Morbidade psicológica e implicações para a recuperação de Adultos após cirurgia oncológica / Psychological morbidity and implications for the recovery of adults after oncology surgery / morbidad psicológica e implicaciones para la recuperación de adultos después de la cirugia oncológica

Objetivo: avaliar o constructo morbidade psicológica (ansiedade/depressão) em adultos submetidos à cirurgia oncológica no pós-operatório, bem como sua possível relação com a recuperação cirúrgica. Método: estudo correlacional, realizado com 96 adultos submetidos a cirurgia oncológica internados em hospital mineiro de grande porte, entre agosto e dezembro de 2015, mediante questionário sociodemográfico, Escala Hospital Anxiety and Depression e o Quality of Recovery Score, para verificação da recuperação cirúrgica. Realizou-se análise descritiva dos dados e os testes Shapiro-Wilk, Mann-Whitney, t-student, além dos coeficientes de correlação de Pearsone Spearman. Resultados: as variáveis ansiedade e depressão apresentaram relação negativa com a recuperação cirúrgica; houve relação negativa entre a variável ansiedade com a idade. 59 (61,5%) participantes apresentaram sintomas de ansiedade e 38 (39,6%) depressão. As variáveis ansiedade e escolaridade mostraram relação positiva. Conclusão: a morbidade psicológica esteve relacionada à qualidade da recuperação cirúrgica, portanto, torna-se importante o planejamento das ações de enfermagem perioperatória (AU).

Objective: to assess the construct of psychological morbidity (anxiety/depression) in adults in the postoperative period after oncology surgery, as well as its possible relationship with surgical recovery. Method: Correlational study with 96 adults who underwent oncology surgery admitted to a large hospital of the state of Minas Gerais, between August and December 2015, through the administration of a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale and the Quality of Recovery Score, to assess surgical recovery. Descriptive analysis of data and Shapiro-Wilk, Mann-Whitney and Student's t-Test, as well as Pearson's and Spearman correlation coefficients were used. Results: the variables anxiety and depression had a negative relationship with surgical recovery. There was a negative relationship between the variables anxiety and age. Fifty nine (61.5%) participants showed anxiety symptoms and 38 (39.6%) had depression. The variables anxiety and schooling showed a positive relationship. Conclusion: Psychological morbidity was related to the quality of surgical recovery. Therefore, the planning of perioperative nursing actions is essential (AU).

Objetivo: evaluar el constructo morbidad psicológica (ansiedad/depresión) en adultos sometidos a cirugía oncológica en pos operatorio, así como su posible relación con la recuperación quirúrgica. Método: estudio correlacional, realizado con 96 adultos sometidos a cirugía oncológica internados en un gran hospital en Minas Gerais, entre agosto y diciembre de 2015, por medio de cuestionario socio demográfico, Escala Hospital Anxiety and Depression y Quality of Recovery Score, para verificación de la recuperación quirúrgica. Se realizó análisis descriptivo de los datos y las pruebas Shapiro-Wilk, Mann-Whitney, t-student, además de los coeficientes de correlación de Pearson y Spearman. Resultados: las variables ansiedad y depresión presentaron relación negativa con la recuperación quirúrgica; hubo relación negativa entre la variable ansiedad con la edad. 59 (61,5%) participantes presentaron síntomas de ansiedad y 38 (39,6%) depresión. Las variables ansiedad y escolaridad evidenciaron relación positiva. Conclusión: la morbidad psicológica estuvo asociada a la cualidad de recuperación quirúrgica, por lo tanto es importante el planeamiento de las acciones de enfermería perioperatoria (AU).

Quantitative analysis of collagen and elastic fibers in the transversalis fascia in direct and indirect inguinal hernia.

PURPOSE: Our previous studies demonstrated structural and quantitative age-related changes of the elastic fibers in transversalis fascia, which may play a role in inguinal hernia formation. To verify whether there were differences in the extracellular matrix between direct and indirect inguinal hernia, we studied the amount of collagen and elastic fibers in the transversalis fascia of 36 male patients with indirect inguinal hernia and 21 with direct inguinal hernia. MATERIAL AND METHODS: Transversalis fascia fragments were obtained during surgical intervention and underwent histological quantitative analysis of collagen by colorimetry and analysis of elastic fibers by histomorphometry. RESULTS: We demonstrated significantly lower amounts of collagen and higher amounts of elastic fibers in transversalis fascia from patients with direct inguinal hernia compared to indirect inguinal hernia patients. The transversalis fascia from direct inguinal hernia patients showed structural changes of the mature and elaunin elastic fibers, which are responsible for elasticity, and lower density of oxytalan elastic fibers, which are responsible for resistance. These changes promoted loss of resiliency of the transversalis fascia. CONCLUSION: These results improve our understanding of the participation of the extracellular matrix in the genesis of direct inguinal hernia, suggesting a relationship with genetic defects of the elastic fiber and collagen synthesis.