Background There is a dearth of studies conducted to understand the socio-professional profile of the vascular surgery specialty and the population demands of specific regions, which are needed to support creation of care policies and direct infrastructure improvements in healthcare. Objectives The purpose of this study was to describe the socio-professional profile of vascular surgeons in the state of Pará, Brazil, to guide creation of tools for professional improvement. Methods A cross-sectional, self-report survey was conducted in Pará using a questionnaire comprising 30 questions covering six main topics. Results All vascular surgeons actively practicing in the state participated in this study. The total number of specialists was 59, with 71.2% working in the greater Belém area and 16.9% exclusively practicing in the interior of the state. The mean age of these professionals was 48 ± 11.1 years, 86.4% of respondents were men, 64.4% of surgeons had completed medical residency, and 96.6% (n=57) of the surgeons would like to improve their skills in venous surgery, echo-guided vascular access, and endovascular surgery. The method of professional improvement of greatest interest was simulation courses (hands-on), endorsed by 93% of the participants. Conclusions Pará has 59 vascular surgeons. These professionals mainly work in the greater Belém (71.2%), in hospitals (100%) or in private clinics or offices (94.9%), performing a wide range of procedures, including venous and arterial surgery, amputations, and provision of hemodialysis access. More than 90% of these surgeons were satisfied professionally and reported that they would choose the specialty again. However, 22% had a pessimistic view of the specialty’s future. The vast majority of professionals (96.6%) consider that training or a continuing education program are necessary.
Vários métodos são utilizados para avaliar e estimar as lesões intestinais de isquemia e reperfusão (IR). Assim, o objetivo do presente trabalho é realizar o estudo comparativo dos aspectos colorimétrico e histológico da lesão intestinal após IR. Para tal, foram utilizados 30 ratos Wistar, machos, pesando entre 310 a 410g, distribuídos em 3 grupos: Grupo Controle (GC), Grupo Isquemia e Reperfusão-1 (GIR-1) e Grupo Isquemia e Reperfusão-3 (GIR-3), com 10 animais cada. Nos grupos GIR-1 e GIR-3 foi realizada isquemia intestinal, por meio de falsa ligadura da artéria mesentérica anterior, durante 30 minutos e após esta a perfusão sangüínea foi restaurada. Estes animais foram submetidos a eutanásia após 1 e 3 dias de reperfusão, respectivamente, sendo colhido material para realização dos estudos colorimétrico, usando o Methyl Thiazolyl Blue (MTT) e histológico pela hematoxilina e eosina. Os resultados obtidos demonstraram uma menor proporção de células viáveis e um maior grau de lesão da túnica mucosa nos animais do grupo GIR-3 em relação ao controle (p<0,05). Desta forma os autores concluem que o estudo colorimétrico, usando o MTT, mostrou-se tão eficaz e confiável quanto o estudo histológico na avaliação das repercussões intestinais produzidas pela IR deste órgão.
O óleo de copaíba é um óleo-resina empregado como fitoterápico na região Amazônica. Sua utilização se faz de forma empírica e pouco se conhece à respeito de seus efeitos sobre os sistemas orgânicos. Objetivo: Verificar os níveis séricos de aminotransferases, bilirrubinas e gama-glutamil transpeptidase após a administração do óleo. Métodos: Foram utilizados 20 ratos Wistar, machos, pesando entre 250 e 300g, distribuídos em 2 grupos: Grupo Cop (n=10) submetidos diariamente à gavagem com administração de 0,63ml/kg do óleo, por 5 dias; Grupo P (n=10), animais nos quais nenhuma substância foi administrada. Ao sexto dia, em ambos os grupos, procedeu-se anestesia inalatória e obtenção de 3ml de sangue da VCI para dosagem dos níveis séricos de ALT, AST, bilirrubinas e GGT. Resultados: Os resultados obtidos com o GCop foram comparados com os do GP e analisados estatisticamente pelo teste t -Student. O GCop apresentou níveis de ALT, AST e GGT significantemente mais baixos que o GP (p<0,01), enquanto os níveis de BT elevaram-se às custas da fração direta. Conclusão: O óleo de copaíba altera os níveis das aminotransferases, bilirrubinas e GGT, sem alterar os níveis da fração indireta.
Objective: to assess the socioeconomic and demographic profiles of patients hospitalized with a diagnosis of diabetic foot in a tertiary hospital in Belem-PA, Brazil, as well as to evaluate risk factors for lower limb amputations in such patients, classifying them according to the Wagner and PEDIS classifications. Methods: we conducted a descriptive, cross-sectional, unicentric, and analytical study carried out through a structured questionnaire. Results: the study consisted of 57 patients, aged between 48 and 84 years old, 66.7% being male. The average income ranged between one and three (61.4%) minimum wages and below one minimum wage (31.6%). Type II Diabetes Mellitus was predominant (86.0%). Concerning comorbidities, arterial hypertension displayed the highest proportion (62.3%), followed by dyslipidemia (52.8%). Smokers comprised 35.1% of the sample. Infectious diabetic foot (50.9%) and mixed diabetic foot (49.1%) were the most common. Of the 20 patients with previous amputation, 90% had undergone minor amputation, and 10%, major ones. Callosity (92.6%) was the most prevalent deformity. Fifty-four (94.7%) patients underwent surgery, those being debridement (24.1%), minor amputation (37.0%) and major amputation (38.9%). During hospitalization, 78.9% of individuals did not require ICU stay. Hospitalization time varied between three and 59 days, and 78.9% of hospitalized patients did not progress to death, but 43.1% of patients submitted to major amputations died. Conclusion: patients with diabetic foot followed-up have a low socioeconomic profile; most of them underwent surgical procedures, whether major or minor, due to the higher prevalence of infectious diabetic foot and/or non-adherence to non-operative treatment.
Copaiba oleoresin is widely used in folk medicine as an antiinflammatory, healing and antiseptic agent. Wistar rats received Copaifera duckei oleoresin (CDO) or saline solution (SS) from 7 days before surgery until killing. Partial hepatectomy (PH) or sham-operation was performed. Hepatocellular proliferation and liver mitochondrial respiration were evaluated 24 h after the procedure. The proliferating cell nuclear antigen labelling index was significantly lower in CDO-treated plus PH rats than in SS-treated plus PH rats, suggesting that CDO inhibited cell proliferation. The state 3 and state 4 respiration rates were greater for CDO-treated groups, and the stimulation of state 4 respiration was more expressive. These data resulted in a significant decrease in the respiratory control ratio observed for CDO-treated groups, demonstrating the ability of CDO to uncouple oxidative phosphorylation in mitochondria, a fact that may be one explanation for the inhibition of hepatocellular proliferation observed in the CDO-treated plus PH group.
Background Microsurgery training is critical to the practice of microvascular procedures in many surgical areas. However, even simple procedures require different levels of complex skills. Therefore, simulation-based surgical training, mainly in the area of vascular anastomosis, is of great importance. In this paper, we present a new microsurgery training model for the development of basic to advanced microsurgical skills. Methods Porcine kidneys were purchased from a legal butchery slaughterhouse. First, kidneys were washed with water to remove blood and clots inside vessels. Then, dissection was performed throughout the vascular pedicle from the renal arteries to the segmentary branches. Finally, the longitudinal sectioning of the kidney parenchyma was performed to expose the vessels necessary for training. Sixty end-to-end anastomoses were performed. Specific instruments and materials were used to perform anastomoses and dissections with magnification by a video system. We evaluated the diameter of vessels, time to perform anastomosis, and patency of anastomosis. Results There was no great anatomical variation among the porcine kidneys. The total length for dissection training was 25.80 ± 7.44 cm using the arterial and venous vessel. The average time to perform arterial anastomoses was 23.79 ± 4.55 minutes. For vessel diameters of ≤ 3, 4 to 6, and 7 to 10 mm, the average procedure times were 27.68 ± 3.39, 22.92 ± 4.12, and 20.77 ± 3.44 minutes, respectively. Regarding venous anastomosis, the average duration of the procedure was 26.17 ± 4.80 minutes, including durations of 31.61 ± 3.86, 25.66 ± 4.19, and 21.24 ± 3.79 minutes for vessel diameters of ≤ 7, 8 to 10, and >10 mm, respectively. Positive patency was achieved in all surgeries. Conclusion The porcine kidney provides an inexpensive and convenient biological model for modeling microanastomosis with high fidelity to vascular structures.
A utilização de plantas medicinais é uma prática comumente observada nos países em desenvolvimento. Desta forma objetivou-se verificar os efeitos microscópicos do óleo de copaíba no fígado de ratos. Para tal foram utilizados 50 Rattus norvegicus albinus, machos, distribuídos em cinco grupos: Grupo Copaíba 0,63 (GC0,63 ml/Kg de óleo de copaíba), Grupo copaíba 0,06 (GC0,06 ml/Kg de óleo de copaíba), Grupo Água (GA0,63 ml/kg de água), Grupo milho (GM0,63 ml/Kg de óleo de milho) e grupo Padrão (GP). As substâncias foram administradas diariamente por 14 dias, quando os animais foram submetidos à eutanásia. Os resultados obtidos demonstraram que microscopicamente, não foram encontradas alterações hepatocelulares, porém, foi verificado congestão vascular nas veias portais e centrolobulares, maior no grupo GC0,63 em relação aos grupos GC0,06, GM, GA e GP (p< 0,05). Já no grupo GC0,06, apesar de não haver diferença estatística, foi observado congestão em maior intensidade que nos grupos GM, GA e GP (p>0,05) o que sugere haver uma relação dose dependente. Os autores concluem que, de acordo com a metodologia empregada, o óleo de copaíba tanto na dose de 0,06 ml/kg como de 0,63 ml/kg foi capaz de promover congestão vascular no fígado de ratos, sugerindo ação dose dependente.
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