Pure-transvaginal natural orifice transluminal endoscopic surgery (NOTES) ovariohysterectomy in bitches: a preliminary feasibility study

Cirurgia endoscópica por orifícios naturais (NOTES) constitui um acesso cirúrgico relativamente novo para abordagem minimamente invasiva, a qual vem sendo amplamente estudada na medicina humana. Porém, poucos estudos envolvendo sua aplicação na prática cirúrgica de pequenos animais foram realizados até o momento. O objetivo do presente estudo foi avaliar a factibilidade da ovário-histerectomia transvaginal por NOTES pura em cadelas. Cinco cadelas foram avaliadas. A cavidade abdominal foi acessada por um trocarte de 11mm introduzido por uma incisão vaginal. Empregando-se um endoscópio rígido com canal de trabalho, os pedículos ovarianos foram coagulados e seccionados usando-se diatermia bipolar. O corno uterino foi tracionado para o interior do trocarte e exteriorizado juntamente com a cânula. O corpo e vasos uterinos foram coagulados ou ligados com sutura. O coto uterino foi reposicionado na cavidade abdominal e o pneumoperitônio, drenado. O procedimento foi realizado com sucesso em quatro das cinco cadelas. Na primeira tentativa, houve conversão para uma técnica de NOTES-híbrida, devido à quebra de uma pinça de coagulação. O tempo cirúrgico médio foi 52,1 (DP±11,5 minutos) para a técnica de NOTES pura. A OHE por NOTES pura é factível em cadelas, sem resultar em complicações maiores e proporcionando excelente recuperação pós-operatória.

Validation of hysteroscopic view in cases of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding

STUDY OBJECTIVE: To validate hysteroscopic view with histology in cases of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding (AUB)DESIGN: Retrospective study.(Canadian Task Force classification II-3).SETTING: University teaching hospitals in Rio de Janeiro and São Paulo, and private office in Rio de Janeiro.PATIENTS: Four thousand and fifty-four patients with AUB in whom hysteroscopic views were complete and the histologic result was conclusive.INTERVENTION: Four thousand and fifty-four office hysteroscopies with complete views and conclusive histologic results. The material for histologic examination was obtained through biopsy of the lesion in an outpatient unit or through the resection of the entire lesion in patients who underwent surgery. Histology was considered the gold standard and compared with the hysteroscopic view.MEASUREMENTS AND MAIN RESULTS: In the histology of the 4054 examinations, 613 (15.2%) were endometrial hyperplasia, and 105 (2.6%) were endometrial cancer. The most frequent hysteroscopic finding was endometrial polyps (31.2%). In endometrial hyperplasia, the sensitivity of the hysteroscopic view was 56.3% (95% CI 52.21-60.2%), specificity was 89.1% (95% CI 88.0%-90.1%), positive predictive value (PPV) was 48.0% (95% CI 44.3%-51.7%), negative predictive value (NPV) was 92.0% (95% Cl 90.1%-92.9%), and accuracy was 72.7% (95% CI 70.7%-74.7%). Accuracy was defined as the proportion of correct results among the hysteroscopic examinations. In endometrial cancer, the sensitivity of the hysteroscopic view was 80.0% (95% Cl 71.1%-87.2%), specificity was 99.5% (95% CI 99.2%-99.7%), PPV was 81.5% (95% Cl 72.7%-88.5%), NPV was 99.5% (95% CI 99.2%-99.7%), and accuracy was 89.8% (95% CI, 85.9%-93.6%). In the 814 patients (20.0%) in whom the hysteroscopic view was normal, there were no false negatives for endometrial cancer; however, there were 37 (4.5%) false negatives for endometrial hyperplasia. In the histologic cases of endometrial cancer, 101 (96.2%) hysteroscopic views were compatible with cancer or hyperplasia (80.0% and 16.2%, respectively). Ninety-seven out of 103 hysteroscopic views with cancer findings (94.2%) had histologic diagnosis of cancer or hyperplasia (81.5% and 12.6%, respectively).CONCLUSION: It seems that even in face of good validity of hysteroscopic view for endometrial hyperplasia and cancer, histologic study is mandatory in the presence of any lesion as the hysteroscopic view cannot completely replace the histologic study in patients with AUB. (C) 2006 AAGL. All rights reserved.

Cutting characteristics of dental diamond burs made with CVD technology

The aim of this study was to determine the cutting ability of chemical vapor deposition (CVD) diamond burs coupled to an ultrasonic dental unit handpiece for minimally invasive cavity preparation. One standard cavity was prepared on the mesial and distal surfaces of 40 extracted human third molars either with cylindrical or with spherical CVD burs. The cutting ability was compared regarding type of substrate (enamel and dentin) and direction of handpiece motion. The morphological characteristics, width and depth of the cavities were analyzed and measured using scanning electron micrographs. Statistical analysis using the Kruskal-Wallis test (p < 0.05) revealed that the width and depth of the cavities were significantly greater when they were prepared on dentin. Wider cavities were prepared when the cylindrical CVD bur was used, and deeper cavities resulted from preparation with the spherical CVD bur. The direction of handpiece motion did not influence the size of the cavities, and the CVD burs produced precise and conservative cutting.

Comparative Analysis of 2 Techniques of Double-Gloving Protection During Arch Bar Placement for Intermaxillary Fixation

Purpose: This study was conducted to comparatively evaluate, in a prospective and randomized manner, 2 techniques for providing double-gloving protection during arch bar placement for intermaxillary fixation. Materials and Methods: A total of 42 consecutive patients in whom application of an Erich bar was indicated for intermaxillary fixation were equally divided into 2 groups. In group 1, 2 sterile surgical gloves were used; in group 2, a nonsterile disposable inner glove was used under a sterile surgical glove. Wilcoxon, Mann-Whitney, Kruskal-Wallis, and binomial statistical tests were used to analyze the findings. Results: A total of 103 perforations were found in the outer gloves (47 in group 1 and 56 in group 2), along with 5 perforations in inner gloves in both groups (α = .01). No significant statistical difference was found between groups in terms of inner glove perforations (α = .05). The nondominant hand presented with 70.9% of the perforations, statistically significant to 1%. Conclusions: Both double-gloving techniques were found to provide effective clinician protection. The use of a nonsterile disposable glove under the surgical glove is possible for less-invasive procedures, offering the same safety as using 2 sterile surgical gloves while decreasing operational costs. This method does not eliminate the need to change gloves when a perforation is suspected or noted during the surgery, however. © 2007 American Association of Oral and Maxillofacial Surgeons.

Overdenture as a restorative option for hypocalcified-hypoplastic amelogenesis imperfecta: a case report.

AIM: The aim of this report is to describe the restorative treatment of an 18-year-old patient diagnosed with autosomal recessive hypocalcified-hypoplastic amelogenesis imperfecta (AI). BACKGROUND: Esthetic and functional rehabilitations in AI cases are challenging and should consider individual aspects, such as age, socioeconomic status, AI type, and intraoral condition. REPORT: AI was diagnosed in an 18-year-old patient. SUMMARY: Considering the short length of crowns and roots, patient life expectancy, minimal invasiveness, amount of treatment time required, and lower costs, oral rehabilitation with overdentures provided an adequate functional and esthetic rehabilitation of the patient. CLINICAL SIGNIFICANCE: This report demonstrated overdentures to be a viable, relatively inexpensive, and non-invasive treatment choice of a patient with AI with concerns about treatment longevity, invasiveness, cost, esthetics, and long-term maintenance.

Arthrocentesis procedure: Using this therapeutic maneuver for TMJ closed lock management

Temporomandibular joint (TMJ) disorder is a term that encompasses a number of overlapping conditions, such as closed lock. Closed lock of the TMJ is considered a consequence of a nonreducing deformed disc acting as an obstacle to the sliding condylar head that usually causes a decrease in the maximum mouth opening and acute pain. The management of the TMJ is still controversial. Thus, arthrocentesis of the TMJ is a valuable modification of the traditional method of arthroscopic lavage, which consists of washing the joint in order to remove chemical inflammatory mediators and intra-articular adhesions, changing intra-articular pressure. TMJ disorder has always presented as a therapeutic challenge to maxillofacial surgeons. Therefore, this paper aimed to describe a clinical report of a closed lock of the left TMJ in a 19-year-old female subject who was successfully treated by arthrocentesis procedure. © 2013 by Mutaz B. Habal, MD.

Comparison of inflammatory cytokine profiles in plasma of patients undergoing otorhinological surgery with propofol or isoflurane anesthesia

Objective and design: The effects of anesthetics on cytokine release in patients without comorbidities who undergo minor surgery are not well defined. We compared inflammatory cytokine profiles in adult patients undergoing minimally invasive surgery who received isoflurane or propofol anesthesia. Methods: Thirty-four patients without comorbidities undergoing minor surgery were randomly assigned to receive an inhaled anesthetic (isoflurane; n = 16) or an intravenous anesthetic (propofol; n = 18). Blood samples were drawn before premedication and anesthesia (T1), 120 min after anesthesia induction (T2), and on the first post-operative day (T3). Plasma concentrations of interleukins (IL-) 1β, 6, 8, 10 and 12 and tumor necrosis factor (TNF)-α were measured using flow cytometry. Results: The pro-inflammatory cytokine IL-6 was increased in the isoflurane group at T2 and T3 compared to T1 (P < 0.01). In the propofol group, IL-6 and IL-8 were significantly increased at T3 compared to T1. However, there were no significant differences in cytokine concentrations between the isoflurane and propofol groups. Conclusion: An inflammatory response occurred earlier in patients who received an inhaled agent compared with an intravenous anesthetic, but no differences in plasma cytokine profiles were evident between isoflurane and propofol anesthesia in patients without comorbidities undergoing minimally invasive surgeries. © 2013 Springer Basel.

Estudo das alterações funcionais respiratórias em pacientes submetidos à colecistectomia videolaparoscópica

Pós-graduação em Bases Gerais da Cirurgia - FMB

Pesquisa e desenvolvimento de microesferas de poli(vinil álcool) com alta cristalinidade para utilização em embolização e quimioembolização

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Síntese e caracterização de partículas de poli(álcool vinílico) utilizadas em aplicações biomédicas: contribuição da análise fractal e entropia de Shannon

Pós-graduação em Biofísica Molecular - IBILCE

Avaliação e comparação da dor e da resposta inflamatória pós-cirúrgica em cadelas submetidas à ovário-histerectomia laparoscópica com único portal; realizada com pinça bipolar com corte e coagulação simultâneos ou por miniceliotomia com ganho de Snook

Pós-graduação em Cirurgia Veterinária - FCAV

Técnicas de ovariectomias por videolaparoscopia em ovelhas da raça Santa Inês

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação da eficácia analgésica da farmacopuntura com meloxicam e da aquapuntura preemptivas em gatas submetidas à ovariosalpingohisterectomia (OSH)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Perfil de citocinas inflamatórias em indivíduos submetidos a procedimentos cirúrgicos utilizando propofol ou isoflurano

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Função renal após colecistectomia por laparoscopia e analgesia com tramadol e dipirona ou cetorolaco

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)