Hernioplasty in One-Day Surgery: result of 228 self-adhesive prosthesis

Aim: To evaluate the outcomes of inguinal hernia repair with ProGrip® mesh in same-day surgery Methods: Follow-up data was collected at 24 hours and 30 days after surgery. Results: In one year, 228 patients underwent surgical repair of unilateral inguinal hernia. At 24 hours after surgery, 50.64% of patients reported some degree of pain and 66.3% were able to move around the house with few limitations. Thirty days after surgery, 94.39% of patients had returned to their routine activities. Conclusions: The use of the ProGrip® mesh is associated with low post-operative pain and rapid recovery

Terapia Celular para o Tratamento de Cardiopatias Isquêmicas: Desenvolvimento de um Protocolo Pré-clinico

RESUMEN Apesar dos avanços clínicos, cirúrgicos e farmacológicos, quando a doença cardíaca isquêmica é muita avançada e difusa, os métodos atualmente disponíveis não são totalmente efetivos para evitar a perda de cardiomiócitos funcionais. Isso acarretará alterações na geometria ventricular (remodelamento), com perda progressiva da função ventricular e desenvolvimento de insuficiencia cardíaca. Recentes avanços na compreensão da biologia das células-tronco reinstalaram o conceito de transplante celular para substituir células não funcionais. A regeneração do miocárdio tem despertado um crescente interesse visando atender este propósito. A proposta deste trabalho é o de desenvolver um protocolo pré-clínico seguro e eficiente que possa contribuir para uma melhor compreensão dos mecanismos envolvidos no processo de regeneração do músculo cardíaco isquêmico, através da terapia celular, associada ou não a terapia gênica, com conseqüente recuperação da função cardíaca, em ratos infartados (modeloIAM).  ABSTRACT In spite of clinical, surgical and pharmacological advances, the currently available methods are not totally effective in treating advanced stage ischemic cardiopathy, permitting functional cardiomiocyte loss which leads to ventricle remodeling, progressive loss of ventricle function and the development of cardiac insufficiency. Recent advances in understanding stem cell biology have established the concept of cellular transplant to substitute non-functional cells. Myocardium regeneration is being greatly considered for such procedure. Our main goal is the development of a safe and effective pre-clinical protocol, which could contribute to clarify the mechanisms involved in myocardium regeneration using cellular therapy, combined or not with gene therapy, leading to cardiac function restoration in rats (IAM model).  Keywords: Stem Cell, myocardium regeneration, cell therapy

Terapia Celular para o Tratamento de Cardiopatias Isquêmicas: Desenvolvimento de um Protocolo Pré-clinico

RESUMEN Apesar dos avanços clínicos, cirúrgicos e farmacológicos, quando a doença cardíaca isquêmica é muita avançada e difusa, os métodos atualmente disponíveis não são totalmente efetivos para evitar a perda de cardiomiócitos funcionais. Isso acarretará alterações na geometria ventricular (remodelamento), com perda progressiva da função ventricular e desenvolvimento de insuficiencia cardíaca. Recentes avanços na compreensão da biologia das células-tronco reinstalaram o conceito de transplante celular para substituir células não funcionais. A regeneração do miocárdio tem despertado um crescente interesse visando atender este propósito. A proposta deste trabalho é o de desenvolver um protocolo pré-clínico seguro e eficiente que possa contribuir para uma melhor compreensão dos mecanismos envolvidos no processo de regeneração do músculo cardíaco isquêmico, através da terapia celular, associada ou não a terapia gênica, com conseqüente recuperação da função cardíaca, em ratos infartados (modeloIAM).  ABSTRACT In spite of clinical, surgical and pharmacological advances, the currently available methods are not totally effective in treating advanced stage ischemic cardiopathy, permitting functional cardiomiocyte loss which leads to ventricle remodeling, progressive loss of ventricle function and the development of cardiac insufficiency. Recent advances in understanding stem cell biology have established the concept of cellular transplant to substitute non-functional cells. Myocardium regeneration is being greatly considered for such procedure. Our main goal is the development of a safe and effective pre-clinical protocol, which could contribute to clarify the mechanisms involved in myocardium regeneration using cellular therapy, combined or not with gene therapy, leading to cardiac function restoration in rats (IAM model).  Keywords: Stem Cell, myocardium regeneration, cell therapy

231 Colecistectomias Laparoscopicas em Ambulatório: Que Resultados?

ntroduction: Laparoscopic cholecystectomy is the gold standard procedure for the treatment of lithiasic gallblader pathology and acute cholecystitis. Whether or not it should be done as ambulatory surgery is still being discussed. The present study aims to analyze the quality and safety of laparoscopic cholecystectomy conducted by the Ambulatory Unit of Hospital de Braga and compare the results with those from other European surgical centers performing LC as ambulatory surgery. Material and Methods: Observational prospective study of patients submitted to laparoscopic cholecystectomy in ambulatory surgery during a period of 26 months. Data regarding patients' demography, peri- and postoperative complications, surgical time, time in recovery room, and readmission rates was collected. Results: A total of 231 patients were subjected to Laparoscopic cholecystectomy in the ambulatory unit with overnight stay (time to discharge less than 24 hours). Three patients presented with intra-operative complications, which needed conversion to laparotomy, and four patients were admitted after surgery. The mean time for the procedure was 58 minutes and the mean time for recovery was 19h19 minutes. Postoperative morbidity was 7.8% with 2 nonscheduled admission having occurred. Discussion: One of the controversies regarding laparoscopic cholecystectomy as an outpatient procedure is the need for overnight hospital surveillance. In our unit, we have started LC on an outpatient basis with an overnight stay. Using this protocol, over the past two years, we have operated 231 patients and our results show that this is a completely safe technique. Conclusions: Data from the study suggests that LC is a safe technique when performed in ambulatory practice, having similar results to other european surgical centers

Spectral catalogue of bright gamma-ray bursts detected with the BeppoSAX/GRBM

The emission process responsible for the so-called "prompt" emission of gamma-ray bursts is still unknown. A number of empirical models fitting the typical spectrum still lack a satisfactory interpretation. A few GRB spectral catalogues derived from past and present experiments are known in the literature and allow to tackle the issue of spectral properties of gamma-ray bursts on a statistical ground. We extracted and studied the time-integrated photon spectra of the 200 brightest GRBs observed with the Gamma-Ray Burst Monitor which flew aboard the BeppoSAX mission (1996-2002) to provide an independent statistical characterisation of GRB spectra. The spectra were fit with three models: a simple power-law, a cut-off power law or a Band function. The typical photon spectrum of a bright GRB consists of a low-energy index around 1.0 and a peak energy of the nuFnu spectrum E_p~240 keV in agreement with previous results on a sample of bright CGRO/BATSE bursts. Spectra of ~35% of GRBs can be fit with a power-law with a photon index around 2, indicative of peak energies either close to or outside the GRBM energy boundaries. We confirm the correlation between E_p and fluence, with a logarithmic dispersion of 0.13 around the power-law with index 0.21+-0.06. The low-energy and peak energy distributions are not yet explained in the current literature. The capability of measuring time-resolved spectra over a broadband energy range, ensuring precise measurements of parameters such as E_p, will be crucial for future experiments (abridged).Comment: 28 pages, 20 figures, 3 tables, accepted to A&

Recommended age groups and frequency of mammography screening : a systematic review

Esta revisão teve por objetivo avaliar a força de evidência do atual indicador de desempenho português relativo ao rastreio do Câncer da Mama através da mamografia, de modo a determinar o grupo etário e a periodicidade recomendadas. Foram pesquisados artigos nas principais bases de dados internacionais de literatura médica. Incluímos artigos publicados entre Janeiro de 2006 e Janeiro de 2012 que correspondiam aos objetivos da revisão. Foi utilizada a taxonomia SORT para a classificação dos resultados. Dos 253 artigos encontrados foram selecionados cinco que cumpriam os critérios de inclusão. Estes incluem três revisões sistemáticas (RS), uma meta-análise (MA) e uma norma de orientação clínica (NOC) baseada numa RS. Os artigos selecionados avaliaram a redução da mortalidade por câncer da mama através do rastreio com mamografia. A realização do rastreio mamográfico entre os 50 e os 69 anos é recomendado em todos os artigos que avaliam esta faixa etária. A NOC recomenda o rastreio bienal. Em suma, a mamografia deverá ser realizada entre os 50 e os 69 anos com uma periodicidade bienal. Estes resultados vão ao encontro do atual indicador de desempenho do rastreio do câncer da mama em Portugal.The scope of this review was to assess the strength of evidence for the current Portuguese performance indicator on breast cancer screening with mammography in order to determine the recommended age group and periodicity for screening. A search for articles was conducted in the main international databases of medical literature. Articles published between January 2006 and January 2012 addressing the objectives of this review were included. The SORT taxonomy was used to classify the results. Of the 253 articles, five articles met the inclusion criteria and were selected for review. These included three systematic reviews, one meta-analysis and one clinical guideline based on a systematic review. A reduction in breast cancer mortality with mamography screening was the outcome in all articles selected. Mammography screening between 50 and 69 years was recommended in all articles that assess this age group. The clinical guidelines recommended screening every two years. In conclusion, the current literature recommends mammography for women every two years between the ages of 50 and 69 years. This is consistent with the current performance indicator for breast cancer screening in Portugal