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Curitiba, Brazil

Isa A.C.,Federal University of Parana | Matias J.E.F.,Federal University of Parana | Yamamoto C.T.,Federal University of Parana | Isa R.H.,Hospital Angelina Caron | And 2 more authors.
Revista do Colegio Brasileiro de Cirurgioes

Objective: To analyze the performance of two surgical meshes of different compositions during the defect healing process of the abdominal wall of rats. Methods: thirty-three adult Wistar rats were anesthetized and subjected to removal of an area of 1.5 cm × 2 cm of the anterior abdominal wall, except for the skin; 17 animals had the defect corrected by edge-to-edge surgical suture of a mesh made of polypropylene + poliglecaprone (Group U – Ultrapro™); 16 animals had the defect corrected with a surgical mesh made of polypropylene + polidioxanone + cellulose (Group P – Proceed™). Each group was divided into two subgroups, according to the euthanasia moment (seven days or 28 days after the operation). Parameters analyzed were macroscopic (adherence), microscopic (quantification of mature and immature collagen) and tensiometric (maximum tension and maximum rupture strength). Results: there was an increase in collagen type I in the Proceed™ group from seven to 28 days, p = 0.047. Also, there was an increase in the rupture tension on both groups when comparing the two periods. There was a lower rupture tension and tissue deformity with Proceed™ mesh in seven days, becoming equal at day 28. Conclusion: the meshes retain similarities in the final result and more studies with larger numbers of animals must be carried for better assessment. © 2015, Colegio Brasileiro de Cirurgioes. All rights reserved. Source

Araujo W.J.B.,Federal University of Parana | Timi J.R.R.,Federal University of Parana | Erzinger F.L.,Federal University of Parana | Caron F.C.,Federal University of Parana | Cambrussi A.K.,Hospital Angelina Caron
Acta Cirurgica Brasileira

PURPOSE: To develop an ex vivo model for the analysis of macroscopic, histological and immunohistochemical changes after experimental endovenous laser ablation (EVLA) of the great saphenous vein (GSV). METHODS: We describe a model produced with glass tubes and introducer sheaths to mimic the physiological conditions of EVLA procedures, such as tumescence and blood flow. A pilot study was conducted to evaluate an ex vivo procedure of EVLA of an incompetent GSV segment using a 1470-nm radial fiber diode laser (7 W power) and an automatic pull-back device. The vein segment was analyzed macroscopically and by hematoxylin & eosin staining, elastic fiber histochemistry, Gomori’s trichrome staining, and alpha-smooth muscle actin immunohistochemistry. RESULTS: No perforations were observed macroscopically. No muscle cell adhesion was observed in the central part of the ablated vein, showing tissue disruption. There was low labeling for elastic fibers, disruption of muscle fibers, and a reduced expression of the specific marker for this cell type. CONCLUSION: This ex vivo endovenous laser ablation model is a low cost alternative to in vivo experiments, providing standardized experimental conditions. © 2016. All rights reserved. Source

de Sousa E.L.,Pontifical Catholic University of Parana | de Figueiredo Wouk A.F.P.,Pontifical Catholic University of Parana | Malafaia O.,Principles of Surgery | Ribas-Filho J.M.,Principles of Surgery | And 6 more authors.
Acta Cirurgica Brasileira

PURPOSE: To compare ileal anastomoses in the immediate postoperative healing period after meloxicam use. METHODS: Forty two male Wistar rats were randomly divided into two groups of 21, COX and control group. To COX meloxicam in combination with morphine was given in 3 days period. Control group received only morphine during the same period. Each group was divided into three sub-groups of 7, which were euthanized at 5, 10, and 21 days postoperatively. Comparison was based in histological evaluation of collagen type I and III using sirius red, immunohistochemical through vascular endothelial growth factor and matrix metalloproteinase-9. RESULTS: Healing process in scheduled periods did not show significant differences (p>0.05) between the COX and control groups during any of the periods. CONCLUSION: The use of meloxicam in the postoperative period following ileal anastomosis did not affect healing. © 2016, Sociedade Brasileira para o Desenvolvimento de Pesquisa em Cirurgia. All rights reserved. Source

Campos L.F.,University of Sao Paulo | Repka J.C.D.,Hospital Angelina Caron | Falcao M.C.,University of Sao Paulo
Jornal de Pediatria

Objective To compare bacterial growth in pure colostrum versus colostrum with human milk fortifier (HMF) containing iron. Methods The growth of Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa in 78 samples of pure colostrum or colostrum with added iron-containing HMF was compared. For qualitative analysis, filter paper discs were immersed in samples from each group and incubated for 48 hours with 101 colony forming units (CFUs)/mL of each strain. For quantitative assessment, 1 mL of each strain containing 107 CFUs/mL was homogenized with 1 mL of either colostrum or colostrum with human milk fortifier, seeded into a Petri dish, and incubated at 37 C. Twenty-four hours later, the number of CFUs was counted. Results The qualitative analysis showed no difference in bacterial growth. In the quantitative evaluation, E. coli growth in the control group was 29.4 ± 9.7 × 106 CFU/mL, while in the HMF group it was 31.2 ± 10.8 × 106 CFU/mL. The difference between the average growth was 1.9 ± 4.9 × 106 CFU/mL (p = 0.001). There were no differences in S. aureus and P. aeruginosa growth. Conclusion Addition of iron at this concentration reduces breast milk bacteriostatic action against E. coli. © 2013 Sociedade Brasileira de Pediatria. Source

Bonilauri Ferreira A.P.R.,Univille | Bonilauri Ferreira A.P.R.,Duke University | Ferreira R.F.,Univille | Rajgor D.,National University of Singapore | And 6 more authors.

Background: Little is known about the reasoning mechanisms used by physicians in decision-making and how this compares to diagnostic clinical practice guidelines. We explored the clinical reasoning process in a real life environment. Method: This is a qualitative study evaluating transcriptions of sixteen physicians' reasoning during appointments with patients, clinical discussions between specialists, and personal interviews with physicians affiliated to a hospital in Brazil. Results: Four main themes were identified: simple and robust heuristics, extensive use of social environment rationality, attempts to prove diagnostic and therapeutic hypothesis while refuting potential contradictions using positive test strategy, and reaching the saturation point. Physicians constantly attempted to prove their initial hypothesis while trying to refute any contradictions. While social environment rationality was the main factor in the determination of all steps of the clinical reasoning process, factors such as referral letters and number of contradictions associated with the initial hypothesis had influence on physicians' confidence and determination of the threshold to reach a final decision. Discussion: Physicians rely on simple heuristics associated with environmental factors. This model allows for robustness, simplicity, and cognitive energy saving. Since this model does not fit into current diagnostic clinical practice guidelines, we make some propositions to help its integration. Copyright: © 2010 Bonilauri Ferreira et al. Source

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