Mesh cancer: long-term mesh infection leading to squamous-cell carcinoma of the abdominal wall

Purpose: It is recognized that chronic inflammation can cause cancer. Even though most of the available synthetic meshes are considered non-carcinogenic, the inflammatory response to an infected mesh plays a constant aggression to the skin. Chronic mesh infection is frequently the result of misuse of mesh, and due to the challenging nature of this condition, patients usually suffer for years until the infected mesh is removed by surgical excision. Methods: We report two cases of squamous-cell carcinoma (SCC) of the abdominal wall, arising in patients with long-term mesh infection. Results: In both patients, the degeneration of mesh infection into SCC was presumably caused by the long-term inflammation secondary to infection. Patients presented with advanced SCC behaving just like the Marjolin's ulcers of burns. Radical surgical excision was the treatment of choice. The involvement of the bowel played an additional challenge in case 1, but it was possible to resect the tumor and the involved bowel and reconstruct the abdominal wall using polypropylene mesh as onlay reinforcement, in a single stage operation. He is now under adjuvant chemotherapy. The big gap in the midline after tumor resection in case 2 required mesh bridging to close the defect. The poor prognosis of case 2 who died months after the operation, and the involvement of the armpit, groin and mesenteric nodes in case 1 shows how aggressive this disease can be. Conclusion: Infected mesh must be treated early, by complete excision of the mesh. Long-standing mesh infection can degenerate into aggressive squamous-cell carcinoma of the skin. © 2013 Springer-Verlag France.

Antagonist coactivation of trunk stabilizer muscles during Pilates exercises

The purpose of this study was to compare the antagonist coactivation of the local and global trunk muscles during mat-based exercises of Skilled Modern Pilates. Twelve women performed five exercises and concurrently, surface EMG from internal oblique (OI), multifidus (MU), rectus abdominis (RA) and iliocostalis lumborum (IL) muscles was recorded bilaterally. The percentage of antagonist coactivation between local (OI/MU) and global muscles (RA/IL) was calculated. Individuals new to the practice of these exercises showed differences in coactivation of the trunk muscles between the exercises and these results were not similar bilaterally. Thus, in clinical practice, the therapist should be aware of factors such as compensation and undesirable rotation movements of the trunk. Moreover, the coactivation of global muscles was higher bilaterally in all exercises analyzed. This suggests that the exercises of Skilled Modern Pilates only should be performed after appropriate learning and correct execution of all principles, mainly the Centering Principle. © 2013 Elsevier Ltd. All rights reserved.

Morphometry and expression of MyoD and Myogenin in white and red skeletal muscles of juvenile fish Colossoma macropomum (Cuvier 1818)

Colossoma macropomum, also known as tambaqui, is an economically important fish species, and interesting new studies have been published with the aim of improving the growth of this fish. In this work, we describe the morphometric characteristics, as well as the mRNA and protein expression levels of two myogenic regulatory factors (MRFs)-myod/MyoD and myogenin/Myogenin-in the white and red muscle types of tambaqui. A high proportion of white and red muscle fibers with large diameters suggest a hypertrophic growth process in the skeletal muscle during juvenile stages. Comparisons between muscle types showed that, in red muscle, myogenin transcript levels were significantly higher than those of myod. In contrast, MyoD protein levels were significantly higher than those of Myogenin in red muscle. These results suggest that in red and white muscles of juvenile tambaqui, independent post-transcriptional mechanisms for regulating MyoD and Myogenin expression may exist, which could be differentially activated during muscle growth. Furthermore, these data also suggest that specific control mechanisms may regulate distinct muscle phenotypes. © 2013 The Royal Swedish Academy of Sciences.

Morphologic and biomechanical changes of thoracic and abdominal aorta in a rat model of cigarette smoke exposure

Background: Smoking is the most relevant environmental factor that affects the development of aortic aneurysm. Smokers have elevated levels of elastase activity in the arterial wall, which leads to weakening of the aorta. The aim of this study was to verify whether cigarette smoke exposure itself is capable of altering the aortic wall. Methods: Forty-eight Wistar rats were divided into 2-, 4-, and 6-month experimental periods and into 2 groups: smokers (submitted to smoke exposure at a rate of 40 cigarettes/day) and nonsmokers. At the end of the experimental periods, the aortas were removed and cross-sectioned to obtain histologic specimens for light microscopic and morphometric analyses. The remaining longitudinal segments were stretched to rupture and mechanical parameters were determined. Results: A degenerative process (i.e., a reduction in elastic fibers, the loss of lamellar arrangement, and a reduction of smooth muscle cells) was observed, and this effect was proportional in intensity to the period of tobacco exposure. We observed a progressive reduction in the yield point of the thoracic aorta over time (P < 0.05). There was a decrease in stiffness (P < 0.05) and in failure load (P < 0.05) at 6 months in the abdominal aorta of rats in the smoking group. Conclusions: Chronic exposure to tobacco smoke can affect the mechanical properties of the aorta and can also provoke substantial structural changes of the arterial wall. © 2013 Elsevier Inc. All rights reserved.

Implantação de biomembrana de colágeno tratada em solução alcalina ou conservada em glicerina a 98% na parede abdominal de equinos

The objective of this research was obtain collagen biomembranes treated in alkaline solution for 72 hours (GE) from tendineous diaphragmatic center of equines and compare its biocompatibility with membranes preserved in a glycerin solution 98% (GG) and membranes do not treated (GC). The membranes were implanted in the internal fascia of recto abdominis muscle of equines and removed, with adjacent tissues, seven, 63 and 126 days postoperative for the preparation of histological slides. The histomorphometric study revealed more intense inflammatory process to GG and CC implants and faster healing for GE implants. It was concluded that the collagen biomembranes treated in alkaline solution is more biocompatible than biomembranes preserved in 98% glycerin.

Intra-abdominal fat is related to metabolic syndrome and non-alcoholic fat liver disease in obese youth

Background: Previous studies have shown an association between adiposity, especially intra-abdominal adipose tissue, and hemodynamic/metabolic comorbidities in adults, however it is not clear in pediatric population. The aim of the study was to analyze the relationship between non-alcoholic fatty liver disease (NAFLD) and components of metabolic syndrome (MS) with values of intra-abdominal (IAAT) and subcutaneous (SCAT) adipose tissue in obese children and adolescents.Methods: Cross-sectional study. Subjects: 182 obese sedentary children and adolescents (aged 6 to 16 y), identified by the body mass index (BMI). Measurements: Body composition and trunk fat by dual-energy X-ray absorptiometry- DXA; lipid profile, blood pressure and pubertal stage were also assessed. NAFLD was classified as absent (0), mild (1), moderate (2) and severe (3), and intra-abdominal and subcutaneous abdominal fat thickness were identified by ultrasound. The MS was identified according to the cut offs proposed by World Health Organization adapted for children and adolescents. The chi-square test was used to compare categorical variables, and the binary logistic regression indicated the magnitude of the associations adjusted by potential cofounders (sex, age, maturation, NAFLD and HOMA-IR).Results: Higher quartile of SCAT was associated with elevated blood pressure (p = 0.015), but not associated with NAFLD (p = 0.665). Higher IAAT was positively associated with increased dyslipidemia (p = 0.001), MS (p = 0.013) and NAFLD (p = 0.005). Intermediate (p = 0.007) and highest (p = 0.001) quartile of IAAT were also associated with dyslipidemia, independently of age, sex, maturation, NAFLD and HOMA-IR (homeostatic model assessment-insulin resistance).Conclusion: Obese children and adolescents, with higher IAAT are more prone to develop MS and NAFLD than those with higher values of SCAT, independent of possible confounding variables. © 2013 Silveira et al.; licensee BioMed Central Ltd.

Energy and fat intake are not associated with abdominal adiposity

Background and objective: Central or abdominal obesity (AA) is a highly prevalent determinant of the metabolic syndrome and its control requires intervention strategies. This study investigated the risk factors associated with the presence of AA in hospitalized individuals. Patients and methods: A total of 1626patients were studied. The investigated risk factors possibly associated with AA were gender, age, body mass index (BMI), habitual energy intake (HEI) and fat intake (FI). AA was determined by waist circumference (WC) and waist-to-hip ratio (WHR). The chi2, Mann-Whitney and Kruskal-Wallis tests were used to compare the data and univariate and multiple logistic regressions were used to identify the predictive factors of AA. Results: Women were at higher risk of developing AA than men (P. <. 0.0001). The HEI and FI of individuals with and without AA and of women and men were not significantly different. According to multivariate analysis, HEI was not a predictive factor of AA, contrary to gender and age. The risk factors for AA, determined by WC, were gender (OR. = 6.8; CI. = 5.3-8.7) and age (OR. = 1.0; CI. = 1.0-1.0). Women were six times more likely to develop AA than men. Conclusions: Evidence of an association between AA and HEI or FI was not found, but gender and age were associated with AA. © 2013 Elsevier Masson SAS.

Electromyographic patterns of lower limb muscles during apprehensive gait in younger and older female adults

Objective: Investigate the influence of apprehensive gait on activation and cocontraction of lower limb muscles of younger and older female adults. Methods: Data of 17 younger (21.47±2.06 yr) and 18 older women (65.33±3.14. yr) were considered for this study. Participants walked on the treadmill at two different conditions: normal gait and apprehensive gait. The surface electromyographic signals (EMG) were recorded during both conditions on: rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), tibialis anterior (TA), gastrocnemius lateralis (GL), and soleus (SO). Results: Apprehensive gait promoted greater activation of thigh muscles than normal gait (F=5.34 and p=0.007, for significant main effect of condition; RF, p=0.002; VM, p<0.001; VL, p=0.003; and BF, p=0.001). Older adults had greater cocontraction of knee and ankle stabilizer muscles than younger women (F=4.05 and p=0.019, for significant main effect of groups; VM/BF, p=0.010; TA/GL, p=0.007; and TA/SO, p=0.002). Conclusion: Apprehensive gait promoted greater activation of thigh muscles and older adults had greater cocontraction of knee and ankle stabilizer muscles. Thus, apprehensive gait may leads to increased percentage of neuromuscular capacity, which is associated with greater cocontraction and contribute to the onset of fatigue and increased risk of falling in older people. © 2013 Elsevier Ltd.

Morfologia e estereologia do peritônio de paca conservado em solução supersaturada de açúcar a 300% ou glicerina a 98% implantados na parede abdominal de ratos

Pós-graduação em Cirurgia Veterinária - FCAV

Análise do princípio centrando do método pilates e de indicadores de resistência e estabilidade da coluna lombar

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Aneurisma da aorta abdominal infra-renal: avaliação ultra-sonográfica em homens acima de 50 anos

Pós-graduação em Bases Gerais da Cirurgia - FMB

Papel da tomografia torácica e abdominal no estadiamento do carcinoma mamário localmente avançado

Pós-graduação em Cirurgia Veterinária - FCAV

Ultrassonografia abdominal de cães e gatos hígidos, adultos e filhotes

Pós-graduação em Medicina Veterinária - FMVZ

Testes de risco cirúrgico relacionados às complicações cardiopulmonares: comparação entre a cirurgia abdominal supra-umbilical e a torácica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Pressão intra-abdominal como preditor de lesão renal aguda no pós-operatório de cirurgias abdominais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)