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

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Performance of blood concentrates in controlling inflammatory signs and symptoms after lower third molar extractions: an overview

Almeida, Vinícius Lima De;

Costa, Marcelo Dias Moreira De Assis;

Mesquita, Caio Melo;

Vieira, Walbert Andrade;

Lima, Rafael Rodrigues;

Lima, Livia Bonjardim;

Rode, Sigmar De Mello;

Paranhos, Luiz Renato;

ABSTRACT Purpose: To summarize the available evidence and answer the following question: What is the current knowledge on the performance of blood concentrates in handling sequelae after lower third molar extractions with the evidence available in systematic reviews? Methods: An electronic search was conducted across nine databases. The study included systematic reviews with or without meta-analyses investigating the performance of blood concentrates in managing sequelae after lower third molar extractions. The four outcomes analyzed were pain, edema, mouth opening, and alveolar osteitis. The AMSTAR-2 tool assessed the methodological quality of the included systematic reviews, while ROBIS evaluated the risk of bias. Results: The electronic search revealed 690 records, of which 15 were eligible systematic reviews for the present study. Overall, these reviews evaluated 75 primary studies published from 2007 to 2023. According to AMSTAR-2, only one systematic review presented high methodological quality. The ROBIS tool showed two systematic reviews with a low risk, and the others had a high risk of bias. Conclusion: The current evidence is based on only one systematic review with high methodological quality and a low risk of bias, while the others exhibited a high risk of bias and low methodological quality. Therefore, the evidence regarding the efficacy of blood concentrates in controlling sequelae following lower third molar extractions is inconclusive.

Holographic model of craniosynostosis for HoloLens

Yoshida, Mauricio Mitsuru;

Freitas, André Luiz Pires De;

Carvalho Júnior, José Da Conceição;

Souza, Julio Sergio De;

Baptista, Vinicius Santos;

Ferreira, Lydia Masako;

ABSTRACT Purpose: To develop a holographic skull model of a deformity resulting from craniosynostosis for the HoloLens. Methods: The methodology for product creation and prototyping was the design thinking structured with the double diamond. A desk survey was conducted with a literature review and an anteriority search. Based on the desk survey results, brainstorming was performed to develop solutions to improve the surgeon’s performance in craniosynostosis using mixed reality. Results: Reports or scientific articles relating mixed reality use to craniosynostosis were not found in search engines or bibliography databases. A surgeon’s performance potential improvement was observed using mixed reality as an auxiliary tool in craniosynostosis surgery. A craniosynostosis skull hologram was developed in mixed reality, with interactivity commands controlled by gestures, facilitating a three-dimensional spatial understanding of cranial anatomy. Conclusion: A holographic skull model with a deformity resulting from craniosynostosis was developed for the HoloLens.

Proper timing or ERCP and cholecystectomy on acute cholecystitis: a systematic review and meta-analysis

Gonçalvez, Giuliana Fulco;

Barros, Louise Lopes;

Gurgel, Sofia Emereciano;

Medeiros, Kleyton Santos De;

Araújo Filho, Irami;

ABSTRACT Purpose: To determine if endoscopic retrograde cholangiopancreatography (ERCP) should be performed with surgery or as a different step, on acute cholecystitis, and which strategy has the least complications and morbimortality. Methods: Various databases (PubMed, Embase, Scopus, Web of Science, Science Direct, Cochrane Central Register of Controlled Trials, CINAHL, Latin American and Caribbean Health Sciences Literature, clinical trials, Google Scholar) were searched for randomized trials comparing the different timings for ERCP and cholecystectomy. No language or time restrictions were applied. Risk of bias was assessed with RoB 2.0 (Cochrane’s Risk of Bias 2), and evidence certainty evaluated using Grading of Recommendations Assessment, Development and Evaluation. Data synthesis used R-4.1.0 Project for Statistical Computing for Windows, with meta-analysis via fixed-effects model and I2 for heterogeneity. Results: Eleven studies was used, and meta-analysis was performed independently for each outcome. Different outcomes were evaluated, with preoperative ERCP as an intervention and intraoperative ERCP as the control: length of stays (four trials with mean differences – MD = -1.44; 95% confidence interval – 95%CI -3,87–0,98); bile leak (odds ratio – OR = 0.67; 95%CI 0.11–4.09); cholangitis (OR = 1.32; 95%CI 0.29–5.98); bleeding from sphincterotomy (OR = 0.98; 95%CI 0.20–4.86); wound infection (OR = 0.33; 95%CI 0.04–3.14); incisional bleeding (OR = 0.5; 95%CI 0.04–5.70); elevated amylase activity (OR = 5.22; 95%CI 2.17–12.59); acute pancreatitis (OR = 4.61; 95%CI 1.72–12.38); operative time (MD = -6,26; 95%CI -37.24–24.73); failure rate (OR = 1.74; 95%CI 0.99–3.05); conversion (OR = 1.34; 95%CI 0.6–2.96); morbidity (OR = 2.75; 95%CI 1.7–4.47). Conclusions: Risk of bias was significant due to lack of blindness. The morbidity, pancreatitis, and elevated amylase activity outcomes were the only ones to find statistical significance and favored the intraoperative approach.

Impact of grape seed proanthocyanidin B2 pretreatment on mitochondrial oxidative stress, endoplasmic reticulum stress, and apoptosis in renal tubular epithelial cells during in-vitro hypoxia-reoxygenation

Wang, Zhi-Shun;

Han, Qi;

Shen, Hao;

Shu, Bo;

Ying, Cheng-Cheng;

Li, Guo-Hao;

Guo, Yong-Lian;

ABSTRACT Purpose: To investigate the impact of grape seed proanthocyanidin B2 (GSPB2) pretreatment on hypoxia-reoxygenation model of HK-2 cells in vitro. Methods: The experiment was divided into five groups: control group (control), GSPB2 group (GSPB2), hypoxia-reoxygenation group (HR), GSPB2 + HR group (GSPB2+HR), and GSPB2 + brusatol (BRU) + HR group (GSPB2 + BRU + HR). Flow cytometry was used to detect apoptosis of cells. Transmission electron microscopy was employed to observe ultrastructural changes of cells. Mitochondrial membrane potential (MMP) was measured. Cellular immunofluorescence was used to assess intracellular Ca²+ concentration. Immunofluorescence staining and Western blotting were conducted to detect expression levels of Nrf2, HO-1, glucose-regulated protein 78 (GRP78), C/EBP homologous protein (CHOP), and cleaved-caspase3. Results: Compared to HR group, GSPB2 + HR group showed significantly increased cell viability, and reduced mitochondrial damage in the cytoplasm. MMP in GSPB2 + HR group was significantly restored, and intracellular Ca²+ concentration was significantly decreased. The expression of Nrf2 and HO-1 proteins was significantly upregulated, while the expression of GRP78, CHOP, and cleaved-caspase3 proteins was markedly downregulated. Conclusion: GSPB2 pretreatment can alleviate oxidative stress damage, mitochondrial injury, and endoplasmic reticulum stress induced by hypoxia-reoxygenation in HK-2 cells in vitro. This effect may be related to the ability of GSPB2 pretreatment to activate the endogenous antioxidant system, particularly through the activation of the Nrf2/HO-1 signaling pathway.

Predictive importance of cartilage acetabular index for acetabular dysplasia in orthopedic surgery

Ziyadanoğulları, Mehmet Onur;

Arslan, Hüseyin;

ABSTRACT Purpose: To investigate the relationship between the cartilage acetabular index and acetabular development and secondary dysplasia. Methods: A total of 58 hips underwent intraoperative arthrography-guided open reduction or limited open reduction due to developmental hip dysplasia between 2011 and 2015 was included in the study. We evaluated patients with acetabular angle 8º as group 2. Intraoperative acetabular cartilage index measurements were performed, and patients with low and high cartilage acetabular index were divided into two groups. Results: There was a correlation between the cartilage acetabular index value, which indicates preoperative cartilage acetabular coverage, and acetabular development and secondary acetabular development. Conclusion: The cartilage acetabular index is a technically easy and uncomplicated evaluation method that can be used to estimate acetabular development and should be used routinely together with the bone acetabular index.

ACTA Cirúrgica Brasileira
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