Acta cirurgica brasileira最新文献

Purpose: To evaluate the effect of curcumin administered by gavage, on reducing intra-abdominal adhesions and attenuating the inflammatory process, assessed by a serum marker.

Methods: Forty Wistar rats were randomly divided into two groups: the curcumin group, and the control group. The curcumin group received curcumin by gavage at the dose of 200 mg/kg over the seven days preceding and the seven days following surgery. In the control group, an isovolumetric administration of 0.9% saline solution was given by gavage. Both groups underwent a median laparotomy and left-sided colotomy. On the eighth postoperative day, the animals were euthanized for intracavitary adhesion analysis and left colon resection for histological examination. Intra-abdominal adhesions were classified from grade 0 to 4 based on increases in number, intensity, and ease of lysis.

Results: Curcumin administration did not significantly reduce the severity of intra-abdominal adhesions (p = 0.7143) nor the severity of colonic inflammatory infiltration. However, a significant reduction in C-reactive protein levels was observed preoperatively in the curcumin group (p 0.05).

Conclusion: While curcumin was not able to reduce the severity of intra-abdominal adhesions, it demonstrated the ability to attenuate the inflammatory process associated with the surgical procedure.

Purpose: To develop a holographic skull model of a deformity resulting from craniosynostosis for the HoloLens.

Methods: The methodology for product creation and prototyping was the design thinking structured with the double diamond. A desk survey was conducted with a literature review and an anteriority search. Based on the desk survey results, brainstorming was performed to develop solutions to improve the surgeon's performance in craniosynostosis using mixed reality.

Results: Reports or scientific articles relating mixed reality use to craniosynostosis were not found in search engines or bibliography databases. A surgeon's performance potential improvement was observed using mixed reality as an auxiliary tool in craniosynostosis surgery. A craniosynostosis skull hologram was developed in mixed reality, with interactivity commands controlled by gestures, facilitating a three-dimensional spatial understanding of cranial anatomy.

Conclusion: A holographic skull model with a deformity resulting from craniosynostosis was developed for the HoloLens.

Purpose: To describe the academic utilization of podcasts as an educational tool for general surgery and emergency medicine residents.

Methods: This narrative report details a one-year group experience incorporating podcasts into the curriculum of the general surgery and emergency medicine residency programs, focusing on podcast-based learning within the academic emergency department of a quaternary university hospital in an urban center in São Paulo, Brazil. The authors, comprising podcast developers, preceptors, and residents, shared their experiences with implementing and utilizing the podcast in the residency curriculum.

Results: Over the course of one year, 50 episodes of the podcast "Mania de Cirurgia" were delivered to residents rotating in the emergency room. The episode content consisted of 64% clinical topics, 12% summaries of scientific events, 12% interviews with specialists, and 12% soft skills development. The authors reported that both residents and preceptors expressed high satisfaction with the podcast's integration as a consistent educational tool in the curriculum.

Conclusion: The incorporation of a podcast as an educational tool was enthusiastically received by both residents and preceptors. Podcasts may serve as a valuable complement to traditional teaching methods, enabling updates on general surgery topics, fostering evidence-based practice, and enriching professional experiences.

Purpose: To describe the varicocelectomy model using bull testicles and to evaluate microsurgical practice using the surgical microscope and video magnification system.

Methods: Bovine testicles and spermatic cords were used, with the medial portion of the cord left free for the microsurgical varicocelectomy technique. Twenty 3rd-year medical students were divided into two groups, the video magnification system group (VSMG) and the surgical microscope group (SMG), to simulate varicocelectomy in the proposed model. Five training sessions were carried out for both groups (D1, D7, D14, D21, and D28), as well as a reassessment (D63), with a checklist applied on the first, third, and fifth day of training and on reassessment.

Results: The model provides practical support for training in instrument handling, dissection of structures, anatomical identification, and vessel ligation as an alternative to learning the surgical technique. There was a drop in training time as the weeks went by, with no significant difference between the groups. There was no statistical difference in time (D14, D28, D63) or scores between groups.

Conclusion: Microsurgical varicocelectomy training using testicles and sperm cords of bovine origin in the video magnification system and surgical microscope contributed to the acquisition of skills.

Purpose: To evaluate the topical treatment with the ethanolic extract of Ocimum basilicum L. (OBEE) on excisional wounds in mice.

Methods: The plant material was identified and collected, and the ethanolic extract was obtained from the aerial parts of O. basilicum. The OBEE was resuspended in saline at concentrations of 38 and 100 mg/kg for topical application on the left and right lesions, respectively. Mice were anesthetized, excisional wounds were made on the dorsal region and divided into four groups (n = 6) based on treatment duration: one, three, five, and 21 days. The control group received saline. After the treatments, the animals were euthanized, and the wounds were collected for histopathological analysis the inflammatory infiltrate, mast cell count, and deposition of newly synthesized collagen matrix.

Results: The daily topical application of OBEE at concentrations of 38 and 100 mg/kg reduced the inflammatory response, evidenced by decreased leukocyte infiltration in the damaged tissue, and improved the deposition of newly synthesized matrix, with thicker, more intertwined collagen fibers resembling intact skin. These effects may be attributed to the phenolic compounds, tannins, flavonoids, and essential oils present in basil.

Conclusion: OBEE shows promise as a potential healing agent in excisional wounds.

Purpose: To evaluate proteins from Plumeria pudica latex (LPPp) for their protective effect against ethanol-induced gastric injury in mice.

Methods: The LPPp fraction was obtained by collecting P. pudica latex in tubes containing distilled water, followed by centrifugation and dialysis. The female Swiss mice (Mus musculus) received saline or LPPp (40 mg/kg) intraperitoneally 1 hour before oral administration of 500 μL of 50% ethanol. One hour later, the animals were euthanized, and their stomachs were removed for evaluation of tissue lesion area, histopathological analysis, and measurements of malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), and nitrate/nitrite (NO3/NO2). An independent experiment assessed the effect of LPPp on gastric mucus production.

Results: The LPPp-treated animals showed a significant reduction in the mean injured areas of gastric tissue (0.73 ± 1.01 mm2) compared to the ethanol group (37.99 ± 3.11 mm2). Histopathological analysis revealed significant preservation of tissue architecture in the LPPp group compared to ethanol group. Additionally, LPPp maintained tissue levels of MDA, GSH, SOD, and NO3/NO2 comparable to the saline group and influenced gastric mucus production favorably (p < 0.05).

Conclusion: These results suggested that LPPp has a protective effect against ethanol-induced gastric lesions, likely involving antioxidant activity and increased gastric mucus production.

Purpose: To evaluate the potential protective effects of naringin on liver by oxidative parameters and signal peptide-CUB-EGF-like domain-containing protein (SCUBE)-1 and 2 in an experimental cholestatic liver ischemia reperfusion (IR) model.

Methods: Twenty-four female rats were divided into three groups; sham, control, and treatment. Groups 2 and 3 underwent bile duct ligation, and one week later, 45 min of ischemia and 1 hour of relaparotomy and reperfusion were performed. To the treatment group, naringin was administered through relaparotomy. Liver tissue and blood samples were taken. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin (TBIL), direct bilirubin (DBIL), ischemia-modified albumin (IMA), SCUBE-1, SCUBE-2, total antioxidant status (TAS), and total oxidant status (TOS) levels were also examined.

Results: Serum ALT, AST, ALP, TBIL, DBIL, and IMA levels were higher in groups 2 and 3. There was no significant difference in terms of SCUBE-1 and 2 levels (p > 0.05). TAS was the highest in group 3, and TOS was the highest in group 2 and lower in group 3. In histopathological analysis, all parameters were statistically significant between group 3 and the other groups (p < 0.05).

Conclusion: Naringin has promising results in the treatment of experimental IR injury in cholestatic liver due to its antioxidant effects. We think that it can be used in clinical studies after more comprehensive studies investigating its effects on IR damage in cholestatic liver.

Purpose: To determine whether pinocembrin (PC) confers protective effects against experimentally induced intestinal ischemia-reperfusion (I/R) injury in rats.

Methods: Thirty Wistar albino rats were randomly divided into three groups (n = 10 each): sham (underwent laparotomy only); I/R (superior mesenteric artery occlusion for 60 min followed by 60 min reperfusion); and I/R + PC (5 mg/kg PC intraperitoneally before ischemia and again prior to reperfusion). Total antioxidant capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) were measured in both plasma and intestinal tissue. Histopathological evaluation was performed using hematoxylin and eosin staining and a modified Chiu scoring system.

Results: Although TAC values did not show significant intergroup differences (p > 0.05), TOS and OSI values were significantly lower in the I/R + PC group than in the I/R group (p < 0.05). Histologically, the I/R + PC group displayed noticeably reduced mucosal damage compared to the untreated I/R group. These results suggest that PC alleviates oxidative stress and improves histological outcomes in intestinal I/R.

Conclusion: PC exhibits a protective effect against intestinal I/R injury by decreasing oxidative stress and preserving tissue architecture. Further studies are warranted to optimize PC's dosing, timing, and mechanistic actions for clinical application.

Purpose: To investigate the impact of grape seed proanthocyanidin B2 (GSPB2) pretreatment on hypoxia-reoxygenation model of HK-2 cells in vitro.

Methods: The experiment was divided into five groups: control group (control), GSPB2 group (GSPB2), hypoxia-reoxygenation group (HR), GSPB2 + HR group (GSPB2+HR), and GSPB2 + brusatol (BRU) + HR group (GSPB2 + BRU + HR). Flow cytometry was used to detect apoptosis of cells. Transmission electron microscopy was employed to observe ultrastructural changes of cells. Mitochondrial membrane potential (MMP) was measured. Cellular immunofluorescence was used to assess intracellular Ca²+ concentration. Immunofluorescence staining and Western blotting were conducted to detect expression levels of Nrf2, HO-1, glucose-regulated protein 78 (GRP78), C/EBP homologous protein (CHOP), and cleaved-caspase3.

Results: Compared to HR group, GSPB2 + HR group showed significantly increased cell viability, and reduced mitochondrial damage in the cytoplasm. MMP in GSPB2 + HR group was significantly restored, and intracellular Ca²+ concentration was significantly decreased. The expression of Nrf2 and HO-1 proteins was significantly upregulated, while the expression of GRP78, CHOP, and cleaved-caspase3 proteins was markedly downregulated.

Conclusion: GSPB2 pretreatment can alleviate oxidative stress damage, mitochondrial injury, and endoplasmic reticulum stress induced by hypoxia-reoxygenation in HK-2 cells in vitro. This effect may be related to the ability of GSPB2 pretreatment to activate the endogenous antioxidant system, particularly through the activation of the Nrf2/HO-1 signaling pathway.

Purpose: To evaluate the angiographic outcomes of the Optima™ coil system in the endovascular treatment of saccular intracranial aneurysms to present real-world experiences.

Methods: The study encompassed patients with both ruptured and unruptured aneurysms who underwent treatment with the Optima™ coil system. A retrospective analysis was conducted to examine patient and aneurysm characteristics, complication rates, and angiographic outcomes.

Results: The total of 326 Optima™ coil implantations was performed in 64 aneurysms, with a mean maximum diameter of 7.49 ± 3.08 mm (range: 2.5-16.5 mm), among 64 patients (37 females and 27 males, mean age: 53.34 ± 14 years old). The average number of implanted coils was 5.06 ± 1.73. The mean packing density was 26.2% (range = 19.2-34.6), observed to be significantly higher in aneurysms with complete occlusion and neck remnants compared to those with a residual dome (p < 0.01). The mean follow-up period was 15.9 ± 8.1 months. One case (1.5%) reported a coil malfunction attributed to coil stretching. The mortality rate was 3.1% (n = 2).

Conclusion: The Optima™ coil system exhibited safety and efficacy in the endovascular treatment of both ruptured and unruptured intracranial aneurysms, demonstrating favorable angiographic outcomes. Nevertheless, further studies are necessary to validate these results over the long term.