Analysis of tissue inflammatory response, fibroplasia, and foreign body reaction between the polyglactin suture of abdominal aponeurosis in rats and the intraperitoneal implant of polypropylene, polypropylene/polyglecaprone and polyester/porcine collagen meshes.

PURPOSE: To compare tissue inflammatory response, foreign body reaction, fibroplasia, and proportion of type I/III collagen between closure of abdominal wall aponeurosis using polyglactin suture and intraperitoneal implant of polypropylene, polypropylene/polyglecaprone, and polyester/porcine collagen meshes to repair defects in the abdominal wall of rats. METHODS: Forty Wistar rats were placed in four groups, ten animals each, for the intraperitoneal implant of polypropylene, polypropylene/polyglecaprone, and polyester/porcine collagen meshes or suture with polyglactin (sham) after creation of defect in the abdominal wall. Twenty-one days later, histological analysis was performed after staining with hematoxylin-eosin and picrosirius red. RESULTS: The groups with meshes had a higher inflammation score (p < 0.05) and higher number of gigantocytes (p < 0.05) than the sham group, which had a better fibroplasia with a higher proportion of type I/III collagen than the tissue separating meshes (p < 0.05). There were no statistically significant differences between the three groups with meshes. CONCLUSIONS: The intraperitoneal implant of polypropylene/polyglecaprone and polyester/porcine collagen meshes determined a more intense tissue inflammatory response with exuberant foreign body reaction, immature fibroplasia and low tissue proportion of type I/III collagen compared to suture with polyglactin of abdominal aponeurosis. However, there were no significant differences in relation to the polypropylene mesh group.

Analysis of tissue inflammatory response, fibroplasia, and foreign body reaction between the polyglactin suture of abdominal aponeurosis in rats and the intraperitoneal implant of polypropylene, polypropylene/polyglecaprone and polyester/porcine collagen meshes

ABSTRACT Purpose To compare tissue inflammatory response, foreign body reaction, fibroplasia, and proportion of type I/III collagen between closure of abdominal wall aponeurosis using polyglactin suture and intraperitoneal implant of polypropylene, polypropylene/polyglecaprone, and polyester/porcine collagen meshes to repair defects in the abdominal wall of rats. Methods Forty Wistar rats were placed in four groups, ten animals each, for the intraperitoneal implant of polypropylene, polypropylene/polyglecaprone, and polyester/porcine collagen meshes or suture with polyglactin (sham) after creation of defect in the abdominal wall. Twenty-one days later, histological analysis was performed after staining with hematoxylin-eosin and picrosirius red. Results The groups with meshes had a higher inflammation score (p < 0.05) and higher number of gigantocytes (p < 0.05) than the sham group, which had a better fibroplasia with a higher proportion of type I/III collagen than the tissue separating meshes (p < 0.05). There were no statistically significant differences between the three groups with meshes. Conclusions The intraperitoneal implant of polypropylene/polyglecaprone and polyester/porcine collagen meshes determined a more intense tissue inflammatory response with exuberant foreign body reaction, immature fibroplasia and low tissue proportion of type I/III collagen compared to suture with polyglactin of abdominal aponeurosis. However, there were no significant differences in relation to the polypropylene mesh group.

Comparative study of peritoneal adhesions after intraperitoneal implantation in rats of meshes of polypropylene versus polypropylene/polyglecaprone versus polyester/porcine collagen.

PURPOSE: To Compare the extent and intensity of adhesions formed between the intra-abdominal organs and the intraperitoneal implants of polypropylene mesh versus polypropylene/polyglecaprone versus polyester/porcine collagen used for correction of abdominal wall defect in rats. METHODS: After the defect in the abdominal wall, thirty Wistar rats were placed in three groups (ten animals each) for intraperitoneal mesh implant: polypropylene group, polypropylene/polyglecaprone group, and polyester/porcine collagen group. The macroscopic evaluation of the extent and intensity of adhesions was performed 21 days after the implant. RESULTS: The polypropylene group had a higher statistically significant impairment due to visceral adhesions (p value = 0.002) and a higher degree of intense adherence in relation to polypropylene/polyglecaprone and polyester/porcine collagen groups (p value<0.001). The polyester/porcine collagen group showed more intense adhesions than the polypropylene/polyglecaprone group (p value=0.035). CONCLUSIONS: The intraperitoneal implantation of polypropylene meshes to correct defects of the abdominal wall caused the appearance of extensive and firm adhesions to intra-abdominal structures. The use of polypropylene/polyglecaprone or polyester/porcine collagen tissue-separating meshes reduces the number and degree of adhesions formed.

Comparative study of peritoneal adhesions after intraperitoneal implantation in rats of meshes of polypropylene versus polypropylene/polyglecaprone versus polyester/porcine collagen

Abstract Purpose To Compare the extent and intensity of adhesions formed between the intra-abdominal organs and the intraperitoneal implants of polypropylene mesh versus polypropylene/polyglecaprone versus polyester/porcine collagen used for correction of abdominal wall defect in rats. Methods After the defect in the abdominal wall, thirty Wistar rats were placed in three groups (ten animals each) for intraperitoneal mesh implant: polypropylene group, polypropylene/polyglecaprone group, and polyester/porcine collagen group. The macroscopic evaluation of the extent and intensity of adhesions was performed 21 days after the implant. Results The polypropylene group had a higher statistically significant impairment due to visceral adhesions (p value = 0.002) and a higher degree of intense adherence in relation to polypropylene/polyglecaprone and polyester/porcine collagen groups (p value<0.001). The polyester/porcine collagen group showed more intense adhesions than the polypropylene/polyglecaprone group (p value=0.035). Conclusions The intraperitoneal implantation of polypropylene meshes to correct defects of the abdominal wall caused the appearance of extensive and firm adhesions to intra-abdominal structures. The use of polypropylene/polyglecaprone or polyester/porcine collagen tissue-separating meshes reduces the number and degree of adhesions formed.

[Metabolic syndrome in outpatient cardiology clinics]. / Síndrome metabólica em ambulatório cardiológico.

BACKGROUND: In Brazil, the prevalence of the metabolic syndrome (MS) is little known in several regions. OBJECTIVE: To analyze the prevalence of MS, its components and the agreement between two diagnostic definitions in a population aged > 13 years. METHODS: Cross-sectional study conducted from June to October 2007 in 719 patients of outpatient cardiology clinics in the city of São Luis, State of Maranhão, Brazil. Blood pressure (BP), weight, height, waist circumference and lipid profile were measured. Risk factors for MS were evaluated according to the International Diabetes Federation (IDF) definition. Prevalence ratios and 95% confidence intervals were estimated using Poisson regression. RESULTS: The prevalence of MS was higher in both genders when using IDF definition (62.3% in men and 64.6% in women) than when using that of the National Cholesterol Education Program - Adult Treatment Prevention (NCEP ATPIII) (48.9% in men and 59% in women). The most prevalent MS components were: hypertension (87.2% and 86%); hypertriglyceridemia (84.4% and 82.5%); increased waist circumference (77.8% and 100%); low HDL-c (58.1% and 49.9%); and high blood glucose (59.9% and 51.9%), using NCEP ATPIII and IDF definitions, respectively. In the adjusted analysis, age > 60 years and body mass index (BMI) > 30 were associated with a higher risk of MS (p<0.001). CONCLUSION: The prevalence of MS was much higher than in the overall population, and hypertension was the most prevalent component. There was good agreement between the two definitions, very good in the female gender and moderate in the male gender.

Síndrome metabólica em ambulatório cardiológico / Metabolic syndrome in outpatient cardiology clinics / Síndrome metabólico en ambulatorio cardiológico

Fundamento: No Brasil, a prevalência de síndrome metabólica (SM) é pouco conhecida em várias regiões. Objetivo: Analisar a prevalência da SM, seus componentes e a concordância entre dois critérios diagnósticos numa população com idade > 13 anos. Métodos: Estudo transversal, realizado de junho a outubro de 2007, em 719 pacientes, em ambulatórios cardiológicos de São Luís, MA. Mediu-se a pressão arterial (PA), peso, altura, circunferência abdominal e perfil lipídico. Avaliaram-se os fatores de risco para a SM segundo o critério da International Diabetes Federation (IDF). Razões de prevalência e intervalos de confiança de 95 por cento foram estimados pela regressão de Poisson. Resultados: A prevalência da SM foi maior em ambos os sexos pelo conceito da IDF (62,3 por cento em homens e 64,6 por cento em mulheres), em relação ao do National Cholesterol Education Program - Adult Treatment Prevention (NCEP ATPIII) (48,9 por cento em homens e 59 por cento em mulheres). Os componentes da SM mais prevalentes foram: hipertensão arterial sistêmica HAS (87,2 por cento e 86 por cento); hipertrigliceridemia (84,4 por cento e 82,5 por cento); circunferência abdominal alterada (77,8 por cento e 100 por cento); HDL-c baixo (58,1 por cento e 49,9 por cento); e glicemia alterada (59,9 por cento e 51,9 por cento), pelos conceitos NCEP ATPIII e IDF, respectivamente. Após análise ajustada, idade > 60 anos e índice de massa corporal (IMC) > 30 foram associados a um maior risco de SM (p < 0,001). Conclusão: A prevalência da SM foi bem maior que a população geral; a (HAS) foi o componente mais prevalente. Houve boa concordância entre os dois critérios, sendo ótima no sexo feminino e regular no masculino.

Background: In Brazil, the prevalence of the metabolic syndrome (MS) is little known in several regions. Objective: To analyze the prevalence of MS, its components and the agreement between two diagnostic definitions in a population aged > 13 years. Methods: Cross-sectional study conducted from June to October 2007 in 719 patients of outpatient cardiology clinics in the city of São Luis, State of Maranhão, Brazil. Blood pressure (BP), weight, height, waist circumference and lipid profile were measured. Risk factors for MS were evaluated according to the International Diabetes Federation (IDF) definition. Prevalence ratios and 95 percent confidence intervals were estimated using Poisson regression. Results: The prevalence of MS was higher in both genders when using IDF definition (62.3 percent in men and 64.6 percent in women) than when using that of the National Cholesterol Education Program - Adult Treatment Prevention (NCEP ATPIII) (48.9 percent in men and 59 percent in women). The most prevalent MS components were: hypertension (87.2 percent and 86 percent); hypertriglyceridemia (84.4 percent and 82.5 percent); increased waist circumference (77.8 percent and 100 percent); low HDL-c (58.1 percent and 49.9 percent); and high blood glucose (59.9 percent and 51.9 percent), using NCEP ATPIII and IDF definitions, respectively. In the adjusted analysis, age > 60 years and body mass index (BMI) > 30 were associated with a higher risk of MS (p<0.001). Conclusion: The prevalence of MS was much higher than in the overall population, and hypertension was the most prevalent component. There was good agreement between the two definitions, very good in the female gender and moderate in the male gender.

Fundamento: En Brasil, la prevalencia de síndrome metabólico (SM) es poco conocida en varias regiones. Objetivo: Analizar la prevalencia del SM, sus componentes y la concordancia entre dos criterios diagnósticos en una población con edad > 13 años. Métodos: Estudio transversal, realizado de junio a octubre de 2007, en 719 pacientes, en ambulatorios cardiológicos de São Luís, MA. Se midió la presión arterial (PA), peso, altura, circunferencia abdominal y perfil lipídico. Se evaluaron los factores de riesgo para el SM según el criterio de la International Diabetes Federation (IDF). Razones de prevalencia de intervalos de confianza del 95 por ciento se estimaron por la regresión de Poisson. Resultados: La prevalencia de SM fue mayor en ambos sexos por el concepto de la IDF (62,3 por ciento en hombres y 64,6 por ciento en mujeres), con relación al del National Cholesterol Education Program - Adult Treatment Prevention (NCEP ATPIII) (48,9 por ciento en hombres y 59 por ciento en mujeres). Los componentes del SM más prevalentes fueron: hipertensión arterial sistémica - HAS (87,2 por ciento y 86 por ciento); hipertrigliceridemia (84,4 por ciento y 82,5 por ciento); circunferencia abdominal alterada (77,8 por ciento y 100 por ciento); HDL-c bajo (58,1 por ciento y 49,9 por ciento); y glucemia alterada (59,9 por ciento y 51,9 por ciento), por los conceptos NCEP ATPIII y IDF, respectivamente. Después del análisis ajustado, edad > 60 años e índice de masa corporal (IMC) > 30 se asociaron a un mayor riesgo de SM (p < 0,001). Conclusión: La prevalencia de SM fue mucho mayor que la población general; la HAS fue el componente más prevalente. Hubo buena concordancia entre los dos criterios, siendo óptima en el sexo femenino y regular en el masculino.

Leiomioma gástrico gigante tratado por gastrectomia / Gastric resection for treatment of giant gastric leiomyoma

Os autores apresentam um caso raro de leiomioma gástrico gigante tratado por gastrectomia. Discutem a importancia do diagnóstico, bem como as opçöes de tratamento.(au)

Ressecção hepática alargada por doença cística do fígado / Extended hepatic resection due to cystic liver disease

O cisto hepatico congênito é uma doença benigna e geralmente assintomática. O tratamesnto é limitado a pacientes sintómaticos ou na vigência de complicações. Várias formas de tratamento têm sido propostas, incluindo procedimento não cirúrgicos e cururgia, tais como excisão parcial laparoscópica, excisão completa e ressecção hepática. Este estudo tem por objetivo descrever um caso de paciente com doença cística do fígado submetido a hepatectomia esquerda alargada. O principal sintoma relatado foi dor no quadrante superior direito epigástrio, sendo o diagnóstico confirmado por tomagrafia computadorizada. Os autores concluíram que a ressecção hepática é um procedimento recomendado para pacientes com grandes cistos e que foram submetidos a tratamento laparoscópicos prévio

Preparo pré-operatório do paciente ictérico / Preoperative preparation of the jaundiced patient

Os autores apresentam uma revisão sobre o preparo pré-operatório do paciente ictérico. Os fators de risco associados, incluindo sepse, hemorragia, insuficiência renal aguda e desnutrição, representam grande importância ma morbidade e mortalidade daqueles pacientes. Uma visão atual dos mecanismos responsáveis por estas complicações e o manuseio geral são discutidos