RESUMO
Chicken meat is rich in unsaturated fatty acids. Therefore, it is more susceptible to lipid oxidation and production of volatile organic compounds (VOC). In this study, we evaluated the fatty acids, antioxidants, and VOC profiles of raw and cooked meat samples derived from 4 strains of chicken differing in their growth rates, which were as follows: slow-growing (SG, Leghorn), medium-growing (MG, Hubbard and Naked Neck), and fast-growing (FG, Ross). The VOC profile of meat was measured using proton-transfer reaction-mass spectrometry (PTR-MS). The VOC were identified using PTR-time of flight-MS (PTR-ToF-MS). The data were analyzed using both univariate and multivariate models. Twenty main VOC were identified, which were classified into the following chemical categories: aldehydes, alkadienes, alkenes, furans, amides, alcohols, and other compounds. Our results revealed that the chicken genotype and the method of cooking strongly influenced the VOC profile of the meat. Identifying the relationships between these traits allowed us to highlight the trade-off of the main substrates such as n-3 and n-6 polyunsaturated fatty acids (PUFA), protective substances (antioxidants), and degradation products (VOC) of the poultry meat produced during cooking. The extent of VOC production and n-3 loss was found to be higher for the SG genotype. Reduction of n-6 was higher in MG, whereas small losses in antioxidants and PUFA were observed in the FG genotype, consequently, resulting in the lowest production of VOC. The SG and MG are genotypes more active from a kinetic point of view respect to the FG ones. For this reason, in the FG genotypes, the antioxidants are less involved in the oxidative stress induced by the movement; thus, they were available to protect the lipid of the meat during the cooking process. These results suggested that the use of SG and MG genotypes requires a specific dietary protocol (i.e., increasing the antioxidants content) to counteract the lipid oxidations in all the phases: in vivo, postmortem, and during/after cooking.
Assuntos
Antioxidantes/análise , Ácidos Graxos/análise , Carne/análise , Compostos Orgânicos Voláteis/análise , Animais , Galinhas/classificação , Culinária , Peroxidação de Lipídeos , Estresse Oxidativo , Análise de Componente Principal , Substâncias Reativas com Ácido Tiobarbitúrico/análise , Tocoferóis/análiseRESUMO
Aroma properties of spices are related to the volatile organic compounds (VOCs) present, which can provide distinct analytical signatures. The aim of the study was to examine similarity and diversity of VOC profiles of six common market spices (black/white pepper, chili paprika, cinnamon, nutmeg and saffron). The key volatiles were identified by PTR-TOFMS. Twelve samples per spice were subjected to PTR-Quadrupole MS (PTR-QMS) and Principal Component Analysis to compare the groups and examine diversity. With PTR-TOFMS, 101 volatile compounds were identified as total sum across all samples by mass and comparing them with literature data. Some spices comprised key character aroma compounds, e.g. cinnamaldehyde in cinnamon. For others, VOC groups, such as terpenes, acids and aldehydes topped the list. The PTR-QMS in combination with variables selection resulted in distinct PCA patterns for each spice. Variation within the spice groups was observed, but varied with the kind of spice. The results are valuable for future authentication studies.
Assuntos
Espectrometria de Massas/métodos , Especiarias/análise , Compostos Orgânicos Voláteis/análise , PrótonsRESUMO
A 14-year-old male fanatic basketball player with a good skill of dunking presented with skin abnormalities on the right side of his back due to sports-related striae, stretch marks.
Assuntos
Basquetebol , Anormalidades da Pele/etiologia , Anormalidades da Pele/patologia , Adolescente , Humanos , Masculino , Anormalidades da Pele/diagnósticoRESUMO
AIM: A survival benefit has been observed for colorectal cancer patients with peritoneal carcinomatosis treated by cytoreductive surgery with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC). However, this treatment modality is associated with a considerable morbidity and mortality and in a significant number of patients survival is not improved. We studied whether poor survivors could be identified on preoperative computed tomography (CT), in order to avoid unnecessary surgery. PATIENTS AND METHODS: Films of abdominopelvic CT scans from 25 such patients treated by cytoreductive surgery and HIPEC were retrospectively analysed by two radiologists separately. A simplified peritoneal cancer index (SPCI) was used to determine the extent of peritoneal involvement. Correlation between the on preoperative CT based SPCI-scores as well as number of involved abdominopelvic areas (N) and survival was examined with the log-rank test. The relation between each affected region and survival was evaluated with Cox regression analysis. RESULTS: The preoperative SPCI- and N-scores of one of the radiologists had no statistically significant prognostic value, while for the second radiologist SPCI > or = 7 and N > or = 4 were associated with particularly poor outcome. Additionally, the presence of ileocaecal region involvement and, depending on the radiologist, the occurrence of tumour deposits in the left subdiaphragmatic area on CT appeared to be unfavourable prognostic signs. CONCLUSIONS: The prognostic value of preoperative conventional CT appeared to be radiologist dependent and may, therefore, be of limited value in selecting colorectal cancer patients with peritoneal carcinomatosis who will not benefit from extensive cytoreductive surgery followed by HIPEC.
Assuntos
Antineoplásicos/administração & dosagem , Carcinoma/diagnóstico por imagem , Neoplasias Colorretais/diagnóstico por imagem , Hipertermia Induzida , Laparotomia , Seleção de Pacientes , Neoplasias Peritoneais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Antineoplásicos/uso terapêutico , Carcinoma/secundário , Carcinoma/terapia , Neoplasias Colorretais/patologia , Neoplasias Colorretais/terapia , Seguimentos , Humanos , Injeções Intraperitoneais , Neoplasias Peritoneais/secundário , Neoplasias Peritoneais/terapia , Cuidados Pré-Operatórios , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Resultado do TratamentoRESUMO
A 68-year-old man presented with painful swollen legs due to elephantiasis nostras verrucosa.
Assuntos
Elefantíase/diagnóstico , Idoso , Edema/etiologia , Edema/patologia , Elefantíase/patologia , Elefantíase/terapia , Pé/patologia , Humanos , Ceratose/diagnóstico , Ceratose/patologia , Ceratose/terapia , Dermatoses da Perna/diagnóstico , Dermatoses da Perna/patologia , Dermatoses da Perna/terapia , Masculino , Resultado do TratamentoRESUMO
Persistent eosinophilia was diagnosed in a 19-year-old woman with general malaise, dyspnoea attacks, coughing and episodes of angioedema and associated swallowing problems, and in a 21-year-old man with visual problems, dyspnoea, fatigue, reduced appetite, weight loss and gastrointestinal problems. Both had hypereosinophilic syndrome (a rare disease) with organ damage. In both patients, fluorescence-in-situ-hybridisation (FISH) was negative for the fusion gene FIP1L1-PDGFRA (FIPI-like-1-platelet-derived growth factor receptor alpha). The female patient's disease did not respond to either oral corticosteroids or imatinib, but did respond to hydroxycarbamide. The male patient successively received prednisone, interferon alpha and hydroxycarbamide. His eosinophilia progressed nonetheless, but responded partially to imatinib. In addition, the patient underwent an allogenic non-myeloblative stem cell transplantation from his HLA-identical sister. In patients with persistent eosinophilia accompanied by organ damage or organ dysfunction, hypereosinophilic syndrome can be diagnosed providing all secondary causes of the eosinophilia have been ruled out. Complementary investigations should include cytogenetic and clonal analysis to rule out haemopoietic malignancy. Prednisone, hydroxycarbamide, interferon alpha and the promising imatinib are all treatment options.
Assuntos
Inibidores Enzimáticos/uso terapêutico , Síndrome Hipereosinofílica , Proteínas de Fusão Oncogênica/genética , Receptor alfa de Fator de Crescimento Derivado de Plaquetas/genética , Fatores de Poliadenilação e Clivagem de mRNA/genética , Adulto , Benzamidas , Diagnóstico Diferencial , Feminino , Humanos , Hidroxiureia/uso terapêutico , Síndrome Hipereosinofílica/diagnóstico , Síndrome Hipereosinofílica/genética , Síndrome Hipereosinofílica/terapia , Mesilato de Imatinib , Hibridização in Situ Fluorescente , Interferon-alfa/uso terapêutico , Masculino , Piperazinas/uso terapêutico , Prednisona/uso terapêutico , Pirimidinas/uso terapêutico , Transplante de Células-TroncoRESUMO
AIMS: To report the results of standard therapy for peritoneal carcinomatosis of colorectal origin, which consists of conventional surgery and systemic chemotherapy. METHOD: In a prospective study 50 patients with proven peritoneal carcinomatosis of colorectal origin were treated with conventional surgery combined with 5-fluorouracil and leucovorin, or irinotecan in patients treated by 5-fluorouracil within 12 months prior to entry. Survival and progression-free survival were studied and prognostic factors were analysed. RESULTS: The median survival time was 12.6 months. The median time to progression was 7.6 months. Location of primary tumour and result of conventional surgery and systemic chemotherapy were prognostic factors related to survival. CONCLUSION: The survival time of patients with peritoneal carcinomatosis of colorectal origin seems to be increased in patients treated by conventional surgery and systemic chemotherapy when compared to minimal treatment.
Assuntos
Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/cirurgia , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/cirurgia , Adulto , Idoso , Antineoplásicos/uso terapêutico , Neoplasias Colorretais/patologia , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Peritoneais/secundário , Prognóstico , Estudos Prospectivos , Análise de SobrevidaRESUMO
The aim of this study was to evaluate the presentation, course and treatment outcome of 15 patients with this rare type of sarcoma. The files of the patients were retrospectively analysed. Overall survival was calculated according to the Kaplan-Meier method. There were 15 patients, 8 male and 7 female. The mean age at diagnosis was 29 years for men and 24 years for women. The median survival was 48 months with an overall 5-year survival of 38%. 5 patients had haematogenic metastases at the time of diagnosis. For the remaining 10 patients with localised disease, the median survival was 48 months and the 5-year survival 48%. The median disease-free survival for these patients was 12 months with a 5-year disease free survival of 40%. After the occurrence of haematogenic metastases, patients survived a median period of 8 months (range 0-45 months). 5 patients are still free of disease after a median period of 234 months (12-295 months). Alveolar soft part sarcoma is found especially in young adults. When diagnosed, it is often metastasised with a poor prognosis. However, when radically resected, long-term survival is possible.
Assuntos
Sarcoma Alveolar de Partes Moles/terapia , Neoplasias de Tecidos Moles/terapia , Adolescente , Adulto , Antineoplásicos/uso terapêutico , Feminino , Seguimentos , Humanos , Lactente , Masculino , Metástase Neoplásica/tratamento farmacológico , Radioterapia Adjuvante , Estudos Retrospectivos , Sarcoma Alveolar de Partes Moles/mortalidade , Neoplasias de Tecidos Moles/mortalidade , Análise de SobrevidaRESUMO
Gas chromatography-olfactometry methods are used in flavor research to determine the odor active compounds in foods. In this review, the four major methods for gas chromatography-olfactometry are described and their potentials and limitations discussed. The methods include dilution analysis, detection frequency methods, posterior intensity methods and time-intensity methods. The value of gas chromatography olfactometry data is shown to depend directly on the gas chromatography-olfactometry method, as well as on sample preparation and analytical conditions. Each of the methods has been used frequently and has its advantages and disadvantages. However, on the methodological side, a considerable area is still to be explored, which would contribute to the interpretation of the data and would improve the value of these techniques for both fundamental and applied research.
Assuntos
Cromatografia Gasosa/métodos , Análise de Alimentos/métodos , Odorantes/análise , Aromatizantes/análise , VolatilizaçãoRESUMO
BACKGROUND: Resection of liver metastases of non-colorectal primary malignancies has been reported to prolong survival. We studied the results in our hospital and compared the survival data with that described in the literature. PATIENTS AND METHODS: Since 1991, a prospective database has been kept at The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital of patients undergoing hepatic surgery (n=180). Between 1991 and 1999, 32 patients underwent laparotomy for hepatic metastases of non-colorectal primaries. This study evaluates the operative technical aspects and determines morbidity, mortality, disease-free and overall survival. RESULTS: There were 11 males and 21 females with a median age of 52 (25-69) years. Histology of the primary tumour were various carcinomas (n=22), melanomas (n=4) and sarcomas (n=6). Resection was performed in 28 patients; four patients appeared to be irresectable. There was no perioperative mortality. Morbidity was 23%. One re-operation was necessary because of haemorrhage. The median disease-free survival for the 28 patients was 12 months with an actuarial 5-year disease-free survival of 20% (Kaplan-Meier). The 5-year overall survival was 35% with a median survival of 21 months. CONCLUSION: Liver metastasectomy for selected types of non-colorectal primary tumours is relatively safe and shows in selected patients long-term survival comparable to that of metastasectomies for colorectal origin.
Assuntos
Hepatectomia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Adulto , Idoso , Análise de Variância , Terapia Combinada , Intervalo Livre de Doença , Feminino , Humanos , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Taxa de SobrevidaRESUMO
Peritoneal benign cystic mesothelioma is a rare tumour of unknown aetiology. It usually presents with mild abdominal pain and a solid tumour on physical examination. The differential diagnosis with solid abdominal tumours is difficult. Computed tomography, magnetic resonance imaging as well as aspiration cytology are useful in suggesting the pre-operative diagnosis. We present one case report and discuss this entity.
Assuntos
Mesotelioma Cístico/patologia , Mesotelioma Cístico/cirurgia , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/cirurgia , Adulto , Biópsia por Agulha , Seguimentos , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Masculino , Resultado do TratamentoRESUMO
AIM: Pseudomyxoma peritonei (PMP) is a rare disease characterized by the abundance of mucus in the abdomen without extra-peritoneal growth. METHODS: Our patients with PMP have been treated with cytoreduction and hyperthermic intraperitoneal chemotherapy since 1996. The clinical and histopathological features of PMP and the relation of these features with disease-free interval and survival were assessed. RESULTS: Sixty-two patients with PMP (24 M/38 F) were studied. Adenomatous mucosal changes were present in 31 patients. In females, the ovaries were normal in 5 patients and pseudomyxoma ovarii was present in 20 patients. Patients with minimal atypia and with 1% focal proliferation or less (n=38) had a better survival (p=0.0008) than those with more focal proliferation (n=14). CONCLUSION: In most patients with PMP the appendix is affected; in females the ovaries are usually also involved. Focal proliferation appears to be a prognostic factor.
Assuntos
Neoplasias Peritoneais , Pseudomixoma Peritoneal , Adenocarcinoma Mucinoso/diagnóstico , Adenocarcinoma Mucinoso/cirurgia , Adulto , Idoso , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/cirurgia , Pseudomixoma Peritoneal/diagnóstico , Pseudomixoma Peritoneal/patologia , Pseudomixoma Peritoneal/cirurgia , Estudos Retrospectivos , Análise de SobrevidaRESUMO
BACKGROUND: Hyperthermic intraperitoneal chemotherapy (HIPEC) with mitomycin C has been applied following cytoreductive surgery for various peritoneal surface malignancies. The aim of this study was to evaluate heat penetration in the abdomen during 10 HIPEC procedures. MATERIALS AND METHODS: Temperature measurements were taken at 5 levels through the abdominal wall. Core temperature and room temperature were also measured. The relationships between the temperature gradient and room or core temperature were studied. RESULTS: At the start of perfusion, the temperature was estimated on average to be 40.6 degrees C at the first level, then it decreased by 1.7 degrees C (SD 1.0 degree C, p = 0.0001) in the first mm. In outward direction, it decreases by a further 1.5 degrees C per cm (SD 0.3 degree C/cm, p < 0.0001). The core temperature influenced the temperature gradient; the room temperature was not found to be a significant factor. At the end of perfusion, the temperature is estimated on average to be 40.1 degrees C at the first level, then it decreased by 0.8 degree C (SD 0.7 degree C, p = 0.011) in the first mm. In an outward direction, it decreased by a further 1.7 degrees C per cm (SD 0.4 degree C/cm, p = 0.0001). No evidence of an association between the temperature gradient and the room temperature or the core temperature was observed. CONCLUSION: Hyperthermia used during HIPEC procedures has a limited penetration depth. The slope in temperature seems to be related to the core temperature.
Assuntos
Parede Abdominal , Antineoplásicos/administração & dosagem , Temperatura Corporal , Carcinoma/terapia , Hipertermia Induzida , Mitomicina/administração & dosagem , Neoplasias Peritoneais/terapia , Pseudomixoma Peritoneal/terapia , Antineoplásicos/uso terapêutico , Carcinoma/tratamento farmacológico , Carcinoma/cirurgia , Neoplasias Colorretais/patologia , Terapia Combinada , Feminino , Humanos , Infusões Parenterais , Masculino , Mitomicina/uso terapêutico , Cavidade Peritoneal , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/cirurgia , Pseudomixoma Peritoneal/tratamento farmacológico , Pseudomixoma Peritoneal/cirurgia , TemperaturaRESUMO
The favorable pharmacokinetics of MMC, used during intraperitoneal chemotherapy, has been reported in several studies [11-19]. A major safety issue in studies using intraperitoneal chemotherapy perfusion is the resulting systemic drug exposure. The AUCplasma is determined by the dose, the clearance, and the fraction absorbed from the peritoneal cavity. The reported mean plasma peak concentrations are about one-third of the systemic exposure following a therapeutic dose of MMC given by intravenous administration [30]. The best method to quantify the exposure to MMC are the time concentration profiles (AUC). Because MMC can still be found in plasma the day after intraperitoneal administration, the AUC0-90 is an underestimate of the real AUC; extrapolation to infinity gives the most reliable AUCplasma value. In our series the AUCplasma is about half the AUCplasma when given a therapeutic dose MMC intravenously [30]. What is the best dose in intraperitoneal chemotherapy perfusion? The ideal amount of MMC should include a high AUCperfusate, a high AUCplasma and an acceptable systemic toxicity. In our series grade III/IV leucopenia was observed in 28% patients. We find this rather high percentage acceptable as the problem has proved to be transient, and we have experienced no toxic deaths in recent years. In a phase I study it was estimated that a dose of 25 mg/m2 would result in approximately 10% of grade III/IV leucopenia [20]. Our data indicate that dosing based on body surface area is rational and reliable. The variation between individuals is low. Dosing based on a fixed concentration per liter perfusion fluid is probably more liable to have unforeseen variations, given the fact that we deal with linear pharmacokinetics of MMC [20]. As represented in Fig. 3, the dose of MMC can best be administered in three divided doses, resulting in the more equal exposure of peritoneal structures to MMC during the perfusion. It must be emphasized that our findings only hold true for the perfusion system as used in The Netherlands Cancer Institute. This involves a semi-open abdomen, basic perfusate volume of 3 L, perfusion rate of 1 L/min, abdominal temperature of 40 degrees C, 90 minutes of perfusion, and three drug additions (50% at t = 0, 25% at t = 30 and t = 60 minutes). The differences in perfusion techniques make comparisons of published pharmacokinetics data difficult. Cautions comparison suggest that most groups are dosing far below the maximal tolerated dose. We assume that there is a dose-effect relation for MMC. This means that obtaining a maximal safe dose is important to get maximal results. It seems that better dosing of intraperitoneal MMC can still improve results. The pharmacokinetics of intraperitoneal MMC can, however, be influenced by many details. Open or closed perfusion for instance may make some essential differences. It is therefore important that each treatment group performs its own pharmacokinetics studies on intraperitoneal MMC to achieve the optimal dose method for their chemotherapy perfusion setting. In conclusion, the major advantage of intraperitoneal chemotherapy is the regional dose intensity provided. Following intraperitoneal MMC administration, the affected peritoneal surface is exposed to high concentrations while the systemic toxicity is limited. Comparative analyses on MMC pharmacokinetics are difficult to perform because the diversity of treatment techniques. We recommend administration of MMC, divided in three drug additions, based on BSA.
Assuntos
Carcinoma/tratamento farmacológico , Infusões Parenterais , Mitomicina/farmacocinética , Neoplasias Peritoneais/tratamento farmacológico , Área Sob a Curva , Disponibilidade Biológica , Carcinoma/patologia , Carcinoma/cirurgia , Quimioterapia Adjuvante , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Masculino , Dose Máxima Tolerável , Mitomicina/administração & dosagem , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/cirurgia , Prognóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoRESUMO
The interactions between saliva components and 20 aroma compounds in water and oil model systems were systematically evaluated as a function of saliva composition and saliva/model system ratio. Air/liquid partition coefficients of dimethyl sulfide, 1-propanol, diacetyl, 2-butanone, ethyl acetate, 1-butanol, 2-pentanol, propyl acetate, 3-methyl-1-butanol, ethyl butyrate, hexanal, butyl acetate, 1-hexanol, 2-heptanone, heptanal, alpha-pinene, 2-octanone, octanal, 2-nonanol, and 2-decanone were determined by static headspace gas chromatography. Chain length of compounds within the homologous series determined the extent of interactions with the model system or saliva. Salts in the artificial saliva hardly interacted with aroma compounds. On the other hand, saliva proteins lowered retention of highly volatile compounds and increased retention of less volatile, hydrophobic compounds. Significant differences in volatility of compounds when artificial saliva or water was added indicated that saliva could not be sufficiently replaced by water. The model system/saliva ratio influenced air/liquid partitioning of the aroma compounds significantly for both model systems. Although saliva composition affected volatility of the aroma compounds, the saliva/model system ratio was of much greater influence.
Assuntos
Óleos , Saliva Artificial , Água , Cromatografia Gasosa , Modelos Químicos , Odorantes , PaladarRESUMO
The formation of odor active compounds resulting from initial lipid oxidation in sunflower oil-in-water emulsions was examined during storage at 60 degrees C. The emulsions differed in initial pH, that is, pH 3 and 6. The volatile compounds were isolated under mouth conditions and were analyzed by gas chromatography/sniffing port analysis. The lipid oxidation rate was followed by the formation of conjugated hydroperoxide dienes and headspace hexanal. The initial pH affected the lipid oxidation rate in the emulsions: the formation of conjugated diene hydroperoxides and the hexanal concentration in the static headspace were increased at pH 6. Pentanal, hexanal, 3-pentanol, and 1-octen-3-one showed odor activity in the emulsions after 6 days of storage, for both pH 3 and 6. Larger amounts of odor active compounds were released from the pH 6 emulsion with extended storage. It was shown that this increased release at pH 6 was not due to increased volatility because an increase in pH diminished the static headspace concentrations of added compounds in emulsions.
Assuntos
Gorduras Insaturadas/química , Conservação de Alimentos , Odorantes/análise , Óleos de Plantas/química , Água/química , Emulsões , Humanos , Concentração de Íons de Hidrogênio , Oxirredução , Óleo de Girassol , VolatilizaçãoRESUMO
Two female patients, aged 50 and 62 years respectively, who were treated with irinotecan, fluorouracil and folinic acid (Saltz scheme) due to metastasised colorectal carcinoma, developed progressive abdominal pain, fever and leucopenia. One patient also exhibited intestinal obstruction. The main problem was differentiating between an acute abdomen and irinotecan toxicity. Both patients recovered without the need for an operative intervention. One patient was treated by means of colonic stent placement. The combination of gastrointestinal irinotecan toxicity and pre-existing passage problems is dangerous. However, in such cases restraint should be exercised with respect to operative interventions.
Assuntos
Antineoplásicos Fitogênicos/efeitos adversos , Camptotecina/análogos & derivados , Camptotecina/efeitos adversos , Neoplasias Colorretais/tratamento farmacológico , Dor Abdominal/induzido quimicamente , Dor Abdominal/etiologia , Antineoplásicos Fitogênicos/uso terapêutico , Camptotecina/uso terapêutico , Feminino , Febre/induzido quimicamente , Febre/etiologia , Humanos , Obstrução Intestinal/induzido quimicamente , Obstrução Intestinal/etiologia , Irinotecano , Leucopenia/induzido quimicamente , Leucopenia/etiologia , Pessoa de Meia-Idade , StentsRESUMO
OBJECTIVE: To evaluate the reliability of registration of wound infections and their contribution to total postoperative morbidity. DESIGN: Prospective. METHOD: During the period from 1 July 1997 through 30 June 1998 of all patients treated in the department of Surgery of the Diaconessen Hospital, Utrecht, the treatment-related complications were recorded during the hospital stay as well as at the first outpatient follow-up. The clinical registration forms were checked and supplemented after discharge, during the transfer and by the hospital hygienist. The precision of registration, the implications of the registered wound infections, and the share of this complication in overall postoperative morbidity were studied. RESULTS: There were 2172 admissions (2004 patients): 996 males and 1176 females (mean age at admission 55 years). The response of registration was 100% during hospital stay and 59.5% in the outpatient department. Postoperative course was complicated in 506 patients (23% of the admissions). Of the 735 registered complications 583 (79%) were recorded during clinical stay. Airway and wound infections were the most frequently registered complications (in 4.4% and 4.3% of the admissions respectively). Of the wound infections 45% were recorded after discharge and 88% fully recovered by conservative means. Both the frequency of wound infections in relation to other postoperative complications and the severity of the registered wound infections varied with the reason of admission. CONCLUSION: The incidence of postoperative wound infections was not reliably measured as a result of low response of registration after hospital discharge. The contribution of wound infections to overall postoperative morbidity and the severity of these infections varied with the reason of admission.