125 research outputs found

    Death certificate: admitting uncertainty

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    The pedagogical value of autopsy

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    Knowledge of human anatomy was acquired through dissections of the human body that may have begun as long as 4000 years ago, in Babylonian times. Later documentation was in Egyptian times (3000 BC-1600 BC), as exemplified with the Ebers and other papyri. Around 300 BC, the Greek physician, Herophilus (335-280 BC), wrote a treatise on human anatomy and Erasistratus (304-250 BC), his student and colleague at the medical school of Alexandria, produced the first description, albeit brief, of liver cirrhosis observing that the liver of a man who died with anasarca (“hydrops”) was “as hard as a rock”, contrasting it with the soft consistency of the liver of another man who died from the bite of a poisonous snake. This description is evidence of Erasistratus’s ability, based on observation, to correlate the diseased organ with the consequence of its involvement and may be the first example of a clinicopathological correlation

    Periprostatic venous thrombosis

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    Thoracoscopy to diagnose and to liberate adhesions in post-operative thoracotomy and in video-assisted thoracic surgery- VATS. Experimental study in dogs

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    Fourteen adult mongrel dogs were used, 7 males and 7 females, proceeding from the Federal University ofSanta Maria, aiming to study thoracoscopy to evaluate comparatively the presence and attempt to liberatepost thoracotomy adhesions (TI) and post video-assisted thoracic surgery (VATS). The animals were dividedin 2 groups. In the X group, the visibilization and attempt of liberate adhesions after VATS were carriedthrough from 3 to 5 days (B1) and from 9 to 11 days (B3) after thoracotomy. In group Y, the procedures werecarried through from 6 to 8 days post thoracotomy (B2). Blood samples for CK screening were taken beforeTI (A0), after the end of the surgical procedure (A1), and in the next 2 days (A2 and A3). The adhesionsenclose the location of VATS and thoracotomy incisions, and their extension is smaller after VATS, due tosmaller tissue damage extension. It is possible to liberate the adhesions by thoracoscopy in up to 5 daysfrom surgical procedure, using two work ports. The increase of the CK seric levels is proportional to thetissue damage. In conclusion, thoracoscopy can be used to diagnose thoracotomy and VATS adhesions,and liberate the adhesion in up to 5 days after the surgical procedure. High incidence of adhesions in thisstudy may lead to serious surgical risks and requires special care in future reinterventions. The ethiccommission from UFSM approved this study UFSM (012/2005). All animals were adopted.Foram utilizados 14 cães, 7 machos e 7 fêmeas, provenientes do Biotério Central da UFSM, objetivando-seutilizar a toracoscopia para avaliar comparativamente a presença e a possibilidade de liberação deaderências pós-toracotomia e pós-CTVA (Cirurgia Torácica Vídeo-Assistida). Todos os animais foramsubmetidos à toracotomia TI e após, estes foram divididos em 2 grupos. No grupo X, a visibilização, aliberação das aderências e a CTVA foram realizadas entre 3 e 5 dias (B1) e entre 9 e 11 dias (B3) de pósoperatório,e no grupo Y, os procedimentos foram realizados entre 6 e 8 dias após a toracotomia (B2). Foicolhido sangue para dosagem de CK (creatina quinase) em diferentes tempos para avaliar a intensidade detrauma tecidual. As aderências localizaram-se nos locais das incisões de CTVA e de toracotomia,apresentando extensão menor após CTVA, devido a menor extensão de dano tecidual. Foi possível realizara liberação de aderências por toracoscopia em até cinco dias de pós-operatório utilizando dois portais. Nascondições em que este trabalho foi realizado, conclui-se que a toracoscopia mostra-se eficiente paradiagnosticar aderências provenientes de toracotomia e de CTVA e podem-se liberar as aderências até cincodias de pós-operatório. A alta incidência de aderências para os procedimentos testados predispõe a sériosriscos cirúrgicos e requer cuidados especiais em futuras re-intervenções, Este estudo foi aprovado pelacomissão de ética da UFSM (012/2005). Todos os animais foram adotados
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