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Introdução: O objetivo do estudo foi comparar os resultados cirúrgicos da nefrolitotripsia percutânea entre as posições prona e Valdivia-Galdakao. Métodos: Foi realizado estudo retrospectivo transversal com análise de dados de pacientes submetidos à NLPC em posição prona e Valdivia-Galdakao. Os pacientes foram subdivididos de acordo com os critérios da Classificação de Guy. Resultados: Foram analisados 136 pacientes (86 em posição prona e 50 em posição Valdivia-Galdakao). A média do tempo cirúrgico da posição prona foi de 161min e da posição Valdivia-Galdakao foi de 134min. A taxa de limpeza completa foi semelhante em ambas as posições, 40% em posição prona e 39,5% em posição Valdivia-Galdakao. Conclusões: O posicionamento cirúrgico em Valdivia-Galdakao apresentou tempo cirúrgico menor que o posicionamento prono, principalmente nos casos menos complexos (Guy's 1). A posição supina é uma opção segura e eficaz no tratamento de litíase renal e uma alternativa atraente em relação à sua variante clássica.
Introduction: The objective was to compare the surgical results of percutaneous nephrolithotomy between the prone and Valdivia-Galdakao positions. Methods: A retrospective cross-sectional study was performed with data analysis from patients submitted to PCNL. The patients were arranged in prone and Valdivia-Galdakao position. Patients were subdivided according to the Guy Classification criteria. Results: A total of 136 patients were analyzed (86 in prone position and 50 in Valdivia-Galdakao). The average surgical time in prone position was 161min and in Valdivia-Galdakao position was 134min. The complete clearing rate was similar in both positions, 40% in prone position and 39,5% in Valdivia-Galdakao position. Conclusions: The Valdivia-Galdakao positioning had less surgical time than prone positioning, especially in less complex cases (Guy's 1). The supine position is a safe and effective option in the treatment of renal lithiasis and an alternative to be considered regarding to the classical variant.
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O abscesso de corpo cavernoso é uma condição bastante rara. Geralmente ocorre devido complicações de trauma, terapia de injeção intracavernosa, cavernosografia, corpos estranhos ou comorbidades, como por exemplo diabetes. Os diabéticos constituem grupo de risco devido à microangiopatia e imunossupressão. Neste relato é descrito o caso de um paciente diabético com aparecimento de abscesso em corpo cavernoso após introdução de corpo estranho em meato uretral. Após a drenagem cirúrgica do abscesso, foi verificado o crescimento de Candida albicans na cultura no material coletado, possibilitando direcionar o tratamento com antibiótico
Corpus cavernosum abscess is a rare condition. It usually occurs due to complications of trauma, intracavernous injection therapy, angiography of the corpus cavernosum, foreign bodies or comorbidities, such as diabetes. Diabetic people constitute a risk group due to microangiopathy and immunosuppression. In this case report is described a case of a diabetic patient with abscess of corpus cavernosum after introduction of foreign body into the urethral meatus. After the surgical drainage of the abscess was verified in the culture of collected material Candida albicans, allowing to direct the antibiotic treatment
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BACKGROUND: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that increases the cardiovascular risk. Regular physical exercise can promote benefits, but the MetS individuals are demotivated to perform it. Thus, new possibilities are important as an alternative intervention. The whole-body vibration can be considered an exercise modality and would be a safe and low-cost strategy to improve functional parameters of individuals in different clinical conditions. The aim of this exploratory study was to assess effects of whole-body vibration on functional parameters of MetS individuals. The hypothesis of this work was that the whole-body vibration could improve the functionality of MetS individuals. METHODS: Twenty-two individuals performed the intervention. The vibration frequency varied from 5 to 14 Hz and the peak-to-peak displacements, from 2.5 to 7.5 mm. Each session consisted of one minute-bout of working time followed by a one minute-bout of passive rest in each peak-to-peak displacement for three-times. The whole-body vibration protocol was applied twice per week for 5 weeks. Data from the trunk flexion, gait speed, sit-to-stand test and handgrip strength were collected. Physiological parameters (blood pressure and heart rate) were also evaluated. The Wilcoxon Rank test and Student t-test were used. RESULTS: No significant changes (p > 0.05) were observed in physiological parameters (arterial blood pressure and heart rate). Significant improvements were found in trunk flexion (p = 0.01), gait speed (p = 0.02), sit-to-stand test (p = 0.005) and handgrip strength (p = 0.04) after the whole-body vibration. CONCLUSIONS: In conclusion, whole-body vibration may induce biological responses that improve functional parameters in participants with MetS without interfering in physiological parameters, comparing before and after a 5-week whole-body vibration protocol. TRIAL REGISTRATION: Register in the Registro Brasileiro de Ensaios Clínicos (ReBEC) with the number RBR 2bghmh (June 6th, 2016) and UTN: U1111-1181-1177. (virgula).
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Terapia por Ejercicio , Síndrome Metabólico/terapia , Vibración , Adaptación Fisiológica/fisiología , Anciano , Estudios de Factibilidad , Femenino , Fuerza de la Mano/fisiología , Humanos , Masculino , Síndrome Metabólico/fisiopatología , Persona de Mediana Edad , Equilibrio Postural/fisiología , Resultado del TratamientoRESUMEN
Bone mineral density is an important parameter for the diagnosis of bone diseases, as well as for predicting fractures and treatment monitoring. Thus, the aim of the present study was to evaluate the potential of Quantitative Ultrasound (QUS) to monitor bone changes after calcium, phosphorus, and magnesium loss in rat femurs in vitro during a demineralization process. Four quantitative ultrasound parameters were estimated from bone surface echoes in eight femur diaphysis of rats. The echo signals were acquired during a decalcification process by Ethylenediaminetetraacetic Acid (EDTA). The results were compared to Quantitative Computed Tomography (QCT) and inductively coupled plasma optical emission spectrometry measurements for validation. Integrated Reflection Coefficient (IRC) reflection parameters and Frequency Slope of Reflection Transfer Function (FSRTF) during demineralization tended to decrease, while the backscattering parameter Apparent Integrated Backscatter (AIB) increased and Frequency Slope of Apparent Backscatter (FSAB) showed an oscillatory behavior with no defined trend. Results indicate a clear relation between demineralization and the corresponding decrease in the reflection parameters and increase in the scattering parameters. The trend analysis of the fall curve of the chemical elements showed a better relationship between IRC and QCT. It was possible to monitor bone changes after ions losses, through the QUS. Thus, it is an indication that the proposed protocol has potential to characterize bone tissue in animal models, providing consistent results towards standardization of bone characterization studies by QUS endorsing its use in humans.
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Huesos/diagnóstico por imagen , Huesos/metabolismo , Calcio/metabolismo , Fémur , Magnesio/metabolismo , Fósforo/metabolismo , Ultrasonografía , Animales , Densidad Ósea , Ratas , Ultrasonografía/métodosRESUMEN
Os hemangiomas são tumores benignos, e raramente podem se apresentar no tecido paratesticular. Sua fisiopatologia ainda é desconhecida, e são poucos os relatos de caso dessa doença, que atinge mais frequentemente pacientes jovens. Apesar de benigna, pode mimetizar tumores malignos do testículo, sendo na maioria das vezes indicada abordagem invasiva para o diagnóstico. Apresentamos o relato de caso de um paciente com nódulo testicular. No decorrer da investigação, suspeitou-se de neoplasia maligna, sendo realizada orquiectomia com posterior análise patológica e diagnóstico de hemangioma paratesticular da túnica vaginal
Hemangiomas are benign tumors, and can rarely occur in the paratesticular tissue. Its etiology is still unkown, and there are few case reports of this disease, which affects younger patients more often. Although benign, it can mimic malignant tumors of the testis, and an invasive approach to diagnosis is indicated. We present the case of a young patient who underwent to orchiectomy for a testicular nodule. Posterior pathological analysis presented as paratesticular hemangioma of the tunica vaginalis
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O objetivo deste estudo foi avaliar os efeitos do Método Pilates sobre a variabilidade da frequência cardíaca, na flexibilidade e nas variáveis antropométricas em indivíduos sedentários. O presente estudo contou com 14 voluntárias do sexo feminino, na faixa etária entre 40 e 55 anos, que realizaram 20 sessões de exercícios do Método Pilates, duas vezes por semana, com duração de 45 minutos cada sessão, dividida em três fases: repouso, exercício e recuperação. As variáveis estudadas foram: os dados antropométricos, flexibilidade avaliada utilizando o teste de sentar-e-alcançar com o Banco de Wells, e intervalos R-R usando um cardiotacômetro. O processamento dos sinais da frequência cardíaca foi efetuado em ambiente MatLab 6.1®, utilizando a TWC. Os dados coletados foram submetidos ao teste de normalidade de Shapiro Wilk e foi utilizado o teste de Wilcoxon e Anova One Way (α = 0,05). Nos resultados, observou-se que não houve diferenças significativas entre os valores antropométricos e de frequência cardíaca, porém houve aumento da flexibilidade com o treinamento. Comparando a primeira e a Artigo original vigésima sessão com relação aos parâmetros low frequency (LF), high frequency (HF), e relação LF/HF, não houve diferença na fase de repouso e foram constatadas diferenças significativas de LF (p = 0,04) e HF (p = 0,04) na fase de exercício e diferença significativa de LF/ HF (p = 0,05) na fase de recuperação. Comparando os parâmetros nos períodos de repouso, exercícios e recuperação durante a primeira sessão e durante a vigésima sessão, não houve diferença significativa nos parâmetros LF, HF e LF/HF. Pode-se concluir que, em relação à flexibilidade, foi observada uma melhora significativa, enquanto a análise da frequência cardíaca caracterizou a intensidade do exercício de 50% da capacidade funcional das voluntárias. Em relação aos parâmetros LF, HF e LF/HF foram observados um aumento da variabilidade da frequência cardíaca, provavelmente produto da atividade do Método Pilates. A Transformada Wavelet (TWC) mostrou-se um Método adequado para as análises da variabilidade da frequência cardíaca. (AU)
The aim of this study was to evaluate the effects of the Pilates method on cardiovascular system through heart rate analysis with Continuous Wavelet Transformation (CWT). In the present study, 14 women, 40 to 55 years old, performed 20 sets of Pilates method exercises twice a week with duration of 45 minutes each set divided in three phases: rest, exercise and recovery. The studied variables were anthropometric data, flexibility which was evaluated using the sit-and-reach test (bench of wells), heart frequency which was monitored through a model s810i (Polar) cardiotachometer and the RR intervals were stored. The signals processing of the FC was computed in MatLab 6.1® environment, utilizing the CWT. The collected data were analyzed using Shapiro Wilk normality test and Wilcoxon and Anova One Way (α = 0.05) tests to compare the parameters. There were no significant differences between anthropometric values and heart rate; however there was an increase in flexibility. Comparing the parameters during the phases rest, exercise and recovery in the first and later in the last session, it was not observed statistically significant changes in heart frequency. Regarding to low frequency (LF), high frequency (HF) and LF/HF parameters, there was no significant difference. Significant differences of LF (p = 0.04) and HF (p = 0.04) were reported in exercise phase and significant difference (p = 0.05) in recovery phase. There was no significant difference in LF, HF and LF/HF parameters in the resting periods, exercises and recovery in the first and twentieth set. In relation to flexibility, a significant improvement was observed, while the heart rate analysis characterized the intensity of the exercise of fifty per cent of the functional capacity of the subjects. In relation to LF, HF and LF/HF parameters, a VFC increase was reported, result of Pilates method activity. The CWT showed itself an adequate method for the heart rate frequency analysis. (AU)
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Humanos , Femenino , Persona de Mediana Edad , Técnicas de Ejercicio con Movimientos , Frecuencia Cardíaca , Análisis de Ondículas , Antropometría , Conducta SedentariaRESUMEN
Vibrations produced in oscillating/vibratory platform generate whole body vibration (WBV) exercises, which are important in sports, as well as in treating diseases, promoting rehabilitation, and improving the quality of life. WBV exercises relevantly increase the muscle strength, muscle power, and the bone mineral density, as well as improving the postural control, the balance, and the gait. An important number of publications are found in the PubMed database with the keyword "flexibility" and eight of the analyzed papers involving WBV and flexibility reached a level of evidence II. The biggest distance between the third finger of the hand to the floor (DBTFF) of a patient with metabolic syndrome (MS) was found before the first session and was considered to be 100%. The percentages to the other measurements in the different sessions were determined to be related to the 100%. It is possible to see an immediate improvement after each session with a decrease of the %DBTFF. As the presence of MS is associated with poorer physical performance, a simple and safe protocol using WBV exercises promoted an improvement of the flexibility in a patient with MS.
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OBJECTIVE: Prolonged warm ischemia time and increased intra-abdominal pressure caused by pneumoperitoneum during a laparoscopic donor nephrectomy could enhance renal ischemia reperfusion injury. For this reason, laparoscopic donor nephrectomy may be associated with a slower graft function recovery. However, an adequate protective response may balance the ischemia reperfusion damage. This study investigated whether laparoscopic donor nephrectomy modified the protective response of renal tissue during kidney transplantation. METHODS: Patients undergoing live renal transplantation were prospectively analyzed and divided into two groups based on the donor nephrectomy approach used: 1) the control group, recipients of open donor nephrectomy (n = 29), and 2) the study group, recipients of laparoscopic donor nephrectomy (n = 26). Graft biopsies were obtained at two time points: T-1 = after warm ischemia time and T+1 = 45 minutes after kidney reperfusion. The samples were analyzed by immunohistochemistry for the Bcl-2 and HO-1 proteins and by real-time polymerase chain reaction for the mRNA expression of Bcl-2, HO-1 and vascular endothelial growth factor. RESULTS: The area under the curve for creatinine and delayed graft function were similar in both the laparoscopic and open groups. There was no difference in the protective gene expression between the laparoscopic donor nephrectomy and open donor nephrectomy groups. The protein expression of HO-1 and Bcl-2 were similar between the open and laparoscopic groups. Furthermore, the gene expression of B-cell lymphoma 2 correlated with the warm ischemia time in the open group (p = 0.047) and that of vascular endothelial growth factor with the area under the curve for creatinine in the laparoscopic group (p = 0.01). CONCLUSION: The postoperative renal function and protective factor expression were similar between laparoscopic donor nephrectomy and open donor nephrectomy. These findings ensure laparoscopic donor nephrectomy utilization in renal transplantation.
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Trasplante de Riñón , Laparoscopía/métodos , Donadores Vivos , Nefrectomía/métodos , Recolección de Tejidos y Órganos/métodos , Adulto , Creatinina/sangre , Funcionamiento Retardado del Injerto/fisiopatología , Femenino , Expresión Génica , Hemo-Oxigenasa 1/sangre , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Reacción en Cadena en Tiempo Real de la Polimerasa , Daño por Reperfusión/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Factor A de Crecimiento Endotelial Vascular/sangre , Isquemia Tibia/métodosRESUMEN
OBJECTIVE: Prolonged warm ischemia time and increased intra-abdominal pressure caused by pneumoperitoneum during a laparoscopic donor nephrectomy could enhance renal ischemia reperfusion injury. For this reason, laparoscopic donor nephrectomy may be associated with a slower graft function recovery. However, an adequate protective response may balance the ischemia reperfusion damage. This study investigated whether laparoscopic donor nephrectomy modified the protective response of renal tissue during kidney transplantation. METHODS: Patients undergoing live renal transplantation were prospectively analyzed and divided into two groups based on the donor nephrectomy approach used: 1) the control group, recipients of open donor nephrectomy (n = 29), and 2) the study group, recipients of laparoscopic donor nephrectomy (n = 26). Graft biopsies were obtained at two time points: T-1 = after warm ischemia time and T+1 = 45 minutes after kidney reperfusion. The samples were analyzed by immunohistochemistry for the Bcl-2 and HO-1 proteins and by real-time polymerase chain reaction for the mRNA expression of Bcl-2, HO-1 and vascular endothelial growth factor. RESULTS: The area under the curve for creatinine and delayed graft function were similar in both the laparoscopic and open groups. There was no difference in the protective gene expression between the laparoscopic donor nephrectomy and open donor nephrectomy groups. The protein expression of HO-1 and Bcl-2 were similar between the open and laparoscopic groups. Furthermore, the gene expression of B-cell lymphoma 2 correlated with the warm ischemia time in the open group (p = 0.047) and that of vascular endothelial growth factor with the area under the curve for creatinine in the laparoscopic group (p = 0.01). CONCLUSION: The postoperative renal function and protective factor expression were similar between laparoscopic ...
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trasplante de Riñón , Donadores Vivos , Laparoscopía/métodos , Nefrectomía/métodos , Recolección de Tejidos y Órganos/métodos , Creatinina/sangre , Funcionamiento Retardado del Injerto/fisiopatología , Expresión Génica , Hemo-Oxigenasa 1/sangre , Periodo Posoperatorio , Reacción en Cadena en Tiempo Real de la Polimerasa , Daño por Reperfusión/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Factor A de Crecimiento Endotelial Vascular/sangre , Isquemia Tibia/métodosRESUMEN
PURPOSE: We evaluated our experience with laparoscopic donor nephrectomy in patients with multiple renal arteries, comparing operative outcomes and early graft function with patients with a single renal artery. MATERIALS AND METHODS: From January 2003 to February 2009, 130 patients underwent laparoscopic donor nephrectomy at our institution, 108 (83 %) with a single renal artery and 22 (17 %) with multiple arteries. Donor and recipient outcomes for single artery and multiple arteries allografts were compared. RESULTS: The LDN operative time was similar between the single artery and multiple arteries groups (162 vs 163 min, respectively, p = 0.87). Allografts with multiple arteries had significantly longer warm ischemia time (3.9 vs 4.9 min, p = 0.05) and cold ischemia time (72 vs 94 min, p < 0.001) than those with single artery. The conversion rate was similar between single and multiple arteries groups (6 % vs 4.5 %, respectively, p = 0.7). Multiple arteries grafts had a non statistically significant higher rate of poor graft function when compared to single artery grafts (23 % vs 12 %, respectively, p = 0.18). Five patients in the single artery group (4.6 %) and one patient in the multiple arteries group (4.5 %) needed dialysis during the first postoperative week. Overall, recipient complication rates were similar between single and multiple arteries groups (12.9 % vs 18.1 %, respectively, p = 0.51). CONCLUSION: Laparoscopic donor nephrectomy with multiple arteries was associated with a non statistically significant higher rate of poor early graft function. The procedure appears to be safe in patients with multiple arteries, with similar complications rates. Multiple arteries should not be a contraindication for laparoscopic donor nephrectomy.
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Trasplante de Riñón/métodos , Laparoscopía/métodos , Donadores Vivos , Nefrectomía/métodos , Arteria Renal/trasplante , Adulto , Femenino , Supervivencia de Injerto , Humanos , Riñón/irrigación sanguínea , Masculino , Persona de Mediana Edad , Tempo Operativo , Complicaciones Posoperatorias , Reproducibilidad de los Resultados , Estadísticas no Paramétricas , Resultado del TratamientoRESUMEN
PURPOSE: We evaluated our experience with laparoscopic donor nephrectomy in patients with multiple renal arteries, comparing operative outcomes and early graft function with patients with a single renal artery. MATERIALS AND METHODS: From January 2003 to February 2009, 130 patients underwent laparoscopic donor nephrectomy at our institution, 108 (83%) with a single renal artery and 22 (17%) with multiple arteries. Donor and recipient outcomes for single artery and multiple arteries allografts were compared. RESULTS: The LDN operative time was similar between the single artery and multiple arteries groups (162 vs 163 min, respectively, p = 0.87). Allografts with multiple arteries had significantly longer warm ischemia time (3.9 vs 4.9 min, p = 0.05) and cold ischemia time (72 vs 94 min, p < 0.001) than those with single artery. The conversion rate was similar between single and multiple arteries groups (6% vs 4.5%, respectively, p = 0.7). Multiple arteries grafts had a non statistically significant higher rate of poor graft function when compared to single artery grafts (23% vs 12%, respectively, p = 0.18). Five patients in the single artery group (4.6%) and one patient in the multiple arteries group (4.5%) needed dialysis during the first postoperative week. Overall, recipient complication rates were similar between single and multiple arteries groups (12.9% vs 18.1%, respectively, p = 0.51). CONCLUSION: Laparoscopic donor nephrectomy with multiple arteries was associated with a non statistically significant higher rate of poor early graft function. The procedure appears to be safe in patients with multiple arteries, with similar complications rates. Multiple arteries should not be a contraindication for laparoscopic donor nephrectomy.
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trasplante de Riñón/métodos , Donadores Vivos , Laparoscopía/métodos , Nefrectomía/métodos , Arteria Renal/trasplante , Supervivencia de Injerto , Riñón/irrigación sanguínea , Tempo Operativo , Complicaciones Posoperatorias , Reproducibilidad de los Resultados , Estadísticas no Paramétricas , Resultado del TratamientoRESUMEN
INTRODUÇÃO: Estudos iniciais observaram um funcionamento mais lento do enxerto renal na primeira semana em rins retirados por laparoscopia. Todavia, a sobrevida do enxerto de cirurgia laparoscópica a longo prazo parece ser semelhante quando comparada à cirurgia aberta. Estudos experimentais sugerem que a cirurgia laparoscópica possa exercer uma ação sobre a lesão de isquemia e reperfusão, porém até o momento seus efeitos na expressão tecidual de fatores protetores e inflamatórios são pouco conhecidos. OBJETIVO: Avaliar a expressão tecidual de fatores protetores e inflamatórios em rins extraídos de doadores vivos, por cirurgia laparoscópica ou aberta, em dois diferentes momentos da cirurgia do transplante: após a retirada do rim e após a reperfusão e correlacionar estes achados com a função do enxerto renal por meio da medida da creatinina sérica no pósoperatório. CASUÍSTICA E MÉTODOS: Foram analisados pacientes transplantados renais submetidos a biópsias renais em 2 momentos, logo após a retirada do rim (T-1) e 45 min após reperfusão (T+1). Compararamse dois grupos: pacientes que receberam rins de nefrectomia laparoscópica e receptores de rins provenientes de cirurgia aberta. Foram analisados os dados clínicos e a função renal através da medida da creatinina sérica do 1º ao 7º dia, 30º dia, 3º e 6º mês pós-operatório. A expressão de RNAm de Bcl- 2, Hsp70, HO-1, VEGF, TNF, IL-6 e HIF1 foi quantificada por PCR em tempo real, e a expressão protéica de HO-1, Bcl-2, Caspase 3 e BAx foram analisadas por imunoistoquímica. RESULTADOS: Foram analisados 55 receptores renais, dos quais em 29 pacientes o enxerto era proveniente de nefrectomia aberta e em 26 pacientes o rim doado foi retirado por via laparoscópica. O tempo de isquemia quente foi maior no grupo laparoscópico (p=0,005). A função renal medida pela área sob a curva de creatinina (ASCcr) e a incidência de retardo de função do enxerto renal no pós-operatório foi semelhante entre os grupos...
INTRODUCTION: Laparoscopically harvested kidneys regain normal function slowly than open recruited organs. However, long term graft survival seems to be similar between two approaches. Experimental studies suggest that laparoscopic surgery may play a role in ischemia reperfusion injury, but at this moment its effects in tissue expression of protective and inflammatory factors are unknown. OBJECTIVES: Evaluate tissue expression of protective and inflammatory factors in living donor kidneys harvested by laparoscopic or open surgery at two time points: after kidney retrieval and after reperfusion and correlate these findings with renal allograft function through postoperative serum creatinine level. METHODS: It was analyzed live renal recipients submitted to renal biopsies at two time points, after kidney retrieval (T-1) and 45 min after reperfusion (T+1). Two groups were compared: patients that received kidneys from laparoscopic nephrectomy and recipients of kidneys from open surgery. It was analyzed clinical data and renal function through serum creatinine level of 1st to 7th day, 30th day, 3rd and 6th postoperative month. The mRNA expression of Bcl-2, Hsp70, HO-1, VEGF, TNF, IL-6 e HIF1 were quantified by real time PCR, and protein expression of HO-1, Bcl-2, Caspase 3 and Bax were analyzed by immunohistochemistry. RESULTS: Fifty five recipients were analyzed, twenty nine patients from open nephrectomy and twenty six patients from laparoscopic nephrectomy. We observed warm ischemia time was longer in laparoscopic donor nephrectomy than open donor nephrectomy (p=0,005). The renal function measured by area under curve of creatinine and incidence of delayed graft function were similar in laparoscopic and open groups...
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Humanos , Apoptosis , Informes de Casos , Expresión Génica , Trasplante de Riñón , Laparoscopía , Daño por ReperfusiónRESUMEN
PURPOSE: To propose a novel model of pseudarthrosis in a small animal and to investigate the ability of backscatter parameters from ultrasound signals in differentiating normal bone from those ones with pseudarthrosis. METHODS: Twelve Rattus norvegicus albinus free from pathogenic species (SPF) were randomly divided in two groups, with six animals each. In the Control group a surgical approach to the femur was made, followed by the synthesis of the muscle and skin layers. The Experimental group was submitted to an osteotomy of the femur and a vascularized flap of the fascia lata was interposed in the line of the fractured bone. Then the alignment and bone stabilization were accomplished, by using nylon stitch in U shape introduced in holes made in the proximal and distal fractured bone. Bone samples were scanned with ultrasound and signals were collected for each one to analyze the parameter Apparent Integrated Backscatter - AIB. RESULTS: Radiological and anatomopathologic studies revealed the absence of bone consolidation with persistence of fiber-osteoid tissue. Values of the ultrasound parameter AIB from normal bones were statistically different from those with pseudarthrosis. CONCLUSION: The experimental model was suitable for pseudarthrosis development in rats and the ultrasound backscatter parameters were able to identify such a bone disease in vitro.
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Seudoartrosis/diagnóstico por imagen , Animales , Modelos Animales de Enfermedad , Fémur/diagnóstico por imagen , Fémur/cirugía , Distribución Aleatoria , Ratas , Estadísticas no Paramétricas , UltrasonografíaRESUMEN
PURPOSE: To propose a novel model of pseudarthrosis in a small animal and to investigate the ability of backscatter parameters from ultrasound signals in differentiating normal bone from those ones with pseudarthorsis. METHODS: Twelve Rattus norvegicus albinus free from pathogenic species (SPF) were randomly divided in two groups, with six animals each. In the Control group a surgical approach to the femur was made, followed by the synthesis of the muscle and skin layers. The Experimental group was submitted to an osteotomy of the femur and a vascularized flap of the fascia lata was interposed in the line of the fractured bone. Then the alignment and bone stabilization were accomplished, by using nylon stitch in U shape introduced in holes made in the proximal and distal fractured bone. Bone samples were scanned with ultrasound and signals were collected for each one to analyze the parameter Apparent Integrated Backscatter - AIB. RESULTS: Radiological and anatomopathologic studies revealed the absence of bone consolidation with persistence of fiber-osteoid tissue. Values of the ultrasound parameter AIB from normal bones were statistically different from those with pseudarthrosis. CONCLUSION: The experimental model was suitable for pseudarthrosis development in rats and the ultrasound backscatter parameters were able to identify such a bone disease in vitro.(AU)
OBJETIVO: Propor um novo modelo de pseudoartrose em animais de pequeno porte e investigar o potencial de parâmetros de retroespalhamento de ultrassônico em diferenciar osso normal e com pseudoartrose. MÉTODOS: Doze Rattus norvegicus albinus (SPF) foram distribuídos aleatoriamente em dois grupos, tendo cada grupo seis animais. No grupo Controle realizou-se uma abordagem cirúrgica ao fêmur, seguida da síntese por planos do músculo e da pele. O grupo Experimental foi submetido à osteotomia do fêmur aduzida da confecção de um retalho pediculado de fascia lata para interposição entre os segmentos resultantes da fratura induzida cirurgicamente. Prosseguiu-se com o alinhamento e estabilização óssea, mediante a confecção de um nó com fio de náilon em formato de U, introduzido em orifícios efetuados nas extremidades proximal e distal à fratura. As amostras ósseas foram irradiadas pelo ultrassom e sinais foram coletados para cada uma no intuito de analisar o parâmetro Retroespalhamento Integrado Aparente - AIB. RESULTADOS: Estudos radiológicos e anatomopatológicos evidenciaram a ausência de consolidação óssea com persistência de tecido fibro-osteóide. Os valores de AIB para ossos normais foram estatisticamente diferentes em relação aos ossos com pseudoartrose. CONCLUSÃO: O modelo experimental apresentou-se adequado para a formação de pseudoartrose em ratos e o parâmetro de retroespalhamento de ultrassom foi capaz de detectar tal doença óssea, in vitro.(AU)
Asunto(s)
Animales , Ratas , Modelos Animales de Enfermedad , Seudoartrosis/cirugía , Osteotomía/métodos , Ultrasonografía/veterinaria , Evaluación de Resultados de Intervenciones TerapéuticasRESUMEN
PURPOSE: To propose a novel model of pseudarthrosis in a small animal and to investigate the ability of backscatter parameters from ultrasound signals in differentiating normal bone from those ones with pseudarthorsis. METHODS: Twelve Rattus norvegicus albinus free from pathogenic species (SPF) were randomly divided in two groups, with six animals each. In the Control group a surgical approach to the femur was made, followed by the synthesis of the muscle and skin layers. The Experimental group was submitted to an osteotomy of the femur and a vascularized flap of the fascia lata was interposed in the line of the fractured bone. Then the alignment and bone stabilization were accomplished, by using nylon stitch in U shape introduced in holes made in the proximal and distal fractured bone. Bone samples were scanned with ultrasound and signals were collected for each one to analyze the parameter Apparent Integrated Backscatter - AIB. RESULTS: Radiological and anatomopathologic studies revealed the absence of bone consolidation with persistence of fiber-osteoid tissue. Values of the ultrasound parameter AIB from normal bones were statistically different from those with pseudarthrosis. CONCLUSION: The experimental model was suitable for pseudarthrosis development in rats and the ultrasound backscatter parameters were able to identify such a bone disease in vitro.
OBJETIVO: Propor um novo modelo de pseudoartrose em animais de pequeno porte e investigar o potencial de parâmetros de retroespalhamento de ultrassônico em diferenciar osso normal e com pseudoartrose. MÉTODOS: Doze Rattus norvegicus albinus (SPF) foram distribuídos aleatoriamente em dois grupos, tendo cada grupo seis animais. No grupo Controle realizou-se uma abordagem cirúrgica ao fêmur, seguida da síntese por planos do músculo e da pele. O grupo Experimental foi submetido à osteotomia do fêmur aduzida da confecção de um retalho pediculado de fascia lata para interposição entre os segmentos resultantes da fratura induzida cirurgicamente. Prosseguiu-se com o alinhamento e estabilização óssea, mediante a confecção de um nó com fio de náilon em formato de U, introduzido em orifícios efetuados nas extremidades proximal e distal à fratura. As amostras ósseas foram irradiadas pelo ultrassom e sinais foram coletados para cada uma no intuito de analisar o parâmetro Retroespalhamento Integrado Aparente - AIB. RESULTADOS: Estudos radiológicos e anatomopatológicos evidenciaram a ausência de consolidação óssea com persistência de tecido fibro-osteóide. Os valores de AIB para ossos normais foram estatisticamente diferentes em relação aos ossos com pseudoartrose. CONCLUSÃO: O modelo experimental apresentou-se adequado para a formação de pseudoartrose em ratos e o parâmetro de retroespalhamento de ultrassom foi capaz de detectar tal doença óssea, in vitro.
Asunto(s)
Animales , Ratas , Seudoartrosis , Modelos Animales de Enfermedad , Fémur/cirugía , Fémur , Distribución Aleatoria , Estadísticas no ParamétricasRESUMEN
PURPOSE: To study the effects of nicotine on inflammatory cells, deposition of collagen and its interference on the strength of tissue in vesical sutures in rabbits. METHODS: Twenty New Zealand rabbits were used, randomized into two groups: group N, consisting of 10 animals, to which nicotine was administered in the dose of 2mg/kg of weight as a subcutaneous injection, diluted in 1ml of saline solution at 0.9 percent in a daily administration during the 28 days prior to the surgery; and group C, consisting of 10 animals, to which saline solution at 0.9 percent was administered in the same conditions and time intervals of the nicotine group. All the animals underwent cystotomy and suture of the bladder wall 28 days after the administration of nicotine or saline solution. The measurements were performed on the fourth and seventh day in each group after cystectomy and euthanasia of the animals. A fragment of bladder was removed and sent for a tensile strength test to evaluate the tissue strength and another fragment underwent a histological analysis of inflammatory process and deposition of collagen. RESULTS: There was a decrease of neutrophils on the fourth postoperative day (p=0.079) and an increase of plasmocytes on the seventh postoperative day (p=0.053) in the animals that were given nicotine, without statistical difference in relation to the control group. In the analysis of the proliferation of fibroblasts, deposition of collagen and tensile strength test, there was no statistical difference in relation to the control group. CONCLUSION: The administration of nicotine in rabbits did not influence the healing process of vesical suture in relation to the inflammatory cells, deposit of collagen and tissue strength of the suture(AU)
OBJETIVO: Estudar os efeitos da nicotina sobre as células inflamatórias, deposição de colágeno e sua interferência sobre a força tecidual em suturas vesicais de coelhos. MÉTODOS: Foram utilizados 20 coelhos Nova Zelândia, divididos de maneira aleatória em dois grupos: grupo N, composto de 10 animais, no qual foi administrada nicotina na dose de 2mg/Kg de peso por via subcutânea, diluída em 1ml de solução fisiológica a 0,9 por cento em 1 aplicação diária por 28 dias prévios à cirurgia; e grupo C, composto por 10 animais, no qual foi administrada solução fisiológica a 0,9 por cento nas mesmas condições e intervalos de tempo do grupo nicotina. Todos os animais foram submetidos à cistotomia com sutura da parede vesical após 28 dias da administração de nicotina ou solução fisiológica. As aferições foram realizadas no 4º e 7º dia em cada grupo após cistectomia e eutanásia dos animais. Uma parte da bexiga foi submetida a teste de tração para avaliar a força tecidual da sutura e outro fragmento foi submetido à análise histológica de processo inflamatório e deposição de colágeno. RESULTADOS: Houve uma diminuição de neutrófilos no 4º dia pós-operatório (p=0,079) e aumento de plasmócitos no 7º dia após a cirurgia (p=0,053) nos animais que receberam nicotina, sem diferença estatística em relação ao grupo controle. Na análise de proliferação de fibroblastos, deposição de colágeno e teste de tração tecidual, não houve diferença estatística em relação ao grupo controle. CONCLUSÃO: A administração de nicotina em coelhos não influenciou no processo de cicatrização de sutura vesicais em relação às células inflamatórias, depósito de colágeno e força tecidual da sutura(AU)
Asunto(s)
Animales , Colágeno , Neutrófilos , Nicotina/farmacología , Vejiga Urinaria/cirugía , Cicatrización de Heridas , Inyecciones Subcutáneas , Recuento de Leucocitos , Neutrófilos , Suturas , Resistencia a la Tracción , Resistencia a la Tracción/fisiologíaRESUMEN
PURPOSE: To study the effects of nicotine on inflammatory cells, deposition of collagen and its interference on the strength of tissue in vesical sutures in rabbits. METHODS: Twenty New Zealand rabbits were used, randomized into two groups: group N, consisting of 10 animals, to which nicotine was administered in the dose of 2mg/kg of weight as a subcutaneous injection, diluted in 1ml of saline solution at 0.9 percent in a daily administration during the 28 days prior to the surgery; and group C, consisting of 10 animals, to which saline solution at 0.9 percent was administered in the same conditions and time intervals of the nicotine group. All the animals underwent cystotomy and suture of the bladder wall 28 days after the administration of nicotine or saline solution. The measurements were performed on the fourth and seventh day in each group after cystectomy and euthanasia of the animals. A fragment of bladder was removed and sent for a tensile strength test to evaluate the tissue strength and another fragment underwent a histological analysis of inflammatory process and deposition of collagen. RESULTS: There was a decrease of neutrophils on the fourth postoperative day (p=0.079) and an increase of plasmocytes on the seventh postoperative day (p=0.053) in the animals that were given nicotine, without statistical difference in relation to the control group. In the analysis of the proliferation of fibroblasts, deposition of collagen and tensile strength test, there was no statistical difference in relation to the control group. CONCLUSION: The administration of nicotine in rabbits did not influence the healing process of vesical suture in relation to the inflammatory cells, deposit of collagen and tissue strength of the suture.
OBJETIVO: Estudar os efeitos da nicotina sobre as células inflamatórias, deposição de colágeno e sua interferência sobre a força tecidual em suturas vesicais de coelhos. MÉTODOS: Foram utilizados 20 coelhos Nova Zelândia, divididos de maneira aleatória em dois grupos: grupo N, composto de 10 animais, no qual foi administrada nicotina na dose de 2mg/Kg de peso por via subcutânea, diluída em 1ml de solução fisiológica a 0,9 por cento em 1 aplicação diária por 28 dias prévios à cirurgia; e grupo C, composto por 10 animais, no qual foi administrada solução fisiológica a 0,9 por cento nas mesmas condições e intervalos de tempo do grupo nicotina. Todos os animais foram submetidos à cistotomia com sutura da parede vesical após 28 dias da administração de nicotina ou solução fisiológica. As aferições foram realizadas no 4º e 7º dia em cada grupo após cistectomia e eutanásia dos animais. Uma parte da bexiga foi submetida a teste de tração para avaliar a força tecidual da sutura e outro fragmento foi submetido à análise histológica de processo inflamatório e deposição de colágeno. RESULTADOS: Houve uma diminuição de neutrófilos no 4º dia pós-operatório (p=0,079) e aumento de plasmócitos no 7º dia após a cirurgia (p=0,053) nos animais que receberam nicotina, sem diferença estatística em relação ao grupo controle. Na análise de proliferação de fibroblastos, deposição de colágeno e teste de tração tecidual, não houve diferença estatística em relação ao grupo controle. CONCLUSÃO: A administração de nicotina em coelhos não influenciou no processo de cicatrização de sutura vesicais em relação às células inflamatórias, depósito de colágeno e força tecidual da sutura.
Asunto(s)
Animales , Masculino , Conejos , Colágeno/efectos de los fármacos , Neutrófilos/efectos de los fármacos , Nicotina/farmacología , Vejiga Urinaria/cirugía , Cicatrización de Heridas/efectos de los fármacos , Inyecciones Subcutáneas , Recuento de Leucocitos , Neutrófilos/patología , Distribución Aleatoria , Suturas , Factores de Tiempo , Resistencia a la Tracción/efectos de los fármacos , Vejiga Urinaria/patologíaRESUMEN
PURPOSE: To study the effects of nicotine on inflammatory cells, deposition of collagen and its interference on the strength of tissue in vesical sutures in rabbits. METHODS: Twenty New Zealand rabbits were used, randomized into two groups: group N, consisting of 10 animals, to which nicotine was administered in the dose of 2mg/kg of weight as a subcutaneous injection, diluted in 1 ml of saline solution at 0.9% in a daily administration during the 28 days prior to the surgery; and group C, consisting of 10 animals, to which saline solution at 0.9% was administered in the same conditions and time intervals of the nicotine group. All the animals underwent cystotomy and suture of the bladder wall 28 days after the administration of nicotine or saline solution. The measurements were performed on the fourth and seventh day in each group after cystectomy and euthanasia of the animals. A fragment of bladder was removed and sent for a tensile strength test to evaluate the tissue strength and another fragment underwent a histological analysis of inflammatory process and deposition of collagen. RESULTS: There was a decrease of neutrophils on the fourth postoperative day (p=0.079) and an increase of plasmocytes on the seventh postoperative day (p=0.053) in the animals that were given nicotine, without statistical difference in relation to the control group. In the analysis of the proliferation of fibroblasts, deposition of collagen and tensile strength test, there was no statistical difference in relation to the control group. CONCLUSION: The administration of nicotine in rabbits did not influence the healing process of vesical suture in relation to the inflammatory cells, deposit of collagen and tissue strength of the suture.
Asunto(s)
Colágeno/efectos de los fármacos , Neutrófilos/efectos de los fármacos , Nicotina/farmacología , Vejiga Urinaria/cirugía , Cicatrización de Heridas/efectos de los fármacos , Animales , Inyecciones Subcutáneas , Recuento de Leucocitos , Masculino , Neutrófilos/patología , Conejos , Distribución Aleatoria , Suturas , Resistencia a la Tracción/efectos de los fármacos , Factores de Tiempo , Vejiga Urinaria/patologíaRESUMEN
A relação médico-paciente tem sido estudada, principalmente no que se refere à escolha do profissional. Entretanto, não há na literatura referências à relação fisioterapeuta-paciente, na qual envolve maior contato físico. Este estudo visa identificar se haveria uma preferência pelo sexo do fisioterapeuta, na possível iminência de tratamento. Um questionário foi desenvolvido, validado e aplicado a 800 estudantes universitários. As perguntas principais foram quanto à preferência pelo sexo do profissional nas situações: fisioterapia em membros, tronco e genitália ou áreas adjacentes. Para análise, utilizou-se teste qui-quadrado (p < 0,05) e análise de homogeneidade com 3 dimensões. Os resultados mostraram que a maioria dos respondentes não se importaria com o sexo. Em terapia em áreas genitais, há mais mulheres que preferem uma mulher fisioterapeuta (p < 0,01). Homens não diferem nas três situações (p ≤ 0,01). Há correspondência entre as perguntas sobre tratamento em membros e tronco, mas pode diferir em genitália.
The physician-patient relation has been studied, mainly regarding to the choice for a therapist. However, there is no literature references on physical therapist-patient relation, which involves more physical contact. This study aims to identify whether there is a preference for therapist gender in the possible imminence of treatment. A questionnaire was developed, validated and applied to 800 university students. The main questions were related to the preference for therapist gender in the following situations: physical therapy in limbs, trunk and genital or adjacent areas. For analysis, chi-square test (p < 0,05) and homogeneity analysis with 3 dimensions were used. The results show that the majority of respondents would not care about gender. In genital areas therapy, there are more women that prefer a female physical therapist (p < 0,01). Men do not disagree in all situations (p ≤ 0,01). There is correspondence between questions about limbs and trunk treatment, but it may differ in genital therapy.
Asunto(s)
Conducta de Elección , Modalidades de Fisioterapia , Especialidad de Fisioterapia , Sexo , Satisfacción del PacienteRESUMEN
This work studied the periodicity of in vitro healthy and pathologic liver tissue, using backscattered ultrasound (US) signals. It utilized the mean scatterer spacing (MSS) as a parameter of tissue characterization, estimated by three methods: the spectral autocorrelation (SAC), the singular spectrum analysis (SSA) and the quadratic transformation method (SIMON). The liver samples were classified in terms of tissue status using the METAVIR scoring system. Twenty tissue samples were classified in four groups: F0, F1, F3 and F4 (five samples for each). The Kolmogorov-Smirnov test (applied on group pairs) resulted as nonsignificant (p > 0.05) for two pairs only: F1/F3 (for SSA) and F3/F4 (for SAC). A discriminant analysis was applied using as parameters the MSS mean (MSS) and standard deviation (sigmaMSS), the estimates histogram mode (mMSS), and the speed of US (mc(foie)) in the medium, to evaluate the degree of discrimination among healthy and pathologic tissues. The better accuracy (Ac) with SAC (80%) was with parameter group (MSS, sigmaMSS, mc(foie)), achieving a sensitivity (Ss) of 92.3% and a specificity (Sp) of 57.1%. For SSA, the group with all four parameters showed an Ac of 75%, an Ss of 78.6% and an Sp of 66.70%. SIMON obtained the best Ac of all (85%) with group (MSS, mMSS, mc(foie)), an Ss of 100%, but with an Sp of 50%.