Anestesia para colecistectomía videolaparoscópica en paciente portador de enfermedad de Steinert. Relato de caso y revisiõn de la literatura

BACKGROUND AND OBJECTIVES: Myotonic dystrophies are autosomal dominant neuromuscular diseases. Among them, myotonic dystrophy type 1 (MD1), or Steinert disease, is the most common in adults, and besides muscular involvement it also has important systemic manifestations. Myotonic dystrophy type 1 poses a challenge to the anesthesiologist. Those patients are more sensitive to anesthetics and prone to cardiac and pulmonary complications. Besides, the possibility of developing malignant hyperthermia and myotonic episodes is also present. CASE REPORT: This is a 39-year old patient with DM1 who underwent general anesthesia for videolaparoscopic cholecystectomy. Total intravenous anesthesia with propofol, remifentanil, and rocuronium was the technique chosen. Intercurrences were not observed in the 90-minute surgical procedure, but after extubation, the patient developed respiratory failure and myotonia, which made tracheal intubation impossible. A laryngeal mask was used, allowing adequate oxygenation, and mechanical ventilation was maintained until full recovery of the respiratory function. The patient did not develop further complications. CONCLUSIONS: Myotonic dystrophy type 1 presents several particularities to the anesthesiologist. Detailed knowledge of its systemic involvement along with the differentiated action of anesthetic drugs in those patients will provide safer anesthetic-surgical procedure.

Avaliação de métodos de escarificação na superação de dormência de chizolobium parahyba (vell.) blake (Fabaceae: caesalpinioideae)

Dormancy caused by the tegument's impermeability to water is a feature of Schizolobium parahyba seeds. So that the best methodology for overcoming the species's dormancy may be determined, the seeds were submitted to mechanical scarification treatments, using sandpaper and scissors, on the opposite side of the hilum. Chemical scarification was also undertaken with sulfuric (H2SO4) and hydrochloric (HCl) acids for 30 minutes. Seeds were distributed in groups of 25 units in four petri plates. The experiment was undertaken in a BOD germination chamber at 25°C and 120 μmol.m^-2.s^-1. Data were used to calculate the germination capacity (G%), the Germination Velocity Index (IVG) and Mean Germination Time (TM). Imbibation curve was also calculated to analyze the dormancy type of the seeds by using the three-phase model where phase FI was completed in 6 hours and FIII was initiated after 12 hours of imbibation. Results show that whereas pre-germinative treatments trigger S. parahyba germination, mechanical scarification is the most effective method to overcome the species's dormancy.

Review of the efficacy and safety of cryoablation for the treatment of small renal masses

Purpose: Small renal masses are increasingly being discovered incidentally on imaging for another reason. The standard of care of these masses involves excision by open or laparoscopic techniques. Recently, ablative techniques, such as radiofrequency ablation (RFA) and cryoablation, have taken a more prominent role in the treatment algorithm of these masses. We evaluate the effectiveness and safety of cryoablation to treat renal tumours. Methods: A review of the literature was conducted. There was no language restriction. Studies were obtained from the following sources: the Cochrane Library, PUBMED, EMBASE and LILACS. Results: There was no clinical trial identified in the literature. Thus, we described the results from 23 case series and retrospective studies with a reasonable sample size (number of reported patients in each study ≥30), with a total of 2104 analyzed tumours from 2038 patients. There was wide variability in the outcomes reported, but success rates were generally good. Follow-up was generally short, but some series reported outcomes at 5 years. The most common complications reported were hemorrhage (some of the patients requiring transfusion), perinephric hematoma and urine leaks. Conclusion: Cryoablation presents a feasible treatment for patients with small renal masses. Only short-term data are available and, as such, meaningful conclusions regarding long-term cancer control cannot be made. More rigorous studies are needed. © 2013 Canadian Urological Association.

Estudo das alterações funcionais respiratórias em pacientes submetidos à colecistectomia videolaparoscópica

Pós-graduação em Bases Gerais da Cirurgia - FMB

Estudo das alterações funcionais respiratórias em pacientes dubmetidos à cirurgia videolaparoscópica de válvula anti-refluxo

Pós-graduação em Bases Gerais da Cirurgia - FMB

Avaliação funcional do esfíncter inferior do esôfago nos períodos pré e pós-operatório de fundoplicatura total: estudo comparativo de duas técnicas de abordagem - laparotômica e laparoscópica

Pós-graduação em Bases Gerais da Cirurgia - FMB

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)

Curva de aprendizado da ovariohisterectomia video-assistida e da miniceliotomia associada à técnica do gancho de snook em gatas (Felis catus, Linnaeus, 1758)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Biópsia hepática guiada por videolaparoscopia em caprinos

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

Avaliação da reatividade peritoneal de equinos submetidos à enterotomia de cólon menor e tratados com heparina pela via subcutânea

Pós-graduação em Medicina Veterinária - FMVZ

Um estudo de fractais geométricos na formação de professores de matemática

Pós-graduação em Educação Matemática - IGCE

Avaliação das alterações funcionais e histológicas na isquemia renal, comparando-se duas técnicas de hipotermia: estudo experimental em suínos

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

Internamento não planejado após cirurgia ambulatorial: estudo retrospectivo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Maturação in vitro de oócitos de ovelhas Santa Inês submetidas a sucessivas sessões de aspiração folicular por videolaparoscopia

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