Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia - Online version e-ISSN: 1678-2674

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Factors associated with recurrence in operable breast cancer patients undergoing surgery as the sole treatment modality

Bonissoni, Maressa Daniela Anghinoni;

Alves, Fernanda Mara;

Almeida, Rafaella Frederico;

Smaniotto, Lucca;

Berny, Maria Paula De Andrade;

Silva, Victor Pereira Da;

Fiuza, Brenda Stephanie;

Rodrigues, Guilherme Cirino;

Neres, Eloisa Maria;

Kern, Rodrigo;

Santos, Carlos Victor Pereira Dos;

Souza, Janoário Athanazio De;

Rech, Daniel;

Panis, Carolina;

ABSTRACT Purpose: Approximately 10% of breast cancer patients with localized operable disease experience recurrence. This study aimed to evaluate patients with early-stage breast cancer (TNM I and II) who underwent surgery without the need for neoadjuvant therapy. Methods: The total of 117 patients was included in the study: 104 without recurrence and 13 with recurrence. We analyzed various clinicopathological parameters, including body mass index, age at diagnosis, menopausal status, pesticide exposure, and tumor characteristics such as HER2 amplification, Ki67 index, molecular subtype, and histological grade. Results: Two primary subsets were identified as being associated with disease recurrence. The first subset (PC1) was characterized by HER2 amplification and metastatic disease, while the second subset (PC2) comprised premenopausal young women exposed to pesticides who had triple-negative tumors. While some of these factors are well-documented in the literature, pesticide exposure emerged as a notable regional factor contributing to poor outcomes in breast cancer patients. Conclusion: These findings underscored the significance of identifying local and regional risk factors when assessing recurrence risk in women with breast cancer, particularly in cases in which surgery is the primary treatment approach.

Acute inflammatory profile of patients submitted to pulmonary resection

Souza, Andrea Pelicia Roso De;

Palhares, Raquel;

Baltieri, Letícia;

Mussi, Ricardo Kalaf;

Antunes, Edson;

Mello, Glaucia Coelho De;

ABSTRACT Purpose: To establish a profile of the inflammatory response in the preoperative and postoperative period of pulmonary resection of patients without postoperative complications, in order to trace the inflammatory profile of lung resection surgery. Methods: Six collections of arterial and venous blood were performed for data analysis, one sample in the preoperative, immediate postoperative, 4, 8, 24, and 48 hours after surgery. Twenty-seven patients with a median age of 63 years old, ranging from 29 to 80 years old, were included. Results: The leukocyte count showed a significant increase in the times: immediate postoperative and 4 hours after surgery, in relation to the preoperative period. Concomitantly, there was an increase in lactate, heart rate, interleukin (IL)-6 and IL-8 after 4 hours of surgery. The platelet count showed a significant decrease in 48 h, associated with an increase in IL-1β and tumor necrosis factor-α. A significant increase in IL-10 was observed in the immediate postoperative. Conclusion: The study may contribute to the search for more specific and adequate alternatives for controlling the inflammatory response. In this way, the intervention would be specific to that cytokine that causes the greatest harm to the patient, as well as to the moment of the intervention.

Mechanisms of photobiomodulation therapy in treating and preventing antineoplastic-induced oral mucositis: a systematic review

Sales, Paulo Victor Alves De;

Godói, Isabella Piassi Dias;

Brito, Gerly Anne De Castro;

Leitão, Renata Carvalho;

Araújo, Aurigena Antunes De;

Medeiros, Caroline Addison Carvalho Xavier De;

ABSTRACT Purpose: To conduct a systematic review of the mechanisms of photobiomodulation therapy (PBMT) for treating or preventing oral mucositis (OM) caused by antineoplastic therapy. Methods: Following PRISMA 2020 guidelines, a search was conducted in Medline, Latin American and Caribbean Health Sciences Literature (LILACS), Scientific Electronic Library Online (SciELO), and Bibliografia Brasileira de Odontologia from August to September 2023 using descriptors related to OM and laser therapy. Studies on the mechanisms of photobiomodulation in OM were included. Randomized (RCTs) or non-randomized trials from the past 10 years were reviewed. Risk of bias was assessed using RoB 2.0 and ROBINS-I tools. Results: A total of 355 studies was identified. After the screening, seven met the eligibility criteria. The RCTs showed a low risk of bias. PBMT reduced OM incidence in patients undergoing chemotherapy/radiotherapy. PBMT decreased pro-inflammatory cytokines (interleukin-6, tumor necrosis factor-α) and increased anti-inflammatory cytokines (interleukin-4, interleukin-10). It also modulated inflammatory mediators, enhancing the antioxidant enzyme superoxide dismutase and overexpressing genes for keratinocyte differentiation, aiding injury repair. Conclusion: The findings suggested that the mechanism of action of PBMT in OM involves modulation of the inflammatory response, balancing oxygen reactive species generation, and expression of factors related to healing or repair. Further studies are needed to elucidate these mechanisms and optimize treatment protocols.

Protective effect of proteins extracted from Plumeria pudica latex on ethanol-induced gastric injury in mice

Moita, Lucas Arruda;

Souza, Bruna Da Silva;

Oliveira, Naylla Veras De Moraes;

Sales, Ana Clara Silva;

Oliveira, Lucas Eduardo Silva;

Oliveira, Ana Patrícia De;

Sousa, Francisca Beatriz Melo;

Medeiros, Jand-Venes Rolim;

Oliveira, Jefferson Soares De;

ABSTRACT Purpose: To evaluate proteins from Plumeria pudica latex (LPPp) for their protective effect against ethanol-induced gastric injury in mice. Methods: The LPPp fraction was obtained by collecting P. pudica latex in tubes containing distilled water, followed by centrifugation and dialysis. The female Swiss mice (Mus musculus) received saline or LPPp (40 mg/kg) intraperitoneally 1 hour before oral administration of 500 μL of 50% ethanol. One hour later, the animals were euthanized, and their stomachs were removed for evaluation of tissue lesion area, histopathological analysis, and measurements of malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), and nitrate/nitrite (NO3/NO2). An independent experiment assessed the effect of LPPp on gastric mucus production. Results: The LPPp-treated animals showed a significant reduction in the mean injured areas of gastric tissue (0.73 ± 1.01 mm2) compared to the ethanol group (37.99 ± 3.11 mm2). Histopathological analysis revealed significant preservation of tissue architecture in the LPPp group compared to ethanol group. Additionally, LPPp maintained tissue levels of MDA, GSH, SOD, and NO3/NO2 comparable to the saline group and influenced gastric mucus production favorably (p < 0.05). Conclusion: These results suggested that LPPp has a protective effect against ethanol-induced gastric lesions, likely involving antioxidant activity and increased gastric mucus production.

Repair methods in peripheral nerves after traumatic injuries: a systematic literature review

Costa, Naely Nobre;

Santos, Jennifer Ferreira Dos;

Aranha, Maria Fernanda De Almeida Cavalcante;

Coelho, Erik William Farias;

Paes, Victor Leno Silva;

Oliveira, Rita De Cássia Silva De;

ABSTRACT Purpose: To identify and describe the most used surgical repair methods for traumatic injuries to peripheral nerves, as well as highlight the causes of trauma to peripheral nerves and the most prevalent traumatized nerves. Methods: This is a systematic literature review using the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The searches were carried out in PubMED, in the time window from January 2018 to December 2022. Results: In total, 3,687 articles were collected, of which, after applying the inclusion and exclusion filters and analyzing the risk of bias, 34 articles remained. It was observed that the age of the injury and type of nerve repair strongly influence the recovery of patients. The most identified trauma repair procedures were neurolysis, direct suturing, grafting, and nerve transfer. Among these four procedures, direct suturing is currently preferred. Conclusion: Several repair methods can be used in peripheral nerve injuries, with emphasis on direct suturing. However, nerve transfer proves to be a differential in those cases in which repair is delayed or the first treatment options have failed, which shows that each method will be used according to the indication for each case.

Public health system expenditure on motor vehicle collisions in Brazil: an ecological study

Viana, Sofia Wagemaker;

Gerk, Ayla;

Schlindwein, Sofia Schmitt;

Marrazzo, Enzzo;

Feres, Brenda;

Ribeiro, Lívia;

Carroll, Madeleine;

Mooney, David Patrick;

Schnitman, Gabriel;

Camargo, Cristina Pires;

ABSTRACT Purpose: To assess the cost of traffic accidents in Brazil and the impact of age/location. Methods: All patients admitted to a Brazilian hospital due to traffic accidents from January 2012 to December 2022 and cost of hospital services were obtained from the Department of Information Technology of the Unified Health System. Demographic data were collected in the Brazilian Institute of Geography and Statistics database. Parametric and nonparametric data were analyzed. The Kruskal-Wallis’ test and a post-hoc test were used for data comparison. The ARIMA linear regression method for trend estimation. Results: In Brazil, 1.6 million individuals were involved in traffic accidents between 2012–2022, resulting in a cumulative hospital expenditure of US$ 38 million. The average hospital admission cost during this time was US$ 239.66, but no correlation was found between the cost per capita and driver population density increase. Hospitalization in the Midwest/South was higher. Conclusion: The economic impact of traffic accidents on the Brazilian public health system is significant. With a high number of victims admitted annually and evident regional and age-related disparities, there is a clear need for comprehensive and cost-effective healthcare strategies.

ACTA Cirúrgica Brasileira
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