Epidemiological profile of patients with vertebral trauma at a reference center in the Amazon / Perfil epidemiológico de pacientes com trauma vertebral em um centro de referência da Amazônia / Perfil epidemiológico de pacientes con trauma vertebral en un centro de referencia en la Amazonia

ABSTRACT Objective To analyze the epidemiological profile of patients with vertebral trauma treated at a medical reference center at the state of Pará, Northern Brazil. Methods A quantitative and retrospective study conducted at Hospital Metropolitano de Urgência e Emergência (HMUE) in Ananindeua, Northern Brazil, from January 2020 to March 2020, using medical records of patients admitted to the hospital from January 2018 to December 2019. Results Data from 270 medical records from the orthopedic and trauma sector of the hospital were analyzed. Conclusion The predominant profile was male patients, aged between 20 and 29 years, with low social conditions, presenting compressive lesions of lumbar vertebrae, submitted to conservative intervention, with hospital stays of 8 to 30 days, and evolving to complete recovery without sequelae. Level of evidence II; Retrospective Study.

RESUMO Objetivo Analisar o perfil epidemiológico de pacientes com trauma vertebral atendidos em centro médico de referência no estado do Pará, norte do Brasil. Métodos Estudo quantitativo e retrospectivo realizado no Hospital Metropolitano de Urgência e Emergência (HMUE), em Ananindeua, norte do Brasil, entre janeiro de 2020 e março de 2020, usando prontuários de pacientes internados entre janeiro de 2018 e dezembro de 2019. Resultados Foram analisados dados de 270 prontuários do setor de ortopedia e trauma do hospital. Conclusão O perfil predominante foi de pacientes do sexo masculino, com idade entre 20 e 29 anos, de baixa condição econômica, que apresentaram lesões compressivas em vértebras lombares, submetidos a intervenção conservadora, internação hospitalar de 8 a 30 dias, que evoluíram para recuperação completa, sem sequelas. Nível de evidência II; Estudo Retrospectivo.

RESUMEN Objetivo Analizar el perfil epidemiológico de pacientes con trauma vertebral atendidos en un centro médico de referencia en el estado de Pará, norte de Brasil. Métodos Estudio cuantitativo y retrospectivo realizado en el Hospital Metropolitano de Urgência e Emergência, en Ananindeua, norte de Brasil, entre enero de 2020 y marzo de 2020, que utilizando historias clínicas de pacientes ingresados en el hospital de enero de 2018 a diciembre de 2019. Resultados Se analizaron los datos de 270 historias clínicas del sector de ortopedia y traumatología del hospital. Conclusión El perfil predominante fue de pacientes del sexo masculino entre 20 y 29 años, de bajas condiciones económicas, que presentaban lesiones compresivas en las vértebras lumbares, sometidos a intervención conservadora, con estancias hospitalarias de 8 a 30 días que evolucionaron hacia recuperación completa sin secuelas. Nivel de evidencia II; Estudio Retrospectivo.

Remote ischemic conditioning improves rat brain antioxidant defense in a time-dependent mechanism

ABSTRACT Purpose To clarify the best protocol for performing remote ischemic conditioning and to minimize the consequences of ischemia and reperfusion syndrome in brain, the present study aimed to evaluate different time protocols and the relation of the organs and the antioxidant effects of this technique. Methods The rat's left femoral artery was clamped with a microvascular clamp in times that ranged from 1 to 5 minutes, according to the corresponding group. After the cycles of remote ischemic conditioning and a reperfusion of 20 minutes, the brain and the left gastrocnemius were collected. The samples were used to measure glutathione peroxidase, glutathione reductase and catalase levels. Results In the gastrocnemius, the 4-minute protocol increased the catalase concentration compared to the 1-minute protocol, but the latter increased both glutathione peroxidase and glutathione reductase compared to the former. On the other hand, the brain demonstrated higher catalase and glutathione peroxidase in 5-minute group, and the 3-minute group reached higher values of glutathione reductase. Conclusions Remote ischemic conditioning increases brain antioxidant capacity in a time-dependent way, while muscle presents higher protection on 1-minute cycles and tends to decrease its defence with longer cycles of intermittent occlusions of the femoral artery.

Ischemic perconditioning on mesenteric ischemia/reperfusion injury in rats

ABSTRACT Purpose: To evaluate if the perconditioning affects the antioxidant capacity in mesenteric ischemia and reperfusion injury. Methods: Twenty-one Wistar rats were assigned into three groups, as follows: Sham, IR and rPER. The animals were subjected to mesenteric ischemia for 30 min. rPER consisted of three cycles of 5-min hindlimb ischemia followed by 5 min hindlimb perfusion at the same time to mesenteric ischemic period. After 5 minutes, blood and 5 cm of terminal ileum were harvested for thiobarbituric acid reactive substances (TBARS) and Trolox equivalent antioxidant capacity (TEAC) measurement. Results: rPER technique was able to reduce intestinal tissue TBARS levels (p<0.0001), but no statistic difference was observed in blood levels between groups, although it was verified similar results in rPER and Sham group. rPER technique also enhanced TEAC levels in both blood (p = 0.0314) and intestinal tissue (p = 0.0139), compared to IR group. Conclusions: rPER appears as the most promising technique to avoid IR injury. This technique reduced TBARS levels in blood and intestinal tissue and promoted the maintenance of antioxidant defense in mesenteric acute injury.

Histopathological and immunohistochemical parameters of breast cancer cases analyzed in a reference laboratory

Objective: To determine the histopathological and immunohistochemical parameters of breast cancer cases treated in Belém, state of Pará, Brazil. Method: This is a cross-sectional, retrospective and observational study in which samples from 278 patients were analyzed. In the histopathological analysis were considered, among other factors, the differentiation and histopathological classification of the tumor, based on the WHO classification. As for immunohistochemistry, the presence and intensity of expression of the cell proliferation antigen Ki-67, gene product of HER2, and estrogen and progesterone receptors were evaluated. Then, the tumors were classified into luminal A, luminal B, luminal hybrid, HER2 group, and basal-like. Results: The most common histological subtypes were invasive carcinoma of no special type (88.7%), carcinoma in situ (5.5%), and invasive mucinous carcinoma (2.9%). The most common immunohistochemical subtypes were luminal A (26.1%), basal-like (23.6%), and luminal B (23.2%). We also found a statistically significant inversely proportional relationship (p<0.01) of hormone receptor expression with nuclear grade. Conclusion: The results show the importance of immunohistochemical analysis for staging, as well as for the therapeutic decision of each patient. However, further studies with a larger sample must be performed for more effective analysis of the general population.

Remote ischemic conditioning protects against testicular ischemia∕reperfusion injury in rats

Abstract Purpose To evaluate the effect of remote ischemic conditioning associated to N-acetylcysteine (NAC) on testicular ischemia∕reperfusion (I∕R) injury in rats. Methods Twenty-five adult male Wistar rats were randomly distributed into five experimental groups (n=5), as follows: Sham, I∕R, Perconditioning (PER), NAC and PER+NAC. Two-hour ischemia was induced by rotating the left testis 720° to clockwise direction, followed by 4 hours of reperfusion. Perconditioning was performed by three I/R cycles of 10 min each on the left limb, 30 min before reperfusion. N-acetylcysteine (150 mg∕kg) was administered 30 min before reperfusion. Results Statistical differences were observed in MDA levels between I/R group with all groups (p<0.01), in addition there was statistical difference between PER and Sham, and PER+ NAC groups (p<0.05) in plasma. Conclusions The protective effect of perconditioning isolated in the reduction of lipid peroxidation related to oxidative stress was demonstrated. However, when Perconditioning was associated with NAC, there was no protective effect against testicular injury of ischemia and reperfusion.

Perconditioning associated to hypertonic saline solution on liver function improvement after ischemia/reperfusion injury

Abstract Purpose: To evaluate the effects of hypertonic saline solution associated to remote ischemic perconditioning in liver ischemia/reperfusion injury in rats. Methods: 25 male rats (Wistar) were distributed into five groups: Sham group (S); Ischemia/Reperfusion group (I/R) with 30 minutes of liver ischemia; Remote ischemic perconditioning group (Per) with three cycles of 10 minutes of I/R performed during liver ischemia; Hypertonic saline solution group (HSS) treated with hypertonic saline solution (4ml/kg); Remote ischemic perconditioning + Hypertonic saline solution group (Per+HSS) with both treatments. Results: Per+HSS group showed a lower degree of liver dysfunction in relation to I/R group, whereas the technique of remote ischemic perconditioning isolated or associated with saline solution significantly improved liver function and reduced histological damage. Conclusion: Remote ischemic perconditioning associated or not to saline solution promoted reduction of acute liver injury induced by ischemia/reperfusion.

Development of a laparoscopic training model using a smartphone / Desenvolvimento de modelo treinamento em cirurgia laparoscópica com utilização de smartphone

ABSTRACT Objective: to develop a model of training in video-surgery, of low cost and that uses a smartphone as an image-generating source. Methods: We developed a 38cm high, 40cm wide, 40cm long hexagonal-shaped training box, with a front opening of 12x8 cm for coupling the smartphone. The internal illumination is made with LED lamps and for the support of the smartphone, we used a selfie stick, fixed in the upper part of the box, that allows control of height, distance, angulation, and the coupling of devices with different formats. We selected 20 undergraduate students without previous training in video-surgery, who performed four exercises in the box, with assessment of the time and amount of errors in the execution of the tasks. Each student completed the training for three consecutive weeks. We collected the data in spreadsheets for later analysis. Results: Nineteen students completed the training program, with significant improvement in the times and in the number of errors. Conclusion: the developed model was feasible and promoted the acquisition of skills in this group of students. In addition, it presents low cost, is portable and uses common equipment, such as smartphones.

RESUMO Objetivo: desenvolver modelo de treinamento em vídeo-cirurgia, de baixo custo e que utiliza smartphone como fonte geradora de imagem. Métodos: foi desenvolvida uma caixa de treinamento em formato hexagonal de 38cm de altura, 40cm de largura e 40cm de comprimento e com abertura na região frontal de 12x8 cm para acoplamento do smartphone. A iluminação interna é feita com lâmpadas de LED e para o suporte do smartphone foi utilizado um selfiestick, fixado na parte superior da caixa, que permite controle de altura, distância, angulação, e possibilita acoplamento de aparelhos com diferentes formatos. Foram selecionados 20 alunos de graduação, sem treinamento prévio em vídeo-cirurgia, que realizaram quatro exercícios na caixa com aferição do tempo e quantidade de erros na execução das tarefas. Cada aluno realizou o treinamento durante três semanas consecutivas. Os dados foram coletados em planilhas e analisados posteriormente. Resultados: dezenove alunos concluíram o treinamento, com melhora significante nos tempos e na quantidade de erros. Conclusão: o modelo desenvolvido mostrou-se viável e promoveu a aquisição de habilidades neste grupo de alunos. Além disso, apresenta baixo custo, é portátil e utiliza equipamento comum, como smartphones.

Effects of hypertonic saline solution associated to remote ischemic perconditioning in kidney ischemia/reperfusion injury in rats

Abstract Purpose: To evaluate the effects of hypertonic saline solution associated to remote ischemic perconditioning in renal ischemia/reperfusion injury in rats. Methods: Twenty five male rats (Wistar) underwent right nephrectomy and were distributed into five groups: Sham group (S); Ischemia/Reperfusion group (I/R) with 30 minutes of renal ischemia; Remote ischemic perconditioning group (Per) with three cycles of 10 minutes of I/R performed during kidney ischemia; Hypertonic saline solution group (HSS) treated with hypertonic saline solution (4ml/kg); remote ischemic perconditioning + Hypertonic saline solution group (Per+HSS) with both treatments. After reperfusion, blood samples were collected for BUN and creatinine serum levels analyzes. TBARS were evaluated in plasma and renal tissue to assess oxidative stress. Kidney histopathological examination were performed. Results: Per+HSS group showed a lower degree of renal dysfunction in relation to I/R group, whereas the technique of remote ischemic perconditioning isolated or associated with saline solution significantly reduced oxidative stress and histological damage. Conclusion: Remote ischemic perconditioning associated or not to saline solution promoted reduction of acute renal injury induced by ischemia/reperfusion.

Influence of remote ischemic conditioning and tramadol hydrochloride on oxidative stress in kidney ischemia/reperfusion injury in rats

Abstract Purpose: To evaluate the effects of tramadol hydrochloride associated to remote ischemic perconditioning on oxidative stress. Methods: Twenty five male rats (Wistar) underwent right nephrectomy and were distributed into five groups: Sham group (S); Ischemia/Reperfusion group (I/R) with 30 minutes of renal ischemia; Remote ischemic perconditioning group (Per) with three cycles of 10 minutes of I/R performed during kidney ischemia; Tramadol group (T) treated with tramadol hydrochloride (40mg/kg); remote ischemic perconditioning + Tramadol group (Per+T) with both treatments. Oxidative stress was assessed after 24 hours of reperfusion. Results: Statistical differences were observed in MDA levels between I/R group with all groups (p<0.01), in addition there was difference between Tramadol with Sham, Per and Per+T groups (p<0.05), both in plasma and renal tissue. Conclusion: Remote ischemic perconditioning was more effective reducing renal ischemia-reperfusion injury than administration of tramadol or association of both treatments.