962 resultados para surgical anatomy


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In this clinical study, we proposed to observe the efficacy of the treatment of squamous cell carcinoma of the tongue (SCCT) by carbon dioxide (CO2) laser surgery. Twelve patients with SCCT were treated with excisional surgery using the CO2 laser with a spot size of 0.8 mm, 10 W, power density of 2.5 W/cm(2) in continuous mode, and under constant vacuum removal of the plume. The post surgical clinical evaluations were done every day until the sutures were removed and then every 7 days up to 1 month postoperatively. Subjects were re-examined quarterly until the fifth year post surgery. After 5 yr of follow-up for all subjects, there was no recurrence of the SCCT at the involved sites. The functional and aesthetic results observed were excellent. It is concluded that CO2 laser ablation of SCCT is an extremely useful surgical technique that can provide a clean field and is capable of providing surgical results consistent with accepted principles of oncological surgery. (C) 2012 Laser Institute of America.

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Objective: To evaluate the effect of periodontal therapy on clinical parameters as well as on total salivary peroxidase (TSP) activity and myeloperoxidase (MPO) activity in the gingival crevicular fluid (GCF) of patients with type 2 diabetes mellitus (DM2) and of systemically healthy individuals.Material and Methods: Twenty DM2 subjects with inadequate metabolic control (test group) and 20 systemically healthy individuals (control group), both groups with chronic periodontitis, were enrolled. Periodontal clinical parameters, namely periodontal probing depth (PD), clinical attachment level (CAL), visible plaque index (VPI), bleeding on probing (BOP), gingival bleeding index (GBI) and presence of suppuration (SUP), as well as TSP activity and GCF MPO activity, were assessed before and 3 months after non-surgical periodontal therapy.Results: At baseline and 3 months post-treatment, the test group presented a higher percentage of sites with VPI and BOP (p < 0.01). MPO activity in the GCF presented lower values (p < 0.05) for the test group at both baseline and the post-treatment period. The periodontal treatment resulted in a significant improvement of most clinical and enzymatic parameters for both groups (p < 0.05).Conclusions: In both groups, the periodontal therapy was effective in improving most clinical parameters and in reducing salivary and GCF enzymatic activity. The diabetic individuals presented lower MPO activity in the GCF.

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Estudou-se a anatomia de raízes, caules, folhas e escapos de espécies de Paepalanthus subseção Aphorocaulon. Estas plantas apresentam caules reduzidos com folhas em roseta, de onde crescem os paracládios (sistemas de inflorescências). As espécies apresentam raízes com epiderme unisseriada e córtex com células isodiamétricas. Tanto os caules reduzidos como os paracládios apresentam espessamento resultante da atividade do periciclo, denominado Meristema de Espessamento Primário (MEP). Ambos apresentam estrutura anatômica semelhante. Os escapos apresentam endoderme descontínua, periciclo sinuoso, o córtex apresenta costelas salientes (5-6). As folhas apresentam células epidérmicas alongadas no sentido longitudinal com paredes levemente espessadas, estômatos somente na face abaxial, com câmara subestomática especializada, feixes vasculares colaterais com bainha dupla. Essas estruturas anatômicas são comuns para as espécies da subseção Aphorocaulon. Algumas características anatômicas observadas nestas espécies são típicas de plantas que crescem nos campos rupestres.

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

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The objective of this study was to analyze the outcome of surgical treatment of pulmonary aspergilloma. To that end, we evaluated 14 adult patients so treated between 1981 and 2009 at the Botucatu School of Medicine University Hospital, in the city of Botucatu, Brazil. Data were collected from the medical records of the patients. Ten patients (71%) presented with simple pulmonary aspergilloma, and 4 (29%) presented with complex pulmonary aspergilloma. Hemoptysis was the most common symptom, and tuberculosis was the most prevalent preexisting lung disease. Two patients (14%) underwent surgery on more than one occasion. There were no intraoperative deaths. Half of the patients developed postoperative complications, prolonged air leak and empyema being the most common.

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The objective is to alert the surgeon about the indiscriminate use of synthetic prosthesis in the correction of inguinal and incisional hernias. The authors provide a brief history of surgery on hernias and a review of the literature, showing the importance of classifying inguinal hernias to fit the type of surgical correction with the defect found, abstaining from treating all hernias, with the same type of surgical procedure. In our opinion, small indirect inguinal hernias (type 1 and 2 of Gilbert) and hernias in women must not, in general, be treated with prostheses. The synthetic material should be reserved for direct and large indirect hernias. Even so, this attitude, besides determining a higher cost for the procedure, can lead to important complications such as infection, rejection, fistula formation, chronic pain, alterations in spermatogenesis and the possibility of carcinogenesis, according to more recent reports. The physiology and anatomy of the abdominal wall should be considered when dealing with incisional hernia corrections, where the surgeon can choose among many techniques to correct those defects, and in selected cases, utilize synthetic material. We conclude that although the use of biomaterials has constituted a great advance in surgery for abdominal wall hernia corrections because they decrease recurrences, and permit treatment of large abdominal hernias, the indiscriminate prosthesis usage is an abuse, and it can determine many serious complications, certainly avoidable with a well indicated non mesh technique .

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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

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

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

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

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Nasopharyngeal colonization with methicillin-resistant Staphylococcus aureus (MRSA) often precedes the development of nosocomial infections. In order to identify risk factors for MRSA colonization, we conducted a case-case-control study, enrolling 122 patients admitted to a medical-surgical intensive care unit (ICU). All patients had been screened for nasopharyngeal colonization with S. aureus upon admission and weekly thereafter. Two case-control studies were performed, using as cases patients who acquired colonization with MRSA and methicillin-susceptible S. aureus (MSSA), respectively. For both studies, patients in whom colonization was not detected during ICU stay were selected as control subjects. Several potential risk factors were assessed in univariate and multivariable (logistic regression) analysis. MRSA and MSSA were recovered from nasopharyngeal samples from 27 and 10 patients, respectively. Independent risk factors for MRSA colonization were: length-of-stay in the ICU (Odds Ratio [OR]=1.12, 95%Confidence Interval[CI]=1.06-1.19, p<0.001) and use of ciprofloxacin (OR=5.05, 95%CI=1.38-21.90, p=0.015). The use of levofloxacin had a protective effect (OR=0.08, 95%CI=0.01-0.55, p=0.01). Colonization with MSSA was positively associated with central nervous system disease (OR=7.45, 95%CI=1.33-41.74, p=0.02) and negatively associated with age (OR=0.94, 95%CI=0.90-0.99, p=0.01). In conclusion, our study suggests a role for both cross-transmission and selective pressure of antimicrobials in the spread of MRSA.

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Malva sylvestris é comumente confundida com Pelargonium graveolens e Pelargonium odoratissimum devido às semelhanças na morfologia foliar. As folhas de M. sylvestris possuem antocianinas com propriedades citotóxicas, antiinflamatória, antitumoral e antioxidante já comprovadas cientificamente. As folhas de P. odoratissimum apresentam óleo essencial com propriedades antibacteriana e espasmolítica, e o óleo essencial da folha de P. graveolens possui atividade antimicrobiana e antifúngica. O objetivo deste estudo foi analisar morfo-anatomicamente as folhas destas espécies, apontando diferenças que possam ser utilizadas para esclarecer controvérsias na sua utilização como planta medicinal. Com a finalidade de se comparar anatomicamente a estrutura de cada planta, as amostras foram observadas por Microscopia de Luz e Microscopia Eletrônica de Varredura (MEV). A anatomia foliar entre as espécies foi bem distinta. Malva sylvestris apresentou tricomas do tipo capitado, estrelado e tector, além de drusas e células mucilaginosas. A distinção entre P. graveolens e P. odoratissimum foi observada em relação aos tricomas. Ambas as espécies apresentaram tricomas glandulares e tectores, sendo que P. graveolens se diferencia pela maior altura dos tricomas tectores e menor quantidade destes em relação ao P. odoratissimum. Este trabalho permitiu constatar diferenças anatômicas, auxiliando na taxonomia e classificação entre estas espécies.