RESUMO
The aim of this work was to optimize the process of elaborating liver pâtés and omental lamb fat and to evaluate the quality of the products. Livers and fats were obtained from lambs fed with diets composed of corn and soybean meal that were partially replaced by cupuaçu, tucumã and palm kernel cake. To prepare the pâtés, livers were baked for 20 minutes at 100°C, weighed, seasoned, crushed, packaged and pasteurized. The best formulation of the pâté was with 40% liver, 10% fat, 35% water, and pasteurized for 20 minutes at 65°C. The pâté from the livers of lambs fed with palm kernel cake obtained a higher caloric value of 193.05 kcal/100 g and all pâtés met the recommended microbiological quality. There was a significant effect (p< 0.05) of the diets on the aroma and texture of the liver pâtés of lambs fed corn and soybean meal and palm kernel cake, and these were 6.38 and 3.37, respectively. Thus, the pâtés can be considered an alternative to increase the options for consumption of liver from lambs, and also for adding commercial value to lamb viscera.
Assuntos
Ração Animal , Fígado , Animais , Fígado/metabolismo , Ovinos , Ração Animal/análise , Omento , Produtos da Carne/análise , Lipídeos/análise , Lipídeos/químicaRESUMO
Leptin regulates lipid metabolism, maximizing insulin sensitivity; however, peripheral leptin resistance is not fully understood, and its contribution to metabolic dysfunction-associated steatotic liver disease (MASLD) is unclear. This study evaluated the contribution of the leptin axis to MASLD in humans. Forty-three participants, mostly female (86.04%), who underwent cholecystectomy were biopsied. Of the participants, 24 were healthy controls, 8 had MASLD, and 11 had metabolic dysfunction-associated steatohepatitis (MASH). Clinical and biochemical data and the gene expression of leptin, leptin receptor (LEPR), suppressor of cytokine signaling 3 (SOCS3), sterol regulatory element-binding transcription factor 1 (SREBF1), stearoyl-CoA desaturase-1 (SCD1), and patatin-like phospholipase domain-containing protein 2 (PNPLA2), were determined from liver and adipose tissue. Higher serum leptin and LEPR levels in the omental adipose tissue (OAT) and liver with MASH were found. In the liver, LEPR was positively correlated with leptin expression in adipose tissue, and SOCS3 was correlated with SREBF1-SCD1. In OAT, SOCS3 was correlated with insulin resistance and transaminase enzymes (p < 0.05 for all. In conclusion, we evidenced the correlation between the peripheral leptin resistance axis in OAT-liver crosstalk and the complications of MASLD in humans.
Assuntos
Tecido Adiposo , Fígado Gorduroso , Leptina , Fígado , Omento , Humanos , Leptina/metabolismo , Feminino , Masculino , Fígado/metabolismo , Pessoa de Meia-Idade , Omento/metabolismo , Omento/patologia , Tecido Adiposo/metabolismo , Adulto , Fígado Gorduroso/metabolismo , Fígado Gorduroso/patologia , Receptores para Leptina/metabolismo , Receptores para Leptina/genética , Proteína 3 Supressora da Sinalização de Citocinas/metabolismo , Proteína 3 Supressora da Sinalização de Citocinas/genética , Resistência à Insulina , Proteína de Ligação a Elemento Regulador de Esterol 1/metabolismo , Proteína de Ligação a Elemento Regulador de Esterol 1/genética , Estearoil-CoA Dessaturase/metabolismo , Estearoil-CoA Dessaturase/genéticaRESUMO
SUMMARY: Experimental studies devoted to the study of the mechanisms of the pathogenesis of acute peritonitis and the development of new methods of medical and surgical treatment are becoming increasingly relevant. Today, experimental medicine knows many different ways to modeling septic peritonitis and eliminate it, but the role of the local immune system is underestimated, whereas it takes a direct part in inflammation. The objective of our work to study morphological features of results of experimental modeling of septic peritonitis in white rats. The study included 15 sexually mature white male rats weighing 276.75±6.56 grams. A simulation of septic peritonitis was performed by perforating the upper part of the cecum with four punctures with a G16 injection needle. As a result of the experiment, after examination of the peritoneal cavity, all 15 animals were diagnosed with omentum tamponade of perforated damage to the caecum. In 11 cases, the perforated wall of the caecum was covered by the greater omentum (73.34 %), and in the other 4 animals, tamponade was performed by one of the epididymal omentum (26.66 %). The initial stage of tamponade with the greater or epididymal omentums of a perforated caecum begins on the first day of the experiment and consists of tight interstitial consolidation between them, as well as in the invasion of blood vessels from the omentum side to the focus of infection, which ensure the delivery of the appropriate immunocompetent cells. As a result of this process, intensive lymphoid infiltrates are formed in this area, as well as the growth of adipose tissue, which isolates the inflammatory focus from the peritoneal cavity with a thick layer.
Las investigaciones experimentales dedicadas al estudio de los mecanismos de patogénesis de la peritonitis aguda y el desarrollo de nuevos métodos de tratamiento médico y quirúrgico son cada vez más relevantes. Hoy en día, la medicina experimental conoce muchas formas diferentes de modelar la peritonitis séptica y eliminarla, pero se subestima el papel del sistema inmunológico local, mientras que él participa directamente en la inflamación. El objetivo de nuestro trabajo fue estudiar las características morfológicas de los resultados del modelado experimental de peritonitis séptica en ratas blancas. El estudio incluyó 15 ratas macho blancas, sexualmente maduras que pesaban 276,75 ± 6,56 gramos. Se realizó una simulación de peritonitis séptica perforando la parte superior del ciego con cuatro punciones con una aguja de inyección G16. Como resultado del experimento, después del examen de la cavidad peritoneal, a los 15 animales se les diagnosticó taponamiento del omento o lesión perforada del ciego. En 11 casos, la pared perforada del ciego fue recubierta por el omento mayor (73,34 %), y en los otros 4 animales el taponamiento se realizó por uno de los epidídimos (26,66 %). La etapa inicial del taponamiento con omento mayor o epidídimo de un ciego perforado comienza el primer día del experimento y consiste en una estrecha consolidación intersticial entre ellos, así como en la invasión de los vasos sanguíneos desde el lado del omento hasta el foco de infección, que aseguran la entrega de las células inmunocompetentes apropiadas. Como resultado de este proceso, se forman intensos infiltrados linfoides en esta zona, así como el crecimiento de tejido adiposo, que aísla el foco inflamatorio de la cavidad peritoneal con una gruesa capa.
Assuntos
Animais , Masculino , Ratos , Peritonite/patologia , Omento/patologia , Linfócitos , Ceco/patologia , Adipócitos , Modelos Animais de Doenças , Duodeno/patologiaRESUMO
Introduction. Perforated peptic ulcer remains one of the critical abdominal conditions that requires early surgical intervention. Leakage after omental patch repair represents one of the devastating complications that increase morbidity and mortality. Our study aimed to assess risk factors and early predictors for incidence of leakage. Methods. Retrospective analysis of data of the patients who underwent omental patch repair for perforated peptic ulcer in the period between January 2019 and January 2022 in Mansoura University Hospital, Egypt. Pre, intra and postoperative variables were collected and statistically analyzed. Incriminated risk factors for leakage incidence were analyzed using univariate and multivariate analysis. Results. This study included 123 patients who met inclusion criteria. Leakage was detected in seven (5.7%) patients. Although associated comorbidities (p=0.01), postoperative intensive care unit admission (p=0.03), and postoperative hypotension (p=0.02) were significant risk factors in univariate analysis, septic shock (p=0.001), delayed intervention (p=0.04), preoperative hypoalbuminemia (p=0.017), and perforation size >5mm (p= 0.04) were found as independent risk factors for leakage upon multivariate analysis. Conclusion. Delayed presentation in septic shock, preoperative hypoalbuminemia, prolonged perforation, operation interval, and large perforation size > 5mm were detected as independent risk factors for leakage. Postoperative tachypnea and tachycardia with increased levels of C-reactive protein and total leucocytic count are alarming signs for incidence of leakage
Introducción. La úlcera péptica perforada es una de las afecciones abdominales críticas que requiere una intervención quirúrgica temprana. La fuga después de la reparación con parche de epiplón representa una de las complicaciones más devastadoras, que aumentan la morbilidad y la mortalidad. Nuestro estudio tuvo como objetivo evaluar los factores de riesgo y los predictores tempranos de fugas. Métodos. Análisis retrospectivo de los datos de los pacientes sometidos a reparación con parche de epiplón por úlcera péptica perforada, en el período comprendido entre enero de 2019 y enero de 2022, en el Hospital Universitario de Mansoura, Egipto. Se recogieron y analizaron estadísticamente variables pre, intra y postoperatorias. Los factores de riesgo asociados a la incidencia de fugas se analizaron mediante análisis univariado y multivariado. Resultados. Este estudio incluyó 123 pacientes que cumplieron con los criterios de inclusión. Se detectó fuga en siete (5,7 %) pacientes. Aunque las comorbilidades asociadas (p=0,01), el ingreso postoperatorio a la unidad de cuidados intensivos (p=0,03) y la hipotensión postoperatoria (p=0,02) fueron factores de riesgo en el análisis univariado, el shock séptico (p=0,001), el retraso en la intervención (p=0,04), la hipoalbuminemia preoperatoria (p=0,017) y el tamaño de la perforación mayor de 5 mm (p=0,04) se encontraron como factores de riesgo de fuga independientes en el análisis multivariado. Conclusión. Se detectaron como factores de riesgo independientes de fuga la presentación tardía en shock séptico, la hipoalbuminemia preoperatoria, la perforación prolongada, el intervalo operatorio y el tamaño de la perforación mayor de 5 mm. La taquipnea posoperatoria y la taquicardia con niveles elevados de proteína C reactiva y recuento leucocitario total son signos de alarma sobre la presencia de fuga.
Assuntos
Humanos , Úlcera Péptica Perfurada , Complicações Pós-Operatórias , Omento , Fatores de RiscoRESUMO
El abdomen agudo comprende un amplio grupo de enfermedades con alta incidencia en la práctica quirúrgica habitual. Se presenta el caso de un paciente masculino, de 23 años, con cuadro abdominal agudo, cuyo diagnóstico preoperatorio fue compatible con una apendicitis aguda; al efectuar la laparotomía exploratoria se constató torsión primaria y segmentaria del omento mayor. Esta es una afección de difícil diagnóstico preoperatorio, generalmente diagnosticada durante el acto quirúrgico porque fácilmente se confunde con otras enfermedades del abdomen agudo quirúrgico. Lo indicado en estos pacientes es la remoción del segmento involucrado por lo que se realizó omentectomía parcial y apendicectomía complementaria; el paciente presentó una evolución clínica favorable.
Acute abdomen comprises a wide group of diseases with a high incidence in routine surgical practice. We present a 23-year-old male patient with acute abdominal symptoms, whose preoperative diagnosis was compatible with acute appendicitis; primary and segmental torsion of the greater omentum was found when performing the exploratory laparotomy. This condition is difficult to diagnose preoperatively; it is generally evident during surgery because it is confused with other diseases of the acute surgical abdomen. The removal of the involved segment is indicated in these patients that is why partial omentectomy and complementary appendectomy were performed; the patient had a favourable clinical evolution.
Assuntos
Omento , Dor Abdominal , Abdome AgudoAssuntos
Linfoma Anaplásico de Células Grandes , Neoplasias Cutâneas , Humanos , Linfoma Anaplásico de Células Grandes/complicações , Linfoma Anaplásico de Células Grandes/diagnóstico , Omento/patologia , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologiaRESUMO
This study aims to evaluate the influence of free omental graft without vascular microanastomosis (FOGWVA) on experimental skin healing in rabbits. Through celiotomy, a 9cm2 free omental fragment was collected in 36 rabbits, with subsequent production of a deep linear cutaneous wound in the dorsal midline measuring 3cm. In 18 animals from the omental group (OG), the omental fragment collected was fixed subcutaneously with six simple interrupted stitches using a 4-0 polyamide thread. In both treated and control (CG) groups, intradermal dermorrhaphy was performed with 4-0 polyamide thread. Experimental wounds were clinically evaluated every day. Each of the groups was divided into three subgroups of 6 animals each for histopathological evaluation on the 7th, 14th, and 28th days of postoperative. In the OG wounds, the increase in volume (omentum activation) stood out after the second postoperative day. Macroscopy showed an organic reaction to the graft on day 7, with a progressive reduction in addition to neovascularization towards the omental graft. The intense presence of mononuclear cells and collagen deposition on day 7 demonstrated an accelerated process of tissue remodeling and repair. The FOGWVA omental graft remained viable and positively influenced the cutaneous healing of the experimental wounds in rabbits.
Neste estudo, objetiva-se avaliar a influência do enxerto omental livre sem microanastomose vascular (FOGWVA) na cicatrização cutânea experimental em coelhos. Por meio de celiotomia, foi coletado fragmento omental livre de 9cm2 em 36 coelhos, com posterior produção de ferida cutânea profunda linear na linha média dorsal medindo 3cm. Apenas em 18 animais, do grupo omento (GO), o fragmento omental coletado foi fixado no subcutâneo com seis pontos simples interrompidos utilizando fio poliamida 4-0. Em ambos os grupos, tratado e controle (GC), efetuou-se dermorrafia intradérmica com fio poliamida 4-0. As feridas experimentais foram avaliadas clinicamente todos os dias. Cada um dos grupos foi dividido em três subgrupos, com seis animais cada, para avaliação anatomopatológica no sétimo, 14º e 28o dias de pós-operatório. Nas feridas do GO, destacou-se aumento de volume (ativação do omento) a partir do segundo dia pós-operatório. A macroscopia evidenciou reação orgânica ao enxerto no dia sete, com redução progressiva, além de neovascularização em direção ao enxerto omental. Intensa presença de células mononucleares e deposição de colágeno no dia sete demonstraram acelerado processo de remodelamento e reparo tecidual. O FOGWVA manteve-se viável e influenciou positivamente na cicatrização cutânea de feridas experimentais em coelhos.
Assuntos
Animais , Coelhos , Omento/transplante , Cicatrização/fisiologia , Colágeno/análise , Neovascularização FisiológicaRESUMO
The objective of this study was to assess healing induction of free skin grafts following transposition of omental flap through a subcutaneous tunnel to the recipient bed. Macroscopic and microscopic evaluations were performed. Nineteen piglets were used. Two surgical wounds were created of each subject. The graft removed from the left side (LS) was placed on the right side (RS) without the omental flap in the graft-bed (control group-CG). On the LS, an omental flap was placed between the graft removed from the RS and the recipient bed (omentum group-OG). Macroscopic evaluations showed edema, which gradually decreased on both groups. Suture dehiscence was highest at day 10 compared to other days in both groups. The CG had a higher incidence of unvitalized tissue compared to OG, although no difference was found among days of postoperative evaluation. The presence of unvitalized tissue was seen on 32% on OG and 53% on CG. Microscopic evaluations revealed higher collagenization, reepithelization, keratinization and less swelling in the OG compared to CG. In conclusion, mesh skin grafts evolved satisfactorily in swine even in newly created bedding without granulation tissue, but with appropriate vascularization. The omentum flap provided better macroscopic and microscopic outcomes regarding graft integration.
O objetivo deste estudo foi verificar a indução da cicatrização de enxertos cutâneos em malha após a utilização de flap de omento transposto através de túnel no subcutâneo até o leito receptor. Avaliações macroscópica e microscópica foram realizadas. Foram utilizados 19 suínos. Duas feridas cirúrgicas foram criadas em cada animal. O enxerto removido do lado esquerdo (LE) foi fixado do lado direito (LD), sem a presença do flap de omento entre o enxerto e o leito receptor (grupo controle - GC). No LE, foi fixado um flap de omento entre o enxerto cutâneo removido do LD e o leito receptor (grupo omento - GO). As avaliações macroscópicas mostraram que o edema diminuiu gradativamente em ambos os grupos. A deiscência foi maior no dia 10 em comparação aos demais dias, em ambos os grupos, entre os diferentes dias de avaliação. Foi verificada a presença de tecido desvitalizado em 32% do GO e em 53% no GC. Foi observada, na avaliação microscópica, maior colagenização, reepitelização, queratinização e menor edema no GO, quando comparado ao GC. Concluiu-se, com este estudo, que enxertos cutâneos em malha evoluíram satisfatoriamente em suínos, mesmo em leito receptor recém-criado e sem presença de tecido de granulação, desde que vascularizado, e que o flap de omento propiciou melhores resultados macro e microscópicos relativos à integração do enxerto.
Assuntos
Animais , Omento/transplante , Suínos/lesões , Neovascularização Fisiológica , Retalhos de Tecido Biológico/veterinária , Procedimentos de Cirurgia Plástica/veterináriaRESUMO
Introducción. Los quistes mesentéricos son tumores poco frecuentes y usualmente benignos, que se diagnostican principalmente en la edad pediátrica, de manera incidental.Caso clínico. Se presenta el caso de una paciente de cuatro años de edad, con dificultad para acceso a servicio de salud por localización de su vivienda, quien cursa con un cuadro clínico de dos años de evolución de distensión abdominal progresiva, interpretada y manejada como ascitis. Se realizó una tomografía de abdomen en la que se documentó una lesión quística gigante, por lo que fue llevada a resección por laparotomía, con confirmación histopatológica de un quiste mesentérico. Discusión. Los quistes mesentéricos pueden tener cualquier localización en el mesenterio del tracto gastrointestinal. Su principal etiología es la proliferación anormal y benigna de tejido linfático mesentérico. Las manifestaciones clínicas van desde la ausencia de síntomas hasta el abdomen agudo. Dentro de los síntomas abdominales no agudos se encuentran masa abdominal indolora, dolor abdominal, distensión abdominal y signos clínicos que simulan ascitis. La resección completa del quiste mesentérico es considerada el tratamiento de elección; el abordaje laparoscópico o abierto dependerá de las características clínicas de cada paciente y la experiencia del cirujano tratante. Conclusión. Es importante que los cirujanos conozcan las principales características y el manejo de esta entidad, que una vez presente, puede simular un síndrome ascítico.
Introduction. Mesenteric cysts are rare and usually benign tumors, which are diagnosed incidentally, mainly in children.Clinical case. We present the case of a 4-year-old patient, with difficulty accessing health services due to the location of her home, who has a 2-year history of progressive abdominal distension, interpreted and managed as ascites. An abdominal tomography was performed in which a giant cystic lesion was documented. She underwent resection by laparotomy, with histopathological confirmation of a mesenteric cyst. Discussion. Mesenteric cysts can have any location in the mesentery of the gastrointestinal tract. Its main etiology is the abnormal and benign proliferation of mesenteric lymphatic tissue. Clinical manifestations range from the absence of symptoms to an acute abdomen. Non-acute abdominal symptoms include a painless abdominal mass, abdominal pain, abdominal distension, and clinical signs that mimic ascites. Complete resection of the mesenteric cyst is considered the treatment of choice; laparoscopic or open approach will depend on the clinical characteristics of each patient and the experience of the treating surgeon. Conclusion. It is important for surgeons to know the main characteristics and management of this entity, which once present, can mimic an ascites syndrome