Acta cirurgica brasileira最新文献

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.

Purpose: To demonstrate the complete process of telementoring implementation using augmented-reality smart glasses for performing a simulated medical procedure.

Methods: Fifteen participants, including physicians and medical students, were recruited to participate in a telementoring session with an educational focus during simulated thoracostomy with closed pleural drainage. A questionnaire assessing technology usability and usefulness was administered, and the results were analyzed by Cronbach's alfa and multiple correspondence analysis (MCA).

Results: The mean age of the participants was 28.8 and 66.67% of them were women. The test results indicated a Cronbach's alpha of 78% and an MCA of 49.48% for the first three dimensions.

Conclusion: The results showed that smart glasses are easy to use and facilitate communication among the professionals involved, providing comfort and safety to participants of care simulations. Additionally, smart glasses were considered to have perceived usefulness.

Purpose: To develop an experimental model of microsurgical scalp reimplantation in rabbits.

Methods: Ten male albino New Zealand rabbits (Oryctolagus cuniculus) were scalped and subjected to scalp reimplantation. The rabbits' scalp regions, including their ears, were surgically amputated. Based on a previous anatomical study, the superficial temporal artery and the central auricular vein were chosen for microanastomosis. Data on the morphometric parameters (vessel weight and caliber), surgical procedure (surgical time and number of stitches), and surgical recovery parameters (venous return, patency, and necrosis) were collected for up to 30 days postoperatively (PO) using a research protocol.

Results: Morphometric and surgical recovery parameters did not significantly differ in our sample. No animals died during the intraoperative period. Three animals were euthanized because they developed partial or total scalp necrosis. The venous return was impaired from three to ten days PO, with spontaneous regression after this period, which significantly improved (p = 0.02) after 14 days PO. Superficial necrosis was observed starting at two days PO with complete resolution by day 21 PO (p <0.01).

Conclusion: The rabbit provides a realistic biological model for training scalp reimplantation with high fidelity to human vascular structures.

Purpose: To reveal the role and underlying mechanism of hirudin in renal fibrosis.

Methods: The unilateral ureteral obstruction (UUO) rat model and ferroptosis activator RSL3-induced human kidney proximal tubular epithelial cells (HK-2) were established. Hematoxylin-eosin staining, commercial kits, and immunohistochemistry were used to assess the effect of hirudin on renal function and renal fibrosis. Cell counting kit-8 assay was employed to test cell viability. Ferroptosis indicator levels were detected using commercial kits. The protein levels were examined by Western blot. The STAT3 activator colivelin was introduced to verify the role of the STAT3/NLRP3 signaling pathway in ferroptosis.

Results: Hirudin alleviated renal injury and improved renal fibrosis in UUO rats. The cell viability of RSL3-treated HK-2 cells was increased after hirudin treatment. In the model group, GPX4, SLC7A11, and glutathione expression decreased, while malondialdehyde and iron content levels increased, indicating that ferroptosis was activated. Besides, p-STAT3 and NLRP3 protein levels were also upregulated. However, hirudin treatment reversed these changes. When the STAT3 activator colivelin was added, the effect of hirudin was altered.

Conclusion: Hirudin improved renal fibrosis by inhibiting ferroptosis via the STAT3/NLRP3 signaling pathway.

Purpose: To determine risk factors for re-stricture after buccal mucosal graft urethroplasty (BMGU) through a systematic review and meta-analysis.

Methods: Following PRISMA guidelines, we collected data from PubMed, Scientific Electronic Library Online (SciELO), and Web of Science databases. The eligibility criteria included studies with male patients over 18 years old with urethral stricture recurrence after BMGU.

Results: We retrieved 646 papers from three electronic databases. Records that did not meet the eligibility criteria and duplicates were excluded, resulting in 14 papers (3,240 patients) that underwent qualitative analysis, from which nine papers were suitable for meta-analysis. The meta-analysis identified diabetes mellitus (relative risk - RR: 1.58 [95% confidence interval - 95%CI 1.02-2.46];p = 0.04), penile/peno-bulbar site (RR: 1.57 [95%CI 1.04-2.37]; p = 0.03), and stricture size higher than 7 cm (RR: 4.13 [95%CI 2.42-7.04]; p 0.00001) as a predictive factor of re-stricture.

Conclusions: These findings may improve understanding the risk factors for this type of urethroplasty and help surgical decisions. For a more effective analysis, larger and better-distributed study groups and cohorts are needed in the future to clarify whether the combination of a previous disease and the urethroplasty etiology may impact a recurrence-free outcome after stricture correction.