Análise das vantagens de duas técnicas anestésicas - Venosa e inalatória - Para colecistectomia por videolaparoscopia

Background and Objectives - It is essential to reduce health care costs without impairing the quality of care. Propofol is associated to faster recovery and it is known that post-anesthesia care unit (PACU) costs are high. The aim of this study was to evaluate the advantages of two anesthesia regimens - propofol continuous infusion or isoflurane - taking into account the cost of both techniques on PACU stay. Methods - Forty seven patients, physical status ASA I, II and III, undergoing laparoscopic cholecystectomy were divided into 2 groups according to the anesthetic agent: G1, conventional propofol continuous infusion (100-150 μg.kg-1.min-1) and G2, isoflurane. All patients were induced with sufentanil (1 μg.kg-1) and propofol (2 mg.kg-1) and were kept in a re-inhalation circuit (2 L.min-1 of fresh gas flow) with 50% N2O in O2, sufentanil (0.01 μg.kg-1.min-1) and atracurium (0.5 mg.kg-1), or pancuronium (0.1 mg.kg-1) for asthma patients. All patients received atropine and neostigmine at the end of the surgery. Prophylactic ondansetron, dipyrone and tenoxican were administered and, when necessary, tramadol and N-butylscopolamine. Costs of anesthetic drugs (COST), total PACU stay (t-PACU), and PACU stay after extubation (t-EXT) were computed for both groups. Results - Costs were significantly lower in the isoflurane group but t-PACU was 26 minutes longer and t-EXT G1

Abordagem diagnóstica dos pacientes com suspeita de trombose venosa profunda dos membros inferiores

Deep venous thrombosis is a relatively common disease, which can present pulmonary embolism as a complication in its acute phase, and later the post-thrombotic syndrome. Thus, diagnosis should be made as soon as possible, in order to prevent or minimize such complications. Several studies have shown that the symptoms and the clinical signs are inaccurate for the deep venous thrombosis diagnosis and that complementary exams are necessary. As an attempt to simplify the patients' assessment, Well et al., in 1997, developed a clinical prediction index that combines symptoms, signs and risk factors for deep venous thrombosis and managed to make a simpler approach through an association of this index with the complementary exams. Phlebography has been considered the gold standard of complementary exams. However, since it is an invasive exam and thus subject to complications, other diagnostic methods were introduced aiming at making the diagnostic approach simpler and less invasive. Doppler ultrasound, duplex scan, impedance plethysmography, computed tomography, and blood tests such as the D-dimer are some of the available methods for assessing the patient with suspicion of deep venous thrombosis. Among them, duplex scan has shown excellent accuracy and it is currently widely accepted as the first choice test for approaching the patient with deep venous thrombosis. Several authors have suggested an association of diagnostic methods to simplify and make the assessment of such patients more cost-effective, leading to the introduction of a wide range of diagnostic strategies. The different diagnostic methods used for assessing deep venous thrombosis are discussed, as well as a review of the literature on the accuracy, advantages and disadvantages of these methods. Copyright © 2005 by Sociedade Brasileira de Angiologia e Cirurgia Vascular.

Vascularização arterial e venosa do linfonodo poplíteo em cães

Poplíteo lympho nodes in the dogs is placed, to the right and the left in popliteo an appointed space fossa, in distal part of the muscles femoral biceps, laterally and semi-tendinous, medially, projecting in the height of the face volume of the joint to femoro tibial e femoro patellar (joint of the knee). In this study twenty and five dogs, males and females adult, originating the Araçatuba municipal kennel had been used whose captures had been effected by the animal sanitary defense of this city. The arterial vessels destined to this structure always derive, of both the sides, the femoral artery distal volume and vary of 10 the 1, more frequently of 2 (7 times, 28%) to the right and of 6 the 2, equally more frequently of 2 (8 times, 32%). So soon as one has still to right 5 and 6 branches (3 times, 12%), 1, 7 and 10 (1 time, 4%). Relatively to the veins derived from this lympho nodes, always converges to the lateral safena vein, these vessels oscillates between 9 and 2, more frequently of 3 (6 times, 24%), to the right and of 12 the 2, more frequently of 3 (10 times, 40%) to the left. Thus, others deriving branches of popliteo lympho nodes right and that if they insert in the above-mentioned vein are in number of 2 and 5 (5 times, 20%), 4 and 6 (2 times, 8%) and 8 and 9 (1 time, 4%). In spite of, to the left side it is examined in number de 2 branches (6 times, 24%), 4 (4 times, 16%), 6 (3 times, 12%) and finishing 9 and 12 branches (1 time, 4%). The size of popliteo lympho node in seropositive dogs for Visceral Leishmaniasis can meets enters 7,8 × 3,8 × 6,1 a 50,0 × 20,7 × 28,5, in mm, being average 26,18 × 10,5 × 15,97 mm for right and 26,98 × 11,14 × 15,25 mm for left (concerning the measures dorsoventral, latero-lateral and cranial-caudal, respectively).

Frugivorous flies (diptera: Tephritidae and lonchaeidae) and native parasitoids (hymenoptera) associated with pouteria caimito (sapotaceae) in Brazil

This study presents new reports on frugivorous flies and their parasitoids associated with the fruits of Pouteria caimito Radlk. (Sapotaceae), a plant native to the Amazon region. In addition to the new reports, this study also presents the infestation and parasitism rates, for dipterous and hymenopteran parasitoids, respectively.

Espectros Clínicos da Trombose Venosa Cerebral

Introduction. Cerebral Venous Thrombosis has a highly variable clinical presentation. Four major syndromes had been described in patients with cerebral venous thrombosis: isolated intracranial hypertension, focal neurological deficits, focal or generalized seizures and disturbances of consciousness and cognitive dysfunction. Method. We describe five consecutive patients admitted to our service with a diagnosis of cerebral venous thrombosis, highlighting the different possibilities of clinical presentation and prognosis. Discussion. The diagnosis of cerebral venous thrombosis should be considered in patients with acute, subacute or chronic headache, with or without signs of intracranial hypertension or focal deficits, even in the absence of cerebrovascular risk factors. Treatment should be started as soon as the diagnosis is confirmed and consists of reversal of the underlying cause when known, control of seizures and intracranial hypertension, and antithrombotic therapy.

Dosagem de NGAL no perioperatório de cirurgia bariátrica videolaparoscópica: comparação de Anestesia Venosa Total (TIVA) versus Sevoflurano

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Associação de doses baixas de heparina não fracionada e de heparina de baixo peso molecular na prevenção de trombose venosa experimental

Pós-graduação em Bases Gerais da Cirurgia - FMB

Estudo comparativo de gel de palquetas home made versus hidrocolóide no processo de cicatrização de úlcera crônicas de etiologia venosa

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Trombose venosa profunda aguda: avaliação prospectiva do início do processo de revanalização das veias dos membros inferiores pelo mapeamento dúplex em cores

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Caracterização venosa central em crianças internadas em Unidades de Terapia Intensiva pediátrica

Pós-graduação em Pediatria - FMB

Diagnóstico da trombose venosa profunda dos membros inferiores, utilizando o modelo clínico de Wells et al. (2003), Dímero-D, Mapeamento Dúplex e avaliação da Proteina C Reativa

Pós-graduação em Bases Gerais da Cirurgia - FMB

Ensaio clínico randonizado e duplo cego de curatios bioativos: cola de fibrina versus gel de papaína® no processo de cicatrização de úlceras crônicas de etiologia venosa

Pós-graduação em Bases Gerais da Cirurgia - FMB

Trombose venosa profunda dos membros inferiores em crianças e adolescentes tratados em um único centro no Brasil: epidemiologia e evolução

Pós-graduação em Bases Gerais da Cirurgia - FMB

Avaliação clínica e ultrassonografia tardia de pacientes com trombose venosa profunda, portadores de trombofilia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Prevalência de trombose venosa profunda e embolia pulmonar em tromboflebite superficial de membros inferiores

Pós-graduação em Bases Gerais da Cirurgia - FMB