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.

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.

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.

Constructing tridimensional modeling and radiographic evaluation of diaphyseal fractures in a canine femur for veterinary education

Lucas, Kleber Dos Anjos;

Souza, Rodrigo Gomes De;

Kassab, Siham;

Sampaio, Marco Aurélio Pereira;

Inpanbutr, Nongnuch;

Carvalho, Yuri Karaccas De;

ABSTRACT Purpose: To create tridimensional (3D) anatomical models of diaphyseal fractures in dogs (3D AMDFD) and to evaluate the models from their radiographs. Methods: The study consisted of six stages: preparation of femur from a healthy dog cadaver; digitalization of the bone through a 3D scanner and creation of the base model; creation of a 3D AMDFD based on the image of the base model, 3D modeling carried out to reproduce five different types of diaphyseal fractures; printing the models produced on a 3D printer with a thermoplastic material; insertion of neodymium magnets in the fracture line to allow the assembly and disassembly of the parts; and radiography of 3D AMDFD in lateromedial and craniocaudal positions. Results: The base model and 3D AMDFD had high precision in the replication of bone structures, like the bone in natura. The radiopacity and radiolucency of the 3D AMDFD did not necessarily correspond to the bone densities found in the radiography of the natural canine femur. Conclusion: The 3D AMDFD and their respective radiographs accurately reproduced the anatomical structures and fracture lines.

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.

ACTA Cirúrgica Brasileira
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