aloenxertos de pele em coelhos, como droga isolada, ou melhorar a eficácia de doses subterapêuticas de ciclosporina, comparando seu efeito ao de doses terapêuticas da ciclosporina e também ao papel antiinflamatório do diclofenaco de sódio. MÉTODOS: Foram estudados 42 coelhos, distribuídos nos seguintes grupos (n=6): Grupo 1 - controle com auto-enxerto; Grupo 2 - controle com aloenxerto; Grupo 3 - aloenxerto sob o efeito de talidomida (100 mg/kg/dia); Grupo 4 - aloenxerto sob o efeito de diclofenaco de sódio (2 mg/kg/dia); Grupo 5 - aloenxerto sob o efeito de ciclosporina (10 mg/kg/dia); Grupo 6 - aloenxerto sob o efeito de ciclosporina (5 mg/kg/dia); Grupo 7 - aloenxerto sob o efeito de ciclosporina (5 mg/kg/dia) associada a talidomida (100 mg/kg/dia). Foram retirados enxertos circulares de pele total do dorso de uma das orelhas do animal. Os medicamentos foram administrados por cateter orogástrico, a partir do dia anterior ao transplante. Os enxertos foram trocados entre coelhos de raças diferentes. RESULTADOS: A ciclosporina a 10 mg/kg/dia prolongou a sobrevida dos enxertos de pele, sendo seu efeito comparável ao obtido com a ciclosporina em dose subterapêutica (5 mg/kg/dia) associada a talidomida a 100 mg/kg/dia. A talidomida isoladamente, mesmo em concentração de 100 mg/kg/dia, e o diclofenaco tiveram efeito mínimo na sobrevida média dos aloenxertos cutâneos. O número de eosinófilos no infiltrado inflamatório circunjacente à necrose foi maior nos grupos tratados com diclofenaco e com ciclosporina a 5 mg/kg/dia e menor no grupo em que se associou ciclosporina com talidomida. CONCLUSÃO: A talidomida pode ser uma droga útil para associar-se a baixas doses de ciclosporina no tratamento de aloenxertos cutâneos.

OBJECTIVE: Allografting is one of the therapeutic alternatives for extensive burn victims without sufficient skin donor areas. This research studied the effects of cyclosporine, as an immunosuppressor model, and thalidomide and dyclofenac as anti-inflammatory drugs on an experimental skin allograft research. METHODS: Forty-two rabbits were divided in the following groups (n=6): Group 1 - autografting control; Group 2 - allografting control; Group 3 - allografts under thalidomide effect (100 mg/kg/day); Group 4 - allografts under sodium dyclofenac effect (2 mg/kg/day); - Group 5 -allografts under cyclosporine effect (10 mg/kg/day); Group 6 - allografts under cyclosporine effect (5 mg/kg/day); Group 7- allografts under cyclosporine (5 mg/kg/day) plus thalidomide (100 mg/kg/day) effect. Drugs were given via orogastric tube since the day before transplantation and daily during the postoperative period. Circular total skin grafts of the ear were exchanged between California and White New Zealand rabbits. RESULTS: Cyclosporine 10 mg/kg/day increased allograft survival and this effect was comparable to the association of cyclosporine 5 mg/kg/day with thalidomide 100 mg/kg/day. Thalidomide as an isolated drug and dyclofenac had a minimum effect on the average survival of the skin allografts. The number of eosinophils around the necrotic skin was higher in the dyclofenac group and lower in the group receiving cyclosporine associated with thalidomide. CONCLUSION: This study showed that thalidomide may be an useful drug when associated with subtherapeutic doses of cyclosporine for treatment of skin allografts.

Avaliação dos espermatozóides em diferentes faixas etárias / Assessment of spermatozoa in different age groups

Objetivo: Verificar, por meio  da análise do líquido seminal de diferentes faixas etárias, a ocorrência de alterações nos espermatozóides. Métodos: Foi estudado o líquido seminal de 80 homens adultos hígidos, com idade entre 21 e 60 anos, após um período de abstinência sexual de cinco dias. Os voluntários foram distribuídos em quatro grupos etários (n = 20): 21 a 30 anos, 31 a 40 anos, 41 a 50 anos e 51 a 60 anos. Rresultados: Não foram encontradas diferenças entre os grupos quanto aos aspectos físico-químicos dos sêmens (odor, cor, volume, viscosidade e pH). Também não houve diferença entre as concentrações ou porcentagem de formas móveis nos grupos estudados. No entanto, embora não significativo, verificou-se um aumento da concentração de espermatozóides no líquido seminal a partir dos 41 anos. A morfologia dos espermatozóides mostrou maior percentual de formas ovais (p = 0,03) e menor de fusiformes entre 41 e 50 anos em relação aos demais grupos (p = 0,02). Cconclusões: Percebeu-se não apenas que não ocorre uma redução na produção de espermatozóides até os 60 anos, mas também que há um aumento das melhores formas para fecundação.

Assessment of the persistence of fecal loading in the cecum in presence of acute appendicitis.

OBJECTIVE: Although the radiographic characteristics of acute appendicitis have been well documented, the value of plain abdominal radiography has not been completely studied. Therefore, the purpose of this investigation was to establish the association and relevance of the image of fecal loading in the cecum detected by plain abdominal X-ray of patients with acute appendicitis. METHODS: One hundred and seventy consecutive patients of both sexes were admitted at the hospital with acute pain in the right flank. The hypothesis of appendicitis was confirmed by operation and histological examination. These patients were distributed into two groups: Group 1 (n=100), patients who had plain abdominal X-rays done a few hours before surgical treatment, and Group 2 (n=70), patients who had plain abdominal X-rays done before the surgical procedure and also the following day. All X-rays were taken from an anteroposterior view of the abdomen. Demographic data such as age, gender, and skin color (white, brown and black) and morphologic stages of acute appendicitis were also assessed. RESULTS: Radiographic sign of fecal loading in the cecum was detected in 97 (97%) patients of Group 1 and in 68 (97.14%) patients of Group 2. This sign could not be detected any longer after surgery in 66 of the 68 positive cases. Sensitivity of this radiographic sign for acute appendicitis was 97.05%. CONCLUSIONS: Radiographic image of fecal loading in the cecum of patients with abdominal pain is associated with acute appendicitis. The image usually becomes undetectable shortly after the appendix removal.

Avaliação endócrina e morfológica de tranplante autógeno de ovários íntegros e fatiados em coelhas / Endocrinologic and morphologic assessment of intact and sliced ovarian autologous tranplantation in rabbits

Os objetivos do presente trabalho foram avaliar aspectos morfológicos e endócrinos de transplantes ovarianos autógenos, fixados em posição ortópica, na forma íntegra e fatiada, sem pedículo vascular. Foram utilizados 42 coelhos da raça Nova Zelândia Branca. No Grupo 1 (n=8) foi realizada apenas laparotomia e laparorrafia. No Grupo 2A (n=8), transplantou-se o ovário na forma íntegra, no Grupo 2B, transplantou-se o ovário na forma fatiada e no Grupo 2C (n=8), transplantou-se de um lado, o ovário íntegro e, do outro lado, fatiado. Não houve anastomose vascular. Dosou-se o estradiol, a progesterona, o hormônio folículo-estimulante e o hormônio luteinizante de cada animal no nono mês pós-operatório. Estudaram-se as morfologias macro e microscópia dos ovários, tubas e útero, de todos os animais. Foram utilizados os testes one-way ANOVA seguido pelo teste de Tukey-Kramer para comparar as dosagens hormonais, considerando p<0,05. Os ovários transplantados estavam rodeados por tecido conjuntivo, bem vascularizado, mostrando folículos em diferentes estádios de desenvolvimento. A histologia tubária e uterina também foi preservada em ambos os grupos. A dosagem hormonal foi normal em todas as coelhas, indicando que o ovário transplantado estava funcionando do ponto de vista endócrino. Conclui-se que o transplante autógeno ortópico de ovários, na forma íntegra ou fatiada, sem preservação do pedículo vascular é variável e preserva as funções endócrinas.

Avaliação pós-transplante de ovários íntegros e fatiados sem anastomose vascular / Endocrinological, morphological and gestational assessment of intact and sliced ovarian orthotopic reimplantation or transplantation without vascular pedicle

OBJETIVO: Avaliar a fertilização, bem como aspectos endócrinos e histológicos do ovário após seu reimplante ou transplante ortotópico, sem anastomose vascular. MÉTODOS: Foram utilizadas 56 coelhas da raça Nova Zelândia Branca e Califórnia distribuídas em: Grupo 1 (n=8) - controle, apenas laparotomia e laparorrafia; Grupo 2A (n=8) - reimplante ortotópico de ovários íntegros; Grupo 2B (n=8) - reimplante ortotópico de ovários fatiados; Grupo 2C (n=8) - reimplantes ovarianos de um lado, íntegros, e, do outro lado, fatiados; Grupo Grupo 3A (n=8) - transplante ortotópico de ovários íntegros; Grupo 3B (n=8) - transplante ortotópico de ovários fatiados; Grupo 3C (n=8) - transplantes ovarianos de um lado, íntegros, e, do outro lado, fatiados. A partir do terceiro mês pós-operatório, cada coelha foi colocada para cópula. Dosou-se o estradiol, a progesterona, o FSH e o LH no nono mês pós-operatório. Estudou as morfologias macro e microscópicas dos ovários, tubas e útero, de todas os animais. Os números de gestações e de filhotes foram avaliados por meio do teste Qui-quadrado e as dosagens hormonais foram comparadas pelo one-way Anova, seguido pelo teste de Tukey-Kramer. RESULTADOS: No Grupo 1, sete (87,5 por cento) coelhas engravidaram entre o segundo e terceiro meses após início da cópula. No Grupo 2, as gestações ocorreram entre o quinto e o oitavo meses pós-operatórios e, no Grupo 3, entre o quarto e o oitavo meses pós-operatórios. A porcentagem de gravidez observada foi de 37,5 por cento no Grupo 2A, 50 por cento no Grupo 2B e 2C, 37,5 por cento no Grupo 3A, 50 por cento no Grupo 3B e 62,5 por cento no Grupo 3C. Os níveis hormonais e o estudo morfofuncional dos ovários, tubas e úteros não apresentaram alterações. CONCLUSÃO: O reimplante ou transplante ovariano homógeno ortotópico sem pedículo vascular é eficaz para a manutenção de níveis normais de hormônios ovarianos e permitiu a fertilização natural.

OBJETIVE: To assess the natural pregnancy and to determine the morphofunctional aspects of ovaries of rabbits submitted to bilateral oophorectomy and orthotopic allogeneic or autologous intact and sliced ovarian transplantation without a vascular pedicle. METHODS: Fifty-six female New Zealand White and California rabbits were studied. The ovaries were removed and orthotopically transplanted or replaced without vascular anastomoses: Group 1 (n = 8), only laparotomy and laparorrhaphy were performed; Group 2A (n = 8) intact ovaries were reimplanted on both sides; Group 2B (n = 8) both ovaries were sliced and orthotopically reimplanted; Group 2C (n = 8), an intact ovary was reimplanted on one side and a sliced ovary on the other side; Group 3A (n = 8) intact ovaries were transplanted on both sides, Group 3B (n = 8) both ovaries were sliced and orthotopically transplanted, Group 3C (n = 8), an intact ovary was transplanted on one side and a sliced ovary on the other side. Three months later, the females were paired with males for copulation. Estradiol, progesterone, follicle stimulating hormone and luteinizing hormone levels were assessed. The morphological aspect of the ovaries was studied and the number of pregnancies and litters were also determined.Tthe number of successful pregnancies and the number of litters was compared between the groups by the chi-square test. One-way ANOVA and the Tukey-Kramer tests compared the hormonal dosages. The significance was of p < 0.05. RESULTS: Pregnancies occurred in seven (87.5 percent) rabbits of Group 1, in 37.5 percent in Groups 2A and 3A, in 50 percent of groups 2B, 2C and 3B, and in 62.5 percent of group 3C. Hormone levels and histology confirmed the vitality of all ovaries. CONCLUSION: Intact or sliced orthotopic allogeneic and autologous ovarian transplantation without a vascular pedicle is viable in rabbits, and preserves their fertility and hormonal functions.

[Endocrinological, morphological and gestational assessment of intact and sliced ovarian orthotopic reimplantation or transplantation without vascular pedicle]. / Avaliação pós-transplante de ovários íntegros e fatiados sem anastomose vascular.

OBJECTIVE: To assess the natural pregnancy and to determine the morphofunctional aspects of ovaries of rabbits submitted to bilateral oophorectomy and orthotopic allogeneic or autologous intact and sliced ovarian transplantation without a vascular pedicle. METHODS: Fifty-six female New Zealand White and California rabbits were studied. The ovaries were removed and orthotopically transplanted or replaced without vascular anastomoses: Group 1 (n = 8), only laparotomy and laparorrhaphy were performed; Group 2A (n = 8) intact ovaries were reimplanted on both sides; Group 2B (n = 8) both ovaries were sliced and orthotopically reimplanted; Group 2C (n = 8), an intact ovary was reimplanted on one side and a sliced ovary on the other side; Group 3A (n = 8) intact ovaries were transplanted on both sides, Group 3B (n = 8) both ovaries were sliced and orthotopically transplanted, Group 3C (n = 8), an intact ovary was transplanted on one side and a sliced ovary on the other side. Three months later, the females were paired with males for copulation. Estradiol, progesterone, follicle stimulating hormone and luteinizing hormone levels were assessed. The morphological aspect of the ovaries was studied and the number of pregnancies and litters were also determined. The number of successful pregnancies and the number of litters was compared between the groups by the chi-square test. One-way ANOVA and the Tukey-Kramer tests compared the hormonal dosages. The significance was of p < 0.05. RESULTS: Pregnancies occurred in seven (87.5%) rabbits of Group 1, in 37.5% in Groups 2A and 3A, in 50% of groups 2B, 2C and 3B, and in 62.5% of group 3C. Hormone levels and histology confirmed the vitality of all ovaries. CONCLUSION: Intact or sliced orthotopic allogeneic and autologous ovarian transplantation without a vascular pedicle is viable in rabbits, and preserves their fertility and hormonal functions.

Avaliação endócrina e morfológica de transplante ovariano homógeno / Endocrine and morphological assessment of ovarian homologous transplantation

INTRODUÇAO: A insuficiência ovariana decorre de ooforectomia bilateral em diversas afecções do ovário, como neoplasia e sepse, além de quimioterapia, radiação pélvica e fatores relacionados à idade. Suas complicações sistêmicas, como insuficiências hormonais, podem ser de difícil controle. OBJETIVOS: Avaliar aspectos endócrinos e histológicos ovarianos após seu transplante ortotópico, sem anastomose vascular e submetidos à imunossupressão pela ciclosporina. MATERIAL E MÉTODO: Foram utilizadas 12 coelhas da raça Nova Zelândia Branca (n = 6) e Califórnia (n = 6), divididas em dois grupos: grupo 1 (n = 4), de controle, submetido apenas a laparotomia, sem outro procedimento cirúrgico; e grupo 2 (n = 8), submetido a ooforectomia bilateral e transplante ortotópico dos ovários, que foram trocados entre as duas raças de animais. De um lado, foi transplantado o ovário íntegro e, do outro, o ovário fatiado. Não houve anastomose vascular. As coelhas foram imunossuprimidas com ciclosporina (10mg/kg ao dia). No final do período de acompanhamento de seis meses, foram feitas dosagens de estradiol, progesterona, hormônio foliculoestimulante (FSH) e hormônio luteinizante (LH), além de estudo histológico de ovários, tuba uterina e útero. RESULTADOS: Os ovários transplantados estavam rodeados por tecido conjuntivo, bem vascularizados, mostrando folículos em diferentes estádios de desenvolvimento. A histologia tubária e uterina também foi preservada em ambos os grupos. A dosagem hormonal foi normal em todas as coelhas, indicando que, do ponto de vista endócrino, o ovário transplantado estava funcionando. O transplante ovariano homógeno ortotópico, sem pedículo vascular e submetido à imunossupressão pela ciclosporina, foi eficaz para a manutenção de hormônios ovarianos em níveis normais.