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- TeseAnálise da relação entre a lactacidemia, força muscular e composição corporal entre o pré e o pós-operatório de derivação gástrica em y de roux em mulheresRibeiro, Guido Assis Cachuba de Sá (2019-01-02)
Faculdade Evangélica Mackenzie do Paraná (FEMPAR)
Lactate is a compound naturally produced in the human body, being the end product of glucose metabolism. Lactacidemia is characterized by the serum levels of lactate found in the blood. The objective of this study was to verify if there is pertinence in the verification of the serum figures of at-rest capillary lactate in the routine exams in the pre and postoperative in the individuals selected for the Laparoscopic Gastroplasty And Roux en Y Bypass surgery, through the correlation of these figures with the components of body composition and generalized muscle strength. Methods: This study was conducted at the Paulo Nassif Institute with patients from the bariatric surgery service of the University Hospital of Faculdade Evangélica Mackenzie do Paraná, in Curitiba-PR. The sample consisted of 21 female patients aged between 18 and 55, with a body mass index (BMI) between 36.6 and 56.7 kg/m². Baseline lactate levels, body components, manual grip strength, lower limbs and lumbars were evaluated in obese patients four months before and four months after the Laparoscopic Gastroplasty And Roux en Y Bypass surgical procedure. Results: in this study, when analyzing the lactacidemia, the absolute figures were not statistically significant (p≤0.05). But when relating to normative figures parametrically, 71.4% of the preoperative sample presented above normal figures, while 28.57% presented normal figures of lactate levels. In the postoperative period, 57% presented above normal figures, 19% normal figures and 24% below the reference figures. There was an average reduction in lactacidemia of 20.8%. The relationship between total fat and fat percentage also decreased, but both were still above the reference figures. There was an average increase in muscle mass of 6.4%, but the sum of absolute forces was significant (p≤0.05) in force loss, with an average decrease of 19%. Conclusion: in the sample involved in this research, taking into consideration the methods used and the previous studies developed, it is possible to interpret how the characteristics of strength and body composition in the postoperative period of Laparoscopic Gastroplasty And Roux en Y Bypass bariatric surgery technique in women will behave, from baseline capillary lactate preoperative figures, allowing its uptake to be part of the preoperative routine in bariatric surgeries. - TeseAnálise imunoistoquímica do CD133, c-MYC e AXL no adenocarcinoma e pólipos colorretais e sua associação prognóstica e clínico-patológicaRutz, Leticia Elizabeth Augustin Czeczko
- TeseAnálise imunoistoquímica do CD133, c-MYC e AXL no adenocarcinoma e pólipos colorretais e sua associação prognóstica e clínico-patológicaRutz, Leticia Elizabeth Augustin Czeczko (2019-01-11)
Faculdade Evangélica Mackenzie do Paraná (FEMPAR)
Introduction: Colorectal cancer (RCC) has been extensively molecularly characterized in recent years to provide tools that can allow differentiation of subgroups with different prognostic and therapeutic implications. CD133 is a transmembrane glycoprotein currently considered to be the most robust surface marker of colorectal cancer tumor stem cells. C-MYC is one of the major genes responsible for regulating cell growth and metabolism and its overexpression makes it a potent oncogene. AXL is a receptor tyrosine kinase that in the context of malignancy drives comprehensive processes including epithelial transition to mesenchyme. Objectives: The purpose of this study was to evaluate the prognosis and clinical and pathological characteristics of CD133, c-MYC and AXL in colorectal adenocarcinomas and to associate its positivity with dysplasia and morphology in polyps. Material and Method: The adenocarcinoma group included 122 patients of both genders, who were diagnosed between 2010 and 2015. In the polyp group, 39 colorectal polyps resulting from polypectomies performed in colonoscopies between 2009 and 2012 were studied. Immunohistochemistry was performed for CD133, c-MYC and AXL biomarkers in all samples. Retrospective clinical data was collected and plotted in two data tables. Through TMA (tissue microarray) technique, the tissues were subjected to immunohistochemistry by the peroxidase technique. Clinical-epidemiological information was crossed with the result obtained by immunostaining and its statistical analysis. Results: The adenocarcinoma group had 63 men (51.6%) with a mean age of 61.9 years. There was a distribution of 40 cases in the right colon (34.4%) and 75 in left colon and rectum (61.4%). Most patients had an advanced UICC classification (III and IV) (n = 74). From the total number of patients, 68 (55.7%) died and poorly differentiated tumors and disease progression were found to be independent risk factors for death (p <0.05). The median estimated overall survival time was 30 months. CD133+ (CD133 positive tumors) showed a protective relationship against death in univariate analysis but this relevance did not occur in multivariate analysis. There was an association between c-MYC+ (c-MYC positive tumors) and metastasis to other sites (non-hepatic, pulmonary and peritoneal). AXL had four positive cases, precluding further analysis. There was no significant association between the other characteristics analyzed. In the polyp group there were 31 adenomas (79.5%) and 15 (38.5%) presented high-grade dysplasia. Of the 39 polyps, 35.9% (n=14) scored positive for CD133: 15.4% (n = 6) for c-MYC and 15.4% (n = 6) for AXL. There was no statistically significant association between positive tumors and polyp size, location, type, histological diagnosis and high-grade dysplasia. Moderate agreement was found between the c-MYC and AXL biomarkers due to 28 (71.8%) cases in agreement and 11 (28.2%) cases in disagreement. Conclusion: CD133 is not an independent protective factor against death in colorectal adenocarcinoma, whereas c-MYC is associated with distant metastasis. Polyps showed no association between CD133, c-MYC, AXL and clinico-pathological variables. There is a tendency for c-MYC and AXL to be overexpressed in the same tumor profile. - TeseEstudo experimental comparativo entre as telas de polipropileno microporoso, polipropileno/poliglecaprone e polipropileno macroporoso utilizadas na correção de defeito na parede abdominal de ratosUtrabo, Carlos Alberto Lima (2019-01-02)
Faculdade Evangélica Mackenzie do Paraná (FEMPAR)
Introdução. O reparo de defeitos da parede abdominal é uma das cirurgias mais realizadas na atualidade. Com o aumento considerável de novas telas para utilização no tratamento das hérnias, existe uma incessante busca pela tela ideal. O uso de telas apresenta, em alguns casos, risco de infecção, seroma, fístula, dor crônica, e de retração da parede tratada. Esta pesquisa tem como objetivo avaliar o processo de cicatrização de defeito produzido em parede abdominal de ratos comparando-se o reparo com a utilização das telas polipropileno microporosa, polipropileno/poliglecaprone macroporosa e polipropileno macroporosa, avaliando-se a parede abdominal tratada no 30º, 60º e no 120º dia de pós-operatório visando: avaliação macroscópica, avaliação tensiométrica, e avaliação microscópica. Material e método: Foram utilizados 90 ratos da raça Wistar (Rattus norvergicus albinus), machos, adultos jovens, com três meses com peso variando de 280 a 300 gramas. Os animais foram distribuídos em três grupos de trinta ratos. Cada grupo foi dividido em três subgrupos de 10 ratos, que foram submetidos a procedimentos cirúrgicos semelhantes, com lesão da parede abdominal, mantendo a integridade do peritônio parietal e correção utilizando as telas estudadas. Realizou-se a eutanásia aos 30,60 e 120 dias de pós-operatório. Os segmentos parede abdominal dos animais foram submetidos à análise tensiométrica, histológica com utilização de hematoxilina/eosina e tricômio de Masson, imunoistoquímica, e avaliação do colágeno com o picrossírius Red. Resultados: O presente estudo demonstrou uma maior resistência dos tecidos reparados, nas telas macroporosas em relação às telas microporosas. O escore do processo inflamatório demonstrou prevalência significativa de processo subagudo no início e no final do estudo. Nas telas microporosas o encapsulamento é em bloco e nas telas macroporosas o encapsulamento é prevalentemente filamentar. O estudo imunoistoquímico com o marcador MMP9 teve redução constante durante todo o período de estudo no grupo G2 (polipropileno/poliglecaprone). Conclusão: As telas mais resistentes ao final do estudo foram as telas macroporosas. Nas telas microporosas o encapsulamento é em bloco e nas macroporosas prevalece o encapsulamento filamentar. Todas as telas estudadas mostraram resistência suficiente para a manutenção da correção do defeito de parede no período avaliado. - TeseEstudo experimental da inibição do VEGF na regeneração hepáticaSousa, Eros Luiz de
- TeseEstudo experimental da inibição do VEGF na regeneração hepáticaSousa, Eros Luiz de (2019-01-09)
Faculdade Evangélica Mackenzie do Paraná (FEMPAR)
Background: extensive liver resections and transplants of liver parts are possible thanks to its regenerative capacity which is dependent on vascular endothelial growth factor (VEGF) activation which also regulates the angiogenesis. Bevacizumab (BV), a monoclonal antibody VEGF inhibitor, is a neoadjuvant treatment of cancers widely used, restricting microvascular density and may cause undesirable effects on postoperative healing and liver regeneration (LR). Objective: to determine the effect of a single dose (5mg/kg) of BV in LR. Methods: 32 rats submitted to partial hepatectomy (PH) were separated into two groups according to saline solution (C) or BV (BV) treatment. According to the observation time (48h and 15 days) they were subdivided in C48 and BV48 and C15 and BV15 sub-groups. In LR, the BV effects were evaluated by weight variation and liver function (albumin, transaminase, bilirubin and APRI ratio) and in remaining liver were evaluated, mitotic activity, microvascular density (angiogenesis), nuclear proliferation, histopathology for fibrosis, edema and congestion. For statistical analysis, the ANOVA and T-Student test was used (of statistical significance when p≤0.05). Results: on the fifteenth day after PH and BV treatment, there were no differences in weight evaluations (p=0.0691), liver function and mitotic indexes (p=0.1576). However, there was a decrease in cell viability (p=0.0000), microvascular density (p = 0.0162) and worsening in the occurrence of histopathological changes such as liver fibrosis, edema and congestion. Conclusion: a single BV dose, on the fifteenth day of evolution has no significant effect in weight evolution, serum biochemical evaluations (albumin, bilirubin and transaminases) and mitotic index. However, it induced microvascular density decreased, cell viability and liver histopathological changes such as fibrosis, edema and congestion.