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1.
Rev. bras. ortop ; 57(3): 351-359, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1388026

ABSTRACT

Abstract Among the pathologies that affect the hip joint, osteonecrosis of the femoral head (ONFH) is probably the most intriguing and challenging. It consists of a multifactorial disease with a highly-variable spectrum in its clinical presentation. It has a devastating effect, due to disabling painful conditions, both for usual activities and sports. Given the huge range of risk factors, such as prolonged use of corticosteroids (especially in cases of rheumatologic diseases), trauma sequelae, sickle cell anemia, HIV, alcoholism, smoking, blood dyscrasias, and several other diseases that compromise the blood supply to the femoral head, ONFH has a varied clinical presentation and prognosis, which makes it difficult to determine a specific treatment, especially in cases in which chondral involvement has not yet occurred and the hip joint is still preserved. These are the main factors found in the literature that determine the classifications of this pathology. The range of treatments includes several options for cases in which an attempt is made to save the joint: conservative treatment, traditional decompression and/or combined with some type of adjuvant treatment (homologous grafting, synthetic grafting, vascularized grafts, tantalum screws, and bone marrow aspirate injection), and, for cases in which there is already a subchondral fracture and/or collapse of the femoral head and/or a reduction in the joint space, femoral osteotomies or total hip arthroplasty are commonly performed.


Resumo Entre as patologias que acometem a articulação coxofemoral, a osteonecrose da cabeça femoral (ONCF) é provavelmente a mais intrigante e desafiadora. Consiste em uma doença multifatorial, com um espectro muito variável em sua apresentação clínica. Tem efeito devastador, devido a quadros dolorosos incapacitantes tanto para atividades habituais quanto esportivas. Dada a gama enorme de fatores de risco, tais como uso prolongado de corticoides (principalmente em casos de doenças reumatológicas), sequelas de trauma, anemia falciforme, HIV, etilismo, tabagismo, discrasias sanguíneas, e várias outras doenças que comprometem a irrigação sanguínea da cabeça femoral, a ONCF tem apresentação clínica e prognósticos bem variados, o que dificulta a determinação de um tratamento específico, especialmente em casos nos quais ainda não houve acometimento condral e a articulação do quadril ainda se mantém preservada, sendo estes os principais fatores encontrados na literatura que determinam as classificações desta patologia. No leque de tratamentos, encontramos diversas opções para os casos em que setenta salvar a articulação: tratamento conservador, descompressão simples e/ou associada a algum tipo de tratamento adjuvante (enxertia homóloga, enxertia sintética, enxertos vascularizados, parafusos de tântalo, e injeção de aspirado de medula óssea), e, para casos nos quais já há fratura subcondral e/ou colapso da cabeça femoral e/ou diminuição do espaço articular, reserva-se, comumente, a realização de osteotomias femorais ou artroplastia total do quadril.


Subject(s)
Humans , Osteonecrosis , Transplants , Femur Head/abnormalities , Hip Prosthesis
2.
Rev. bras. ortop ; 57(1): 180-184, Jan.-Feb. 2022. graf
Article in English | LILACS | ID: biblio-1365736

ABSTRACT

Abstract Although it is a versatile tendon, only 1% of surgeons choose to use the quadricipital tendon as a graft in anterior cruciate ligament (ACL) reconstruction. The present article aims to describe a quadricipital graft removal technique in which its deepest part is maintained. The technique consists of an approach in which the first incision is made in the medial part of the quadricipital tendon to prevent it from getting too short. This is due to its triangular design. The technique also addresses the depth and identification of the three layers of the quadricipital tendon so that it is possible to preserve its deepest part. This approach aims to preserve the extensor apparatus and to not communicate it with the joint environment, avoiding fluid extravasation both in the trans and postoperative periods.


Resumo Ainda que seja um tendão versátil, apenas 1% dos cirurgiões optam por utilizar o tendão quadricipital como enxerto na reconstrução do ligamento cruzado anterior (LCA). O presente artigo tem o objetivo de descrever uma técnica de retirada do enxerto quadricipital na qual a sua porção mais profunda é mantida. A técnica consiste em uma abordagem na qual a primeira incisão é feita na porção medial do tendão quadricipital para evitar que ele fique muito curto. Isso acontece devido ao seu desenho triangular. A técnica também aborda a profundidade e a identificação das três camadas do tendão quadricipital para que seja possível preservar sua porção mais profunda. Esta conduta tem o objetivo de uma maior preservação do aparelho extensor e de não haver comunicação com o meio articular, evitando extravasamento de líquido tanto no trans- quanto no pós-operatório.


Subject(s)
Humans , Postoperative Period , Anterior Cruciate Ligament , Transplants , Knee
3.
Goiânia; SES-GO; 23 dez. 2021. 1-14 p. quad.
Non-conventional in Portuguese | LILACS, ColecionaSUS, CONASS, SES-GO | ID: biblio-1397529

ABSTRACT

Em Goiás, desde a publicação do Decreto N.º 4.930/98, que criou o Programa Goiás Transplantes, as ações relacionadas aos transplantes, tem evoluído constantemente, atingindo um maior número de doadores, os órgãos e tecidos captados são enviados para outras unidades federativas. Diante disso, todo esse processo complexo é monitorado pelo Sistema Nacional de Transplantes ­ SNT do Ministério da Saúde ­ MS e para padronizar e organizar essas atividades a Portaria MS/SAS N.º 2600/2009, determina que a coordenação, promoção, controle e fiscalização das ações relacionadas aos transplantes, são incumbências das Centrais Estaduais de Transplantes ­ CETs. Tendo em vista que no âmbito dos receptores, as ações iniciam-se com a inclusão em lista de espera para o transplante, desse modo, é intrínseco que entre as responsabilidades da CET/GO há o compromisso com as atividades de regulação do acesso, para este fim. De modo a atender a demanda existente em Goiás, a CET/GO apresenta o fluxo regulatório para as solicitações do agendamento de consultas destinadas à avaliação especializada em transplantes em todas as modalidades disponibilizadas, via SUS no Estado


In Goiás, since the publication of Decree N.º 4.930/98, which created the Goiás Transplants Program, actions related to transplants have constantly evolved, reaching a greater number of donors, the organs and tissues collected are sent to other federative units. . Therefore, this entire complex process is monitored by the National Transplant System - SNT of the Ministry of Health - MS and to standardize and organize these activities, Ordinance MS/SAS N.º 2600/2009 determines that the coordination, promotion, control and supervision of actions related to transplants, are the responsibility of the State Transplant Centers ­ CETs. Considering that, in the scope of the recipients, the actions begin with the inclusion in the waiting list for the transplant, in this way, it is intrinsic that among the responsibilities of the CET/GO there is the commitment to the activities of access regulation, to this end. In order to meet the existing demand in Goiás, CET/GO presents the regulatory flow for requests for scheduling appointments for specialized evaluation in transplants in all available modalities, via SUS in the State


Subject(s)
Humans , Transplants/supply & distribution , Transplants/classification , Transplants/standards , Transplants/transplantation
4.
Nursing (Säo Paulo) ; 24(283): 6656-6665, dez. 2021.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1371257

ABSTRACT

OBJETIVO: Conhecer as emoções identificadas por enfermeiros no processo de doação ao transplante de órgãos e tecidos. METODOLOGIA: Estudo qualitativo descritivo-exploratório, fundamentado na perspectiva Sociopoética. O Grupo- Pesquisador foi desenvolvido em 2015 é composto por 8 enfermeiros que trabalhavam há mais de 6 meses no processo de doação/transplantes de órgãos de um hospital geral do extremo sul do estado da Bahia, Brasil. A produção de dados foi orientada por desenhos, para estímulo dos sentidos. Os áudios foram transcritos, textualizados e categorizados segundo análise de conteúdo de Bardin. As exigências éticas da pesquisa com seres humanos do país foram cumpridas. RESULTADOS: As principais dimensões dos enfermeiros sobre as emoções no trabalho de doação para transplante de órgãos e tecidos foram agrupadas nos seguintes temas: prazer do resultado, da incerteza da doação à satisfação do transplante, a motivação para transformar a aflição em contentamento, e da dor da perda ao júbilo por receber um órgão e finalmente obter qualidade de vida. CONCLUSÕES: Concluiu-se que a identificação das dimensões das emoções presentes no processo de doação de órgãos e tecidos, por enfermeiros, têm a possibilidade de promover aprimoramento de suas atividades cotidianas dentre outros fatores que influenciam o trabalho desses profissionais.(AU)


OBJECTIVES: To investigate the process of organ and tissue donation for transplantation from the perspective of nurses. METHODS: Qualitative descriptive-exploratory study, based on the Sociopoetic perspective. The Researcher Group was developed in 2015 and consists of 8 nurses who had worked for more than 6 months in the organ donation / transplantation process of a general hospital in the extreme south of the state of Bahia, Brazil. The production of data was guided by drawings, to stimulate the senses. The audios were transcribed, textualized and categorized according to Bardin's content analysis. The ethical requirements of research with human beings in the country have been met. RESULTS: Las principales dimensiones de las emociones de las enfermeras en el trabajo de donación para el trasplante de órganos y tejidos se agruparon en los siguientes temas: placer por el resultado, desde la incertidumbre de la donación hasta la satisfacción del trasplante, la motivación para transformar la angustia en alegría y el dolor de pérdida de alegría por recibir un órgano y finalmente obtener calidad de vida. CONCLUSIONS: It was concluded that the identification of the dimensions of the emotions present in the organ and tissue donation process, identified by nurses, has the possibility of promoting improvement in their daily activities, among other factors that influence the work of these professionals.(AU)


OBJETIVO(S): Investigar el proceso de donación de órganos y tejidos para trasplante desde la perspectiva de las enfermeras de un hospital de referencia general para una organización de obtención de órganos. METODOLOGÍA: Estudio cualitativo descriptivo-exploratorio, basado en la perspectiva Sociopoética. El Grupo de Investigadores se desarrolló en 2015 y está integrado por 8 enfermeras que habían trabajado durante más de 6 meses en el proceso de donación / trasplante de órganos de un hospital general en el extremo sur del estado de Bahía, Brasil. La producción de datos fue guiada por dibujos, para estimular los sentidos. Los audios se transcribieron, textualizaron y categorizaron de acuerdo con el análisis de contenido de Bardin. Se han cumplido los requisitos éticos de la investigación con seres humanos en el país. RESULTADOS: Las principales dimensiones de las emociones de las enfermeras en el trabajo de donación para el trasplante de órganos y tejidos se agruparon en los siguientes temas: placer por el resultado, desde la incertidumbre de la donación hasta la satisfacción del trasplante, la motivación para transformar la angustia en alegría y el dolor de pérdida de alegría por recibir un órgano y finalmente obtener calidad de vida. CONCLUSIONES: Se concluyó que la identificación de las dimensiones de las emociones presentes en el proceso de donación de órganos y tejidos, identificadas por los enfermeros, tiene la posibilidad de promover la mejora en sus actividades diarias, entre otros factores que influyen en el trabajo de estos profesionales.(AU)


Subject(s)
Work , Nursing , Health Personnel , Transplants
5.
An. Fac. Cienc. Méd. (Asunción) ; 54(3): 173-178, Dec. 2021.
Article in Spanish | LILACS | ID: biblio-1352991

ABSTRACT

El colgajo de fascia temporal superficial es muy versátil para la reconstrucción de defectos tisulares localizados en los tercios superior y medio de la cara, en la región orbito-palpebral, en la cavidad oral, en la base del cráneo y a nivel mandibular. En nuestra experiencia, constituye una opción segura para reconstrucciones complejas de cavidades. En el presente artículo los autores exponen el caso de una paciente en quien se reconstruyó un defecto de órbita con un colgajo de fascia temporal superficial prelaminado


The superficial temporal fascia flap is versatile for the reconstruction of tissue defects located in the upper and middle thirds of the face, in the orbital-palpebral region, in the oral cavity, at the base of the skull and at the mandibular level. In our experience, it is a safe option for complex cavity reconstructions. In this article the authors present the case of a patient in whom an orbit defect was reconstructed with a pre-laminated superficial temporal fascia flap


Subject(s)
Transplants , Orbit , Fascia
6.
Rev. bras. ortop ; 56(6): 705-710, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1357134

ABSTRACT

Abstract Obstetric brachial plexus palsy is a rather common injury in newborns, caused by traction to the brachial plexus during labor. In this context, with the present systematic review, we aimed to explore the use of nerve graft and nerve transfer as procedures to improve elbow flexion in children with obstetric palsy. For the present review, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the MEDLINE, EMBASE, LILACS, The Cochrane Central Register of Controlled Trials, Web of Science, Wholis and SCOPUS databases. Predetermined criteria defined the following requirements for inclusion of a study: Clinical trials, quasi-experiments, and cohort studies that performed nerve graft and nerve transfer in children (≤ 3 years old) with diagnosis of obstetric palsy. The risk of bias in nonrandomized studies of interventions assessment tool was used for nonrandomized studies. Out of seven studies that used both procedures, three of them compared the procedures of nerve graft with nerve transfer, and the other four combined them as a reconstructive method for children with obstetric palsy. According to the Medical Research Council grading system, both methods improved equally elbow flexion in the children. Overall, our results showed that both techniques of nerve graft and nerve transfer are equally good options for nerve reconstruction in cases of obstetric palsy. More studies approaching nerve reconstruction techniques in obstetric palsy should be made, preferably randomized clinical trials, to validate the results of the present systematic review.


Resumo A paralisia obstétrica do plexo braquial é uma lesão bastante comum em neonatos, sendo causada pela tração do plexo braquial durante o trabalho de parto. A presente revisão sistemática tem como objetivo exploraro uso de enxertose transferências de nervo como procedimentos para melhora da flexão do cotovelo em crianças com paralisia obstétrica. A presente revisão sistemática seguiu as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, na sigla em inglês) e foi baseada em pesquisa nos bancos de dados MEDLINE, EMBASE, LILACS, The Cochrane Central Register of Controlled Trials, Web of Science, Wholis e SCOPUS. De acordo com os critérios pré-determinados, os artigos incluídos eram ensaios clínicos, quase-experimentos, e estudos de coortes sobre enxertos e transferências de nervos em crianças (de até 3 anos de idade) com diagnóstico de paralisia obstétrica. A ferramenta de avaliação Risk of Bias in Non-Randomized Studies of Interventions foi usada em estudos não randomizados. Sete estudos utilizaram os dois procedimentos; três deles compararam os procedimentos de enxerto e transferência de nervo, enquanto os outros quatro os combinaram como método reconstrutivo em crianças com paralisia obstétrica. Segundo o sistema de classificação do Medical Research Council, os dois métodos melhoraram a flexão do cotovelo das crianças de maneira similar. De modo geral, nossos resultados mostraram que o enxerto de nervo e a transferência de nervo são opções igualmente boas para a reconstrução nervosa em casos de paralisia obstétrica. Mais estudos sobre as técnicas de reconstrução nervosa na paralisia obstétrica devem ser realizados, de preferência ensaios clínicos randomizados, para validação dos resultados dessa revisão sistemática.


Subject(s)
Paralysis, Obstetric , Randomized Controlled Trials as Topic , Nerve Transfer , Transplants , Neonatal Brachial Plexus Palsy
7.
Rev. argent. cir. plást ; 27(2): 67-70, 20210000. graf, fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1357667

ABSTRACT

Introducción. Hasta un 90% de las mordeduras de animales son producidas por perros. Los niños son la población más vulnerable frente a las mordeduras ya que suelen afectar una mayor proporción de superficie corporal. Objetivo. Analizar la casuística de mordeduras de perro y su repercusión en nuestro entorno. Métodos. Estudio observacional, descriptivo, retrospectivo de un período de 8 años, que incluyó a todos los pacientes de 0 a 18 años con diagnóstico de mordedura de perro. Resultados. Se incluyeron 183 pacientes con diagnóstico de mordedura de perro. El promedio de edad fue de 6,1 años, y el grupo etario más afectado fue el de los niños de 3 a 5 años (38,3%). El tratamiento quirúrgico fue dividido en pacientes que requirieron rafia por planos (84,6%), colgajos (11,4%), injertos (3,4%) y puntos de aproximación (1%). Se reportaron 8 pacientes con complicaciones (4,4%). Conclusión. Los niños de 3 a 5 años son los más afectados por mordeduras de perro y la zona de cabeza y cuello es la más común. Un porcentaje importante de pacientes requirieron colgajos e injertos con buenos resultados.


Introduction. Up to 90% of animal bites are produced by dogs. Children are the most vulnerable population because bites tend to affect greater body surface area. Outcome. Analyze dog bites cases and their impact on our environment. Methods. An observational, descriptive, retrospective study during an 8 year period was carried out, which included all patients from 0 to 18 years with a diagnosis of dog bite. Results. A total of 183 patients with a diagnosis of dog bite were found. The average age was 6.1 years, and the age group most affected was children from 3 to 5 years old (38.3%). Surgical treatment was divided into: patients who required suture by planes (84.6%), flaps (11.4%) and grafts (3.4%) and approximation stitches (1%). Complications were reported in 8 patients (4.4%). Conclusion. Children from 3 to 5 years old are the most affected by dog bites, the head and neck area is the most common. A significant percentage of patients required flaps and grafts with good results.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Wounds and Injuries/surgery , Bites and Stings/therapy , Epidemiology, Descriptive , Retrospective Studies , Vaccination , Neck Injuries/therapy , Transplants/surgery , Lower Extremity/injuries , Upper Extremity/injuries , Dogs/injuries , Facial Injuries/therapy , Wound Closure Techniques , Anti-Bacterial Agents/therapeutic use
9.
Rev. argent. cir ; 113(2): 224-228, jun. 2021. graf
Article in Spanish | LILACS, BDNPAR | ID: biblio-1365477

ABSTRACT

RESUMEN Antecedentes: los avances en cuidados perioperatorios e inmunosupresión permitieron que la su pervivencia de los pacientes trasplantados aumente significativamente, así observamos que la litiasis vesicular es más frecuente en este grupo de pacientes. Objetivo: el objetivo de este trabajo es analizar y describir los resultados obtenidos en colecistecto mías en pacientes trasplantados cardíacos. Material y métodos: seleccionamos los pacientes mediante una búsqueda cruzada entre las bases de datos de Trasplante Cardíaco y Cirugía Biliar. Recopilamos información sobre sus antecedentes médi cos, parámetros clínicos y de laboratorio, entre otros. Resultados: entre enero 1994-diciembre 2017 se realizaron 154 trasplantes cardíacos con una edad media de 40 años; 16 pacientes fueron incluidos en este estudio y en los cuales fue realizada la cole cistectomía laparoscópica posterior al trasplante. No se registraron morbilidad, readmisiones ni mor talidad. Conclusión: la colecistectomía laparoscópica es segura y es el método de elección en pacientes tras plantados cardíacos. Se debe realizar colangiografía intraoperatoria, ya que los predictores de litiasis coledociana suelen estar alterados.


ABSTRACT Background: The advances in perioperative care and immunosuppressive treatment resulted in a significant increase in survival of transplant patients; as a result, cholelithiasis is more common in transplant patients. Objective: The aim of this study is to analyze and describe the results obtained in cholecystectomies in heart transplant patients. Material and methods: We selected patients by cross-referencing the databases of heart transplantation and scheduled biliary surgeries, and collected information on their medical history, clinical parameters and laboratory tests, among other data. Results: Between January 1994 and December 2017, 154 heart transplant procedures were performed; mean age was 40 years; 16 underwent laparoscopic cholecystectomy after heart transplantation and were included in this study. There were no complications, readmissions or deaths. Conclusion: Laparoscopic cholecystectomy is safe and is the method of choice for heart transplant patients with cholelithiasis. Intraoperative cholangiography should be performed as the predictors of choledocholithiasis are usually abnormal.


Subject(s)
Humans , Male , Heart Transplantation , Cholecystectomy, Laparoscopic/methods , Perioperative Care/methods , Cystectomy , Immunosuppression Therapy , Transplants , Choledocholithiasis , Alkalies , Heart
10.
Quito; Alvear Delgado, Plinio (Comp.); Arbeláez Rodríguez, Gloria (Comp.); Primera; 2021/05/31. 566 p. ilus, tabs, grafs..
Monography in Spanish | LILACS | ID: biblio-1253693

ABSTRACT

Prólogo. La obra recopiló los hitos históricos, las acciones en gestión y la visión futura de las Unidades Médicas, Administrativas y de Enfermería, en homenaje a los 50 años de función del Hospital de Especialidades Carlos Andrade Marín como ícono de la Seguridad Social del Ecuador, entre el periodo 1970 a diciembre 2020. Cada autor registró el título entrelazado un pensamiento, previo a la cronología de los hechos suscitados en los servicios brindados en beneficio de los pacientes que se atendieron en esta casa de salud. La obra se clasificó en capítulos por Unidades Médicas: Críticas, Clínicas, Quirúrgicas, Administrativas y de Enfermería, se incluyeron tablas, figuras, producción médica, patologías, cambios de técnicas o procedimientos y sustentó su accionar con citas textuales y referen-cias bibliográficas. Además, se narraron mejoras continuas transmitidas de los ilustres y legados maestros, especialistas médicos por varias generaciones, en conjunto con el personal de salud con vocación de servicio, en una reflexión profunda con mensajes vivos de su accionar. En las modalidades de publicación se realizaron aportes de visión nacional e internacional en los ámbitos asistenciales, administrativos, docente, de investigación y producción científica de alto nivel del contexto y naturaleza del emblemático hospital. Finalmente, se agradece a los funcionarios y ex trabajadores que colaboraron durante el proceso de construcción de la obra, así como a ex colaboradores que motivaron aportes de experiencias y la apreciación personal.


Prologue. The work compiled the historical milestones, management actions and future vision of the Medical, Administrative and Nursing Units, in tribute to the 50 years of function of the Carlos Andrade Marin Specialty Hospital as an icon of the Social Security of Ecuador, between 1970 and December 2020. Each author recorded the title intertwined with a thought, prior to the chronology of the events that took place in the services provided for the benefit of patients who were treated in this health center. The work was classified in chapters by Medical Units: Critical, Clinical, Surgical, Administrative and Nursing, and included tables, figures, medical production, pathologies, changes in techniques or procedures, and supported his actions with textual quotations and bibliographical references. In addition, continuous improvements were narrated and transmitted from the illustrious and legacy masters, medical specialists for several generations, together with the health personnel with vocation of service, in a deep reflection with living messages of their actions. In the publication modalities, contributions of national and international vision were made in the care, administrative, teaching, research and scientific production of high level of the context and nature of the emblematic hospital. Finally, we would like to thank the employees and former workers who collaborated during the construction process, as well as former collaborators who contributed with their experiences and personal appreciation.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , History, 21st Century , Young Adult , Research , General Surgery , Surgery, Plastic , Thoracic Surgery , Urology , Health Services Administration , Obstetrics and Gynecology Department, Hospital , Hospital Services , Blood Banks , Cardiology , Hospital Records , Mental Health , Maternal and Child Health , Oncology Service, Hospital , Coronavirus Infections , Transplants , Critical Care , Emergency Operations Center , Dermatology , Ecuador , Emergency Medicine , Endocrinology , Hospital Care , Hemodynamics , History , Hospital Administration , Hospitals, Special , Ancillary Services, Hospital , Intensive Care Units , Internal Medicine , Obesity
11.
An. Fac. Cienc. Méd. (Asunción) ; 54(1): 137-142, 20210000.
Article in Spanish | LILACS | ID: biblio-1178959

ABSTRACT

El desbridamiento temprano seguido de cobertura con piel autóloga ha demostrado reducir la mortalidad en los pacientes quemados. En pacientes con quemaduras extensas, la carencia de zonas de piel donante es un factor limitante a la hora del tratamiento. El hecho de que no se pueda lograr un desbridamiento y cobertura completos en un primer tiempo favorece la infección de la quemadura y la septicemia, pudiendo tener consecuencias nefastas. Por tanto, es necesario disponer de otras opciones distintas a los injertos mallados de piel parcial, el tratamiento estándar hoy día. Presentamos el caso clínico de un niño con quemaduras severas y describimos los resultados obtenidos con el uso de la membrana amniótica como cobertura temporal y al injerto mallado tipo MEEK.


Early debridement followed by coverage with autologous skin has been shown to reduce mortality in burn patients. In patients with extensive burns, the lack of areas of donor skin is a limiting factor at the time of treatment. The fact that a complete debridement and coverage cannot be achieved in the first stage favors the infection of the burn and septicemia, which can have dire consequences. Therefore, it is necessary to have other options than partial skin mesh grafts, the standard treatment today. We present the clinical case of a child with severe burns and describe the results obtained with the use of the amniotic membrane as temporary covering and the MEEK-type mesh graft.


Subject(s)
Burns , Sepsis , Transplants , Amnion , Infections
12.
Rev. cuba. angiol. cir. vasc ; 22(1): e281, ene.-abr. 2021. fig
Article in Spanish | LILACS, CUMED | ID: biblio-1251684

ABSTRACT

Los traumas vasculares periféricos poseen una frecuencia elevada en relación con las lesiones vasculares y conllevan a una incapacidad significativa a pacientes relativamente jóvenes. La identificación oportuna y el manejo inicial adecuado de este tipo de lesión son muy importantes para su posterior evolución. Este artículo tuvo como objetivo exponer la importancia del tratamiento oportuno del trauma vascular en dos pacientes llegados el mismo día al servicio de urgencias del Hospital Militar Central "Dr. Luis Díaz Soto". Se presenta como primer caso a un paciente masculino de 44 años de edad, con antecedentes de salud aparente. Sufrió una herida de aproximadamente 12 cm en el brazo izquierdo, que se acompañó de sangramiento e hipotensión arterial. Se le colocó injerto protésico y se le realizó anastomosis término-terminal en la arteria humeral porque presentaba sección completa de esta; su evolución fue favorable. El segundo caso se trata de un paciente masculino de 60 años de edad, con antecedentes de salud aparente. Sufrió un trauma en el antebrazo izquierdo que le provocó una herida de alrededor de 8 cm, con sangramiento, palidez y frialdad del tercio distal del antebrazo, cianosis reversible de la mano, impotencia funcional, ausencia de pulso radial e hipotensión arterial. Se le realizó anastomosis término-terminal de arteria radial porque presentaba sección completa de esta y su evolución resultó favorable. El tratamiento oportuno y acertado del trauma vascular evitó la pérdida de la vida de los pacientes, disminuyó la presencia de complicaciones, aseguró una evolución rápida y redujo incapacidades en estos(AU)


Peripheral vascular traumas have a high frequency in relation to vascular lesions, and lead to significant disability in relatively young patients. Timely identification and adequate initial management of this type of lesion are very important for its subsequent evolution. This article aimed to show the importance of timely treatment of vascular trauma in two patients who arrived on the same day at the emergency service of Dr. Luis Díaz Soto Central Military Hospital. The first case presented corresponds to a 44-year-old male patient apparently without previous heath conditions. He had a wound of approximately twelve centimeters on the left arm, which was accompanied by bleeding and arterial hypotension. The patient was placed a prosthetic graft and performed an end-to-end anastomosis in the brachial artery because it was completely sectioned. The patient's evolution was favorable. The second case corresponds to a 60-year-old male patient with an apparent health history. He suffered a trauma to his left forearm that caused a wound of about 8 cm, with bleeding, paleness and coldness of the distal third of the forearm, reversible cyanosis of the hand, functional impotence, absence of radial pulse and arterial hypotension. End-to-end anastomosis of the radial artery was performed because the patient presented complete section of the artery and his evolution was favorable. Timely and correct treatment of vascular trauma prevented the loss of life in both patients, reduced the presence of complications, ensured a rapid evolution, and reduced their disabilities(AU)


Subject(s)
Humans , Male , Female , Pulse , Brachial Artery , Radial Artery , Transplants , Emergencies , Vascular System Injuries
13.
Saúde Soc ; 30(4): e201049, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1341683

ABSTRACT

Resumo Trata-se de uma pesquisa qualitativa, ancorada na Teoria das Representações Sociais, com o objetivo de analisar as possíveis representações sociais que adolescentes do Ensino Médio de uma escola da rede pública têm sobre o processo de doação de órgãos e tecidos para transplantes. Participaram do estudo 60 adolescentes, com idade entre 14 e 18 anos, matriculados no Ensino Médio de uma instituição de ensino situada no norte do Paraná. Os resultados, obtidos mediante técnica de associação livre de palavras, indicaram que o núcleo central das representações sociais em relação à doação de órgãos e ao ato de ser um doador de órgãos é composto por palavras que definem o sentido de amor, vida, solidariedade, compaixão, salvação, ajuda e, como elementos intermediários e periféricos, os vocábulos morte, sangue, esperança, felicidade e compaixão. Os resultados delineiam as possíveis representações sociais sobre doação de órgãos entre os adolescentes como um processo capaz de promover a recuperação da vitalidade humana, remetendo a sentimentos de gratidão e felicidade, inseridos numa sociedade mais consciente e solidária.


Abstract Anchored in the Theory of Social Representations, this qualitative research aims to analyze the possible social representations of adolescents enrolled in public high school regarding organ and tissue donations for transplantations. In total, 60 adolescents aged between 14 and 18 years, enrolled in a public high school in the north of Paraná were included in the study. Based on a word association technique, we verified the central nucleus of social representations regarding organ donation and being an organ donor to comprise words defining the meaning of love, life, solidarity, compassion, salvation, and help. In turn, words such as death, blood, hope, happiness, and compassion comprised intermediate and peripheral elements. In this sense, the social representation of organ donation among adolescents may be understood as a process capable of promoting the recovery of human vitality, referring to feelings of gratitude and happiness, inserted in a more conscious and caring society.


Subject(s)
Humans , Male , Female , Adolescent , Tissue and Organ Procurement , Adolescent , Nursing , Transplants , Education, Primary and Secondary
14.
Acta cir. bras ; 36(2): e360208, 2021. graf
Article in English | LILACS | ID: biblio-1152704

ABSTRACT

ABSTRACT Purpose Although transplanting two kidneys from a single donor to two recipients has some advantages, the right and left kidneys are not anatomically identical; thus, a surgical procedure considering the anatomical features of the donor kidneys is needed when transplanting them into the opposite renal fossae. Based on vast experience, the surgical details of pig orthotopic kidney transplantation from one donor to two recipients was reported. Methods When the right kidney was transplanted to the left renal fossa, the graft was inverted upside down, not backwards, thus ensuring that the anteroposterior relationship of the renal vessels was maintained and anatomically natural vascular anastomosis could be performed. Results Using this technique, we could have developed a pig experimental model that is safe and has a high success rate, even for researchers in the middle of their training. This technique of inverting the graft upside down was reported in human kidney transplantation to make vascular anastomosis easier. Conclusions In pig orthotopic kidney transplantation from one donor to two recipients, an anatomically natural vascular anastomosis could be performed via inverted grafting when the right kidney was transplanted into the left renal fossa.


Subject(s)
Animals , Kidney Transplantation , Transplants , Swine , Kidney/surgery , Nephrectomy
15.
Article in English | LILACS, BBO | ID: biblio-1180861

ABSTRACT

ABSTRACT Objective: To describe dental findings of kidney and liver, pre and post-transplant patients of an oral health care service from a Brazilian Southeast state. Material and Methods: A descriptive cross-sectional study was developed with a sample of patients attending the oral health care program for transplantation of Universidade Federal de Minas Gerais. Participants were divided into two groups according to the kind of transplantation-kidney or liver. Characteristics of the sample, sex (male/female), age (18-44; 45-54; 55-80), living region (Belo Horizonte, or outside), phase of transplantation (pre-Tx or post-Tx), and self-report of diabetes mellitus and hypertension were presented by frequencies. Dental caries experienced was measured by Decayed, Missing and Filled-Teeth (DMF-T) index. Results: 185 patients, kidney (46; 24.9%), and liver (139; 75.1%) were included. Mean DMFT was 18.3 (20.0). DMFT scores of males (18.7; 20.0), females (17.2; 18.0), pre-transplanted (18.3; 20.0), and post-transplanted (18.1; 20.0) were similar. The liver transplantation group (19.3; 20.0) showed higher caries experience comparing to kidney´s (15.2; 17.0). Conclusion: Dental caries experience was high in kidney and liver patients under transplantation therapy. This highlights the demand for treatment need in this population.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Brazil/epidemiology , Kidney Transplantation , Liver Transplantation , Dental Care for Chronically Ill , Dental Caries/prevention & control , Dental Health Services , Epidemiology, Descriptive , Cross-Sectional Studies/methods , Transplants
16.
J. Health Biol. Sci. (Online) ; 9(1): 1-6, 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1370072

ABSTRACT

Objetivo: Este estudo visa avaliar o perfil metabólico de pacientes que foram submetidos a TxC em um centro de referência do estado do Ceará. Métodos: Trata-se de um estudo transversal, quantitativo, em que se avaliaram 110 pacientes receptores de TxC no Hospital de Messejana de Fortaleza, no período de 2011 a 2018, por meio de uma ficha clínica. Resultados: observou-se que a maioria dos pacientes era do gênero masculino (76,5%), e a média de idade foi de 46,26 ± 12,73 anos. Entre os pacientes, observou-se que previamente à cirurgia, 42,5% tinham histórico familiar de doença cardíaca, 40,1% estavam com sobrepeso e 15% eram diabéticos. A classe de medicação mais utilizada para as doenças de bases foram os diuréticos, inibidores da enzima conversora da angiotensina e bloqueadores de receptores da angiotensina. A principal etiologia que levou à necessidade do TxC foi a miocardiopatia isquêmica. Conclusões: Nesta amostra, a doença de base com maior prevalência que levou ao transplante foi a miocardiopatia isquêmica. A maioria dos pacientes apresentou rejeição ao enxerto em algum momento do período estudado. Todos os pacientes que apresentaram descompensação glicêmica fizeram uso de insulina.


Objective: This study aims to assess the metabolic profile of patients who underwent HT at a referral center in the state of Ceará. Methods: This is a cross-sectional, quantitative study, in which 110 patients receiving HT were evaluated at the Hospital de Messejana in Fortaleza, from 2011 to 2018, through a clinical form. Results: It was observed that the majority of patients were male (76.5%) and the mean age was 46.26 ± 12.73 years. Among the patients, it was observed that prior to surgery, 42.5% had a family history of heart disease, 40.1% were overweight, and 15% were diabetic. The most used class of medication for underlying diseases were diuretics, angiotensin-converting-enzyme inhibitors, and angiotensin receptor blockers. The main etiology leading to the need for HT was ischemic cardiomyopathy. Conclusions: In this sample, the most prevalent underlying disease leading to transplantation was ischemic cardiomyopathy. Most patients presented graft rejection at some point during the study period. All patients who presented glycemic decompensation used insulin.


Subject(s)
Transplants , Transplant Recipients , Diuretics , Enzyme Inhibitors , Metabolome , Heart , Cardiomyopathies
17.
Acta cir. bras ; 36(5): e360503, 2021. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1278103

ABSTRACT

ABSTRACT Purpose As a classical xenotransplantation model, porcine kidneys have been transplanted into the lower abdomen of non-human primates. However, we have improved upon this model by using size-matched grafting in the orthotopic position. The beneficial aspects and surgical details of our method are reported herein. Methods Donors were two newborn pigs (weighting 5 to 6 kg) and recipients were two cynomolgus monkeys (weighting, approximately, 7 kg). After bilateral nephrectomy, kidneys were cold-transported in Euro-Collins solution. The porcine kidney was transplanted to the site of a left nephrectomy and fixed to the peritoneum. Results Kidneys transplanted to the lower abdomen by the conventional method were more susceptible to torsion of the renal vein (two cases). In contrast, early-stage blood flow insufficiency did not occur in orthotopic transplants of theleft kidney. Conclusions Size-matched porcine-primate renal grafting using our method of transplanting tothe natural position of the kidneys contributes to stable post-transplant blood flow to the kidney.


Subject(s)
Animals , Kidney Transplantation , Transplants , Swine , Graft Survival , Kidney/surgery , Macaca fascicularis , Nephrectomy
19.
Braz. dent. sci ; 24(3): 1-12, 2021. ilus, tab
Article in English | LILACS, BBO | ID: biblio-1281002

ABSTRACT

Objective: The aim of this study was to compare the horizontal dimensional changes of split-bone block and cortico-cancellous block graft in horizontal ridge augmentation using Cone Beam Computed Tomography (CBCT). The quality of the regenerated bone in both groups was compared histologically and histomorphometrically. Material and methods: Twenty patients were randomly divided in two equal groups (n= 10): Split-bone block group which was harvested from the external oblique ridge or cortico-cancellous block graft group which was harvested from the mandibular symphysis. Pre-augmentation crestal ridge width was measured using bone caliper. CBCT scans were taken on the 2nd week and 4th month post-operatively to measure crestal and total horizontal ridge dimensions. A biopsy was collected from the regenerated ridge immediately before implant insertion on the 4thmonth post-operatively. Results: Pre-augmentation crestal bone widths of both groups were comparable (P= 0.870). On the 2nd week and 4th month post-operatively, split-bone block showed a significantly wider crestal (P= 0.028 and P= 0.001 respectively) and total horizontal ridge dimension (P= 0.025 and P= 0.002 respectively), and on the 4th month post-operatively, it showed significantly lesser resorption at crest (P= 0.040) and in total horizontal ridge dimension (P= 0.017) than cortico-cancellous block. Histologically, the regenerated bone quality was similar in both groups. Histomorphometric analysis showed a non-significant difference in percentage of mature (P= 0.365) and immature collagen (P= 0.531) between both groups. Conclusion: Split-bone block maintained a significantly wider ridge and experienced less resorption after 4 months than the cortico-cancellous block graft, with no difference in regenerated bone quality between both groups. (AU)


Objetivo: O objetivo deste estudo foi comparar as mudanças dimensionais horizontais do enxerto de bloco ósseo dividido e do enxerto de bloco córtico-esponjoso no aumento de rebordo horizontal por meio da Tomografia computadorizada de feixe cônico (TCFC). A qualidade do osso regenerado em ambos os grupos foi comparada histológica e histomorfometricamente. Material e Métodos:Vinte pacientes foram divididos aleatoriamente em dois grupos iguais (n=10): Grupo de blocos de osso dividido retirado da crista oblíqua externa ou Grupo de enxerto em bloco córtico-esponjoso retirado da sínfise mandibular. A largura da crista pré-aumentada foi medida usando calibrador ósseo. Os exames de TCFC foram realizados na segunda semana e quarto mês de pós operatório para medir as dimensões da crista e dimensões horizontais totais do rebordo. Uma biopsia foi coletada da crista regenerada imediatamente antes da inserção do implante no quarto mês pós-operatório. Resultados: As larguras do osso crestal pré-aumentado de ambos os grupos eram compatíveis (p = 0,870). Na segunda semana e quarto mês pós-operatórios, o bloco ósseo dividido mostrou uma crista significativamente mais larga (p = 0,28 e p = 0,001 respectivamente) e a dimensão da crista horizontal total (p = 0,025 e p = 0,002 respectivamente), e no quarto mês pós-operatório, apresentou reabsorção significativamente menor na crista (p = 0,040) e na dimensão da crista horizontal total (p = 0,017) em comparação ao bloco córtico-esponjoso. Histologicamente, a qualidade do osso regenerado foi semelhante em ambos os grupos. A análise histomorfométrica mostrou uma diferença não significativa na porcentagem de colágeno maduro (p = 0.365) e colágeno imaturo (p = 0,531) entre ambos os grupos. Conclusão: O bloco ósseo dividido manteve uma crista significativamente mais larga e apresentou menos reabsorção após 4 meses, em comparação ao enxerto em bloco córtico-esponjoso, sem diferença na qualidade do osso regenerado entre ambos os grupos. (AU)


Subject(s)
Humans , Dental Implants , Transplants , Cone-Beam Computed Tomography
20.
Pesqui. vet. bras ; 40(12): 1018-1028, Dec. 2020. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1155043

ABSTRACT

The present study aimed to evaluate the effects of mesenchymal stem cells derived from canine adipose tissue in the healing process of full-thickness mesh skin grafts in rabbits. The stem cells were collected from young dogs; and, after characterization, remained in cryopreservation, in independent doses containing 2 x 106 cells. The mesh distal limb graft technique was performed in 60 rabbits, divided into three groups, CG (Control Group), GT1 (Intralesional Stem Cell Treated Group), and GT2 (Intravenous Stem Cell Treated Group), containing 20 animals each. After grafting, each group was randomly divided into four subgroups according to euthanasia time 3, 7, 14, and 30 days, containing five animals in each group. Animals of GT1_14, GT1_30, and GT2_14, GT2_30 subgroups received a second dose of xenogeneic cells on the seventh day. Meanwhile, animals from GT1_30 and GT2_30 received the third dose of xenogeneic cells on day 14. The groups treated with xenogeneic stem cells positively affected type III collagen re-epithelialization and deposition, and possibly GT1 had a controlled inflammatory response. However, no effect on angiogenesis. Thus, it was possible to demonstrate tolerance and therapeutic action of mesenchymal stem cells from canine adipose tissue in skin grafts in rabbits.(AU)


O presente estudo teve como principal objetivo avaliar os efeitos das células-tronco mesenquimais derivadas do tecido adiposo de cães no processo de cicatrização de autoenxertos de pele de espessura total em malha em coelhos. As células-tronco foram coletadas de cães jovens, após a caracterização estas permaneceram em criopreservação, em doses individuais contendo 2 x 106 células. A técnica de enxerto em malha na região distal do membro foi realizada em 60 coelhos, divididos em três grupos, GC (Grupo Controle), GT1 (Grupo tratado com células-tronco intralesional) e GT2 (Grupo tratado com células-tronco via endovenosa), contendo 20 animais cada. Imediatamente após a enxertia, cada grupo foi dividido aleatoriamente em quatro subgrupos, de acordo com o tempo de eutanásia 3, 7, 14 e 30 dias contendo cinco animais cada. Animais dos subgrupos GT1_14, GT1_30 e GT2_14, GT2_30 receberam uma segunda dose de células xenógenas no sétimo dia. Ademais, animais do GT1_30 e do GT2_30 receberam a terceira dose de células xenógenas no dia 14. Os grupos tratados com células-tronco xenógenas tiveram um efeito positivo na reepitelização e deposição de colágeno tipo III, e possivelmente, o GT1 teve uma resposta inflamatória controlada, entretanto o efeito na angiogênese não foi observado. Dessa forma, foi possível demonstrar que houve tolerância e ação terapêutica das células-tronco mesenquimais derivadas do tecido adiposo de cães em enxertos de pele em coelhos.(AU)


Subject(s)
Animals , Dogs , Rabbits , Stem Cells , Adipose Tissue , Transplants , Mesenchymal Stem Cells , Autografts , Wound Healing , Neovascularization, Physiologic
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