Theses / Dissertations 2016

 

MASTER

Author: Roberta Rehder
Original Title: Variation of the slope of the tentorium during childhood

Neural structures in the posterior fossa grow at different rates during development. While there are computationally intensive approaches to analyze growth of the cerebellum and brainstem, there is a paucity of information about summary measures of normal posterior fossa development suitable for real time clinical use. Objectives: The present study investigates the changes in the trajectory of the tentorium as measured by the occipital and tentorial angles at different stages of development and correlates the changes in the inclination of the tentorium with childhood development. Materials and Methods: A retrospective study was conducted drawing from a database of Boston Children’s Hospital of over 1500 MRI studies. The study population included fetuses older than 20 gestational weeks and children between the ages of 0 and 10 years. Two parameters were measured for all subjects: (1) the tentorial angle (the angle between the tentorium and a line from the internal occipital protuberance to the tuberculum sellae) and (2) the occipital angle (the angle between the tentorium and a line from the internal occipital protuberance to the opisthion). Descriptive statistics were used to analyze the study cohort. Results: 1510 brain MRI studies were reviewed, in which 367 studies met the inclusion criteria (125 fetal and 242 postnatal studies). During fetal development, the inclination of the tentorium showed an ascending course, while it plateaus after birth. Conclusion: During the second and third trimester, the tentorial and occipital angles steadily increase reflecting the dynamic growth of the posterior fossa structures. Postnatally, the tentorial angle decreases and the tentorium slopes downward and plateaus, possibly due to stabilization of posterior fossa development and ongoing growth of the cerebrum. Together, these findings suggest that the tentorial angle can serve as an imaging biomarker of posterior fossa development during the second half of fetal life.

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Artigo: https://www.ncbi.nlm.nih.gov/pubmed/26362679

 

Author: Carlos Eduardo Oliveira dos Santos
Original Title: The impact of hyoscine butylbromide for the detection of colorectal adenomas

INTRODUCTION: The removal of premalignant colorectal lesions prevents cancer, and the adenoma detection rate (ADR) is an important indicator of the quality of a colonoscopy. Hyoscine has been recommended to improve the visualization of colonic mucous through the reduction of spasms, facilitating adenoma diagnosis. OBJECTIVES: Evaluating if the use of hyoscine provides a greater detection of adenomas and to investigate if it acts in the differentiation of neoplastic and non-neoplastic lesions under the digital chromoscopy. METHODS: In a randomized and double-blind study, 440 patients received either saline solution (control group) or hyoscine in a proportion of 1:1, in consecutive colonoscopies, given when the cecum was visible. The lesions were analyzed in terms of number, size, morphology, location, capillary pattern, and histology. FICE (Flexible spectral Intelligent Color Enhancement) digital chromoscopy was used. The bivariate analysis of comparison between the two groups was performed by means of the precise Fisher test, along with either a T-test for independent samples for comparisons of averages, or a Wilcoxon test for comparisons of medians. To analyze the ADR, the Odds ratio (OR), IC95% and the value p was used. A level of significance was given at 5% for two-tailed tests. RESULTS: The overall ADR was 49.3%, while the ADR was 50.5% for the control group and 46.8% for the hyoscine group (ns). The advanced adenoma and advanced neoplasia rates were 12.7% vs 11.8%, and 13.6% vs. 12.3%, respectively (ns). The averages of adenoma, advanced adenoma and advanced neoplasia per patient were 0.92, 0.16, and 0.16 in the first group, and 0.86, 0.18, and 0.18 in the second group, respectively. The adenomas were more frequent in the right colon in both groups (80.3% vs 83.1%, p = 0.55), including non-polypoid adenomas (76.3% vs 80.4%, p = 0.52). The probability of adenomas in the right colon was greater in the hyoscine group than in the control group, OR 5.8 (CI95% 2.8-12), p < 0.01 vs OR 1.8 (CI95% 0.9-3.7), p = 0.1. Using digital chromoscopy, the accuracy was 94.3%, sensibility was 94.1%, specificity was 94.7%, positive predictive value was 98%, and negative predictive value was 85.7% in the control group. Meanwhile, the results for the same diagnostic criteria in the hyoscine group were 95%, 93.7%, 97.8%, 98.9%, and 88.1%, respectively. CONCLUSIONS: This study did not observed an impact that supports the routine use of hyoscine to improve the rate of detection of adenoma and advanced adenomas, as well as there was no improvement in the differentiation of neoplastic lesions of nonneoplastic lesions evaluated by digital chromoscopy.

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Author: Débora Azeredo Pacheco Dias da Costa
Original Title: Comparative analysis between magnetic colangiopancreatoressonance and effective punctuation with fine needle for diagnosis and follow-up of mucineal intraduction neoplasms pancreatic papilifer

Background: Intraductal papillary mucinous tumor (IPMN) is being diagnosed with increasing frequency. Computerized tomography scanning is commonly used as the primary imaging modality before treatment. Colangioresonance (MRCP) provides better characterization type and extension. Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) has been increasingly used in order to make preoperative histological diagnosis. Objective: Compare results of MRCP and EUS-FNA with surgical and pathological findings for diagnosis and classification of IPMN. Methods: This study involved 36 patients submitted to surgical resection with preoperative suspect of IPMN, all of them presented pancreatic cystic lesion before surgery, in both MRCP and EUS-FNA previously performed. All patients were sent to the last exam, with the objective of histological diagnosis and IPMN confirmation. The anatomopathological obtained in this puncture was routinely used. Images obtained by both methods were analyzed using a standardization containing type and classification of the lesion. Fisher's exact test and the ROC curve for statistical analysis were used, that compared the images tests with the purpose of finding the best method for diagnosis and classification of IPMN. Results: Twenty-nine revealed non-invasive neoplasia and invasive form in 4 patients. MRCP and EUS-FNA have correctly diagnosed and classified (type of IPMN), in 62.5% and 83.3% (p=0.811), the affected segment location in 69% and 92% (p=0.638) and identification of nodules and/or vegetation presence in 45% and 90% (p=0.5). Regarding to histopathological diagnosis by endoscopic ultrasound-guided fine needle aspiration the sensitivity was 83.3%; specificity was 100%; positive predictive value was 100%; negative predictive value was 33.3% and accuracy was 91.7%. Conclusions: The both diagnosis methods did not present statistical differences. However, endoscopic ultrasound showed absolute results better than magnetic resonance cholangiopancreatography to identify nodules and/or vegetation.

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Author: Rodrigo Araldi Nery
Original Title: Association between uricemia, severity and leg ulcer healing in patients of a University Hospital

Background: Leg ulcers are common entities that affect patient’s quality of life. The presence of inflammatory cells at the wound site releasing lysosomal enzymes and oxygen free radicals, contributes to tissue damage and persistence of the wound. Objective: Presently, we aimed to investigate the influence of serum uric acid (a marker of oxidative stress) in the severity of leg ulcers and their healing. Methods: Ninety-one patients were included (64.8% women; 35.1% men, mean age 63.3±12.1 years) with chronic leg ulcers. Two sequential observations on number, size and appearance of ulcers (presence of fibrin, hyperkeratosis, necrosis and granulation tissue) as well as degree of pain generated by the ulcer were done.  Pain was measured on a visual analog scale (0 to 10). The two visits obeyed an interval of three months and, on the first visit, a blood sample for uric acid dosage was withdrawn. Next, the results of uric acid levels were studied in relation to the reduction of wound area at this time (healing), changes in the appearance and in the degree of pain. Results: The levels of serum uric acid showed a positive correlation with degree of pain (p=0.008) and ulcers in the presence of fibrin at the first visit (p=0.03). However it was not possible to correlate the serum uric acid level with healing area (p=0.79), the change in pain level (p=0.65) or number of wounds (p=0.85). Conclusion: There is a correlation of serum uric acid levels with degree of pain and with the presence of fibrin leg ulcers but this radical does not seem to influence the ulcer healing.

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Artigo: http://www.ncbi.nlm.nih.gov/pubmed/26734804

 

Author: Alexandre Gomes
Original Title: Conventional videoendoscopy can identify helicobacter pylori gastritis?

Background: Studies with the latest technologies such as endoscopy with magnification and chromoendoscopy showed that various endoscopic aspects are clearly related to infection by Helicobacter pylori (Hp). The description of different patterns of erythema in gastric body under magnification of images revived interest in identifying these patterns by standard endoscopy. Aim: To validate the morphological characteristics of the gastric mucosa in gastritis related to Helicobacter pylori infection using conventional endoscopy and allowing the predictability of their diagnosis and appropriate targeted biopsies. Methods: Prospective study of 339 consecutive patients with the standard videoendoscope image analysis were obtained, recorded and stored in a program database. These images were studied with respect to the presence or absence of Hp, diagnosed by rapid urease test (RUT) and / or by histological analysis. Aspects that were studied included: a) normal mucosa appearance; b) mucosal nodularity; c) diffuse nonspecific erythema or redness (with or without edema of folds and exudate) of antrum and body; d) mosaic pattern with focal area of hyperemia; e) erythema in streaks or bands (red streak); f) elevated (raised) erosion; g) flat erosions; h) fundic gland polyps. The main exclusion criteria were the use of drugs, Hp pre-treatment and other entities that could affect results. Results: Applying the exclusion criteria, 170 of the 339 patients were included, of which 52 (30.58%) were positive for Helicobacter pylori and 118 negative. On the positive findings, the most associated with infection were: nodularity in the antrum (26.92%); presence of raised erosion (15.38%) and mosaic mucosa in the body (21,15%). On the negative group the normal appearance of the mucosa was 66.94%; erythema in streaks or bands in 9.32%; flat erosions 11.86%; and fundic gland polyps 11.86%. Conclusion: Endoscopic findings are useful in the predictability of the result and in directing biopsies. The most representative form of Hp related gastritis was the nodularity of the antral mucosa. The raised erosion and mucosa in mosaic in the body are suggestive but not specific to the infection. The other forms were not conclusive of the presence of Hp.

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Artigo: http://www.ncbi.nlm.nih.gov/pubmed/27438029

 

Author: Artur Adolfo Parada
Original Title: Comparative analysis of endoscopic and histopathological features of superficial elevated lesions resected by endoscopic mucosal resection in the distal and proximal colon

Introduction: The colorectal cancer is one of the main medical issues nowadays. There have been discussions regarding interval carcinoma, emphasizing the assistance of loss of superficial lesions in proximal colon, which would be answerable for these cases. Objective: Comparing endoscopic and histopathological aspects of superficially sizeable lesions, by measuring 1,0 cm or over in diameter, diagnosed by video colonoscopy and Endoscopic Mucosal Resection (EMR) of the distal colon and proximal colon. Method: It is a retrospective, cross-sectional, observational study, and involving 8075 video colonoscopies in 9 de Julho Hospital, from 2011 2014. There have been appraised endoscopic and histopathological aspects from 166 EMR in 145 patients. These cases were divided in 2 groups: G1 - 52 patients with 58 lesions in distal colon (sigmoid, descendant and splenic flexure) and G2 - 100 patients with 108 lesions in proximal colon (transverse, ascending and caecum). Results: The prevalence of lesions was smaller in G1 than in G2 (34,9% X 65,0%). In G1 the average of age was 64,2 ± 12,3 years, consisting 25 (48,1%) male and 27 (51,9%) female and in G2, 65,4 ± 10,2, consisting 45 (45%) male and 55 (55%) female. The average size of lesions was 1,9 cm in G1 and 2,0 cm in G2 (p: 0,921). The surfaces were divided in granular, nodular and flat. There were no significant surface differences related to location (p: 0,575). Histopathology: considering Low Grade Intraepithelial Neoplasia (LG-IEN), High Grade IEN (including Carcinomas) and Hyperplastic, there were not any differences between 2 groups (p: 0,527), just as there were not when neoplastic lesions have divided in serrated and not serrated (p: 0,124). Excluding 13 hyperplastic lesions and 2 carcinomas, there are 151 remains lesions: 124 (82,1%) were not serrated and 27 (17,9%) serrated, consisting 6 (11,1% of 58) on distal colon and 21 (21,6% of 108) in proximal. There have been diagnosed 118 LG-IEN: 44 (75,8%) in G1 and 74 (68,5%) in G2 (p: 0,237). HG-IEN, in 33, being 10 in G1, (17,2%) and 23 in G2 (21,2%) (p: 0,536). Additionally, 2 adenocarcinomas occupying up to sm1, being 1 not serrated in G1 and 1 serrated in G2. When hyperplastic lesions are considered serrated lesions: 41 serrated lesions in 166 (24,6%), being 9 in distal colon (15,5% of 58) and 32 16 (29,6%) in proximal, including serrated adenocarcinoma (p: 0,061), there has any statistical significance, however indicating a tendency of significance association between lesion location and the presence of serrated characteristics. Conclusion: There have not been observed considerable differences between endoscopic and histopathological aspects of superficially sizeable EMR lesions, by measuring 1,0 cm or over in diameter located in distal colon, in relation to proximal colon. Most of the lesions are LG-IEN (75,8% in G1 and 68,5% in G2). The HG-IEN occurred in 17,2% of distal colon lesions and in 21,2% of proximal. Even though it is not statistical significant, there is a tendency of significance association between lesion location and the presence of serrated characteristics (p: 0,061).

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Artigo: https://www.ncbi.nlm.nih.gov/pubmed/27556542

 

Author: Bárbara Stadler Kahlow
Original Title: Relation between serum levels of mannose-binding lectin and carotid stenosis in patients with rheumatoid arthritis

Introdution: The mannose binding lectin (MBL) is a serum protein of the colectin family that appears to be involved in the inflammatory process and in the genesis of atherosclerotic disease. Objective: To study the association of MBL serum levels and its genotypic variation with carotid arteries intimal thickness (IMT) in rheumatoid arthritis (RA) patients from Southern Brazil. Methods: MBL serum levels, MBL2 genotyping and IMT were investigated in 90 RA patients along with their demographic, clinical and laboratory profile. MBL levels and MBL2 genotyping were evaluated in 90 healthy controls. Results: A significant decrease in MBL serum concentration was observed in patients with RA in relation to controls (528 ng/mL vs 937.5 ng/mL, p=0.05, respectively). The median IMT in RA patients was 0.59 mm (0.51 to 0.85 mm). There was no correlation between levels of MBL with disease activity measured by DAS-28 (disease activity score-28), erythrocyte sedimentation rate (ESR), autoantibodies presence or IMT (p=NS). A negative correlation was found between MBL and CPR (C reactive protein) levels (p=0.02). The MBL2 variant at codon 54 (variant B) and HYPA haplotype were the most frequently observed in the RA sample (67.5% and 31.7%, respectively). MBL2 wild type (A/A) was associated with lower values of IMT when compared to medium producers (A/O; p=0.04) and low producers (O/O; p=0.05). In addition, high producers genotypes had lower levels of CPR when compared with medium producers (p=0.04) or with low producers (p=0.05). Conclusion: RA patients had lower MBL levels than controls. MBL levels were negatively associated with CPR serum levels; genotypes that are low MBL producers had increased IMT than high producers.

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Artigo: http://www.ncbi.nlm.nih.gov/pubmed/27120743

 

Author: Luciano Dias de Oliveira
Original Title: Preliminary analysis of Interleukin-6 changes in pre- and postoperative in diabetic patients with BMI<35 submitted to partial duodenal switch

Introduction: The obesity-related studies have shown with an association with insulin resistance, diabetes mellitus type II (DM2), hypertension and consequent cardiovascular complications, setting this sum of comorbidities such as metabolic syndrome. The discovery that obesity per se is capable of promoting low grade cronic inflammation without the classic cardinal signs, has led several research groups to characterize the cell type and the mechanism involved in this process. Objective: To evaluate the secretion of inflammatory citokyn interleukin-6 in diabetic patients with IMC < 35 Kg/m² pre and post partial duodenal switch and the variation of HbA1c in the same period. Methods: Eight patients were submitted to partial duodenal switch and serum levels of Interlukin – 6 measured pre and one year post operatively by ELISA method. Results: Quantification of Interleukin was 65.50436 2.911993 + pg / mL as mean and standard deviation pre operatively and 39,47739 + 3.410057 pg / mL one year post surgery. Statistical evaluation was performed using Student's T test for paired samples with p <0.05. The HbA1c levels also had a significant drop, from 10.67 to 5.88 5 in the same period. Conclusion: Partial duodenal switch was able to reduce HbA1c in diabetic patients with BMI <35 kg / m² and the effects of chronic inflammation observed by decreased the serum concentration of the pro inflammatory citokin Interleukin-6.

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Artigo: https://www.ncbi.nlm.nih.gov/pubmed/?term=Luciano+Dias+de+Oliveira+Reis

 

 

 

DOCTORATE

Author: Carlos Hespanha Marinho Junior
Original Title: Evaluation of cicatricial effects after reversal of cervical sympathetic nerve clipping of rabbits

Introduction: The surgical treatment of hyperhidrosis by thoracic sympathectomy has brought, in addition to symptomatic relief for many, its main adverse effect: compensatory or reflex sweating. The clipping technique in place of the sympathetic nerve section gave rise to the hope of reversibility, but the positive results show to be quite divergent, evidencing the academic deficiency regarding the study of this phenomenon. Objective: To observe micro and macroscopic damage caused by the polymer clip on sympathetic nerve of rabbits seven days after their clipping and the findings after three weeks of clip removal. Material and method: In this experimental study, 20 rabbits were divided into two groups of 10, group 1 (clipping) and group 2 (de-clipping). The right cervical sympathetic nerve of all animals was clamped with polymeric clip, and in group 2 the nerve was unclipped 7 days later. Group 1 rabbits were induced to death on the 7th postoperative day, and group 2 rabbits on the 21st day after removal of the polymer clip. Macroscopic variables were: clip appearance, presence of discontinuity lesion, infection and adhesions around the nerve. Hematoxylin-eosin staining was used in the evaluation of the phases and degree of the inflammatory process and presence of necrosis, and Picrosirius red F3BA for quantification of collagen. The t-test was used in the comparisons of type I and type III collagens between the groups and the Fisher's test to compare the macroscopic variables, the degree of the inflammatory process and the presence of necrosis. The index for statistical significance was set at 0.05 or 5%. Results: The cervical sympathetic nerve was intact, without necrosis or infection in all animals of the experiment; there were adhesions in both groups, being minimal in 8 animals of each group and moderate or intense in 2; the clip was completely closed in all animals at the 7th postoperative day; the inflammatory process shown was chronic, with monomorphonuclear predominance. There was no significant difference between groups regarding the intensity the inflammatory process (p 0.5), but the amount of collagen type I and type III in micrometer Square was significantly higher in group 2 (p <0.0001). Conclusions: clipping of the cervical sympathetic nerve with polymer clip was linked to the presence of adhesions predominantly classified as minimal and unchanged after the clip was removed; low intensity of chronic inflammatory process remained present even after removal of the polymeric clip, but the amounts of type I and type III collagen fibers were significantly higher in the nerves of the animals in the group 2.

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Author: Octávio Antonio Azevedo da Costa Filho
Original Title: Matrix 9 metalloproteinase expression (MMP-9), Beta-transforming growth factor (TGF-β) and smooth muscle alpha-actin (α-AML) in the healing of aponeurosis of the abdominal wall of rats with cold knife scalpel and With ultrasonic harmonic scalpel.

Introduction: With technological advancement, incision procedures and hemostasis are performed with various types of machinery, in a wide range of operations, in order to provide effective hemostasis and a reduced surgical time, without prejudice healing tissue. Objective: To assess macro and microscopic evolution of the wound healing process with ultrasonic harmonic scalpel (UHS) in the middle aponeurosis of the rectus abdominis muscle of rats and compare it to those made with cold scalpel blade (CSB). Material and Methods: 80 Wistar rats were divided into two groups, who suffered medial incisions in the aponeurosis at the junction of the rectus abdominis with the CBS and UHS, respectively in each group. The macro and microscopic ratings were performed in subgroups of 10 animals in the 3rd, 7th, 14th and 21st days. After removal of the anterior abdominal wall of each rat . For macroscopic analysis was used to inspect the wound before and after the death of animals and microscopic analysis, we used the immunohistochemical method, matrix metalloproteinase 9 (MMP-9), the beta transforming growth factor (TGF-β) and alpha smooth muscle actin (α-AML) in both incisions and its evolution in the samples 3, 7, 14 and 21 days and the Sirius Red technique, formation of collagen type I and III. Data were statistically analyzed with the Student t test for immunohistochemical analysis for the study of bruising, infection, dehiscence, and adhesions was performed chi-square test. For the analysis of variance on the type of collagen and its concentration was used the nonparametric Mann-Whitney. Results: Macroscopic, complications studied showed no statistical difference. Immunohistochemical analysis for MMP-9 was more intense in UHS group at 3 and 7 days, with no difference after 14 days, and less after 21 days (p <0.05). Toward the TGF β, had his lower expression in UHS group at 14 and 21 days, with no statistical difference at 3 and 7 days (p <0.05). The α-AML expression appeared higher in UHS group after 14 days and remained similar to 3, 7 and 21 days (p <0.05) .In relation to collagen deposition, there was no change as the deposition type I collagen, and increased deposition of type III collagen in the animals submitted to the court with UHS, which is higher by 3 °, 21 days and overall, the 7th day the deposition was higher in the group with the CSB, the 14 ° day was similar in both groups (p <0.001). Conclusions: The use of UHS compared to the CSB has a higher lesion area at the time of the incision; as well as it led to the delay of regeneration and scar maturation process.

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Author: Manoel Alberto Prestes
Original Title: Secondary wound healing on dorsum of rats using dressing with ionic silver and nanocrystalline.

INTRODUCTION: The second-intention healing occurs in open, large and total thickness lesions, with loss of soft tissue. These wounds take longer to heal and the process is much slower. Silver, according to literature, promotes precocity of the healing process of these wounds. OBJECTIVE: Evaluate the results of second intention healing in rats, using ionic silver and nanocrystalline silver dressings. Through the macroscopic measurement of wound contraction, by measuring the diameter of the lesions; microscopic evaluation using H&E staining to observe the inflammatory process to intensity; using the picrosirius red staining for the quantification of collagen type I and III and immunohistochemical analysis using CD34 to assess angiogenesis. MATERIAL and METHOD: Were used 60 Wistar rats, on which were performed surgical wounds with punches of 8mm diameter. On 30 rats were made two diametrically opposed lesions on the backs of the animals belonging to the nanocrystalline silver group (NS) and control group (DW). In the lesion on the right side, used nanocrystalline silver dressings, and on the left side distilled water dressing (DW). On the other group of 30 rats, was performed only an injury with the punch on the left side and ionic silver dressings (IS). The groups were divided into subgroups, according to the day of death (7, 14 and 21 days). For macroscopic evaluation, were measured the lesion diameters to study the wounds contraction. Microscopically, was used H&E staining, by which observed the inflammation; with picrosirius red staining, it was quantified the type I and type III collagens; immunohistochemical evaluation was carried out via CD34 to study angiogenesis. For statistical analysis, considered the non-parametric Mann-Whitney tests (independent groups) or Wilcoxon (paired groups). Values of p<0,05 indicate statistical significance. RESULTS: Macroscopically, through measurements of the lesions diameters, groups NS and IS showed better results than the DW group (p<0,05), in the 7 and 21 days subgroups. Microscopically, the H&E staining, showed sharper varying degrees of inflammation (p=0,006) in the DW group, 7 days subgroup. With the picrosirius red staining, the collagen type I, IS group, showed greater quantification in the 14 and 21 days subgroups (p<0,001) and the type III, increased quantification in the NS group, in the 14 and 21 days subgroups (p<0,041). With respect to immunohistochemical analysis using the CD34, the NS and IS groups had better results (p<0,001) than the DW group, in the 21 days subgroup. CONCLUSION: Regarding the wound contraction, the NS and IS groups had better results than the DW group. H&E staining showed higher inflammatory intensity in the DW group, subgroup 7 days. The picrosirius red staining in the IS group showed greater quantification of collagen type I and the NS group showed greater quantification of type III in the subgroups 14 and 21 days. The immunohistochemical analysis with marker CD34 showed increased angiogenesis in the NS and IS groups in the subgroup 21 days.

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Author: Marcelo Tizzot Miguel
Original Title: Endoleak assessment in the treatment of endovascular abdominal aortic infrarenal aneurysm

Introduction: aneurysms of the infrarenal abdominal aorta are responsible for over 15,000 deaths annually in the United States and its incidence is increasing in absolute numbers. As a new surgical technique arises, complications also arise from such treatment. Of the complications from endovascular treatment, the endoleak should receive special attention, since its occurrence implies the risk of aneurysm rupture and these indexes are substantial. Objectives: to evaluate the endovascular treatment of aneurysms of the infrarenal abdominal aorta, analyzing: the sample according to gender and the average age; the size of the aneurysm’s diameter and the size of the proximal neck; the relationship with hypertension, diabetes mellitus, smoking and dyslipidemia; the incidence of endoleaks, and; identify those risk factors, those that interfere with the occurrence of endoleak. Patients and methods: it was held in Servico de Angiologia e Cirurgia Vascular Hospital Universitário Evangélicode Curitiba/PR, in the period between January 2005 and December 2015, and of Servico de Angiologia e Cirurgia Vascular do Hospital do Rocio - Campo Largo/PR, between January 2013 and December 2015, on a prospective basis. The final sample consisted of 155 patients who underwent endovascular treatment of aneurysms of the infrarenal abdominal aorta, and had one year of monitoring through imaging method. All the patients obligatorily underwent CT angiography to define the operative method. For then routine monitoring it was used the eco-Doppler ultrasound and CT angiography as imaging method. The imaging results were filed within 30 days, 3 months, 6 months and 1 year after the surgery. Results: Most patients were male (79.40%) with a average of 68.1 years. Among the risk factors studied, hypertension was present in 66.50%, diabetes mellitus in 23.20%, smoking in 74.20% and dyslipidemia in 46.50% of patients. The average aortic diameter was 63,3mm and the proximal neck was of 20,6mm. The endoleak was found in 18.10% of patients. The most common type found was the IB type (35.7%) and the type II (35.7%), followed by the type IA (21.4%) and finally the type IV (7.2%). Conclusions: the sample's prevalence of men, the average age was 68.1 years and; and the mean aneurysm diameter 63.6 mm and the average size of the proximal colon of 20.6 mm. The most frequent risk factor was smoking, followed by hypertension and dyslipidemia, and diabetes mellitus. The incidence of endoleaks was 18.1% in the sample. No risk factors had a significant influence on the occurrence of endoleak.

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Author: Rodrigo Beraldi Kormann
Original Title: New acrylic resin for orbital implant in anophthalmic cavity reconstruction

AIM: To evaluate a new resin (FullCure 720®) as orbital implant for the repair of anophthalmic socket. METHOD: The implants were made by a rapid prototyping machine (Eden 250®). Ten patients were operated. The clinical response was evaluated, as well as systemic toxicity analysed through biochemical exams; the size and location of the orbital implants were assessed through image investigation. After the evisceration, a FullCure 720® resin sphere of adequate size was implanted in the scleral socket. The patients were monitored for a one-year period, in which were evaluated the clinical condition and signs, such as: conjunctival hyperemia, ocular secretion, chemosis, exposure or extrusion of the orbital implant. Computerized tomography of the orbits was requested at two and 12 months post-operative, and new biochemical exams were requested one year after to evaluate systemic toxicity inherent to the material. RESULTS: All patients had normal clinical conditions, with symptoms and signs within the normal range for this type of clinical procedure. There were no cases of extrusion of the orbital implant and the complementary exams were considered normal. CONCLUSION: The FullCure 720® resin orbital implant was tolerated by patients submitted to evisceration.

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