Coronary Artery Bypass Grafting: A Comparative Exercise between Patients from the BYPASS Registry and Patients from a University Hospital.

INTRODUCTION: The coronary artery bypass grafting (CABG) data provided by the Brazilian Registry of Cardiovascular Surgeries in Adults (BYPASS) Registry is a Brazilian reality. OBJECTIVE: To carry out a comparative exercise between the BYPASS Registry published data and data from patients operated on in a randomly chosen period (2013-2015) at Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP). METHODS: This is a retrospective study reviewing 173 electronic medical records of CABG patients from the HCFMRP-USP. These data were compared with the BYPASS Registry published data. Chi-square test was used to verify the changes within the prevalence of adequate/inadequate biochemical tests before and after surgery. The sample was divided into groups consistent with cardiopulmonary bypass (CPB) time (CPB ≤ 120 minutes and CPB > 120 minutes). For the complications, prevalence by the chi-square test was adopted. Significant P-values are < 0.05. RESULTS: The comparative operative data of the BYPASS Registry and the HCFMRP-USP patients were quite similar, except for the isolate use of only arterial grafts, which was more frequent on HCFMRP-USP patients (30.8% vs. 15.9%), and the use of radial artery, also more frequent on HCFMRP-USP patients (48.8% vs. 1.1%). CONCLUSION: The comparative study suggested that the BYPASS Registry should be a reference for CABG quality control.

Vascular atypia and irregularity on surface as signs of malignant adnexal mass: a complementary method of laparoscopic assessment.

STUDY OBJECTIVE: To evaluate the risk of malignancy associated with the main macroscopic findings observed on adnexal masses during a laparoscopic approach. DESIGN: Prospective series of consecutive patients (Canadian Task Force classification II-2). SETTING: Tertiary care university hospital. PATIENTS: One hundred fifteen patients were included. Ninety-eight had benign and 17 malignant adnexal masses. INTERVENTIONS: Diagnostic and operative laparoscopy. MEASUREMENTS AND MAIN RESULTS: Adnexal images were obtained during laparoscopy, recorded, and analyzed according to irregularity on surface, presence of atypical vessels, lobular form, absence of coral-like surface, implants, large-volume ascites, and cloudy or hemorrhagic ascites. A logistic regression was applied, and the independent findings associated with malignant disease were atypical vessels (OR 16.37; 95% CI 2.85-94.13; p <.01) and irregularity on tumor surface (OR 43.41; 95% CI 8.02-234.96; p <.05). In this way, 95% of the cases were correctly diagnosed. CONCLUSIONS: Atypical vessels and irregularity on tumor surface were important criteria of malignancy during laparoscopic treatment of adnexal masses. The recognition of these features can be helpful in choosing the ideal surgical approach mainly when the preoperative evaluation is unsatisfactory.