Effects of face mask on pulse rate and blood oxygenation

ABSTRACT Objective The World Health Organization and Centers for Disease Control and Prevention recommend the use of face masks in public. This study aimed to evaluate the effects of face masks on pulse rate and partial blood oxygen saturation in patients without cardiorespiratory disorders. Methods A total of 150 volunteers of both sexes were divided into three groups (n=50) according to age (children, young adults, and older adults). The partial blood oxygen saturation and pulse rate were measured for each volunteer using a digital oximeter while wearing a facial mask and remaining at rest. The masks were removed for two minutes, and partial blood oxygen saturation and pulse rate were remeasured. The materials and types of masks used were recorded. The t -test for paired samples was used to compare the mean values obtained before and after removing the masks. Results The most frequently used mask was a two-layered cloth (64.7%). A decrease in pulse rate was observed after removing the face mask in males, particularly in children (p=0.006) and young adults (p=0.034). Partial blood oxygen saturation levels increased in young adult males after mask removal (p=0.01). Conclusion The two-layer cotton tissue face masks are associated with a higher pulse rate and reduced arterial blood oxygen saturation without associated clinical disorders, mainly in adult men with a lower tolerance to breathing and ear discomfort.

Megavoltage radiotherapy effects on organs of the reticuloendothelial system

Purpose: To study the uptake capacity of cells from the reticuloendothelial system after irradiation with high-energy X-rays. Methods: Eighteen male Wistar rats were distributed in three groups: group A (n = 6): control, unirradiated animals studied alongside animals from group B; group B (n = 6) and group C (n = 6): animals irradiated and studied after 24 and 48 hours, respectively. The rats were anesthetized and placed on a 10 MV linear accelerator. Next, they were irradiated in the abdominal region, with 8 Gy. Twenty-four (groups A and B) and 48 hours later (group C), a colloidal carbon solution (1 mL/kg) was intravenously injected in the tail vein. Fifty minutes later, the spleens and livers were withdrawn and prepared to be studied. Kupffer cells and splenic macrophages containing carbon pigments were counted in an optical microscope. Arithmetic means were calculated for each group and compared among them. Results: X-rays were associated with a reduced number of Kupffer cells containing colloidal carbon, proliferation and enlargement of biliary ducts, hypoplasia, and hepatocyte necrosis. In the irradiated spleen, the colloidal carbon uptake was concentrated in the marginal zone around the white pulp, with an inexpressive uptake of pigments by macrophages from white and red pulps. Conclusions: The X-rays in the rat abdomen are associated with a reduction in the Kupffer cells uptake of colloidal carbon, hepatocyte disorders, bile duct proliferation, and splenic uptake of colloidal carbon concentrated in the marginal zone.

Anatomical variations of portal venous system: importance in surgical clinic / Variações anatômicas do sistema venoso porta: importância em clínica cirúrgica

ABSTRACT - BACKGROUND: Knowledge of the portal system and its anatomical variations aids to prevent surgical adverse events. The portal vein is usually made by the confluence of the superior mesenteric and splenic veins, together with their main tributaries, the inferior mesenteric, left gastric, and pancreaticoduodenal veins; however, anatomical variations are frequent. AIM: This article presents a literature review regarding previously described anatomical variations of the portal venous system and their frequency. METHODS: A systematic review of primary studies was performed in the databases PubMed, SciELO, BIREME, LILACS, Embase, ScienceDirect, and Scopus. Databases were searched for the following key terms: Anatomy, Portal vein, Mesenteric vein, Formation, Variation, Variant anatomic, Splenomesenteric vein, Splenic vein tributaries, and Confluence. RESULTS: We identified 12 variants of the portal venous bed, representing different unions of the splenic vein, superior mesenteric vein, and inferior mesenteric vein. Thomson classification of the end of 19th century refers to the three most frequent variants, with type I as predominant (M=47%), followed by type III (M=27.8%) and type II (M=18.6%). CONCLUSION: Thomson classification of variants is the most well-known, accounting for over 90% of portal venous variant found in clinical practice, inasmuch as the sum of the three junctions are found in over 93% of the patients. Even though rarer and accounting for less than 7% of variants, the other nine reported variations will occasionally be found during many abdominal operations.

RESUMO - RACIONAL: O conhecimento do sistema porta e de suas variações anatômicas contribui para prevenir acidentes cirúrgicos. Usualmente, a veia porta é formada pela confluência das veias mesentérica superior e esplênica, junto com suas principais tributárias: as veias mesentérica inferior, gástrica esquerda e pancreaticoduodenal. Entretanto, variações anatômicas são frequentes. OBJETIVO: Este artigo apresenta uma revisão da literatura em relação às variações anatômicas previamente descritas do sistema venoso porta e sua frequência. MÉTODOS: Foi realizada revisão sistemática de estudos primários nas bases de dados PubMed, Scielo, BIREME, LILACS, Embase, Science Direct e Scopus. As bases de dados foram pesquisadas pelas seguintes palavras-chave: Anatomia, Veia porta, Veia mesentérica, Formação, Variação, Variante anatômica, Veia esplenomesentérica, Veia esplênica, tributárias e Confluência. RESULTADOS: Foram identificadas doze variantes do sistema venoso portal, representando diferentes formações da veia esplênica, veia mesentérica superior e veia mesentérica inferior. A classificação de Thomson, do final do século XIX, refere três variantes mais frequentes, com predomínio do tipo I (M = 47%), seguido do tipo III (M = 27,8%) e do tipo II (M = 18,6%). CONCLUSÃO: A classificação de variantes de Thomson é a mais conhecida e responde por mais de 90% da variante venosa portal encontrada na prática clínica, na medida em que a soma das três junções é encontrada em mais de 93% dos pacientes. Embora mais raras e representando menos de 7% das variantes, as outras nove variações relatadas ocasionalmente serão encontradas durante muitas cirurgias abdominais.

The left gastro-omental vessels are able to maintain the entire spleen blood supply / Os vasos gastromentais esquerdos são capazes de manter o suprimento sanguíneo de todo o baço

Abstract The spleen is supplied by blood flow through the splenic artery and vein. The purpose of this communication is to report an ectopic spleen supplied only by reverse flow through the left gastro-omental vessels. A 14-year-old boy presented with pelvic splenomegaly supplied only by the left gastro-omental artery and veins connected to the inferior polar vessels, which were the only vessels communicating with the spleen. After detorsion of the spleen and splenopexy, the spleen returned to normal dimensions. The patient had uneventful follow-up. In conclusion, the left gastroepiploic vessels are able to maintain the entire spleen blood supply.

Resumo O baço é suprido pelo fluxo sanguíneo da artéria e veia esplênicas. O objetivo desta comunicação é apresentar um baço ectópico suprido apenas pelo fluxo sanguíneo reverso proveniente dos vasos gastromentais esquerdos. Um paciente de 14 anos apresentou esplenomegalia pélvica suprida apenas por artéria e veia gastromentais esquerdas, conectadas aos vasos polares inferiores, que eram os únicos presentes nesse baço. Após a distorção do baço e a esplenopexia, o baço voltou às dimensões normais. Não houve intercorrências no acompanhamento do paciente. Em conclusão, os vasos gastromentais esquerdos são capazes de suprir o fluxo sanguíneo de todo o baço.

Etiopathogenic, epidemiologic and clinical-therapeutic comparison of non-hodgkins lymphoma and kaposis sarcoma / Comparação etiopatogênica, epidemiológica e clinicoterapêutica de linfoma não hodgkin e sarcoma de kaposi

ABSTRACT Background: Non-Hodgkin's lymphomas (NHL) are primary neoplasms derived from lymphocytes, and Kaposi's sarcoma (SK) is a multicentric disease of viral etiology and is associated with HIV. Aim: To study the etiopathogenesis and clinical characteristics of NHL and KS, describing their mutual factors. Methods: This retrospective investigation was performed on 101 medical charts. The patients were studied according to their age, gender, and HIV-positivity, following the PRISMA guidelines. The characteristics of the tumors and comorbidities were analyzed according to their age and lymphatic metastasis. Results: The mean age of the patients ranged between 15-87 years for NHL and between 25-54 for KS, but the age of patients with NHL associated with HIV did not surpass 34 years. The ratio male: female was 1,8:1 for NHL, but only men presented KS. HIV-positivity was found in five patients with NHL and in 14 with KS. The stages of NHL were: I (21%), II (18,4%), III (26,3%), and IV (34,2%), but KS were found only at III (40%) and IV (60%) stages. The lymphatic metastases were positive in 62 patients NHL and in four with KS. HIV-positivity occurred in 60% of patients with NHL and in 50% with KS. Conclusion: The HIV seropositivity was revealed for most of patients during the NHL and SK propaedeutic and none of them present clinical manifestations of AIDS. NHL associated with HIV was found only in young patients. NHL and KS patients have similar epidemiological, clinical, and therapeutic characteristics.

RESUMO Racional: Os linfomas não Hodgkin (LNH) são neoplasias primárias derivadas de linfócitos e o sarcoma de Kaposi (SK) é doença multicêntrica de etiologia viral, ambas associadas ao HIV. Objetivo: Avaliar características clínicas dos LNH e SK, relacionando fatores etiopatogênicos mútuos. Métodos: Foram avaliados retrospectivamente 101 prontuários. Os doentes foram analisados quanto a idade, sexo e soropositividade para o HIV, de acordo com o PRISMA guidelines. Os tumores foram classificados por estadiamento, presença de linfonodos regionais invadidos e tipo celular. Resultados: A idade variou entre 15 e 87 anos para o LNH e 25 a 54 anos para o SK, mas a idade dos pacientes com LNH associado com o HIV não ultrapassou 34 anos. A proporção homem: mulher foi de 1,8:1 para o LNH, enquanto SK foi registrado apenas em homens. A soropositividade para o HIV ocorreu em cinco pacientes com LNH e 14 com SK. A invasão de linfonodos regionais foi positiva em 62 com LNH e quatro com SK. Os linfomas foram 27,9% de baixo grau, 17,4% de grau intermediário e 12,8% de alto grau. A soropositividade para HIV, foi diagnosticada durante a propedêutica do tumor em 60% dos pacientes com LNH e 50% dos com SK. Conclusão: A maioria dos pacientes portadores de HIV descobriram a soropositividade durante propedêutica para LNH e SK, sem manifestações clínicas de AIDS. Todos os pacientes com LNH associado com o HIV eram jovens. Pacientes com LNH e com SK apresentam características epidemiológicas, clínicas e terapêuticas semelhantes entre si.

Alcohol consumption by medical students

SUMMARY OBJECTIVE Excessive alcohol consumption is a global health issue. This article aims to evaluate the consumption of alcohol by medical students in relation to their personal and social aspects. METHODS This study was conducted with students in the first, third, and sixth year of medical school at the Federal University of Minas Gerais in 2019. Students were invited to participate anonymously by responding to a questionnaire with 15 questions regarding student characteristics (gender, age, family income, physical activity, origin, housing condition, and academic performance) and alcohol consumption (onset, reason, occasions of use, type of drink, amount consumed). Data were compared with significance corresponding to p<0.05. RESULTS A sample of 382 students of both sexes responded to the questionnaire. Alcohol consumption was reported by 85% of students. About 70% of first and third-year students and 47% of those of the sixth year were motivated by socializing with peers. Alcohol consumption was prevalent among those who practice physical activities (93%) and live with their families (89%). Around 80% had consumed alcohol before starting medical school, and consumption was more frequent in males. CONCLUSIONS Alcohol consumption begins during high school, stimulated by socialization. Men who practice physical activities and live with their families are the largest consumers.

RESUMO OBJETIVO O consumo excessivo de álcool é um problema de saúde presente no mundo inteiro. Este artigo avalia o consumo de bebidas alcoólicas por estudantes de Medicina e sua relação com características pessoais e aspectos sociais. MÉTODOS Estudo realizado com estudantes dos 1o, 3o e 6o anos do curso de medicina da Universidade Federal de Minas Gerais no ano de 2019. Os alunos foram convidados a participar anonimamente, respondendo a um questionário com 15 perguntas relativas a características do estudante (sexo, idade, renda familiar, prática de atividades físicas, origem, condição de moradia e desempenho discente) e ao consumo de bebidas alcoólicas (início, motivo, ocasiões de uso, tipo de bebida, quantidade consumida). Os dados foram comparados com significância correspondente a p<0,05. RESULTADOS Um total de 382 estudantes de ambos os sexos respondeu ao questionário. O consumo de bebidas alcoólicas foi relatado por 85% dos entrevistados. Cerca de 70% dos alunos de 1o e 3o anos e 47% dos alunos do 6o ano foram motivados pela socialização com colegas. O consumo de bebida alcoólica foi prevalente entre os que praticavam atividades físicas (93%) e moravam com a família (89%). Ao redor de 80% consumiram bebidas alcoólicas antes do ingresso na faculdade, com maior frequência no sexo masculino. CONCLUSÕES O consumo de álcool começa durante o ensino médio, estimulado pela socialização. Os homens que praticam atividades físicas e moram com a família são os maiores consumidores.

Correlation between the values of circulating blood elements with the size of spleen in the presence of schistosomal splenomegaly

Abstract Purpose: To evaluate a possible relationship between the size of the spleen and values of circulating blood elements in patients with schistosomatic splenomegaly. Methods: ixty one patients with hepatosplenic schistosomiasis mansoni underwent a clinical exam and peripheral venous blood was collected for a hemogram. The erythrocyte, hemoglobin, hematocrit, leukocyte, and platelet values were determined. All patients underwent abdominal ultrasound to measure the spleen. The hematological test results were compared to the size of the spleen. Results: The size of the spleen varied from 14.0 to 28.4 (19.9 ± 3.7) cm according to the ultrasound image. Thrombocytopenia was observed 58 (95%) patients, leukopenia in 55 (90%) patients, and anemia in 32 (52.4%) patients. Leukopenia was proportional to splenomegaly. Conclusion: Schistosomal splenomegaly leads to leukopenia in direct proportion to the size of the spleen.

Effects of different periods of gastric ischemia on liver as a remote organ

Abstract Purpose: To evaluate the hepatic changes associated with gastric ischemia. Methods: Thirty male rabbits were studied, distributed in 3 groups (n=10). Group 1: ligature and section of the gastric vasculature and removal of the liver after three hours; Group 2: ligature and section of the gastric vasculature and removal of the liver after 6 hours; Group 3: ligature and section of the gastric vasculature and removal of the liver after 12 hours. Blood samples were collected immediately before surgery and after the determined time of ischemia in each group to evaluate the hepatic function. After the death of the rabbits, the liver was removed for macro and microscopic study. Results: An increase in aminotransferases and bilirubin occurred in groups 2 and 3. Total protein and albumin diminished in all of the animals. All of the rabbits from groups 2 and 3 presented hepatocellular necrosis. Conclusion: The devascularization of the stomach for a period of above three hours is associated with hepatic morphological and functional disorders.

Intravascular and intraparenchymatous hepatic segmentary sclerosis

Abstract Purpose: To evaluate the morphological effects of injected sclerosing agents into the liver. Methods: This study was performed on twenty dogs, distributed into five groups: Group 1 (n = 5) - control, Group 2 (n = 5) - injection of 50% glucose solution inside hepatic parenchyma and animals followed during seven days, Group 3 (n = 10) - injection of ethanol inside hepatic parenchyma and animals distribution into two subgroups Subgroup 3A (n = 5) - followed during 24 hours and subgroup 3B (n = 5) - followed during seven days (group 3B), Group 4 (n = 5) - ethanol injection inside left portal vein branch and followed during 24 hours. Livers were macroscopically evaluated, submitted to hepatic arteriography and portography, then histology. Results: All animals in Group 4 died within 23 hours due to diffuse hepatic necrosis. The animals of groups 2 and 3 had a satisfactory evolution. Fibrosis formed in the segment reached by the sclerosant solution and interruption of the contrast flow injected into the portal system. Conclusion: Intrahepatic parenchymal ethanol injection is well tolerated and causes sclerosis restricted to a specific segment; however, intraportal ethanol injection causes massive hepatic necrosis and can lead to death.

Influence of oophorectomy on glycemia and lipidogram

Abstract Purpose: To verify the influence of oophorectomy on lipidogram and glycemia. Methods: Fifty six female rats were divided into the following 7 groups (n = 8): group 1 - sham group, group 2 - oophorectomy 30 days, group 3 - oophorectomy 35 days, group 4 - oophorectomy 40 days, group 5 - oophorectomy 45 days, group 6 - oophorectomy 70 days, group 7 - oophorectomy 55 days. Animals were following by number of days according the group. Was evaluated the serum levels of glucose and lipid profile. Results: The oophorectomized rats presented higher glycemia. Groups 3, 4, 6 and 7 had a higher glycemia and LDL levels (except for group 6) and groups 6 and 7 had lowest levels of HDL. Group 7 had highest level of VLDL than oophorectomy groups. There was no difference in triglycerides levels. Conclusion: Oophorectomy was related to dyslipidemia and insulin resistance, mainly after 50th days.

Splenic implant preservation after conservation in lactated Ringer´s solution / Preservação de implante esplênico autógeno após conservação em solução de Ringer-lactato

ABSTRACT Objective: to evaluate the morphology and function of autogenous splenic tissue implanted in the greater omentum, 24 hours after storage in Ringer-lactate solution. Methods: we divided 35 male rats into seven groups (n=5): Group 1: no splenectomy; Group 2: total splenectomy without implant; Group 3: total splenectomy and immediate autogenous implant; Group 4: total splenectomy, preservation of the spleen in Ringer-lactate at room temperature, then sliced ​​and implanted; Group 5: total splenectomy, ​​spleen sliced and preserved in Ringer-lactate at room temperature before implantation; Group 6: total splenectomy with preservation of the spleen in Ringer-lactate at 4°C and then sliced ​​and implanted; Group 7: total splenectomy and the spleen sliced for preservation in Ringer-lactate at 4°C before implantation. After 90 days, we performed scintigraphic studies with Tc99m-colloidal tin (liver, lung, spleen or implant and clot), haematological exams (erythrogram, leucometry, platelets), biochemical dosages (protein electrophoresis) and anatomopathological studies. Results: regeneration of autogenous splenic implants occurred in the animals of the groups with preservation of the spleen at 4ºC. The uptake of colloidal tin was higher in groups 1, 3, 6 and 7 compared with the others. There was no difference in hematimetric values ​​in the seven groups. Protein electrophoresis showed a decrease in the gamma fraction in the group of splenectomized animals in relation to the operated groups. Conclusion: the splenic tissue preserved in Ringer-lactate solution at 4ºC maintains its morphological structure and allows functional recovery after being implanted on the greater omentum.

RESUMO Objetivo: avaliar morfologia e função de tecido esplênico autógeno, implantado no omento maior, 24 horas após conservação em solução de Ringer-lactato. Métodos: foram estudados 35 ratos machos, distribuídos em sete grupos (n=5): Grupo 1: sem esplenectomia; Grupo 2: esplenectomia total sem implante; Grupo 3: esplenectomia total e implante autógeno imediato; Grupo 4: esplenectomia total, preservação do baço em Ringer-lactato à temperatura ambiente, em seguida, fatiado e implantado; Grupo 5: esplenectomia total, baço fatiado e preservado em Ringer-lactato à temperatura ambiente antes de ser implantado; Grupo 6: esplenectomia total com preservação do baço em Ringer-lactato a 4°C e, em seguida, fatiado e implantado; Grupo 7: esplenectomia total e baço fatiado, para preservação em Ringer-lactato a 4°C antes de ser implantado. Após 90 dias, realizaram-se estudos cintilográficos com estanho coloidal-Tc99m (fígado, pulmão, baço ou implante e coágulo), hematológicos (eritrograma, leucometria, plaquetas), bioquímicos (eletroforese de proteínas) e anatomopatológicos. Resultados: ocorreu regeneração dos implantes esplênicos autógenos nos animais dos grupos com preservação do baço a 4ºC. A captação de estanho coloidal foi superior nos grupos 1, 3, 6 e 7 em relação aos demais. Não houve diferença nos valores hematimétricos nos sete grupos. A eletroforese de proteínas mostrou diminuição da fração gama no grupo de animais esplenectomizados em relação aos grupos operados. Conclusão: o tecido esplênico conservado em solução de Ringer-lactato à temperatura de 4ºC mantém sua estrutura morfológica e permite a recuperação funcional após ser implantado sobre o omento maior.

Influence of splenic implants in the subcutaneous tissue on asplenic animals survival / Influência de implante esplênico em subcutâneo na sobrevida de animais esplenectomizados

ABSTRACT Background: The best site for splenic implant was not defined, mainly evaluating the functionality of the implant. Aim: To evaluate the effects of autogenous splenic implantation on the subcutaneous tissue in the survival of splenectomized rats. Method: Twenty-one randomly assigned rats were studied in three groups (n=7): group 1 - manipulation of the abdominal cavity and preservation of the spleen; group 2 - total splenectomy; group 3 - splenectomy and implant of the tissue removed in the subcutaneous. The animals were followed for 90 days postoperatively. Results: There was a higher mortality in groups 2 (p=0.0072) and 3 (p=0.0172) in relation to group 1. There was no difference between groups 2 and 3 (p=0.9817). Conclusion: The splenic implant in the subcutaneous is ineffective in the survival of rats submitted to splenectomy.

RESUMO Racional: O melhor sítio para implante esplênico não foi definido, principalmente avaliando a funcionalidade do implante. Objetivo: Avaliar os efeitos do implante esplênico autógeno subcutâneo na sobrevida de ratos esplenectomizados. Métodos: Foram estudados 21 ratos alocados aleatoriamente em três grupos (n=7): grupo 1 - manipulação da cavidade abdominal e preservação do baço; grupo 2 - esplenectomia total; grupo 3 - esplenectomia e implante do tecido retirado no subcutâneo. Os animais foram acompanhados por 90 dias pós-operatórios. Resultados: Houve mortalidade maior nos grupos 2 (p=0,0072) e 3 (p=0,0172) em relação ao grupo 1. Não houve diferença entre os grupos 2 e 3 (p=0,9817). Conclusão: O implante esplênico no subcutâneo é ineficaz na sobrevida de ratos submetidos à esplenectomia.

Comparative study of intraperitoneal adhesions related to light-weight polypropylene mesh and type I polymerized and purified bovine collagen coated light-weight polypropylene mesh in rabbits

Abstract Purpose: To compare the effectiveness of light-weight polypropylene mesh coated with polymerized and purified bovine type I collagen (Surgidry HNB) in the treatment of abdominal wall defect and the degree of adhesion formation. Methods: Two types of polypropylene mesh were implanted after creation of defect measuring 6.0cm X 5.5cm in the anterior abdominal wall of 32 male New Zealand breed rabbits, divided in two groups (n = 32): (1) light-weigh macroporous polypropylene, (2) type I polymerized and purified bovine collagen coated light-weigh macroporous polypropylene. These animals were further accessed for adhesions, histological evaluation of inflammation and wall's thickness. Results: The percentage of the area adhered in group 1 (62.31 ± 16.6) was higher compared to group 2 (22.19 ± 14.57) (p <0.05). There was an association between the percentage of the covered area by adhesions and the type of adhesion, toughness and the scores obtained by the adhesion score by correlation analysis (p <0.05). There was no difference between the groups in any variables in relation to the degree of inflammation. Conclusion: The purified type I bovine collagen coated light-weigh polypropylene mesh showed to be effective in the repair of abdominal wall defects and reducing adhesion formation.

The impact of colostomy on the patient's life / O impacto da colostomia na vida de seus portadores

Abstract Purpose To evaluate the emotional, psychological, sexual, social, and professional impact, before and after surgery, on individuals submitted to a colostomy. Methods The study was carried out in two stages, with the participation of 15 individuals. First, we evaluated the emotional, psychic, sexual, social, and professional aspects of their lives, in the preoperative period of colostomy surgery. After that, the same aspects were evaluated six months after the surgery. This evaluation was based on the application of a questionnaire with 16 objective questions. Results Of the interviewees, 53.64% decreased their willingness to go out and do activities outside their homes, with a statistical significance of p = 0.001. Regarding the environment, 53.85% of the interviewees showed a perception of worsening of the environment. About physical activity, 66.65% showed a difference in the performance of physical activity after colostomy, being statistically significant, with p = 0.001. The sports environment did not change in 50% of the participants. Patient sexuality showed a significant decline with statistical significance (p = 0.008). Conclusion The impact that the colostomy generated on the patients' lives, regarding the evaluated aspects, was perceptible, being of great importance the careful indication of this procedure to the patient.

Resumo Objetivos Avaliar o impacto emocional, psíquico, sexual, social e profissional, pré e pós colostomia, em indivíduos que passaram por cirurgia de colostomia. Método Foi realizado em duas etapas com participação de 15 indivíduos. Na primeira houve avaliação sobre os aspectos emocional, psíquico, sexual, social e profissional de suas vidas, no momento pré-operatório à cirurgia de colostomia. Na segunda avaliaram-se os mesmos aspectos seis meses após a cirurgia. Esta avaliação foi a partir da aplicação de um questionário com 16 questões objetivas. Resultados Dos entrevistados, 53,64% diminuíram a vontade de sair e fazer atividades fora do lar, com significância estatística de p = 0,001. Quanto ao ambiente instalado, em 53,85% dos entrevistados apresentaram percepção de piora do ambiente. Em relação à atividade física, 66,65% dos participantes apresentaram diferença no desempenho da atividade física pós-colostomia, sendo este dado estatisticamente significante com p = 0,001. O ambiente esportivo não mudou para 50% dos participantes. A sexualidade do paciente evidenciou grande decaimento com significância estatística (p = 0,008). Conclusão Foi perceptível o impacto que a colostomia gerou na vida de seus portadores nos aspectos avaliados, sendo de grande importância a indicação criteriosa desse procedimento ao paciente.

Aspectos fisiopatológicos da síndrome pós-ressecção anterior do reto para o tratamento de câncer retal / Pathophysiological aspects of the low anterior resection syndrome for treatment of rectal cancer

RESUMO O número de pacientes com distúrbios funcionais intestinais em decorrência das operações para o tratamento do câncer retal tem aumentado durantes as últimas décadas. Alterações anatômicas e funcionais após a retirada do reto provocam aumento da frequência evacuatória, urgência evacuatória, evacuações múltiplas e incontinência para fezes e flatos, caracterizando a síndrome da ressecção anterior baixa ou LARS - "low anterior resection syndrome". Este artigo apresenta uma revisão geral do tema, com ênfase para conceitos atuais e aspectos fisiopatológicos de distúrbios funcionais do intestino após o tratamento cirúrgico do câncer retal. É fundamental que o cirurgião compreenda esses mecanismos, para melhor abordagem dos pacientes e restabelecimento da sua qualidade de vida.

ABSTRACT The number of patients with bowel dysfunction due to the treatment of rectal cancer has increased during the recent decades. Anatomical and functional disorders after the removal of the rectum are followed by increased stool frequency, urgency, multiple evacuations and flatus or stool incontinence characterizing the low anterior resection syndrome - LARS. The purpose of this article is to present a review of the literature on current concepts and pathophysiological aspects of bowel dysfunction after resection of rectal cancer. It is essential to understand these mechanisms for a better management of patients and recovery of their quality of life.