Implantable Medical Devices and Tissue Engineering: An Overview of Manufacturing Processes and the Use of Polymeric Matrices for Manufacturing and Coating their Surfaces.

Medical devices are important diagnosis and therapy tools for several diseases which include a wide range of products. Technological advances in this area have been proposed to reduce adverse complication incidences. New technologies and manufacturing processes, as well as the development of new materials or medical devices with modified surface and the use of biodegradable polymeric devices such as a substrate for cell culture in the field of tissue engineering, have attracted considerable attention in recent years by the scientific community intended to produce medical devices with superior properties and morphology. This review article focused on implantable devices, addresses the major advances in the biomedical field related to the devices manufacture processes such as 3D printing and hot melting extrusion, and the use of polymer matrices composed of copolymers, blends, nanocomposites or grafted with antiproliferative drugs for manufacturing and/or coating the devices surface.

PANCREATICODUODENECTOMY: IMPACT OF THE TECHNIQUE ON OPERATIVE OUTCOMES AND SURGICAL MORTALITY.

BACKGROUND: Pancreaticoduodenectomy (PD) is a procedure associated with significant morbidity and mortality. Initially described as gastropancreaticoduodenectomy (GPD), the possibility of preservation of the gastric antrum and pylorus was described in the 1970s. AIM: To evaluate the mortality and operative variables of PD with or without pyloric preservation and to correlate them with the adopted technique and surgical indication. METHOD: Retrospective cohort on data analysis of medical records of individuals who underwent PD from 2012 through 2017. Demographic, anthropometric and operative variables were analyzed and correlated with the adopted technique (GPD vs. PD) and the surgical indication. RESULTS: Of the 87 individuals evaluated, 38 (43.7%) underwent GPD and 49 (53.3%) were submitted to PD. The frequency of GPD (62.5%) was significantly higher among patients with pancreatic neoplasia (p=0.04). The hospital stay was significantly shorter among the individuals submitted to resection due to neoplasias of less aggressive behavior (p=0.04). Surgical mortality was 10.3%, with no difference between GPD and PD. Mortality was significantly higher among individuals undergoing resection for chronic pancreatitis (p=0.001). CONCLUSION: There were no differences in mortality, surgical time, bleeding or hospitalization time between GPD and PD. Pancreas head neoplasm was associated with a higher indication of GPD. Resection of less aggressive neoplasms was associated with lower morbidity and mortality.

Pancreaticoduodenectomy: impact of the technique on operative outcomes and surgical mortality / Duodenopancreatectomia: impacto da técnica nos resultados operatórios e mortalidade cirúrgica

ABSTRACT Background: Pancreaticoduodenectomy (PD) is a procedure associated with significant morbidity and mortality. Initially described as gastropancreaticoduodenectomy (GPD), the possibility of preservation of the gastric antrum and pylorus was described in the 1970s. Aim: To evaluate the mortality and operative variables of PD with or without pyloric preservation and to correlate them with the adopted technique and surgical indication. Method: Retrospective cohort on data analysis of medical records of individuals who underwent PD from 2012 through 2017. Demographic, anthropometric and operative variables were analyzed and correlated with the adopted technique (GPD vs. PD) and the surgical indication. Results: Of the 87 individuals evaluated, 38 (43.7%) underwent GPD and 49 (53.3%) were submitted to PD. The frequency of GPD (62.5%) was significantly higher among patients with pancreatic neoplasia (p=0.04). The hospital stay was significantly shorter among the individuals submitted to resection due to neoplasias of less aggressive behavior (p=0.04). Surgical mortality was 10.3%, with no difference between GPD and PD. Mortality was significantly higher among individuals undergoing resection for chronic pancreatitis (p=0.001). Conclusion: There were no differences in mortality, surgical time, bleeding or hospitalization time between GPD and PD. Pancreas head neoplasm was associated with a higher indication of GPD. Resection of less aggressive neoplasms was associated with lower morbidity and mortality.

RESUMO Racional : A duodenopancreatectomia (DP) é procedimento associado com significativa morbimortalidade. Inicialmente descrita como gastroduodenopancreatectomia (GDP), a possibilidade de preservação do antro gástrico e piloro foi descrita na década de 1970. Objetivo : Avaliar a mortalidade e variáveis operatórias da DP com ou sem preservação pilórica e correlacioná-las com a técnica adotada e indicação cirúrgica. Método: Estudo de coorte histórica, baseado em análise de dados de registros médicos de indivíduos submetidos à DP entre os anos de 2012 a 2017. Foram analisadas variáveis demográficas, antropométricas e operatórias e correlacionadas com a técnica adotada (GDP vs. DP) e a indicação cirúrgica. Resultados : Dos 87 indivíduos avaliados, 38 (43,7%) foram submetidos à GDP e 49 (53,3%) à DP. A frequência de realização da GDP (62,5%) foi significativamente maior entre os pacientes com neoplasia de pâncreas (p=0,04). O tempo de internação total foi significativamente menor entre os indivíduos submetidos à ressecção por neoplasias de comportamento menos agressivo (p=0,04). A mortalidade cirúrgica foi de 10,3%, não havendo diferença entre GDP e DP. A mortalidade foi significativamente maior entre os indivíduos submetidos à ressecção por pancreatite crônica (p=0,001). Conclusão : Não houve diferenças na morbimortalidade, tempo cirúrgico, sangramento ou tempo de internação entre GDP e DP. A neoplasia de cabeça de pâncreas associou-se mais com indicação de GDP. A ressecção de neoplasias menos agressivas associou-se a menor morbimortalidade.

Estudo clínico-epidemiológico de pacientes queimados internados em uma unidade de terapia intensiva em Goiás / Epidemiological portrait of burned patients admitted into an intensive care unit in Goiás, Brazil / Estudio clínico epidemiológico de pacientes quemados ingresados en una unidad de cuidados intensivos en Goiás

OBJETIVO: Avaliar o perfil clínico epidemiológico de pacientes atendidos em unidade de terapia intensiva (UTI) no estado de Goiás. MÉTODO: Estudo epidemiológico do tipo inquérito, descritivo, retrospectivo realizado por meio da análise de 196 prontuários, selecionados de maneira aleatória, por cálculo de amostragem populacional de pacientes atendidos em UTI de um hospital terciário de Goiás entre 2010 e 2015. RESULTADOS: Em 5 anos, foram internados 357 pacientes na UTI, sendo avaliados 196. A média de idade dos internados na UTI foi de 32 anos e 2 meses, com a faixa etária variando de 1 mês a 87 anos e 5 meses. O gênero masculino foi responsável por 63% (n=123) das internações. Ao se avaliar o local de acidente, observamos uma maior ocorrência do mesmo no ambiente domiciliar, muito associado ao uso de álcool 33% (n=65). Os líquidos inflamáveis, como, por exemplo, álcool, gasolina e óleo, foram responsáveis por 56% (n=110) das internações em UTI. Encontrou-se que 38% (8) dos pacientes que foram a óbito tiveram sua lesão decorrente de tentativa de autoextermínio. Houve significância estatística entre o óbito e a necessidade de hemodiálise e também entre óbito e a tentativa de autoextermínio. CONCLUSÕES: De acordo com os dados analisados, o sexo masculino é o mais acometido por acidentes com queimaduras, tendo o álcool como a principal fonte de acidentes em todas as faixas etárias, exceto em crianças. Além disso, é a alta porcentagem de óbito na população com tentativa de autoextermínio, sendo líquidos inflamáveis o meio mais comum.(AU)

OBJECTIVE: To evaluate the clinical epidemiological profile of patients treated at an intensive care unit (ICU) in the state of Goiás. METHOD: A retrospective analysis of 196 randomly selected charts of patients admitted to an ICU of a tertiary hospital in Goiás between 2010 and 2015. RESULTS: In 5 years, 357 patients were hospitalized in the ICU, and we evaluated 196. The average age of patients in the ICU was 32 years and 2 months, with the age range varying from 1 month to 87 years and 5 months. Males were responsible for 63% (n=123) of ICU admissions. When assessing the accident site, we observed a higher occurrence of the accidents in the home environment, very associated with the use of alcohol 33% (n=65). Flammable liquids, such as alcohol, gasoline and oil, accounted for 56% (n=110) of ICU admissions. We found that 38% (n=8) of the patients in the group evolving to death had their injury due to a self-extermination attempt. There was statistical significance between death and need for hemodialysis and self-extermination. CONCLUSIONS: According to the analyzed data, males are most affected by burn accidents, with alcohol being the main source of accidents in all age groups, except for children. In addition, there is a high percentage of death in the population that attempts self-extermination, being that inflammable liquids are the most common means.

Objetivo: Evaluar el perfil clínico epidemiológico de los pacientes atendidos en la unidad de terapiaintensiva del estado de Goiás. Método: Estudio epidemiológico de tipo encuesta, descriptivo, retrospectivo realizado por medio del análisis de 196 histórias clínicas seleccionados al azar de los pacientes tratados en la unidad de cuidados intensivos de un hospital de tercer nivel de Goiás entre 2010 y 2015. Resultados: En 5 años, 357 pacientes fueron ingresados en la UCI, se evaluaron 196. La media de edad de los internados en la UCI fue de 32 años y dos meses, variando de um mes a 87 años y cinco meses. En cuanto al género, los pacientes de sexo masculino representaron el 63% (n=123) de los ingresos en la UCI. Al evaluar el lugar del accidente, se observó mayor ocurrencia en el ambiente del hogar, en el ambiente del hogar, estrechamente asociado con alcohol 33% (n=65). Los líquidos inflamables, tales como alcohol, gasolina y petróleo representaron el 56% (n=110) de los ingresos de UCI. Se encontró que 38% (n=8) de los pacientes que fueron a óbito y tuvieron sus lesiones decorrentes de autoexterminio. Hubo significancia estadistica entre óbito y necesidad de hemodialisis y entre óbito y autoexterminio. Conclusiones: De acuerdo con los datos analizados, los hombres son los más afectados por accidentes con quemaduras, que tienen el alcohol como la principal fuente de accidentes en todas las edade, execto en los niños. Además de eso, hay alto porcentaje de óbitos en la población de intención de autoexterminio, siendo los líquidos inflamables el agente más comun.(AU)