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Search Results: 1 - 10 of 471930 matches for " Willy Marcus Fran?a "
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Evaluation of a Modified Scleral Contact Lens as a Riboflavin Delivery Device for Corneal Collagen Crosslinking  [PDF]
Ricardo Torres Soares, Neil F. Novo, Willy Marcus Frana
Open Journal of Ophthalmology (OJOph) , 2017, DOI: 10.4236/ojoph.2017.74036
Introduction: Keratoconus is a complex corneal disease that reduces visual acuity by progressively modifying the corneal shape and thickness, usually producing myopia and irregular astigmatism. Corneal collagen crosslinking with riboflavin + ultraviolet-A radiation (CXL) has become a widely accepted treatment for progressive keratoconus. During CXL, riboflavin administration is performed by repeated manual instillation of solution drops on the cornea for 30 minutes, a procedure that is often uncomfortable for many patients and that consumes surgical facilities and staff resources. In this study, especially modified scleral contact lenses (MSCL) were employed for delivering riboflavin to the cornea during CXL. Objective: The study aimed at evaluating the safety and efficacy of MSCL as a drug delivery system, verifying if anterior chamber flare confirms riboflavin penetration and describes the impact on patient comfort and optimization of surgical staff and facility resources. Material and Method: This study included 8 eyes of 6 patients aged 16 - 25 years old with history of progressive keratoconus. After mechanical removal of corneal epithelium, the concave surface of the modified scleral contact lens was filled with riboflavin solution and the lens was placed on the patient’s eye during 30 minutes. The lens design allows the formation of a riboflavin layer between the lens and the exposed corneal stroma to facilitate riboflavin penetration. Patients with lens were allowed to stand up and wait for the second UVA phase outside the surgical room. Riboflavin diffusion was confirmed by biomicroscopic examination of the corneal stroma and anterior chamber with the lens in place. Patients returned and the lens was removed before UV-A irradiation at 3 mW/cm2 for 30 minutes. Statistical analysis was performed by comparing the following parameters of each patient pre- and post-CXL: Spherical equivalent (Sph.Eq.), Mean simulated keratometry (SimK-m) and corrected distance visual acuity (CDVA) using the Wilcoxon method for non-parametric data (p < 0. 05). Results: The MSCL allowed patients to be transferred from the surgical room to wait for corneal impregnation with riboflavin. The MSCL was effective in delivering riboflavin to the cornea as confirmed by biomicroscopic examination of the cornea and anterior chamber. No intraoperative or postoperative complications were observed. MSCL use improved the patient comfort and reduced the burden
Influence of Peritoneal Suture on the Formation of Abdominal Adhesions in Wistar Rats: Is Suturing Worthwhile?  [PDF]
Nathália Andrade, Michel Vinagre, Luciana Canabarro, Willy Marcus Frana
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.49078

Purpose: The purpose of the present study was to determine the effect of peritoneal closure on the formation of abdominal adhesions by verifying their degree of damage on intestinal portions and the omentum with the abdominal wall. Given the different reports found in the literature concerning peritoneal closure mostly in obstetrics and gynecology, any objective information based on statistically tested results may be of great value in the everyday surgery practice. Material and Method: This is an experimental model on which a laparotomy is performed on the free cavity of the abdominal wall in growing rats. Young Wistar rats (approximately 1 month old) were operated through a long median xipho-umbilical abdominal incision. The animals were divided in 3 groups with fifteen rats each: in Group I, only the peritoneum was left open and all the other layers of the abdominal wall were closed; the rats in Group II had their peritoneums closed with unabsorbable cord (Prolene 4-0, Ethicon?). The abdominal wall of the rats in Group III (control) was only opened up to the musculature. The peritoneum, which remained intact and closed, was carefully prodded with the grip of tweezers to avoid lesions and/or perforations in the peritoneum. Results: There were no deaths nor incisional dehiscence and/or hernias among the animals. Nine animals of

Comparative Study of Bovine Pericardium and Gore-Tex in Tissual Interaction with Wistar Rats Diaphragm  [PDF]
Artur Fracassi Guerra, Mauro Razuk Filho, Neil Ferreira Novo, Willy Marcus Frana
Surgical Science (SS) , 2016, DOI: 10.4236/ss.2016.79055
Abstract: Introduction: Simple suture isn’t always possible in large congenital diaphragmatic hernia (cdh) defects. Synthetic materials are used for correction such as Silastic®, Gore-Tex® (GT), Teflon® or biological, such as autologous muscle patches. It was shown that bovine pericardium (bp) was effective to correct those large defects with many positive outcomes when compared with syntactic materials. Aim: This study aims to establish an experimental model of correction for large diaphragmatic defect with PB and GT patches to compare histologically the tissue interaction between them and diaphragm in young Wistar rats. Materials & Methods: 15 wistar rats were divided in 3 groups: Rats that used BP was named G1; Rats that used GT was named G2; and rats with only scraping in the diphragm, named G3 (control). Animals were submited to a laparotomy and fixed pathces to diaphragms and harvested 3 weeks later. Area between normal diaphragm and patches were isolated and separated for histological analysis, such as lymphocytic infiltration (inflammation), neovascularization and fibrosis. Results: G1 presented inflammation between BP and Diaphragm In 5 Samples. G2 Presented Neovascularization In 5 Samples, But No inflammation. Fibrotic tissue overlapping GT patches occurred in 3 samples in G2. Comparing G1 with G2 there was a significant statistical difference concerning inflammation (
Epidemiological Study of Pediatric Surgery at Regional Hospital of Sorocaba between 2008 and 2012 by a Single Surgeon  [PDF]
Raíssa Teixeira Rosalino, Natália Iwakura Martelli, Neil F. Novo, Willy Marcus Frana
Surgical Science (SS) , 2017, DOI: 10.4236/ss.2017.88041
Abstract: Introduction: volume increase of Pediatric Surgery (PedSur) due to factors not yet fully clarified contrast with the scarcity of pediatric surgeons in Brazil and globally. Geographic distribution, surgical care costs, and graduation period might contribute to this dearth. In Brazil, vacancy occupation rate in PedSur is below 43% (162 vacancies/year). Aim: analyze the volume of procedures performed on 0 - 12 year-old patients in PedSur by a single Specialist at Hospital Regional (HR); compare with the literature and propose the outset of a PedSur Medical Residence program. Material & Method: 1912 attendances were fulfilled on 986 children who were submitted to surgical procedures between 2008 and 2012 at HR by a single specialist. Results: Surgical procedures were performed on 1137 children, an average of 227/year or 197 children per year. Surgery was carried out in 667 (68%) boys and 319 (32%) girls. Hernias, appendectomies and circumcisions were the most frequent external surgeries. 437 (44%) patients were discharged on the same day and, 549 (56%) were hospitalized. In the Pediatric ICU and in the Neonatal ICU 181 procedures were performed (18%). Conclusion: It was possible to make evident the distribution of surgeries on children, the degree of complexity and a sufficient number of subjects for training in this Specialty. The obtained data allow the development of a study with regards to the inception of a Medical Residence in PedSur at HR for training and retaining the professional in the region.
Timing of Surgery and Complications of Acute Appendicitis: A Retrospective Study  [PDF]
Ricardo Purchio Galletti, Vinicius Oliveira Fernandes, Neil Ferreira Novo, Willy Marcus Frana
Surgical Science (SS) , 2019, DOI: 10.4236/ss.2019.105018
Introduction: Acute appendicitis (AA) is the most frequent surgical condition of the abdomen during childhood. Its clinical presentation in children under 5 may be atypical and thus causes a delay in diagnosis, which often leads to complications such as perforation and peritonitis. Patients with unperforated AA at hospital admission may have their surgery postponed up to 24 hours while antibiotics are initiated without significant increase in complications, instead of undergoing immediate surgery. Immediate surgery to prevent complications has been questioned. Delaying surgery in patients admitted to hospital with AA has not increased the risk of perforation. Objective: To determine the impact of timing of surgery of patients with AA admitted to our Pediatric Surgery Ward of the Sorocaba Hospital Complex of the Medical Science and Health Faculty (CHS-PUC/SP) on the rate of complications (perforation, peritoneal drainage and infection of the surgical wound). Methods: We reviewed the records of 195 children aged 4 to 12 years, admitted between 2010 and 2014. They were separated in 2 groups according to timing of surgery under 7 hours (group A) and 7 to 24 hours (group B) and had their rate of complications (infection of the surgical wound, drainage and perforation (grade IV) assessed. Results: Ninety-seven children underwent surgery less than 7 hours after admission (group A) and 98 children were operated between 7 and 24 hours after admission (group B). Groups A and B had no significant difference regarding the rates of wound infection (p = 0.2277), peritoneal drain insertion (p = 0.4085) or perforation (p = 0.7125). Conclusions: In our study, timing of surgery for AA had no impact on the occurrence of complications, such as infection of the surgical wound, peritoneal drainage or perforation.
Venous Catheterization Experimental Model in Rabbits: Histological Alterations in the Catheter Region  [PDF]
Bianca Ribeiro Rodrigues, Gabriela Samaha Frana, Maria Cecília Ferro, Canabarro Luciana, Willy Marcus Frana
Surgical Science (SS) , 2015, DOI: 10.4236/ss.2015.612076
Abstract: Central venous access is one of the most common surgery procedures worldwide, especially in pediatric surgery. Local and regional complications as the result of venous catheter permanence time are frequently described as: thrombosis, infection, edema and local cellulite, movement and loss of the catheter. Other severe complications such as endocardiac and hemorrhagic lesions are also described and considered the cause of catheter early removal. In the literature few studies have addressed vascular and perivascular lesions and complications as the result of central venous access to peripheral veins, given the difficulty of setting up venous catheterization experimental models to study blood vessels and perivascular tissue alterations after catheterization. In the present venous catheterization experimental model, rabbits were divided into two groups based on the time that the venous catheters were maintained in their veins. Group a composed of 7 New Zealand male rabbits was submitted to a 15-day treatment; and the 6 New Zealand male rabbits of group B were treated during 90 days. Both groups presented similar inflammatory conditions since there was no significant difference between groups. Therefore, the results may well suggest that the endothelial inflammatory reaction could have developed at an early initial short period and by maintaining the catheter, the inflammatory reactions would have decreased or disappeared. Aimed at studying these vascular and perivascular alterations in venous catheterization, the present study proposes an experimental rabbit model that allows the analysis of differences in local vascular and perivascular histological variations and compares histological differences between both venous catheterization groups each of them with different periods of treatment.
Histological and Morphological Study of the Intestines of Wistar Rat Fetuses in a Modified Gastroschisis Experimental Model  [PDF]
André Luis Hecht Sartori, Marina Ferreira Rosa de Vilhena, Gabriela Samaha Frana, Willy Marcus Frana
Surgical Science (SS) , 2016, DOI: 10.4236/ss.2016.72010
Abstract: In gastroschisis (G), the lesion degree of exposed intestinal segments is related to the time of its contact with the amniotic fluid (AF) and exposure to meconium which is the cause of intestinal morphological and histological alterations. The outcome of these alterations is intestinal hypoperistalsis and nutrient absorption deficiency, which contribute to increased morbidity and high medical-hospital costs. In this study, morphological and histological intestine alterations were identified at two different contact occasions with AF. Experimental gastroschisis (G) was performed on Wistar rat fetuses at a single gestational age on day 18.5th. The fetuses were removed on the 20.5th (G-1) and 21.5th days (G-2). Fetuses of both groups were divided in 3 sub-groups: control (C), gastroschisis (G) and sham (S). Measurements were taken of the Whole Set including fetus, placenta and membranes with AF (WS), fetus body weight (BW), intestinal weight (IW) and their diameters (DI). The objective of the present study is to test a new gastroschisis experimental model and identify differences in morphological and histological alterations in these two gestational periods that may be directly related to intestinal motility disorders in G. The WS and BW presented no significant statistical difference when compared G1 and G2. The results of the intestine average weight of G2 fetuses were significantly higher when compared to G1 fetuses in all subgroups (C: p = 0.02; G: p = 0.01; S: p = 0.02, Mann Whitney). The results of the intestinal average diameters (D/d) in G1 and G2 presented significant statistical difference only in G subgroup (p < 0.05, Kruskal Wallis). When compared intestinal average diameters, there was significant statistical difference of G fetuses in G1 and G2 (p < 0.05, Mann Whitney). In conclusion, the present experimental G model was adequate to reproduce G in rat fetuses. All G fetuses presented significant statistical difference when compared to other group in their subgroup and when compared G1 and G2 (p < 0.05). These alterations can explain the difficulties in accomplishing adequate peristalsis in G neonate bearers.
Preduodenal Portal Vein (PDPV): A Very Rare Cause of Duodenum Obstruction  [PDF]
Beatriz Dinamarco, Elsner Gonzaga, Willy Marcus Frana, Pedro Luis Escher Parron, Patrícia Junqueira Mais Soares
Surgical Science (SS) , 2017, DOI: 10.4236/ss.2017.812055
Abstract: Congenital duodenal obstruction (CDO) is one of the most common anomalies presented in the neonatal period of intestinal obstruction, with an incidence of 1:10,000, and Preduodenal Portal Vein (PDPV) is a rare extrinsic cause of CDO. PDPV leads to CDO with a persistent vomiting, impairment of the oral feeding and weight loss, but other publications state an asymptomatic disease that may requires late surgical correction. Prenatal diagnosis of CDO, including PDPV, is evidenced by association of polyhydramnios with a dilated fluid-filled gastric and duodenum and a double-bobble image in the ultrasonography and permits a proper management of associated malformation, delivery, surgery and allows family counseling. PDPV is commonly associated to other intestinal obstruction such as extrinsic (annular pancreas, adhesive bands, malrotation, peritoneal bands, intestinal duplication), and intrinsic (atresia, web and stenosis), and also associated with cardiovascular anomalies, situs inversus, Down’s syndrome and polysplenia. This is full term 5 days old newborn, 2865 g girl, without prenatal diagnosis of CDO. It was not still established PDPV until surgery procedure such as Duodenoduodenostomy (Diamond-Shape) and can guide Paediatric Surgeons that face high intestinal obstruction in the neonate with or without prenatal diagnosis. In the ambulatory follow up after 4 months, baby has developed very well, in breast-feeding associated with formula-feeding with a normal weight gain (average of 550 g/month).
Are Fetuses Affected by Gastroschisis Benefited from Prenatal Maternal Corticosteroid Use and Early Parturition?  [PDF]
Mateus Guimar?es Massimo, Anna Paula Auada Kopaz, Neil Ferreira Novo, Willy Marcus Frana
Surgical Science (SS) , 2019, DOI: 10.4236/ss.2019.105019
Introduction: Gastroschisis (G) is a congenital defect of the abdominal walls through which intestinal herniation and permanent exposure to amniotic liquid (AL) and its components are developed at the end of gestation. G affects mostly fetuses from young mothers under 25 - 29 years old, but it occurs more often in fetuses of mothers’ ages between 12 - 15 years old. Some authors assert that it is not the low weight, nor the low gestational age that influences mortality. In addition to morphological alterations, histological alterations are characterized by disorganization, distribution and the degree of ganglia maturity and myenteric plexuses. The literature describes parturition anticipation of G disease carriers to minimize damages to intestinal loops. There are studies suggesting corticosteroids at the end of gestation in order to avoid morphological and histological damages to the intestinal loop. Objective: Identify if live newborn infants delivery anticipation, that is, gestational date less than 37 weeks and prenatal maternal use of corticosteroid were benefited from early enteral diet, namely, less than 10 post-surgery days. Material and Method: From 33 newborns researched in the period from 2010 to 2014; 28 newborns full records were included in the study with 15.2% mortality rate. These newborns were divided in 3 groups according to maternal age: 6 newborns from mothers’ age between 16 - 20 years old (Group 1); 14 newborns from mothers’ age between 21 - 25 years old (Group 2) and 8 newborns from mothers’ age between 26 - 29 years old (Group 3). Gestational age at birth and prenatal maternal usage of corticosteroid and beginning oral feeding were assessed. Results: From 28 newborns, 19 mothers ingested prenatal corticosteroid and 16 newborns received the first enteric diet 10 days before and 3 days later. The mothers of the other 9 newborns were not treated with corticosteroid; only 3 newborns were fed before 10 days and 6 were fed later (p = 0.0016). Regarding gestational age, 17 newborns were born before 37 weeks and their 1st enteral diet was offered before 10 days. From the 11 newborns born after 37 weeks, only 4 received the 1st enteral diet before 10 days (p = 0.015). Conclusion: Newborn infants born with gestational age below 37 weeks, whose mothers received prenatal corticosteroid, were benefited with the first enteral diet before 10
Atratividade da isca granulada de polpa de fruto do jatobá para saúva-lim?o, no campo
Teixeira, Maria Lucia Frana;Santos, Marcus Nascimento;
Ciência Rural , 2008, DOI: 10.1590/S0103-84782008000400001
Abstract: attractiveness of the leaf-cutting ant, atta sexdens rubropilosa to jatobá's fruit pulp was evaluated, having the dehydrated citrus pulp as comparative parameter, used as vehicle by several commercial brands. the experiment was conducted on four nests of leaf-cutting ants on lawns with arboreal species. jatobá baits and dehydrated citric pulp both without active principle were made into granules with form and diameter similar to the commercial granulated baits. jatobá baits were more attractive to the laborers of leaf-cutting ants which made the first contact after 17s, contrasting with 29s before the first contact with citric pulp baits. jatobá baits were also carried earlier, after 26s, while citric pulp baits were carried 48s later. the great acceptance of jatobá baits was strengthened by the short time to end the tests, 5min 39s, contrasting with 11min 17s to end the test with the citric pulp. the pulp of jatobá's fruit was more attractive to leaf-cutting ants than the dehydrated citric pulp.
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