RESUMO
A degeneração mixomatosa valvar mitral (DMVM) costuma ser diagnosticada pelo ecocardiograma, porém o eletrocardiograma (ECG) pode sugerir alterações específicas e auxiliar no diagnóstico e no tratamento. A deflexão intrinsecóide (DI) é uma medida simples do ECG, que representa o início da despolarização ventricular e pode indicar a presença de sobrecargas e hipertrofia no ventrículo esquerdo. O objetivo deste trabalho é comparar dados prévios sobre condição clínica e ecocardiograma de cães com endocardiose de mitral e o valor da deflexão intrinsecóide do ECG, para buscar uma relação de concordância. Foram selecionados os arquivos de 45 cães anteriormente atendidos na rotina clínica do HV-UPFR. A estatística mostrou diferença relevante nos grupos B1, B2 e C nas derivações D2, D3, aVF, rV, V2 e V4 (P<0,05), o que permitiu classificá-los de acordo com o tamanho da DI, e esse resultado correspondeu à classificação do consenso de endocardiose de mitral em cães nesses estágios. Concluiu-se que há um aumento gradativo no valor da DI à medida que a DMVM avança, principalmente nos estágios B1, B2 e C, associado à sobrecarga e à hipertrofia ventricular esquerda, portanto esse parâmetro pode ser usado na classificação da doença.(AU)
The mitral valve myxomatous degeneration (DMVM) is usually diagnosed by echocardiography, however, electrocardiogram (ECG) may suggest specific alterations and aid diagnosis and treatment. Intrinsicoid deflection (DI) is a simple ECG measure that represents the onset of ventricular depolarization and may indicate the presence of overload and hypertrophy in the left ventricle. The objective of this study is to compare previous data on clinical condition and echocardiogram of dogs with mitral endocardiosis and the value of the intrinsicoid deflection from ECG to obtain a concordance relation. The archives of 45 previously examined dogs in the clinical routine of HV-UFPR were selected. The statistic showed a significant difference in groups B1, B2 and C in leads D2, D3, aVF, rV, V2 and V4 (P< 0,05), which allowed to classify them according to the DI size, and this result corresponded to the consensus classification of mitral endocardiosis in dogs at these stages. It was concluded that there is a gradual increase in the value of DI as DMVM progresses, especially in stages B1, B2 and C, associated with left ventricular overload and hypertrophy, so this parameter can be used to classify the disease.(AU)
Assuntos
Animais , Cães , Técnicas de Diagnóstico Cardiovascular/veterinária , Eletrocardiografia/veterinária , Doenças das Valvas Cardíacas/diagnóstico , Doenças das Valvas Cardíacas/veterinária , Valva MitralRESUMO
A degeneração mixomatosa valvar mitral (DMVM) costuma ser diagnosticada pelo ecocardiograma, porém o eletrocardiograma (ECG) pode sugerir alterações específicas e auxiliar no diagnóstico e no tratamento. A deflexão intrinsecóide (DI) é uma medida simples do ECG, que representa o início da despolarização ventricular e pode indicar a presença de sobrecargas e hipertrofia no ventrículo esquerdo. O objetivo deste trabalho é comparar dados prévios sobre condição clínica e ecocardiograma de cães com endocardiose de mitral e o valor da deflexão intrinsecóide do ECG, para buscar uma relação de concordância. Foram selecionados os arquivos de 45 cães anteriormente atendidos na rotina clínica do HV-UPFR. A estatística mostrou diferença relevante nos grupos B1, B2 e C nas derivações D2, D3, aVF, rV, V2 e V4 (P<0,05), o que permitiu classificá-los de acordo com o tamanho da DI, e esse resultado correspondeu à classificação do consenso de endocardiose de mitral em cães nesses estágios. Concluiu-se que há um aumento gradativo no valor da DI à medida que a DMVM avança, principalmente nos estágios B1, B2 e C, associado à sobrecarga e à hipertrofia ventricular esquerda, portanto esse parâmetro pode ser usado na classificação da doença.(AU)
The mitral valve myxomatous degeneration (DMVM) is usually diagnosed by echocardiography, however, electrocardiogram (ECG) may suggest specific alterations and aid diagnosis and treatment. Intrinsicoid deflection (DI) is a simple ECG measure that represents the onset of ventricular depolarization and may indicate the presence of overload and hypertrophy in the left ventricle. The objective of this study is to compare previous data on clinical condition and echocardiogram of dogs with mitral endocardiosis and the value of the intrinsicoid deflection from ECG to obtain a concordance relation. The archives of 45 previously examined dogs in the clinical routine of HV-UFPR were selected. The statistic showed a significant difference in groups B1, B2 and C in leads D2, D3, aVF, rV, V2 and V4 (P< 0,05), which allowed to classify them according to the DI size, and this result corresponded to the consensus classification of mitral endocardiosis in dogs at these stages. It was concluded that there is a gradual increase in the value of DI as DMVM progresses, especially in stages B1, B2 and C, associated with left ventricular overload and hypertrophy, so this parameter can be used to classify the disease.(AU)
Assuntos
Animais , Cães , Técnicas de Diagnóstico Cardiovascular/veterinária , Eletrocardiografia/veterinária , Doenças das Valvas Cardíacas/diagnóstico , Doenças das Valvas Cardíacas/veterinária , Valva MitralRESUMO
This cross-sectional study aimed to assess the influence of different surgical treatment modalities on the level of physical activity, functional capacity, and quality of life of breast cancer survivors. One hundred eighty women aged 30-60 years old were selected and allocated to control group (CG, women without breast cancer, nâ¯=â¯45), breast-conserving surgery group (BCG, nâ¯=â¯45), mastectomy group (MG, nâ¯=â¯45), and breast reconstruction group (BRG, nâ¯=â¯45). Physical activity, functional capacity, and quality of life were assessed, respectively, using the following self-report questionnaires validated for use in Brazil: International Physical Activity Questionnaire (IPAQ), Stanford Health Assessment Questionnaire (HAQ-20), and Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). The groups were homogeneous relative to sociodemographic variables. The scores for physical activity (IPAQ) did not differ between CG and BRG, whereas they were better for CG than for BCG and MG (pâ¯=â¯0.0270). The results for functional capacity (HAQ-20) were better for CG than for MG (pâ¯=â¯0.0450), with no difference between the remaining groups. Differences were found for the SF-36 domains "physical functioning" (pâ¯<â¯0.01), "physical role functioning" (pâ¯<â¯0.001), "emotional role functioning" (pâ¯=â¯0.0174), and "general health" (pâ¯=â¯0.0307). CG and BRG differed significantly relative to the domains "physical role functioning" and "emotional role functioning" only. We concluded that patients who underwent breast reconstruction exhibited higher levels of physical activity and quality of life than patients subjected to mastectomy alone or breast-conserving surgery.
Assuntos
Atividades Cotidianas , Neoplasias da Mama/cirurgia , Exercício Físico , Qualidade de Vida , Adulto , Estudos Transversais , Feminino , Humanos , Mastectomia , Mastectomia Segmentar , Pessoa de Meia-Idade , Inquéritos e Questionários , SobreviventesRESUMO
The prevalence of cardiovascular and metabolic diseases is increased in postmenopausal women, which contributes to the burden of illnesses in this period of life. Yerba mate (Ilex paraguariensis) is a native bush from Southern South America. Its leaves are rich in phenolic components, which may have antioxidant, vasodilating, hypocholesterolemic, and hypoglycemic proprieties. This post hoc analysis of the case-control study nested in the Obesity and Bone Fracture Cohort evaluated the consumption of yerba mate and the prevalence of hypertension, dyslipidemia, and coronary diseases in postmenopausal women. Ninety-five postmenopausal women were included in this analysis. A questionnaire was applied to evaluate the risk factors and diagnosis of cardiovascular diseases and consumption of yerba mate infusion. Student's t-test and chi-square test were used to assess significant differences between groups. The group that consumed more than 1 L/day of mate infusion had significantly fewer diagnoses of coronary disease, dyslipidemia, and hypertension (P<0.049, P<0.048, and P<0.016, respectively). Furthermore, the serum levels of glucose were lower in the group with a higher consumption of yerba mate infusion (P<0.013). The serum levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides were similar between the groups. This pragmatic study points out the benefits of yerba mate consumption for the cardiovascular and metabolic systems. The ingestion of more than 1 L/day of mate infusion was associated with fewer self-reported cardiovascular diseases and lower serum levels of glucose. Longitudinal studies are needed to evaluate the association between yerba mate infusion and reduction of cardiovascular diseases in postmenopausal women.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/prevenção & controle , Dislipidemias/prevenção & controle , Ilex paraguariensis/química , Preparações de Plantas/administração & dosagem , Pós-Menopausa/efeitos dos fármacos , Idoso , Estudos de Casos e Controles , Feminino , HumanosRESUMO
Concepts regarding the best way to treat a surgical wound vary, in literature, ranging from no dressing use to dressing maintenance for 24 to 48 hours or until suture removal. This study aimed to evaluate the influence of the length of dressing maintenance after breast augmentation with implants on cutaneous colonization and surgical site infection. This is a two-arm, parallel group, randomized clinical trial. Eighty patients who were candidates for augmentation mammoplasty with silicone implants were randomly allocated to two groups, in which the dressing was removed on postoperative day 1 (group A, n = 40) or postoperative day 6 (group B, n = 40). Cutaneous colonization was examined by culturing samples collected before and after dressing removal. The criteria defined by the Centers for Disease Control and Prevention were used to assess surgical site infection. No significant difference regarding cutaneous colonization was observed between groups before dressing application. On postoperative day 6, significantly more bacterial growth was observed in group A (p = 0.01). No surgical site infection occurred. We concluded that maintaining the dressing for 6 days led to a lower cutaneous colonization but did not influence surgical site infection rates.
Assuntos
Bandagens , Mamoplastia/efeitos adversos , Cuidados Pós-Operatórios/métodos , Pele/microbiologia , Infecção da Ferida Cirúrgica/microbiologia , Ferida Cirúrgica/terapia , Adolescente , Adulto , Implantes de Mama , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Tempo , Adulto JovemRESUMO
The objective of this study was to investigate the bone regeneration of a "gold standard" (autograft) from iliac crest associated with cellular therapy in rabbits. A bone defect was created with 10x5x5mm in 28 rabbit mandibles. The control group animals (n=14) were repaired with autograft of iliac crest and the experimental group animals (n=14) received iliac crest autograft in association with mononuclear cells from the bone marrow of the femur. Weekly radiographs were taken of the surgery region and histological analyses was performed in seven animals in each group at 15 days and in seven animals of each group at 30 days after the surgery. A gradual increase of bone density was observed and the experimental animals presented the bone bridge in 85.7 percent (6/7) of the cases, while only 42.8 percent (3/7) of the animals in the control group presented this structure 28 days after the surgery. The histopathological parameters analyzed did not show any statistical difference between the control and experimental group in 15 and 30 days of analysis. The results suggest that the mononuclear cells from the marrow bone can better support the autograft regeneration in mandible defects in rabbits.(AU)
Avaliou-se a regeneração óssea de auto-enxerto, considerado "padrão ouro" da crista ilíaca associado à terapia celular da medula óssea em coelhos. Foi criado um defeito ósseo de 10x5x5mm na mandíbula de 28 coelhos, distribuídos em grupo-controle com, 14 animais, reparados com auto-enxerto de crista ilíaca, e grupo experimental com, 14 animais, em que o auto-enxerto foi associado a células mononucleares da medula óssea autógena do fêmur. Foram realizadas radiografias semanais da região operada e análise histológica em sete animais de cada grupo aos 15 e em sete de cada grupo aos 30 dias do pós-operatório. Houve aumento gradativo da densidade óssea, e 85,7 por cento (6/7) dos animais do grupo experimental e 42,8 por cento (3/7) do grupo-controle apresentaram formação de ponte óssea 28 dias após a cirurgia. Na análise histopatológica aos 15 dias, os enxertos foram facilmente visualizados e a atividade das células fagocitárias foi intensa. Já aos 30 dias, a visualização foi mais difícil e, quando possível, apenas um resquício foi visualizado. Os resultados sugerem que a adição de células mononucleares da medula óssea favorece a regeneração do auto-enxerto em defeitos mandibulares de coelhos.(AU)
Assuntos
Animais , Masculino , Coelhos , Regeneração Óssea , Mandíbula , Transplante Autólogo/veterinária , Transplante Ósseo/veterinária , Ílio/transplante , Células da Medula Óssea , Densidade Óssea , Mastigação , Deglutição , Separação CelularRESUMO
The objective of this study was to investigate the bone regeneration of a "gold standard" (autograft) from iliac crest associated with cellular therapy in rabbits. A bone defect was created with 10x5x5mm in 28 rabbit mandibles. The control group animals (n=14) were repaired with autograft of iliac crest and the experimental group animals (n=14) received iliac crest autograft in association with mononuclear cells from the bone marrow of the femur. Weekly radiographs were taken of the surgery region and histological analyses was performed in seven animals in each group at 15 days and in seven animals of each group at 30 days after the surgery. A gradual increase of bone density was observed and the experimental animals presented the bone bridge in 85.7 percent (6/7) of the cases, while only 42.8 percent (3/7) of the animals in the control group presented this structure 28 days after the surgery. The histopathological parameters analyzed did not show any statistical difference between the control and experimental group in 15 and 30 days of analysis. The results suggest that the mononuclear cells from the marrow bone can better support the autograft regeneration in mandible defects in rabbits.
Avaliou-se a regeneração óssea de auto-enxerto, considerado "padrão ouro" da crista ilíaca associado à terapia celular da medula óssea em coelhos. Foi criado um defeito ósseo de 10x5x5mm na mandíbula de 28 coelhos, distribuídos em grupo-controle com, 14 animais, reparados com auto-enxerto de crista ilíaca, e grupo experimental com, 14 animais, em que o auto-enxerto foi associado a células mononucleares da medula óssea autógena do fêmur. Foram realizadas radiografias semanais da região operada e análise histológica em sete animais de cada grupo aos 15 e em sete de cada grupo aos 30 dias do pós-operatório. Houve aumento gradativo da densidade óssea, e 85,7 por cento (6/7) dos animais do grupo experimental e 42,8 por cento (3/7) do grupo-controle apresentaram formação de ponte óssea 28 dias após a cirurgia. Na análise histopatológica aos 15 dias, os enxertos foram facilmente visualizados e a atividade das células fagocitárias foi intensa. Já aos 30 dias, a visualização foi mais difícil e, quando possível, apenas um resquício foi visualizado. Os resultados sugerem que a adição de células mononucleares da medula óssea favorece a regeneração do auto-enxerto em defeitos mandibulares de coelhos.
Assuntos
Animais , Masculino , Células da Medula Óssea , Regeneração Óssea , Ílio/transplante , Mandíbula , Coelhos , Transplante Autólogo/veterinária , Transplante Ósseo/veterinária , Densidade Óssea , Separação Celular , Deglutição , MastigaçãoRESUMO
Well-designed, well-conducted and well-reported randomised clinical trials (RCTs) can significantly impact medical care, by contributing to a strong evidence base from which clinical guidelines can be derived. In a previous study, we assessed the quality of reports of RCTs in plastic surgery published from 1966 to 2003. The aim of the present study was to verify what have changed over the last years. RCTs in plastic surgery published from 2004 to 2008 were identified through electronic searches, and classified according to their allocation concealment. Trials with allocation concealment appropriately described were evaluated as to their quality. Two independent reviewers performed the evaluations, using two tools: the Delphi List and the Jadad's quality scale. From 3840 identified studies, 96 were selected for classification according to allocation concealment; 28 (29%) of them appropriately described allocation concealment. From 1966 to 2003, 34 (17%) RCTs appropriately described allocation concealment (χ2=22.98, p<0.000). In the evaluation of the 28 RCTs by the Delphi List, the agreement coefficient between raters (kw) was 0.46 (z=7.24, p<0.000). Groups were similar at baseline in 96.4% of these trials, and this was the only item of the Delphi List, which significantly improved when compared with the period from 1966 to 2003 (χ2=18.53, p<0.000). When evaluated by Jadad's criteria, 14% of the RCTs were scored two points or less and thus considered of low quality (kw=0.72, z=8.57, p<0.001). From 1966 to 2003, 59% of RCTs were scored two points or less (χ2=17.07, p<0.004). We concluded that the quality of reports of RCTs in plastic surgery (as measured by the Jadad's criteria and only one component of the nine components of the Delphi List) significantly increased over the last years.
Assuntos
Procedimentos de Cirurgia Plástica , Ensaios Clínicos Controlados Aleatórios como Assunto , Cirurgia Plástica/métodos , HumanosRESUMO
Radiographic exams still the main form to evaluate small bowel in all its extension, and when surveyprojections are not diagnostic, barium series are used although its sensibility can be imitated by filledoverlapped loops, difficulting detailed mucosa visualization. The objective of this study was to adjust anexam technique with intestinal double-contrast, based on techniques used in the human medicine, whichresulted satisfactorily in the demonstration of the mucosal surface in the 30 dogs submitted to the exam.The double-contrast in the lumen was achieved by a combination of a positive contrast medium,recovering the mucosal surface, and a negative filling the lumen. Ambient air and carboximethylcelullosewere the negative contrast medium tested and both were radiographicaly similar.