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1.
Int. j. morphol ; 41(4): 1004-1008, ago. 2023. ilus, tab
Article in English | LILACS | ID: biblio-1514328

ABSTRACT

SUMMARY: For the purposes of teaching anatomy, the use of cadaver preparations is considered the most efficient way of ensuring that students retain knowledge. Nevertheless, in Ecuador the use of animal specimens in universities must comply with the internationally accepted principles of replacement, reduction and refinement (3Rs). Plastination is an alternative technique which allows organs to be conserved in the long term and complies with the 3Rs. The object of the present work was to use cold-temperature silicone plastination with Biodur® products to obtain long-lasting, easy-to-handle canine organs for use as tools for the teaching of animal anatomy. Six canine cadavers were obtained from local animal protection charities. The hearts, brains and kidneys of the cadavers were dissected and fixed with formaldehyde 10 %. They were then dehydrated with acetone at -20 °C. The specimens were impregnated with Biodur® S10:S3 (-20 °C) and finally cured with Biodur® S6. We plastinated six hearts, twelve kidneys, four brains and one encephalic slice of canine. The application of cold-temperature plastination to canine organs followed the parameters established for the conventional protocol, enabling us to obtain organs of brilliant appearance, free of odours, in which the anatomical form was preserved. Thus the technique helped us to comply with the 3Rs, as we obtained easy-to-handle teaching models to replace fresh or formaldehyde-fixed samples for the teaching-learning of the canine anatomy.


En la enseñanza de la Anatomía, el uso de preparaciones cadavéricas se considera el método que permite a los estudiantes retener el conocimiento de una forma más eficiente. No obstante, en Ecuador, el uso de especímenes animales en las universidades se debe realizar bajo el principio internacional de reemplazo, reducción y refinamiento (3Rs). La técnica de plastinación es una técnica alternativa que permite preservar órganos a largo plazo y que se adapta al principio de las 3Rs. El objetivo del trabajo fue utilizar la técnica de plastinación en silicona al frío con productos Biodur® para obtener órganos caninos duraderos y manejables útiles como herramienta para la enseñanza de la anatomía animal. Se obtuvieron seis cadáveres de caninos de fundaciones locales para la protección animal. Se realizaron disecciones de corazones, cerebros y riñones de los cadáveres caninos. Los órganos se fijaron con formalina al 10 %. A continuación, se llevó a cabo la deshidratación con acetona a -20 °C. Los especímenes fueron impregnados con S10:S3 Biodur® (-20 °C) y al final fueron curados con Biodur® S6. Se lograron plastinar seis corazones, doce riñones, cinco encéfalos y un tallo encefálico de canino. La técnica de plastinación al frío utilizada para obtener órganos de canino conservó los parámetros empleados en el protocolo convencional y permitió obtener órganos que presentaron aspecto brillante, ausencia de olores y mantuvieron la forma anatómica. Por lo que, la técnica facilitó cumplir con el principio de las 3Rs al obtenerse modelos didácticos fáciles de manipular que pueden reemplazar muestras frescas o formolizadas en el proceso de enseñanza-aprendizaje de la anatomía del canino.


Subject(s)
Animals , Dogs , Organ Preservation/methods , Cryopreservation , Plastination , Anatomy, Veterinary/education , Silicones , Tissue Preservation/methods , Cold Temperature , Cerebrum/anatomy & histology , Heart/anatomy & histology , Kidney/anatomy & histology
2.
Rev. Cient. Esc. Estadual Saúde Pública de Goiás Cândido Santiago ; 9 (Ed. Especial, 1ª Oficina de Elaboração de Pareceres Técnicos Científicos (PTC): 9e9- EE3, 2023. ilus
Article in Portuguese | LILACS, CONASS, ColecionaSUS, SES-GO | ID: biblio-1524143

ABSTRACT

Tecnologia: máquina de perfusão hipotérmica. Indicação: Transplante renal de doador falecido. Pergunta: Qual a efetividade da máquina de perfusão hipotérmica (HMP) para a preservação do rim de doador falecido, quando comparada ao armazenamento estático a frio (SCS)? Objetivo. Avaliar a efetividade da máquina de perfusão hipotérmica na preservação do rim de doador falecido, em comparação com o armazenamento estático a frio. Métodos: Revisão de revisões sistemáticas (overview) do tipo revisão rápida. Foi realizado um levantamento bibliográfico nas bases de dados: PubMed, Embase, BVS, Epistemonikos, Cochrane Library e em bases de registro de protocolos de revisões sistemáticas e ensaios clínicos, utilizando descritores e estratégias de busca predefinidas. A avaliação da qualidade metodológica dos estudos incluídos foi feita através da ferramenta AMSTAR-2 (Assessing the Methodological Quality of Systematic Reviews Version 2). Resultados: Duas revisões sistemáticas atenderam aos critérios de elegibilidade e foram incluídas na análise. Uma delas apresentou alto nível de qualidade metodológica. Conclusão: O uso da HMP para a preservação de rins de doadores falecidos foi associado a melhores desfechos clínicos relacionados à função retardada e à sobrevida do enxerto e foi considerado custo-efetivo, quando comparado ao SCS. Faz-se necessária a geração de evidências mais robustas acerca dos custos e benefícios do uso desta tecnologia no âmbito do SUS


Technology: hypothermic machine perfusion. Indication: Deceased donor kidney transplantation. Question: How effective is hypothermic machine perfusion (HMP) for preserving deceased donor kidneys compared to static cold storage (SCS)? Objective: To evaluate the effectiveness of the hypothermic machine perfusion in preserving the deceased donor kidney, compared to static cold storage. Methods: Rapid review of systematic reviews (overview). A bibliographic survey was carried out in the databases: PubMed, Embase, VHL, Epistemonikos, Cochrane Library and in databases of systematic review protocols and clinical trials, using predefined descriptors and search strategies. The assessment of the methodological quality of the included studies was performed using the AMSTAR-2 tool (Assessing the Methodological Quality of Systematic Reviews Version 2). Results: Two systematic reviews met the eligibility criteria and were included in the analysis. One of them performed a high level of methodological quality. Conclusion: The use of HMP for the preservation of deceased donor kidneys was associated with better clinical outcomes related to delayed graft function and graft survival and was considered cost-effective. It is necessary to generate more evidence about the costs and benefits of using this technology within the Brazilian Unified System of Healthcare (SUS)


Subject(s)
Humans , Male , Female , Organ Preservation/methods , Kidney Transplantation , Cold Ischemia
3.
Arq. bras. oftalmol ; 84(2): 163-169, Mar,-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153124

ABSTRACT

ABSTRACT Purpose: The aim of this study was to evaluate the physical and chemical characteristics of coconut water and to analyze the use of coconut water solution for the conservation of human corneas. Methods: This was an experimental and controlled study performed at the Eye Bank of the General Hospital of Fortaleza. The coconut water-based solution was prepared at the Goat Seed Technology Laboratory of the Department of Veterinary Medicine of the State University of Ceará. Discarded corneas from the Eye Bank were divided into two groups for sequential experiments: G1, coconut water-based solution (experimental group), and G2, conservative treatment with OPTISOL GS® (control group). The osmolality of corneas in G1 was analyzed sequentially at 275, 300, 325, 345, 365, and 400 mOsm/L. The viability of the corneas was determined by specular microscopy and biomicroscopy on the first, third, and seventh days. Results: Corneas preserved in a solution of 365 and 345 mOsm/L had a transparency of 8 mm until the third day and had diffuse edema in the periphery, central folds, and partial epithelium loss until the seventh day. The 365-mOsm/L solution was associated with the worst results during follow-up. Corneas placed in Optisol-GS retained their original aspects. Conclusions: Coconut water-based preservative partially maintained corneal transparency and epithelial integrity, especially during the first three days of follow-up. The coconut water-based solutions used were not effective for use as preservatives in a human eye bank.(AU)


RESUMO Objetivos: As características físico-químicas e o baixo custo da água de coco foram fundamentais para o este estudo. Analisar o uso de solução a base de água de coco como meio de conservação de córneas humanas em banco de olhos. Métodos: Estudo experimental e controlado realizado no Banco de Olhos do Hospital Geral de Fortaleza. Utilizou-se solução à base de água de coco preparada no laboratório de Tecnologia de Sêmen de Caprinos do Departamento de Medicina Veterinária da Universidade Estadual do Ceará. Foram usadas córneas de descartes divididas em dois grupos: G1 (Conservante com água de coco) - grupo experimental e G2 (grupo Conservante com OPTISOL GS®) grupo controle, em experimentos sequenciais. A osmolaridade do G1 foi analisada sequencialmente com 275, 300, 325, 345, 365 e 400 mOsm/L. A viabilidade das córneas foram realizadas por microscopia especular e biomicroscopia nos 1º, 3º e 7º dias. Resultados: As córneas em solução de 365 e 345 mOsm/L apresentavam transparência nos 8mm centrais até o 3º dia, com edema em toda periferia, dobras centrais e edema 2+, com perda parcial do epitélio até 7º dia, sendo o de maior osmolaridade com melhor transparência durante o seguimento. Grupo com 275, 300 e 400 mOsm/L, córnea opaca, edema difuso, perda total do epitélio no 3º dia. As córneas em Optisol mantiveram seus aspectos. Conclusões: O conservante à base de água de coco manteve em parte a transparência corneana e a integridade epitelial, especialmente nos primeiros 3 dias de seguimento. A solução conservante com água de coco nas formulações utilizadas não se mostrou eficaz para o uso em banco de olhos humanos.(AU)


Subject(s)
Humans , Organ Preservation/methods , Biotechnology/methods , Organ Preservation Solutions/chemistry , Foods Containing Coconut , Eye Banks/organization & administration
4.
Arq. bras. oftalmol ; 82(1): 56-61, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-973867

ABSTRACT

ABSTRACT Purpose: The porcine eye is frequently used as a research model. This paper analyzes the effect of different storage methods on the transparency of pig crystalline lens. Methods: A spectral transmission curve (from 220 to 780 nm) for the crystalline lens was determined experimentally after storage in different conditions: saline solution, formalin, castor oil, and freezing at -80°C. The total transmission in the visible spectrum, which was used as an index of transparency, was calculated from these curves. For comparative purposes, fresh lenses were evaluated and used as controls. Results: Storing the porcine crystalline lens in saline solution or castor oil resulted in a transparency loss of approximately 10% after 24 h and storage in formalin resulted in a loss of nearly 30%. Storage by freezing at -80°C for 4 weeks maintained the transparency of the crystalline lens; the spectral transmission measured immediately after defrosting at room temperature coincided exactly with that of the freshly extracted lens. Conclusions: The transparency of porcine crystalline lens is affected by the storage method. The visible spectrum is the most affected, evidenced by the effect on the transparency and consequently the amount of light transmitted. The results show that freezing at -80°C maintains the transpa rency of the crystalline lens for at least 4 weeks.


RESUMO Objetivos: Olho de porco é frequentemente usa do como modelos de pesquisa. Este estudo analisa o efeito de di ferentes métodos de armazenamento na preservação da transparência do cristalino de porco. Métodos: Uma curva de transmissão espectral (de 220 até 780 nm) para o cristalino foi experimentalmente determinada após armazenamento em diferentes condições: solução salina, formol, óleo de mamona e congelamento a -80°C. Transmissão total do espectro visível, que foi usada como um índice de transparência foi calculada a partir dessas curvas. Para fins comparativos, lentes frescas foram avaliadas e usadas como controles. Resultados: O armazenamento do cristalino suíno em solução salina ou óleo de mamona resultou uma perda de transparência de aproximadamente 10% após 24 h e o armazenamento em formol resultou uma perda de quase 30%. O armazenamento por congelamento a -80°C durante 4 semanas manteve a transparência do cristalino; a transmissão espectral medida imediatamente após o descongelamen to à temperatura ambiente coincidiu exatamente com a da lente extraída recentemente. Conclusão: A transparência do cristalino suíno é afetada pelo método de armazenamento. O espectro visível é o mais afetado, evidenciado pelo efeito sobre a transparência e consequentemente a quantidade de luz transmitida. Os resultados mostram que o congelamento a -80°C mantém a transparência do cristalino suíno por pelo menos 4 semanas.


Subject(s)
Animals , Organ Preservation/methods , Lens, Crystalline/anatomy & histology , Reference Values , Spectrophotometry/instrumentation , Spectrophotometry/methods , Swine , Time Factors , Ultraviolet Rays , Castor Oil/chemistry , Reproducibility of Results , Models, Animal , Formaldehyde/chemistry , Freezing , Lens, Crystalline/physiology , Lens, Crystalline/diagnostic imaging , Light
5.
Rev. Col. Bras. Cir ; 46(2): e2079, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1003093

ABSTRACT

RESUMO Com a utilização crescente da máquina de perfusão no transplante renal, tem sido constatado que a isquemia dinâmica correlaciona-se à melhora da preservação orgânica. Nesse contexto, realizamos uma revisão sistemática que procurou avaliar a eficácia do uso de máquina de perfusão portátil (LifePort Kidney Transporter Machine®), utilizada no Brasil, comparada ao armazenamento estático, no que tange à função retardada do transplante renal de doadores com morte encefálica. Foi efetuada pesquisa bibliográfica, nas bases LILACS, MEDLINE via PubMed, Scopus, Clarivate Analytics, Cochrane Library, Embase, SciELO, além de busca manual no Google acadêmico. A revisão sistemática, finalizada em abril 2017, foi constituída somente por ensaios clínicos randomizados. Para metanálise, foram avaliadas Razão de Risco e Razão de Chance. Foram identificados 86 documentos e selecionados, ao final, dois artigos com critérios de elegibilidade para metanálise, de grupos europeus e brasileiros. Nestes, 374 rins foram alocados para a máquina de perfusão, e igual número para o armazenamento estático. A função retardada do enxerto foi constatada em 84 e 110 pacientes, respectivamente. Na metanálise, foram obtidas uma Razão de Risco de 0,7568 (p=0,0151) e uma Razão de Chance de 0,6665 (p=0,0225), ambas com intervalo de confiança de 95%. A máquina de perfusão reduziu a incidência de função retardada do enxerto de doadores com morte encefálica.


ABSTRACT With the increasing use of machine perfusion in kidney transplantation, it has been observed that dynamic ischemia correlates with the improvement of organ preservation. In this context, we performed a systematic review that aimed to evaluate the efficacy of the portable machine perfusion (LifePort Kidney Transporter Machine®), used in Brazil, compared to cold storage, regarding the delayed graft function of deceased donors with brain death. Literature search was carried out in LILACS, MEDLINE via PubMed, Scopus, Clarivate Analytics, Cochrane Library, Embase, and SciELO, as well as in Google Scholar manually. The systematic review consisted only of randomized clinical trials. For meta-analysis, relative risk and odds ratio were evaluated. Eighty-six documents were identified and two papers from European and Brazilian groups were selected at the end, with eligibility criteria for meta-analysis. In these, 374 kidneys were assigned to machine perfusion and 374 kidneys were assigned to cold storage. Delayed graft function was observed in 84 and 110 patients, respectively. In meta-analysis, a risk ratio of 0.7568 (p=0.0151) and an odds ratio of 0.6665 (p=0.0225) were obtained, both with a 95% confidence interval. Machine perfusion reduced the incidence of delayed graft function of deceased donors with brain death.


Subject(s)
Humans , Organ Preservation/methods , Perfusion/methods , Brain Death , Cold Ischemia/methods , Kidney , Organ Preservation/instrumentation , Perfusion/instrumentation , Time Factors , Pulsatile Flow , Reproducibility of Results , Risk Factors , Kidney Transplantation/methods , Delayed Graft Function
6.
Acta cir. bras ; 34(4): e201900402, 2019. tab, graf
Article in English | LILACS | ID: biblio-1001091

ABSTRACT

Abstract Purpose: To evaluate the effect of amniotic fluid in liver preservation in organ transplantation, and compare it with standard preservation solutions. Methods: The groups consisted of Group 1: Ringer Lactate (RL) group, Group 2: HTK group, Group 3: UW group, Group 4: AF group. The livers of rats from Group 1, 2, 3, and 4 were perfused and placed into falcon tubes containing RL, HTK, UW, and AF solutions at +4‎°C, respectively. The tubes were stored for 12 hours in the refrigerator at +4°C. Tissue samples were taken at the 6th and 12th hours for histopathological examinations of the perfused livers, and storage solutions for biochemical analyzes at 6th and 12th hours. Results: AF was shown to maintain organ viability by reducing the number of cells undergoing apoptosis. Histopathological changes such as sinusoidal dilatation, hydropic degeneration, and focal necrosis were found to be similar to the groups in which the standard organ preservation solutions were used. Additionally, the results of INOS, IL-10, and TNF-α,which were evaluated immunohistochemically, have been shown to be similar to the UW and HTK groups. Conclusions: AF provided conservation similar to UW and HTK in the 12-hour liver SCS process. The fact that apoptosis values are comparable to standard preservation solutions supports the success of AF in the cold storage of the liver.


Subject(s)
Animals , Male , Cryopreservation/methods , Organ Preservation Solutions/pharmacology , Amniotic Fluid , Liver/blood supply , Liver/pathology , Organ Preservation/methods , Potassium Chloride/pharmacology , Procaine/pharmacology , Reference Values , Time Factors , Tissue Survival , Immunohistochemistry , Reperfusion Injury/prevention & control , Random Allocation , Reproducibility of Results , Tumor Necrosis Factor-alpha/analysis , Interleukin-10/analysis , Rats, Wistar , In Situ Nick-End Labeling , Nitric Oxide Synthase Type II/analysis , Ringer's Solution/pharmacology , Glucose/pharmacology , Mannitol/pharmacology
7.
Einstein (Säo Paulo) ; 17(4): eAO4288, 2019. tab, graf
Article in English | LILACS | ID: biblio-1012012

ABSTRACT

ABSTRACT Objective: To assess the feasibility and impact of ex vivo lung perfusion with hyperoncotic solution (Steen Solution™) in the utilization of these organs in Brazil. Methods: In this prospective study, we subjected five lungs considered to be high risk for transplantation to 4 hours of ex vivo lung perfusion, with evaluation of oxygenation capacity. High-risk donor lungs were defined by specific criteria, including inflammatory infiltrates, pulmonary edema and partial pressure of arterial oxygen less than 300mmHg (inspired oxygen fraction of 100%). Results: During reperfusion, the mean partial pressure of arterial oxygen (inspired oxygen fraction of 100%) of the lungs did not change significantly (p=0.315). In the first hour, the mean partial pressure of arterial oxygen was 302.7mmHg (±127.66mmHg); in the second hour, 214.2mmHg (±94.12mmHg); in the third hour, 214.4mmHg (±99.70mmHg); and in the fourth hour, 217.7mmHg (±73.93mmHg). Plasma levels of lactate and glucose remained stable during perfusion, with no statistical difference between the moments studied (p=0.216). Conclusion: Ex vivo lung perfusion was reproduced in our center and ensured the preservation of lungs during the study period, which was 4 hours. The technique did not provide enough improvement for indicating organs for transplantation; therefore, it did not impact on use of these organs.


RESUMO Objetivo: Avaliar a exequibilidade e o impacto da perfusão pulmonar ex vivo com solução hiperoncótica (Steen Solution™) na taxa de utilização desses órgãos no Brasil. Métodos: Neste estudo prospectivo, submetemos cinco pulmões considerados de alto risco para o transplante a 4 horas de perfusão pulmonar ex vivo, com avaliação da capacidade de oxigenação pulmonar. Os pulmões de doadores de alto risco foram definidos por critérios específicos, incluindo infiltrado inflamatório, edema pulmonar e pressão parcial de oxigênio arterial inferior a 300mmHg (fração inspirada de oxigênio de 100%). Resultados: Durante a reperfusão, a pressão parcial de oxigênio arterial (fração inspirada de oxigênio de 100%) média dos pulmões não sofreu alteração significativa (p=0,315). Na primeira hora, a pressão parcial de oxigênio arterial média foi de 302,7mmHg (±127,66mmHg); na segunda, 214,2mmHg (±94,12mmHg); na terceira, 214,4mmHg (±99,70mmHg); e na quarta, 217,7mmHg (±73,93mmHg). Os níveis plasmáticos de lactato e glicose se mantiveram estáveis ao longo da perfusão, sem diferença estatística na comparação entre os momentos estudados (p=0,216). Conclusão: A perfusão pulmonar ex vivo foi reproduzida em nosso centro e garantiu a preservação de pulmões durante o período de estudo, que foi de 4 horas. A técnica não promoveu melhora suficiente para indicação do órgão para o transplante e, portanto, não impactou na taxa de utilização desses órgãos.


Subject(s)
Humans , Male , Female , Adult , Organ Preservation/methods , Perfusion/methods , Tissue Donors , Lung Transplantation/methods , Brazil , Lung Compliance , Cross-Sectional Studies , Prospective Studies , Donor Selection , Lung/blood supply , Middle Aged
8.
J. bras. pneumol ; 45(4): e20170288, 2019. graf
Article in English | LILACS | ID: biblio-1040273

ABSTRACT

ABSTRACT Liquid perfluorocarbon (PFC) instillation has been studied experimentally as an adjuvant therapy in the preservation of lung grafts during cold ischemia. The objective of this study was to evaluate whether vaporized PFC is also protective of lung grafts at different cold ischemia times. We performed histological analysis of and measured oxidative stress in the lungs of animals that received only preservation solution with low-potassium dextran (LPD) or vaporized PFC together with LPD. We conclude that vaporized PFC reduces the production of free radicals and the number of pulmonary structural changes resulting from cold ischemia.


RESUMO O perfluorocarbono (PFC) líquido tem sido estudado experimentalmente como uma substância adjuvante na preservação de enxertos pulmonares durante o período de isquemia fria. O objetivo deste estudo foi avaliar se o PFC vaporizado (e não instilado) também atuaria como protetor de enxertos pulmonares em diferentes tempos de isquemia fria. Realizamos análise histológica e dosamos o estresse oxidativo em pulmões de animais que receberam somente uma solução de preservação com low-potassium dextran (LPD, dextrana com baixa concentração de potássio) ou PFC vaporizado associado a LPD. Concluímos que o PFC vaporizado reduziu a produção de radicais livres e provocou menor número de alterações estruturais pulmonares decorrentes do período de isquemia fria que o uso de LPD isoladamente.


Subject(s)
Humans , Organ Preservation/methods , Lung Transplantation/methods , Oxidative Stress/drug effects , Cold Ischemia/methods , Fluorocarbons/pharmacology , Lung/drug effects , Reference Values , Time Factors , Reproducibility of Results , Dextrans/pharmacology , Organ Preservation Solutions , Glucose/pharmacology , Lung/pathology
9.
Arch. argent. pediatr ; 116(3): 359-364, jun. 2018. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-950012

ABSTRACT

Introducción. El tratamiento quirúrgico adecuado para las pacientes pediátricas con lesiones ováricas es heterogéneo, y en las niñas es conveniente conservar los ovarios. El objetivo de este estudio es analizar los hallazgos relacionados con un grupo de pacientes a las que se operó por lesiones ováricas. Pacientes y métodos. Un estudio retrospectivo realizado durante 13 años con 56 pacientes menores de 17 años. Estas pacientes se dividieron en 3 grupos según el diagnóstico de patología ovárica: 25 tenían lesiones funcionales (quistes y torsión), 18 tenían lesiones ováricas epiteliales y 13 tenían tumores germinales. Se comparó a estos tres grupos en términos de menarquia, torsión, edad, duración, tamaño, dolor, tumor, vómitos, menstruación irregular, ubicación y tipo de operación. Resultados. Enestosgrupos,fueronmásfrecuentes los quistes foliculares, los cistoadenomas serosos y los teratomas. La media de edad de las pacientes fue de 12,18 ± 4,84 años. Los síntomas y signos más frecuentes fueron dolor (85,7%) e hinchazón (37,5%) en la región abdominopélvica. Se observó torsión en 21 pacientes (37,5%); la media del tamaño del tumor fue de 10,46 ± 6,55 cm. Se realizó una salpingoovariectomía (SO, por sus siglas en inglés) en 38 pacientes y una resección del quiste (CE, por sus siglas en inglés) en 18 pacientes. Se observaron más casos de torsión en las pacientes premenárquicas que en las menárquicas y en el grupo de lesiones funcionales. Se realizaron más resecciones quirúrgicas en el grupo de lesiones funcionales, y más SO en los grupos de lesiones epiteliales y tumores germinales. Conclusión. Se considera que la torsión y las patologías ováricas funcionales son frecuentes en la edad premenstrual, y las lesiones malignas son muy raras en todos los grupos etarios, por lo que se recomienda preservar la fertilidad en la cirugía.


Introduction. The appropraite surgical treatment to pediatric patients with ovarian lesions are heterogeneous and ovarian preservation is desirable in children. The aim of this study is to the discuss findings related to a set of patients who were operated on for ovarian lesions. Patients and methods. A retrospective study carried out in 13 years on 56 patients under the age of 17. These patients were divided into 3 groups according to ovarian pathologic diagnosis: 25 with functional (cyts and torsion), 18 with epithelial ovarian lesions and 13 with germ cell tumours. These three groups were compared in terms of menarche, torsion, age, duration, size, pain, mass, vomiting, irregular menstruation, location and operation type. Results. Follicle cysts, serous cyst adenomas and teratomas were the most common in these groups. The mean age of the patients was 12.18+4.84 years. The most common symptoms and signs were abdominal-pelvic pain (85.7%) and swelling(37.5%). Torsion was seen in 21 patients (37.5%), mean mass size was found to be 10.46+6.55 cm. A salpingo-oophorectomy (SO) was performed in 38 patients and cyst excision (CE) was performed in 18 patients. In premenarcheal cases, torsion was seen more in menarcheal cases and in the functional lesion group. CE was performed more often in the functional and t SO was performed often in the epithelial and germ cells groups. Conclusion. Torsion and functional ovarian pathologies are thought to be common in premenstrual ages and malign lesions are very rare in all age groups so we recommend ovarian protective surgery should be preferred.


Subject(s)
Humans , Female , Infant , Child, Preschool , Child , Adolescent , Ovarian Cysts/surgery , Ovarian Diseases/surgery , Ovarian Neoplasms/surgery , Neoplasms, Germ Cell and Embryonal/surgery , Organ Preservation/methods , Ovarian Cysts/diagnosis , Ovarian Diseases/diagnosis , Ovarian Neoplasms/diagnosis , Torsion Abnormality/surgery , Torsion Abnormality/diagnosis , Abdominal Pain/etiology , Retrospective Studies , Age Factors , Pelvic Pain/etiology , Neoplasms, Germ Cell and Embryonal/diagnosis , Salpingo-oophorectomy/methods
10.
Medwave ; 18(7): e7359, 2018.
Article in English, Spanish | LILACS | ID: biblio-966472

ABSTRACT

INTRODUCCIÓN: La adecuada preservación del aloinjerto previo al trasplante renal es crucial para mantener buenos resultados luego del trasplante. En la actualidad existen dos métodos principales, la perfusión hipotérmica asistida por una máquina y la preservación en frío estático. El objetivo principal de este resumen es comparar ambos sistemas de preservación. MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos 10 revisiones sistemáticas que en conjunto incluyeron 34 estudios primarios, de los cuales 13 corresponden a ensayos aleatorizados. Concluimos que la preservación mediante perfusión hipotérmica de máquina probablemente disminuye el riesgo de retraso en el funcionamiento del injerto y podría llevar a un leve aumento en la sobrevida del injerto. Sin embargo, no existen diferencias en la sobrevida del paciente entre ambos métodos.


INTRODUCTION: The adequate preservation of the allograft prior to kidney transplant is key for a good outcome after transplantation. Currently, there are two main methods: hypothermic machine perfusion and static cold preservation. The main objective of this summary is to compare both preservation systems. METHODS: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified 10 systematic reviews including 34 primary studies, of which 13 were randomized trials. We concluded preservation by hypothermic machine perfusion probably decreases the risk of delayed graft function and could lead to a slight increase in graft survival. However, there are no differences in patient survival between the two methods.


Subject(s)
Humans , Organ Preservation/methods , Kidney Transplantation/methods , Delayed Graft Function/prevention & control , Perfusion/methods , Randomized Controlled Trials as Topic , Databases, Factual , Cold Temperature , Graft Survival
11.
J. bras. pneumol ; 42(2): 95-98, Mar.-Apr. 2016. tab, graf
Article in English | LILACS | ID: lil-780886

ABSTRACT

Objective: To evaluate the use of ex vivo lung perfusion (EVLP) clinically to prepare donor lungs for transplantation. Methods: A prospective study involving EVLP for the reconditioning of extended-criteria donor lungs, the criteria for which include aspects such as a PaO2/FiO2 ratio < 300 mmHg. Between February of 2013 and February of 2014, the lungs of five donors were submitted to EVLP for up to 4 h each. During EVLP, respiratory mechanics were continuously evaluated. Once every hour during the procedure, samples of the perfusate were collected and the function of the lungs was evaluated. Results: The mean PaO2 of the recovered lungs was 262.9 ± 119.7 mmHg at baseline, compared with 357.0 ± 108.5 mmHg after 3 h of EVLP. The mean oxygenation capacity of the lungs improved slightly over the first 3 h of EVLP-246.1 ± 35.1, 257.9 ± 48.9, and 288.8 ± 120.5 mmHg after 1, 2, and 3 h, respectively-without significant differences among the time points (p = 0.508). The mean static compliance was 63.0 ± 18.7 mmHg, 75.6 ± 25.4 mmHg, and 70.4 ± 28.0 mmHg after 1, 2, and 3 h, respectively, with a significant improvement from hour 1 to hour 2 (p = 0.029) but not from hour 2 to hour 3 (p = 0.059). Pulmonary vascular resistance remained stable during EVLP, with no differences among time points (p = 0.284). Conclusions: Although the lungs evaluated remained under physiological conditions, the EVLP protocol did not effectively improve lung function, thus precluding transplantation.


Objetivo: Avaliar o emprego da técnica de perfusão pulmonar ex vivo (PPEV) clinicamente com a finalidade de transplante. Métodos: Estudo prospectivo envolvendo o recondicionamento de pulmões limítrofes, definidos por critérios específicos, tais como relação PaO2/FiO2 < 300 mmHg, com um sistema de PPEV. Entre fevereiro de 2013 e fevereiro de 2014, os pulmões de cinco doadores foram submetidos à PPEV por até 4 h. Durante a PPEV, a mecânica pulmonar foi avaliada continuamente. Amostras do perfusato foram colhidas a cada hora, assim como foi realizada a avaliação funcional dos órgãos. Resultados: A média de PaO2 dos pulmões captados foi de 262,9 ± 119,7 mmHg, sendo que, ao final da terceira hora de perfusão, essa foi de 357,0 ±108,5 mmHg. A capacidade de oxigenação dos pulmões apresentou discreta melhora durante a PPEV nas primeiras 3 h (246,1 ± 35,1; 257,9 ± 48,9; e 288,8 ± 120,5 mmHg, respectivamente), sem diferenças significativas entre os momentos (p = 0,508). As médias de complacência estática foram de, respectivamente, 63.0 ± 18,7; 75,6 ± 25,4; e 70,4 ± 28,0 mmHg após 1, 2 e 3 h, com melhora significativa entre a hora 1 e 2 (p = 0,029), mas não entre a hora 2 e 3 (p = 0,059). A resistência vascular pulmonar permaneceu estável durante a PPEV, sem diferenças entre os momentos (p = 0,284). Conclusões: Os pulmões avaliados permaneceram em condições fisiológicas de preservação; no entanto, o protocolo não foi efetivo para promover a melhora na função pulmonar, inviabilizando o transplante.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Lung Transplantation/methods , Lung/blood supply , Organ Preservation/methods , Perfusion/methods , Tissue Donors , Analysis of Variance , Brazil , Lung/pathology , Lung/physiology , Partial Pressure , Prospective Studies , Reproducibility of Results , Respiratory Mechanics , Statistics, Nonparametric , Time Factors
12.
Med. infant ; 22(2): 72-77, Junio 2015. tab
Article in Spanish | LILACS | ID: biblio-905797

ABSTRACT

Introducción: La membrana amniótica (MA) posee varias propiedades clínicas que la hacen útil en el tratamiento de diferentes patologías. El principal efecto clínico es que permite la epitelización de los tejidos, favorece el crecimiento, adhesión y diferenciación de las células epiteliales, además de prevenir su apoptosis, reduciendo la cicatrización. Objetivo: Describir la utilidad de la membrana amniótica como alternativa en el tratamiento de la superficie ocular. Son abordados tópicos como las diferentes formas de obtención, preparación y conservación de la misma, así como sus mecanismos de acción y aplicaciones. Resultados: En el Servicio de Oftalmología del Hospital de Pediatría J. P. Garrahan se usaron 429 membranas amnióticas en 294 pacientes desde el año 2002 hasta octubre 2014 para el tratamiento de distintas patologías oculares. Los pacientes estudiados presentaron reducción de la inflamación, vascularización y mejor cicatrización. Conclusión: la MA es en la actualidad una alternativa en el tratamiento de patologías de difícil manejo que no responden a las terapias médicas convencionales. Sin embargo, su empleo deberá ser racional, para evitar falsas expectativas de considerarla como panacea en toda patología corneal o conjuntival (AU)


Introduction: Amniotic membrane has several clinical properties rendering it useful in different pathologies. Its main clinical effect is the epithelization of tissue, favoring growth, adhesion and differentiation of epithelial cells as well as prevention of apoptosis and reduction of scarring. Objective: To determine the usefulness of amniotic membrane as an alternative for ocular surface treatment. Issues such harvesting techniques, preparation, and storage of the amniotic membrane, as well as mechanisms of action and use are discussed. Results: At the Department of Ophthalmology of the Pediatric Hospital J. P. Garrahan 429 amniotic membranes were used in 294 patients between 2002 and October 2014 for the treatment of different eye pathologies. The patients studied presented with reduced inflammation and better vascularisation and scarring. Conclusion: Amniotic membrane is currently a treatment option in difficult-to-treat pathologies that do not respond to conventional therapies. Nevertheless, it should be used rationally to avoid unrealistic expectations considering it the panacea for all corneal or conjunctival pathologies (AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Amnion/transplantation , Biological Dressings , Eye Diseases/surgery , Ophthalmologic Surgical Procedures , Organ Preservation/methods , Tissue Banks
13.
Acta cir. bras ; 30(5): 359-365, 05/2015. tab, graf
Article in English | LILACS | ID: lil-747026

ABSTRACT

PURPOSE: To evaluate a new perfusate solution to be used for ex vivo lung perfusion. METHODS: Randomized experimental study using lungs from rejected brain-dead donors harvested and submitted to 1 hour of ex vivo lung perfusion (EVLP) using mainstream solution or the alternative. RESULTS: From 16 lungs blocs tested, we found no difference on weight after EVLP: Steen group (SG) = 1,097±526g; Alternative Perfusion Solution (APS) = 743±248g, p=0.163. Edema formation, assessed by Wet/dry weigh ratio, was statistically higher on the Alternative Perfusion Solution group (APS = 3.63 ± 1.26; SG = 2.06 ± 0.28; p = 0.009). No difference on PaO2 after EVLP (SG = 498±37.53mmHg; APS = 521±55.43mmHg, p=0.348, nor on histological analyses: pulmonary injury score: SG = 4.38±1.51; APS = 4.50±1.77, p=0.881; apoptotic cells count after perfusion: SG = 2.4 ± 2.0 cells/mm2; APS = 4.8 ± 6.9 cells/mm2; p = 0.361). CONCLUSION: The ex vivo lung perfusion using the alternative perfusion solution showed no functional or histological differences, except for a higher edema formation, from the EVLP using Steen Solution(r) on lungs from rejected brain-dead donors. .


Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Lung Transplantation/methods , Lung/blood supply , Organ Preservation Solutions , Organ Preservation/methods , Perfusion/methods , Extracorporeal Circulation/methods , Reperfusion Injury , Reproducibility of Results , Statistics, Nonparametric , Time Factors , Tissue Donors , Tissue and Organ Harvesting/methods
14.
Rev. méd. Chile ; 142(12): 1584-1593, dic. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-734865

ABSTRACT

Solid organ transplantation is limited by donor availability. The loss of brain function produces hemodynamic, respiratory, hormonal and metabolic changes that lead to hypotension and organ dysfunction. Management of a potential donor is similar to any critically ill patient. Cardiovascular stability and protective ventilatory support must be pursued, aimed at minimizing the local and systemic inflammatory response that is triggered by brain death. There is no consensus on protocols for hormonal supplementation. The administration of vasopressin analogues and steroids may be beneficial under certain conditions. Appropriate medical management helps to optimize the function of different organs prior to transplantation. This may increase the number of harvested organs and improve their functional outcome in the recipient.


Subject(s)
Humans , Tissue Donors , Tissue and Organ Harvesting/methods , Tissue and Organ Procurement , Brain Death/physiopathology , Organ Preservation/methods , Organ Transplantation/methods , Respiration, Artificial , Terminal Care/methods
15.
Trends psychiatry psychother. (Impr.) ; 36(1): 32-39, Jan-Mar/2014. tab
Article in English | LILACS | ID: lil-707278

ABSTRACT

OBJECTIVE: To determine the association between postpartum depression (PPD), intensification of back pain and exacerbation of changes in postural alignment intrinsic to puerperium. METHODS: Eighty women at 2 to 30 weeks postpartum were included in the study according to the following criteria: literate mothers, gestation of 34 to 42 weeks, and healthy live-born infants. All mothers agreed to participate in the study. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Pain was assessed using a visual analogue scale (VAS) and the Nordic Musculoskeletal Questionnaire (NMQ), and posture, using real time naturalistic observation. RESULTS: There was a statistically significant association between PPD and pain intensity (p = 0.002). The upper back was the most frequent pain site among depressed women, both before (p = 0.04) and after delivery (p = 0.01). There were no associations between PPD and type of posture (p = 0.328). However, pain intensity was greater among depressed women in the swayback group (p < 0.001). CONCLUSION: The intensification of puerperal pain is closely associated with PPD. Our results suggest that back pain may be both a risk factor and a comorbidity of PPD among puerperal women and that pain and type of posture are interdependent. .


OBJETIVO: Verificar a associação entre depressão pós-parto (DPP), intensificação do quadro álgico na região posterior do tronco e exacerbação das alterações no alinhamento postural intrínsecas ao puerpério. MÉTODOS: Foram selecionadas 80 mulheres em pós-parto de 2 a 30 semanas, de acordo com os seguintes critérios: mães alfabetizadas; gestação entre 34 e 42 semanas; parição de bebê saudável e vivo. Todas as mães concordaram em participar da pesquisa. Os sintomas depressivos foram rastreados através da Escala de Depressão Pós-natal de Edimburgo (EDPE). A avaliação da dor ocorreu através de uma escala visual analógica (EVA) e do Questionário Nórdico de Sintomas Osteomusculares (QNSO). Para avaliação postural, empregou-se observação naturalística em tempo real. RESULTADOS: Foi verificada associação estatisticamente significativa entre DPP e maior intensidade de dor referida (p = 0,002). A região dorsal foi o sítio doloroso mais apontado pelas puérperas deprimidas, tanto no período pré-puerperal (p = 0,04), quanto no puerpério (p = 0,01). Não houve associação estatística entre DPP e tipo postural (p = 0,328). No entanto, a intensidade da dor foi maior entre as mulheres deprimidas no grupo com postura desleixada (swayback) (p < 0,001). CONCLUSÃO: A intensificação do quadro álgico puerperal associa-se fortemente à DPP. Nas puérperas deste estudo, a dor na região dorsal aparentemente se comportou tanto como um fator de risco quanto como uma comorbidade de DPP. Admite-se que existe uma relação de interdependência entre dor e tipo postural. .


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Hypothermia, Induced , Kidney Transplantation , Organ Preservation/methods , Tissue Donors , Body Mass Index , Brain Death , Cadaver , Kidney/physiology , Prospective Studies
16.
São Paulo med. j ; 132(1): 28-35, 2014. tab, graf
Article in English | LILACS | ID: lil-699301

ABSTRACT

CONTEXT AND OBJECTIVE: Lung preservation remains a challenging issue for lung transplantation groups. Along with the development of ex vivo lung perfusion, a new preservation method known as topical-ECMO (extracorporal membrane oxygenation) has been proposed. The present study compared topical-ECMO with cold ischemia (CI) for lung preservation in an ex vivo experimental model. DESIGN AND SETTING: Randomized experimental study, conducted at a public medical school. METHOD: Fourteen human lungs were retrieved from seven brain-dead donors that were considered unsuitable for transplantation. The lung bloc was divided and each lung was randomized to be preserved by means of topical-ECMO or CI (4-7 °C) for eight hours. These lungs were then reconnected to an ex vivo perfusion system for functional evaluation. Lung biopsies were obtained at three times. The functional variables assessed were oxygenation capacity (OC) and pulmonary artery pressure (PAP); and the histological variables were lung injury score (LIS) and apoptotic cell count (ACC). RESULTS : The mean OC was 468 mmHg (± 81.6) in the topical-ECMO group and 455.8 (± 54) for CI (P = 0.758). The median PAP was 140 mmHg (120-160) in the topical-ECMO group and 140 mmHg (140-150) for CI (P = 0.285). The mean LIS was 35.57 (± 4.5) in the topical-ECMO group and 33.86 (± 6.1) for CI (P = 0.367). The ACC was 25.00 (± 9.34) in the topical-ECMO group and 24.86 (± 10.374) for CI (P = 0.803). CONCLUSIONS: The present study showed that topical-ECMO was not superior to cold ischemia for up to eight hours of lung preservation. .


CONTEXTO E OBJETIVO: A preservação pulmonar permanece um desafio para os grupos transplantadores. Com o desenvolvimento da perfusão pulmonar ex vivo, foi proposto um novo método de preservação chamado de ECMO-tópico (oxigenação de membrana extracorpórea). O presente estudo compara ECMO-tópico com isquemia fria (IF) para preservação pulmonar em um modelo experimental ex vivo. TIPO DE ESTUDO E LOCAL: Estudo experimental randomizado, conduzido em uma faculdade de medicina pública. MÉTODO: Quatorze pulmões humanos foram retirados de sete doadores de morte cerebral considerados não aptos a transplante. O bloco pulmonar foi dividido e cada um foi aleatorizado para preservação por ECMO-tópico ou IF (4-7 °C) durante oito horas. Esses pulmões foram então re-conectados a um sistema de perfusão ex vivo para avaliação funcional. Biópsias pulmonares foram obtidas em três tempos. As variáveis funcionais avaliadas foram: capacidade de oxigenação (CO) e pressão de artéria pulmonar (PAP). As variáveis histológicas estudadas foram escore de lesão pulmonar (ELP) e contagem de células apoptóticas (CCA). RESULTADOS: A média da CO foi de 468 mmHg (± 81.6) no grupo ECMO-tópico e 455.8 (± 54) no grupo IF (P = 0,758); a PAP média foi de 140 mmHg (120-160) para ECMO-tópico e 140 mmHg (140-150) para IF (P = 0,285); o ELP médio foi 35,57 (± 4,5) no ECMO-tópico e 33,86 (± 6,1) no IF (P = 0,367). A CCA foi 25,00 (± 9,34) no grupo ECMO-tópico e 24,86 (± 10,374) no IF (P = 0,803). CONCLUSÕES: O presente estudo demonstrou que o ECMO-tópico não é superior a IF para oito horas de preservação pulmonar. .


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Cold Ischemia/methods , Extracorporeal Membrane Oxygenation/methods , Lung , Organ Preservation/methods , Perfusion/methods , Cell Count , Medical Illustration , Organ Preservation Solutions , Reperfusion Injury , Reproducibility of Results , Statistics, Nonparametric , Time Factors , Tissue Donors
17.
Acta cir. bras ; 29(supl.3): 28-32, 2014. graf
Article in English | LILACS | ID: lil-726240

ABSTRACT

PURPOSE: To evaluate the NAC effects on liver hypothermic preservation at different time intervals. METHODS: For this, we used livers of male Wistar rats weighing between 250 and 300g, undergoing preservation in Ringer solution at 4°C for up to 24 hours. Tissue samples were obtained at four moments of preservation for histological examination by hematoxylin and eosin staining: T0 = beginning of preservation, T12 = 12 hours, T18 = 18 hours and T24 = 24 hours. Will be analyzed vacuolation, hepatic apoptosis by optical microscopy and parenchymal. RESULTS: The results showed a progressive increase in hepatic injury in both groups and showed that NAC was effective at T0. The parenchyma preservation was better in the NAC group and no difference when vacuolization of the cells. CONCLUSION: Hypothermic preservation, over time, causes changes in the hepatic parenchyma with increased apoptosis, loss of architecture, vacuolization, culminating in severe injury. The administration of N-acetylcysteine protects against preservation liver injury. .


Subject(s)
Animals , Male , Acetylcysteine/pharmacology , Cryopreservation/methods , Free Radical Scavengers/pharmacology , Liver/drug effects , Organ Preservation/methods , Apoptosis/drug effects , Liver/anatomy & histology , Models, Animal , Organ Preservation/adverse effects , Random Allocation , Rats, Wistar , Reperfusion Injury/prevention & control , Time Factors
18.
Rev. bras. cir. cardiovasc ; 28(4): 524-530, out.-dez. 2013. ilus, tab
Article in English | LILACS | ID: lil-703122

ABSTRACT

INTRODUCTION: Myocardial preservation during open heart surgeries and harvesting for transplant are of great importance. The heart at the end of procedure has to resume its functions as soon as possible. All cardioplegic solutions are based on potassium for induction of cardioplegic arrest. OBJECTIVE: To assess a cardioplegic solution with no potassium addition to the formula with two other commercially available cardioplegic solutions. The comparative assessment was based on cytotoxicity, adenosine triphosphate myocardial preservation, and caspase 3 activity. The tested solution (LIRM) uses low doses of sodium channel blocker (lidocaine), potassium channel opener (cromakalin), and actin/myosin cross bridge inhibitor (2,3-butanedione monoxime). METHODS: Wistar rats underwent thoracotomy under mechanical ventilation and three different solutions were used for "in situ" perfusion for cardioplegic arrest induction: Custodiol (HTK), Braile (G/A), and LIRM solutions. After cardiac arrest, the hearts were excised and kept in cold storage for 4 hours. After this period, the hearts were assessed with optical light microscopy, myocardial ATP content and caspase 3 activity. All three solutions were evaluated for direct cytotoxicity with L929 and WEHI-164 cells. RESULTS: The ATP content was higher in the Custodiol group compared to two other solutions (P<0.05). The caspase activity was lower in the HTK group compared to LIRM and G/A solutions (P<0.01). The LIRM solution showed lower caspase activity compared to Braile solution (P<0.01). All solutions showed no cytotoxicity effect after 24 hours of cells exposure to cardioplegic solutions. CONCLUSION: Cardioplegia solutions without potassium are promised and aminoacid addition might be an interesting strategy. More evaluation is necessary for an optimal cardioplegic solution development.


INTRODUÇÃO: Preservação do miocárdio durante cirurgias cardíacas abertas e de colheita para transplante são de grande importância. O coração ao final do processo tem de retomar as suas funções, logo que possível. Todas as soluções cardioplégicas são baseadas em potássio, para indução de parada cardioplégica. OBJETIVO: Comparar a uma solução cardioplégica sem adição de potássio à sua fórmula com duas outras soluções cardioplégicas disponíveis comercialmente. A avaliação comparativa foi baseada na citotoxicidade, preservação miocárdica (adenosina trifosfato, ATP) e atividade da caspase 3. A solução testada (LIRM) utiliza baixas doses de bloqueador de canal de sódio (lidocaína), abridor do canal de potássio (cromacalina) e inibidor da ponte actina/miosina (2,3-butanodiona monoxima). MÉTODOS: Ratos Wistar foram submetidos à toracotomia sob ventilação mecânica e três soluções diferentes foram utilizadas para perfusão in situ para a indução de parada cardioplégica: soluções Custodiol (HTK) Braile (G/A) e LIRM. Após parada cardíaca, os corações foram retirados e mantidos em câmara fria por 4 horas. Após esse período, o coração foi avaliado com microscopia de luz ótica, o conteúdo de ATP miocárdico e atividade da caspase 3. Todas as três soluções foram avaliadas quanto à citotoxicidade direta com células L929 e WEHI-164. RESULTADOS: A quantidade de ATP foi maior no grupo Custodiol em comparação às com outras duas soluções (P<0,05). A atividade de caspase foi menor no grupo HTK quando comparado às soluções LIRM e G/A (P<0,01). A solução LIRM demonstrou menor atividade da caspase em comparação à solução Braile (P<0,01). Todas as soluções não mostraram qualquer efeito de citotoxicidade após 24 horas de exposição das células às soluções cardioplégicas. CONCLUSÃO: Soluções cardioplégicas sem potássio são uma perspectiva e a adição de aminoácido pode ser uma estratégia interessante. Mais avaliações são necessárias para o desenvolvimento ideal da solução cardioplégica.


Subject(s)
Animals , Rats , Cardioplegic Solutions/pharmacology , Heart Arrest, Induced/methods , Heart/drug effects , Organ Preservation/methods , Adenosine Triphosphate/analysis , Cardioplegic Solutions/chemistry , /analysis , Cell Survival/drug effects , Glucose/chemistry , Glucose/pharmacology , Models, Animal , Mannitol/chemistry , Mannitol/pharmacology , Myocardial Reperfusion Injury/prevention & control , Potassium Chloride/chemistry , Potassium Chloride/pharmacology , Potassium/chemistry , Potassium/pharmacology , Procaine/chemistry , Procaine/pharmacology , Rats, Wistar , Reproducibility of Results , Sodium Channel Blockers/chemistry , Time Factors
19.
Guatemala; MSPAS; 18 nov. 2013. 5 p.
Non-conventional in Spanish | LILACS, LIGCSA | ID: biblio-1224168

ABSTRACT

El documento tiene algunos problemas de nitidez, que dificultan un tanto su lectura, pero solo al inicio. Las afecciones de córnea, son una de las 5 enfermedades que causan ceguera y que son prevenibles. Describe las normas y requisitos para su autorización y funcionamiento. Incluye varias definiciones de conceptos inherentes al tema del acuerdo. Además de describir la organización y estructura de los bancos de córneas, propone la conformación de un comité de trasplantes, describiendo los profesionales que deben conformarlo y sus específicas funciones. Describe también las funciones de los técnicos de cada establecimiento, público y/o privado. Enumera y describe las características físicas (infraestructura), así como el equipamiento y detalles complementarios que deberán ser cumplidas por cada establecimiento solicitante. Otro tanto hace con los detalles, tanto de donadores como de receptores.


Subject(s)
Humans , Male , Female , Tissue Banks/legislation & jurisprudence , Tissue Donors/legislation & jurisprudence , Tissue and Organ Procurement/legislation & jurisprudence , Tissue and Organ Harvesting/legislation & jurisprudence , Eye Banks/legislation & jurisprudence , Organ Preservation/methods , Sclera , Transplantation/legislation & jurisprudence , Tissue and Organ Procurement/organization & administration , Cornea , Tissue and Organ Harvesting/classification , Guatemala
20.
Acta cir. bras ; 28(8): 619-623, Aug. 2013. ilus, tab
Article in English | LILACS | ID: lil-680618

ABSTRACT

PURPOSE: To present lyophilized esophageal segments that can be used to learn surgical skills. METHODS: Four esophagus were harvested from four non-esophagus related research dogs at the moment of euthanasia. Each esophagus was trimmed in 3 cm long segments. They were lyophilized and stored during 30 days. The day programmed for surgical skills practice, they were rehydrated. RESULTS: Sixteen segments have been used. After rehydrating, all the segments kept their normal anatomic shape and structural integrity. One incision was made on every esophageal segment and sutured with running stitches of 3-0 polyglactin 910. There were no complications, such as tissue tears, nor esophageal hardening. CONCLUSIONS: The lyophilized esophagus is a high fidelity, practical, reproducible, portable, low-cost bench model. It allows general surgery apprentices to learn how to handle an esophagus, as well as to perfect their surgical and suture abilities before applying them on real patient's esophagus.


Subject(s)
Animals , Dogs , Digestive System Surgical Procedures/education , Esophagus , Models, Educational , Organ Preservation/methods , Digestive System Surgical Procedures/methods , Freeze Drying , Models, Animal , Reproducibility of Results , Time Factors
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