Care to mastectomy with axillary lymphadenectomy, lymphedema prevention: An integrative review

Objective: to examine the care provided to women affected by breast cancer and who has performed axillary lymphadenectomy. Method: integrative review conducted in the databases LILACS and PubMed between 2000 and 2012, leaving the question << What care is provided to prevent lymphedema in women who underwent lymphadenectomy? >> Resulting in 18 articles, analyzed under the following variables: author, title, methodology, year, journal, goal, prevention and control of lymphedema therapies and adherence to rehabilitation. Results: three categories are identified for rehabilitation of patient: prevention and control, therapies and adherence. Conclusion: preoperative is poorly addressed by; emphasizes the importance of home visits as part of rehabilitation, which is effective with the accession of the patient who needs information for its follow-up, no need for a guideline for this type treatment.

Analysis of renal function after on and off pump coronary artery bypass grafting

Cardiopulmonary bypass (CPB) is often associated with renal dysfunction, as measured by plasma creatinine levels and hemodialysis rates. Aim. To compare creatinine clearance (CrCl), estimated with the Cockroft and Gault formula, between patients undergoing off-pump coronary artery bypass grafting (OPCAB) versus on-pump CABG (on-CAB). Material and methods. Between April 2008 and April 2009, 119 patients underwent coronary bypass graft surgery. Fifty-eight (58) of these patients underwent OPCAB while 61 had on-CAB. Creatinine clearance, plasma creatinine levels, and clinical outcome were compared between the groups. A creatinine clearance value of 50 mL/minute was accepted as the lowest limit of normal renal function. Results. There were two hospital deaths caused by sepses after pulmonary infection. Creatinine clearance (Preoperative OPCAB 73,64±33,72 x on-CAB 75,70±34,30mL/min; discharge OPCAB 75,73±35,07 x on-CAB 79,07±34,71 mL/ min; p=0,609), and creatinine levels (Preoperative OPCAB 1,04±0,38 x on-CAB 1,13±0,53 mg/dL; discharge OPCAB 1,12±0,79 x on-CAB 1,04±0,29mg/dL; p=0,407) did not show statistically inter-group differences. Conclusion. Deterioration in renal function is associated with higher rates of postoperative complications. No significant difference in CrCl could be demonstrated between the groups.

A systematic review and meta-analysis of cohort studies of echocardiographic findings in OSA children after adenotonsilectomy

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

Probabilistic ictal EEG sources and temporal lobe epilepsy surgical outcome

Objective - For patients with medication refractory medial temporal lobe epilepsy (MTLE), surgery offers the hope of a cure. However, up to 30% of patients with MTLE continue to experience disabling seizures after surgery. The reasons why some patients do not achieve seizure freedom are poorly understood. A promising theory suggests that epileptogenic networks are broadly distributed in surgically refractory MTLE, involving regions beyond the medial temporal lobe. In this retrospective study, we aimed to investigate the distribution of epileptogenic networks in MTLE using Bayesian distributed EEG source analysis from preoperative ictal onset recordings. This analysis has the advantage of generating maps of source probability, which can be subjected to voxel-based statistical analyses.Methods - We compared 10 patients who achieved post-surgical seizure freedom with 10 patients who continued experiencing seizures after surgery. Voxel-based Wilcoxon tests were employed with correction for multiple comparisons.Results - We observed that ictal EEG source intensities were significantly more likely to occur in lateral temporal and posterior medial temporal regions in patients with continued seizures post-surgery.Conclusions - Our findings support the theory of broader spatial distribution of epileptogenic networks at seizure onset in patients with surgically refractory MTLE.

Validation of the UNESP-Botucatu unidimensional composite pain scale for assessing postoperative pain in cattle

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

Avaliação da eficácia da analgesia com acupuntura pela análise imuno-histoquimica da expressão de proteína C-Fos: estudo em modelo experimental de dor aguda em ratos

The behavior and experience of pain are characterized by alertness and anxiety, which disappear soon after the healing process begins. Based on this area, the present study aimed to quantify the expression of c-fos in segments of the brain of rats after surgical stimulation in one rear hind paw (analgesia), using anesthesia with sodium thiopental and practices of acupuncture pre and post operative. The animals were stimulated with intraperitoneal injections of solution (NaCl) 0.2% (2ml), and divided into three groups, control, preoperative and postoperative. Each treatment was divided in manual acupuncture (AM) and electroacupuncture (EA). The animals were randomly distributed in each group. The c-fos expression was quantitated using immunohistochemistry for all situations. The results showed a great efficiency of all treatment compared to the control group (p <0.001), thus reenforcing data in the literature on the potential of acupuncture analgesia. There were no statistical differences among the different treatments, although there was a trend of EA being more efficient than AM

Mensuração e análise do ph salivar em pacientes com hiperidrose submetidos a cirurgia de simpatectomia videotoracoscópica

The study was performed to verify if there are changes in salivary pH in patients with hyperhidrosis who were treated by Videothoracoscopic Sympathectomy. Twelve patients underwent sympathectomy with clamping the sympathetic chain along the vertebrae T2, T3 and T4, under inhalation and intravenous general anesthesia and with drainage of pneumothorax through probe N° 16. These patients had their saliva collected 1 day before and 7 days after surgery for measurement of pH by the colorimetric method with indicator paper. All patients showed no sign or symptom of hyperhidrosis in the immediate postoperative period, which demonstrates the success of sympathetic denervation on these levels. No patient had compensatory sweating and there was no post-operatively surgical complication. No drug or substance has been administered to patients for the study. The pH results obtained were analyzed using test ´´t´´ Student. Although the average pH in samples obtained after surgery was lower than the preoperative, the test revealed no statistically significant difference (p = 0.181). It is concluded that sympathectomy, an excellent therapeutic and definitive method for hyperhidrosis, does not alter the salivary pH, and so, did not influence the cariogenic process

Administração transmucosa oral de analgésicos: eficácia pós-operatória em cadelas

Pós-graduação em Cirurgia Veterinária - FCAV

Efeito do 1,3/1,6 beta-glucano no sistema imune de cadelas submetidas a ovário-histerectomia

Pós-graduação em Medicina Veterinária - FCAV

Achados clínicos, hemodinâmicos e hemogasométricos da infusão contínua de propofol associado ou não ao tramadol em ovelhas submetidas à videolaparoscopia

Pós-graduação em Cirurgia Veterinária - FCAV

Salivary and serum proteomics in head and neck carcinomas before and after surgery and radiotherapy

Several body fluids have been evaluated as new sources for cancer biomarker discovery. In this context, salivary and serum proteomics seem promising diagnostic and predictive tools for head and neck diseases. In the present study, we performed a proteomic analysis of saliva and serum from patients presenting head and neck squamous cell carcinoma (HNSCC) and compared the results before and after therapy. In saliva of cancer patients, we observed an altered protein profile, including over-expression of PLUNC and zinc-alpha-2-glycoprotein. Both proteins may contribute to control tumor growth and, therefore, represent targets for new analysis. We also detected serotransferrin and a modified transthyretin form with altered levels in serum from patients. Comparing preoperative and postreatment samples, the results showed that the protein profile after treatment reverted to a pattern closer to those observed for controls. These results add information on the role of secreted proteins in the cancer process and emphasize the potential of saliva and serum analysis for diagnosis and monitoring of HNSCC.

Prevalência de alterações sistêmicas em pacientes atendidos na disciplina de cirurgia e traumatologia bucomaxilofacial do curso de Odontologia da UNIARA

Introduction: pre-operative assessment is of fundamental importance for the prevention of transoperative and of postoperative complications. Objective: to identify the prevalence of diseases and systemic conditions in patients undergoing surgical treatment in the discipline of surgery and Traumatology of University Center of Araraquara, in the period of 2004 to 2009. Material and method: for the development of this study, a survey in medical records of patients was performed and the factors considered included: age, sex, presence of vices, and systemic conditions that affect the world’s population. The data obtained were analyzed quantitatively and recorded in a table. Result:  Considering all patient records analyzed (693), 340 affirmative responses were detected (49,06%) to one or more diseases. Cardiovascular diseases were the most prevalent (22,34%). Considering the prevalence of diseases related to age, the age of less than 20 years represented 16,32%; of 20-29 years, 43,06%; 30-39 years, 45,16%; 40-44 years, 48,64%; 45-49 years, 56,25%; 50-54 years, 58,33%; 55-59 years, 57,74%; 60-64 years, 70,37%; 65-69 years, 66,66%; and 70 years or more, 68,75%. Conclusion: diseases and systemic alterations with higher prevalence were cardiovascular diseases, anemia, sinusitis and diabetes. The frequency of affirmative answers to systemic conditions was age-dependent and there was a predominance of females. The tobacco addiction was the most frequent. Thus, it was found that the preoperative assessment of the health of patients who will undergo surgical dental treatment is of fundamental importance.

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Reabilitação do assoalho pélvico em pacientes com incontinência urinária pós prostatectomia radical

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

Cutaneous sensibility impairmentafter mandibular sagittal split osteotomy: a prospective clinical study of the spontaneous recovery

Purpose The aim of this prospective study was to objectively evaluate the inferior alveolar nerve (IAN) sensory disturbances in patients who underwent sagittal split ramus osteotomy (SSRO) and its spontaneous recovery and to define the incidence of sensibility loss, time, and area at which the recovery occurs. Patients and Methods Clinical evaluation of the IAN sensory disturbance was undertaken preoperatively and at the first week, fourth week, 2 months, and 6 months postoperatively in 30 patients who underwent SSRO at the Oral and Maxillofacial Surgery Division of the Araraquara Dental School--Unesp and at the Plastic Surgery Division of the Medical Sciences School--Unicamp. The 30 patients were examined at all periods regarding the IAN functionality by Semmes-Weinstein testing. Results The mean age of the patients included in this study was 29.36 years old. All patients showed sensibility loss at the 7-day evaluation time. The comparison between sides, gender, and age did not show any significant difference. In most of the examined zone, the data collected at 6 months were statistically similar to the data collected at the preoperative period. All zones presented significant recovery, starting from 30 days after surgery. Twenty patients had total spontaneous recovery at the final period, in all examined zones. Conclusions The SSRO presents the disadvantage of temporary paresthesia; however, spontaneous nerve function recovery does occur. The Semmes-Weinstein test is a reliable, inexpensive, and easy-to-apply tool, which can be used for clinical evaluation on a daily basis at offices and hospitals.