Enhanced Recovery After Surgery®: resultados iniciais da implementação do programa em cirurgia de cólon e fígado na Santa Casa de Porto Alegre, Brasil

The ERAS protocol aims to reduce the stress response associated with surgery.El protocolo ERAS tiene como meta reducir la respuesta al estrés asociada a cirugía.O protocolo ERAS visa reduzir a resposta ao estresse associada à cirurgi

Altered expression of COX-2 and TNF-α in patients with hepatocellular carcinoma

Background and aim: hepatocellular carcinoma is a type of cancer related with inflammation, as 90% of cases develop in a chronic inflammation condition. Excess inflammation can affect tissue homeostasis. Cytokines and inflammatory mediators are immunological components that can influence the functioning of cells and tissues. In addition, the estrogen receptor appears to play an important role in hepatocarcinogenesis. The aim of the study was to evaluate the expression of inflammatory markers and ER in patients with hepatocellular carcinoma. Methods: data from 143 patients of ISCMPA were analyzed. Immunohistochemistry was performed of cyclooxygenase-2 enzyme (COX-2), nuclear factor kappa B (NF-κB), tumor necrosis factor alpha (TNF-α) and ER in paraffin-embedded hepatic tissue. The percentage of the stained area, intensity of staining and of the number of ER positive nuclei were evaluated using the ImageJ 1.50 software. Results and conclusion: there was a significant difference between the groups in terms of the percentage of marked area (p = 0.040) for COX-2 and the intensity of staining of TNF-α (p = 0.030). No significant differences were observed in any of other parameters evaluated. In conclusion, COX2 and TNF-α are possible markers that should be further studied to determine their immunohistochemical profile and role in HCC development

Contribuição ao estudo do carcinoma epidermóide de esôfago

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Contribuição ao estudo do carcinoma epidermóide de esôfago

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Implicações cirurgicas do carcinoma multifocal do esofago

Orientador : Luiz Sergio LeonardiTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias MedicasResumo: Neste estudo foram avaliados 58 pacientes portadores de carcinoma epidermóide de esôfago. Aspectos da clínica cirúrgica destes pacientes foram analisados secundariamente, pois a ênfase deste trabalho foi o estudo anatomopatológico de peças operatórias. Foram realizados vários cortes a partir da borda tumoral com o objetivo de estudar o fenômeno do carcinoma multifocal do esôfago, as alterações celulares e a permeação vascular na base tumorale Os resultados obtidos mostraram nesta série, 8 (13,79%) casos de carcinoma multifocal. Estes dados contra-indicam ressecções segmentares que estariam propensas a recidivas locais ou a não remoção de foco tumoral distante do tumor principal.Abstract: In this study fifty eigth patients with epidermoid carcinoma of the esophagus have been evaluated. Since the emphasis was on the pathological anatomy of the surgically removed specimens, the clinical aspects were put on a second plan. Several slices have been done from macroscopic tumoral edge aiming to detect the phenomenon of the multicentric carcinoma of the esophagus, celular alterations and the vaseular permeation of the tumoral base. The obtained results showed in this series 8 (13,79%) cases of multicentric carcinoma. These data do not recommend segmental ressections wich could allowed local recurrences or the non removal of a distant tumoral foci from the principal tumor.DoutoradoDoutor em Cirurgi