Ivone da Silva Duarte

Avaliação clínica e epidemiológica das úlceras por pressão em pacientes internados no Hospital São Paulo

BACKGROUND: To determine the profile of patients at the Hospital Sao Paulo with pressure ulcers (PU). METHODS: A prospective study was carried out. Seventy-eight patients with pressure ulcers were evaluated between May 1st and 31st of 2002. The questionnaire consisted of demographic and clinical data of the population, PU classification and Braden Scale. RESULTS: Concerning 78 patients with PU: 66.7% were over 61 years old (average: 64). The average period of hospitalization was 33 days. 68% (53) developed ulcers while hospitalized, of which 43.7% (34) were pre-ulcers. The most frequent causes of hospitalization were neurological diseases (29.5%) and cancer (29.5%). Regarding the classification of the pressure ulcers, all stages were found on the sacrum, being 24.4% (19) pre-ulcer, 38.5% (30) stage II, 11.5%(9) stage III and 12.8%(10) at stage IV. According to the Braden Scale, half of the patients hospitalized showed severe risk of PU development, while 20.5% (16) showed moderate risk and 19.3% (15) showed low risk. CONCLUSIONS: The study showed a high risk of PU development, indicating the importance of having knowledge about the main characteristics of the hospitalized patients who may develop pressure ulcers, and, thus, preventing them.

Experimental model for fibroblast culture

The use of cell culture methods in Plastic Surgery opened a new horizon in the research of cellular mechanisms of proliferation and biosynthesis functions. Several types of cells have been investigated in the cutaneous compartment. Keratinocytes and fibroblasts have been studied aiming the possibility of developing biomaterial for skin substitution. The present study describes the standardization for the development of fibroblast primary culture, its utilization in experiments and its storage.

Electric microcurrent in the restoration of the skin undergone a trichloroacetic acid peeling in rats

OBJETIVO: Investigar a influencia da estimulacao eletrica neuromuscular por microcorrente (MENS - Microcurrent Electric Neuromuscular Stimulation) na restauracao da pele de ratos submetidos ao peeling com ATA (acido tricloroacetico). METODOS: Foram utilizados 32 ratos hair less machos adultos, separados em dois grupos (com 16 animais cada).No Grupo Controle (G1) foi simulada a aplicacao da microcorrente 48 horas apos o peeling. No Grupo Experimental (G2) a MENS foi aplicada 48 horas apos o peeling com ATA, realizada, a cada 48 horas, ate o 21o dia, com frequencia de 0,5 Hz, intensidade de 50m A e duracao de 20 minutos. Avaliou-se a area da lesao no 7o ,14o e 21o dia pos-peeling, com o Metodo Gabarito de Papel, e no 21o dia foi realizada a analise histologica. RESULTADOS: Na microscopia foram observadas modificacoes na quantidade e na estrutura dos fibroblastos, e no colageno do Grupo Experimental em relacao ao Grupo Controle. Pelo Metodo Gabarito de Papel, observou-se reducao do tempo para a restauracao total da area de lesao no grupo experimental , com diferenca de significância estatistica de (p<0,01). CONCLUSAO: A MENS diminuiu o periodo de restauracao da area submetida ao peeling com ATA em pele de ratos.

STEM CELLS HEMATOPOIETIC NICHES AND INFLAMMATORY RESPONSE TO DIFFERENT SYNTHETIC PROSTHESIS IMPLANTED IN RAT WITH INCISIONAL HERNIAS

ABSTRACT Background: Extramedullary hematopoiesis depends on complex pathophysiological mechanisms linked to hematopoietic stem cells and the proteins considered mediators of the inflammation. The identification of hematopoietic cells outside bone marrow in the adult is an occurrence that can occasionally follows the inflammatory response, was considered a secondary occurrence, but current biomolecular studies have changed that concept. Aim: Describe the presence of clusters of precursor cells of platelets (megakaryocytes), and cells of the inflammatory response in the abdominal wall and spleen of rats with experimentally induced incisional hernias and repaired with different synthetic prostheses. Methods: Twenty-five rats with incisional hernias previously performed, were divided into groups of five animals each: Group 1, repair of the hernia defect without prosthetic implant; Group 2, repair with polypropylene prosthesis; Group 3, repair using polypropylene with low weight; Group 4, the use of polypropylene and polyglecaprone prosthesis; Group 5, of polypropylene and polyglactin prosthesis. All prostheses were cut in rhombus format with area 2,625 cm². The animals were reoperated after 10 days, the abdominal walls were removed with the viscera attached to them and the material was processed for histological study. Results: Megakaryocyte niches in the abdominal wall and spleen, occasionally removed together with the adhesions produced in animals with implantation of prostheses and significant inflammatory reaction. Conclusion: The intense inflammatory reaction due to the prostheses with polypropylene in their composition was disproportionate to the expected response, indicating that further studies should be accomplished including immunophenotyping evaluation and specific panels of monoclonal antibodies to better understand the findings.

Vitamin C and oxidative stress on cultured human keratinocytes

The aim of this research was to study the hypoxia-induced oxidative stress on cultured human keratinocytes. Control and cultured human keratinocytes were treated with vitamin C, and were then assessed by determining the concentration of malonyl dialdehyde (a final product of lipid peroxidation) existing in the cultured environment. Forty-eight flasks with culture of keratinocytes in confluent layer were divided into four groups: one control and one experimental group treated with vitamin C, and one control and one experimental group without vitamin C. All the cultures were sampled for malonyl dialdehyde assessment immediately after the end of a 30 min period of hypoxia. The statistical analysis of the results showed that vitamin C was not an effective protective agent against oxidative stress caused by hypoxia.

Tratamento cirúrgico da ptose palpebral adquirida (linfocitoma cútis)

A clinical case of acquired palpebral ptosis caused by a rare pathology, lymphocitoma cutis, is reported. An eyelid ptosis was characterized with the patient unable to lift the eyelid. The resection of the eyelid nodules was performed using blefaroplasty incision as access and the result of the anatomopathological examination confirmed the diagnosis: lymphocitoma cutis. The surgical result was satisfactory not only esthetically but also functionally (2-year follow-up).

Disseminated Lymphocytoma Cutis: Case Report

Lymphocytoma Cutis is a rare pathology affecting mainly the head and neck. Because of its rarity, the authors describe a clinical case in which the face was severely affected. Histological examination was conducted, and surgical management for functional eyelid improvement was prescribed.Abstract. Lymphocytoma Cutis is a rare pathology affecting mainly the head and neck. Because of its rarity, the authors describe a clinical case in which the face was severely affected. Histological examination was conducted, and surgical management for functional eyelid improvement was prescribed.