Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFα, IL-1β, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNFα, IL-1β and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFα, IL-1β and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO2 pneumoperitoneum reduced the inflammatory response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals

Fatores críticos de sucesso das empresas familiares: uma abordagem competitiva

The present objective study to inside identify the critical factors of success of the local family companies of a competitive boarding. For in such a way the same it understands the culture and the management of the family companies of success, identifies the essential areas of performance, it establishes the restrictive factors of the success, and analyzes the level of influence of the critical factors of success in the competitiveness of this type of company. In function of the subject little to be explored, and of this study to provide a general vision concerning the factors that take the family companies to get success, this research is explorer. On the other hand, for describing characteristic of the familiar companies in prominence in the local scene and for being worried about the practical performance, the same one also is descriptive. The sample in turn is the not-probabilist one of the intentional type, for accessibility. For operacionalization of the collection of data, the direct contact was used, being the composed instrument of research for variable as management, culture, critical factors of success and competitiveness. The study it evidences that in regards to the management and the culture of the family companies of success, some variable are turned aside from the standard of the conventional family companies cited by literature. Of general form in the familiar companies of success it has a bigger level of professionalization of the management. As for the value given to the knowledge, the study sample that the conventional family companies give little importance to it, in contrast of the family companies in prominence, who value of significant form the search for the knowledge. He is demonstrated despite the family companies of success, even so total are not professionalized, possess a bigger level of professionalization of the management, ratifying of certain forms the reason for which the majority develops the Strategical Planning formal periodically. In short, the results point 17 critical factors of success with respect to the family companies, in special factors as the product quality and services, and the use of the technology