Cuidados cirúrgicos durante a pandemia mundial do COVID-19: rotinas alternativas para minimizar os riscos / Surgical care during worldwide COVID-19 pandemic: alternative routines aimed at minimizing the risks

A pandemia do COVID-19, causada por um novo coronavírus, tem preocupado autoridades e profissionais da saúde. Pouco se sabe ainda sobre a doença ou seu agente etiológico, motivo pelo qual muitas das condutas tomadas são empíricas. Os profissionais de saúde envolvidos no cuidado cirúrgico estão sujeitos a um grande risco, devido à exposição a diversos tipos de secreção. Os pacientes cirúrgicos também estão expostos a um risco elevado de contraírem a doença no pós-operatório, com repercussão na morbi-mortalidade. Portanto, alguns cuidados são fundamentais na prevenção, tanto para profissionais quanto para pacientes. Muitos serviços estão desenvolvendo seus próprios protocolos, com algumas diferenças, tendo em vista o baixo nível de evidência para as recomendações. Neste artigo apresentaremos algumas condutas sugeridas para o cuidado no pré, per e pós-operatório, de forma a minimizar os riscos envolvidos.

The increasing pandemic of COVID-19, caused by a new coronavirus, has challenged authorities and health care professionals. Most preventive measures are empirical, due to the small amount of information on the disease and etiological agent so far. Surgical care professionals are exposed to a greater risk, owing to manipulation of all kind of discharge. Surgical patients are also at risk of developing this condition post-operatively, increasing their morbi-mortality. Hence, preventive care is vital both for professionals and patients. Each surgical team is developing its own protocol, with some differences between them, due to the low level of evidence for the recommendation. In this article we will present some suggested measures for the pre, per and post-operative care, in order to minimize the risks involved.

Evaluation of mesalazine polymeric conjugate in the treatment of actinic proctitis in rats

ABSTRACT Purpose: The present study aimed at testing a new formulation of mesalazine linked to chondroitin sulfate and its components alone in the treatment of actinic proctitis in rats. Methods: Forty-seven female Wistar rats were submitted to pelvic radiation and divided into eight groups: control A, mesalazine A, chondroitin A, and conjugate A, gavage of the according substance two weeks after irradiation and sacrifice three weeks after oral treatment; control C, mesalazine C, chondroitin C, and conjugate C, sacrifice six weeks after oral treatment. The rectum was submitted to histological characterization for each of the findings: inflammatory infiltrate, epithelial degeneration, mucosal necrosis, and fibrosis. Results: The inflammatory infiltrate was more intense in chondroitin A, mesalazine A, and conjugate C. The collagen deposition was less intense in chondroitin A, and mesalazine A, and more intense in control C. Conclusions: Mesalazine and chondroitin alone were efficacious in inducing a delayed inflammatory response, hence reducing the late fibrosis. The conjugate was able to induce an ever more delayed inflammatory response.

Development of a new model of actinic enteritis in rats using a cobalt-60 open source and a protection device as a collimator

Abstract Purpose: To describe a new model of actinic enteritis that does not use radiotherapy machines. Methods: Sixteen Wistar rats were divided into four groups, consisting of four animals each: control (group A), two weeks after irradiation (group B), five weeks after irradiation (group C) and eight weeks after irradiation (group D). Animals were given a 10Gy radiation from a Cobalt-60 natural source in a nuclear technology research center. Protections of the surrounding tissues were obtained through the usage of plumb devices with a hole in the center, which served as a collimator. We obtained irradiated and non-irradiated colons from each animal. Results: In group B we found an important inflammatory response in the irradiated colon, which appeared in a reduced way in group C and was minimal in group D, in which we found a relevant collagen submucosal deposition/fibrosis. In all groups, the non-irradiated colon had a lower pathological damage in comparison with the irradiated colon. Conclusion: We thus described an efficient and feasible technique for obtaining an animal model of actinic enteritis.

Bilateral paracoccidioidomycotic iliopsoas abscess associated with ileo-colonic lesion / Abscesso paracoccidioidomicótico bilateral do iliopsoas associado ao acometimento íleo-colônico

This case report shows the clinical development of a patient with systemic paracoccidioidomycosis presenting with lymphatic-intestinalmanifestation. The patient initially had a substantial clinical improvement but had a recrudescence after six months of sulfamethoxazoletrimethoprim oral treatment, with the emergence of feverish syndrome, lumbar pain, and intermittent claudication, characterizing a bilateral iliopsoas muscle abscess, necessitating clinicosurgical therapeutics.

Este relato de caso descreve a evolução clínica de paciente comparacoccidioi-domicose sistêmica com manifestação linfática-intestinal.O paciente evoluiu inicialmente com melhora clínica acentuada erecrudescência após seis meses de uso de SMX-TMP pela via oral, com o surgimento de síndrome febril, dor lombar, e claudicação intermitente,caracterizando um abscesso bilateral do músculo íleopsoas, comnecessidade de terapêutica clínico-cirúrgica.