Acta cirurgica brasileira最新文献

Purpose: To evaluate peripheral blood mononuclear cells (PBMCs) from patients with advanced head and neck squamous cell carcinoma (HNSCC) in comparison with healthy volunteers, as they can be potential biomarkers.

Methods: Immunophenotyping was performed using flow cytometry of blood mononuclear cells from two groups of adult men: group 1 (n = 14), diagnosed with HNSCC (mouth, larynx, and hypopharynx); and group 2 (n = 14), volunteers, healthy, and without the use of drugs. The cell groups studied were T lymphocytes (CD3, CD4, CD8, CD56 and CD69), B lymphocytes (CD19, CD69), neutrophils (CD11a, CD16, CD66b, HLA-DR), and monocytes (CD14, CD86).

Results: In group 1, there were an increase in CD3+CD4+ T lymphocytes (p < 0.001) and NK 56+ cells (p = 0.009) and a decrease in CD3+CD8+ T lymphocytes (p = 0.02) in comparison with group 2. In patients with HNSCC, an increase was found in the expression of the CD69 marker in CD3+CD4+ T lymphocytes (p = 0.03) and CD19+ B lymphocytes (p = 0.01) when compared to healthy volunteers.

Conclusion: HNSCC triggers a systemic inflammatory response with a decrease in CD8 T cells and an increase in CD4 T and CD56 natural killer cells. CD69 early activation marker was expressed by T and B cells.

Purpose: To evaluate the effectiveness and biocompatibility of a three-dimensional (3D) thermoplastic elastomer (TPE) prosthesis for repairing partial tracheal defects using 3D printing with fused deposition modelling.

Methods: Thirty-two rabbits underwent partial resection of five tracheal rings and were divided into two groups: the muscular flap group (GFM), which received a sternocephalic muscle flap over the defect; and the TPE group (GTPE), which received a 3D-printed TPE prosthesis. Clinical evaluations were performed at seven, 15, 30, and 60 days postoperatively.

Results: Cough was significantly more frequent in the GFM group (p = 0.035). Thermography showed no significant differences in surgical site temperatures between groups or time points. Tracheoscopy revealed more intraluminal secretions in the GTPE group (p = 0.006) and more exuberant tissue formation in the GFM group (p = 0.001). Complete epithelialization was observed in the GFM group after 60 days.

Conclusion: The 3D TPE prosthesis demonstrated tissue compatibility and viability as an implant for partial tracheal defects, with minimal respiratory complications during the 60-day evaluation period.

Purpose: To scrutinize the hepatoprotective effect of Paederia foetida against paracetamol-induced hepatobiliary in rats.

Methods: Rats were received the oral administration of paracetamol (3 mg/kg) empty stomach for the induction of hepatobiliary in rats except normal rats. the rats were received the oral administration of P. foetida. The hepatic, non-hepatic, antioxidant, and inflammatory parameters were estimated, as well as the mRNA expression.

Results: Paederia foetida treatment remarkably suppressed the level of hepatic parameters such as alkaline phosphatase, alanine transaminase, aspartate aminotransferase; and non-hepatic parameters like creatinine, total protein, bilirubin, and blood urea nitrogen level at dose dependent manner. It also altered the level of antioxidant parameters such as lipid peroxidation, superoxide dismutase, glutathione peroxidase, glutathione, and catalase in the serum, as well as hepatic tissue, and also suppressed the level of cytokines such as tumor necrosis factor-α, interleukin-1β, interleukin-6; and inflammatory parameters such as cyclooxygenase-2, prostaglandin, and nuclear factor kappa B, respectively. Paederia foetida also altered the level of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1).

Conclusion: Paederia foetida exhibited the hepatoprotective effect against paracetamol-induced hepatobiliary disease in rats via inflammatory and Nrf2/HO-1 pathway.

Purpose: To evaluate post-bariatric patients' intentions to undergo reconstructive plastic surgery in Brazil's public health system.

Methods: This cross-sectional study, conducted between May 2022 and February 2023, contacted 539 post-bariatric patients (≥ one year post surgery) via telephone, of whom 150 completed an online survey. Participants assessed their interest in reconstructive surgery and completed the validated Body-Q instrument to evaluate body image, sexual function, and related outcomes.

Results: Most respondents were female (88%) and married (68%), with an average age of 43 years old. The preoperative and postoperative body mass indices were 44.5 and 28.1, respectively, with an average weight loss of 44 ± 12.8 kg. A total of 90.7% expressed interest in reconstructive surgery, particularly for the abdomen (75.3%) and breasts (68%). Lower education level was linked to higher aesthetic expectations (p = 0.014). Patients interested in arm surgery had significantly lower sexual function scores (p = 0.006). There was no significant correlation between total weight loss and surgical interest.

Conclusion: Post-bariatric patients in Brazil's public healthcare system showed a high demand for reconstructive surgery, with education level and body satisfaction influencing interest more than weight loss. Targeted counseling may help align expectations and enhance post-bariatric care for patients.

Purpose: We builted a orthotopic autologous liver transplantation (OALT) model in rats to evaluate the possible mechanisms of berberine against lung injury.

Methods: Forty clean grade Sprague-Dawley rats (male, healthy, 250-280 g) were divided into five groups (n = 8): sham-operated group (group S), orthotopic autologous liver transplantation group (group T), berberine group (group B), peroxisome proliferator-activated receptor gamma (PPARγ) inhibitor GW9662 group (group G), and berberine + GW9662 group (group B+G). In group S, the relevant tissues around the liver were dissociated only. Orthotopic autologous liver transplantation was used in other groups, berberine 200 mg/kg/day was given one week before surgery in group B and group B+G. GW9662 1 mg/kg was intraperitoneally injected in group G and group B+G 4 hours before surgery. Blood samples were obtained for detecting PaO2 and the concentration of serum clam cell protein (CC16), surfactant protein-D (SP-D), interleukin (IL)-1β and IL-18. The immunohistochemical method detects the expression of PPARγ and nuclear factor-kappa B (NF-κB) in lung tissues. The expression of PPARγ, NF-κBand pyroptosis-related proteins were analysed by western blotting.

Results: Rats exhibited increased histological lung injury following OALT. Liver transplantation caused upregulated CC16, SP-D, IL-18 and IL-1β levels, reduced PaO2 and the PPARγ expression, upregulated the NF-κB and pyroptosis-related protein expressions. BBR pretreatment greatly alleviates these lung damages induced by OALT. However, administration of GW9662 partially reversed the beneficial effects of BBR on lung injury.

Conclusion: Berberine may play protective capacities against lung injury by upregulating PPARγ to downregulate the NF-κB-mediated pyroptosis pathway.

Purpose: To examine the antiulcerative and antioxidant action of the Anacardium occidentale hydroalcoholic leaf extract (HEA) on experimentally induced colitis in rats via acetic acid (AA).

Methods: Male rats were distributed into six groups (n = 10 per group): C (control), CC (colitis control), SZC (sulfasalazine 500 mg/kg), and three doses of HEA (HEA50 = 50 mg/kg, HEA100 = 100 mg/kg, HEA200 = 200 mg/kg).

Results: The treatment with HEA100 for seven days decreased diarrhea, increased food intake, attenuated weight loss, and recovered the macroscopic and histological parameters of the colon, mitigating the severity of colitis and restoring the intestinal morphophysiology of animals with induced colitis. Additionally, HEA50 and HEA100 treatment increased the activity of superoxide dismutase, catalase, and thiol, and reduced the levels of thiobarbituric acid reactive substances and carbonyl, contributing to the re-establishment of antioxidant homeostasis.

Conclusion: This study provided preclinical evidence of the potential of A. occidentale leaf extract, particularly at the concentration of 100 mg/kg, as an antiulcer agent for attenuating colitis in rats, likely due to the positive modulation of the antioxidant system.

Purpose: To evaluate the effectiveness of a new format of prophylactic mesh, with a new method of placement.

Methods: Rabbits were randomly distributed into four groups: control rabbits without laparotomy group; sutured rabbits (SR); light-weight mesh rabbits (LWMR); and heavy-weight mesh rabbits (HWMR). The meshes were cut to a size of 10 cm in length by 1 cm in width. A longitudinal, median abdominal incision, 11 cm in length, was performed, followed by an incision over the linea alba, encompassing the entire thickness of the abdominal wall. On the 91st postoperative day, the animals were killed for linea alba scar evaluation.

Results: There was a significant difference among the evaluated groups concerning elongation, maximum load, and elasticity modulus. HWMR and LWMR were statistically different from controls regarding elongation. As for the elasticity modulus, SR presented a higher mean when compared to the others. Microscopic visual analysis showed greater fibrotic scarring with a larger amount of implanted material in HWMR.

Conclusion: The reinforcement of scars with polypropylene mesh does not increase tensile strength when compared to the use of sutures. Mesh implantation results in scar remodeling with greater fibrosis, leading to increased elongation. However, midline reinforcement using only sutures has greater elasticity than the groups reinforced with mesh.

Purpose: To evaluate ceftriaxone's potential in enhancing peripheral nerve injuries (PNIs) recovery.

Methods: Thirty male Wistar rats were divided into control (no surgery), vehicle (sciatic nerve injury + 0.9% NaCl), and ceftriaxone (sciatic nerve injury + 50 mg/kg/day ceftriaxone) groups. Treatments were administered intraperitoneally for 12 weeks. Functional recovery was assessed using inclined plane tests and electromyography. Sciatic nerve regeneration was evaluated via histology, nerve growth factor (NGF) immunohistochemistry, and enzyme-linked immunosorbent assay.

Results: Compared to the control group, inclined plane test scores, nerve action potentials, NGF expression, axon counts, and diameters were diminished in both injury groups (p 0.001). However, these parameters were significantly improved in the ceftriaxone group compared to the vehicle group (p 0.001). Increased fibrosis was observed in the ceftriaxone group.

Conclusion: Ceftriaxone demonstrates potential as a pharmacological agent for PNI recovery by enhancing nerve regeneration and functional outcomes. Further studies are warranted to elucidate its mechanisms.

Purpose: To detail a technique to implant a double-lumen catheter to remove anti-pig antibodies. We transplanted fetal pig kidneys into cynomolgus monkeys using a double filtration plasma exchange (DFPP) protocol.

Methods: Two approaches for double-lumen catheter insertion in monkeys (3-9.2 kg) were developed. DFPP was performed using hydroxyethyl starch (6%) as a replacement fluid. We transplanted fetal porcine kidneys, administered immunosuppressive agents, and evaluated the grafts.

Results: The catheter insertion site was large, with postoperative hemostasis similar to blind subcutaneous puncture. Monkeys tolerated DFPP well, maintaining stable blood pressure. The technique reduced anti-pig antibodies by 67%, though acute rejection was not fully suppressed.

Conclusion: A safe technique for double-lumen catheter placement in cynomolgus monkeys was developed, along with a DFPP protocol for reducing anti-pig antibodies.

Purpose: To develop a pericardiocentesis (PCT) simulation model applied for undergraduate medical training.

Methods: A PCT simulator consisted of a torso mannequin, a silicone rubber heart (SRH), a container, and a filling system. The mannequin was submitted to a coronal section and an 18 × 18-cm precordial area opening. The SRH was prepared in accordance with structural dimensions of a normal heart. The elaboration of a structure container to simulate the pericardial cavity consisted of a non-leakable unit inside a cardboard (PcavBox). The PcavBox filling system was connected to a 10-mm diameter tube and a total of 2.5 L of saline solution. This structure was adapted inside the mannequin and covered with a thermoformable rubber material of 2 mm in skin color. For PCT simulation, we used a 10-mL syringe connected to a 14G needle for an imaging guided puncture facilitated by a portable ultrasound.

Results: A SRH was successfully developed and fixed inside the Pcav Box, connected to the fluid pressure system. It was able to simulate a cardiac tamponade scenario identified by ultrasound. A series of 50 punctures was successively performed without liquid leak.

Conclusion: A low-cost PCT simulator was developed and coan be applied to healthcare education.