Liver regeneration after extensive hepatectomy in rats: effect of preoperative chemotherapy with intravenous 5-fluorouracil

Purpose: To evaluate the effect of preoperative intravenous chemotherapy with 5-fluorouracil on liver regeneration in an experimental model of major hepatectomy in rats. Methods: Wistar rats were divided into two groups of 20 animals each and submitted to 70% hepatectomy 24 h after intravenous injection of 5-fluorouracil 20 mg/kg (fluorouracil group, FG) or 0.9% saline (control group, CG). After hepatectomy, each group was subdivided into two subgroups of 10 animals each according to the day of sacrifice (24 h or 7 days). Liver weight during regeneration, liver regeneration rate using Kwon formula, and the immunohistochemical markers proliferating cell nuclear antigen (PCNA) and Ki-67 were used to assess liver regeneration. Results: At early phase (24 h after hepatectomy) it was demonstrated the negative effect of 5-fluorouracil on liver regeneration when assessed by Kwon formula (p < 0.0001), PCNA analysis (p = 0.02). With regeneration process complete (7 days), it was possible to demonstrate the sustained impairment of chemotherapy with 5-fluorouracil on hepatocytes regeneration phenomenon when measured by Kwon formula (p = 0.009), PCNA analysis (p = 0.0001) and Ki-67 analysis (0.001). Conclusions: Preoperative chemotherapy with intravenous 5-fluorouracil negatively affected the mechanisms of liver regeneration after major hepatectomy in rats.

Tensiometric evaluation of the effect of lowfrequency electric stimulation on healing Achilles tendons in rats

Abstract Purpose: To evaluate the effects of low-frequency electric stimulation on biomechanics following surgical treatment of the Achilles tendon in rats. Methods: Forty-two rats were divided into two groups. One was given electric stimulation and the other was not. All were submitted to Achilles tenotomy and tenorrhaphy performed with a modified Kessler stitch. The experiment group underwent electric stimulation with 2 Hz, a nonpolarized current of 1 mA intensity for 14 days. The animals were euthanized at 2, 4 and 6 weeks for the biomechanical study. Results: The work performed, that is, the tendon's capacity to absorb energy until rupture, was greater in the electrically stimulated group in the 2nd (p = 0.032) and in the 6th week (p = 0.010). The maximum tension, which is the capacity to support a load, was higher in the treated group in the 2nd (p = 0.030) and the 6th week (p = 024). These results indicate greater resistance of the electrically stimulated tendons. An analysis of the elastic module showed no differences. Conclusion: Low-frequency electric stimulation increased the resistance of the tendons at 2 and 6 weeks of evolution in rats.

Analysis of double balloon enteroscopy: indications, findings, therapeutic and complications / Análise da enteroscopia por duplo balão: indicações, achados, terapêutica e complicações

ABSTRACT Background: The double balloon enteroscopy is an important method for the endoscopic approach of the small bowel that provides diagnosis and therapy of this segment's disorders, with low complication rate. Aim: Analysis of patients undergoing double balloon enteroscopy. The specific objectives were to establish the indications for this method, evaluate the findings by the double balloon enteroscopy, analyze the therapeutic options and the complications of the procedure. Methods: It is a retrospective analysis of 65 patients who underwent double balloon enteroscopy. Results: Sixty-five procedures were performed in 50 patients, 63.1% were women and 36.9% were men. The mean age was 50.94 years. The main indication it was gastrointestinal bleeding, followed by abdominal pain and Crohn's disease. Most procedures were considered normal. Polyps were the most prevalent finding, followed by angioectasias and duodenitis. In 49.2% of the cases, one or more therapeutic procedures were performed, (biopsy was the most prevalent). There was only one case of acute pancreatitis, which was treated clinically. Conclusion: The enteroscopy is good and safe method for the evaluation of the small bowel, and its main indications are gastrointestinal bleeding and abdominal pain. It has low complications rates and reduces the necessity of surgery.

RESUMO Racional: A enteroscopia por duplo balão é importante método endoscópico para abordagem do intestino delgado, permitindo o diagnóstico e a terapêutica de afecções com baixa taxa de complicações. Objetivo: Análise de pacientes submetidos à enteroscopia por duplo balão, estabelecendo as indicações para realização do exame e seus achados, analisando a terapêutica realizada e observando as complicações decorrentes do procedimento. Métodos: Estudo retrospectivo de análise de 65 prontuários de pacientes submetidos à enteroscopia por duplo balão. Os dados foram armazenados em planilhas e foi realizada a análise estatística. Resultados: Foram 65 enteroscopias em 50 pacientes, sendo 63,1% mulheres e 36,9% homens, com média de idade de 50,94 anos. A principal indicação foi sangramento intestinal, seguida por dor abdominal e doença de Crohn. A maioria dos procedimentos foi considerada normal, sendo que o achado mais prevalente foram os pólipos, seguido por angioectasias e duodenites. Em 49,2% dos exames foi realizado algum procedimento terapêutico, sendo a biópsia o mais prevalente. Houve apenas um caso de complicação de pancreatite aguda. Conclusão: A enteroscopia por duplo balão é bom e seguro método para a avaliação do intestino delgado, possuindo como principais indicações o sangramento intestinal e a dor abdominal. Possui baixas taxas de complicações e, por meio de suas opções terapêuticas, diminui a necessidade de procedimentos cirúrgicos.

Avaliação dos pacientes submetidos à cirurgia bariátrica por meio do baros / Evaluation of patients who underwent bariatric surgery through baros

Análise de pacientes que foram submetidos à cirurgia bariátrica. Casuística e métodos- Foram analisados 92 pacientes que se submeteram a cirurgia bariátrica pelas técnicas Bypass Gástrico em Y de Roux, Scopinato e Mason, utilizando o "Bariatric Analysis and Reporting Outcome System". Resultado - Dos pacientes que se submeteram ao Bypass Gástrico em Y de Roux 95,4 por cento apresentaram resultado de "melhor" e 4,6 por cento de "não melhor"; na técnica de Scopinaro 93,8 por cento mostraram-se "melhor" e 6,4 por cento "não melhor"; e na de Mason foram 90 por cento "melhor" contra 10 por cento "não melhor". Com relação à qualidade de vida, a maioria dos pacientes encaixou-se no perfil de "muito melhor", "melhor" e o "mesmo" e uma minoria em "pior" e "muito pior", independente da idade, sexo e perda do excesso de peso dos pacientes. Conclusão - Em todas as técnicas cirúrgicas houve melhora nos aspectos psicossociais e físicos na grande maioria dos pacientes, porém, comparando os três tipos de cirurgia, o Bypass Gástrico em Y de Roux apresentou-se mais eficaz.