Use of fibrinogen and thrombin sponge in pediatric split liver transplantation

Purpose: To analyze the use of this sponge in pediatric patients undergoing split-liver transplantation. Methods: Retrospective study, including 35 pediatric patients undergoing split-liver transplantation, divided into two groups according to the use of the sponge: 18 patients in Group A (no sponge) and 17 in Group B (with sponge). Results: The characteristics of recipients and donors were similar. We observed greater number of reoperation due to bleeding in the wound area in Group A (10 patients - 55.5%) than in Group B (3 patients - 17.6%)p = 0.035. The median volume of red blood cells transfused in Group A was significantly higher (73.4 +/- 102.38 mL/kg) than that in Group B (35.1 +/- 41.67 mL/kg)p = 0.048. Regarding bile leak there was no statistical difference. Conclusion: The use of the human fibrinogen and thrombin sponge, required lower volume of red blood cell transfusion and presented lower reoperation rates due to bleeding in the wound area.Univ Fed São Paulo UNIFESP, Postgrad Program Interdisciplinary Surg Sci, São Paulo, BrazilUniv Fed São Paulo, Dept Surg, Div Surg Gastroenterol, São Paulo, SP, BrazilUniv Fed São Paulo, Dept Surg, Div Pediat Surg, São Paulo, SP, BrazilUniv Fed São Paulo UNIFESP, Dept Surg, Div Surg Gastroenterol, São Paulo, SP, BrazilUniv Fed São Paulo UNIFESP, Postgrad Program Interdisciplinary Surg Sci, São Paulo, BrazilUniv Fed São Paulo, Dept Surg, Div Surg Gastroenterol, São Paulo, SP, BrazilUniv Fed São Paulo, Dept Surg, Div Pediat Surg, São Paulo, SP, BrazilUniv Fed São Paulo UNIFESP, Dept Surg, Div Surg Gastroenterol, São Paulo, SP, BrazilWeb of Scienc

Cítopunção mamária por capilaridade. Técnica e análise da eficácia do método

Entre janeiro de 1986 e dezembro de 1987, na Unidade de Mastologia do Hospital de Base do Distrito Federal, foram realizadas 525 citopunções por capilaridade, das quais 243 tiveram comprovação histopatológica através de forage e/ou peça operatória. A técnica utilizada consiste em puncionar a área suspeita com agulha calibre 25 x 0,6 mm ou 25 x 0,7 mm, em várias direções, a fim de obter material por capilaridade sem aspiração. Dos 243 casos com comprovação histopatológica, em 29 (12%) o material foi insuficiente, restando 214 casos satisfatórios para diagnóstico. A sensibilidade total nos 214 casos foi de 97%, sendo a especificidade 100% e o valor preditivo também de 100%. Não tivemos resultados falso-positivos. Em relação ao tamanho de tumores malignos, a sensibilidade foi de 95% nos tumores menores que 2,5 cm; 94% entre 2,5cm e 5,0 cm e 100% nos maiores de 5cm. A sensibilidade do método relacionou-se com as características do tumor, a técnica utilizada e a experiência do citopatologista. Com a citopunção sem aspiração, observamos uma menor distorção celular e menos esfregaços hemorrágicos, quando em comparação com a citopunção aspirativa. É uma técnica simples, inócua e barata, mas que exige treinamento e sensibilidade táctil para obtermos bons resultados

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost