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

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A microscope in your pocket: can smartphones be used to perform microsurgery?

Menezes Neto, Balduino Ferreira De;

Magnani, Lucas Vannuchi;

Fernandes, Matheus Scuracchio;

Brunello, Luis Fernando Spagnuolo;

Souza, Thales Fernandes De;

Viterbo, Fausto;

ABSTRACT Purpose: To evaluate the use of the latest generation smartphone camera in performing arterial microanastomosis in rats. Methods: Ten Wistar rats were divided into 2 groups and underwent anastomosis of the right carotid artery with the aid of magnification from a microscope (group M) and a smartphone camera (group S), to compare patency in 72 hours, as well as to measure the weight of the animals, diameter of the carotid arteries and anastomosis time. Results: There was no statistical difference between the weight of the animals or the diameter of the carotid arteries. There was a statistical difference for the time spent on anastomoses, which was greater in group S, with higher rates of thrombosis (p < 0.05). Conclusions: Although our patency and anastomosis time results were statistically lower in the smartphone group, there was success in some cases. As the segment continues to progress, it is likely that the results will improve in line with the evolution of camera technology.

A neural cell automated analysis system based on pathological specimens in a gerbil brain ischemia model

Katsumata, Eri;

Ranjan, Abhishek Kumar;

Tashima, Yoshihiko;

Takahata, Takayuki;

Sato, Toshiyuki;

Kobayashi, Motoaki;

Ishii, Masami;

Takahashi, Toyomi;

Oda, Asahi;

Hirano, Momoko;

Hakamata, Yoji;

Sugai, Kazuhisa;

Kobayashi, Eiji;

ABSTRACT Purpose: Amid rising health awareness, natural products which has milder effects than medical drugs are becoming popular. However, only few systems can quantitatively assess their impact on living organisms. Therefore, we developed a deep-learning system to automate the counting of cells in a gerbil model, aiming to assess a natural product’s effectiveness against ischemia. Methods: The image acquired from paraffin blocks containing gerbil brains was analyzed by a deep-learning model (fine-tuned Detectron2). Results: The counting system achieved a 79%-positive predictive value and 85%-sensitivity when visual judgment by an expert was used as ground truth. Conclusions: Our system evaluated hydrogen water’s potential against ischemia and found it potentially useful, which is consistent with expert assessment. Due to natural product’s milder effects, large data sets are needed for evaluation, making manual measurement labor-intensive. Hence, our system offers a promising new approach for evaluating natural products.

Combined administration of gallic acid and glibenclamide mitigate systemic complication and histological changes in the cornea of diabetic rats induced with streptozotocin

Zhao, Jing;

Hussain, Shaik Althaf;

Maddu, Narendra;

ABSTRACT Purpose: To determine the effect of gallic acid or its combination with glibenclamide on some biochemical markers and histology of the cornea of streptozotocin (STZ) induced diabetic rats. Methods: Following induction of diabetes, 24 male albino rats were divided into four groups of six rats each. Groups 1 and 2 (control and diabetic) received rat pellets and distilled water; group 3 (gallic acid) received rat pellets and gallic acid (10 mg/kg, orally) dissolved in the distilled water; and group 4 (gallic acid + glibenclamide) received rat pellets, gallic acid (10 mg/kg, orally), and glibenclamide (5 mg/kg, orally) dissolved in the distilled water. The treatments were administered for three months after which the rats were sacrificed after an overnight fast. Blood and sera were collected for the determination of biochemical parameters, while their eyes were excised for histology. Results: STZ administration to the rats induced insulin resistance, hyperglycemia, microprotenuria, loss of weight, oxidative stress, inflammation, and alteration of their cornea histology, which was abolished following supplementation with gallic acid or its combination with glibenclamide. Conclusions: The study showed the potentials of gallic acid and glibenclamide in mitigating systemic complication and histological changes in the cornea of diabetic rats induced with STZ.

Prevalence of postoperative complications in oncologic gastro-esophageal surgeries: a cross-sectional study

Lima, Laura Mota Vieira;

Guimarães, Paula Costa;

Montenegro, Daniele De Oliveira;

Filgueira, Fernanda De Sousa;

Gomes Neto Júnior, José;

Cobucci, Ricardo Ney;

Medeiros, Kleyton Santos De;

Araújo-Filho, Irami;

ABSTRACT Purpose: This study evaluated the prevalence of complications in the postoperative period of esophagogastric oncological surgeries. Methods: We conducted a retrospective cross-sectional study, adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The study size implied 163 patients who underwent surgical treatment for esophageal and gastric cancer and experienced postoperative complications between January 2018 and December 2022. These patients were treated at the Liga Norte Riograndense Contra o Câncer, a high-complexity oncology center and a reference for cancer treatment in Northeast Brazil. Results: The prevalence found was 88.3%. The most prevalent complications were Clavien-Dindo I and II, and infection was the most common. According to our statistics analysis, hypoalbuminemia showed a positive correspondence with the occurrence of postoperative complications (odds ratio = 8.60; 95% confidence interval 1.35–54.64, p = 0.0358). Conclusions: Postoperative complications of gastroesophageal surgeries increase patient morbidity and mortality.

Acute-on-chronic liver failure: a retrospective review of cases at a transplantation center in Brazil

Fernandes, Fernando Camargo;

Boteon, Amanda Pinter Carvalheiro Da Silva;

Rossi, Giovana Garcia;

Marques, Fernanda;

Della-Guardia, Bianca;

Boteon, Yuri Longatto;

ABSTRACT Purpose: Acute-on-chronic liver failure (ACLF) is a leading cause of death in cirrhotic patients. This study aims to describe the outcomes of in-patients with ACLF at a liver transplantation (LT) center in Brazil. Methods: Retrospective study analyzing patient data from 2017 to 2022. Re-transplant cases and patients without previous chronic liver disease were excluded. The ACLF diagnosis was based on the European Association for the Study of the Liver-Chronic Liver Failure criteria and assessments repeated on days 3 and 7 after the initial diagnosis. Results: Among 381 patients, 10.49% (n = 40) were diagnosed with ACLF. Bacterial infection was the most common precipitating factor (45%). Kidney failure occurred in 65% of the cases. The 28-day mortality rate was 35% and varied according to ACLF severity at diagnosis, from single organ failure (ACLF-1) at 22% to three organ failures (ACLF-3) at 60%. Eighteen patients (45%) were transplanted with a 100% 28-day survival rate. For ACLF-3 cases at diagnosis (n = 15), the 28-day and 1-year survival rates with a transplant (n = 4) were 100% and 80%, respectively, and without transplant (n = 11), 10 and 0%, respectively. Conclusions: ACLF was associated with high mortality rates. LT was an effective therapeutic option, particularly for ACLF-3 cases.

Antibiotics prophylaxis at the time of catheter removal after radical prostatectomy: a systematic review of the literature and meta-analysis

Santos, Letícia Lourenço Dos;

Fraga, Isabela De Almeida;

Almeida, Vitor Amaral De;

Santos, Andressa Hellen Ribeiro;

Almeida, Isabelle Matos;

Nascimento, Tatiana Roberta;

Porto, Breno Cordeiro;

Passerotti, Carlo Camargo;

Artifon, Everson Luiz De Almeida;

Otoch, Jose Pinhata;

Cruz, José Arnaldo Shiomi Da;

ABSTRACT Purpose: To conduct a systematic literature review with meta-analysis to identify whether antibiotic prophylaxis after removal of the indwelling urinary catheter reduces posterior infections. Methods: A systematic literature review was conducted in the databases PubMed, Embase, Cochrane, Google Scholar, and Latin American and Caribbean Health Sciences Literature, using the keywords “antibiotics” AND “prostatectomy” AND “urinary catheter.” Results: Three articles were identified having the scope of our review, with 1,040 patients, which were subjected to our meta-analysis revealing a marginally significant decrease in the risk of urinary infection after indwelling urinary catheter removal (odds ratio–OR = 0.51; 95% confidence interval–95%CI 0.27–0.98; p = 0.04; I2 = 0%). No difference was found regarding the presence of bacteriuria (OR = 0.39; 95%CI 0.12–1.24; p = 0.11; I2 = 73%). Conclusions: In our meta-analysis, there was a significant decrease in urinary tract infection with antibiotic prophylaxis after indwelling urinary catheter removal following radical prostatectomy.