Cardosin A is extracted from the pistils of the plant Cynara cardunculus L. and chitosan is a polysaccharide derived from chitin with valuable properties as a biomaterial. In this work we report our experiments on the synthesis of chitosan sponges and immobilisation of cardosin A, by entrapment. We observed that 10-15% of the incorporated cardosin A were released over 6 days of incubation. In addition, we could also note that this immobilisation procedure did not induce any specificity alterations on cardosin A. The specificity study of the enzyme, using beta-chain of oxidised insulin, showed that the immobilised and released enzymes have the same hydrolysis pattern as the free enzyme. The ability of this enzyme to hydrolyse type I collagen was maintained, after the immobilisation procedure. The biocompatibility in vivo of these sponges was evaluated by histological staining after implantation in rats submitted to abdominal surgery. Results of this study demonstrated that these chitosan sponges are very promising vehicles for the application of cardosin A, in abdominal cavity for prevention and reduction of the adhesions formation.
Two surgical models of intestinal transplantation in the rat are described. One is the implantation of fetal and newborn intestine as free grafts into the omentum of adult recipients, the other the adult intestine transplantation as an accessory graft using vascular anastomoses. A hundred and sixteen smallbowel transplantations were done; 36 of which were fetal intestine (group I), 40 of newborn intestine (group II), and 40 of adult intestine (group III). In the fetal and newborn intestinal transplantation, we emphasize the practices that allowed us to avoid ischemic and traumatic injury to the graft. In the adult intestine transplantation with vascular anastomoses, we heighten the modifications in the surgical technique that made the operation easier and the strategies used to prevent hypothermia and hypovolemic shock. Once experienced with the two chosen surgical techniques, transplantation using an avascular segment became much easier and quicker than transplantation with vascular anastomoses.Os autores descrevem dois modelos cirú rgicos de transplantaçã o intestinal no rato. Um corresponde à implantação de intestino de feto e de intestino de recé m-nascido, como enxertos livres, no epíploon de receptores adultos, e o outro corresponde à transplantaçã o de intestino de adulto, como enxerto acessório, usando anastomoses vasculares. Fizémos 116 transplantaçõ es intestinais: 36 de intestino fetal (grupo I), 40 de intestino de recé m-nascido (grupo II) e 40 de intestino de adulto (grupo III). Realçá mos os mé todos utilizados para evitar a isqué mia e a lesã o traumá tica do enxerto, nas transplantaçõ es de intestino de feto e de recé m-nascido. Na transplantaçã o de intestino de adulto com anastomoses vasculares, enfatizá mos as modificações na té cnica cirú rgica, que facilitaram a operaçã o, e as estraté gias usadas para evitar a hipotermia e o choque hipovolé mico. Apó s a familiarizaçã o com os dois modelos cirú rgicos, a transplantação intestinal como enxerto avascular revelou-se de execução mais simples e mais rá pida do que a transplantaçã o intestinal com realizaçã o de anastomoses vasculares.© 1998 Wiley-Liss, Inc. MICROSURGERY 18:424-429 1998Nowadays, the laboratory rat (Rattus norvegicus) is one of the most popular models for intestinal transplantation. Its use started with Monchick and Russell's work 1,2 in the 1970s, in which they applied the surgical techniques with vascular anastomoses, previously developed in bigger models by other investigators. 3,4 The intestinal transplantation technique varies according to the kind of graft and the investigation. While studying immunogenicity of fetal, newborn, and adult jejunal allografts in the rat, the authors used two methods of small-bowel transplantation. Fetal and newborn grafts were implanted as an avascular segment into the omentum of adult recipients. Adult allograft was transplanted to an adult recipient as a heterotopic accessory graft using aorta-aorta and porto-caval anastomoses. 5 The aim of this study is to review the intestinal transplantatio...
Venous thromboembolism (VTE) risk assessment is a cornerstone for the achievement of best practices and outcomes. Epidemiologic data and practices related to venous thromboprophylaxis as considered by the global ENDORSE study, (Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting), enrolled 68,183 patients from 32 countries, in which Portugal. Within ENDORSE, data from all participant countries analyzed to determine their risk of VTE and to evaluate the suitability of prophylaxis.European patients were enrolled from randomly selected hospitals in Portugal (European Hospital Register), according to ENDORSE study inclusion/exclusion criteria. The Seventh ACCP evidence-based consensus guidelines were employed to evaluate VTE risk and prophylaxis use.From a total of 3,145 beds assessed, 2,183 were considered eligible and 1,632 met all criteria. Of these, 860 (52.7%; 95% CI 50.3-55.1) were at risk of VTE: 525 surgical patients (68.9%; 95% CI 65.5-72.1) and 335 medical patients (38.5%; 95% CI 35.3-41.2). The rate of prophylaxis according to ACCP guidelines in overall patients at risk was 58.5% (503 patients). The prophylaxis rate for VTE was 59% (310 patients) in surgical patients and 57.6% (n=193) in medical patients. 39.7% of surgical patients and 39.4 % of medical patients who did not meet the criteria for prophylaxis were also on prophylaxis with an anticoagulant, which was considered to be inappropriate.More than a half of these hospitalized patients in Portugal were deemed at risk of VTE and less than two-thirds of them received appropriate prophylaxis. New strategies are required for implementation of venous thromboprophylaxis in Portuguese hospitals.
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