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1.
Int. j. morphol ; 37(2): 730-734, June 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1002285

RESUMO

In this work the quantitative data of the surfaces that limit the sub-spaces that constitute the peritoneal space are shown. The methodology of measurement of the two sheets (parietal and visceral) of the peritoneal serosa applied in our previous paper (Albanese et al., 2009), in non-eviscerated corpses, allowed us to know for the first time, the surface or total extension of the peritoneum "in situ". This methodology was useful to determine the surface or area of the two sheets of the peritoneum, which limit the peritoneal space. Our objective in this study was to determine the total peritoneal areas (visceral + parietal) in human corpses that are not eviscerated, which limit the different sub-spaces that make up the peritoneal space. Ten female cadavers fixed in 5 % formaldehyde solution were used. Small cellophane films were placed directly on the peritoneal sheets. The digital images were obtained by scanning these models. The surface was determined by the "Scion image for Windows" program. The results were expressed as mean +/- SE. The analysis of variance (ANOVA) was used for the statistical study. The results obtained showed that the peritoneal sub-space of greater surface area was retro-omental (mean +/- SE 7767.81 +/- 646.70 cm2 p <0.01 ANOVA), due to the large extension of its visceral surface ( mean +/- SE 7401.82 +/- 640.99 cm2). More than 50 % of the surface of the entire peritoneum corresponds to said sub-space. The smallest peritoneal sub-space (3 % of the total peritoneal surface) was the pelvic sub-space (mean +/- SE 431.30 +/- 41.62 cm2). We believe that this information may be useful in case of peritoneal pathological processes or those affected by prolonged peritoneal dialysis, and that knowledge of the surface and extension of the peritoneal space involved may contribute to the estimation of the peritoneal surface involved and help to plan the treatment.


En este trabajo se muestran los datos cuantitativos de las superficies que limitan el espacio peritoneal y los sub-espacios que lo componen. La metodología de medición de las dos hojas (parietal y visceral) de la serosa peritoneal empleada en cadáveres no eviscerados, permitió conocer por primera vez, la superficie o extensión total del peritoneo in situ. El objetivo en este trabajo fue determinar -en cadáveres humanos no evisceradoslas áreas peritoneales totales (visceral + parietal) que limitan los distintos sub-espacios que conforman el espacio peritoneal. Se han utilizado diez cadáveres femeninos no eviscerados fijados en solución de formaldehido al 5 %. Pequeñas películas de celofán se colocaron directamente sobre las hojas peritoneales. La obtención de imágenes digitales se realizó escaneando estos modelos. La superficie fue determinada por el programa "Scion image for Windows". Los resultados se expresaron como media +/- SE. Para el estudio estadístico se utilizó el análisis de varianza (ANOVA). Los resultados obtenidos demostraron que el sub-espacio peritoneal de mayor superficie fue el retro-omental (media +/- SE 7767,81 +/ - 646,70 cm2 p<0.01 ANOVA), debido a la gran extensión de su superficie visceral (media +/- SE 7401,82 +/- 640,99 cm2). Más del 50 % de la superficie de todo el peritoneo corresponde a dicho sub-espacio. El sub-espacio peritoneal más pequeño (3 % de la superficie peritoneal total) fue el sub-espacio pélvico (media +/SE 431,30 +/- 41,62 cm2). Esta información podrá ser de utilidad en el caso de procesos patológicos peritoneales o áreas afectadas por diálisis peritoneal prolongada. De esta manera el conocimiento de la extensión del espacio peritoneal involucrado, puede contribuir a la estimación de la magnitud y gravedad de la superficie peritoneal comprometida. Además puede ayudar a planificar el tratamiento.


Assuntos
Humanos , Feminino , Peritônio/anatomia & histologia , Cavidade Peritoneal/anatomia & histologia , Cadáver , Análise de Variância
2.
Acta cir. bras ; 34(4): e201900405, 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1001089

RESUMO

Abstract Purpose: To evaluate the effects of the nutraceuticals omega-6/3 and omega-9/6 on endometriosis-associated infertility and pain. Methods: Controlled experimental study, with each group composed of eight female rats. Fertility groups: sham-operated control (0.9% saline solution); control with endometriosis (0.9% saline); omega-6/3 (1.2 g/kg/day); omega-9/6 (1.2 g/kg/day); and meloxicam (0.8 mg/kg/day). Pain groups: sham-operated control (0.9% saline); control with endometriosis (0.9% saline); omega-6/3 (1.2 g/kg/day); omega-9/6 (1.2 g/kg/day); medroxyprogesterone acetate (5 mg/kg/every 3 days); and meloxicam (0.8 mg/kg/day). Peritoneal endometriosis was surgically induced. Pain was evaluated with the writhing test. Fertility was evaluated by counting the number of embryos in the left hemi-uterus. Results: The mean number of writhings was as follows: sham-operated, 11.1 ± 2.9; control with endometriosis, 49.3 ± 4.4; omega-6/3, 31.5 ± 2.7; omega-9/6, 34.1 ± 4.5; medroxyprogesterone acetate, 2.1 ± 0.8; meloxicam, 1 ± 0.3. There was a significant difference between both controls and all drugs used for treatment. Regarding fertility, the mean values were as follows: sham-operated, 6.8 ± 0.6; control with endometriosis, 4.2 ± 0.7; omega-6/3, 4.7 ± 1; omega-9/6, 3.8 ± 0.9; and meloxicam, 1.8 ± 0.9. Conclusions: The omega-6/3 and omega-9/6 nutraceuticals decreased pain compared to the controls. There was no improvement in fertility in any of the tested groups.


Assuntos
Animais , Feminino , Ratos , Dor/tratamento farmacológico , Ácidos Graxos Ômega-3/administração & dosagem , Acetato de Medroxiprogesterona/administração & dosagem , Endometriose/tratamento farmacológico , Fertilidade/efeitos dos fármacos , Meloxicam/administração & dosagem , Peritônio/patologia , Modelos Animais de Doenças , Endometriose/patologia
4.
Acta cir. bras ; 33(2): 102-109, Feb. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-886261

RESUMO

Abstract Purpose: To compare polyglactin 910 and simple catgut sutures for the incidence of intraperitoneal adhesions. Methods: Twenty female Wistar rats were placed into two groups. Group 1 received ischemic sutures and Group 2 received polyglactin 910. Five sutures inductive of adhesions in each rat were made. After 14 days, the rats were euthanized with an assessment of the presence of adhesions, the number of sutures involved and classification according to the Granat et al. scale described by Ozel et al17. Results: In total, 19 of the 20 rats presented adhesions, with nine from Group 1 and ten from Group 2. There was a smaller number of affected sutures in Group 1, while in Group 2 the majority of the sutures formed adhesions (p=0.0197). According to the Granat et al. scale, Group 1 predominately developed fine, filamentous adhesions or thickening in a restricted area. Group 2 mainly presented extensive, thick adhesions with the involvement of the viscera (p=0.0055). Conclusion: Polyglactin 910 sutures formed more adhesions that were more extensive and thicker than the simple catgut sutures.


Assuntos
Animais , Feminino , Ratos , Doenças Peritoneais/etiologia , Peritônio/cirurgia , Poliglactina 910/efeitos adversos , Técnicas de Sutura/efeitos adversos , Categute/efeitos adversos , Isquemia/etiologia , Doenças Peritoneais/prevenção & controle , Peritônio/irrigação sanguínea , Poliglactina 910/farmacocinética , Complicações Pós-Operatórias/etiologia , Aderências Teciduais/etiologia , Aderências Teciduais/prevenção & controle , Categute/tendências , Ratos Wistar , Modelos Animais de Doenças
5.
Acta cir. bras ; 33(2): 134-143, Feb. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-886257

RESUMO

Abstract Purpose: To investigate the effects of pycnogenol on peritoneal adhesions and additionally to investigate the immunohistochemical effects of free oxygen radicals and reactive lymph nodes detected in the adhesive tissue that was sampled surrounding the cecum on intra-abdominal adhesions. Methods: Twenty-seven Wistar Albino rats were divided into three groups. In group 1 (sham), laparotomy was performed and stitched up. In group 2 (control), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered 2 cc of saline. In group 3 (experimental), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered a sterile Pycnogenol derivative. The rats in all groups were re-laparotomized on postoperative day 7; samples were obtained from the peritoneal tissue surrounding the cecum, and the rats were sacrificed. Results: In group 3, there was a statistically significant difference in terms of inflammation, lymph node size, and free oxygen radicals; these parameters tended to increase. In terms of fibrosis evaluated using H&E and MT, there was no significant difference between groups 2 and 3. Conclusions: No positive outcomes indicating that pycnogenol reduces intra-abdominal adhesions were obtained. However, it caused severe inflammation in the tissue. Moreover, a significant increase in lymph node size was detected secondary to inflammation. Additionally, in immunohistochemical analyses conducted to detect oxidative stress, pycnogenol increased the production of free oxygen radicals in the tissue.


Assuntos
Animais , Ratos , Doenças Peritoneais/prevenção & controle , Peritônio/cirurgia , Flavonoides/uso terapêutico , Aderências Teciduais/prevenção & controle , Doenças Peritoneais/etiologia , Peritônio/patologia , Complicações Pós-Operatórias , Flavonoides/efeitos adversos , Imuno-Histoquímica , Extratos Vegetais , Aderências Teciduais/etiologia , Aderências Teciduais/patologia , Espécies Reativas de Oxigênio/metabolismo , Ratos Wistar , Estresse Oxidativo/efeitos dos fármacos , Modelos Animais de Doenças , Radicais Livres/análise , Inflamação/induzido quimicamente , Inflamação/patologia , Laparotomia , Linfonodos/efeitos dos fármacos , Linfonodos/patologia , Anti-Inflamatórios/uso terapêutico , Antioxidantes/uso terapêutico
6.
Acta méd. (Porto Alegre) ; 39(2): 82-91, 2018.
Artigo em Português | LILACS | ID: biblio-987631

RESUMO

Introdução: O câncer gástrico (CG) é a segunda principal causa de morte relacionada a câncer no mundo. A incidência global e os tipos histológicos estão mudando. A incidência dos tumores da transição esofagogástrica e o adenocarcinoma da cárdia estão aumentando, embora tenha havido uma redução da incidência de CG distal desde a década de 1970. Grande parte dos pacientes apresenta-se com doença localmente avançada ou metastática. A carcinomatose peritoneal (CP) de origem gástrica tem um prognóstico desfavorável e uma sobrevida curta devido à ausência de modalidades terapêuticas efetivas. Métodos: Foi realizada uma revisão da literatura nas bases de busca PubMed, Scielo e Embase, sendo selecionados os artigos mais relevantes a fim de organizar uma revisão concisa e atualizada do assunto. Resultados: O prognóstico do CG depende de estágio e localização. A disseminação metastática pode ser hematogênica ou por disseminação para a cavidade peritoneal. Estudos recentes mostram que a disseminação peritoneal é mais frequente do que metástases hematogênicas. Apesar de ser a causa de 60% das mortes no câncer gástrico, a metástase peritoneal pode ser considerada uma doença local, e uma abordagem multimodal pode melhorar o prognóstico, mesmo se tratando de uma doença avançada. Na falta de tratamento curativo, a quimioterapia sistêmica pode ser considerada uma opção, ainda que seja de valor limitado para pacientes com CG e CP. Atualmente, a quimioterapia intraperitoneal hipertérmica (HIPEC) está sendo muito estudada e debatida no tratamento das doenças da superfície peritoneal. Conclusão: Dado o mau prognóstico, o custo-benefício dos regimes quimioterápicos atuais permanece questionável. Pesquisas adicionais devem ser realizadas para otimizar terapia.


Introduction: Gastric cancer (GC) is the second leading cause of cancer-related death in the world. The overall incidence and histological subtypes is changing. The incidence of esophagogastric transitional tumor and cardia adenocarcinoma is increasing, although there has been a reduction in the incidence of distal GC since the 1970s. Majority of patients present with locally advanced or metastatic disease. Peritoneal carcinomatosis (PC) of gastric origin has an unfavorable prognosis and short survival due to the lack of effective therapeutic modalities. Methods: A review of the literature was carried out in PubMed, Scielo and Embase, and the most relevant articles were selected in order to organize a concise and updated review of the subject. Results: The prognosis of GC depends on stage and location. Metastatic dissemination may be hematogenic or disseminated into the peritoneal cavity. Recent studies show that peritoneal dissemination is more frequent than hematogenous metastases. Although it is the cause of 60% of deaths in gastric cancer, peritoneal metastasis can be considered a local disease, and a multimodal approach may improve the prognosis, even if it is a terminal disease. In the absence of curative treatment, systemic chemotherapy may be considered an option, although it is of limited value for patients with GC and PC. Currently, hyperthermic intraperitoneal chemotherapy (HIPEC) is the most widely accepted treatment for peritoneal diseases. Conclusion: Given the poor prognosis, the cost-effectiveness of current chemotherapy regimens remains questionable. Additional research should be done to optimize therapy.


Assuntos
Neoplasias Gástricas , Peritônio , Gastroenterologia , Oncologia , Medicina
7.
Acta cir. bras ; 32(12): 1006-1012, Dec. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-886195

RESUMO

Abstract Purpose: To evaluate the efficacy of nivolumab and comparison with dacarbazine (DTIC) on peritoneal carcinomatosis of malignant melanoma in mouse model. Methods: Mouse skin melanoma cells was injected under the capsule of the peritoneal surface in the left side of the abdomen. On postoperative day ten, mouses randomised into three groups. Group 1: Control, Group 2: HIPEC (Hyperthermic intraperitoneal chemotherapy) with DTIC and Group 3: HIPEC with Nivolumab. After the sacrification on postoperative day fifteen, peritoneum evaluated macroscopically and histopathologically by using peritoneal regression grading score (PRGS). Results: In the 15th day exploration, all animals developed extensive intraperitoneal tumor growth in Group 1. In Group 2 and Group 3 median tumor size was 0.7±0.3cm and 0.3±0.2cm respectively (p: 0.023). Peritoneal carcinomatosis index (PCI) were significantly lower in Group 3 than other groups (p: 0.019). The lowest total tumor nodules in group 3 was 4 ± 2. The PGRS score was found significantly lower in Group 3 than other groups (p: 0.03). Lymphocytic response rate was found higher in the Group 3. Conclusions: It has been found that nivolumab significantly better than DTIC on peritoneal metastases of malign melanoma in mouse models. Nivolumab treatment gives promising results with pathological evidence in the treatment of metastatic disease of malignant melanoma.


Assuntos
Animais , Masculino , Ratos , Neoplasias Peritoneais/tratamento farmacológico , Peritônio/patologia , Melanoma/tratamento farmacológico , Anticorpos Monoclonais/farmacologia , Antineoplásicos/farmacologia , Neoplasias Peritoneais/cirurgia , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/secundário , Peritônio/efeitos dos fármacos , Distribuição Aleatória , Análise de Regressão , Dacarbazina/uso terapêutico , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Gradação de Tumores , Nivolumabe , Hipertermia Induzida , Melanoma/secundário , Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/uso terapêutico
9.
Acta cir. bras ; 32(12): 1056-1063, Dec. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-886194

RESUMO

Abstract Purpose: To evaluate the technical feasibility and homogeneity of drug distribution of pressurized intraperitoneal aerosol chemotherapy (PIPAC) based on a novel process of intraperitoneal drug application (multidirectional aerosolization). Methods: This was an in vivo experimental study in pigs. A single-port device was manufactured at the smallest diameter possible for multidirectional aerosolization of the chemotherapeutic drug under positive intraperitoneal pressure. Four domestic pigs were used in the study, one control animal that received multidirectional microjets of 9 mL/sec for 30 min and three animals that received multidirectional aerosolization (pig 02: 9 mL/sec for 30 min; pigs 03 and 04: 3 mL/sec for 15 min). Aerosolized silver nitrate solution was applied for anatomopathological evaluation of intraperitoneal drug distribution. Results: Injection time was able to maintain the pneumoperitoneum pressure below 20 mmHg. The rate of moderate silver nitrate staining was 45.4% for pig 01, 36.3% for pig 02, 36.3% for pig 03, and 72.7% for pig 04. Conclusions: Intra-abdominal drug distribution had a broad pattern, especially in animals exposed to the drug for 30 min. Our sample of only four animals was not large enough to demonstrate an association between aerosolization and a higher silver nitrate concentration in the stained abdominal regions.


Assuntos
Animais , Neoplasias Peritoneais/tratamento farmacológico , Sistemas de Liberação de Medicamentos/métodos , Aerossóis/administração & dosagem , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/secundário , Peritônio/efeitos dos fármacos , Pressão , Fatores de Tempo , Insuflação , Estudos de Viabilidade , Sistemas de Liberação de Medicamentos/instrumentação , Aerossóis/farmacocinética , Cavidade Abdominal , Sus scrofa , Modelos Animais de Doenças , Injeções Intraperitoneais
10.
Rev. chil. cir ; 69(6): 495-497, dic. 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-899643

RESUMO

Resumen Objetivo: Presentar un caso de hernia femoral de Littré estrangulada. Caso clínico: Hombre de 86 años, que consultó por cuadro de dolor abdominal periumbilical postraumático de 4 días de evolución que se acompañaba de vómitos y ausencia de deposiciones con tránsito de gases conservado. Destacaba al examen masa dolorosa e indurada de 3 cm de diámetro no reductible bajo arcada inguinal derecha. Se realizó una herniorrafia femoral con abordaje preperitoneal, identificando una hernia de Littré estrangulada y realizándose una resección intestinal más reparación tisular del defecto herniario. Conclusión: Las hernias de Littré femorales son una entidad extremadamente rara y el manejo quirúrgico óptimo no está establecido.


Abstract Objective: To present a case of strangulated Littré femoral hernia. Clinical case: 86 years old man with 4 days of post-traumatic periumbilical abdominal pain accompanied by vomiting and absence of stools with gas transit preserved. Examination highlighted a painful and indurated mass of 3 cm in diameter that it was not reducible below right inguinal arch. A femoral hernia repair with preperitoneal approach was performed by identifying a strangulated Littré hernia performing bowel resection and tissue repair of the hernia defect. Conclusion: Littré femoral hernias are an extremely rare entity and optimal surgical management is not established.


Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Hérnia Femoral/cirurgia , Hérnia Femoral/complicações , Divertículo Ileal/etiologia , Peritônio , Herniorrafia/métodos , Divertículo Ileal/cirurgia
11.
Acta cir. bras ; 32(6): 467-474, June 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-886203

RESUMO

Abstract Purpose: To establish and evaluate the feasibility of continuous peritoneal lavage with vacuum peritoneostomy in an animal model. Methods: Eight pigs aged 3-4 months, females, were anesthetized and submitted to laparotomy and installation of a continuous peritoneal lavage with vacuum peritoneostomy. The sta-bility of the system, the physiological effects of washing with NaCl 0.9% and the sys-tem clearance were evaluated. Results: Stability of vacuum peritoneostomy was observed, with no catheter leaks or obstructions and the clearance proved adequate, however, the mean volume of fluids aspirated by the peritoneostomy at the end of the experiment was higher than the volume infused by the catheters (p=0.02). Besides that, the animals presented a progressive increase in heart rate (p=0.04) and serum potassium (p=0.02). Conclusion: The continuous peritoneal lavage technique with vacuum peritoneostomy is feasible and presents adequate clearance.


Assuntos
Animais , Feminino , Peritônio/cirurgia , Lavagem Peritoneal/métodos , Suínos , Estudos de Viabilidade , Modelos Animais
12.
J. appl. oral sci ; 25(3): 265-273, May-June 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-893620

RESUMO

Abstract Elderly denture wearers are commonly affected by Candida-associated denture stomatitis (DS), an inflammatory process of the oral mucosa strongly associated with Candida spp and other microorganisms, as well as local and systemic factors. The impaired immune response against pathogens is among the inherent host factors that have been also associated with the pathogenesis of DS. Mononuclear phagocytes respond to the pathogens through phagocytosis followed by the production of several substances inside the phagosomes, among them are the reactive nitrogen species (RNS). A failure in these mechanisms may contribute to the DS development. Objective The aim of this study was to investigate the influence of aging on the internalization and the production of nitric oxide (NO) by peritoneal adherent cells (PAC), in response to Candida albicans (C. albicans). Material and methods PAC obtained from young and aged mice were challenged with dead or viable C. albicans by using predetermined proportions (cells:yeast) for 30 and 120 minutes. Phagocytosis was analyzed by acridine orange dye, and NO production by the Griess reaction. Results C. albicans phagocytosis by PAC from aged mice was similar to that of young mice, although the cells from older mice cells present more internalized fungi compared with matched control. In addition, a tendency towards impaired NO production by peritoneal mononuclear phagocytes from aged mice was observed. Conclusions PAC from aged mice may capture and store many fungi, which in turn may mean that these cells are effectively unable to eliminate fungi, probably due to impaired NO production. Therefore, considering the important role of C. albicans overgrowth in the pathogenesis of DS and the aspects observed in this study, aging may favor the onset and severity of local candidosis such as DS and its systemic forms.


Assuntos
Animais , Masculino , Fagocitose/fisiologia , Estomatite sob Prótese/metabolismo , Estomatite sob Prótese/microbiologia , Candida albicans/patogenicidade , Envelhecimento/fisiologia , Adesão Celular/fisiologia , Óxido Nítrico/biossíntese , Peritônio/citologia , Valores de Referência , Fatores de Tempo , Candida albicans/isolamento & purificação , Candidíase/microbiologia , Fatores Etários , Camundongos Endogâmicos C57BL , Óxido Nítrico/análise
14.
Rev. chil. cir ; 68(4): 323-327, jul. 2016. ilus
Artigo em Espanhol | LILACS | ID: lil-788902

RESUMO

Objetivo Reportar un caso de grave fractura pélvica y sangrado masivo tratado inicialmente con packing pélvico. Caso clínico Paciente precipitado hemodinámicamente debido a varias fracturas abiertas, entre las que se incluye fractura pélvica con importante diástasis púbica. Se decide intervención quirúrgica procediendo a fijación externa de la pelvis, y posteriormente se realiza un packing extraperitoneal dado el gran hematoma extraperitoneal con sangrado en sábana. Finalmente, se practica arteriografía donde se ve sangrado arterial activo dependiente del tronco pudendo obturador y de la arteria glútea superior izquierda que se embolizan, con posterior estabilización hemodinámica. Conclusión La arteriografía puede mejorar el control de la hemorragia en los pacientes con sangrado arterial y hemodinámicamente estables, pero el packing tiene prioridad en los pacientes con fracturas de pelvis e inestabilidad hemodinámica.


Aim To report a case of severe pelvic fracture and massive bleeding initially treated with pelvic packing. Clinical case Patient who falls off a high place, hemodynamically unstable due to several open fractures including a pelvic fracture with significant pubic diastasis. It is decided to operate on the patient, proceeding to external fixation of the pelvis and performing, afterwards, an extraperitoneal packing due to the large extraperitoneal hematoma with oozing hemorrhage. Lastly an arteriography is done, where active arterial bleeding is observed localized at the obturator pudendal trunk and the left superior gluteal artery, which are embolized with hemodynamic stabilization. Conclusion Arteriography can improve hemorrhage control in hemodynamically stable patients with arterial bleeding, but packing has the priority on patients with pelvic fractures and hemodynamic instability.


Assuntos
Humanos , Masculino , Adulto , Ossos Pélvicos/cirurgia , Técnicas Hemostáticas , Fraturas Ósseas/complicações , Exsanguinação/terapia , Peritônio , Acidentes por Quedas , Traumatismo Múltiplo , Fixadores Externos , Tratamento de Emergência/métodos , Fraturas Ósseas/cirurgia , Exsanguinação/etiologia , Hemodinâmica
15.
Acta cir. bras ; 31(6): 389-395, tab, graf
Artigo em Inglês | LILACS | ID: lil-785020

RESUMO

ABSTRACT PURPOSE: To investigate the potential efficacy of beractant (Survanta(r)) and Seprafilm(r) on the prevention of postoperative adhesions. METHODS: Forty Wistar-albino female rats were used. The rats were randomly allocated into four groups of 10 rats each as control group (CG), beractant group (BG), Seprafilm(r) group (SG), and combined group (COG). All rats underwent cecal abrasion via midline laparotomy. Before abdominal closure, isotonic saline, beractant, Seprafilm, and combined agents were intraperitoneally administered. Adhesions were classified macroscopically with Canbaz Scoring System on postoperative day 10. Ceacum was resected for histopathological assessment. RESULTS: Macroscopic adhesion scores were significantly lower in BG, SG, and COG than CG (p<0.05); (45%, 15%, 25%, and 15%; respectively). Histopathological assessment revealed a reduced inflammation and fibrosis score in the study groups than CG (p<0.05). In BG, adhesion development, inflammation and fibrosis scores were lower than SG; however, it was not statistically significant. CONCLUSIONS: Intra-abdominal application of beractant is significantly effective for the prevention of adhesion formation with no adverse effect by covering the whole peritoneal mesothelium with excellent gliding properties in a rat model. The combination of both agents is also effective in reducing adhesion formation, however, not superior to single beractant application.


Assuntos
Animais , Feminino , Produtos Biológicos/farmacologia , Doenças do Ceco/prevenção & controle , Ceco/efeitos dos fármacos , Ácido Hialurônico/farmacologia , Peritônio/efeitos dos fármacos , Peritônio/patologia , Cuidados Pós-Operatórios/instrumentação , Fibrose , Distribuição Aleatória , Ceco/cirurgia , Ceco/patologia , Aderências Teciduais/patologia , Aderências Teciduais/prevenção & controle , Ratos Wistar , Modelos Animais , Quimioterapia Combinada/métodos , Inflamação/patologia , Inflamação/prevenção & controle
16.
Acta cir. bras ; 31(4): 227-234, Apr. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-781325

RESUMO

PURPOSE: To investigate the efficacy of intralesional 20% aspirin injection for treatment of experimental peritoneal endometriosis. Methods: Peritoneal endometriosis was experimentally induced in forty adult nulligravid female rabbits. On day 30 post-endometriosis induction, rabbits were randomly divided to assess early (10 days) and late (20 days) effects of intralesional injection of physiological saline solution (control groups) in comparison to intralesional injection of 20% bicarbonate aspirin solution (experimental groups) as follows: control group 1 (10 days, n=10); control group 2 (20 days, n=10); experimental group 3 (10 days, n=10); experimental group 4 (20 days, n=10). Resected tissues, including endometriosis foci, were qualitatively (general morphology and signs of inflammatory cells infiltrate, necrosis and apoptosis) and quantitatively (remaining endometriosis area) assessed by histopathological analysis. Results: Extensive necrosis, hemorrhage, apoptosis, and fibrosis were observed in the experimental groups 3 and 4. Groups 1 and 2 presented typical endometrial tissue cysts, respectively. Groups 3 and 4 showed sparse endometrial tissue foci and no endometrial tissue, respectively. Quantitative analysis revealed that aspirin-treated groups 3 and 4 had significantly (p<0.05) smaller remaining endometriosis area, compared to control groups 1 and 2. Conclusion: Intralesional 20% aspirin injection caused total destruction of peritoneal endometriosis foci in rabbits.


Assuntos
Animais , Feminino , Coelhos , Doenças Peritoneais/tratamento farmacológico , Injeções Intralesionais , Aspirina/administração & dosagem , Inibidores de Ciclo-Oxigenase/administração & dosagem , Endometriose/tratamento farmacológico , Doenças Peritoneais/patologia , Peritônio/efeitos dos fármacos , Peritônio/patologia , Fatores de Tempo , Reprodutibilidade dos Testes , Resultado do Tratamento , Apoptose , Modelos Animais de Doenças , Endometriose/patologia , Endométrio/efeitos dos fármacos , Endométrio/patologia , Anti-Inflamatórios/administração & dosagem
17.
Hosp. Aeronáut. Cent ; 11(1): 13-7, 2016. ilus
Artigo em Espanhol | LILACS | ID: biblio-910450

RESUMO

Introducción: Los traumatismos abdominales penetrantes son debidos generalmente a heridas de arma blanca o heridas de arma de fuego. Todas deben explorarse instrumentalmente bajo anestesia local con el objetivo de determinar la integridad del peritoneo. El ultrasonido es una herramienta muy útil utilizada en trauma, además del FAST, se lo puede utilizar en la urgencia como método de gran ayuda al realzar la exploración inicial de la herida para evaluar la integridad del peritoneo. Objetivos: Destacar la importancia del conocimiento anatómico y la correlación anatomo-clínico quirúrgica y ecográfica en la interpretación de imágenes obtenidas por ultrasonografía en la evaluación de la integridad de la pared del abdomen en heridas penetrantes por arma blanca. Material y métodos: FAST y ecografía de partes blandas instrumentándose la herida abdominal bajo anestesia local evaluando la indemnidad del peritoneo mediante la observación por ultrasonografía del abdomen y de la pared antero lateral del mismo en 14 de 42 pacientes con heridas por arma blanca en abdomen en el Servicio de Emergencias del Hospital Municipal de Morón y en el Servicio de Cirugía General del Hospital Aeronáutico Central. Período entre Febrero 2014 y Marzo 2015. Resultados: 42 (100%) pacientes con heridas de arma blanca en abdomen. 28 (66,66%) fueron inicialmente intervenidos quirúrgicamente. A 14 (33,34%) se le realizó FAST en búsqueda de líquido libre y ecografía de partes blandas instrumentándose la herida abdominal bajo anestesia local evaluando la indemnidad del peritoneo. Conclusiones: El conocimiento de las estructuras anatómicas y la disposición de las mismas que componen la pared anterolateral del abdomen permiten facilitar el reconocimiento de la indemnidad o no del peritoneo en las imágenes obtenidas por ultrasonido en pacientes con heridas abiertas por arma blanca, evitando así la realización de procedimientos quirúrgicos innecesarios.(AU)


Introduction: Penetrating abdominal trauma are usually due to stab wounds or gunshot wounds. All instrumentally be explored under local anesthesia in order to determine the integrity of the peritoneum. Ultrasound is a very useful tool used in trauma, in addition to FAST, I can use the urgency as a means of great help to enhance the initial exploration of the wound to evaluate the integrity of the peritoneum. Objectives: Highlighting the importance of the anatomical knowledge and surgical and anatomical clinical ultrasound in interpreting images obtained by ultrasonography in the evaluation of the integrity of the abdominal wall in penetrating stab wounds correlation. Material and methods: FAST ultrasound was performed and soft tissue abdominal wound became operational under local anesthesia indemnity evaluating the peritoneum through observation by ultrasound of the abdomen and the anterolateral wall thereof in 14 of the 42 patients with stab wounds in the abdomen Service Municipal Emergency Hospital of Moron and the Department of General Surgery of the Central Aeronautical Hospital, period between February 2014 and March 2015. Results: Of the 42 (100%) patients with stab wounds to the abdomen, 28 (66.66%) initially underwent surgery, and 14 (33.34%) were performed in FAST Search of free fluid and soft tissue ultrasound became operational abdominal wound under local anesthesia indemnity evaluating the peritoneum. Conclusions: Knowledge of the anatomical structures and arrangement thereof comprising the anterolateral wall of the abdomen allow easy recognition of indemnity or not the peritoneum in the ultrasound images in patients with stab wounds open, thus avoiding making unnecessary surgical procedures.


Assuntos
Humanos , Abdome/anatomia & histologia , Peritônio/ultraestrutura , Ultrassom/instrumentação
18.
Rev. colomb. radiol ; 27(2): 4424-4433, 2016. ilus, tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-987334

RESUMO

Introducción: El peritoneo es una delgada membrana compuesta por células mesoteliales y tejido conectivo, que es prácticamente inaparente en la escanografía de abdomen de pacientes sanos. Sin embargo, representa una importante vía de diseminación de diferentes patologías. Objetivo: Describir la anatomía del peritoneo en la escanografía abdominal, así como los hallazgos imaginológicos de las patologías más comunes, con el fin de generar un enfoque práctico a través de diagnósticos diferenciales que le permitan al radiólogo realizar una adecuada aproximación diagnóstica. Metodología: Se utilizaron las escanografías de pacientes que acudieron tanto de manera ambulatoria como al servicio de urgencias con patología peritoneal. Conclusiones: La escanografía de abdomen es la herramienta más útil para la evaluación del peritoneo patológico que, además, aporta información adicional sobre la patología de base de los pacientes.


Introduction: The peritoneum is a thin membrane composed of mesothelial cells and connective tissue, which is practically inapparent in abdominal scanography of healthy patients. Nevertheless, it constitutes an important route of spread for various diseases. Objectives: To describe peritoneal anatomy in abdominal scanography, as well as imaging findings of the most common peritoneal diseases, in order to present differential diagnoses that allow radiologists to employ an adequate diagnostic approach. Methodology: The study used scans of patients who attended both outpatient and emergency services at our institution with peritoneal pathology. Conclusions: Abdominal scanography is the most useful tool for evaluating pathological peritoneum; it also provides additional information on the underlying diseases of patients.


Assuntos
Humanos , Peritônio , Tomografia Computadorizada por Raios X , Anatomia
19.
Iatreia ; 28(4): 443-448, oct.-dic. 2015. ilus, tab
Artigo em Espanhol | LILACS, COLNAL | ID: lil-765523

RESUMO

El fibrohistiocitoma benigno es un tumor raro en niños y más frecuente en adultos, que afecta principalmente la piel de las extremidades; su tamaño es usualmente pequeño. Según datos de la Organización Mundial de la Salud, menos del 1 % de los fibrohistiocitomas benignos son profundos. No se ha informado previamente su presencia en el peritoneo de niños. Por su gran interés, presentamos el caso de un niño de 14 meses con fibrohistiocitoma benigno peritoneal irresecable.


Benign fibrous histiocytoma is very rare in children, and more frequent in adults. It is commonly found in the skin, especially in the limbs. Usually it is small. According to the World Health Organization, less than 1 % of benign fibrous histiocytomas are found in deep tissues. Peritoneal location of this kind of tumor has not been previously reported in children. Due to its great interest, we report the case of a 14 month-old male with a peritoneal benign fibrous histiocytoma. No resection of the lesion was feasible.


O fibrohistiocitoma benigno é raro em crianças e mais frequente em adultos. Afeta mais a pele das extremidades e seu tamanho é pequeno. Segundo dados da Organização Mundial da Saúde, menos de 1 % dos fibrohistiocitomas benignos são profundos. Não se informou previamente sua presença no peritônio de crianças. Por seu grande interesse, apresentamos o caso de uma criança de 14 meses com fibrohistiocitoma benigno peritoneal irressecável.


Assuntos
Lactente , Histiocitoma Fibroso Benigno , Peritônio , Neoplasias
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