ABSTRACT
Objective: To determine the impact of the quality of colonoscopy examination for colorectal cancer screening. Methods: Retrospective observational study ofmedical records from patients treated at the endoscopy and colonoscopy service of Hospital Universitário Evangélico Mackenzie (Curitiba, PR, Brazil) from January 2019 to January 2020. Results: The analysis was based on 337 medical records from patients with adenomas identified during colonoscopy, and 1,385 medical records from patients without adenomas. The estimated occurrence rate of diagnosis of adenoma during colonoscopy in the target population of the study was of 19.6%, with a 95% confidence interval ranging from 17.7 to 21.5%. Of the 337 patients with adenoma, 136 (40.4%) presented the advanced form. Statistical analysis indicated a significant association between the quality of colonoscopy preparation and test completion. Conclusion: The quality of colonoscopy images is a critical factor for colorectal cancer screening, as it leads to higher rates of adenoma detection and test completion. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Polyps , Colorectal Neoplasms/diagnosis , Adenoma , Mass Screening , Sensitivity and Specificity , Colonoscopy , EndoscopyABSTRACT
ABSTRACT Objective: the study aims to analyze the performance and outcome of resuscitation thoracotomy (TR) performed in patients victims of penetrating and blunt trauma in a trauma center in southern Brazil during a 7 years period. Methods: retrospective study based on the analysis of medical records of patients undergoing TR, from 2014 to 2020, in the emergency service of the Hospital do Trabalhador, Curitiba - Paraná, Brazil. Results: a total of 46 TR were performed during the study period, of which 89.1% were male. The mean age of patients undergoing TR was 34.1±12.94 years (range 16 and 69 years). Penetrating trauma corresponded to the majority of indications with 80.4%, of these 86.5% victims of gunshot wounds and 13.5% victims of knife wounds. On the other hand, only 19.6% undergoing TR were victims of blunt trauma. Regarding the outcome variables, 84.78% of the patients had declared deaths during the procedure, considered non-responders. 15.22% of patients survived after the procedure. 4.35% of patients undergoing TR were discharged from the hospital, 50% of which were victims of blunt trauma. Conclusion: the data obtained in our study are in accordance with the world literature, reinforcing the need for a continuous effort to perform TR, respecting its indications and limitations in patients victims of severe penetrating or blunt trauma.
RESUMO Objetivo: analisar o desempenho e o desfecho das toracotomias de reanimação (TR) realizadas nos pacientes vítimas de trauma penetrante e contuso em um hospital de referência em trauma no Sul do Brasil durante um período de sete anos. Métodos: estudo retrospectivo baseado na análise de prontuários de pacientes submetidos a TR, no período de 2014 a 2020, no serviço de emergência do Hospital do Trabalhador, Curitiba - Paraná, Brasil. Resultados: um total de 46 TR foram realizadas durante o período de estudo, dos quais 89.1% eram do sexo masculino. A média de idade dos pacientes submetidos a TR foi de 34.1±12.94 anos (variação de 16 e 69 anos). O trauma penetrante correspondeu pela maioria das indicações de TR com 80.4%, destas 86.5% vítimas de ferimentos por arma de fogo e 13.5% vítimas de ferimento por arma branca. Por outro lado, apenas 19.6% submetidos a TR foram vítimas de trauma contuso. No que se refere as variáveis de desfecho, 84.78% dos pacientes tiveram óbitos declarados durante o procedimento, considerados não respondedores. 15.22% dos pacientes apresentaram sobrevida após o procedimento. 4.35% dos pacientes submetidos à TR tiveram alta hospitalar, sendo 50% pacientes vítimas de trauma contuso. Conclusão: os dados obtidos em nosso estudo estão em conformidade com a literatura mundial, reforçando a necessidade de um esforço contínuo para realização da TR respeitando suas indicações e limitações em pacientes vítimas de trauma grave penetrante ou contuso.
Subject(s)
Humans , Adolescent , Adult , Aged , Young Adult , Wounds, Gunshot , Thoracotomy , Trauma Centers , Brazil , Retrospective Studies , Middle AgedABSTRACT
ABSTRACT Purpose: To compare biological compatibility, hemostasis, and adhesion formation between oxidized regenerated cellulose and lyophilized hydrolyzed porcine collagen in liver trauma. Methods: Forty male Wistar rats constituted two groups: group A (oxidized cellulose) and group B (lyophilized hydrolyzed collagen). Standardized liver trauma was made, and the hemostatic agent was applied. Animals in subgroups A7 and B7 were submitted to euthanasia and relaparotomy after seven days, and in subgroups A14 and B14 after 14 days. Macroscopic and microscopic results were evaluated. Results: There was no fluid in the cavity in any of the animals, and adhesions were present in all of them. In the analysis after seven days, the adhesions were grades 3 or 4 and consisted of omentum, small intestine, and abdominal wall (p<0.05). In both groups, the mesh was surrounded by a capsule, which was not observed after 14 days. In the evaluation after 14 days, adhesions were grades 2 or 3 (p>0.05). The microscopic examination showed subacute and chronic reactions, in both groups and in both timepoints, with similar frequency. The intensity of fibrosis always presented positive scores. Microabscesses and xanthomatous macrophages were observed in both groups. Conclusions: There was no superiority of one agent over the other.