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Rio de Janeiro, Brazil

de Carvalho M.F.P.,University of Sao Paulo | Pereira C.S.B.,University of Sao Paulo | Fregnani J.H.,Research and Teaching Institute | Ribeiro F.A.Q.,University of Sao Paulo
Acta Cirurgica Brasileira

PURPOSE: To compare histologically the action of Mitomycin C and that of Clobetasol propionate for surgical wound healing in rats. METHODS: A circular skin fragment was surgically removed from 57 Wistar rats. Twenty-two animals were treated with Mitomycin C with topical medication in a single dose, 22 with Clobetasol propionate with a cream medication once a day for 15 days and 13 did not receive any medication. The animals were euthanized 30 and 60 days, and the scars subjected to histological examination. RESULTS: The histological analysis on the samples did not show statistically significant differences regarding the quantities of fibroblasts, fibrocytes and vascular proliferation in the three groups, in the evaluations after 30 and 60 days. In the treated groups with Mitomycin C and Clobetasol there was a decrease in collagen concentration over the 30-day period and an increase in collagen concentration over the 60-day period, in comparison with the control group.CONCLUSIONS: The actions of Mitomycin C and Clobetasol were equivalent and not interfere in fibroplasias and in angiogenesis. Both drugs initially cause a decrease in collagen over a 30-day period and an increase over a 60-day period, demonstrating a delay in the wound healing. © 2015, Sociedade Brasileira para o Desenvolvimento de Pesquisa em Cirurgia. All Rights Reserved. Source

Costa R.F.A.,Graduate Program of Oncology | Longatto-Filho A.,Molecular Oncology Research Center | Longatto-Filho A.,University of Sao Paulo | Longatto-Filho A.,University of Minho | And 4 more authors.

Background The Cervical Cancer Database of the Brazilian National Health Service (SISCOLO) contains information regarding all cervical cytological tests and, if properly explored, can be used as a tool for monitoring and managing the cervical cancer screening program. The aim of this study was to perform a historical analysis of the cervical cancer screening program in Brazil from 2006 to 2013. Material and Methods The data necessary to calculate quality indicators were obtained from the SISCOLO, a Brazilian health system tool. Joinpoint analysis was used to calculate the annual percentage change. Results We observed important trends showing decreased rates of low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and an increased rate of rejected exams from 2009 to 2013. The index of positivity was maintained at levels below those indicated by international standards; very low frequencies of unsatisfactory cases were observed over the study period, which partially contradicts the low rate of positive cases. The number of positive cytological diagnoses was below that expected, considering that developed countries with low frequencies of cervical cancer detect more lesions annually. Conclusions The evolution of indicators from 2006 to 2013 suggests that actions must be taken to improve the effectiveness of cervical cancer control in Brazil. © 2015 Costa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Source

Rezze G.G.,Hospital AC Camargo | Fregnani J.H.T.G.,Research and Teaching Institute | Duprat J.,Hospital AC Camargo | Landman G.,Hospital AC Camargo
Human Pathology

Cutaneous melanoma is an aggressive cancer derived from skin melanocytes. Tissue microarrays are being used to evaluate the roles of numerous proteins implicated in some of the pathways involved in melanoma pathogenesis. Based on a previous study using a complementary DNA microarray platform, the aim of this study was to evaluate the immunohistochemical expression of the adhesion and communication molecules connexin 43, desmocollin 3, cytokeratin 5, kallikrein 6, and kallikrein 7 in a melanoma progression model. We analyzed 59 common nevi, 22 atypical nevi, and 162 invasive and 29 metastatic melanomas on tissue microarrays using digital microscopy. The expression of desmocollin 3 and connexin 43 was higher in melanomas (P < .001). Kallikrein 6 expression was higher in melanomas than in common nevi (P < .006). The expression of cytokeratin 5 and kallikrein 7 was higher in atypical nevi than in melanomas (P < .001) and was higher in melanomas than in common nevi (P < .001). The expression of desmocollin 3 and connexin 43 in melanomas indicates loss of cell-cell interactions, which starts in the early steps of the melanoma progression model. Keratin expression in melanomas may play a particular role during melanocyte development. The expression of kallikrein 7 and kallikrein 6 in melanomas may be responsible for the loss of cell-cell adhesion. © 2011 Elsevier Inc. Source

Bueno L.R.,Federal University of Rio Grande do Sul | Binda M.,Hospital de Clinicas de Porto Alegre | Monego H.,Hospital de Clinicas de Porto Alegre | Scherer R.L.,Federal University of Rio Grande do Sul | And 4 more authors.
International Journal of Surgery

Objective: Compare blood loss during cold knife conization of the cervix with and without lateral hemostatic sutures in the cervical branches of the uterine arteries. Design: Randomized clinical trial. Setting: Hospital de Clínicas de Porto Alegre (HCPA). Population: 102 patients that underwent cold knife conization. Methods: Women that underwent cold knife conization of the cervix were randomized to undergo the procedure with or without lateral hemostatic sutures. Main outcome measures: Primary outcome measure: blood loss measured in grams. Secondary outcome measures: operative time and postoperative intervention. Only the participants were blinded to group assignment. Results: From March 2009 to August 2012, patients were randomly assigned to one of the study groups. There were no differences in amount of blood loss between patients that underwent the procedure with and without sutures (p=0.39). Operative time was shorter in the group without suture (p=0.020). There were no differences in intervention due to bleeding (p=0.20). Blood loss was greater among menstruating women than for menopausal women (p=0.011). There were no differences in amount of blood lost between smoking and nonsmoking patients (p=0.082). Conclusions: Lateral hemostatic sutures do not affect the amount of intraoperative bleeding or the number of postoperative interventions. Their use is not necessary because they result in longer operative time, have a higher cost due to the use of suture material and pose the risk of ureter lesion in case the sutures are not placed at a lower position in the cervix. © 2015 IJS Publishing Group Limited. Source

Vazquez V.D.L.,Melanoma Sarcoma | Vazquez V.D.L.,Research and Teaching Institute | Vazquez V.D.L.,Molecular Oncology Research Center | Silva T.B.,Research and Teaching Institute | And 6 more authors.
BMC Research Notes

Background: The incidence of melanoma, one of the most aggressive of the skin cancers, has been increasing worldwide in the last few decades. Data from Latin America and Brazil remain scarce. We aimed to describe the demographic, clinical, and histopathological data; therapy characteristics; and survival rates of the Brazilian melanoma patient population. Results: We collected and analysed retrospective data from 15 years at a tertiary cancer centre. We describe patient characteristics and treatment. We calculated survival, and identified the main prognostic factors through univariate and multivariate analysis. We analysed a total of 1073 patients, with a mean age of 56.7 years. Men and women experienced similar prevalence, and 91.2% of patients had white skin. The most prevalent subtype was superficial spreading, and the most prevalent anatomic location was the trunk (32.2%), followed by the lower extremities (28%). Of all cases, 567 (52.9%) were assigned to clinical stages I and II, while 382 (32.6%) were stages III and IV. Surgery was the main treatment. Sentinel node biopsy was performed in 373 patients, with 23.8% positivity. Overall actuarial 5-year survival was 67.6%. Multivariate analysis showed that gender, serum lactate dehydrogenase (LDH) levels at diagnosis; anatomic location, TNM stage, and local recurrence were significant prognostic factors. Conclusions: Overall survival was lower than worldwide rates. The main factors influencing survival were similar to those in other populations. Local recurrence was independently associated with lower survival rates. The high prevalence of advanced cases reinforces the importance of strategies to diagnose melanomas in the early stages. There is a need for future multi-institutional prospective studies to attain a better understanding of possible socioeconomic and other influences on survival among melanoma populations in Brazil and Latin America. © 2015 Vazquez et al.; licensee BioMed Central. Source

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