Anatomorphometry of the brachial plexus under high-definition system: an experimental study in rats

Purpose: To study the anatomorphometry of the plexus brachialis (PB) of rats under a high-definition video system. Methods: Ten male Wistar rats discarded from other research that did not interfere in the morphology of the animal, respecting the principle of reduction, were used. All animals were submitted to the same protocol. Initially, the cervical region was shaved. The animals were placed in a dorsal position. A single elbow-to-elbow incision was performed and dissection started at the deltopectoral sulcus. The procedures were performed under a video system. To measure the structures, the Image J software was used. Results: All the PB evaluated originated from the C5-T1 spinal nerves. C5 and C6 converged to form the truncus superior, the root of C7 originated the truncus medius, and the confluence of C8 and T1 originated the truncus inferior. It was found the union of C7, C8, and T1 to form truncus inferomedialis instead of separate medial and inferior truncus. C8 (1.31 mm) was the thickest root, the truncus inferior (1.80 mm) and the nerve radialis (1.02 mm), were the thickest. Conclusions: The anatomy of the PB is comparable to humans, admitting variations. The videomagnification system is useful to perform microsurgical dissection.

Incisional hernia repair in rats: description of the sublay technique under videomagnification system

Purpose: To describe the technique of sublay correction of incisional hernia in Wistar rats under videomagnification system. Methods: Five male rats of the species Rattus norvegicus, of the Wistar lineage, with body weight between 250­350 g and 60 days old were used. Incisional hernia was inducted in all animals. After that, the incisional hernia was immediately corrected by the sublay method. Results: There were no cases of recurrence of the incisional hernia after placement of the polypropylene mesh using the sublay technique. No postoperative complications were observed. Conclusions: The technique is suitable for execution in Wistar rats.

A new anesthetic protocol to medullary nerve roots access in rats

ABSTRACT Purpose: To describe a new anesthetic protocol medullary and nerve roots access and in Rattus norvegicus. Methods: Seventy female Wistar rats (n=70) were used. The animals were randomly divided into two laminectomy groups: cervical (n=40) and thoracic (n=30). In cervical group, a right posterior hemilaminectomy was performed to access the nerve roots. In thoracic group, a laminectomy of the eighth thoracic vertebra was accomplished. Thirty-five rats (20 cervical and 15 thoracic) were submitted to old anesthetic protocol (ketamine 70 mg/kg plus xylazine 10 mg/kg); and the 35 other animals (20 cervical and 15 thoracic) were submitted to a new anesthetic protocol (ketamine 60 mg/kg,xylazine 8 mg/kg and fentanyl 0.03 mg/kg). Results: The time to complete induction was 4.15 ±1.20 minin ketamine, xylazine and fentanyl group, and it was 4.09 ±1.47 min in the ketamine and xylazine group. There was no correlation in the time required to perform the cervical laminectomy in the old anesthetic protocol. In all groups, the animals submitted to the old anesthetic protocol had a higher level of pain on the first and third postoperative days than the animals submitted to the new anesthetic protocol. Conclusions: The new anesthetic protocol reduces the surgical time, allows better maintenance of the anesthetic plan, and brings more satisfactory postoperative recovery.

O oftalmologista e as uvas: Um modelo de treinamento microcirúrgico / The ophthalmologist and the grapes: A microsurgical training model

Resumo Objetivo: Desenvolver um modelo de treinamento de cirurgias corneanas utilizando uvas. Métodos: Foram empregadas uvas como estruturas que mimetizam o tamanho do globo ocular humano, recobertas com materiais de látex, simulando a pratica de cirurgias de córnea utilizando um sistema de videomagnificação. Foram realizados oito pontos simples. Foi avaliado o tempo de confecção do procedimento. Resultados: Foram realizadas 25 simulações como o modelo descrito. O tempo médio de realização da rafia foi de 34,56 ±5,79 minutos. A análise da correlação entre o tempo e a ordem das cirurgias mostrou uma redução no tempo de confecção. Conclusão: O modelo de treinamento oftalmológico utilizando uvas mostrou-se capaz de simular as etapas básicas do treinamento de suturas microcirúrgicas.

Abstract Objective: Develop a training model for corneal surgery using grapes. Methods: Grapes were used as structures that mimic the size of the human eyeball, covered with latex materials, simulating the practice of corneal surgery using a videomagnification system. Eight simple stitches were performed. The surgical time was evaluated. Results: 25 simulations were carried out as the model described. The mean time taken for the raffia was 34.56 ± 5.79 minutes. The analysis of the correlation between the time and the order of the surgeries showed a reduction in the confection time. Conclusion: The ophthalmic training model using grapes proved to be capable of simulating the basic stages of microsurgery suture training.

Se a vida lhe der tomates, treine microcirurgia / If lives gives you tomatoes, training microsurgery

Resumo Objetivo: Desenvolver um modelo treinamento utilizando tomates para aquisição de habilidades microcirúrgicas oftalmológicas. Métodos: Duas espécies de tomates (Tomate longa vida e cereja) foram utilizados, sendo utilizados tomates verdolengos e maduros. Delimitou-se com marcador permanente um círculo de raio de 0,5cm. Sob magnificação de um sistema de vídeo, foi realizado a separação da casca, tentando evitar lesionar a fruta. Após a dissecção, foi realizado a rafia da região removida com fio de mononáilon 10-0. Resultados: Os modelos utilizados mostraram-se viáveis para a realização do treinamento de dissecção microcirúrgica independente da espécie. O custo médio de cada simulador foi de menos de R$2,00. O tempo médio de dissecção foi de 10,40 ±1,84 minutos no tomate maduro e 15,20 ±2,25 minutos no verdolengos. Apenas nos tomates verdolengos foi possível realizar a rafia. Conclusão: O modelo de treinamento desenvolvido mostrou-se adequado para o treinamento inicial de várias habilidades oftalmológicas. Além disso, apresenta um baixo custo e fácil aquisição e confecção.

Abstract Objectives: Develop a training model using tomatoes to acquire ophthalmic microsurgical skills. Methods: Two species of immature and mature tomatoes (long life and cherry tomato) were used. A 0.5cm radius circle was delimited with a permanent marker. Under a magnification by a video system, the peel was separated, trying to avoid damaging the fruit. After dissection, it was performed the raffia of the peel with 10-0 mononylon thread. Results: The models used proved to be viable for training in microsurgical dissection, regardless of the species. The average cost of each simulator was less than U$ 1.00. The average dissection time was 10.40 ± 1.84 minutes for ripe tomatoes and 15.20 ± 2.25 minutes for greens. Only in immature tomatoes was it possible to make the raffia. Conclusion: The training model developed proved to be suitable for the initial training of many ophthalmic skills. In addition, it has a low cost and is easy to purchase and manufacture.

Remote ischemic conditioning enhances heart and brain antioxidant defense / Condicionamento isquêmico remoto melhora a defesa antioxidante do coração e do cérebro

Abstract Background Ischemia-reperfusion injury contributes to morbidity after revascularization procedures. Along with early reperfusion, tissue conditioning by alternating intervals of brief ischemia-reperfusion episodes is considered the best approach to limit tissue damage. Remote ischemic conditioning is conducted remotely, in tissues other than those under ischemia. Despite this, remote ischemic conditioning protection mechanisms are poorly understood, which can lead to misapplication. Objectives To assess whether remote ischemic conditioning works in the heart and brain through enhancement of cells' antioxidant defenses and whether the response is sustained or temporary. Methods Twenty-one male Wistar rats were assigned to three groups (n = 7): SHAM: same procedure as the other groups, but no remote ischemic conditioning was carried out. RIC 10: heart and brain were harvested 10 minutes after the remote ischemic conditioning protocol. RIC 60: heart and brain were harvested 60 minutes after the remote ischemic conditioning protocol. The remote ischemic conditioning protocol consisted of 3 cycles of 5 min left hindlimb ischemia followed by 5 min left hindlimb perfusion, lasting 30 min in total. Heart and brain samples were used to measure the tissue antioxidant capacity. Results Remote ischemic conditioning increased heart and brain antioxidant capacity after 10 minutes (0.746 ± 0.160/0.801 ± 0.227 mM/L) when compared to SHAM (0.523 ± 0.078/0.404 ± 0.124 mM/L). No enhancement of heart or brain antioxidant capacity was detected 60 minutes after remote ischemic conditioning (0.551 ± 0.073/0.455 ± 0.107 mM/L). Conclusions Remote ischemic conditioning temporarily enhances heart and brain antioxidant defenses in male Wistar rats.

Resumo Contexto A lesão de isquemia e reperfusão contribui para a morbidade após procedimentos de revascularização. Juntamente com a reperfusão precoce, o condicionamento tecidual através de breves episódios de isquemia e reperfusão é considerado a melhor abordagem para limitar o dano tecidual. Apesar disso, os mecanismos do condicionamento isquêmico remoto são pouco compreendidos, o que pode levar a uma aplicação incorreta. Objetivos Avaliar se o condicionamento isquêmico remoto funciona no coração e no cérebro através do aprimoramento da defesa antioxidante das células e se é uma resposta sustentada ou temporária. Métodos Vinte e um ratos Wistar foram divididos em três grupos (n = 7): SHAM, no qual não foi realizado condicionamento isquêmico; RIC 10, no qual 10 minutos após o protocolo de condicionamento isquêmico, foi realizada a coleta dos órgãos; e RIC 60, no qual 60 minutos após o protocolo de condicionamento isquêmico, foi realizada a coleta dos órgãos. O protocolo de condicionamento isquêmico remoto consistiu em três ciclos de 5 minutos de isquemia, seguidos de 5 minutos de perfusão no membro posterior esquerdo, com duração total de 30 minutos. Amostras foram usadas para medir a capacidade antioxidante do tecido. Resultados O condicionamento isquêmico remoto aumentou a capacidade antioxidante do coração e do cérebro após 10 minutos (0,746 ± 0,160/0,801 ± 0,227 mM/L) quando comparado ao SHAM (0,523 ± 0,078/0,404 ± 0,124 mM/L) . Sessenta minutos após o condicionamento isquêmico remoto, não foi detectado aumento da capacidade antioxidante do coração ou do cérebro (0,551 ± 0,073/0,455 ± 0,107 mM/L). Conclusões O condicionamento isquêmico remoto melhora temporariamente as defesas antioxidantes do coração e do cérebro em ratos Wistar.

Bioética e discentes de medicina: transição do método de ensino / Bioethics and medical students: teaching method transition / Bioética y estudiantes de medicina: transición del método de enseñanza

Resumo As metodologias ativas vêm se mostrando a melhor alternativa para o ensino médico. Ainda assim, não há na literatura pesquisas que comparem sua utilização no ensino da ética e bioética. Nessa perspectiva, este estudo busca relacionar o conhecimento de alunos de medicina de duas modalidades de ensino distintas (tradicional e ativa) sobre o Código de Ética Médica. O tipo de metodologia não se mostrou impactante no grau de leitura ou de conhecimento do Código de Ética Médica, e os estudantes acreditaram ter o mesmo grau de conhecimento. No entanto, os discentes da metodologia ativa deram mais importância à disciplina de bioética e ética médica e apresentaram maior conhecimento em uma das questões sobre a normatização do Código de Ética Médica.

Abstract Active methodologies has proven to be the best alternative for medical education. However, there no research, in the literature, comparing its use in teaching ethics and bioethics. Therefore, this study seeks to compare the knowledge of medical students from two different types of teaching (traditional and active) regarding the Code of Medical Ethics. The type of teaching methodology did not show impact on the degree of reading or knowledge of the Code of Medical Ethics, in addition both types of students believed to present the same degree of knowledge. However, students of the active methodology gave more importance to the bioethics and medical ethics discipline and presented greater knowledge on one of the questions concerning the standardization of the Code of Medical Ethics.

Resumen Las metodologías activas vienen mostrándose como la mejor alternativa para la formación médica. Sin embargo, no hay en la literatura investigaciones que comparen su utilización en la enseñanza de ética y bioética. En esta perspectiva, este estudio procura relacionar el conocimiento de estudiantes de medicina de dos modalidades de enseñanza distintas (tradicional y activa) sobre el Código de Ética Médica. El tipo de metodología no se mostró impactante en el grado de lectura o de conocimiento del Código de Ética Médica, y los estudiantes creyeron presentar el mismo grado de conocimiento. No obstante, los estudiantes de la metodología activa dieron mayor importancia a la asignatura de bioética y ética médica, y presentaron mayor conocimiento en una de las preguntas sobre la normativización del Código de Ética Médica.

Bilateral compartment syndrome of the lower limbs after urological surgery in the lithotomy position: a clinical case / Síndrome compartimental dos membros inferiores após cirurgia urológica na posição de litotomia: um relato de caso

Acute compartment syndrome of the lower extremities after urological surgery in the lithotomy position is a rare but potentially devastating clinical and medicolegal problem. We report the case of a 67-year-old male who underwent laparoscopic prostatectomy surgery to treat cancer, spending 180 minutes in surgery. Postoperatively, the patient developed acute compartment syndrome of both legs, needing emergency bilateral four-compartment fasciotomies, with repeated returns to the operating room for second-look procedures. The patient also exhibited delayed wound closure. He regained full function within 6 months, returning to unimpaired baseline activity levels. This report aims to highlight the importance of preoperative awareness of this severe complication which, in conjunction with early recognition and immediate surgical management, may mitigate long-term adverse sequelae and improve postoperative outcomes

A síndrome compartimental aguda dos membros inferiores após cirurgia urológica na posição de litotomia é um problema clínico e médico-legal raro, mas potencialmente devastador. Reportamos o caso de um homem de 67 anos submetido a uma prostatectomia laparoscópica por câncer. A cirurgia durou 180 min. No pós-operatório, o paciente desenvolveu síndrome compartimental aguda de ambos os membros inferiores, necessitando de fasciotomias de urgência, com retornos repetidos à sala de cirurgia para procedimentos adicionais. O paciente também apresentou fechamento tardio da ferida. Ele recuperou a função completa dentro de 6 meses e retornou a um nível de atividade basal irrestrito. Este artigo tem a importância de ressaltar a consciência pré-operatória desta grave complicação que, em conjunto com o reconhecimento precoce e o tratamento cirúrgico imediato, pode mitigar sequelas adversas em longo prazo e melhorar os resultados pós-operatórios

New training model using chickens intestine for pediatric intestinal anastomosis

Abstract Purpose: To develop a new low-cost, easy-to-make and available training model using chickens' intestine for infant intestinal anastomosis. Methods: Segments of chicken intestine were used to create an intestinal anastomosis simulator. We tried to perform an end-to-end, end-to-side and side-to-side anastomosis. Handsewn sutured anastomosis were performed in single layered with interrupted prolene 5-0 suture. The parameters analyzed were cost, intestine's diameter and length, anastomosis patency and flow-through and leakage amount. Results: In all cases it was possible to make the anastomosis in double layered without difficulties, different from the usual ones. There was a positive patency at all anastomoses after the end of the procedure, with no need for reinterventions. Conclusion: The new training model using chickens' intestine for infant intestinal anastomosis is low-cost, easy-to-make and easy available.

Effect of copaiba oil in intestinal mucosa of rats submitted to hypovolemic shock / Efeito do óleo de copaíba na mucosa intestinal de ratos submetidos ao choque hipovolêmico

ABSTRACT Background: Hypovolemic shock is a common disease in polytrauma patients and may develop ischemia in various organs, increasing morbidity and mortality. The bowel is usually most affected by this condition. Aim: To evaluate the effects of copaiba oil on the intestinal mucosa's injury of rats submitted to hypovolemic shock. Method: Fifteen rats were divided into three groups: sham - simulated surgery; ischemia - animals submitted to hypovolemic shock; and copaiba - animals submitted to hypovolemic shock previously treated with copaiba oil. Mean blood pressure, arterial blood gas after shock induction, degree of intestinal lesion and villus length were evaluated. Results: The sham presented the lowest values of lactate and PaCO2 and the highest values of mean arterial pressure, pH and bicarbonate in relation to the other groups. The degree of mesenteric lesion was zero in the sham group; 3.00±1.00 in the ischemia group; and 3.00±0.71 in the copaiba group. The villus length was 173.60±8.42 in the sham, 142.77±8.33 in the ischemia and 143.01±9.57 in the copaiba group. There was a significant difference between the sham and the other groups (p<0.05); however, there not significant difference between groups Ischemia and copaiba. Conclusion: Administration of copaiba oil did not reduce the intestinal mucosa lesion of rats after hypovolemic shock.

RESUMO Racional: O choque hipovolêmico é situação comum em pacientes politraumatizados, podendo acarretar isquemia de vários órgãos, aumentando a morbimortalidade. O intestino é geralmente um dos órgãos mais afetados por essa condição. Objetivo: Avaliar os efeitos do óleo de copaíba na lesão da mucosa intestinal de ratos submetidos ao choque hipovolêmico. Métodos: Quinze ratos foram distribuídos em três grupos: Sham - operação simulada; isquemia - submissão ao choque hipovolêmico; e copaíba - submissão ao choque hipovolêmico previamente tratados com óleo de copaíba. A pressão arterial média, a gasometria arterial após a indução do choque, o grau da lesão intestinal e o tamanho das vilosidades foram avaliados. Resultados: O grupo sham apresentou os menores valores de lactato e PaCO2 e os maiores valores de pressão arterial média, pH e bicarbonato em relação aos demais grupos. O grau de lesão mesentérica foi de zero no sham; 3,0±1,00 no grupo isquemia; e 3,0±0,71 no da copaíba. O comprimento dos vilos foi de 173,60±8,42 no grupo sham, 142,77±8,33 no da isquemia e 143,01±9,57 no da copaíba. Houve diferença significante entre o grupo sham e os demais grupos (p<0.05); contudo, não houve diferença estatística entre os grupos submetidos ao choque hipovolêmico. Conclusão: A administração do óleo de copaíba não reduziu a lesão da mucosa intestinal de ratos submetidos ao choque hipovolêmico.

Does the type of electrode affect the electromyoneurographic parameters in rats?

Abstract Purpose: To evaluate if the type of electrode (needle vs. surface) affects the electromyoneurography parameters in rats. Methods: Twenty male rats were anesthetized, then compound muscle action potential were recorded using a Neuropack S1 MEB- 9400©. All animals were submitted to two electroneuromyography analysis: first with surface electrode and then by needle electrode. We evaluated the latency, amplitude, duration and area of the negative peak of the gastrocnemius and cranial tibial muscles. Results: There were no significant differences between the groups in the mean of duration, latency, amplitude or area of the negative peak in gastrocnemius and cranial tibial muscles. Conclusion: The type of electrode does not affect the electroneuromyography parameters.

Influence of tramadol on functional recovery of acute spinal cord injury in rats

Abstract Purpose: To evaluate the influence tramadol on functional recovery of acute spinal cord injury in rats. Methods: Ten rats were divided into two groups (n = 5). All animals were submitted by a laminectomy and spinal cord injury at eighth thoracic vertebra. In control group, the rats didn't receive any analgesic. In tramadol group, the rats received tramadol 4mg/Kg at 12/12h until 5 days by subcutaneous. Animals were following by fourteen days. Was evaluated the Basso, Beattie, Bresnahan scale (locomotor evaluation) and Rat Grimace Scale (pain evaluation) at four periods. Results: There no difference between the groups in locomotor evaluation in all periods evaluated (p>0.05) and in both groups there was a partial recover of function. The tramadol group show a lower pain levels at the first, third and seventh postoperatively days when comparing to the control group. Conclusion: The tramadol as an analgesic agent don't influence on functional recovery of acute spinal cord injury in rats

Modelo de dissecção e acesso vascular de baixo custo / Low cost model for vascular dissection and access

OBJETIVO: Descrever um modelo de treinamento de baixo custo de dissecção e acesso vascular utilizando língua bovina. MÉTODOS: Foram utilizadas dez línguas de boi para confecção de simuladores. Inicialmente, o corpo da língua foi dissecado, separando as camadas epitelial e muscular, e o pedículo vascular foi destacado da base da língua. A artéria principal da língua foi, então, cateterizada e conectada a uma seringa, sendo, em seguida, fixada à porção muscular. Após, para simular o tecido celular subcutâneo, foi confeccionada uma pasta amarela gelatinosa, que foi posicionada de modo a cobrir a extensão do pedículo vascular por inteiro. Por fim, a camada epitelial da língua foi reposicionada sob a camada muscular, por meio de sutura contínua. Para avaliar o modelo, foram observados o tempo de confecção do modelo, sua durabilidade, seu custo e o número de vezes que pôde ser usado. RESULTADOS: O tempo médio para confecção do modelo foi de 15,82±2,45 minutos, com durabilidade de 20 dias sob refrigeração. O custo médio foi de R$25,00, podendo ser utilizado, em média, por 3,8±0,63 vezes. Não houve falhas na montagem do modelo. CONCLUSÃO: O modelo de língua de boi se mostrou viável e de fácil aplicação para o treinamento de técnica cirúrgica de dissecção vascular. (AU)

OBJECTIVE: To describe a low cost training model for dissection and vascular access using a bovine tongue. METHODS: Ten bovine tongues were used to build simulators. First, the body of the tongue was dissected, with its epithelial layer being separated from the muscular layer, and the vascular pedicle was detached from the base of the tongue. The tongue main artery was then catheterized and connected to a syringe, and subsequently fixed to the muscle layer. Then, the entire vascular pedicle was covered with a yellow gelatinous paste to simulate the subcutaneous tissue. Finally, the epithelial layer was repositioned above the muscle layer through continuous suture. To evaluate the model, 4 variables were considered: 1) time for building the model, 2) its durability, 3) its cost, 4) number of times that it could be used. RESULTS: The mean time to make the model was 15.82 ±2.45 minutes, with a durability of 20 days under refrigeration. The mean cost of each model was U$10.00, and could be used about 3.8±0.63 times. There were no fails to build the model. CONCLUSIONS: The model with a bovine tongue proved to be viable and easy to be applied for training the surgical technique of vascular dissection. (AU)

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.

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.

Continuous versus interrupted suture technique in microvascular anastomosis in rats

Abstract Purpose: To compare the continuous and interrupted suture technique on femoral artery on rats after vessel repair and 14 days after. Methods: Twenty rats were operated randomly divided into two group matched according to the suture technique used: interrupted or continuous. We performed a femoral anastomosis on the right femoral artery. We analyzed weight, arterial caliber, anastomosis time and patency after vessel repair and 14 days after. Results: There was no significant difference between groups in the weight (p=0.64), diameter of the femoral artery (p=0.95) and patency (p=1.00). The time spent in the anastomosis was 451 seconds in the continuous group and 718 seconds in the interrupted group, presenting significant difference (p<0.01). Conclusion: The continuous suture technique shows a similar patency rates than interrupted technique, however with a shorter time to perform the anastomosis.

Perconditioning combined with postconditioning on kidney ischemia and reperfusion

Abstract Purpose: To evaluate if combination of perconditioning and postconditioning provides improved renal protection compared to perconditioning alone in a model of renal reperfusion injury. Methods: Thirty rats were assigned into 6 groups: normality; sham; ischemia and reperfusion; postconditioning; perconditioning; perconditioning + postconditioning. Animals were subjected to right nephrectomy and left renal ischemia for 30 minutes. Postconditioning consisted of 3 cycles of 5 min renal perfusion followed by 5 min of renal ischemia after major ischemic period. Perconditioning consisted of 3 cycles of 5 min hindlimb ischemia followed by 5 min of hindlimb perfusion contemporaneously to renal major ischemic period. After 24 hours, kidney was harvested and blood collected to measure urea and creatinine. Results: Perconditioning obtained better values for creatinine and urea level than only postconditioning (p<0.01); performing both techniques contemporaneously had no increased results (p>0.05). Regarding tissue structure, perconditioning was the only technique to protect the glomerulus and tubules (p<0.05), while postconditioning protected only the glomerulus (p<0.05). Combination of both techniques shows no effect on glomerulus or tubules (p>0.05). Conclusions: Perconditioning had promising results on ischemia and reperfusion induced kidney injury, enhanced kidney function and protected glomerulus and tubules. There was no additive protection when postconditioning and perconditioning were combined.

Different protocols of postconditioning does not attenuate mesenteric ischemia-reperfusion injury after short-term reperfusion / Diferentes protocolos de pós-condicionamento não atenua a lesão de isquemia e reperfusão mesentérica após curto período de reperfusão

ABSTRACT Background: Mesenteric ischemia is a challenging diagnosis. Delay in diagnosis can lead to extent bowel necrosis and poor outcomes. Ischemia and reperfusion syndrome plays an important role in this scenario. Aim: To access effects of different post-conditioning cycles on mesenteric ischemia-reperfusion syndrome. Method: Twenty-five rats were assigned into five groups: Sham, used to establish normal parameters; control group, submitted to mesenteric ischemia for 30 min; in groups GP3, GP1 and GP30, ischemia was followed by post-conditioning protocol, which consisted of 1 cycle of 3 min (GP3), 3 cycles of 1 min (GP1) or 6 cycles of 30 s (GP30), respectively. Ileum samples were harvested after one hour of reperfusion. Intestinal mucosal injury was evaluated through histopathological analysis. Results: The average of mesenteric injury degree was 0 in the sham group, 3.6 in the control group, 3.4 in GP3, 3.2 in GP1, and 3.0 in GP30; villous length average was 161.59 in sham group, 136.27 in control group, 135.89 in GP3, 129.46 in GP1, and 135.18 in GP30. Was found significant difference between sham and other groups (p<0.05); however, there was no difference among post-conditioning groups. Conclusion: Post-conditioning adopted protocols were not able to protect intestinal mucosa integrity after mesenteric ischemia and short term reperfusion.

RESUMO Racional: O desfecho satisfatório na abordagem cirúrgica da obesidade deve contemplar, além da perda de peso, alteração significativa nas comorbidades preexistentes e na qualidade de vida dos pacientes. Objetivo: Avaliar a qualidade de vida no pós-operatório tardio de pacientes submetidos à cirurgia de gastrectomia vertical por videolaparoscopia. Métodos: Foi aplicado o questionário "Bariatric Analysis and Reporting Outcome System" (BAROS) em pacientes submetidos à gastrectomia vertical por videolaparoscopia. Resultados: Foram avaliados 47 pacientes, entre 21 e 60 anos de idade. O IMC médio antes da operação era 43,06±5,87 kg/m². A média percentual de redução do excesso de peso após foi de 85,46±23,6%. A pontuação obtida pelos pacientes no questionário sobre a melhora na qualidade de vida evidenciou resultado excelente (36,17%), ótimo (40,43%), bom (21,28%) e razoável (2,13%). Houve melhora clínica após a operação em todas as comorbidades investigadas. Conclusão: A perda de peso foi fundamental para a melhoria na qualidade de vida e proporcionou resolução ou a melhora clínica em todas as comorbidades investigadas.

Morphometric analysis of rat femoral vessels under a video magnification system / Análise morfométrica dos vasos femorais de ratos sob magnificação por sistema de vídeo

The right femoral vessels of 80 rats were identified and dissected. External lengths and diameters of femoral arteries and femoral veins were measured using either a microscope or a video magnification system. Findings were correlated to animals' weights. Mean length was 14.33 mm for both femoral arteries and femoral veins, mean diameter of arteries was 0.65 mm and diameter of veins was 0.81 mm. In our sample, rats' body weights were only correlated with the diameter of their femoral veins

Os vasos femorais de 80 ratos foram identificados e dissecados. O comprimento e o diâmetro externo da artéria e da veia femoral foram mensurados com o auxílio de um microscópio e um sistema de magnificação por vídeo. Esses parâmetros foram correlacionados com o peso do animal. O comprimento de ambos os vasos femorais foi de 14,33 mm, e a média do diâmetro das artérias foi de 0,65 mm, e das veias, de 0,81 mm. Na nossa amostra, o peso dos animais se correlacionou apenas com o diâmetro da veia femoral

Kidney ischemia and reperfunsion syndrome: effect of lidocaine and local postconditioning / Síndrome de isquemia e reperfussão renal: efeito da lidocaína e do pós-condicionamento local

ABSTRACT Objective: to evaluate the effects of blocking the regulation of vascular tone on the ischemia and reperfusion syndrome in rats through the use of lidocaine in the postconditioning technique. Methods: we randomized 35 rats into seven groups of five animals: Group 1- Control; Group 2- Ischemia and Reperfusion; Group 3- Ischemia, Reperfusion and Saline; Group 4- Ischemic Postconditioning; Group 5- Ischemic Postconditioning and Saline; Group 6- Lidocaine; Group 7- Ischemic Postconditioning and Lidocaine. Except for the control group, all the others were submitted to renal ischemia for 30 minutes. In postconditioning groups, we performed ischemia and reperfusion cycles of five minutes each, applied right after the main ischemia. In saline and lidocaine groups, we instilled the substances at a rate of two drops per minute. To compare the groups, we measured serum levels of urea and creatinine and also held renal histopathology. Results: The postconditioning and postconditioning + lidocaine groups showed a decrease in urea and creatinine values. The lidocaine group showed only a reduction in creatinine values. In histopathology, only the groups submitted to ischemic postconditioning had decreased degree of tubular necrosis. Conclusion: Lidocaine did not block the effects of postconditioning on renal ischemia reperfusion syndrome, and conferred better glomerular protection when applied in conjunction with ischemic postconditioning.

RESUMO Objetivo: avaliar os efeitos do bloqueio da regulação do tônus vascular por meio do uso da lidocaína na técnica de pós-condicionamento isquêmico na síndrome de isquemia e reperfusão renal em ratos. Métodos: trinta e cinco ratos foram randomizados em sete grupos de cinco animais: Grupo 1- Controle; Grupo 2- Isquemia e Reperfusão; Grupo 3- Isquemia, Reperfusão e Solução Salina; Grupo 4- Pós-condicionamento Isquêmico; Grupo 5- Pós-condicionamento Isquêmico e Solução Salina; Grupo 6- Lidocaína; Grupo 7- Pós-condicionamento Isquêmico e lidocaína. Com exceção do grupo controle, todos os demais foram submetidos à isquemia renal de 30 minutos. Nos grupos de pós-condicionamento, foi realizado o ciclo de isquemia e reperfusão de cinco minutos cada, aplicado logo após a isquemia principal. Nos grupos salina e lidocaína foram instiladas as substâncias numa taxa de duas gotas por minuto. Para comparar os grupos, foram dosados os níveis séricos de ureia e creatinina e análise histopatológica renal. Resultados: os grupos pós-condicionamento e pós-condicionamento + lidocaína apresentaram uma redução nos valores de ureia e creatinina. O grupo lidocaína apresentou apenas uma redução nos valores de creatinina. Na análise histopatológica, apenas os grupos submetidos ao pós-condicionamento isquêmico apresentaram redução do grau de necrose tubular. Conclusão: a lidocaína não bloqueou os efeitos do pós-condicionamento na síndrome de isquemia e reperfusão renal, mas conferiu melhor na proteção glomerular quando aplicada em conjunto com o pós-condicionamento isquêmico.