Análise de casos cirúrgicos para o tratamento de hemorragia subaracnóidea aneurismática / Analysis of Surgical Cases for the Treatment of Subarachnoid Hemorrhage Aneurysmal

Objetivo Avaliar o perfil epidemiológico, os resultados cirúrgicos e os casos de hemorragia subaracnóidea aneurismática ocorridos no Hospital de Ensino da Univasf. Métodos Estudo descritivo e analítico, com abordagem quantitativa, baseado no caráter não experimental, documental e retrospectivo, os prontuários dos pacientes com diagnóstico de hemorragia subaracnóidea aneurismática não traumática admitidos em um hospital de ensino de setembro de 2008 a setembro de 2012. esultados Verificou-se uma prevalência de hemorragia subaracnóidea aneurismá-tica em Petrolina de 1,8 para cada 10 mil habitantes. Dos 55 prontuários, o sexo feminino foi o mais acometido (61,81%), com faixa etária de 41 a 50 anos. Aneurismas múltiplos foram encontrados em 23,5%. Com relação às escalas de Hunt-Hess e Fisher, obtivemos respectivamente 40% com Hunt-Hess grau dois e 35,7% com Fisher grau três. Não apresentaram nenhum tipo de déficit neurológico desde a admissão até a alta hospitalar 54,8% dos pacientes, e somente 1,81% apresentaram déficit neurológico após o procedimento cirúrgico. A reabordagem cirúrgica foi necessária em 3,7% dos casos. A mortalidade cirúrgica foi de 3,5%. Conclusão Existe uma prevalência de hemorragia subaracnóidea aneurismática em Petrolina/PE de 1,8 por 10 mil habitantes.

Objective To evaluate the epidemiological profile, the surgical results and cases of Subarachnoid Hemorrhage Aneurysmal occurred in the UNIVASF Teaching Hospital. Methods A descriptive and analytical study with a quantitative approach based on non-experimental, documentary and retrospective study, the charts of patients with nontraumatic Subarachnoid Hemorrhage Aneurysmal admitted to a teaching hospital from September 2008 to September 2012. Results It has been found a prevalence of Subarachnoid Hemorrhage Aneurysmal in Petrolina 1.8 per 10 thousand inhabitants. Of the 55 records, females were more prevalent 61.81%, ranging in age from 41 to 50 years; 23.5% had multiple aneurysms. Regarding Hunt-Hess and Fisher scales, respectively obtained 40% with Hunt-Hess grade two and 35.7% with Fisher grade three. 54.8% did not experience any neurological deficit from admission to discharge, and only 1.81% had neurological deficits after surgery; 3.7% of cases needed to be surgically re-approached. Operative mortality was 3.5%. Conclusion There is a prevalence of Subarachnoid Hemorrhage Aneurysmal in Petrolina/PE 1.8 per 10,000 inhabitants.

Effects of maternal ischemic preconditioning in the colon of newborn rats submitted to hypoxia-reoxygenation insult

PURPOSE: To evaluate the effects of maternal remote ischemic preconditioning (IPCr) in the colonic mucosa of newborn rats subjected to hypoxia and reoxygenation. METHODS: Newborn Wistar rats were divided into three groups. Control Group (CG), Hypoxia and Reoxygenation Group (HRG) and Remote Ischemic Preconditioning Group (IPCrG). Hypoxia and reoxygenation was performed 2x per day, with an interval of 6 hours, on the 1st, 2nd and 3rd days of life, with 10 minutes of CO2 at 100%, followed by 10 minutes O2 at 100%(HRG/IPCrG). The maternal IPCr was performed 24 hours before delivery by applying a rubber band tourniquet to the left hind limb (IPCrG). Segments of the colon underwent histological (HE) and immunohistochemical analysis for caspase-3 and COX - 2. RESULTS: The histological findings showed no intestinal mucosal damage in the CG group and severe lesions in HRG that was attenuated in the IPCrG (p<0.05). The expression of the apoptotic cells was lower in the HRG group than in the CG and IPCrG. The COX-2 expression was intense in HRG and attenuated in the IPCrG (p<0.05). CONCLUSIONS: Maternal IPCr protected the colonic mucosa of newborn rats subjected to hypoxia and reoxygenation, reducing the morphological alterations and inflammatory response. It ameliorates the occurrence of apoptosis, keeping the physiological process of renewal and regeneration in the epithelial lining of the colonic mucosa. .

Alprostadil attenuates inflammatory aspects and leucocytes adhesion on renal ischemia and reperfusion injury in rats

PURPOSE: To evaluate the effects of alprostadil in an experimental model of ischemia and reperfusion injury (IRI) in rat renal tissue. METHODS: Adult male Wistar rats were randomized into three groups Vehicle-treated group(Veh), Alprostadil-treated(Al), and sham(Sh) group. Veh and Al groups had suprarenal aorta occluded for 30 minutes and reperfused for 60 minutes. Saline or 20 µg/kg of Alprostadil was intravenously infused immediately before declamping. Sh group animals underwent similar procedure without aortic occlusion. Left nephrectomy and blood sampling were performed after 60 minutes of reperfusion. Renal ICAM-1 expression and histological analysis were performed to estimate inflammatory response and tissue disarrangement. Serum biochemical markers for IRI were also measured. Kruskal-Wallis test was used to assess differences between the groups. RESULTS: There was lower expression of ICAM-1 in groups Veh and Sh. On histologically evaluation, inflammation and necrosis in the Veh group was significantly higher (grades III/IV) than Al group (Veh>Al=Sh; p = 0.025), as well as CPK levels (Veh>Al=Sh; p = 0.03). CONCLUSION: Alprostadil attenuates the immunohistochemical and histological repercussions in the renal tissue of rats submitted to a post-ischemic reperfusion with supra-renal aortic clamping. .