Perfurações esofágicas

RACIONAL: Dentre as perfurações do trato gastrointestinal, as lesões do esôfago são as de pior prognóstico. OBJETIVO: Avaliar os aspectos etiológicos, diagnósticos e terapêuticos de pacientes com perfuração esofágica atendidos no Hospital das Clínicas da Faculdade de Medicina de Botucatu - UNESP. MÉTODOS: Avaliação retrospectiva de pacientes internados no período de janeiro de 1999 a dezembro de 2006. Foram estudados 24 pacientes (18 homens e 6 mulheres) com idade média de 52 anos. Os pacientes foram divididos em dois grupos de 12. O Grupo 1 compreendia os pacientes cuja perfuração ocorreu na evolução de câncer do esôfago e o Grupo 2 os pacientes com perfuração devida a causas diversas. No Grupo 2 as causas foram: procedimento endoscópico em três casos, fundoplicatura em três, ingestão de corpo estranho em dois, balão de Blackmore em um, ingestão de antiinflamatório em um, pós-operatório de diverticulectomia em um, ferimento por arma de fogo em um. O esôfago torácico foi o local mais acometido (12 pacientes no Grupo 1 e sete no Grupo 2. em cinco pacientes do Grupo 1 foi realizada entubação transtumoral e nos demais gastrostomia ou jejunostomia. No Grupo 2, o procedimento realizado nas perfurações do esôfago torácico foi esofagectomia. RESULTADOS: A mortalidade operatória no Grupo 1 foi de 25% e no Grupo 2 de 8,33%. Conclusão - a) A lesão do esôfago cervical apresenta, em geral, evolução favorável; b) a conduta cirúrgica, mesmo quando realizado em fase não precoce (primeiras 24 horas), resulta em boa resolução.

Avaliação das silagens de capim-elefante aditivadas com nabo forrageiro, pinhão manso e tremoço, pela técnica de produção de gases

Objetivou-se, na condução deste trabalho, a avaliação das silagens de capim-elefante aditivadas com tortas de nabo forrageiro, pinhão manso e tremoço pela técnica de produção de gás. O experimento foi desenvolvido no Laboratório de Nutrição Animal do Centro de Energia Nuclear na Agricultura da Universidade de São Paulo (LANA/CENA/USP). Como doadores de líquido de rúmen, foram utilizados 2 ovinos da raça Santa Inês, machos, adultos, castrados e providos de cânula ruminal permanente. A alimentação dos animais doadores foi constituída de forragem de gramínea cultivada e uma suplementação, ao final do dia, com feno de Tifton, concentrado comercial e sal mineral à vontade. Os substratos foram secos a 60ºC, moídos em moinho do tipo Willey, provido de peneira com perfurações de 2 mm. Os gases produzidos durante os diferentes períodos de fermentação (0, 4, 8, 12, 24, 36, 48, 72 e 96 h) foram medidos com um transducer - medidor de pressão.O experimento foi instalado segundo um delineamento de blocos ao acaso em que os tratamentos foram arranjados em um esquema de parcelas subdivididas no tempo. Os maiores valores de produção de gás observados para os tratamentos em que adicionou-se torta de tremoço quando comparados com as outras tortas, decorreu do fato da torta de tremoço apresentar menor teor de fibras, propiciando assim, uma maior fermentação ruminal e, consequentemente, maior produção de gás em relação a outros alimentos com maior proporção de carboidratos estruturais (parede celular).As taxas de degradação da fração solúvel da matéria seca foi menor para NF 8% e PM 11% em relação às outras silagens estudadas. Foram encontradas diferenças significativas para as TNF, TPM e TT, nos diferentes níveis, em relação ao volume de gases em 96 h de incubação (P<0,05). As silagens contendo torta de tremoço apresentaram maior produção de gases quando comparadas Às outras tortas. em todos os tratamentos, exceto naqueles em que adicionou-se TT, houve diminuição (P<0,05) nos valores médios de degradabilidade da matéria seca às 96 horas, à medida que aumentou-se o nível de inclusão das tortas. As silagens de capim-elefante adicionadas de tortas de nabo forrageiro ou tremoço, nos diferentes níveis, apresentaram maiores taxas de degradação e maiores produções de gases que as adicionadas de torta de pinhão manso.

Avaliação radiográfica, densitométrica e histológica do uso de perfurações ósseas para o estímulo de consolidação de fraturas do terço distal do rádio de cães

To stimulate the bone callus development process from distal third of radius, 24 adult mongrel dogs used were from both sexes. These dogs were separated in two experimental groups of 12 animals each, named control and treated, divided in 4 moments (M1=15 days; M2=30 days; M3=45 days; M4=60 days), who underwent were performed surgical fractures. In treated group, it was performed bone perforations on proximal and distal edges, craniolateral and mediolateral to the fracture site. At the end of each moment, control and treated animals were evaluated by radiography, histology, and bone mineral densitometry (BMD) was determined on fracture site. According to the radiographic data of treated dogs, it was verified on days 15 and 30 more intense bone regeneration than control group. During M3 and M4, it wasn't detected any difference in bone reparation process betweencontrol and treated groups. In densitometric study, BMD values were greater in treated animals than in control dogs. Histological studies revealed at 15 and 30 days chondrocyte hyperplasia and initial endochondral ossification on drilled limbs; control group showed sustainment connective tissue and initial chondrocyte hiperplasia. At M3 and M4 of the treated group, were verified development and remodeling of periosteal callus in more advanced phases when comparing with limbs from control group. It can be concluded that using perforations enhances blood flow supply and activation of osteogenic cells on fracture site, stimulating the beginning of fracture consolidation process.

Estudo morfológico e histológico dos ovos de seis espécies do gênero Triatoma (Hemiptera: Reduviidae)

The objective of this study was to analyze the morphological and histological characteristics of eggs from six triatomine species in order to obtain a generic and specific characterization of this group of Trypanosoma cruzi vectors and better understand their phylogenetic and taxonomic aspects. The eggs of the respective species came from the collection of the Laboratório de Triatomíneos e Culicídeos da Faculdade de Saúde Pública/USP, from the Insetário do Serviço Especial de Saúde de Araraquara - SESA and from the Triatomine insectary of the Laboratório Nacional e Internacional de Referência em Taxonomia de Triatomíneos (FIOCRUZ), in Rio de Janeiro. Morphological studies were done with optical microscopy and scanning electron microscopy. Histological analyses used only optical microscopy. All of the species analyzed showed a predominance of hexagonal cells. The exchorion of Triatoma breyeri Del Ponte, T. costalimai Verano & Galvão, and T. tibiamaculata (Pinto) consists of unornamented cells, overlapping or slightly separated, with a smooth, padded appearance. Meanwhile, in T. matogrossensis Leite & Barbosa, T. sherlocki Papa, Juberg, Carcavallo, Cerqueira & Barata, and T. williami Galvão, Souza & Lima, the exchorion cells are ornamented on their entire surface with perforations and fissures. Egg histology showed undulations, pores, and orifices. The study helps to expand the generic and specific knowledge of the Triatominae subfamily. The characteristics identified in the exchorion of the eggshells can help separate close species. These new parameters will back the elaboration of future dichotomous keys, help to determine each vector species' role and expand knowledge of the various species.

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.

Integrated clinical treatment of gingival recession secondary to root perforation: case report.

Among the factors that influence the success of treatment of a root perforation, its location and possibility of contamination are determinant because the interaction of these 2 factors may result in significant periodontal injury. The management of cases of hard-to-reach contaminated perforations depends on the choice of an adequate technique. In the case reported in this article, controlled orthodontic tooth extrusion was successfully performed to treat gingival recession secondary to root perforation. The outcomes showed that this technique preserves the zone of attached gingiva, maintains the crown height, and prevents the involvement of the supporting bone tissue. The favorable clinical and radio?graphic conditions after 7 years of follow-up demonstrate the viability of this treatment approach.

Immunohistochemical, tomographic and histological study on onlay bone graft remodeling. Part II: Calvarial bone

Objectives: Little information is available on the molecular events that occur during graft incorporation over time. The calvarial bone (Cb) grafts have been reported to produce greater responses compared with other donor regions in maxillofacial reconstructions, but the scientific evidences for this are still lacking. The objectives of this study are (1) to study the morphological pattern of Cb onlay bone grafts and compare them with the biological events through immunohistochemical responses and (2) to establish the effects of perforations in maintaining the volume and bone density of the receptor bed. Material and methods: Sixty New Zealand White rabbits were submitted to Cb onlay bone grafts on the mandible. In 30 rabbits, the receptor bed was perforated (perforated group), while for the remaining animals the bed was kept intact (non-perforated group). Six animals from each group were sacrificed at 5, 7, 10, 20 and 60 days after surgery. Histological sections from the grafted area were prepared for immunohistochemical and histological analyses. Immuno-labeling was found for proteins Osteoprotegerin (OPG), receptor activator of nuclear factor-κβ ligand (RANKL), alkaline phosphatase (ALP), osteopontin (OPN), vascular endothelial growth factor (VEGF), tartrate-resistant acid phosphatase (TRAP), Type I collagen (COL I) and osteocalcin (OC). The tomography examination [computerized tomography (CT) scan] was conducted just after surgery and at the sacrifice. Results: The histological findings revealed that the perforations contributed to higher bone deposition during the initial stages at the graft-receptor bed interface, accelerating the graft incorporation process. The results of the CT scan showed lower resorption for the perforated group (P≤0.05), and both groups showed high bone density rates at 60 days. This set of evidences is corroborated by the immunohistochemical outcomes indicating that proteins associated with revascularization and osteogenesis (VEGF, OPN, TRAP and ALP) were found in higher levels in the perforated group. Conclusions: These findings indicate that the bone volume of calvarial grafts is better maintained when the receptor bed is perforated, probably resulting from more effective graft revascularization and greater bone deposition. The process of bone resorption peaked between 20 and 60 days post-operatively in both groups although significantly less in the perforated group. © 2009 John Wiley & Sons A/S.

Latin American South-South integration and cooperation: from a regional public goods perspective

Includes bibliography

Avaliação radiográfica da aplicação do polímero de mamona em falhas ósseas induzidas em equinos

It was evaluated the radiographs alteration of the castor oil bean polymer applied for the filing of induced bone fault in horses. Five animals were evaluated, subjected to a local anesthesia and sedation, proceeding to a surgical induction of a hole in the radio bone, in both members with three centimeters depth perforations. It was used a drill of eight millimeters of diameter. The right member served as a control, without filling induced holes. The holes in left radio were filled with the commercial polymer derived from the castor oil bean. We evaluated the localized swelling and radiological aspects as: the establishment of scores for bone filling, sclerosis and a morphometric analysis of the sclerosis area, in 15, 45, 90 and 180 days of lesion evolution. There was more swelling in local members whose injuries were filled with polymer from castor oil bean. By comparison, the radiographic examination showed better bone filling in the gaps of members control. We concluded that the completion of castor oil bean polymer in bone holes induced in radio of horses, delayed the bone healing, in the radiographic evaluation.

Light microscopic evaluation and scanning electron microscopic analysis of horse eyes following deep anterior lamellar keratectomy

Objective To describe the technique of deep anterior lamellar keratoplasty (DALK) with Descemet's membrane (DM) exposure in horse eyes. Also, to compare the efficacy and safety of viscodissection and big-bubble techniques for DALK. Animals studied Thirty-four ex vivo horse eyes. Procedure Deep anterior lamellar keratoplasty was performed in 34 ex vivo horse eyes. Two groups (Group V - viscodissection - 2% sodium hyaluronate; Group A - air - big-bubble) of 17 eyes were studied. Other than the substance used, the surgical technique was similar for both groups. Nonperforated eyes were submitted for light microscopic histologic evaluation and scanning electron microscopic (SEM) analysis. Results Group V - Perforations occurred in 18% of the eyes during surgery. Light microscopy revealed exposure of DM in 28% of the eyes with mean thickness of the remaining stroma being 70.4μm. Group A - Perforations occurred in 42% of the eyes. Light microscopy revealed exposure of DM in 60% of the eyes with mean thickness of the remaining stroma being 23.3μm. No significant differences in safety, efficacy and thickness of the remaining stroma (including all eyes or excluding those with DM exposure) were observed. SEM of the surgical site revealed a more even surface in those eyes with DM exposure compared to eyes with thicker remaining stroma in both groups. Conclusions We describe two DALK techniques (viscodissection and big-bubble) for use in horses. No significant differences in safety, efficacy and thickness of the remaining stroma were observed. However, a nonsignificant trend toward the big-bubble technique being more efficacious but less safe was observed. © 2012 American College of Veterinary Ophthalmologists.

Pollen morphology in Brazilian species of Codonanthe (Mart.) Hanst. and Nematanthus Schrader (Gesneriaceae)

Pollen morphology of 24 Brazilian species of Codonanthe and Nematanthus (Gesneriaceae) was investigated by means of light microscopy, scanning and transmission electron microscopy, in search of new characters that might contribute to taxonomic characterisation of the genera. The pollen grains are tricolpate or tricolporate, semitectate, reticulate, with simplicolumellate muri, sometimes with microreticulum and perforations, or duplicolumellate muri ring-shaped around lumina. The species studied were grouped into five pollen types on the basis of aperture characteristics and details of surface ornamentation. Sub-types were defined with reference to presence or absence of microreticulum and perforations around the lumina. Based on analysis of the morphology and measurements of pollen grains, we verified a close relationship among the genera, but can nevertheless discriminate their species. © 2013 Copyright Collegium Palynologicum Scandinavicum.

Citotoxicidade e genotoxicidade de cimentos endodônticos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação de solubilidade e desintegração, alteração dimensional e resistência à compressão de cimentos endodônticos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Reação histológica do periodonto, subjacente à região de furca perfurada e preenchida com diferentes materiais, em molares de ratos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência do preparo biomecânico na microdureza e selamento marginal do MTA e do polímero derivado da mamona em perfurações radiculares simuladas

Pós-graduação em Odontologia Restauradora - ICT