Diagnosis of Bowel Endometriosis Using Endoscopic Ultrasound-guided Fine Needle Aspiration.

Endometriosis is a relatively common gynecological condition in women of reproductive age. The rectosigmoid region is the most commonly affected segment when the gastrointestinal tract is involved. A differential diagnosis of colorectal neoplasia is difficult because of the similar clinical, endoscopic, and radiology findings. A 42-year-old female presented with abdominal distention and was subsequently diagnosed with a large bowel obstruction in the rectum. A temporary colostomy was performed, and endoscopy revealed a rectal mass obstructing the rectum. The biopsy showed normal mucosa, and it was difficult to exclude rectal malignancies even after the imaging workup. Endoscopic ultrasound demonstrated a hypoechoic lesion below the rectal mucosa, and fine needle aspiration confirmed the diagnosis of bowel endometriosis. Bowel endometriosis is a challenging diagnosis. Endoscopic ultrasound- guided fine-needle aspiration is useful for acquiring adequate samples for histological confirmation and a definitive diagnosis of bowel endometriosis.

Resultados terapéuticos de la papilomatosis respiratoria recurrente en otorrinolaringología Hospital de Clínicas periodo 2005 a 2020 / Therapeutic results of recurrent respiratory papillomatosis in otorhinolaryngology Hospital de Clinicas period 2005 to 2020

Introducción: La papilomatosis respiratoria recurrente es el crecimiento de lesiones papilomatosas en el tracto aerodigestivo causada por el virus del papiloma humano, aparece más entre los 3 y 6 años (juvenil) y entre la tercera y quinta décadas (adulta). Los síntomas suelen ser disfonía y dificultad respiratoria. La terapéutica consiste en la resección de lesiones y terapia adyuvante (bevacizumab e interferón). Su curso es variable, tiende a recidivar y maligniza en 3-7%, más en adultos. Objetivos: Describir resultados terapéuticos de la papilomatosis respiratoria recurrente en nuestro servicio. Materiales y métodos: Estudio observacional, descriptivo con asociación cruzada, transversal, retrospectivo, muestreo no probabilístico de casos consecutivos, de pacientes con papilomatosis respiratoria recurrente operados en la Cátedra y Servicio Otorrinolaringología del Hospital de Clínicas en el periodo 2005-2020. Resultados: Se estudiaron 40 pacientes, 65% hombres y 35% mujeres; 35% adultos y 65% juveniles. La media de edad fue 16,05±18,042 años; en los casos juveniles fue 4,69±2,908 años, en los adultos 37,14±14,94 años. Se observaron alteraciones de la voz en el 100% y de la mecánica respiratoria en el 72,5%. Se contabilizaron 119 procedimientos, en 11 pacientes se realizó solamente resección, 29 con adyuvancia, de estos 22,5% recibieron bevacizumab y 50% interferón. No hubo diferencia significativa en la media de tiempo sin lesiones entre jóvenes y adultos (p>0,05), pero si según la terapéutica con tendencia favorable con la adyuvancia, sobre todo con bevacizumab. Se constató displasia en 10% y malignización en 2,5%. La afectación fue: glotis 100% (cuerda vocal derecha 92,5%, izquierda 82,5%, ambas 77,5%, comisura anterior 62,5%), supraglotis 20% y subglotis 10%. El promedio de número de áreas afectas fue 3,34±1,274, hubo una diferencia significativa (p<0,05) entre los casos adultos (2,071±0,379) y juveniles (3,846±1,015) constatándose mayor afectación en este último. Conclusión: La mayor parte fueron casos juveniles masculinos. Las zonas más afectas fueron la glotis, sobre todo cuerdas vocales. En jóvenes se vio mayor número de regiones afectas. Todos presentaban disfonía o afonía, seguido por dificultad respiratoria. Las terapéuticas fueron resección quirúrgica sola o asociada a adyuvancia (bevacizumab o Interferón). El tiempo de recurrencia fue mayor al emplear adyuvancia terapéutica con tendencia favorable hacia el bevacizumab. La malignización ocurrió en un caso.

Introduction: Recurrent respiratory papillomatosis is the growth of papillomatous lesions in the aerodigestive tract caused by human papillomavirus, appears more between the ages of 3 and 6 years (juvenile) and between the third and fifth decades (adult). Symptoms are usually dysphonia and respiratory distress. The therapy consists of resection of lesions and adjuvant therapy (bevacizumab and interferon). Its course is variable, it tends to recur and malignancy occurs in 3-7%, more in adults. Objectives: To describe therapeutic results of recurrent respiratory papillomatosis in our service. Materials and methods: Observational, descriptive, cross-sectional, cross-sectional, retrospective, retrospective, non-probabilistic sampling of consecutive cases, of patients with recurrent respiratory papillomatosis operated in the Otorhinolaryngology Department of the Hospital de Clínicas in the period 2005-2020. Results: We studied 40 patients, 65% male and 35% female; 35% adults and 65% juveniles. Mean age was 16.05±18.042 years. In juvenile cases the mean age was 4.69±2.908 years, in adults 37.14±14.94 years. Voice alterations were observed in 100% and respiratory mechanics in 72.5%. There were 119 procedures, 11 laryngeal microsurgery alone, 29 associated with adjuvant, of these 22.5% received bevacizumab and 50% interferon. There was no significant difference in the mean time without lesions between young people and adults (p>0.05), but there was a favorable trend with adjuvant therapy, especially with bevacizumab. Dysplasia was found in 10% and malignization in 2.5%. The involvement was: glottis 100% (right vocal cord 92.5%, left 82.5%, both 77.5%, anterior commissure 62.5%), supraglottis 20% and subglottis 10%. The average number of affected areas was 3.34±1.274, there was a significant difference (p<0.05) between adult (2.071±0.379) and juvenile (3.846±1.015) cases, with greater involvement in the latter. Conclusion: Most of the cases were juvenile male cases. The most affected areas were the glottis, especially vocal cords. A greater number of affected regions were seen in young people. All presented dysphonia or aphonia, followed by respiratory distress. Therapeutics were surgical resection alone or associated with adjuvant therapy (bevacizumab or interferon). The time to recurrence was longer when adjuvant therapy was used, with a favorable trend towards bevacizumab. Malignization occurred in one case.

A survey on the impact of IBD in sexual health: Into intimacy.

Patients with Inflammatory Bowel Disease (IBD) are at increased risk of psychological and physical burden, including sexual dysfunction (SD). This study aimed to assess the prevalence of SD and to identify its predictive factors, in IBD patients. This unicentric cross-sectional case-control survey (ratio 2:1) included patients followed at the day hospital IBD consultation, in the Gastroenterology department of a tertiary referral center, for 2 years. Participants received anonymous questionnaires, concerning basic characteristics and sexual function, and a questionnaire on anxiety and depression, body image, fatigue, and IBD-specific health-related quality of life (QoL). We analyzed data from 120 IBD patients and 60 healthy controls. Forty-two female (56.8%) and 6 male (14.6%) IBD patients, and 6 women (15%) and 2 males (10%) of the control group presented SD. SD was significantly higher in IBD patients with age between 18 and 30 and 51 and 60 than in healthy controls (P < .05) Regarding multivariate analysis, age was a predictive factor for SD in males (P = .014), and anxiety and depression (P = .002) and fatigue (P = .043) in females. SD is a predictor of lower QoL among IBD patients, considering the last 15 (P < .001) and 60 days (P = .001), regarding univariate analysis. SD (P = .007), body image distortion (P < .001), and fatigue (P = .004) were predictors of low QoL (last 15 days, multivariate analysis). SD was more prevalent in IBD patients than in the control group and impacted negatively the QoL of patients. Age was a predictive factor for SD in men while anxiety and depression, and fatigue were predictive of SD in women.

Age at Diagnosis Is Determinant for the Outcome of Inflammatory Bowel Disease: Is It a Myth?

INTRODUCTION: Patients with elderly-onset inflammatory bowel disease were previously associated with a less aggressive course of the disease. However, there are conflicting data that need further validation. We aimed to determine the association between age at diagnosis and the development of progressive disease in patients with Crohn's disease (CD) and ulcerative colitis (UC). METHODS: This cohort study included patients with CD and UC followed in 6 secondary and tertiary care centers in mainland Portugal. Patients were divided into a derivation (80%) cohort and a validation (20%) cohort. The primary outcome was progressive disease. Logistic regression analysis, receiver operating characteristic curves, and the areas under the curve (AUC) were performed. Odds ratios with 95% confidence intervals (CIs) were estimated. RESULTS: The derivation cohorts included 1245 patients with CD (68% with progressive disease) and 1210 patients with UC (37% with progressive disease), whereas the validation cohorts included 302 patients with CD and 271 patients with UC, respectively, with similar outcome proportions. In our final model, age at diagnosis older than 60 years was significantly associated with a lower risk of developing progressive disease (odds ratio 0.390, 95% CI 0.164-0.923, P = 0.032), with a high discriminative power (AUC 0.724, 95% CI 0.693-754) in patients with CD. However, according to this model, no significant associations were found between age at diagnosis and the risk of developing progressive disease in patients with UC. No differences were observed in the AUC values between the validation and the derivation cohorts. DISCUSSION: Patients with elderly-onset CD, but not patients with UC, were associated with a less progressive course of the disease.

Sepse neonatal - perfil microbiológico e sensibilidadeantimicrobiana em um hospital no Nordeste do Brasil / Neonatal sepsis - microbiological profile and antimicrobial sensitivity in a hospital in the Northeast of Brazil

Objetivo: Determinar a prevalência de microrganismos e o perfil de sensibilidade antimicrobiana em hemoculturas positivas de pacientes com infecção de corrente sanguínea na Unidade de Terapia Intensiva neonatal de um hospital no Nordeste brasileiro. Métodos: Estudo transversal, retrospectivo, com descrição quantitativa dos resultados de hemoculturas de neonatos admitidos na unidade terapia intensiva neonatal de um hospital do Nordeste brasileiro. Resultados: A sepse neonatal teve como principal etiologia bactérias Gram-positivas, responsáveis por 73,1% das culturas positivas, sendo o Staphylococcus Coagulase-negativa o principal agente, enquanto que 21,5% se deram por um agente Gram-negativo. As bactérias Gram-positivas apresentaram boa sensibilidade ao linezolida e à vancomicina e a maioria das Gram-negativas foi sensível a colistina, meropenem e imipenem. Todos os isolados de Staphylococcus coagulase negativa foram sensíveis ao linezolida, à vancomicina e à tigeciclina. Conclusão: O conhecimento das características relacionadas à sensibilidade e resistência antimicrobiana é fundamental para uma melhor abordagem ao paciente com sepse neonatal, promovendo um manejo mais direcionado que possibilita uma recuperação mais rápida do recém-nascido. O conhecimento adquirido com esse estudo possibilitará um tratamento mais eficiente em cada caso, com base no quadro apresentado pelo paciente e as características do agente causador.

Objective: To determine the prevalence of microorganisms and the antimicrobial sensitivity profile in positive blood cultures of patients with bloodstream infection in the neonatal Intensive Care Unit of a hospital in the Brazilian Northeast. Methods: Cross-sectional, retrospective study with quantitative description of hemoculture results of neonates admitted to the neonatal intensive care unit of a Brazilian Northeast hospital. Results: Neonatal sepsis had as its main etiology Gram-positive bacteria responsible for 73.1% of the positive cultures, with coagulase-negative Staphylococcus being the main agent, while 21.5% were due to a Gramnegative agent. Gram-positive bacteria showed good sensitivity to linezolid and vancomycin and most Gram-negative strains were susceptible to colistin, meropenem and imipenem. All coagulase-negative Staphylococcus isolates were sensitive to linezolid, vancomycin and tigecycline. Conclusion: Knowledge of the characteristics related toantimicrobial susceptibility and resistance is fundamental for a better approach to the patient with neonatal sepsis, promoting a more targeted management that allows a faster recovery of the newborn. The knowledge gained from this study will allow a more efficient treatment in each case, based on the patient's presentation and the characteristics of the causative agent

Facial-Aging Mobile Apps for Smoking Prevention in Secondary Schools in Brazil: Appearance-Focused Interventional Study.

BACKGROUND: Most smokers start smoking during their early adolescence, often with the idea that smoking is glamorous. Interventions that harness the broad availability of mobile phones as well as adolescents' interest in their appearance may be a novel way to improve school-based prevention. A recent study conducted in Germany showed promising results. However, the transfer to other cultural contexts, effects on different genders, and implementability remains unknown. OBJECTIVE: In this observational study, we aimed to test the perception and implementability of facial-aging apps to prevent smoking in secondary schools in Brazil in accordance with the theory of planned behavior and with respect to different genders. METHODS: We used a free facial-aging mobile phone app ("Smokerface") in three Brazilian secondary schools via a novel method called mirroring. The students' altered three-dimensional selfies on mobile phones or tablets and images were "mirrored" via a projector in front of their whole grade. Using an anonymous questionnaire, we then measured on a 5-point Likert scale the perceptions of the intervention among 306 Brazilian secondary school students of both genders in the seventh grade (average age 12.97 years). A second questionnaire captured perceptions of medical students who conducted the intervention and its conduction per protocol. RESULTS: The majority of students perceived the intervention as fun (304/306, 99.3%), claimed the intervention motivated them not to smoke (289/306, 94.4%), and stated that they learned new benefits of not smoking (300/306, 98.0%). Only a minority of students disagreed or fully disagreed that they learned new benefits of nonsmoking (4/306, 1.3%) or that they themselves were motivated not to smoke (5/306, 1.6%). All of the protocol was delivered by volunteer medical students. CONCLUSIONS: Our data indicate the potential for facial-aging interventions to reduce smoking prevalence in Brazilian secondary schools in accordance with the theory of planned behavior. Volunteer medical students enjoyed the intervention and are capable of complete implementation per protocol.

Estudo de revisão da cirurgia de hernioplastia inguinal: técnica de Lichtenstein versus laparoscópica / Revision study of inguinal hernia repair surgery: Lichtenstein technique versus laparoscopic

Introdução: As hérnias inguinais são das afecções mais comuns na cirurgia geral e fomentam uma rica discussão sobre qual o melhor método cirúrgico para sua correção. Objetivos: O objetivo deste artigo é fazer uma revisão de literatura não sistemática descrevendo e comparando a técnica de Lichtenstein e a técnica laparoscópica, ressaltando os prós e contras de cada abordagem. Métodos: Essa revisão foi realizada entre novembro de 2015 e fevereiro de 2016 nos bancos de dados: PubMed/Medline, Biblioteca Virtual de Saúde (BVS), Bireme, Scielo, Lilacs, além de livros. Todas as buscas basearam-se nos seguintes descritores: "Hernia inguinal, laparotomy, laparoscopic". Resultados: A laparoscopia possui melhores indicativos quanto à dor crônica pós-operatória. As taxas de recidiva em análise de curto prazo são semelhantes, entretanto, alguns estudos evidenciam divergências quanto aos resultados em longo prazo. O tempo de recuperação é menor na técnica por vídeo, porém o tempo de internação hospitalar pós-procedimento não apresentou variação significativa. A videolaparoscopia possui, entretanto, maiores custos e riscos quando comparada com a técnica aberta de Lichtenstein. Vários desses riscos são associados à necessidade de realização de anestesia geral e à maior curva de aprendizado no desenvolvimento da técnica, acarretando em complicações intraoperatórias mais evidentes que na técnica aberta. Conclusão: A escolha do método mais adequado para a hernioplastia deve ser feita levando-se em consideração os riscos de cada uma delas, bem como características particulares de cada caso, como experiência do cirurgião, preferência do paciente, estado de saúde, custo e benefícios de uma em relação à outra. (AU)

Introduction: Inguinal hernias are one of the most common conditions in general surgery services and promote a substantial discussion about the best surgical intervention method. Objective: The aim of this study was to perform a non-systematic review describing and comparing the Lichtenstein open technique and the laparoscopic technique, highlighting the pros and cons of each surgical approach. Methods: A review was performed between November 2015 and February 2016 in databases such as PubMed/Medline, Virtual Health Library (BVS), Bireme, Scielo, Lilacs and also some textbooks. All searches were based on the following descriptors: "Inguinal Hernia, laparotomy, laparoscopic". Results: Laparoscopic repair has better indicators concerning postoperative chronic pain. Short-term analysis of recurrence rates is similar, although some studies show divergence in long-term results. A shorter recovery time is seen in video technique, but the length of post-procedure hospital stay does not show significant change. However, laparoscopy has higher costs and more severe risks when compared to open Lichtenstein technique. Several of these risks are associated with general anesthesia and the largest learning curve in the development of the technique which leads to more statistically evident intraoperative complications than the open technique. Conclusion: The choice of the most suitable method for hernia repair should take into consideration the risks and particular characteristics of each case, as well as the experience of the surgeon, patient preference, health status and costs and benefits of each one of the techniques. (AU)

Pseudomyxoma peritonei: a clinical case of this poorly understood condition.

BACKGROUND: Pseudomyxoma peritonei is an uncommon condition with an estimated incidence of one to two per million (worldwide) per year. It is characterized by the peritoneal deposition of mucinous tumors, most commonly of the appendix, and occasionally from the ovary, coupled by mucinous ascites. CASE PRESENTATION: We report the case of a 76-year-old woman who presented with increased abdominal girth and dyspnea for 2 weeks. She was diagnosed as a case of pseudomyxoma peritonei. She was submitted to right oophorectomy, omentectomy, and pseudomyxoma debulking. The histology was compatible with a mucinous tumor of colorectal/appendicular origin. Chemotherapy was not administered because of her functional status. Two years and 8 months later, she refers with postprandial fullness and has moderate ascites.

[Oncocytic tumors of the adrenal gland]. / Tumores oncocíticos da supra-renal.

The oncocytic tumors of the adrenal gland are rare. To date there's only 147 cases published. The authors present a case of a 34 year-old man admitted to the hospital with lumbar pain and fever. At medical examination a mass was found in the left upper quadrant of the abdomen. The hormonal measurements of the adrenal gland were normal and the abdominal angio CT showed a left retroperitoneal lesion measuring 145 x 157 x 128 mm with extensive necrotic and hemorrhagic areas. The patient underwent a complete surgical resection of the lesion. The mass weighted 1495g and the histological exam revealed an oncocytic tumor of the adrenal gland with uncertain potential. Most of the oncocytic tumors are non functioning and must be considered in the differential diagnosis of adrenocortical tumors. The biologic behavior and the prognosis of these tumors are variable and still need a better definition. Due to the rarity of these tumors the authors made a revision on the published bibliography.

Os tumores oncocíticos da supra-renal são neoplasias pouco frequentes. Atualmente existem 147 casos publicados. Os autores descrevem o caso de um homem de 34 anos admitido no hospital por lombalgias e febre. À observação identificava-se massa no quadrante superior esquerdo do abdomen. Os doseamentos das hormonas da supra-renal foram normais e a angiotomografia abdominal mostrou lesão retroperitoneal esquerda com 145 x 157 x 128 mm com extensas áreas necrosadas e hemorrágicas. O doente foi submetido a ressecção cirúrgica completa da lesão. O tumor pesava 1495 g e o exame anatomo-patológico concluiu tratar-se de tumor oncocítico da supra-renal com potencial maligno incerto. A maioria dos tumores oncocíticos é não funcionante e devem ser considerados no diagnóstico diferencial de tumores do córtex da supra-renal. O comportamento biológico e o seu prognóstico são variáveis e ainda estão mal estabelecidos. A propósito da raridade deste tipo de tumores os autores fazem uma revisão da bibliografia publicada.

The relationship between teaching styles and motivation to teach among physical education teachers.

UNLABELLED: This study aims to investigate how teachers' motivation to teach is related to different teaching styles. A hundred and seventy six physical education teachers from five European countries participated in the study. Teachers' motivation was measured using an instrument developed by Roth et al., 2007 based on the Self-Determination Theory (Deci and Ryan, 1985) which was tested for suitability for use with physical education teachers. The use of teaching styles was assessed through teachers' self-reported data according to the description of teaching styles presented by Curtner-Smith et al., 2001. The revised confirmatory factor model of the teachers' motivation instrument, with three factors, met the criteria for satisfactory fit indices. The results showed that teachers were more intrinsically motivated to teach than externally. Cross-cultural comparison indicated that the Spanish teachers were more intrinsically motivated whilst Lithuanian teachers were more externally motivated than teachers from the other four countries. Teachers from all five countries reported a more frequent use of reproductive styles than productive styles. The results of the present study confirmed the hypotheses that teachers' autonomous motivation is related to the student-centered or productive teaching styles whilst non-autonomously motivated teachers adopt more teacher-centered or reproductive teaching styles. Intrinsic and introjected motivation was significantly higher among teachers who more frequently employed productive teaching styles than teachers who used them less frequently. Intrinsically motivated teachers using more productive teaching styles can contribute more to the promotion physical activity among students. KEY POINTS: PE teachers were more intrinsically motivated to teach than externally.Spanish PE teachers were more intrinsically motivated, whereas Lithuanian PE teachers were more externally motivated.Teachers from all five countries reported a more frequent use of reproductive styles than productive styles.Teachers' autonomous motivation is related to student-centered teaching styles and not autonomously motivated teachers adopt more teacher-centered teaching styles.Intrinsic and introjected motivations were significantly higher among PE teachers using frequently productive teaching styles.

Phylogenetically and spatially close marine sponges harbour divergent bacterial communities.

Recent studies have unravelled the diversity of sponge-associated bacteria that may play essential roles in sponge health and metabolism. Nevertheless, our understanding of this microbiota remains limited to a few host species found in restricted geographical localities, and the extent to which the sponge host determines the composition of its own microbiome remains a matter of debate. We address bacterial abundance and diversity of two temperate marine sponges belonging to the Irciniidae family--Sarcotragus spinosulus and Ircinia variabilis--in the Northeast Atlantic. Epifluorescence microscopy revealed that S. spinosulus hosted significantly more prokaryotic cells than I. variabilis and that prokaryotic abundance in both species was about 4 orders of magnitude higher than in seawater. Polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) profiles of S. spinosulus and I. variabilis differed markedly from each other--with higher number of ribotypes observed in S. spinosulus--and from those of seawater. Four PCR-DGGE bands, two specific to S. spinosulus, one specific to I. variabilis, and one present in both sponge species, affiliated with an uncultured sponge-specific phylogenetic cluster in the order Acidimicrobiales (Actinobacteria). Two PCR-DGGE bands present exclusively in S. spinosulus fingerprints affiliated with one sponge-specific phylogenetic cluster in the phylum Chloroflexi and with sponge-derived sequences in the order Chromatiales (Gammaproteobacteria), respectively. One Alphaproteobacteria band specific to S. spinosulus was placed in an uncultured sponge-specific phylogenetic cluster with a close relationship to the genus Rhodovulum. Our results confirm the hypothesized host-specific composition of bacterial communities between phylogenetically and spatially close sponge species in the Irciniidae family, with S. spinosulus displaying higher bacterial community diversity and distinctiveness than I. variabilis. These findings suggest a pivotal host-driven effect on the shape of the marine sponge microbiome, bearing implications to our current understanding of the distribution of microbial genetic resources in the marine realm.

Tratamento periodontal por transplante autógeno de medula óssea / Periodontal treatment through autogenous transplantation of bone marrow

Foi desenvolvida uma nova técnica cirúrgica para tratamento das lesões infra-ósseas periodontais avançadas, com o uso do transplante autógeno de medula óssea do platô tibial. A técnica não apresentou, após 12 anos de controle, reabsorção radicular ou qualquer outra alteração, nos casos controlados

Assincronismo atrioventricular em portador de marcapasso dupla câmara normofuncionante (Síndrome do marcapasso à esquerda): apresentaçäo de caso / Atrioventricular asynchronism in patients of normofunctional dual chamber pacemaker (Left pacemaker syndrome): report of case

Os autores apresentam um caso de assincronismo atrioventricular à esquerda, causado por importante distúrbio da conduçäo interatrial, com manifestaçöes tanto de insuficiência cardíaca esquerda como de arritmias atriais, em paciente portador de marcapasso dupla câmara normofuncionante, implantado para o tratamento de grave disfunçäo sinusal, em síndrome braditaqui. Antes da adeqüaçäo do delay AV, orientada pela observaçäo do atriograma esofágico, a ativaçäo atrial esquerda se fazia simultaneamente à ativaçäo ventricular, mesmo quando o delay AV se encontrava programado em 200 ms. Programando-se o delay AV para 240 ms observou-se que o potencial atrial esquerdo se inscrevia precocemente em relaçäo ao potencial ventricular, restabelecendo-se desta maneira o sincronismo AV nas câmaras esquerdas. Após essa programaçäo, o paciente que persistia com queixas do cansaço fácil e palpitaçöes tornou-se absolutamente assintomático, näo mais apresentando arritmias atriais do tipo fibrilaçäo que antes eram freqüentes

Resultados iniciais com a prótese de fluxo central tipo Omni Science. Experiência em 93 casos / Preliminary results with Omni Science type central flow prosthesis. Experience in 93 cases

A protese de Omni Science apresenta caracteristicas basicas que lhe dao melhor perfil hemodinamico que as proteses metalicas anteriormente disponiveis. Apresentamos nossa experiencia inicial em 93 casos consecutivos com 96 proteses instaladas num periodo de 31 meses. A mortalidade intra hospitalar foi de 4% nos casos eletivos, sendo maior em cirurgias aorticas com procedimentos associados ou quando realizada de emergencia em casos "in extremis". Em 9 pacientes, no inicio da experiencia, tivemos trombose de protese mitral necessitando reoperacao, com 1 obito; todos os pacientes estao anticoagulados e nao tivemos nenhum caso de embolismo ate o presente. Os resultados clinicos ate o momento, embora seja uma experiencia inicial, sao bastante promissores. A Ommi Science e portanto uma nova alternativa de valvula tipo fluxo central apresentando entretanto caracteristicas proprias que exigem atencao redobrada em sua colocacao, especialmente em posicao mitral