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1.
Injury ; 53(2): 453-456, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34819230

RESUMO

INTRODUCTION: Reviewing the profile of patients admitted at the Burns Intensive Care Unit at São Paulo Hospital - UNIFESP, as well as the available literature, it becomes evident the need for tools able to predict those patients' outcomes. Distinct score models are used in different health centers, not only as prognostic models, but also as research and quality control tools. Amongst these prognostic scores, there are two strands, the burns specific scores - which consider the injury's characteristics - and the general critical patient's scores. OBJECTIVE: This study aims to analyze the differences and tendencies in mortality prediction of two broadly used scores when applied to São Paulo Hospital's Burns Intensive Care Unit patients, ABSI - burns specific score - and SAPS 3 - general score for critical patients. METHODS: This is an individual, observational, retrospective and comparative study, developed with medical records review. Both scores were applied to every patient admitted at São Paulo Hospital's Burns Intensive Care Unit from 2011 to 2016. Statistical analyses used the non-parametric test of Kolmogorov-Smirnov, a p-value <0.05 was considered significant. RESULTS: 122 patients were included, the average age was 34,4 years old. 70,5% of patients were male and 49% had a total body surface area burned of 20%. 27% of the patients died. Statistical analyses do not show significant differences between ABSI and SAPS3 mortality predictions for burns patients at this health center. CONCLUSION: The study evidences that SAPS 3 score, frequently used at general Intensive Care Units, has a similar performance to ABSI score, which is specific for burns populations. ABSI score is easier to implement, as it is simpler and able to show instant results.


Assuntos
Queimaduras , Escore Fisiológico Agudo Simplificado , Brasil/epidemiologia , Estado Terminal , Humanos , Unidades de Terapia Intensiva , Masculino , Estudos Retrospectivos
2.
Acta Cir Bras ; 34(10): e201901007, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31826150

RESUMO

PURPOSE: To conduct a scope review of the experimental model described by Walker and Mason, by identifying and analyzing the details of the method. METHODS: The authors searched Pubmed-Medline, Cochrane-Bireme and PEDro databases for articles published between January 2016 and December 2018, using the following search queries: burns, burn injuries, models animal, and animal experimentation. All articles whose authors used Walker and Mason's model - with or without changes to the method in Wistar rats - were included in this study. RESULTS: The search identified 45 mentions of Walker and Mason's model; however, after reading each summary, 20 were excluded (of which 5 due to duplicity). The inconsistencies observed after the scope review were: water temperature, length of time of exposure of the experimental model's skin to water, extent of the burnt area, and the description of the thickness/depth of the injury. CONCLUSIONS: Reproducibility of a scientific method is the basis to prove the veracity of the observed results. Thus, it is necessary to have a greater number of publications that adopt a reproducible scientific method, for this review found inconsistencies in the description of Walker and Mason's model.


Assuntos
Queimaduras/etiologia , Modelos Animais de Doenças , Temperatura Alta , Animais , Reprodutibilidade dos Testes , Pele/lesões , Fatores de Tempo , Água
3.
Acta cir. bras ; 34(10): e201901007, Oct. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1054673

RESUMO

Abstract Purpose: To conduct a scope review of the experimental model described by Walker and Mason, by identifying and analyzing the details of the method. Methods: The authors searched Pubmed-Medline, Cochrane-Bireme and PEDro databases for articles published between January 2016 and December 2018, using the following search queries: burns, burn injuries, models animal, and animal experimentation. All articles whose authors used Walker and Mason's model - with or without changes to the method in Wistar rats - were included in this study. Results: The search identified 45 mentions of Walker and Mason's model; however, after reading each summary, 20 were excluded (of which 5 due to duplicity). The inconsistencies observed after the scope review were: water temperature, length of time of exposure of the experimental model's skin to water, extent of the burnt area, and the description of the thickness/depth of the injury. Conclusions: Reproducibility of a scientific method is the basis to prove the veracity of the observed results. Thus, it is necessary to have a greater number of publications that adopt a reproducible scientific method, for this review found inconsistencies in the description of Walker and Mason's model.


Assuntos
Animais , Queimaduras/etiologia , Modelos Animais de Doenças , Temperatura Alta , Pele/lesões , Fatores de Tempo , Água , Reprodutibilidade dos Testes
4.
Rev. bras. cir. plást ; 33(3): 423-427, jul.-set. 2018. ilus
Artigo em Inglês, Português | LILACS | ID: biblio-965628

RESUMO

Introdução: A incidência de queimaduras em gestantes não é bem estabelecida na literatura mundial, mas estima-se que varie entre 3% e 7%. Os cuidados da gestante queimada representam um grande desafio com impacto significante nos resultados e prognóstico materno-fetais. Relato de Caso: No presente estudo relatamos dois casos de gestantes vítimas de queimaduras que foram tratadas na unidade de tratamento de queimaduras na Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/UNIFESP), uma no primeiro trimestre e a outra no terceiro trimestre. Conclusão: Em ambos os casos, as gestantes receberam tratamento especializado para queimaduras em conjunto com acompanhamento clínico da equipe da obstetrícia, com boa evolução materno-fetal.


Introduction: The incidence of burns involving pregnant women is not well established in the literature, but is estimated to be between 3% and 7%. The management of burns in pregnancy represents a great challenge with significant impact on outcomes and maternal-fetal prognosis. Case Report: In the present study, we report two cases of pregnant burn victims who were treated in the burn unit in the Paulista School of Medicine, Federal University of São Paulo (EPM/UNIFESP). One patient was treated in the first trimester and the other in the third trimester. Conclusion: In both cases, the pregnant women received specialized treatment for burns in conjunction with clinical follow-up by the obstetrics team, with good maternal-fetal outcomes.


Assuntos
Humanos , Feminino , Adulto , Complicações na Gravidez/cirurgia , Procedimentos Cirúrgicos Operatórios/métodos , Procedimentos Cirúrgicos Operatórios/reabilitação , Transplante/métodos , Ferimentos e Lesões , Hipovolemia/diagnóstico , Feto/cirurgia , Pacientes , Unidades de Queimados , Gravidez , Gravidez de Alto Risco
5.
Rev Col Bras Cir ; 45(4): e1715, 2018 Aug 02.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30088522

RESUMO

OBJECTIVE: to evaluate the characteristics of the patients with cutaneous melanoma treated at the São Paulo Hospital - UNIFESP. METHODS: we conducted a retrospective study of 184 cases of cutaneous melanoma. We analyzed information on gender, age, tumor characteristics, histological characteristics and staging. RESULTS: mean age at diagnosis was 58.7 years, with homogeneous age distribution between genders and predominance in white individuals (70.6%). There was a predominance of trunk involvement in men (36.7%) and lower limbs in women (42%). Sun exposure, with sunburns, was more common among males (31.2%) than among females (23.5%). There was an approximately three-fold increase in lymph node involvement when the mitotic index rose from zero (11.9%) to one or more mitosis per field (36.2%). In addition, the greater the Breslow thickness, the greater the lymph node involvement and poor the outcomes: 10.2% when less than 1mm and 59.2% when greater than 4mm. CONCLUSION: the characteristics of patients with cutaneous melanoma treated at Hospital São Paulo are similar to those found in the literature.


OBJETIVO: avaliar as características dos pacientes portadores de melanoma cutâneo atendidos no Hospital São Paulo - UNIFESP. MÉTODOS: estudo retrospectivo de 184 casos de melanoma cutâneo. Foram analisadas as informações sobre sexo, idade, características do tumor, características histológicas e estadiamento. RESULTADOS: a média de idade ao diagnóstico foi de 58,7 anos, com distribuição etária homogênea entre os sexos e predominância em indivíduos brancos (70,6%). Observou-se acometimento predominante de tronco, em homens (36,7%), e de membros inferiores, em mulheres (42%). A exposição solar, com queimaduras, foi mais comum entre homens (31,2%) do que entre mulheres (23,5%). Houve aumento de aproximadamente três vezes no acometimento linfonodal quando o índice mitótico subia de zero (11,9%) para uma ou mais mitoses por campo (36,2%), e aumento progressivo do acometimento linfonodal e de desfechos ruins quanto maior a espessura de Breslow: 10,2% quando menor do que 1mm e 59,2% quando maior do que 4mm. CONCLUSÃO: as características dos pacientes portadores de melanoma cutâneo atendidos no Hospital São Paulo são semelhantes às encontradas na literatura.


Assuntos
Melanoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Distribuição por Idade , Brasil/epidemiologia , Feminino , Humanos , Linfonodos , Masculino , Pessoa de Meia-Idade , Mitose , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Queimadura Solar/epidemiologia , Melanoma Maligno Cutâneo
6.
Rev. Col. Bras. Cir ; 45(4): e1715, 2018. tab, graf
Artigo em Português | LILACS | ID: biblio-956577

RESUMO

RESUMO Objetivo: avaliar as características dos pacientes portadores de melanoma cutâneo atendidos no Hospital São Paulo - UNIFESP. Métodos: estudo retrospectivo de 184 casos de melanoma cutâneo. Foram analisadas as informações sobre sexo, idade, características do tumor, características histológicas e estadiamento. Resultados: a média de idade ao diagnóstico foi de 58,7 anos, com distribuição etária homogênea entre os sexos e predominância em indivíduos brancos (70,6%). Observou-se acometimento predominante de tronco, em homens (36,7%), e de membros inferiores, em mulheres (42%). A exposição solar, com queimaduras, foi mais comum entre homens (31,2%) do que entre mulheres (23,5%). Houve aumento de aproximadamente três vezes no acometimento linfonodal quando o índice mitótico subia de zero (11,9%) para uma ou mais mitoses por campo (36,2%), e aumento progressivo do acometimento linfonodal e de desfechos ruins quanto maior a espessura de Breslow: 10,2% quando menor do que 1mm e 59,2% quando maior do que 4mm. Conclusão: as características dos pacientes portadores de melanoma cutâneo atendidos no Hospital São Paulo são semelhantes às encontradas na literatura.


ABSTRACT Objective: to evaluate the characteristics of the patients with cutaneous melanoma treated at the São Paulo Hospital - UNIFESP. Methods: we conducted a retrospective study of 184 cases of cutaneous melanoma. We analyzed information on gender, age, tumor characteristics, histological characteristics and staging. Results: mean age at diagnosis was 58.7 years, with homogeneous age distribution between genders and predominance in white individuals (70.6%). There was a predominance of trunk involvement in men (36.7%) and lower limbs in women (42%). Sun exposure, with sunburns, was more common among males (31.2%) than among females (23.5%). There was an approximately three-fold increase in lymph node involvement when the mitotic index rose from zero (11.9%) to one or more mitosis per field (36.2%). In addition, the greater the Breslow thickness, the greater the lymph node involvement and poor the outcomes: 10.2% when less than 1mm and 59.2% when greater than 4mm. Conclusion: the characteristics of patients with cutaneous melanoma treated at Hospital São Paulo are similar to those found in the literature.


Assuntos
Humanos , Masculino , Feminino , Neoplasias Cutâneas/epidemiologia , Melanoma/epidemiologia , Queimadura Solar , Brasil/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Distribuição por Idade , Linfonodos , Pessoa de Meia-Idade , Mitose
7.
Burns ; 43(2): 343-349, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27663506

RESUMO

PURPOSE: A major fire occurred on January 27, 2013, at 02:30 at Kiss nightclub in the city of Santa Maria, State of Rio Grande do Sul, in Southern Brazil. In this retrospective report, we aimed to describe the nightclub fire event, its immediate consequences, and evaluated its impact on legislation. Our objective was to disseminate the lessons we learned from this large-scale nightclub fire disaster. METHODS: We conducted a literature review in PubMed and Lilacs database from 2013 to 2015 related to the nightclub Kiss, Santa Maria, fire, burns, and similar events worldwide over the past 15 years. We searched in the general press and online media information sites, and seeking legislation about this topic at the federal level in Brazil. We reported on the legislation changes that resulted from this nightclub fire. RESULTS: Current federal legislation on fire prevention and the scope of public safety, including night clubs and discos, states is the duty of the state and everyone's responsibility, pursuant to Article 144 of the Federal Constitution of Brazil. Thus, the federal union, individual states and municipalities have the power to legislate on fire prevention, and especially to ensure the security of the population. A state law called "Law Kiss", was passed in 2014, establishing standards on safety, prevention and protection against fire in buildings and areas of fire risk in the state of Rio Grande do Sul. On a national level, a law of prevention and fire fighting in Brazil was also drafted after the Santa Maria disaster (Law project no. 4923, 2013). Currently, this bill is still awaiting sanction before it can take effect. CONCLUSION: As we push for enactment of the national law of prevention and fire fighting in Brazil, we will continue emphasizing fire prevention, fire protection, fire fighting, means of escape and proper management. All similar events in this and other countries remind us that similar tragedies may occur anywhere, and that the analysis of facts, previous mistakes, during and after the incident are crucial to our understanding, and will help us lessen the chance of future occurrences.


Assuntos
Queimaduras/prevenção & controle , Desastres/prevenção & controle , Incêndios/prevenção & controle , Incidentes com Feridos em Massa/prevenção & controle , Política Pública , Segurança/legislação & jurisprudência , Brasil/epidemiologia , Queimaduras/epidemiologia , Intoxicação por Monóxido de Carbono/epidemiologia , Aglomeração , Incêndios/legislação & jurisprudência , Humanos , Hidrolases/intoxicação , Incidentes com Feridos em Massa/estatística & dados numéricos , Estudos Retrospectivos , Lesão por Inalação de Fumaça/epidemiologia
8.
Rev. bras. cir. plást ; 32(2): 245-251, 2017. ilus
Artigo em Inglês, Português | LILACS | ID: biblio-847378

RESUMO

Introdução: A mão representa 3% da superfície corporal total, porém seu envolvimento em trauma grave, como uma queimadura, pode levar a sequelas funcionais graves. O presente estudo descreve os procedimentos no atendimento de pacientes na fase aguda com queimaduras envolvendo as mãos. Métodos: 122 pacientes com queimaduras térmicas envolvendo uma ou ambas as mãos foram incluídos no estudo, entre agosto de 2011 a julho de 2014. No exame físico inicial, determinou-se a extensão e a profundidade da lesão; as queimaduras profundas e circulares, com sinais e sintomas de perfusão inadequada, tiveram escarotomias realizadas para evitar perda de extremidade. As queimaduras de espessura parcial profunda ou de espessura total no dorso das mãos foram submetidas à excisão tangencial até 5 dias após o trauma; e o enxerto de pele parcial foi realizado em todos os pacientes antes do 15º dia do trauma. Resultados: Os homens representaram a maioria (58% da casuística). Em relação ao agente das queimaduras, os líquidos inflamáveis corresponderam a 46,7% das internações. Em 50,8% dos casos, as queimaduras eram de espessura parcial profunda ou de espessura total e necessitaram de procedimento operatório. Não foi identificada perda de enxerto no grupo. As escarotomias foram realizadas em 12,3% dos pacientes. Conclusão: A mão queimada necessita de atenção e cuidados locais adequados, juntamente com excisão precoce e enxertia de pele.


Introduction: The hand represents 3% of total body surface, but its involvement in severe trauma, such as burns, can lead to serious functional sequelae. The present study describes procedures in the care of patients in the acute phase with burns involving the hands. Methods: 122 patients with thermal burns involving one or both hands were included in the study between August 2011 and July 2014. On initial physical examination, the extent and depth of the lesions were determined; deep and circular burns, with signs and symptoms of inadequate perfusion, had escharotomies performed to avoid the loss of extremity. Burns of partial deep thickness or full thickness on the back of the hands received tangential excision within 5 days after the trauma; partial skin grafting was performed on all patients before the 15th day of the trauma. Results: Men represented the majority of cases (58%). In relation to the burn agent, flammable liquids caused 46.7% of admissions. In 50.8% of the cases, the burns were of partial deep thickness or of total thickness and required an operative procedure. No graft loss was identified in the group. Escharotomies were performed in 12.3% of the patients. Conclusion: The burned hand needs proper local attention and care, along with early excision and skin grafting.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , História do Século XXI , Pacientes , Satisfação Pessoal , Ferimentos e Lesões , Queimaduras , Transplante de Tecidos , Transplante de Pele , Procedimentos de Cirurgia Plástica , Retalhos de Tecido Biológico , Mãos , Ferimentos e Lesões/cirurgia , Ferimentos e Lesões/terapia , Queimaduras/cirurgia , Queimaduras/terapia , Transplante de Tecidos/reabilitação , Transplante de Pele/métodos , Procedimentos de Cirurgia Plástica/métodos , Procedimentos de Cirurgia Plástica/reabilitação , Transplantes/cirurgia , Retalhos de Tecido Biológico/cirurgia , Mãos/cirurgia
9.
Burns ; 41(6): 1147-51, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26048132

RESUMO

In recent years, there has been an increased use of neuroleptic agents in the unit care in trauma patients. There is a lack of prospective data, and most of the information is obtained from related cases. It is needed to have a high index of suspicion with regard to excluding neuroleptic malignant syndrome (NMS) in patients taking neuroleptics and presenting with hyperthermia, because of the potentially fatal consequences. It is a rare syndrome in the burn patient with a lack of proven treatments, and high morbidity and mortality are related. In the actual literature there are few related cases of NMS in the polytrauma patient, particularly in association with psychiatric conditions. In burn NMS is a rare complication with difficult diagnosis, because of the similar symptoms that can occur either in patients in the Burn Unit Care with other fatal conditions that are present in the acute phase response. Actually, there is no marker for the NMS, which difficult the early diagnosis and prognosis. The treatment still is based on case reports, with lack of clinical trials, but remain as standard and universally accepted. Besides that, the neural signaling of the NMS indicates possibilities for better understanding of the pathophysiology treatment protocol.


Assuntos
Antipsicóticos/efeitos adversos , Queimaduras/complicações , Síndrome Maligna Neuroléptica/etiologia , Humanos , Síndrome Maligna Neuroléptica/diagnóstico , Síndrome Maligna Neuroléptica/terapia , Fatores de Risco , Ferimentos e Lesões/complicações
10.
Burns ; 41(2): e15-8, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25440855

RESUMO

Decompensation of epilepsy in burned patients may be caused by several factors. Burn is a classic etiology of systemic inflammatory response syndrome, and evolves into two physiological phases. The first 48h after injury corresponds to the first phase involving severe hypovolemic shock. The second phase corresponds to the hypermetabolic response to burns. Altered pharmacokinetics of anticonvulsant drugs is observed. Albumin and other plasma proteins are reduced, leading to increased free fraction of phenytoin, resulting in greater clearance and a lower total drug concentration. Associated with metabolic changes of burned patient, this fact predisposes to seizures in epileptic burned patients. The authors present the case of an epileptic 36-year-old-woman who developed recurrent seizures after a thermal injury, despite using the same medications and doses of anticonvulsant drugs of last 12 years, with controlled epilepsy.


Assuntos
Queimaduras/complicações , Epilepsia/etiologia , Adulto , Anticonvulsivantes/farmacocinética , Queimaduras/metabolismo , Epilepsia/tratamento farmacológico , Feminino , Humanos , Fenitoína/farmacocinética
11.
Rev. bras. cir. plást ; 30(1): 86-92, 2015. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-885

RESUMO

INTRODUÇÃO: As queimaduras são traumas graves, que geram 100 mil atendimentos hospitalares por ano, no Brasil. As Unidades de Queimados são fundamentais para o tratamento desses pacientes e a produção de conhecimento sobre o tema. MÉTODO: O estudo estabeleceu o perfil de atendimento em cada ano de funcionamento da unidade no período de 2009 a 2012, e comparou, entre esses anos, a quantidade de pacientes internados, a procedência, os graus de queimadura, a idade, a superfície corporal queimada, os dias de internação, os tipos de procedimentos cirúrgicos, os agentes e a mortalidade. Para avaliação das possíveis associações, foi utilizado o teste do Qui-quadrado. RESULTADOS: Foram internados 321 pacientes. Em 2009, 70% dos pacientes apresentavam queimadura de II grau e, em 2012, 66% dos pacientes tinham queimadura de III grau. Em 2009, 37% vieram referenciados de outros serviços, e em 2012, 72%. A idade média dos pacientes foi de 29 anos em 2009 e 44 anos, em 2012. A superfície corporal queimada no início era de 13%, e em 2012, foi 8%. O tempo de internação subiu de 11 para 21 dias. Em 2009, realizaram-se 50 procedimentos cirúrgicos. Em 2012, foram 103. O agente causal mais encontrado foram os líquidos inflamáveis e a mortalidade global caiu de 7% para 4%, ao longo dos anos. CONCLUSÃO: Houve um aumento na quantidade de pacientes referenciados e complexos, com queimaduras de maior grau, exigindo mais procedimentos e maior hospitalização, ao longo dos anos. A taxa de mortalidade diminuiu, refletindo melhora técnica da Unidade, que se estabeleceu como referência regional no tratamento de queimados.


INTRODUCTION: Burns constitute severe trauma and account for 100,000 hospital visits per year in Brazil. Burns units are essential for the treatment of these patients and the generation of knowledge on this subject. METHOD: This study established the annual profile of burn unit attendance between 2009 and 2012. During these years of activity, we compared the number of hospitalized patients, patient origin, burn degree, age, burn body surface area, days of hospitalization, types of surgical procedures, agents, and mortality. Possible combinations were evaluated with the chi-square test. RESULTS: A total of 321 patients were hospitalized. In 2009, 70% of the patients presented secon-degree burns; in 2012, 66% of the patients presented third-degree burns. In 2009, 37% of the patients were referred to other services; in 2012, 72% were referred. The average patient age was 29 years old in 2009 and 44 years old in 2012. Burn body surface was 13% in 2009 and 8% in 2012. Hospitalization time increased from 11 to 21 days. A total of 50 surgical procedures were performed in 2009, while 103 were performed in 2012. Flammable liquids were the most commonly observed causal agents. The overall mortality rate decreased from 7% to 4% over the study period. CONCLUSION: There was an increase in the number of referred and complex patients with higher degree burns who required longer hospital stays and a greater number of procedures over the years. The decreased mortality rate reflected the technical improvement of the unit that was established as a regional reference for the treatment of burn victims.


Assuntos
Humanos , Masculino , Feminino , Adulto , História do Século XXI , Procedimentos Cirúrgicos Operatórios , Cirurgia Plástica , Ferimentos e Lesões , Unidades de Queimados , Queimaduras , Queimaduras Químicas , Epidemiologia , Estudos Retrospectivos , Estudo de Avaliação , Procedimentos Cirúrgicos Operatórios/métodos , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Cirurgia Plástica/métodos , Cirurgia Plástica/estatística & dados numéricos , Ferimentos e Lesões/cirurgia , Unidades de Queimados/normas , Queimaduras/cirurgia , Queimaduras/terapia , Queimaduras/epidemiologia , Queimaduras Químicas/cirurgia , Queimaduras Químicas/terapia , Estudos Epidemiológicos , Epidemiologia/estatística & dados numéricos
12.
São Paulo med. j ; 132(6): 372-376, Nov-Dec/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-726381

RESUMO

CONTEXT: Electrical burns are an important etiology in dealing with patients suffering from burns. In situations of extensive deep lesions of multiple organs and systems affecting young and economically active people, there is a need for expensive multidisciplinary treatment, with a high socioeconomic cost for the community. Among the permanent injuries that explain this high cost, eye injuries stand out, since they are widely disabling. Although rare, lesions of the posterior segment of the eye are associated with higher incidence of major sequelae, and thus deserve special attention for dissemination and discussion of the few cases observed. CASE REPORT: The authors report the case of a patient who suffered high-voltage electrical burns and presented bilateral maculopathy, which evolved with a need for a surgical approach to repair retinal detachment and permanent low visual acuity. CONCLUSION: This report highlights the rarity of the etiology of maculopathy and the need for campaigns for prevention not only of burns in general, but also especially of electrical burns. .


CONTEXTO: As queimaduras elétricas representam etiologia importante na abordagem de pacientes vítimas de queimaduras. Lesões extensas e profundas de múltiplos órgãos e sistemas e o acometimento de população jovem economicamente ativa apontam para a necessidade de tratamento multidisciplinar dispendioso, com alto custo socioeconômico para as comunidades. Dentre as lesões permanentes que justificam esse alto custo, as oculares têm local de destaque, porque são amplamente incapacitantes. Embora raras, as lesões do segmento posterior do olho estão associadas a maior incidência de sequelas importantes, merecendo atenção especial para divulgação e discussão dos poucos casos observados. RELATO DE CASO: Os autores relatam o caso de paciente vítima de queimadura elétrica com fio de alta voltagem que apresentou maculopatia bilateral, evoluindo com necessidade de abordagem cirúrgica para correção de descolamento de retina e baixa acuidade visual permanente. CONCLUSÃO: Este relato destaca a raridade da etiologia da maculopatia e a necessidade de campanhas de prevenção não só das queimaduras em geral, mas especialmente das queimaduras elétricas. .


Assuntos
Adulto , Humanos , Masculino , Queimaduras por Corrente Elétrica/complicações , Traumatismos por Eletricidade/complicações , Doenças Retinianas/cirurgia , Queimaduras por Corrente Elétrica/terapia , Traumatismos por Eletricidade/terapia , Seguimentos , Descolamento Retiniano/complicações , Doenças Retinianas/complicações , Doenças Retinianas/diagnóstico , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade Visual
13.
Sao Paulo Med J ; 132(6): 372-6, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25351759

RESUMO

CONTEXT: Electrical burns are an important etiology in dealing with patients suffering from burns. In situations of extensive deep lesions of multiple organs and systems affecting young and economically active people, there is a need for expensive multidisciplinary treatment, with a high socioeconomic cost for the community. Among the permanent injuries that explain this high cost, eye injuries stand out, since they are widely disabling. Although rare, lesions of the posterior segment of the eye are associated with higher incidence of major sequelae, and thus deserve special attention for dissemination and discussion of the few cases observed. CASE REPORT: The authors report the case of a patient who suffered high-voltage electrical burns and presented bilateral maculopathy, which evolved with a need for a surgical approach to repair retinal detachment and permanent low visual acuity. CONCLUSION: This report highlights the rarity of the etiology of maculopathy and the need for campaigns for prevention not only of burns in general, but also especially of electrical burns.


Assuntos
Queimaduras por Corrente Elétrica/complicações , Traumatismos por Eletricidade/complicações , Doenças Retinianas/cirurgia , Adulto , Queimaduras por Corrente Elétrica/terapia , Traumatismos por Eletricidade/terapia , Seguimentos , Humanos , Masculino , Descolamento Retiniano/complicações , Doenças Retinianas/complicações , Doenças Retinianas/diagnóstico , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade Visual
14.
Acta Cir Bras ; 29 Suppl 2: 15-20, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25229509

RESUMO

PURPOSE: To propose an experimental burn model in NIH-3T3 cell line. METHODS: Induction of thermal injury in cultures of mouse fibroblast - NIH-3T3- cell line and determination of cell viability by MTT and immunofluorescence. RESULTS: The heating of the Petri dish increased proportionally to the temperature of the base and the time of exposure to microwave. In this in vitro burn model, using the cell line NIH-3T3 was observed drastic cellular injury with significant changes in cell viability and activity. It showed drastically modified cell morphology with altered membrane, cytoskeleton and nucleus, and low cellularity compared to the control group. CONCLUSION: The burn model in vitro using the cell line NIH-3T3 was reproductive and efficient. This burn model was possible to determine significant changes in cell activity and decreased viability, with drastic change in morphology, cell lysis and death.


Assuntos
Queimaduras/patologia , Técnicas de Cultura de Células/métodos , Modelos Animais de Doenças , Células NIH 3T3 , Animais , Sobrevivência Celular , Imunofluorescência , Formazans , Temperatura Alta , Técnicas In Vitro/métodos , Camundongos , Microscopia Confocal , Reprodutibilidade dos Testes , Sais de Tetrazólio , Fatores de Tempo
15.
Acta Cir Bras ; 29 Suppl 1: 57-61, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25185058

RESUMO

PURPOSE: To simulate a lymph node metastasis in an animal model using activated carbon, assess their identification in frozen section analysis and compare with histopathological examination in paraffin. METHODS: Thirty two adult female rats were used. They received the carbon injection on its hind legs. Half of the rats was sacrificed on day one, and the other half after 21 days. Thus, 64 lymph nodes were dissected and split longitudinally. One half of the lymph node was sent immediately to frozen section analysis. The other half was fixed in 10% formaldehyde to be cut in paraffin. Slides were divided into quadrants and classified by the presence of carbon in these four quadrants_ They were also classified by the carbon staining intensity. RESULTS: Comparing the slides obtained in the first day and 21 days, there was a tendency of carbon to spread over time, but without statistical significance. The intensity did not alter over time. CONCLUSION: There was no concordance between the two methods of pathological analysis, however the actived carbon was seen in all lymph nodes.


Assuntos
Secções Congeladas/métodos , Linfonodos/patologia , Inclusão em Parafina/métodos , Biópsia de Linfonodo Sentinela/métodos , Animais , Carvão Vegetal , Modelos Animais de Doenças , Feminino , Metástase Linfática/patologia , Melanoma/patologia , Melanoma/secundário , Ratos , Padrões de Referência , Reprodutibilidade dos Testes , Fatores de Tempo
16.
Acta cir. bras ; 29(supl.1): 57-61, 2014. tab
Artigo em Inglês | LILACS | ID: lil-720396

RESUMO

PURPOSE: To simulate a lymph node metastasis in an animal model using activated carbon, assess their identification in frozen section analysis and compare with histopathological examination in paraffin. METHODS: Thirty two adult female rats were used. They received the carbon injection on its hind legs. Half of the rats was sacrificed on day one, and the other half after 21 days. Thus, 64 lymph nodes were dissected and split longitudinally. One half of the lymph node was sent immediately to frozen section analysis. The other half was fixed in 10% formaldehyde to be cut in paraffin. Slides were divided into quadrants and classified by the presence of carbon in these four quadrants_ They were also classified by the carbon staining intensity. RESULTS: Comparing the slides obtained in the first day and 21 days, there was a tendency of carbon to spread over time, but without statistical significance. The intensity did not alter over time. CONCLUSION: There was no concordance between the two methods of pathological analysis, however the actived carbon was seen in all lymph nodes. .


Assuntos
Animais , Feminino , Ratos , Secções Congeladas/métodos , Linfonodos/patologia , Inclusão em Parafina/métodos , Biópsia de Linfonodo Sentinela/métodos , Carvão Vegetal , Modelos Animais de Doenças , Metástase Linfática/patologia , Melanoma/patologia , Melanoma/secundário , Padrões de Referência , Reprodutibilidade dos Testes , Fatores de Tempo
17.
Acta cir. bras ; 29(supl.2): 15-20, 2014. graf
Artigo em Inglês | LILACS | ID: lil-721379

RESUMO

PURPOSE: To propose an experimental burn model in NIH-3T3 cell line. METHODS: Induction of thermal injury in cultures of mouse fibroblast - NIH-3T3- cell line and determination of cell viability by MTT and imunofluorescence. RESULTS: The heating of the Petri dish increased proportionally to the temperature of the base and the time of exposure to microwave. In this in vitro burn model, using the cell line NIH-3T3 was observed drastic cellular injury with significant changes in cell viability and activity. It showed drastically modified cell morphology with altered membrane, cytoskeleton and nucleus, and low cellularity compared to the control group. CONCLUSION: The burn model in vitro using the cell line NIH-3T3 was reproductive and efficient. This burn model was possible to determine significant changes in cell activity and decreased viability, with drastic change in morphology, cell lysis and death. .


Assuntos
Animais , Camundongos , Queimaduras/patologia , Técnicas de Cultura de Células/métodos , Modelos Animais de Doenças , Sobrevivência Celular , Imunofluorescência , Formazans , Temperatura Alta , Técnicas In Vitro/métodos , Microscopia Confocal , Reprodutibilidade dos Testes , Sais de Tetrazólio , Fatores de Tempo
18.
Acta Cir Bras ; 27(12): 855-60, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23207751

RESUMO

PURPOSE: To evaluate telomerase activity and proliferation of HS839.T melanoma cells, subjected to the action of AZT. METHODS: Cells were grown in triplicate, AZT at different concentrations: 50, 100 and 200 µM, was added and left for 24 and 48 hours, and its effects were compared with the control group. Telomerase activity was detected by PCR and cell proliferation was evaluated by MTT. RESULTS: After 24 hours, there was no inhibition of cell proliferation or telomerase activity when compared to the control group. After 48 hours, there was a momentary decrease, suggesting that the cell lines used in this study are sensitive to AZT, but quickly recover both the enzyme activity and cell proliferation. CONCLUSION: The action of AZT on the melanoma cells studied, at the concentrations and times tested, did not inhibit telomerase activity nor affect cell proliferation.


Assuntos
Proliferação de Células/efeitos dos fármacos , Melanoma/patologia , Neoplasias Cutâneas/patologia , Telomerase/metabolismo , Zidovudina/farmacologia , Adulto , Linhagem Celular Tumoral , Relação Dose-Resposta a Droga , Feminino , Humanos , Melanoma/enzimologia , Neoplasias Cutâneas/enzimologia , Telomerase/antagonistas & inibidores , Fatores de Tempo , Zidovudina/administração & dosagem
19.
Acta cir. bras ; 27(12): 855-860, dez. 2012. graf
Artigo em Inglês | LILACS | ID: lil-657968

RESUMO

PURPOSE: To evaluate telomerase activity and proliferation of HS839.T melanoma cells, subjected to the action of AZT. METHODS: Cells were grown in triplicate, AZT at different concentrations: 50, 100 and 200μM, was added and left for 24 and 48 hours, and its effects were compared with the control group. Telomerase activity was detected by PCR and cell proliferation was evaluated by MTT. RESULTS: After 24 hours, there was no inhibition of cell proliferation or telomerase activity when compared to the control group. After 48 hours, there was a momentary decrease, suggesting that the cell lines used in this study are sensitive to AZT, but quickly recover both the enzyme activity and cell proliferation. CONCLUSION: The action of AZT on the melanoma cells studied, at the concentrations and times tested, did not inhibit telomerase activity nor affect cell proliferation.


OBJETIVO: Avaliar a atividade da telomerase e da proliferação de células de melanoma HS839.T submetidas à ação do AZT. MÉTODOS: As células foram cultivadas, em triplicata, com diferentes concentrações de AZT: 50, 100 e 200µM, por 24h e 48h, seus efeitos comparados com o grupo controle. A atividade da telomerase foi detectada por PCR e a proliferação celular avaliada por MTT. RESULTADOS: No tempo de 24 horas, não houve inibição da proliferação celular e da atividade da telomerase em comparação com o grupo controle. No período de 48 horas, houve uma diminuição momentânea, sugerindo que as células das linhagens utilizadas neste estudo são sensíveis ao AZT, mas que recuperam a atividade enzimática e proliferativa. CONCLUSÃO: Nas células de melanoma HS839.T estudadas e nas concentrações e tempos propostos, a ação do AZT não inibiu a atividade da telomerase e não afetou a proliferação celular.


Assuntos
Adulto , Feminino , Humanos , Proliferação de Células/efeitos dos fármacos , Melanoma/patologia , Neoplasias Cutâneas/patologia , Telomerase/metabolismo , Zidovudina/farmacologia , Linhagem Celular Tumoral , Relação Dose-Resposta a Droga , Melanoma/enzimologia , Neoplasias Cutâneas/enzimologia , Fatores de Tempo , Telomerase/antagonistas & inibidores , Zidovudina/administração & dosagem
20.
Acta cir. bras ; 25(5): 434-439, Sept.-Oct. 2010. ilus, tab
Artigo em Inglês | LILACS | ID: lil-558730

RESUMO

PURPOSE: To qualify the FT-Raman spectral data of primary and metastatic cutaneous melanoma in order to obtain a differential diagnosis. METHODS: Ten normal human skin samples without any clinical or histopathological alterations, ten cutaneous melanoma fragments, and nine lymph node metastasis samples were used; 105, 140 and 126 spectra were obtained respectively. Each sample was divided into 2 or 3 fragments of approximately 2 mm³ and positioned in the Raman spectrometer sample holder in order to obtain the spectra; a monochrome laser light Nd:YAG at 1064 nm was used to excite the inelastic effect. RESULTS: To differentiate the three histopathological groups according to their characteristics extracted from the spectra, data discriminative analysis was undertaken. Phenylalanine, DNA, and Amide-I spectral variables stood out in the differentiation of the three groups. The percentages of correctly classified groups based on Phenylalanine, DNA, and Amide-I spectral features was 93.1 percent. CONCLUSION: FT-Raman spectroscopy is capable of differentiating melanoma from its metastasis, as well as from normal skin.


OBJETIVO: Qualificar os dados espectrais FT-Raman do melanoma cutâneo primário e metastático e assim realizar o diagnóstico diferencial. MÉTODOS: Foram utilizadas amostras de 10 fragmentos de pele sem alterações clínicas ou histopatológicas, 10 de melanomas cutâneos e 9 de metástases linfonodais; 105, 140 and 126 espectros foram obtidos respectivamente. Cada amostra foi dividida em 2 ou 3 frações de 2 mm³ e posicionada no porta amostras do espectrômetro Raman para obtenção dos espectros, por meio da excitação do espalhamento inelástico pelo laser de Nd:YAG em 1064 nm incididos na amostra. RESULTADOS: Para diferenciar os três grupos formados de acordo com as características fornecidas pelos espectros, realizamos a análise discriminante dos dados. As variáveis espectrais Fenilalanina, DNA e Amida-I se destacaram na capacidade de diferenciação dos três grupos histológicos. A porcentagem de classificação correta utilizando estes critérios foi de 93,1 por cento; o que mostra a eficiência da análise realizada. CONCLUSÃO: A espectroscopia FT-Raman é capaz de diferenciar o melanoma de sua metástase, assim como da pele normal.


Assuntos
Humanos , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Análise Espectral Raman/normas , Amidas/análise , Diagnóstico Diferencial , DNA , Melanoma/química , Melanoma/secundário , Fenilalanina/análise , Neoplasias Cutâneas/química , Neoplasias Cutâneas/patologia , Pele/química , Análise Espectral Raman/métodos
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