Retalho perfurante da artéria epigástrica profunda superior : efeito da vascularização venosa ampliada em modelo experimental em ratos /

Orientador: Antonio Carlos L.CamposDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Clínica Cirúrgica. Defesa: Curitiba, 2005.Inclui bibliografia e anexo

Breast implant-associated anaplastic large cell lymphoma: a diagnostic challenge

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a provisional entity with morphological and immunophenotypic characteristics indistinguishable from ALK-negative anaplastic large cell lymphoma (ALCL). Unlike ALCL, BIA-ALCL arises mainly in association with breast implantation. Diagnostic confirmation of BIA-ALCL can be difficult and associating morphological and pathological hallmarks with flow cytometry and immunohistochemistry can assist in the diagnosis. The objective of this report is to describe a case of BIA-ALCL in which cytological and immunophenotypological analysis using flow cytometry suggested the presence of large CD30-positive cells in the effusion fluid

Retalho perfurante da artéria epigástrica profunda superior : efeito da vascularização venosa ampliada em modelo experimental em ratos /

Orientador: Antonio Carlos L.CamposDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Clínica Cirúrgica. Defesa: Curitiba, 2005.Inclui bibliografia e anexo

Dianexina na lesão de isquemia reperfusão na musculatura estriada de ratos

Orientador: Prof. Dr. Antonio Carlos L. CamposTese (doutorado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Clínica Cirúrgica. Defesa: Curitiba, 20/04/2011Bibliografia: fls. 58-63Resumo: Introdução: Lesão de isquemia reperfusão e uma sequela comum e devastadora do retorno do fluxo sanguíneo a um tecido submetido a isquemia. Fosfatidilserina e um fosfolipide que compõe a membrana celular, e que sob condições normais, encontra-se apenas na face citoplasmática da membrana celular. Entretanto, durante a isquemia, a fosfatidilserina é translocada para a face externa da membrana celular, e, no caso das celulas endoteliais, para o interior da microcirculação. A externalização da fosfatidilserina promove a ativação dos leucócitos e plaquetas, com consequente piora da lesão de isquemia reperfusão. Dianexina e um dímero sintético da anexina A5 humana, e um potente bloqueador da fosfatidilserina, com maior meia vida e afinidade pela fosfatidilserina do que a anexina a5. Esta capacidade de bloqueio da fosfatidilserina pela dianexina inibe a ligação de leucócitos ao endotelio, com possíveis aplicações no tratamento/prevenção da lesão de isquemia reperfusão. O objetivo do presente estudo é determinar se a dianexina tem efeitos protetores na microcirculação no retalho de músculo cremaster de ratos submetido a 2 horas de isquemia. Material e Método: 53 ratos Lewis foram submetidos a dissecação do retalho cremaster e distribuidos aleatoriamente em 4 grupos: 1)CONTROLE sem isquemia; 2)PLACEBO e 2h de isquemia; 3)PRE . administração de 100ƒÊg/kg de dianexina antes do período de 2 h de isquemia; e 4)POS - administração de 100ƒÊg/kg de dianexina imediatamente após o período 2 h de isquemia. Foram realizadas observações seqüênciais de parâmetros hemodinâmicos e de permeabilidade: diâmetro dos vasos; velocidade de fluxo sanguíneo; índice de edema; densidade capilar; interações leucócitos endoteliais e índice de permeabilidade. A media de cada parâmetro a cada momento de avalição foi comparada entre os grupos utilizando análise de variancia (ANOVA) e teste t foi utilizado para comparações entre pares de grupos. Os dados são expressos como média } erro padrão (p.0,05). Resultados: O grupo POS obteve o menor índice de permeabilidade comparado ao grupo PLACEBO (0,45 }0,035 vs 054 }0,046)(p=0,043). O grupo POS demonstrou aumento no diâmetro da arteríola de 1a ordem em comparação ao grupo CONTROLE (91,71 }3,36 vs 69,61 }7,81)(p=0,011) e ao grupo PRE (91,71 }3,36 vs 73,22 }4,03)(p=0,015). A dianexina inibiu a transmigração de leucócitos no grupo POS, a adesao de leucócitos ao endotelio no grupo PRE e o rolamento de leucócitos nos grupos PRE e POS. Conclusão: A administraçao de dianexina, especialmente quando administrada apos a isquemia (grupo POS) promove redução da ativação dos leucócitos e protege o músculo da o de isquemia reperfusão em um modelo de 2h de isquemia em músculo cremaster de ratos.Abstract: Introduction: Ischemia reperfusion injury is a common and devastating sequel of blood flow restoration after ischemia. Phosphatidylserine is a phospholipid restricted to the inner side of the cell membran however, during ischemia, PS is externalized to the microcirculation lumen, thereby activating leukocytes and platelets, and aggravating ischemia reperfusion injury. Diannexin is a syntetic drug, a recombinant homodimer of human anexin A5, and a potent blocker of phosphatidylserine, with higher affinity for phosphatidylserine and longer half life than the monomer. Such affinity for phosphatidylserine inhibits leucocyte attachment to endothelial cells with possible application in ischemia reperfusion injury treatment/prevention. The aim of the study to to determine if Diannexin has protective effects on the rat cremaster muscle flap microvascular network submitted to 2 hours of ischemia. Material and Method: Fifty three Lewis rats were randomly assigned into the following groups: 1)CONTROL without ischemia; 2)PLACEBO and 2h ischemia; 3)PRE -100ƒÊg/kg Diannexin before 2h ischemia; and 4)POS - 100ƒÊg/kg Diannexin after 2h ischemia. All animals were submitted to cremaster muscle flap dissection and intravital observations, for hemodynamics and permeability parameters. Vessels diameters, blood flow velocity, edema index, capillary density, leukocyte interactions and permeability index were obtained. The mean of all parameters at each time point were compared between groups using analysis of variance (ANOVA) models, and T tests were used for comparison between pair of groups. The data is expressed as mean } standard error. Results: POS group showed the lowest permeability index compared to PLACEBO (0,45 }0,035 vs 054 }0,046)(p=0,043). Also, first-order arterioles had diameter increase in the POS group vs CONTROLE (91,71 }3,36 vs 69,61 }7,81)( p=0,011) and vs PRE (91,71 }3,36 vs 73,22 }4,03)(p=0,015). Diannexin inhibited transmigration of leukocytes in POS group, leukocyte adhesion in PRE group and leukocyte rolling in POS and PRE groups. Conclusion: Diannexin administration, particularly after the ischemic event (group POS) reduces leukocyte activation and protects muscle against IRI in a rat cremaster muscle flap submitted to 2 h ischemia

Barriers and facilitators for sustainable weight loss in the pre-conception period among Danish women with overweight or obesity – a qualitative study

Abstract Background The prevalence of overweight or obesity in women of reproductive age continues to increase. A high pre-pregnancy body mass index (BMI) has been shown to increase the risk of pregnancy complications and predispose offspring to childhood obesity. However, little is known about factors affecting women’s ability to achieve sustainable weight management and very few studies have applied behavior change theory to qualitative data. Aim This study aimed to explore barriers and facilitators for weight management among women with overweight or obesity, who wanted to lose weight before pregnancy. Methods We conducted semi-structured interviews with 17 women with a BMI ≥ 27 kg/m2, who planned to become pregnant in the near future. Data were analyzed using an abductive approach and the Capability, Opportunity, Motivation, and Behavior model was applied as a conceptual framework. Results The women’s strongest motivator for pre-conception weight loss was their ability to become pregnant. Barriers to successful weight management included their partners’ unhealthy behaviors, mental health challenges, competing priorities, and internalized weight stigmatization. The women described careful planning, partners’ health behaviors, social support, and good mental health as facilitators for sustainable weight management. Conclusion Our study provides insights into factors affecting weight management among women with overweight or obesity in the pre-conception period. Future interventions on weight management require a holistic approach, including a focus on social support, especially from the partner, and mental health, as well as an effort to limit internalized weight stigma

Robotic nipple-sparing mastectomy for cancer risk reduction: demonstration of applicability and surgical results

Introduction: Robotic nipple sparing mastectomy (RNSM) may be a breakthrough for breast cancer risk reduction surgeries, providing better aesthetic results. This study aims to spread the knowledge of the robotic surgical technique, still little performed in the world, and to demonstrate the applicability and surgical results. Methods: RNSM was offered to patients with small or medium volume breasts, ptosis up to grade 2, and all with genetic mutations at increased risk for breast cancer. The Surgical System da Vinci Si® (Intuitive Surgical, Sunnyvale, CA) was used for the surgeries. The satisfaction of each patient and the time of the surgeries were evaluated. Results: A total of 4 patients underwent surgery, all of whom had genetic mutations that would make breast cancer prevalent. The duration of the surgery was drastically reduced from 6h20min to 3h in the last surgery. There were no serious complications, such as prosthesis loss or nipple necrosis. Skin burning was noted in two patients, with complete resolution over the weeks. Conclusion: RNSM has a fast-learning curve and excellent aesthetic results in patients who fit the criteria for surgery