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Práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras: uma análise secundária do estudo Fluid-TRIPS
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Freitas, Flavio Geraldo Rezende de
; Hammond, Naomi
; Li, Yang
; Azevedo, Luciano Cesar Pontes de
; Cavalcanti, Alexandre Biasi
; Taniguchi, Leandro
; Gobatto, André
; Japiassú, André Miguel
; Bafi, Antonio Tonete
; Mazza, Bruno Franco
; Noritomi, Danilo Teixeira
; Dal-Pizzol, Felipe
; Bozza, Fernando
; Salluh, Jorge Ibrahin Figueira
; Westphal, Glauco Adrieno
; Soares, Márcio
; Assunção, Murillo Santucci César de
; Lisboa, Thiago
; Lobo, Suzana Margarete Ajeje
; Barbosa, Achilles Rohlfs
; Ventura, Adriana Fonseca
; Souza, Ailson Faria de
; Silva, Alexandre Francisco
; Toledo, Alexandre
; Reis, Aline
; Cembranel, Allan
; Rea Neto, Alvaro
; Gut, Ana Lúcia
; Justo, Ana Patricia Pierre
; Santos, Ana Paula
; Albuquerque, André Campos D. de
; Scazufka, André
; Rodrigues, Antonio Babo
; Fernandino, Bruno Bonaccorsi
; Silva, Bruno Goncalves
; Vidal, Bruno Sarno
; Pinheiro, Bruno Valle
; Pinto, Bruno Vilela Costa
; Feijo, Carlos Augusto Ramos
; Abreu Filho, Carlos de
; Bosso, Carlos Eduardo da Costa Nunes
; Moreira, Carlos Eduardo Nassif
; Ramos, Carlos Henrique Ferreira
; Tavares, Carmen
; Arantes, Cidamaiá
; Grion, Cintia
; Mendes, Ciro Leite
; Kmohan, Claudio
; Piras, Claudio
; Castro, Cristine Pilati Pileggi
; Lins, Cyntia
; Beraldo, Daniel
; Fontes, Daniel
; Boni, Daniela
; Castiglioni, Débora
; Paisani, Denise de Moraes
; Pedroso, Durval Ferreira Fonseca
; Mattos, Ederson Roberto
; Brito Sobrinho, Edgar de
; Troncoso, Edgar M. V.
; Rodrigues Filho, Edison Moraes
; Nogueira, Eduardo Enrico Ferrari
; Ferreira, Eduardo Leme
; Pacheco, Eduardo Souza
; Jodar, Euzebio
; Ferreira, Evandro L. A.
; Araujo, Fabiana Fernandes de
; Trevisol, Fabiana Schuelter
; Amorim, Fábio Ferreira
; Giannini, Fabio Poianas
; Santos, Fabrício Primitivo Matos
; Buarque, Fátima
; Lima, Felipe Gallego
; Costa, Fernando Antonio Alvares da
; Sad, Fernando Cesar dos Anjos
; Aranha, Fernando G.
; Ganem, Fernando
; Callil, Flavio
; Costa Filho, Francisco Flávio
; Dall´Arto, Frederico Toledo Campo
; Moreno, Geovani
; Friedman, Gilberto
; Moralez, Giulliana Martines
; Silva, Guilherme Abdalla da
; Costa, Guilherme
; Cavalcanti, Guilherme Silva
; Cavalcanti, Guilherme Silva
; Betônico, Gustavo Navarro
; Betônico, Gustavo Navarro
; Reis, Hélder
; Araujo, Helia Beatriz N.
; Hortiz Júnior, Helio Anjos
; Guimaraes, Helio Penna
; Urbano, Hugo
; Maia, Israel
; Santiago Filho, Ivan Lopes
; Farhat Júnior, Jamil
; Alvarez, Janu Rangel
; Passos, Joel Tavares
; Paranhos, Jorge Eduardo da Rocha
; Marques, José Aurelio
; Moreira Filho, José Gonçalves
; Andrade, Jose Neto
; Sobrinho, José Onofre de C
; Bezerra, Jose Terceiro de Paiva
; Alves, Juliana Apolônio
; Ferreira, Juliana
; Gomes, Jussara
; Sato, Karina Midori
; Gerent, Karine
; Teixeira, Kathia Margarida Costa
; Conde, Katia Aparecida Pessoa
; Martins, Laércia Ferreira
; Figueirêdo, Lanese
; Rezegue, Leila
; Tcherniacovsk, Leonardo
; Ferraz, Leone Oliveira
; Cavalcante, Liane
; Rabelo, Ligia
; Miilher, Lilian
; Garcia, Lisiane
; Tannous, Luana
; Hajjar, Ludhmila Abrahão
; Paciência, Luís Eduardo Miranda
; Cruz Neto, Luiz Monteiro da
; Bley, Macia Valeria
; Sousa, Marcelo Ferreira
; Puga, Marcelo Lourencini
; Romano, Marcelo Luz Pereira
; Nobrega, Marciano
; Arbex, Marcio
; Rodrigues, Márcio Leite
; Guerreiro, Márcio Osório
; Rocha, Marcone
; Alves, Maria Angela Pangoni
; Alves, Maria Angela Pangoni
; Rosa, Maria Doroti
; Dias, Mariza D’Agostino
; Martins, Miquéias
; Oliveira, Mirella de
; Moretti, Miriane Melo Silveira
; Matsui, Mirna
; Messender, Octavio
; Santarém, Orlando Luís de Andrade
; Silveira, Patricio Júnior Henrique da
; Vassallo, Paula Frizera
; Antoniazzi, Paulo
; Gottardo, Paulo César
; Correia, Paulo
; Ferreira, Paulo
; Torres, Paulo
; Silva, Pedro Gabrile M. de Barros e
; Foernges, Rafael
; Gomes, Rafael
; Moraes, Rafael
; Nonato filho, Raimundo
; Borba, Renato Luis
; Gomes, Renato V
; Cordioli, Ricardo
; Lima, Ricardo
; López, Ricardo Pérez
; Gargioni, Ricardo Rath de Oliveira
; Rosenblat, Richard
; Souza, Roberta Machado de
; Almeida, Roberto
; Narciso, Roberto Camargo
; Marco, Roberto
; waltrick, Roberto
; Biondi, Rodrigo
; Figueiredo, Rodrigo
; Dutra, Rodrigo Santana
; Batista, Roseane
; Felipe, Rouge
; Franco, Rubens Sergio da Silva
; Houly, Sandra
; Faria, Sara Socorro
; Pinto, Sergio Felix
; Luzzi, Sergio
; Sant’ana, Sergio
; Fernandes, Sergio Sonego
; Yamada, Sérgio
; Zajac, Sérgio
; Vaz, Sidiner Mesquita
; Bezerra, Silvia Aparecida Bezerra
; Farhat, Tatiana Bueno Tardivo
; Santos, Thiago Martins
; Smith, Tiago
; Silva, Ulysses V. A.
; Damasceno, Valnei Bento
; Nobre, Vandack
; Dantas, Vicente Cés de Souza
; Irineu, Vivian Menezes
; Bogado, Viviane
; Nedel, Wagner
; Campos Filho, Walther
; Dantas, Weidson
; Viana, William
; Oliveira Filho, Wilson de
; Delgadinho, Wilson Martins
; Finfer, Simon
; Machado, Flavia Ribeiro
.
RESUMO Objetivo: Descrever as práticas de ressuscitação volêmica em unidades de terapia intensiva brasileiras e compará-las com as de outros países participantes do estudo Fluid-TRIPS. Métodos: Este foi um estudo observacional transversal, prospectivo e internacional, de uma amostra de conveniência de unidades de terapia intensiva de 27 países (inclusive o Brasil), com utilização da base de dados Fluid-TRIPS compilada em 2014. Descrevemos os padrões de ressuscitação volêmica utilizados no Brasil em comparação com os de outros países e identificamos os fatores associados com a escolha dos fluidos. Resultados: No dia do estudo, foram incluídos 3.214 pacientes do Brasil e 3.493 pacientes de outros países, dos quais, respectivamente, 16,1% e 26,8% (p < 0,001) receberam fluidos. A principal indicação para ressuscitação volêmica foi comprometimento da perfusão e/ou baixo débito cardíaco (Brasil 71,7% versus outros países 56,4%; p < 0,001). No Brasil, a percentagem de pacientes que receberam soluções cristaloides foi mais elevada (97,7% versus 76,8%; p < 0,001), e solução de cloreto de sódio a 0,9% foi o cristaloide mais comumente utilizado (62,5% versus 27,1%; p < 0,001). A análise multivariada sugeriu que os níveis de albumina se associaram com o uso tanto de cristaloides quanto de coloides, enquanto o tipo de prescritor dos fluidos se associou apenas com o uso de cristaloides. Conclusão: Nossos resultados sugerem que cristaloides são usados mais frequentemente do que coloides para ressuscitação no Brasil, e essa discrepância, em termos de frequências, é mais elevada do que em outros países. A solução de cloreto de sódio 0,9% foi o cristaloide mais frequentemente prescrito. Os níveis de albumina sérica e o tipo de prescritor de fluidos foram os fatores associados com a escolha de cristaloides ou coloides para a prescrição de fluidos.
Abstract Objective: To describe fluid resuscitation practices in Brazilian intensive care units and to compare them with those of other countries participating in the Fluid-TRIPS. Methods: This was a prospective, international, cross-sectional, observational study in a convenience sample of intensive care units in 27 countries (including Brazil) using the Fluid-TRIPS database compiled in 2014. We described the patterns of fluid resuscitation use in Brazil compared with those in other countries and identified the factors associated with fluid choice. Results: On the study day, 3,214 patients in Brazil and 3,493 patients in other countries were included, of whom 16.1% and 26.8% (p < 0.001) received fluids, respectively. The main indication for fluid resuscitation was impaired perfusion and/or low cardiac output (Brazil: 71.7% versus other countries: 56.4%, p < 0.001). In Brazil, the percentage of patients receiving crystalloid solutions was higher (97.7% versus 76.8%, p < 0.001), and 0.9% sodium chloride was the most commonly used crystalloid (62.5% versus 27.1%, p < 0.001). The multivariable analysis suggested that the albumin levels were associated with the use of both crystalloids and colloids, whereas the type of fluid prescriber was associated with crystalloid use only. Conclusion: Our results suggest that crystalloids are more frequently used than colloids for fluid resuscitation in Brazil, and this discrepancy in frequencies is higher than that in other countries. Sodium chloride (0.9%) was the crystalloid most commonly prescribed. Serum albumin levels and the type of fluid prescriber were the factors associated with the choice of crystalloids or colloids for fluid resuscitation.
https://doi.org/10.5935/0103-507x.20210028
273 downloads
2.
Ischemic perconditioning on mesenteric ischemia/reperfusion injury in rats
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Cavalcante, Lainy Carollyne da Costa
; Rodrigues, Giannini Medeiros
; Ribeiro Júnior, Rubens Fernando Gonçalves
; Monteiro, Andrew Moraes
; Damasceno, Ananda Vitória Barros Suzuki
; Couteiro, Rodrigo Paracampo
; Yasojima, Edson Yuzur
; Brito, Marcus Vinicius Henriques
; Percário, Sandro
.
ABSTRACT Purpose: To evaluate if the perconditioning affects the antioxidant capacity in mesenteric ischemia and reperfusion injury. Methods: Twenty-one Wistar rats were assigned into three groups, as follows: Sham, IR and rPER. The animals were subjected to mesenteric ischemia for 30 min. rPER consisted of three cycles of 5-min hindlimb ischemia followed by 5 min hindlimb perfusion at the same time to mesenteric ischemic period. After 5 minutes, blood and 5 cm of terminal ileum were harvested for thiobarbituric acid reactive substances (TBARS) and Trolox equivalent antioxidant capacity (TEAC) measurement. Results: rPER technique was able to reduce intestinal tissue TBARS levels (p<0.0001), but no statistic difference was observed in blood levels between groups, although it was verified similar results in rPER and Sham group. rPER technique also enhanced TEAC levels in both blood (p = 0.0314) and intestinal tissue (p = 0.0139), compared to IR group. Conclusions: rPER appears as the most promising technique to avoid IR injury. This technique reduced TBARS levels in blood and intestinal tissue and promoted the maintenance of antioxidant defense in mesenteric acute injury.
https://doi.org/10.1590/acb360903
45 downloads
3.
BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 2): UPDATE ON TREATMENT
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BARCHI, Leandro Cardoso
; RAMOS, Marcus Fernando Kodama Pertille
; DIAS, André Roncon
; FORONES, Nora Manoukian
; CARVALHO, Marineide Prudêncio de
; CASTRO, Osvaldo Antonio Prado
; KASSAB, Paulo
; COSTA-JÚNIOR, Wilson Luiz da
; WESTON, Antônio Carlos
; ZILBERSTEIN, Bruno
; Ferraz, Álvaro Antônio Bandeira
; ZeideCharruf, Amir
; Brandalise, André
; Silva, André Maciel da
; Alves, Barlon
; Marins, Carlos Augusto Martinez
; Malheiros, Carlos Alberto
; Leite, Celso Vieira
; Bresciani, Claudio José Caldas
; Szor, Daniel
; Mucerino, Donato Roberto
; Wohnrath, Durval R.
; JirjossIlias, Elias
; Martins Filho, Euclides Dias
; PinatelLopasso, Fabio
; Coimbra, Felipe José Fernandez
; Felippe, Fernando E. Cruz
; Tomasisch, Flávio Daniel Saavedra
; Takeda, Flavio Roberto
; Ishak, Geraldo
; Laporte, Gustavo Andreazza
; Silva, Herbeth José Toledo
; Cecconello, Ivan
; Rodrigues, Joaquim José Gama
; Grande, José Carlos Del
; Lourenço, Laércio Gomes
; Motta, Leonardo Milhomem da
; Ferraz, Leonardo Rocha
; Moreira, Luis Fernando
; Lopes, Luis Roberto
; Toneto, Marcelo Garcia
; Mester, Marcelo
; Rodrigues, Marco Antônio Gonçalves
; Franciss, Maurice Youssef
; AdamiAndreollo, Nelson
; Corletta, Oly Campos
; Yagi, Osmar Kenji
; Malafaia, Osvaldo
; Assumpção, Paulo Pimentel
; Savassi-Rocha, Paulo Roberto
; Colleoni Neto, Ramiro
; Oliveira, Rodrigo Jose de
; AissarSallun, Rubens Antonio
; Weschenfelder, Rui
; Oliveira, Saint Clair Vieira de
; Abreu, Thiago Boechat de
; Castria, Tiago Biachi de
; Ribeiro Junior, Ulysses
; Barra, Williams
; Freitas Júnior, Wilson Rodrigues de
.
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
- Journal Metrics
RESUMO Racional: O II Consenso Brasileiro de Câncer Gástrico da Associação Brasileira de Câncer Gástrico ABCG (Parte 1) foi recentemente publicado. Nesta ocasião inúmeros especialistas que atuam no tratamento desta doença expressaram suas opiniões diante declarações apresentadas. Objetivo: Apresentar as Diretrizes da ABCG (Parte 2) quanto às indicações de tratamento cirúrgico, técnicas operatórias, extensão de ressecção e terapia combinada. Métodos: Para formulação destas diretrizes os autores realizaram extensa e atual revisão referente a cada declaração presente no II Consenso, utilizando as bases Medline/PubMed, Cochrane Library e SciELO, inicialmente com os seguintes descritores: câncer gástrico, gastrectomia, linfadenectomia, terapia combinada. Ainda, cada declaração foi classificada de acordo com o nível de evidência e grau de recomendação. Resultados: Das 43 declarações presentes neste estudo, 11 (25,6%) foram classificadas com nível de evidência A, 20 (46,5%) B e 12 (27,9%) C. Quanto ao grau de recomendação, 18 (41,9%) declarações obtiveram grau de recomendação 1, 14 (32,6%) 2a, 10 (23,3%) 2b e um (2,3%) 3. Conclusão: O complemento das diretrizes aqui presentes possibilita que cirurgiões e oncologistas que atuam no combate ao câncer gástrico possam oferecer o melhor tratamento possível, de acordo com as condições locais disponíveis.
ABSTRACT Background : The II Brazilian Consensus on Gastric Cancer of the Brazilian Gastric Cancer Association BGCA (Part 1) was recently published. On this occasion, countless specialists working in the treatment of this disease expressed their opinion in the face of the statements presented. Aim : To present the BGCA Guidelines (Part 2) regarding indications for surgical treatment, operative techniques, extension of resection and multimodal treatment. Methods: To formulate these guidelines, the authors carried out an extensive and current review regarding each declaration present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases initially with the following descriptors: gastric cancer, gastrectomy, lymphadenectomy, multimodal treatment. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results : Of the 43 statements present in this study, 11 (25,6%) were classified with level of evidence A, 20 (46,5%) B and 12 (27,9%) C. Regarding the degree of recommendation, 18 (41,9%) statements obtained grade of recommendation 1, 14 (32,6%) 2a, 10 (23,3%) 2b e one (2,3%) 3. Conclusion : The guidelines complement of the guidelines presented here allows surgeons and oncologists who work to combat gastric cancer to offer the best possible treatment, according to the local conditions available.
https://doi.org/10.1590/0102-672020210001e1563
768 downloads
4.
BRAZILIAN GASTRIC CANCER ASSOCIATION GUIDELINES (PART 1): AN UPDATE ON DIAGNOSIS, STAGING, ENDOSCOPIC TREATMENT AND FOLLOW-UP
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BARCHI, Leandro Cardoso
; RAMOS, Marcus Fernando Kodama Pertille
; YAGI, Osmar Kenji
; MUCERINO, Donato Roberto
; BRESCIANI, Claudio José Caldas
; RIBEIRO JÚNIOR, Ulysses
; ANDREOLLO, Nelson Adami
; ASSUMPÇÃO, Paulo Pimentel
; WESTON, Antônio Carlos
; COLLEONI NETO, Ramiro
; ZILBERSTEIN, Bruno
; Ferraz, Álvaro Antônio Bandeira
; Charruf, Amir Zeide
; Dias, André Roncon
; Brandalise, André
; Silva, André Maciel da
; Alves, Barlon
; Malheiros, Carlos Alberto
; Marins, Carlos Augusto Martinez
; Leite, Celso Vieira
; Szor, Daniel
; Wohnrath, Durval R.
; Ilias, Elias Jirjoss
; Martins Filho, Euclides Dias
; Lopasso, Fabio Pinatel
; Coimbra, Felipe José Fernandez
; Felippe, Fernando E. Cruz
; Tomasisch, Flávio Daniel Saavedra
; Takeda, Flavio Roberto
; Ishak, Geraldo
; Laporte, Gustavo Andreazza
; Silva, Herbeth José Toledo
; Cecconello, Ivan
; Rodrigues, Joaquim José Gama
; Grande, José Carlos Del
; Lourenço, Laércio Gomes
; Motta, Leonardo Milhomem da
; Ferraz, Leonardo Rocha
; Moreira, Luis Fernando
; Lopes, Luis Roberto
; Toneto, Marcelo Garcia
; Mester, Marcelo
; Rodrigues, Marco Antônio Gonçalves
; Carvalho, Marineide Prudêncio de
; Franciss, Maurice Youssef
; Forones, Nora Manoukian
; Corletta, Oly Campos
; Castro, Osvaldo Antonio Prado
; Malafaia, Osvaldo
; Kassab, Paulo
; Savassi-Rocha, Paulo Roberto
; Oliveira, Rodrigo Jose de
; Sallun, Rubens Antonio Aissar
; Weschenfelder, Rui
; Oliveira, Saint Clair Vieira de
; Abreu, Thiago Boechat de
; Castria, Tiago Biachi de
; Barra, Williams
; Costa Júnior, Wilson Luiz da
; Freitas Júnior, Wilson Rodrigues de
.
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
- Journal Metrics
RESUMO Racional: O II Consenso Brasileiro de Câncer Gástrico da Associação Brasileira de Câncer Gástrico (ABCG) foi recentemente publicado. Nesta ocasião, inúmeros especialistas que atuam no tratamento desta doença expressaram sua opinião diante declarações apresentadas. Objetivo: Apresentar as Diretrizes da ABCG (Parte 1) quanto ao diagnóstico, estadiamento, tratamento endoscópico e seguimento dos pacientes com câncer gástrico. Métodos: Para formulação destas Diretrizes os autores realizaram extensa e atual revisão referente a cada declaração presente no II Consenso, utilizando as bases Medline/PubMed, Cochrane Library e SciELO com os seguintes descritores: câncer gástrico, estadiamento, tratamento endoscópico e seguimento. Ainda, cada declaração foi classificada de acordo com o nível de evidência e grau de recomendação. Resultados: Das 24 declarações, duas (8,3%) foram classificadas com nível de evidência A, 11 (45,8%) B e 11 (45,8%) C. Quanto ao grau de recomendação, seis (25%) declarações obtiveram grau de recomendação 1, nove (37,5%) grau 2a, seis (25%) 2b e três (12,5%) 3. Conclusão: As diretrizes aqui presentes têm a finalidade de auxiliar os profissionais que atuam no combate ao câncer gástrico com informações relevantes e atuais, permitindo que sejam aplicadas na prática médica diária.
ABSTRACT Background: The II Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Association (ABCG) was recently published. On this occasion, several experts in gastric cancer expressed their opinion before the statements presented. Aim: To present the ABCG Guidelines (part 1) regarding the diagnosis, staging, endoscopic treatment and follow-up of gastric cancer patients. Methods: To forge these Guidelines, the authors carried out an extensive and current review regarding each statement present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases with the following descriptors: gastric cancer, staging, endoscopic treatment and follow-up. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results: Of the 24 statements, two (8.3%) were classified with level of evidence A, 11 (45.8%) with B and 11 (45.8%) with C. As for the degree of recommendation, six (25%) statements obtained grade of recommendation 1, nine (37.5%) recommendation 2a, six (25%) 2b and three (12.5%) grade 3. Conclusion: The guidelines presented here are intended to assist professionals working in the fight against gastric cancer with relevant and current information, granting them to be applied in the daily medical practice.
https://doi.org/10.1590/0102-672020200003e1535
2100 downloads
5.
II BRAZILIAN CONSENSUS ON GASTRIC CANCER BY THE BRAZILIAN GASTRIC CANCER ASSOCIATION
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BARCHI, Leandro Cardoso
; RAMOS, Marcus Fernando Kodama Pertille
; DIAS, André Roncon
; ANDREOLLO, Nelson Adami
; WESTON, Antônio Carlos
; LOURENÇO, Laércio Gomes
; MALHEIROS, Carlos Alberto
; KASSAB, Paulo
; ZILBERSTEIN, Bruno
; Ferraz, Álvaro Antônio Bandeira
; Charruf, Amir Zeide
; Brandalise, André
; Silva, André Maciel da
; Alves, Barlon
; Marins, Carlos Augusto Martinez
; Leite, Celso Vieira
; Bresciani, Claudio José Caldas
; Szor, Daniel
; Mucerino, Donato Roberto
; Wohnrath, Durval R.
; Ilias, Elias Jirjoss
; Martins Filho, Euclides Dias
; Lopasso, Fabio Pinatel
; Coimbra, Felipe José Fernandez
; Felippe, Fernando E. Cruz
; Tomasisch, Flávio Daniel Saavedra
; Takeda, Flavio Roberto
; Ishak, Geraldo
; Laporte, Gustavo Andreazza
; Silva, Herbeth José Toledo
; Cecconello, Ivan
; Rodrigues, Joaquim José Gama
; Grande, José Carlos Del
; Motta, Leonardo Milhomem da
; Ferraz, Leonardo Rocha
; Moreira, Luis Fernando
; Lopes, Luis Roberto
; Toneto, Marcelo Garcia
; Mester, Marcelo
; Rodrigues, Marco Antônio Gonçalves
; Carvalho, Marineide Prudêncio de
; Franciss, Maurice Youssef
; Forones, Nora Manoukian
; Corletta, Oly Campos
; Yagi, Osmar Kenji
; Castro, Osvaldo Antonio Prado
; Malafaia, Osvaldo
; Assumpção, Paulo Pimentel
; Savassi-Rocha, Paulo Roberto
; Colleoni Neto, Ramiro
; Oliveira, Rodrigo Jose de
; Sallun, Rubens Antonio Aissar
; Weschenfelder, Rui
; Oliveira, Saint Clair Vieira de
; Abreu, Thiago Boechat de
; Castria, Tiago Biachi de
; Ribeiro Junior, Ulysses
; Barra, Williams
; Costa Júnior, Wilson Luiz da
; Freitas Júnior, Wilson Rodrigues de
.
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
- Journal Metrics
RESUMO Racional: Desde a publicação do primeiro Consenso Brasileiro sobre Câncer Gástrico em 2012 realizado pela Associação Brasileira de Câncer Gástrico (ABCG), novos conceitos sobre o diagnóstico, estadiamento, tratamento e seguimento foram incorporados. Objetivo: Promover uma atualização aos profissionais que atuam no combate ao câncer gástrico (CG) e fornecer diretrizes quanto ao manejo dos pacientes portadores desta afecção. Métodos: Cinquenta e nove especialistas responderam 67 declarações sobre o diagnóstico, estadiamento, tratamento e prognóstico do CG com cinco alternativas possíveis: 1) concordo plenamente; 2) concordo parcialmente; 3) indeciso; 4) discordo e 5) discordo fortemente. Foi considerado consenso a concordância de pelo menos 80% da soma das respostas “concordo plenamente” e “concordo parcialmente”. Este artigo apresenta apenas as respostas dos especialistas participantes. Os comentários sobre cada declaração, assim como uma revisão da literatura serão apresentados em publicações futuras. Resultados: Das 67 declarações, houve consenso em 50 (74%). Em 10 declarações, houve concordância de 100%. Conclusão: O tratamento do câncer gástrico evoluiu consideravelmente nos últimos anos. Este consenso reúne princípios consolidados nas últimas décadas, novos conhecimentos adquiridos recentemente, assim como perspectivas promissoras sobre o manejo desta doença.
ABSTRACT Background: Since the publication of the first Brazilian Consensus on Gastric Cancer (GC) in 2012 carried out by the Brazilian Gastric Cancer Association, new concepts on diagnosis, staging, treatment and follow-up have been incorporated. Aim: This new consensus is to promote an update to professionals working in the fight against GC and to provide guidelines for the management of patients with this condition. Methods: Fifty-nine experts answered 67 statements regarding the diagnosis, staging, treatment and prognosis of GC with five possible alternatives: 1) fully agree; 2) partially agree; 3) undecided; 4) disagree and 5) strongly disagree A consensus was adopted when at least 80% of the sum of the answers “fully agree” and “partially agree” was reached. This article presents only the responses of the participating experts. Comments on each statement, as well as a literature review, will be presented in future publications. Results: Of the 67 statements, there was consensus in 50 (74%). In 10 declarations, there was 100% agreement. Conclusion: The gastric cancer treatment has evolved considerably in recent years. This consensus gathers consolidated principles in the last decades, new knowledge acquired recently, as well as promising perspectives on the management of this disease.
https://doi.org/10.1590/0102-672020190001e1514
3675 downloads
6.
Remote ischemic conditioning protects against testicular ischemia∕reperfusion injury in rats
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Damasceno, Ananda Vitória Barros Suzuki
; Barros, Charles Alberto Villacorta de
; Percario, Sandro
; Ribeiro Junior, Rubens Fernando Gonçalves
; Monteiro, Andrew Moraes
; Gouveia, Eduardo Henrique Herbster
; Henriques, Higor Yuri Bezerra
.
Abstract Purpose To evaluate the effect of remote ischemic conditioning associated to N-acetylcysteine (NAC) on testicular ischemia∕reperfusion (I∕R) injury in rats. Methods Twenty-five adult male Wistar rats were randomly distributed into five experimental groups (n=5), as follows: Sham, I∕R, Perconditioning (PER), NAC and PER+NAC. Two-hour ischemia was induced by rotating the left testis 720° to clockwise direction, followed by 4 hours of reperfusion. Perconditioning was performed by three I/R cycles of 10 min each on the left limb, 30 min before reperfusion. N-acetylcysteine (150 mg∕kg) was administered 30 min before reperfusion. Results Statistical differences were observed in MDA levels between I/R group with all groups (p<0.01), in addition there was statistical difference between PER and Sham, and PER+ NAC groups (p<0.05) in plasma. Conclusions The protective effect of perconditioning isolated in the reduction of lipid peroxidation related to oxidative stress was demonstrated. However, when Perconditioning was associated with NAC, there was no protective effect against testicular injury of ischemia and reperfusion.
https://doi.org/10.1590/s0102-865020200020000003
678 downloads
7.
Perconditioning associated to hypertonic saline solution on liver function improvement after ischemia/reperfusion injury
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Ribeiro Júnior, Rubens Fernando Gonçalves
; Couteiro, Rodrigo Paracampo
; Monteiro, Andrew Moraes
; Rodrigues, Ivone Aline da Silva
; Cavalcante, Lainy Carollyne da Costa
; Gouveia, Eduardo Henrique Herbster
; Galvão, Lucas Nascimento
; Lopes, Luiz Renato Oliveira
; Yasojima, Edson Yuzur
; Brito, Marcus Vinicius Henriques
.
Abstract Purpose: To evaluate the effects of hypertonic saline solution associated to remote ischemic perconditioning in liver ischemia/reperfusion injury in rats. Methods: 25 male rats (Wistar) were distributed into five groups: Sham group (S); Ischemia/Reperfusion group (I/R) with 30 minutes of liver ischemia; Remote ischemic perconditioning group (Per) with three cycles of 10 minutes of I/R performed during liver ischemia; Hypertonic saline solution group (HSS) treated with hypertonic saline solution (4ml/kg); Remote ischemic perconditioning + Hypertonic saline solution group (Per+HSS) with both treatments. Results: Per+HSS group showed a lower degree of liver dysfunction in relation to I/R group, whereas the technique of remote ischemic perconditioning isolated or associated with saline solution significantly improved liver function and reduced histological damage. Conclusion: Remote ischemic perconditioning associated or not to saline solution promoted reduction of acute liver injury induced by ischemia/reperfusion.
https://doi.org/10.1590/s0102-865020170110000006
887 downloads
8.
Influence of remote ischemic conditioning and tramadol hydrochloride on oxidative stress in kidney ischemia/reperfusion injury in rats
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Oliveira, Rita de Cássia Silva de
; Brito, Marcus Vinicius Henriques
; Ribeiro Júnior, Rubens Fernando Gonçalves
; Oliveira, Leonam Oliver Durval
; Monteiro, Andrew Moraes
; Brandão, Fernando Mateus Viegas
; Cavalcante, Lainy Carollyne da Costa
; Gouveia, Eduardo Henrique Herbster
; Henriques, Higor Yuri Bezerra
.
Abstract Purpose: To evaluate the effects of tramadol hydrochloride associated to remote ischemic perconditioning on oxidative stress. Methods: Twenty five male rats (Wistar) underwent right nephrectomy and were distributed into five groups: Sham group (S); Ischemia/Reperfusion group (I/R) with 30 minutes of renal ischemia; Remote ischemic perconditioning group (Per) with three cycles of 10 minutes of I/R performed during kidney ischemia; Tramadol group (T) treated with tramadol hydrochloride (40mg/kg); remote ischemic perconditioning + Tramadol group (Per+T) with both treatments. Oxidative stress was assessed after 24 hours of reperfusion. Results: Statistical differences were observed in MDA levels between I/R group with all groups (p<0.01), in addition there was difference between Tramadol with Sham, Per and Per+T groups (p<0.05), both in plasma and renal tissue. Conclusion: Remote ischemic perconditioning was more effective reducing renal ischemia-reperfusion injury than administration of tramadol or association of both treatments.
https://doi.org/10.1590/s0102-865020170030000007
1482 downloads
9.
Effects of hypertonic saline solution associated to remote ischemic perconditioning in kidney ischemia/reperfusion injury in rats
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Brito, Marcus Vinicius Henriques
; Yasojima, Edson Yuzur
; Percário, Sandro
; Ribeiro Júnior, Rubens Fernando Gonçalves
; Cavalcante, Lainy Carollyne da Costa
; Monteiro, Andrew Moraes
; Couteiro, Rodrigo Paracampo
; Rodrigues, Ivone Aline da Silva
; Santos, Hellen Aparecida Geyer dos
.
Abstract Purpose: To evaluate the effects of hypertonic saline solution associated to remote ischemic perconditioning in renal ischemia/reperfusion injury in rats. Methods: Twenty five male rats (Wistar) underwent right nephrectomy and were distributed into five groups: Sham group (S); Ischemia/Reperfusion group (I/R) with 30 minutes of renal ischemia; Remote ischemic perconditioning group (Per) with three cycles of 10 minutes of I/R performed during kidney ischemia; Hypertonic saline solution group (HSS) treated with hypertonic saline solution (4ml/kg); remote ischemic perconditioning + Hypertonic saline solution group (Per+HSS) with both treatments. After reperfusion, blood samples were collected for BUN and creatinine serum levels analyzes. TBARS were evaluated in plasma and renal tissue to assess oxidative stress. Kidney histopathological examination were performed. Results: Per+HSS group showed a lower degree of renal dysfunction in relation to I/R group, whereas the technique of remote ischemic perconditioning isolated or associated with saline solution significantly reduced oxidative stress and histological damage. Conclusion: Remote ischemic perconditioning associated or not to saline solution promoted reduction of acute renal injury induced by ischemia/reperfusion.
https://doi.org/10.1590/s0102-865020170030000005
1233 downloads
10.
Effects of nitrofurazone on correction of abdominal wall defect treated with polypropylene mesh involved by fibrous tissue
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Yasojima, Edson Yuzur
; Ribeiro Júnior, Rubens Fernando Gonçalves
; Pessôa, Thyago Cezar Prado
; Cavalcante, Lainy Carollyne da Costa
; Ramos, Suzana Rodrigues
; Gouveia, Eduardo Henrique Herbster
; Galvão, Lucas Nascimento
; Serruya, Yuri Aarão Amaral
; Moraes, Mateus Malta de
.
PURPOSE: To evaluate the effects of nitrofurazone on the correction of abdominal wall defect treated with polypropylene mesh involved by fibrous tissue in rats. METHODS: A defect in the abdominal wall was created and corrected with polypropylene mesh in 20 rats. They were randomly distributed into four groups: control, fibrous mesh, nitrofurazone and nitrofurazone dip in the mesh. Euthanasia was performed in 21 post-operative days. The healing process was analyzed regarding the meshes and macroscopic and microscopic aspects. RESULTS: All animals had adhesions. However, no statistically significant difference (p>0.05) when compared between groups. Similarly microscopic analysis, in which there was no statistical significance level for the evaluated parameters such as mono and polymorphonuclear lymphocytes, granuloma, fibrosis, necrosis and collagen proliferation. CONCLUSION: There was no significant effect on the abdominal wall defect repair with polypropylene mesh surrounded by fibrous tissue when dipped in nitrofurazone 2%.
https://doi.org/10.1590/S0102-865020150100000006
1906 downloads
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