Membrana de Biopolímero da Cana-de-acúcar: Uma Realidade como Opção para Correção da Incontinência Urinária

Resumo Introdução: A cirurgia de Sling é considerada padrão ouro para o tratamento da Incontinência Urinária de Esforço. Essa técnica cirúrgica utiliza um material sintético no espaço suburetral para prover um arcabouço de fibrose e corrigir a perda urinária. A partir do melaço da cana-de-açúcar, por síntese da bactéria Zoogloea sp, obtivemos o biopolímero da cana-de-acúcar que pode ser processada em forma de membrana. Nosso objetivo é mostrar a ação do biopolímero da cana-de-açúcar comparando-o com o polipropileno, no tocante à reação inflamatória e indução da formação de fibras colágenas. Material e Métodos: Trata-se de um estudo experimental, prospectivo, controlado, tipo ensaio clínico. Utilizámos 30 ratos Wistar, divididos em dois grupos de 15 animais, que tiveram uma tela de polipropileno e outra membrana do biopolímero da cana-de-açúcar implantadas no subcutâneo da parede abdominal. Sendo esses animais sacrificados após sete e 120 dias do procedimento. Analisámos e comparámos a reação inflamatória e a deposição de fibras colágenas induzidas pelos materiais utilizados. Todas as conclusões foram tomadas ao nível de significância de 5%. Resultados: As reações inflamatória aguda e linfoplasmocitária foram maiores, nos primeiros sete dias, induzidas pelo biopolímero. Sendo essas respostas semelhantes entre os materiais após 120 dias. A deposição de fibras colágenas foi significativamente maior quando induzida pelo biopolímero, tanto após sete dias, quanto após 120 dias. Não foi demonstrada rejeição, infecção, necrose em nenhum dos animais do estudo. Discussão: A reação inflamatórias aguda e linfoplasmocitária mais intensa no biopolímero causou uma maior produção de células gigantes de corpo estranho. Consequentemente a isso, tivemos uma maior deposição de fibras colágenas induzidas pelo biopolímero sem que esse material induzisse a rejeição. Conclusão: O biopolímero no subcutâneo dos ratos, em nosso experimento, estimulou uma resposta inflamatória e um acúmulo de fibras colágenas que mimetiza o processo cicatricial ocorrido abaixo da uretra de mulheres submetidas a cura da Incontinência Urinária.Abstract Introduction: The Sling surgery is considered the gold standard for the treatment of Stress Urinary Incontinence. This surgical technique uses a synthetic material in the sub urethral space to provide a framework of fibrosis and correct urinary loss. From the molasses of sugarcane by synthesis of bacteria Zoogloea sp is obtained the biopolymer from sugarcane that can be processed in the form of membrane. Our goal is to show the action of the sugarcane biopolymer compared with polypropylene, regarding the inflammatory response and induction of collagen fiber formation. Material and Methods: This is an experimental study, prospective, controlled, clinical trial type. We used 30 Wistar rats, divided into two groups of 15 animals, one had a polypropylene mesh and the other biopolymer membrane of sugarcane implanted subcutaneously in the abdominal wall. Being these animals euthanized after seven and 120 days after the procedure. We analyzed and compared the inflammatory reaction and collagen deposition induced by the materials used. Results: The acute inflammatory reaction and lymphoplasmocytary were higher in the first seven days induced by biopolymer. Being similar responses among these materials after 120 days. The collagen fibers deposition was significantly greater when induced by biopolymer, after seven days, and after 120 days. It was not demonstrated rejection, infection, necrosis of none of the animals in the study. Conclusion: The biopolymer in subcutaneous of rats in our experiment, stimulated an inflammatory response and an accumulation of collagen fibers that mimics the healing process that occurred below the urethra in women undergoing the cure of Urinary Incontinence

Concordance for curve type in idiopathic scoliosis among family members

OBJECTIVE: To evaluate the concordance for the curve pattern, side and levels of the superior apical vertebrae, apex and inferior apical vertebrae of curves in patients and their relatives with idiopathic scoliosis. METHODS: Concordance according to the Lenke classification for curve pattern, side and levels of the superior apical vertebrae, apex and inferior apical vertebrae were evaluated comparative and prospectively in 243 pairs of patients and respective relatives with idiopathic scoliosis. RESULTS: The family concordance for the curve pattern and side was 51.4% (125 pairs). Among these pairs, the concordance of the levels of the vertebrae was 91.2% (114 pairs). The concordance rate for the curve pattern and side between parents/children was 51.6% and between siblings was 50.0% (p-value= 0.411). The concordance rates of the levels of vertebrae were 86.8% and 95.1%, respectively (p-value = 0.219). CONCLUSION: Curve shape in idiopathic scoliosis is related to family and degree of kinship, since the data showed a high concordance for the curve pattern, side and levels of the apical vertebrae and apex between patients and relatives with this deformity. The concordance was higher in those with a closer degree of kinship. Level of Evidence II, Lesser Quality Prospective Study

Innervation of the nipple-areolar complex after reduction mammaplasty: a histological study

INTRODUCTION: The periareolar dermal release maneuver in mammoplasty promotes better mobility of the nipple-areola complex. However, there are doubts on possible nerve damages in this kind of topography. This quantitative analysis compared the nerve branches density from the medial, lateral and caudal side-flow of the nipple-areola complex (NAC). METHODS: This was a prospective study. The study included 26 women who have undergone a mammaplasty reduction using the Pitanguy's classic technique. The dermis fragments collected from the medial, lateral and caudal sides were properly prepared and subjected to a histological study in order to determine the nerve branches density in each studied sides. RESULTS: Of 26 studied patients, 42.3% had a higher nerve branches density in the lateral side; 38.5%, on the medial side and 19.2% on the caudal side. The statistical analysis used to evaluate whether there was a predominance of one side where the dermis has been sectioned showed that the proportion comparison test was not significant (p = 0.304). CONCLUSION: The comparative analysis has shown that there is no preponderance of nerve density in any periareolar dermis side