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Search Results: 1 - 10 of 22 matches for " Fontelles "
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Trauma torácico: importancia da antibioticoterapia sobre o tempo de interna??o
Fontelles, Mauro José;Mantovani, Mario;
Acta Cirurgica Brasileira , 2001, DOI: 10.1590/S0102-86502001000300004
Abstract: background. a great deal of controversy still exists about using antibiotic therapy in association with the tested efficacy of closed chest drainage.the authors studied 167 patients with isolated thoracic trauma to assess the importance of antibiotic therapy to the hospitalization period of post closed chest drainage cases. methods: a longitudinal prospective study of cohorts was conducted by randomly selecting two groups of patients. the control group consisted of 104 patients who were not given antibiotics and 63 patients in the experimental group were given cephalothin sodium during the post operative period. (500 mg iv - 6/6 hrs). results : the patients had suffered the following kinds of injuries: closed trauma -12 cases (7.2%); knife injuries - 98 cases (58.7%); firearm injuries - 41 cases (24.6%); lesions caused by other agents - 16 cases (9.6%). the results showed that the average period of hospitalization for the control group was 5.7±3.2 days and for the antibiotic group it was 5.7±2.9 days. conclusion: the results indicated that hospitalization period for the patients in the control group, who were not given antibiotics and who developed some kind of pleuropulmonary complication, was 3.2 days more than the others.
Incidence of infectious complications following tube thoracostomy with and without use of antibiotic therapy: meta-analysis study
Fontelles, Mauro José;Mantovani, Mario;
Acta Cirurgica Brasileira , 2001, DOI: 10.1590/S0102-86502001000400002
Abstract: objective - thoracic lesions and resulting complications have gained increased importance in literature because they present a serious problem despite the generalized use of antibiotic therapy. our study, therefore, aims at obtaining better estimates regarding the benefits obtained using antibiotic therapy in patients with isolated thoracic trauma and who have undergone closed chest drainage. methods - eight prospective and randomized studies were selected and meta-analysis was used to statistically associate the results. results - the results demonstrated a statistical significance which favored the use of antibiotic therapy in preventing pleural empyema and a 9.25 (ic 95% 2.85 - 30.01) total relative risk for patients who did not receive antibiotic therapy. the total risk regarding all the infectious complications that occurred was 4.29 (ic 95% 2.70 - 8.97). conclusion - the results of this meta-analysis study showed that antibiotic therapy effectively reduces the incidence of infectious complications in patients with isolated thoracic trauma, who have undergone closed pleural drainage.
Incidência de empiema pleural no trauma isolado do tórax com e sem uso da antibioticoterapia
Fontelles, Mauro José;Mantovani, Mario;
Revista do Colégio Brasileiro de Cirurgi?es , 2001, DOI: 10.1590/S0100-69912001000300008
Abstract: background: the aim of this study was to evaluate the incidence of pleural empiema associated with tube thoracostomy on patients with isolated chest injury, with or without the use of associated antibiotic therapy. method: using cohorts accompaniment statistical model, the authors analysed 167 patients with blunt or penetrating chest trauma. two groups were selected for this study. control group included 104 (62.3%) patients without antibiotic therapy; the experimental group, 63 (37.7%) patients, received cefalotin postopertively (500mg iv; every 6 hours). results: twelve (7.2%) presented blunt trauma; 98 (58,7%) were stabbed, 41(24.6%) were wounded by fire arms; 16 (9.5%) injuries were associated with other type of accidents. the average length of stay for the control group in was 5.7±3.2 days, and for the antibiotic group was 5.7±2.9 days. the results showed that eight patients evolved with the pleural empyema, being seven cases from the control group, and only one from the experimental group (p=0.02). clotted hemotorax was the most frequent non infectious complication occurring on 21 (12.5%) patients. conclusions: the use of antibiotics were not effective on lowering the incidence of pleural empyema on patients that submitted to post-traumatic pleural drainage.
Isquemia e reperfus?o hepática total associada ao estado de choque hemorrágico controlado: efeitos no seqüestro de neutrófilos no íleo terminal e cólon sigmóide do rato
Fontelles, Mauro José;Mantovani, Mario;
Revista do Colégio Brasileiro de Cirurgi?es , 2002, DOI: 10.1590/S0100-69912002000300005
Abstract: background: the purpose of this experimental work was to study the effects of total hepatic ischemia and reperfusion on the accumulation of neutrophils in the terminal ileum and sigmoid colon of rats, under normal conditions and under controlled hemorrhagic shock. method: thirty two adult male wistar rats, were divided into four groups: sham group, was submitted to standard procedures for a period of 60 min. of observation; shock group, was submitted to controlled hemorrhagic shock (mean arterial blood pressure = 40mmhg, 20 min.) followed by fluid resuscitation (lactated ringer's solution + blood, 3:1) and reperfusion for 60 min.; pringle group, was submitted to total hepatic ischemia for 15 min. and reperfusion for 60 min.; total group, was submitted to controlled hemorrhagic shock for 15 min. followed by volemic resuscitation (lactated ringer's solution + blood, 3:1) and reperfusion for 60 min. neutrophils counting on intestinal tissues was performed after euthanasia. results: values for neutrophils counting on the distal ileum indicate that, only animals from shock group differed from other groups (p<0.001) (sham 1.33±0.55, shock 5.48±2.65, pringle 2.47±1.38, total 2.44±0.56). on sigmoid colon, shock group differed only from sham group (p=0.021) and did not differ from other groups (sham 0.66±0.44, shock 2.08±1.11, pringle 1.04±0.71, total 1.21±1.03). conclusions: differently from hemorrhagic shock, total hepatic ischemia for 15 minutes, followed by 60 minutes of reperfusion, did not present significant neutrophils accumulation on distal ileum and sigmoid colon tissues.
Trauma torácico: importancia da antibioticoterapia sobre o tempo de interna o
Fontelles Mauro José,Mantovani Mario
Acta Cirurgica Brasileira , 2001,
Abstract: No que tange a comprovada eficácia da drenagem pleural fechada, grande controvérsia ainda persiste em rela o ao uso associado da antibioticoterapia. Os autores estudaram 167 pacientes, com trauma isolado do tórax, com objetivo de avaliar a importancia do uso do antibiótico sobre o tempo de interna o pós-drenagem pleural fechada. Dois grupos de pacientes foram incluídos num estudo longitudinal e prospectivo de acompanhamento de coortes. O grupo controle incluiu 104 pacientes sem uso da antibioticoterapia; no grupo experimental, 63 pacientes receberam a cefalotina sódica no pós-operatório (500 mg IV - 6/6 h). Entre os pacientes estudados, 12 (7.2%) apresentavam trauma fechado; 98 (58.6%), ferimento por arma branca; 41 (24.6%) ferida por projétil de arma de fogo e, 16 (9.6%) les es por outros agentes vulnerantes. Entre os pacientes do grupo controle o tempo médio de permanência hospitalar foi de 5.7± 3.2 dias e, no grupo com antibiótico, 5.7± 2.9 dias. Os resultados mostraram que nos pacientes que n o receberam antibiótico e evoluíram com algum tipo de complica o pleuropulmonar, o tempo de interna o foi, em média, 3.2 dias maior que nos demais.
Incidence of infectious complications following tube thoracostomy with and without use of antibiotic therapy: meta-analysis study
Fontelles Mauro José,Mantovani Mario
Acta Cirurgica Brasileira , 2001,
Abstract: Objective - Thoracic lesions and resulting complications have gained increased importance in literature because they present a serious problem despite the generalized use of antibiotic therapy. Our study, therefore, aims at obtaining better estimates regarding the benefits obtained using antibiotic therapy in patients with isolated thoracic trauma and who have undergone closed chest drainage. Methods - Eight prospective and randomized studies were selected and meta-analysis was used to statistically associate the results. Results - The results demonstrated a statistical significance which favored the use of antibiotic therapy in preventing pleural empyema and a 9.25 (IC 95% 2.85 - 30.01) total relative risk for patients who did not receive antibiotic therapy. The total risk regarding all the infectious complications that occurred was 4.29 (IC 95% 2.70 - 8.97). Conclusion - The results of this meta-analysis study showed that antibiotic therapy effectively reduces the incidence of infectious complications in patients with isolated thoracic trauma, who have undergone closed pleural drainage.
Trauma torácico: fatores de risco de complica??es pleuropulmonares pós-drenagem pleural fechada
Fontelles, Mauro José Pantoja;Mantovani, Mario;
Revista do Colégio Brasileiro de Cirurgi?es , 2000, DOI: 10.1590/S0100-69912000000600008
Abstract: the objective of this study was to analyse the risk factors for the development of thoracic infections after tube thoracostomy. although technically simple, this procedure, 1 to 25 percent of the patients develop some type of intra or post-operative complications. a total of 167 patients, submitted to emergency tube thoracostomy, were admitted and stratified into two groups selected by randomic sampling to a cohorts accompanying study. one hundred and four patients, without antibiotic therapy, were considered as been the control group; and, 63 patients using cefalotin in post-operative as the experimental group. the mean age of the patients in the control group was 26.8±8.9 years (range, 13 - 53), and 24.9±7.9 years (range, 15 - 57) for experimental group, predominating the male sex (95.2%) in both studied groups. the penetrating chest trauma was present in 92.8% of the patients, with a higher incidence of stab wounds (58.7%) in contrast to gunshot wounds (24.6%). thoracic complications were present in 35 patients (33.7%) of the control group, whereas, in the experimental group, only 18 patients (28.6%) developed this kind of complication. in the statistic significance analysis, the bivariate model indicated that the variable trauma type and the duration of pleural space drainage were the most relevant ones as predictive factors for infections complications. in the multivariate logistic regression, the variables blunt chest trauma, length of hospital stay and drainage blood volume higher than 500 ml, when associated, influenciated positively on the occurrence of these complications.
Anatomic study of portal vein: transpancreatic vessels injuries approach
Mantovani, Mario;Leal, Raquel Franco;Fontelles, Mauro José;
Acta Cirurgica Brasileira , 2002, DOI: 10.1590/S0102-86502002000400005
Abstract: introduction: the commitment of the great blood-vessels make up a situation of great complexity and a high rate of the complications and mortality patients with abdominal trauma. the injury of the portal vein matters because of the difficulty on the diagnosis and the approach surgery. objective: to set the standard on the transverse section of the pancreas looking for a safer surgical access to repair the portal vein injuries. methods: a quantitative analysis was performed to characterize the anatomical relationship between the portal vein and their tributaries relating them to the pancreas. on these corpses, the measurements of a anatomical triangle were studied. it base was the upper limit of the superior mesentericvein and the initial portion of the portal vein; the apex, a point located on the upper limit of the confluence of the splenic vein and superior mesenteric vein, situated at the middle line of the superior mesenteric_ vein. results: the portal vein is formed 3.24cm from the internal border of the duodenal arc at a distance of 1.61cm and 1.07 from the inferior and superior pancreas borders, respectively. conclusion: the present study allow us to conclude that, to have access to the origin of the portal vein, in case of trauma of this vessel, one should proceed a transverse section of the neck of the pancreas next to the superior mesenteric vein, because its confluence with splenic vein occur, on average, 1.07cm and 1.61cm from the superior and inferior border of the gland, respectively.
Incidência de colelitíase em necropsias realizadas em hospital universitário no município de Campinas-SP
Mantovani, Mario;Leal, Raquel Franco;Fontelles, Mauro José;
Revista do Colégio Brasileiro de Cirurgi?es , 2001, DOI: 10.1590/S0100-69912001000400005
Abstract: background: the aim of the present study is to evaluate the incidence of cholelithiasis on necropsies performed at the unicamp clinical hospital and relate them to other associated diseases. method: the authors analyzed the incidence of cholelithiasis on 2355 autopsies performed at the pathological anatomy department of unicamp, between 1975 and 1998, among patients older than 10 years old. chi-square and odds ratio tests were used to analyze correlation with other diseases. results: there were 243 (10,3%) cases of cholelithiasis, in 110 men (7,9%) and 133 (13,6%) women (p=0,00001), a proportion of 1:17. this incidence increased with age (p<0,000000001), and differed significantly between ethnical groups being, 195 (11,1%) among whites and 48 (7,8%) among non whites (p=0,02). regarding other hepatic diseases, estheatosis was present in 33 (13,5%), malignant neoplasms in 31 (12,7%); cirrhosis in 30 (12,3%), virus hepatitis and cronical liver congestion in 16 each (6,5%). malignant neoplasm, liver infarction, and hepatic dystrophic disease showed a significantly statistical association with the incidence of cholelithiasis. only seven (0,29%) cases of gallbladder cancer were detected. conclusions: our results show a progressive raise on the incidence of cholelitiasis with aging, being more common on the population over 80 years old, and with a white ethnical background.
Anatomic study of portal vein: transpancreatic vessels injuries approach
Mantovani Mario,Leal Raquel Franco,Fontelles Mauro José
Acta Cirurgica Brasileira , 2002,
Abstract: Introduction: The commitment of the great blood-vessels make up a situation of great complexity and a high rate of the complications and mortality patients with abdominal trauma. The injury of the portal vein matters because of the difficulty on the diagnosis and the approach surgery. Objective: To set the standard on the transverse section of the pancreas looking for a safer surgical access to repair the portal vein injuries. Methods: A quantitative analysis was performed to characterize the anatomical relationship between the portal vein and their tributaries relating them to the pancreas. On these corpses, the measurements of a anatomical triangle were studied. It base was the upper limit of the superior mesenteric vein and the initial portion of the portal vein; the apex, a point located on the upper limit of the confluence of the splenic vein and superior mesenteric vein, situated at the middle line of the superior mesenteric_ vein. Results: The portal vein is formed 3.24cm from the internal border of the duodenal arc at a distance of 1.61cm and 1.07 from the inferior and superior pancreas borders, respectively. Conclusion: The present study allow us to conclude that, to have access to the origin of the portal vein, in case of trauma of this vessel, one should proceed a transverse section of the neck of the pancreas next to the superior mesenteric vein, because its confluence with splenic vein occur, on average, 1.07cm and 1.61cm from the superior and inferior border of the gland, respectively.
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