cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.6992090.v1
title: What is the ideal working length for bridge plating osteosynthesis of a femoral shaft fracture? A multinational online survey evaluation

description: ABSTRACT Objective: to evaluate how orthopedic surgeons in Latin America define the working length for distinct patterns of femoral shaft fracture. Methods: a survey was developed presenting different options of working length in four femoral fracture patterns. The survey was submitted to the participants using Google Forms tool. The association between professional characteristics and medical management options according to each type of fracture was analyzed by Chi-square test, with 5% significance level. Results: seven hundred and seven professionals from all Latin America answered the survey. The majority prefered a smaller working length for all situations presented in the study. There was a significant association between the main interest area and the medical preference for the management in fracture types AO 32-B3 and 32-C2 (p&lt;0.05). Other professional characteristics had no significant association at the level of 5%. Conclusion: most of the study participants preferred constructions with smaller working length, representing approximately one-third of the total length of the plate, regardless of fracture pattern. There was a significant association between the main interest area (orthopedic trauma) and medical management options for fracture type AO 32-B3 and 32-C2. This can be attributed in part to the fact that these two types of fractures are considered, in the view of the authors, intermediate patterns in terms of strain. This study reinforces the importance of understanding the concept of working length, showing that its calculation remains more based on the surgeons' experience than grounded by strong biomechanical concepts governing the fracture healing process.
DOI: 10.6084/m9.figshare.6992159
title: Initial experience with negative-pressure wound therapy with instillation in complex wounds

description: ABSTRACT Objective: to report the initial experience with Negative-Pressure Wound Therapy with instillation in infected or contaminated complex wounds. Methods: the negative-pressure wound therapy with instillation used was V.A.C. Ulta with Veraflo instillation (Kinetic Concepts, Inc). The mode of operation was continuous with negative pressure set at 125 mmHg for two hours and instillation between the pauses. The instillation time was 20 minutes (contact time of the topical agent with the wound) and the instilled substance was 0.9% normal saline. After adequate preparation of the wound, it was covered with graft or flap. Results: ten patients with complex or contaminated wounds were operated on. The mean number of NPWTi changes was 1.4, the mean number of surgeries was 2.4, the interval until complete wound coverage was 6.3 days, and the interval up to the time of discharge was 11.4 days. Conclusion: the comparison of the negative-pressure wound therapy with instillation with two previous studies (historical control) evidenced a shorter hospitalization time, favoring TPNi. This study had an initial character, making it necessary to conduct a randomized and controlled trial to confirm the efficacy of this therapy and verify its cost-effectiveness.
DOI: 10.6084/m9.figshare.6992159.v1
title: Initial experience with negative-pressure wound therapy with instillation in complex wounds

description: ABSTRACT Objective: to report the initial experience with Negative-Pressure Wound Therapy with instillation in infected or contaminated complex wounds. Methods: the negative-pressure wound therapy with instillation used was V.A.C. Ulta with Veraflo instillation (Kinetic Concepts, Inc). The mode of operation was continuous with negative pressure set at 125 mmHg for two hours and instillation between the pauses. The instillation time was 20 minutes (contact time of the topical agent with the wound) and the instilled substance was 0.9% normal saline. After adequate preparation of the wound, it was covered with graft or flap. Results: ten patients with complex or contaminated wounds were operated on. The mean number of NPWTi changes was 1.4, the mean number of surgeries was 2.4, the interval until complete wound coverage was 6.3 days, and the interval up to the time of discharge was 11.4 days. Conclusion: the comparison of the negative-pressure wound therapy with instillation with two previous studies (historical control) evidenced a shorter hospitalization time, favoring TPNi. This study had an initial character, making it necessary to conduct a randomized and controlled trial to confirm the efficacy of this therapy and verify its cost-effectiveness.
DOI: 10.6084/m9.figshare.6991559
title: Video-thoracoscopic approach, without suture, of late thoracic esophageal perforations

description: ABSTRACT Objectives: to evaluate the use of video-thoracoscopy, in the treatment of late perforations of the thoracic esophagus, without suture or organ resection. Methods: retrospective analysis of patients with late diagnosis (&gt; 12 hours) of thoracic esophageal perforation treated by video-thoracoscopy, without suture or organ resection, over a 15-year period. Results: sixteen patients were operated on, ten men and six women, aged between 48 and 66 years, with time between the diagnosis of the perforation and the surgery ranging from 16 to 26 hours. All patients underwent video-thoracoscopy, with pulmonary decortication, pleural loculations approach, opening of the mediastinal pleura near the perforation site and debridement of the devitalized tissues, followed by double drainage of the pleural cavity. No esophageal suture or resection was performed, and the patients evolved with complete closure of the lesions, without deaths. Conclusion: the video-thoracoscopic surgical approach was able to control pleural infection, pulmonary expansion and enable complete regeneration of the esophagus with late-diagnosed perforation.
DOI: 10.6084/m9.figshare.6991559.v1
title: Video-thoracoscopic approach, without suture, of late thoracic esophageal perforations

description: ABSTRACT Objectives: to evaluate the use of video-thoracoscopy, in the treatment of late perforations of the thoracic esophagus, without suture or organ resection. Methods: retrospective analysis of patients with late diagnosis (&gt; 12 hours) of thoracic esophageal perforation treated by video-thoracoscopy, without suture or organ resection, over a 15-year period. Results: sixteen patients were operated on, ten men and six women, aged between 48 and 66 years, with time between the diagnosis of the perforation and the surgery ranging from 16 to 26 hours. All patients underwent video-thoracoscopy, with pulmonary decortication, pleural loculations approach, opening of the mediastinal pleura near the perforation site and debridement of the devitalized tissues, followed by double drainage of the pleural cavity. No esophageal suture or resection was performed, and the patients evolved with complete closure of the lesions, without deaths. Conclusion: the video-thoracoscopic surgical approach was able to control pleural infection, pulmonary expansion and enable complete regeneration of the esophagus with late-diagnosed perforation.
DOI: 10.6084/m9.figshare.6992309
title: Comparative efficacy of immunohistochemical markers in surgical healing

description: ABSTRACT Objective: to evaluate the efficacy of three immunohistochemical markers involved in the wound healing process. Methods: experimental study of 40 Wistar rats of the markers metalloproteinases and matrix metalloproteinase 9 (MMP-9), beta transforming growth factor (TGF-β) and myofibroblasts and smooth muscle actin alpha (α-MLA) markers, studied from fragments of surgical scar of abdominal incision involving skin, aponeurosis and peritoneum. The animals were divided into four subgroups of ten according to the day of death, scheduled in three, seven, 14 and 21 days. Results: MMP-9 expression showed a progressive increase of its concentration, more evident from 7th to 14th days, varying the tissue immunoexpression between 2.65% and 11.50% . TGF- β showed expression at high level on the 3rd day, fell in the 7th, rising again in the 14th, with a small decrease in the 21st day, varying the tissue immunoexpression between 0.03% and 2.92%. The α-AML presented levels with little variation and a slight increase, varying the tissue immunoexpression between 0.88% and 3.23%. Conclusion: MMP-9 presented as the best marker, followed by TGF-β. However, α-AML was not a good indicator of the evolution of tissue repair.
DOI: 10.6084/m9.figshare.6992309.v1
title: Comparative efficacy of immunohistochemical markers in surgical healing

description: ABSTRACT Objective: to evaluate the efficacy of three immunohistochemical markers involved in the wound healing process. Methods: experimental study of 40 Wistar rats of the markers metalloproteinases and matrix metalloproteinase 9 (MMP-9), beta transforming growth factor (TGF-β) and myofibroblasts and smooth muscle actin alpha (α-MLA) markers, studied from fragments of surgical scar of abdominal incision involving skin, aponeurosis and peritoneum. The animals were divided into four subgroups of ten according to the day of death, scheduled in three, seven, 14 and 21 days. Results: MMP-9 expression showed a progressive increase of its concentration, more evident from 7th to 14th days, varying the tissue immunoexpression between 2.65% and 11.50% . TGF- β showed expression at high level on the 3rd day, fell in the 7th, rising again in the 14th, with a small decrease in the 21st day, varying the tissue immunoexpression between 0.03% and 2.92%. The α-AML presented levels with little variation and a slight increase, varying the tissue immunoexpression between 0.88% and 3.23%. Conclusion: MMP-9 presented as the best marker, followed by TGF-β. However, α-AML was not a good indicator of the evolution of tissue repair.
DOI: 10.6084/m9.figshare.6991721
title: Laryngeal chondroradionecrosis following radiotherapy

description: ABSTRACT Objective: to study larynx chondroradionecrosis related to radiotherapy and chemotherapy treatment and provide a treatment flowchart. Methods: retrospective study with clinical data analysis of all larynx cancer patients admitted in a two tertiary hospital in a five years period. Results: from 131 patients treated for larynx cancer, 28 underwent chemoradiotherapy with curative intent and three of them presented chondroradionecrosis. They were treated with hiperbaric oxigen therapy and surgical debridment following our flowchart, preserving the larynx in all. Conclusions: the incidence of chondroradionecrosis as a complication of chemoradiotherapy in our series was 10,7% and the treatment with hiperbaric oxigen therapy, based in our flowchart, was effective to control this complication.
DOI: 10.6084/m9.figshare.6991721.v1
title: Laryngeal chondroradionecrosis following radiotherapy

description: ABSTRACT Objective: to study larynx chondroradionecrosis related to radiotherapy and chemotherapy treatment and provide a treatment flowchart. Methods: retrospective study with clinical data analysis of all larynx cancer patients admitted in a two tertiary hospital in a five years period. Results: from 131 patients treated for larynx cancer, 28 underwent chemoradiotherapy with curative intent and three of them presented chondroradionecrosis. They were treated with hiperbaric oxigen therapy and surgical debridment following our flowchart, preserving the larynx in all. Conclusions: the incidence of chondroradionecrosis as a complication of chemoradiotherapy in our series was 10,7% and the treatment with hiperbaric oxigen therapy, based in our flowchart, was effective to control this complication.
DOI: 10.6084/m9.figshare.6991634.v1
title: Surgical approach of hypertelorbitism in craniofrontonasal dysplasia

description: ABSTRACT Objective: to present our experience in the hypertelorbitism surgical treatment in craniofrontonasal dysplasia. Methods: retrospective analysis of craniofrontonasal dysplasia patients operated through orbital box osteotomy or facial bipartition between 1997 and 2015. Surgical data was obtained from medical records, complementary tests, photographs, and clinical interviews. Surgical results were classified based on the need for additional surgery and orbital relapse was calculated. Results: seven female patients were included, of whom three (42.86%) underwent orbital box osteotomy and four (57.14%) underwent facial bipartition. There was orbital relapse in average of 3.71±3,73mm. Surgical result according to the need for further surgery was 2.43±0.53. Conclusion: surgical approach to hypertelorbitism in craniofrontonasal dysplasia should be individualized, respecting the age at surgery and preferences of patients, parents, and surgeons.
DOI: 10.6084/m9.figshare.6991634
title: Surgical approach of hypertelorbitism in craniofrontonasal dysplasia

description: ABSTRACT Objective: to present our experience in the hypertelorbitism surgical treatment in craniofrontonasal dysplasia. Methods: retrospective analysis of craniofrontonasal dysplasia patients operated through orbital box osteotomy or facial bipartition between 1997 and 2015. Surgical data was obtained from medical records, complementary tests, photographs, and clinical interviews. Surgical results were classified based on the need for additional surgery and orbital relapse was calculated. Results: seven female patients were included, of whom three (42.86%) underwent orbital box osteotomy and four (57.14%) underwent facial bipartition. There was orbital relapse in average of 3.71±3,73mm. Surgical result according to the need for further surgery was 2.43±0.53. Conclusion: surgical approach to hypertelorbitism in craniofrontonasal dysplasia should be individualized, respecting the age at surgery and preferences of patients, parents, and surgeons.
DOI: 10.6084/m9.figshare.6991553
title: Predictive factors of axillary metastasis in patients with breast cancer and positive sentinel lymph node biopsy

description: ABSTRACT Objective: to evaluate the risk factors for the presence of non-sentinel axillary metastatic disease in patients with breast cancer and positive sentinel node biopsy. Methods: retrospective cross-sectional study of women with breast cancer operated at the Cancer Institute of Ceará between 2002 and 2012 and submitted to sentinel lymph node biopsy. Results: Among 946 breast cancer patients, 331 underwent sentinel lymph node biopsy, which was positive in 83. These patients underwent axillary lymphadenectomy and 39 (46%) had metastases in other axillary lymph nodes. The variables that were significant for additional axillary disease included Ki67&gt;14 (p=0.043), angiolymphatic invasion (p=0.01) and tumor size (p=0.027). No association was observed with estrogen, progesterone, tumor grade and Her-2 receptors. Discussion: the presence of angiolymphatic invasion and tumor size have also been related to additional axillary metastasis in other studies. In addition to these variables, the same predictive effect was observed when we evaluated Ki67. The validation of these results may allow the customization of breast cancer treatment, which may reduce its morbidity. Conclusion: angiolymphatic invasion, tumor size (T3/T4) and Ki67&gt;14 were factors predictive of axillary metastasis involvement in addition to the sentinel lymph node.
DOI: 10.6084/m9.figshare.6991553.v1
title: Predictive factors of axillary metastasis in patients with breast cancer and positive sentinel lymph node biopsy

description: ABSTRACT Objective: to evaluate the risk factors for the presence of non-sentinel axillary metastatic disease in patients with breast cancer and positive sentinel node biopsy. Methods: retrospective cross-sectional study of women with breast cancer operated at the Cancer Institute of Ceará between 2002 and 2012 and submitted to sentinel lymph node biopsy. Results: Among 946 breast cancer patients, 331 underwent sentinel lymph node biopsy, which was positive in 83. These patients underwent axillary lymphadenectomy and 39 (46%) had metastases in other axillary lymph nodes. The variables that were significant for additional axillary disease included Ki67&gt;14 (p=0.043), angiolymphatic invasion (p=0.01) and tumor size (p=0.027). No association was observed with estrogen, progesterone, tumor grade and Her-2 receptors. Discussion: the presence of angiolymphatic invasion and tumor size have also been related to additional axillary metastasis in other studies. In addition to these variables, the same predictive effect was observed when we evaluated Ki67. The validation of these results may allow the customization of breast cancer treatment, which may reduce its morbidity. Conclusion: angiolymphatic invasion, tumor size (T3/T4) and Ki67&gt;14 were factors predictive of axillary metastasis involvement in addition to the sentinel lymph node.
DOI: 10.6084/m9.figshare.6992258.v1
title: Pathophysiological aspects of the low anterior resection syndrome for treatment of rectal cancer

description: ABSTRACT The number of patients with bowel dysfunction due to the treatment of rectal cancer has increased during the recent decades. Anatomical and functional disorders after the removal of the rectum are followed by increased stool frequency, urgency, multiple evacuations and flatus or stool incontinence characterizing the low anterior resection syndrome - LARS. The purpose of this article is to present a review of the literature on current concepts and pathophysiological aspects of bowel dysfunction after resection of rectal cancer. It is essential to understand these mechanisms for a better management of patients and recovery of their quality of life.
DOI: 10.6084/m9.figshare.6992258
title: Pathophysiological aspects of the low anterior resection syndrome for treatment of rectal cancer

description: ABSTRACT The number of patients with bowel dysfunction due to the treatment of rectal cancer has increased during the recent decades. Anatomical and functional disorders after the removal of the rectum are followed by increased stool frequency, urgency, multiple evacuations and flatus or stool incontinence characterizing the low anterior resection syndrome - LARS. The purpose of this article is to present a review of the literature on current concepts and pathophysiological aspects of bowel dysfunction after resection of rectal cancer. It is essential to understand these mechanisms for a better management of patients and recovery of their quality of life.
DOI: 10.6084/m9.figshare.6992285
title: Modified technique for percutaneous endoscopic gastrojejunostomy placement

description: ABSTRACT The placement of percutaneous endoscopic gastrojejunostomy (PEG-J) provides diet delivery beyond the angle of Treitz, and it is associated with decrease of complications related to gastroparesis, such as aspiration pneumonia. There are many different techniques to perform a PEG-J described in the literature, with variable degrees of technical success. In this article, we suggest modifications to the technique of PEG-J placement in order to reduce time of procedure and minimize the risk of technical failure.
DOI: 10.6084/m9.figshare.6992285.v1
title: Modified technique for percutaneous endoscopic gastrojejunostomy placement

description: ABSTRACT The placement of percutaneous endoscopic gastrojejunostomy (PEG-J) provides diet delivery beyond the angle of Treitz, and it is associated with decrease of complications related to gastroparesis, such as aspiration pneumonia. There are many different techniques to perform a PEG-J described in the literature, with variable degrees of technical success. In this article, we suggest modifications to the technique of PEG-J placement in order to reduce time of procedure and minimize the risk of technical failure.
DOI: 10.6084/m9.figshare.5980153
title: Prognostic factors and overall survival of breast cancer in the city of Goiania, Brazil: a population-based study

description: ABSTRACT Objective: to analyze the overall survival and prognostic factors of women with breast cancer in the city of Goiânia. Methods: this is a retrospective, cross-sectional, observational study that included women with malignant neoplasms of the breast identified by the Goiânia Population-based Cancer Registry. The variables studied were age at diagnosis, tumor size, staging, axillary lymph node involvement, tumor grade, disease extent, hormone receptors, and c-erb-B2 oncoprotein. We performed overall survival analyzes of five and ten years. Results: we included 2,273 patients in the study, with an overall survival of 72.1% in five years and 57.8% in ten years. In the multivariate analysis adjusted for tumor size, the factors that influenced the prognosis were axillary lymph nodes, histological grade, progesterone receptor, c erb B2, T staging and disease extension. Conclusion: overall survival in ten years is below that observed in other countries, and possibly reflects what happens with the majority of the Brazilian population. The prognostic factors found in this population follow the same international patterns.
DOI: 10.6084/m9.figshare.5980153.v1
title: Prognostic factors and overall survival of breast cancer in the city of Goiania, Brazil: a population-based study

description: ABSTRACT Objective: to analyze the overall survival and prognostic factors of women with breast cancer in the city of Goiânia. Methods: this is a retrospective, cross-sectional, observational study that included women with malignant neoplasms of the breast identified by the Goiânia Population-based Cancer Registry. The variables studied were age at diagnosis, tumor size, staging, axillary lymph node involvement, tumor grade, disease extent, hormone receptors, and c-erb-B2 oncoprotein. We performed overall survival analyzes of five and ten years. Results: we included 2,273 patients in the study, with an overall survival of 72.1% in five years and 57.8% in ten years. In the multivariate analysis adjusted for tumor size, the factors that influenced the prognosis were axillary lymph nodes, histological grade, progesterone receptor, c erb B2, T staging and disease extension. Conclusion: overall survival in ten years is below that observed in other countries, and possibly reflects what happens with the majority of the Brazilian population. The prognostic factors found in this population follow the same international patterns.
DOI: 10.6084/m9.figshare.5980384
title: Thoraco-laparoscopic esophagectomy: thoracic stage in prone position

description: ABSTRACT Objective: to analyze the National Cancer Institute Abdominopelvic Division (INCA / MS/HC I) initial experience with thoraco-laparoscopic esophagectomy with thoracic stage in prone position. Methods: we studied 19 consecutive thoraco-laparoscopic esophagectomies from may 2012 to august 2014, including ten patients with squamous cells carcinoma (five of the middle third and five of the lower third) and nine cases of gastroesophageal junction adenocarcinoma (six Siewert I and three Siewert II). All procedures were initiated by the prone thoracic stage. Results: There were minimal blood loss, optimal mediastinal visualization, oncological radicality and no conversions. Surgical morbidity was 42 %, most being minor complications (58% Clavien I or II), with few related to the technique. The most common complication was cervical anastomotic leak (37%), with a low anastomotic stricture rate (two stenosis: 10.53%). We had one (5.3%) surgical related death, due to a gastric tube`s mediastinal leak, treated by open reoperation and neck diversion. The median Intensive Care Unit stay and hospital stay were two and 12 days, respectively. The mean thoracoscopic stage duration was 77 min. Thirteen patients received neoadjuvant treatment (five squamous cells carcinoma and eight gastroesophageal adenocarcinomas). The average lymph node sample had 16.4 lymph nodes per patient and 22.67 when separately analyzing patients without neoadjuvant treatment. Conclusion: the thoraco-laparoscopic approach was a safe technique in the surgical treatment of esophageal cancer, with a good lymph node sampling.