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Acta Cirúrgica Brasileira, Volume: 29, Número: 3, Publicado: 2014
  • Influence of Annona muricata (soursop) on biodistribution of radiopharmaceuticals in rats Original Articles

    Holanda, Cecília Maria de Carvalho Xavier; Barbosa, Delianne Azevedo; Demeda, Vanessa Fávero; Bandeira, Flora Tamires Moura; Medeiros, Hilkéa Carla Souza de; Pereira, Kércia Regina Santos Gomes; Barbosa, Vanessa Santos de Arruda; Medeiros, Aldo Cunha

    Resumo em Inglês:

    PURPOSE: To evaluate the effect of hydroalcoholic extract of A. muricata on biodistribution of two radiopharmaceuticals: sodium phytate and dimercaptosuccinic acid (DMSA), both labeled with 99mtechnetium. METHODS: Twenty four Wistar rats were divided into two treated groups and two controls groups. The controls received water and the treated received 25mg/kg/day of A. muricata by gavage for ten days. One hour after the last dose, the first treated group received 99mTc-DMSA and the second sodium 99mTc-phytate (0.66MBq each group), both via orbital plexus. Controls followed the same protocol. Forty min later, all groups were sacrificed and the blood, kidney and bladder were isolated from the first treated group and the blood, spleen and liver isolated from the second treated group. The percentage of radioactivity per gram of tissue (%ATI/g) was calculated using a gamma counter. RESULTS: The statistical analysis showed that there was a statistically significant decrease (p<0.05) in the uptake of %ATI/g in bladder (0.11±0.01and1.60±0.08), kidney (3.52±0.51and11.84±1.57) and blood (0.15±0.01and 0.54±0.05) between the treated group and control group, respectively. CONCLUSION: The A. muricata hydroalcoholic extract negatively influenced the uptake of 99mTc-DMSA in bladder, kidney and blood of rats.
  • Behavioural and cognitive effects of simvastatin dose used in stimulation of bone regeneration in rats Original Articles

    Sousa, Dircilei Nascimento de; Santana, Washington Macedo de; Ferreira, Vania Moraes; Duarte, Wagner Rodrigues

    Resumo em Inglês:

    PURPOSE: To analyze the effects of simvastatin (SVT) in the locomotion, anxiety and memory of rats, as a reflection of the administration of a minimum dose capable of stimulating bone regeneration in defects in the calvariae. METHODS: Surgical procedures were performed in 15 female Wistar rats, 2-month old, to insert the grafting material regenerator (Bone-ceramic(r)) and/or SVT, followed by behavioural and cognitive assessments in the 7th, 30th and 60th days post surgery. RESULTS: The SVT locally applied with the goal of bone regeneration in defects created in rat calvariae does not interfere with locomotion, anxiety levels and/or memories of rats, except for the first week following surgery, when an anxiolytic effect was observed, as a result of a possible central action. CONCLUSION: Failure to provoke any response within 30 and 60 days post surgical procedures suggests that SVT may constitute a good choice in stimulating bone regeneration without affecting the long term neural functions.
  • Validation of the gastroschisis experimental model and the influence of the mother's diet enriched with glutamine in the fetal morphology Original Articles

    Caporossi, Cervantes; Nogueira, Paulo Luiz Batista; Marques, José Carlos Costa; Assis, Rafael Moraes de; Aguilar-Nascimento, José Eduardo de

    Resumo em Inglês:

    PURPOSE: To validate the gastroschisis experimental model in female rats and the effects on the glutamine fetal morphology during pregnancy. METHODS: Twelve pregnant rats Wistar were separated in two groups: Group I (n = 6 rats, 71 fetuses) took glutamine and Group II (n = 6 rats, 75 fetuses) took isocaloric supplementation. At the 18th day of pregnancy, female rats were taken to hysterotomy and the fetuses which were selected for the act of gastroschisis were partially removed from the womb and by the laparotomy technique, the exclusion of the intestine was done. After that, fetuses were put in the womb cavity again and the rats' abdomen sutured. At the 21st day of pregnancy, date before delivery, by C-section ordinary animals and the ones with gastroschisis were removed and studied separately. The morphometrical parameters studied were the body weight (PC); the intestine weight (PI); the intestine length (CI) and its relations (PI/PC, PI/CI e PC-PI). RESULTS: The intestine weight (PI) and the intestine length (CI) were different in fetuses with gastroschisis (p<0.05), however no difference between the groups regarding supplementation with glutamine. CONCLUSIONS: The gastroschisis experimental model is valid and reproducible. The nutritional therapy with glutamine did not change the morphometrical parameters.
  • Description of a new experimental model skin flap for studying skin viability in rats Original Articles

    Camargo, Cristina Pires; Margarido, Nelson Fontana; Guandelini, Eduardo; Vieira, Guilherme Alexandre Barrucci; Jacomo, Alfredo Luiz; Gemperli, Rolf

    Resumo em Inglês:

    PURPOSE: To describe a new experimental flap for studying skin viability in rats. METHODS: Twenty male Wistar rats weighing between 250-300g were divided into two groups: group A - McFarlane technique, a 4 x 10cm flap was used (McFarlane); and in group B modified McFarlane technique, a 3 x 10cm flap was used. Seven days later, the animals were sacrificed and the area of necrosis was evaluated in both groups. RESULTS: Group A presented necrosis in 3% of the total area of the flap (CI: 0.01-0.05), Group B presented necrosis in 37% of the total area of the flap (CI: 0.29-0.46), (p<0.001). CONCLUSION: The modified McFarlane flap presented a larger area of necrosis and could be an adequate experimental model of skin flap viability.
  • Comparative efficacy of Belzer or Euro-Collins solutions for pancreatic preservation during cold ischemic storage in rats Original Articles

    Perez, Rogério Renato; Goldenberg, Alberto; Netto, Alcides Augusto Salzedas; Gonzalez, Adriano Miziara

    Resumo em Inglês:

    PURPOSE: To compare the efficacy of different types of solutions (Belzer or Euro-Collins) for the preservation of rat pancreas during cold ischemia. METHODS: Thirty Wistar rats were divided into three groups according to the perfusion or storage solution: Group E (perfusion and storage in Euro-Collins solution); Group B (perfusion and storage in Belzer solution) and Group BE (Perfusion in Belzer solution and storage in Euro-Collins solution). After perfusion, the pancreas was excised and stored at 4˚C for 18 hours. Amylase was measured at 6, 12 and 18h, and histological analysis of the pancreas was performed after 18h of cold storage. RESULTS: Amylase was elevated and comparable in Groups E and BE after 12 and 18 hours of ischemia (p<0.05). In the exocrine pancreas, histological differences in the amount of necrosis (p=0.049), lymphocytic infiltrate (p<0.001) and neutrophilic infiltrate (p=0.004) were observed, with more favorable features present in Group B. In the endocrine pancreas, Group B showed less edema (p<0.001), but other parameters were similar among all groups. CONCLUSION: The Euro-Collins solution is inferior to the Belzer solution for the preservation of rat pancreas during cold ischemia.
  • Oxidative stress and fatty acid profile in Wistar rats subjected to acute food restriction and refeeding with high-fat diets Original Articles

    Nassar, Ana Lígia da Silva; Marot, Luisa Pereira; Ovidio, Paula Payão; Castro, Gabriela Salim Ferreira de; Jordão Júnior, Alceu Afonso

    Resumo em Inglês:

    PURPOSE: To assess oxidative stress and the profile of fatty acids incorporated into the hepatic tissue of animals refed with high-fat (HF) diets after acute food restriction. METHODS: Fifty male Wistar rats were divided into five groups and fasting for 48 hours. One group was sacrificed without refeeding (NR), a control group (C) was refed with the standard AIN-93 diet and the remaining groups with HF diets respectively consisting of hydrogenated vegetable oil (PHVO), trans-free (TF) margarine and trans-free margarine enriched with ω-3 and ω-6 (O). After this period the animals were sacrificed for malondialdehyde (MDA), catalase and hepatic fatty acid determination. RESULTS: The groups refed with HF diets showed elevation of MDA levels compared to the C group (p<0.001 for GVH and p<0.01 for TF and O). Hepatic catalase activity was higher in the TF and O groups compared to group C (p<0.05 for both). The amount of saturated fatty acids was lower in the PHVO and O groups compared to the remaining ones (p<0.001). CONCLUSION: The consumption of high-fat diets after prolonged fasting favors oxidative imbalance in hepatic tissue.
  • Gene expression profile of oxidative stress in the lung of inbred mice after intestinal ischemia/reperfusion injury Original Articles

    Ikejiri, Adauto Tsutomu; Somaio Neto, Frederico; Chaves, José Carlos; Bertoletto, Paulo Roberto; Teruya, Roberto; Bertoletto, Eduardo Rodrigues; Taha, Murched Omar; Fagundes, Djalma José

    Resumo em Inglês:

    PURPOSE: To determine the gene expression profile associated with oxidative stress and antioxidant defense in the lung tissue of mice subjected to intestinal ischemia and reperfusion. METHODS: Twelve male, inbred mice (C57BL/6) were randomly assigned to one of two groups. The control group (CG) underwent anesthesia and laparotomy and was observed for 120 minutes; the ischemia/reperfusion group (IRG) was subjected to anesthesia, laparotomy, and ischemia of the small intestine for 60 minutes and to 60 minutes of reperfusion. A pool of six mice from each group was subjected to a reverse transcription-quantitative polymerase chain reaction (RT-qPCR) to analyze the oxidative stress and antioxidant defense genes. All genes that were up-regulated or down-regulated greater than three-fold, based on the algorithm [2^(ΔΔCt)], were considered to be biologically meaningful. RESULTS: Out of a total of 84 genes in the lung that are related to oxidative stress, 67 (79.7%) were up-regulated and 17 (20.2%) were down-regulated. Only two genes (2.3%), Lpo (lactoperoxidase) (+3.51) and Gpx4 (glutathione peroxidase) (+4.10), were expressed above the three-fold threshold, while none of the down-regulated genes were expressed outside of this threshold. CONCLUSION: The intestinal ischemia/reperfusion injury promoted a gene expression profile consisting of the positive expression of oxidative genes in a remote organ. This suggests that activate signaling pathways are implicated in both cell survival and the maintenance of genome integrity in the lung.
  • Torsional force applied to the tibia of living lambs in an attempt to change the bone rotational axis Original Articles

    Volpon, José Batista; Falcai, Maurício José; Moro, Carlos Alberto; Leal, Daniel Mendes

    Resumo em Inglês:

    PURPOSE: To evaluate the effects of torsional force on the rotational axis of living lamb tibias. METHODS: An external fixator device was designed to apply rotation to the tibias of lambs. Once a week, the bone distal extremity was rotated 2º. After achieving ~20º of internal rotation, the turning was discontinued and the device was maintained in situ for one month and euthanasia occurred in group A (n=10) after this. In group B (n=9) euthanasia occurred three months after removing the device. Computed tomography scans evaluated the rotational angle; dual-energy X-ray absorptiometry assessed the bone mineral density, and conventional and polarized light microscopy studied the bone microstructure. RESULTS: In group A, the mean angle of the external rotation in the control tibias was 24º and 8º in the twisted tibias (p<0.0001); in group B, the angle was 23º (control) and 7º (twisted, p<0.0001), with no differences between groups A and B (p=0.9567). The BMD increased in the twisted tibias in group A (p<0.0001) and in group B (p=0.0023), with no between-group differences (p>0.05). Microscopically, the twisted tibias showed asymmetrical subperiosteal bone deposition on the lateral cortex surface. CONCLUSION: Gradual torsion applied to the immature tibia significantly modified its rotational axis.
  • Epidural anesthesia with ropivacaine with or without clonidine and postoperative pain in hemorrhoidectomies Original Articles

    Baptista, João Florêncio de Abreu; Gomez, Renato Santiago; Paulo, Danilo Nagib Salomão; Carraretto, Antonio Roberto; Brocco, Marcos Celio; Silva, José Jorge

    Resumo em Inglês:

    PURPOSE: To determine the safety, pain intensity correlated with age and body mass index (BMI), epidural anesthesia with ropivacaine and clonidine in hemorrhoidectomy. METHODS: Eighty patients, both genders, 20-70 years old, ASA I or II, for hemorrhoidectomy were randomly divided into two groups: Control (n=38), epidural anesthesia with 14 mL of ropivacaine 0.75 % plus 0.0266 mL/kg of 0.9% saline solution; Experimental (n=42) epidural anesthesia with 14 mL of 0.75% ropivacaine plus 4.0 mcg/kg of clonidine. In preoperative and postoperative period were evaluated: systolic blood pressure (SBP), diastolic blood pressure (DBP ), heart rate (HR ), pulse oximetry (SpO2), electrocardiography (ECG), pain intensity (VAS ) in four, eight and, 12 hours and analgesic consumption. RESULTS: The VAS values differed between four, eight and 12 hours in the Experimental Group, where correlation of VAS 12h with age (p<0.05) occurred and not with BMI and more patients (p<0.05) did not receive analgesics. SBP, DBP, HR changed similarly in both groups at 15, 30 and 45 min. The ECG and SpO2 remained unchanged. CONCLUSIONS: Clonidine (4mcg/kg) in epidural anesthesia with ropivacaine 0.75% in hemorrhoidectomy showed safety and greater analgesia within four hours. The pain at 12 hours showed correlation with age and not with body mass index.
  • Antibiotic prophylaxis in obese patients submitted to bariatric surgery. A systematic review Original Articles

    Fischer, Maria Isabel; Dias, Cícero; Stein, AirtonTetelbom; Meinhardt, Nelson Guardiola; Heineck, Isabela

    Resumo em Inglês:

    PURPOSE: To review the use of cefazolin in prophylaxis of surgical wound infection (SSI) in bariatric surgery (BS). METHODS: A systematic review was performed from October to November, 2013 using the following databases: The Cochrane Library, Medline, LILACS, and EMBASE. The inclusion criteria were randomized clinical trials and observational studies that were evaluated by two independent reviewers. RESULTS: Nine hundred and sixty one titles were recovered after preliminary analysis (title and abstract), seven studies remained for final analysis. There were three clinical trials (one with SSI, and two with antibiotic levels as the outcome), and four were observational studies (three cohorts and one case-control, all had SSI as the outcome). After administration of 1g or 2 g, levels of cefazolin in serum and tissue were suboptimal according to two studies. Results from observational studies indicated that different antibiotics were used for prophylaxis of SSI in BS and that use of other drugs may be associated with higher rates of SSI. CONCLUSION: The use of cefazolin for surgical wound infection prophylaxis in bariatric surgery is recommended, however further studies are needed in order to refine parameters as initial dose, redose, moment of administration and lasting of prophylaxis.
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