Topical 1% Nalbuphine on corneal sensivity and epitheilization after experimental lamellar keratectomy in rabbits

The present study was aimed to evaluate the effects of topical 1% nalbuphine on corneal sensitivity and re-epithelialization, after lamellar keratectomy in rabbits. All protocols were approved by the Animal Care Comission of São Paulo State University (Protocol 028793-08) and were conducted in accordance with the Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO) statement for the use of animals in research. Surgeries were performed on the left eye (Nalbuphine Group) and on the right eye (Control Group). Two groups were formed (n=10) and corneas received either 30µl of 1% nalbuphine (NG) or 30µl of 0,9% saline (CG). Treatments occurred at 7, 11, 15 and 19 hours. After the surgery, the corneas were stained with fluorescein and photographed daily; corneal touch threshold (CTT) was assessed with Cochet-Bonnet aesthesiometer, at 7 and 19 hours, 20 minutes after treatments. Data were statistically compared with repeated measures ANOVA and Bonferroni post-hoc test, and T test (P0.05); however, a higher area under the curve for both parameters was observed in the NG (2771), in comparison to CG (2164). Topical 1% nalbuphine did not change significantly corneal sensitivity and re-epithelialization, after experimental lamellar keratectomy in rabbits.Avaliaram-se os efeitos da nalbufina 1% sobre o limiar de sensibilidade corneal (LSC) e a epitelização corneal em coelhos submetidos à ceratectomia lamelar unilateral. Os procedimentos foram aprovados pela Comissão de Ética no Uso de Animais da Faculdade de Ciências Agrarias e Veterinárias da Universidade Estadual Paulista (Protocolo no 028793-08), de acordo com as normas do Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO). Conceberam-se dois grupos (n=10) e os olhos foram tratados com 30µl de Nalbufina 1% (Olho esquerdo - GN) ou com 30µl de solução salina (Olho direito - GC), às 7, 11, 15 e 19 horas das ceratectomias unilaterais, até sua reepitelização. O limiar de sensibilidade corneal (LSC) foi avaliado 20 minutos após cada tratamento, 48 horas antes e depois da ceratectomia a intervalos regulares de 12 horas (7 e 19 horas) com estesiômetro de Cochet-Bonnet. Após a realização da cirurgia, diariamente, as córneas foram coradas com fluoresceína e registradas em fotos digitais para mensuração em software Image-J. A normalidade dos dados foi avaliada ao teste de Kolmogorov-Smirnov. O limiar de sensibilidade e a área ulcerada foram comparados ao teste de Bonferroni, após ANOVA de medias repetidas (P0,05), todavia, constatou-se maior área sob a curva, relativamente ao LSC, no GN (2771), comparativamente ao GC (2164). O tempo médio±DP de reepitelização no GN foi de 7,40±0,47 dias e de 8,90±0,31 dias no GC, não havendo diferença significativa entre os grupos (P=0,11). Como conclusão, tem-se que o uso tópico de nalbufina 1% não alterou significativamente o limiar de sensibilidade e a reepitelização corneais em coelhos submetidos a ceratectomia lamelar experimental

Time to Surgery Following Short-Course Radiotherapy in Rectal Cancer and its Impact on Postoperative Outcomes. A Population-Based Study Across the English National Health Service, 2009–2014

Aims Preoperative short-course radiotherapy (SCRT) is an important treatment option for rectal cancer. The length of time between completing SCRT and surgery may influence postoperative outcomes, but the evidence available to determine the optimal interval is limited and often conflicting. Materials and methods Information was extracted from a colorectal cancer data repository (CORECT-R) on all surgically treated rectal cancer patients who received SCRT in the English National Health Service between April 2009 and December 2014. The time from radiotherapy to surgery was described across the population. Thirty-day postoperative mortality, returns to theatre, length of stay and 1-year survival were investigated in relation to the interval between radiotherapy and surgery. Results Within the cohort of 3469 patients, the time to surgery was 0–7 days for 76% of patients, 8–14 days for 19% of patients and 15–27 days for 5% of patients. There was a clear variation in relation to different patient characteristics. There was, however, no evidence of differences in postoperative outcomes in relation to interval length. Conclusions This study suggests that the time interval between SCRT and surgery does not influence postoperative outcomes up to a year after surgery. The study provides population-level, real-world evidence to complement that from clinical trials