To evaluate the use of external fixators in the delta-type kickstand configuration as an adjuvant method in the postoperative period of patients submitted to free flaps in the lower limbs.
A total ...of 17 external delta fixators were used in patients submitted to free flaps in the lower limbs. The surgical technique was performed in a standardized manner, with the distal pin located 6 cm proximally to the anastomosis, and the proximal pin, 6 cm distally to the anterior tuberosity of the tibia.
The mean age of the sample was of 34.76 years (range: 15 to 66 years). In total, 11 men and 6 women were selected. The posterior tibial artery was used in 14 cases, and the anterior tibial artery, in 3 cases. The mean time of use of the external fixators was of 3.88 weeks. The rate of reoperation was of 17.64%; that of retail loss was of 11.76%; that of success rate was of 88.23%; and the rate of infection was of 5.9%.
The use of delta-type fixators as an adjunct method in the postoperative period is reliable; however, more studies are needed to evaluate its true role in the postoperative period.
Consumption of a Western diet during the perinatal period is associated with development of cardiovascular disease. Resistance training (RT) has been used to treat cardiovascular disorders. The aim ...of this work was to assess the effect of RT on cardiometabolic disorders in rats exposed to a Western diet in the perinatal period.
Female Wistar rats were fed with control or Western diet during pregnancy and lactation. The pups were divided into three groups: Control (C), Western Diet Sedentary (WDS) and Western Diet + RT (WDRT). At 60 days of age, all animals started the RT protocol (five times a week for four weeks). At the end, blood pressure was recorded for analysis of heart rate variability and baroreflex sensitivity (BRS). Blood samples were collected for biochemical analysis.
RT reduced blood pressure and vascular sympathetic modulation and increased BRS. There were improvements in biochemical profile, with reductions in fasting blood glucose, total cholesterol and low-density lipoprotein, and an increase in high-density lipoprotein.
RT led to beneficial adaptations in the cardiovascular system, mediated by changes in the mechanisms of autonomic control and biochemical profile of animals exposed to a Western diet in the perinatal period.
Background Survival in pancreatic cancer remains poor with curative potential dependent on operative resection. We reviewed national adherence to practice guidelines to evaluate regional variation in ...the treatment and survival of patients with pancreatic cancer. Methods Retrospective cohort review of adults with pancreatic adenocarcinoma using the National Cancer Data Base from 2006 to 2013. Overall survival was compared by the Kaplan-Meier method and Cox proportional hazards models. Sequential multivariate logistic regression models were generated for odds of: a) diagnosis in stage I/II, b) resection, and c) receipt of multimodality therapy, defined as operative resection plus chemotherapy with or without radiation. Five geographic regions of the United States were used for analyses. Results A total of 115,952 patients were identified. At least 22% of patients in all stages received no treatment, with only 38.4% and 32.3% of stage I and II patients receiving multimodality therapy. On unadjusted analysis, the Northeast had the greatest survival for all stages of disease, most pronounced for stage I where patients lived 2 to 3 more months (log-rank P < .0001). While adjusted odds of early diagnosis and resection were comparable or greater across regions relative to the Northeast, patients who underwent resection in the Northeast were significantly more likely to receive multimodality therapy. Multivariate Cox modeling for patients receiving multimodality therapy accounted for differences in 3 of 4 remaining regions. Conclusion Regional variations exist in pancreatic cancer treatment and survival. While providing multimodality cancer-directed therapy can help mitigate these differences, survival with pancreatic cancer needs to be interpreted in the context of overall health, underlying risk factors, and life expectancy.
Resumo
Objetivo
Avaliar o uso de fixadores externos, na configuração
kickstand
do tipo delta, como método adjuvante no período pós-operatório de pacientes submetidos a retalhos livres nos membros ...inferiores.
Métodos
Ao todo, 17 fixadores externos do tipo delta foram utilizados em pacientes submetidos a retalhos livres nos membros inferiores. A técnica cirúrgica foi realizada de forma padronizada, com o pino distal localizado 6 cm proximal à anastomose, e o pino proximal, 6cm distal à tuberosidade anterior da tíbia.
Resultados
A idade média da amostra foi de 34,76 anos (variação: 15 a 66 anos). Foram selecionados 11 homens e 6 mulheres. Utilizou-se a artéria tibial posterior em 14 casos, e a tibial anterior, em 3 casos. O tempo médio de uso dos fixadores externos foi de 3,88 semanas. A taxa de reoperação foi de 17,64%; a de perda do retalho foi de 11,76%; a de sucesso foi de 88,23%; e a taxa de infecção foi de 5,9%.
Conclusão
O uso de fixadores do tipo delta como método adjuvante no pós-operatório é confiável; porém, mais estudos são necessários para avaliar seu verdadeiro papel no pós-operatório.
Abstract
Objective
To evaluate the use of external fixators in the delta-type kickstand configuration as an adjuvant method in the postoperative period of patients submitted to free flaps in the lower limbs.
Methods
A total of 17 external delta fixators were used in patients submitted to free flaps in the lower limbs. The surgical technique was performed in a standardized manner, with the distal pin located 6 cm proximally to the anastomosis, and the proximal pin, 6 cm distally to the anterior tuberosity of the tibia.
Results
The mean age of the sample was of 34.76 years (range: 15 to 66 years). In total, 11 men and 6 women were selected. The posterior tibial artery was used in 14 cases, and the anterior tibial artery, in 3 cases. The mean time of use of the external fixators was of 3.88 weeks. The rate of reoperation was of 17.64%; that of retail loss was of 11.76%; that of success rate was of 88.23%; and the rate of infection was of 5.9%.
Conclusion
The use of delta-type fixators as an adjunct method in the postoperative period is reliable; however, more studies are needed to evaluate its true role in the postoperative period.
The superiority of surgical cut-down of the cephalic vein versus percutaneous catheterization of the subclavian vein for the insertion of totally implantable venous access devices (TIVADs) is ...debated. To compare the safety and efficacy of surgical cut-down versus percutaneous placement of TIVADs. This is a single-institution retrospective cohort study of oncologic patients who had TIVADs implanted by 14 surgeons. Primary outcomes were inability to place TIVAD by the primary approach and postoperative complications within 30 days. Multivariate analysis was performed by logistic regression. Secondary outcomes included operative time. Two hundred and forty-seven (55.9%) percutaneous and 195 (44.1%) cephalic cut-down patients were identified. The 30-day complication rate was 5.2 per cent: 14 patients (5.7%) in the percutaneous and nine (4.6%) in the cut-down group. The technique was not a significant predictor of having a 30-day complication (odds ratio = 0.820; 95% confidence interval 0.342–1.879). Implantation failure was observed in 16 percutaneous patients (6.5%) and 28 cut-down patients (14.4%) (adjusted odds ratio for cephalic vs cut-down = 2.387; 95% confidence interval 1.275–4.606). The median operative time for percutaneous patients was 46 minutes (interquartile range = 35, 59) versus 37.5 minutes (interquartile range = 30, 49) for cut-down patients(P < 0.0001). Both the percutaneous and cut-down technique are safe and effective for TIVAD implantation. Operative times were shorter and the odds of implantation failure higher for cephalic cut-down. As implantation failure is common, surgeons should familiarize themselves with both techniques.
O consumo da dieta ocidental está associado ao surgimento de doenças cardiovasculares. O treinamento de resistência (TR) tem sido utilizado no tratamento destas doenças. O objetivo deste trabalho foi ...avaliar o efeito do TR sobre as alterações cardiometabólicas na prole de ratas expostas a dieta ocidental no período perinatal.
Ratas Wistar receberam dieta controle ou ocidental durante a gravidez e lactação. Os filhotes foram divididos em três grupos: Controle (C), dieta ocidental sedentário (OCS) e dieta ocidental+TR (OCTR). Aos 60 dias de vida, os animais iniciaram o protocolo de TR realizado cinco vezes por semana durante quatro semanas. Ao fim, foi registrada pressão arterial para análise da variabilidade da frequência cardíaca e sensibilidade do barorreflexo (SBR). Amostras de sangue foram coletadas para análise bioquímica.
O TR foi capaz de reduzir a pressão arterial, a modulação simpática vascular e aumentar a SBR. Houve melhoria no perfil bioquímico, com redução na glicemia de jejum, colesterol total e lipoproteínas de baixa densidade, além de aumento das lipoproteínas de alta densidade.
O TR promoveu adaptações benéficas ao sistema cardiovascular, mediadas por ajustes nos mecanismos de controle autonômico e perfil bioquímico dos animais expostos à dieta ocidental no período perinatal.
Consumption of a Western diet during the perinatal period is associated with development of cardiovascular disease. Resistance training (RT) has been used to treat cardiovascular disorders. The aim of this work was to assess the effect of RT on cardiometabolic disorders in rats exposed to a Western diet in the perinatal period.
Female Wistar rats were fed with control or Western diet during pregnancy and lactation. The pups were divided into three groups: Control (C), Western Diet Sedentary (WDS) and Western Diet + RT (WDRT). At 60 days of age, all animals started the RT protocol (five times a week for four weeks). At the end, blood pressure was recorded for analysis of heart rate variability and baroreflex sensitivity (BRS). Blood samples were collected for biochemical analysis.
RT reduced blood pressure and vascular sympathetic modulation and increased BRS. There were improvements in biochemical profile, with reductions in fasting blood glucose, total cholesterol and low‐density lipoprotein, and an increase in high‐density lipoprotein.
RT led to beneficial adaptations in the cardiovascular system, mediated by changes in the mechanisms of autonomic control and biochemical profile of animals exposed to a Western diet in the perinatal period.
Resumo: Introdução e objetivos: O consumo da dieta ocidental está associado ao surgimento de doenças cardiovasculares. O treinamento de resistência (TR) tem sido utilizado no tratamento destas ...doenças. O objetivo deste trabalho foi avaliar o efeito do TR sobre as alterações cardiometabólicas na prole de ratas expostas a dieta ocidental no período perinatal. Métodos: Ratas Wistar receberam dieta controle ou ocidental durante a gravidez e lactação. Os filhotes foram divididos em três grupos: Controle (C), dieta ocidental sedentário (OCS) e dieta ocidental + TR (OCTR). Aos 60 dias de vida, os animais iniciaram o protocolo de TR realizado cinco vezes por semana durante quatro semanas. Ao fim, foi registrada pressão arterial para análise da variabilidade da frequência cardíaca e sensibilidade do barorreflexo (SBR). Amostras de sangue foram coletadas para análise bioquímica. Resultados: O TR foi capaz de reduzir a pressão arterial, a modulação simpática vascular e aumentar a SBR. Houve melhoria no perfil bioquímico, com redução na glicemia de jejum, colesterol total e lipoproteínas de baixa densidade, além de aumento das lipoproteínas de alta densidade. Conclusão: O TR promoveu adaptações benéficas ao sistema cardiovascular, mediadas por ajustes nos mecanismos de controle autonômico e perfil bioquímico dos animais expostos à dieta ocidental no período perinatal. Abstract: Introduction and objectives: Consumption of a Western diet during the perinatal period is associated with development of cardiovascular disease. Resistance training (RT) has been used to treat cardiovascular disorders. The aim of this work was to assess the effect of RT on cardiometabolic disorders in rats exposed to a Western diet in the perinatal period. Methods: Female Wistar rats were fed with control or Western diet during pregnancy and lactation. The pups were divided into three groups: Control (C), Western Diet Sedentary (WDS) and Western Diet + RT (WDRT). At 60 days of age, all animals started the RT protocol (five times a week for four weeks). At the end, blood pressure was recorded for analysis of heart rate variability and baroreflex sensitivity (BRS). Blood samples were collected for biochemical analysis. Results: RT reduced blood pressure and vascular sympathetic modulation and increased BRS. There were improvements in biochemical profile, with reductions in fasting blood glucose, total cholesterol and low‐density lipoprotein, and an increase in high‐density lipoprotein. Conclusion: RT led to beneficial adaptations in the cardiovascular system, mediated by changes in the mechanisms of autonomic control and biochemical profile of animals exposed to a Western diet in the perinatal period. Palavras‐chave: Treinamento de resistência, Sistema nervoso autônomo, Dieta ocidental, Keywords: Resistance training, Autonomic nervous system, Western diet
AbstractIntroduction and ObjectivesConsumption of a Western diet during the perinatal period is associated with development of cardiovascular disease. Resistance training (RT) has been used to treat ...cardiovascular disorders. The aim of this work was to assess the effect of RT on cardiometabolic disorders in rats exposed to a Western diet in the perinatal period.MethodsFemale Wistar rats were fed with control or Western diet during pregnancy and lactation. The pups were divided into three groups: Control (C), Western Diet Sedentary (WDS) and Western Diet+RT (WDRT). At 60 days of age, all animals started the RT protocol (five times a week for four weeks). At the end, blood pressure was recorded for analysis of heart rate variability and baroreflex sensitivity (BRS). Blood samples were collected for biochemical analysis.ResultsRT reduced blood pressure and vascular sympathetic modulation and increased BRS. There were improvements in biochemical profile, with reductions in fasting blood glucose, total cholesterol and low-density lipoprotein, and an increase in high-density lipoprotein.ConclusionRT led to beneficial adaptations in the cardiovascular system, mediated by changes in the mechanisms of autonomic control and biochemical profile of animals exposed to a Western diet in the perinatal period.
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Studies have shown that hormonal, metabolic and nutritional disorders during the early phase of development and/or in the gestation may lead to transitory or permanent structural and ...functional changes of several organs of the offspring. Our aim was to investigate the impact of high fat diet during the gestation and lactation on biochemical parameters in the offspring of rats. High fat diet was given from day 1 of gestation until weaning of puppies. The biochemical evaluation was performed at 30, 60 and 90 days after birth from High Fat Diet dams (HFDD, n= 6) or Normal Diet dams (NDD, n= 6). Animals from HFDD group presented hyperglycemia starting from day 30 (119 ± 1.6 vs 94.03 ± 2 mg/dl, p<0.05) and LDL (45 ± 7 vs 23 ± 4 mg/dl, p<0.05). In the day 60 OHFD showed difference at TAG ( 61 ± 3 vs 51 ± 1 mg/dl, p<0.05), TC ( 98 ± 5 vs 75 ± 2 mg/dl, p<0.05), VLDL ( 13 ± 0.69 vs 10 ± 0.2 mg/dl, p<0.05) and decrease HDL (42 ± 3 vs 61.42 ± 4 mg/dl, p<0.05). These findings suggest that high fat diet during pregnancy and lactation leads dyslipidemia in adult offspring rats.
Support: CNPq, Fapitec and CAPES
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