835 resultados para abdominal hysterectomy


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O objetivo deste experimento foi comparar a sutura contínua e a sutura com pontos separados no fechamento da parede abdominal. Foram utilizados 48 ratos machos Wistar, submetidos a laparotomia com técnica de diérese padronizada, 24 submetidos a sutura da parede abdominal por técnica contínua e 24 com pontos separados, com fio polidioxanona. No 7º e 14º dia de pós-operatório foram submetidos a eutanásia 12 animais de cada grupo e deles retirados a camada músculo-fascial abdominal envolvendo a cicatriz operatória e dividida aleatoriamente em dois segmentos (cranial e caudal), um para ser submetido a avaliação da força de rotura mediante o uso de tensiômetro e outro para exame histológico, onde foi realizada a avaliação quantitativa de colágeno na linha de sutura. Os resultados encontrados foram analisados estatisticamente. Concluiu-se que no 7º dia de pós-operatório a parede abdominal suturada com pontos separados é mais resistente, porém sem diferenças significantes na quantidade de colágeno, do que a suturada por técnica contínua, e no 14º dia, ambas se equivalem nos dois parâmetros estudados, em ratos.

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OBJETIVO: avaliar a influência do alcoolismo crônico experimental na morfologia e biomecânica da artéria aorta de ratos. MÉTODOS:ratos Wistar foram divididos em dois grupos de 22 animais. Grupo alcoolista: os ratos receberam água com concentração crescente de etanol e ração ad libitum durante 6 meses. Grupo controle: os animais receberam água e ração ad libitum pelo mesmo período. Os animais foram sacrificados com overdose de pentobarbital e as aortas abdominais foram excisadas para realização de histologia (hematoxilina-eosina, tricrômio de Masson, Calleja, Picrosirius red), histomorfometria e avaliação biomecânica (carga máxima, alongamento na carga máxima, limite de proporcionalidade, alongamento no limite de proporcionalidade e coeficiente de rigidez). RESULTADOS: A histologia e a histomorfometria não mostraram diferenças significantes na morfologia da aorta em ambos os grupos. A avaliação biomecânica mostrou aumento do alongamento no limite de proporcionalidade no grupo alcoolista (p<0.05). CONCLUSÃO: o alcoolismo crônico experimental não provocou alterações morfológicas na parede da aorta, mas causou aumento da sua elasticidade, sem modificar as outras propriedades mecânicas avaliadas.

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OBJETIVO: Analisar a associação entre obesidade abdominal e pressão arterial elevada em adolescentes da rede pública de ensino da região metropolitana da cidade de Londrina (PR). MÉTODOS: Constituiu-se uma amostra de 656 adolescentes com idades entre dez e 13 anos. Foram realizadas análises antropométricas de massa corporal, estatura e circunferência de cintura, além da aferição da pressão arterial de repouso. Para análise e comparação dos dados, foram aplicados Mann-Whitney e o teste t de Student. Também foram analisadas as possíveis associações entre pressão arterial e circunferência de cintura por meio do teste do qui-quadrado. RESULTADOS: Foram identificadas associações entre obesidade abdominal e pressão arterial elevada em ambos os sexos (RP 2,7; IC95% 1,8-4,2). Além disso, verificou-se que, independentemente do grupo etário, a obesidade abdominal associa-se com valores mais elevados de pressão arterial. CONCLUSÕES: A obesidade abdominal está associada à ocorrência de aumento da pressão arterial em adolescentes.

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OBJETIVO: Analisar a concordância e eficiência de três valores críticos para índice de massa corporal (IMC) na indicação da obesidade abdominal e do excesso de gordura corporal em adolescentes. MÉTODOS: Análise transversal, em que participaram do estudo 807 jovens, de ambos os sexos (entre 11 e 17 anos), e foram aferidos valores de massa corporal, estatura, circunferência de cintura e gordura corporal relativa. A curva ROC analisou a eficiência dos pontos de corte para índice de massa corporal. RESULTADOS: Os três valores críticos analisados apresentaram moderada concordância na indicação da obesidade abdominal (0,54 a 0,66) e elevados valores de sensibilidade (77,4% a 92,8%) e especificidade (75,6% a 91,6%) para a indicação do estado nutricional. A proposta nacional foi mais sensível na indicação de concomitante excesso de gordura corporal e obesidade abdominal (97,8%). CONCLUSÃO: Todos os valores críticos analisados apresentaram desempenho similar na indicação do estado nutricional e da obesidade abdominal, no entanto a proposta nacional foi mais sensível na indicação de indivíduos obesos com elevado risco cardiovascular.

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Objectives. This study was undertaken to evaluate the expression of p53, Ki-67, and CD31 both in the tumor and in the vaginal margins of radical hysterectomy in patients with stage IB squamous cell carcinoma of the cervix, as an attempt to use these proteins as possible markers for residual tumor in cervical cancer.Methods. Thirty patients with stage IB squamous cell carcinoma of the cervix were submitted to radical hysterectomy (study group), and thirty patients with uterine myoma were submitted to vaginal hysterectomy (control group) and were prospectively studied from November 2001 to September 2002. Tissue samples were taken from the tumor or cervix, anterior vaginal margin (AVM), and posterior vaginal margin (PVM) and were immunohistochemically evaluated by monoclonal antibodies for p53, Ki-67, and CD31. Vaginal samples in which the histological examination showed tumor involvement were excluded from the study.Results. Patient's mean age was 48.7 +/- 10.4 years (27-73 years). The clinical stage was IB1 in 22 patients (73.3%) and IB2 in eight patients (26.7%). The expressions of p53, Ki-67, and CD31 were significantly higher in the tumor than in the benign cervix (P < 0.001). Higher expressions of these markers were noted in the vaginal margins of radical hysterectomy in patients with cervical carcinoma compared to the vaginal margins of control patients. This association was demonstrated for p53 in the AVM proximal (P = 0.045), for Ki-67 in AVM proximal (P < 0.001), AVM distal (P < 0.001), PVM proximal (P = 0.009), and PVM distal (P < 0.001), and for CD31 in AVM proximal (P = 0.003) and AVM distal (P = 0.018). There was no difference in p53, Ki-67, and CD31 expression between the proximal and distal regions of the vaginal margins in patients with carcinoma of the cervix.Conclusion. The expressions of p53, Ki-67, and CD31 were significantly higher in both the histologically positive (cervical tumor) and negative (vaginal margins) tissues of patients who had undergone radical hysterectomy for cervical cancer compared to the benign control tissues. (C) 2004 Elsevier B.V. All rights reserved.

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Objectives. The aim of this study was to investigate the feasibility of sentinel lymph node (SLN) identification using radioisotopic lymphatic mapping with technetium-99 m-labeled phytate in patients undergoing radical hysterectomy with pelvic lymphadenectomy for treatment of early cervical cancer.Methods. Between July 2001 and February 2003, 56 patients with cervical cancer 1160 stage I (it 53) or stage 11 (it 3) underwent sentinel lymph node detection with preoperative lymphoscintigraphy (Te-99m-labeled phytate injected into the uterine cervix, at 3, 6, 9, and 12 o'clock, at a dose of 55-74 MBq in a volume of 0.8 ml) and intratoperative lymphatic mapping with a handheld gamma probe, Radical hysterectomy was aborted in three cases because parametrial invasion was found intraoperatively and we performed only sentinel node resection. The remaining 53 patients underwent radical hysterectomy with complete pelvic lymphadenectomy, Sentinel nodes were detected using a handheld gamma-probe and removed for pathological assessment during the abdominal radical hysterectomy and pelvic lymphadenectomy.Results. One or more sentinel nodes were detected in 52 out of 56 eligible patients (92.8%). A total of 120 SLNs were detected by lymphoscintigraphy (mean 2.27 nodes per patient) and intraoperatively by gamma probe, Forty-four percent of SLNs were found in the external iliac area, 39% in the obturator region, 8.3% in interiliae region, and 6.7),) in the common iliac area. Unilateral sentinel nodes were found in thirty-one patients (59%). The remaining 21 patients (4100 had bilateral sentinel nodes, Microscopic nodal metastases were confirmed in 17 (32%) cases. In 10 of these patients, only SLNs had metastases. The 98 sentinel node.,, that were negative on hematoxylin and eosin were submitted to cytokeratin immunohistochemical analysis. Five (5.1%) micrometastases were identified with this technique. The sensitivity of the sentinel node was 82.3% (CI 95% - 56.6-96.2) and the negative predictive value was 92.1% (CI 95% 78.6 98.3) the accuracy of sentinel node in predicting the lymph node status was 94.2%,Conclusion. Preoperative lymphoscintigraphy and intraoperative lymphatic mapping with Tc-99-labeled phytate are effective in identifying sentinel nodes in patients undergoing radical hysterectomy and to select women in whom lymph node dissection call be avoided. (c) 2005 Elsevier B.V. All rights reserved.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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This paper reports on a rare case of fetal papyraceous mummification after asymptomatic uterine rupture in an elderly female dog with pyometra. The patient had a history of mating six months before the examination but no apparent signs of gestation or parturition. Exploratory laparotomy was used to identify a rupture of the left uterine horn and the presence of cystic endometrial hyperplasia and pyometra. Two mummified papyraceous fetuses were observed in the abdominal cavity and had adhered to the spleen, pancreas, intestine and omentum. Ovariehysterectomy and corrective surgery were performed. The patient had remained healthy after uterine rupture until a new estrous cycle and the development of pyometra. Bitches that are 10 years old or more are predisposed to implantation failure, pregnancy or parturition problems and they should not be breed to avoid complications.

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The resistance of the abdominal aorta of rats after 6, 7 and 8 weeks of malnutrition, compared with control animals, was evaluated by longitudinal tensiometry. Weakness of this vessel in malnourished rats was demonstrated; microscopic examination of the aorta stained by Masson, Calleja and hematoxylin-eosin methods showed a decrease in amorphous ground substance and an increase in the width of elastic laminae. There was no visible alteration either in the endothelial lining layer or in the smooth muscle fibers. Such alterations of the aorta are, to the authors' knowledge, the first reported modifications in the peripheral vasculature after malnutrition.

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Overwhelming helminthiasis is still a problem in endemic areas, especially in immunocompromised patients. We report a case of invasive intestinal strongyloidiasis that was clinically expressed as acute abdominal distress in a 73-year-old man from São Paulo who had been receiving methylprednisone, 20 mg/day, for one year for osteoarthritis. A surgical specimen from the ileum revealed invasive enteritis with severe infestation by Strongyloides stercoralis. The patient died of sepsis 6 days after surgery. The possibility of invasive strongyloidiasis should be considered in the differential diagnosis of acute abdominal distress in patients undergoing immunosuppressive therapy.

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It is usual to find athletes that can perform de curl up test easily, but are unable to maintain the stabilization of the low back during the double straight leg lowering (DSLL). In spite of having strong abdominal muscles, its stabilization role seems not to be effective. Thus, the purpose of this study was to verify the relation among individuals with strong abdominal muscles and the ability in perform posterior pelvic tilt (PPT); the ability to stabilize the low back during the DSLL and the eletromyographic activity of the abdominal muscles. Eighteen male subjects (aged 19.27 ± 3.5), without history of muscle skeletal dysfunction, performed both the PPT and DSLL tests. During these tests electromyographic signals of the rectus abdominis (RA), obliquus internus abdominis (01) and obliquus externus abdominis (OE) were recorded, the angle of the hip and the pressure under the low back were measured The results of analyses of variance (ANOVA) show that most volunteers accomplished the PPT test, actively flattening the low back with regular or good quality. However, none of them was able to stabilize the low back during the DSLL test. During the PPT test all abdominal muscle portions analysed were activated without significant differences. In an attempt of maintaining the lumbo-pelvic region stabilized during the DSLL, it was observed a tendency of higher bilateral activation of OE when compared to RA and 01 muscle portions between 70 and 20 degrees of hip flexion.

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This study was undertaken to evaluate the telomerase activity both in the tumor and in the vaginal margins of radical hysterectomy in patients with squamous cell carcinoma (SCC) of the cervix. Thirty-three patients with SCC of the cervix (study group) and 13 patients with uterine myoma (control group) were prospectively studied. Tissue samples were taken from the tumor or cervix, anterior vaginal margin (AVM), and posterior vaginal margin (PVM). The specimens were analyzed by histopathology, by a telomerase PCR-TRAP-ELISA kit, and by polymerase chain reaction using human papillomavirus (HPV) DNA. The telomerase activity was significantly higher in the tumor than in the benign cervix (P < 0.001). There was no difference in telomerase activity in the AVM and PVM in patients with cervical carcinoma compared to the control group. Telomerase activity was associated with the presence of histologic malignancy in the PVM of patients submitted to radical hysterectomy (P = 0.03). This association was not observed with the presence of HPV in AVM or PVM in the study group. Telomerase activity is a marker of histologic malignancy in patients with SCC of the cervix. There was no association between the telomerase activity and the presence of HPV in vaginal margins of patients submitted to radical hysterectomy. © 2006, Copyright the Authors.

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An involvement of the transient receptor potential vanilloid (TRPV) 1 channel in the regulation of body temperature (T b) has not been established decisively. To provide decisive evidence for such an involvement and determine its mechanisms were the aims of the present study. We synthesized a new TRPV1 antagonist, AMG0347 [(E)-N-(7-hydroxy-5,6,7,8-tetrahydronaphthalen-1- yl)-3-(2-(piperidin-1-yl)-6-(trifluoromethyl)pyridin-3-yl)acrylamide], and characterized it in vitro. We then found that this drug is the most potent TRPV1 antagonist known to increase T b of rats and mice and showed (by using knock-out mice) that the entire hyperthermic effect of AMG0347 is TRPV1 dependent. AMG0347-induced hyperthermia was brought about by one or both of the two major autonomic cold-defense effector mechanisms (tail-skin vasoconstriction and/or thermogenesis), but it did not involve warmth-seeking behavior. The magnitude of the hyperthermic response depended on neither T b nor tail-skin temperature at the time of AMG0347 administration, thus indicating that AMG0347-induced hyperthermia results from blockade of tonic TRPV1 activation by nonthermal factors. AMG0347 was no more effective in causing hyperthermia when administered into the brain (intracerebroventricularly) or spinal cord (intrathecally) than when given systemically (intravenously), which indicates a peripheral site of action. We then established that localized intra-abdominal desensitization of TRPV1 channels with intraperitoneal resiniferatoxin blocks the T b response to systemic AMG0347; the extent of desensitization was determined by using a comprehensive battery of functional tests. We conclude that tonic activation of TRPV1 channels in the abdominal viscera by yet unidentified nonthermal factors inhibits skin vasoconstriction and thermogenesis, thus having a suppressive effect on T b. Copyright © 2007 Society for Neuroscience.

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The objective of the present research was to investigate the ultrastructural peculiarities of the aortic wall of the rat. Seven young adult rats were used, from which fragments of the infrarenal abdominal aorta were collected. After collection, the vascular segments were fixed and sent for analysis by scanning electron microscope. The elastic lamellae appear interposed with smooth muscular fibers; this pattern was verified mainly at the medial layer structure. Among the mural elements a well defined interrelationship was established through connective lamellae of the arterial wall. The collagen lamellae mainly provided anchoring among the elastic and smooth muscular constituents. The intimal layer showed special ultrastructural features, such as a non-continuous inner elastic lamina presented in certain sites of the vascular wall, followed by endothelial pores. This mural pattern of the abdominal aorta provided support to vascular functions such as shrinkage among the laminar composition of the arterial layers, also acting in mechanical properties of the vascular wall, such as viscoelasticity and contractility - essential actions to blood vessel hemodynamics.