cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.7045802.v1
title: Evaluation of postoperative complications in elderly patients submitted to parotidectomy.

description: ABSTRACT Objective: to evaluate the most incident histological subtypes and the main postoperative complications in elderly patients with parotid tumors submitted to parotidectomy. Methods: we conducted a retrospective study with 57 elderly patients submitted to parotidectomy from 2003 to 2017, at the São José County Hospital of Joinville, Santa Catarina, Brazil. Results: thirty-three (57.9%) patients had benign tumors, the most frequent being Warthin's tumor, and 17 (29.8%), malignant tumors, squamous cell carcinoma being the most frequent. Seven patients (12.3%) presented clinical complications, arterial pressure instability and respiratory complications being the most frequent, in four (7%) and three (5.3%) cases, respectively. Thirteen (22.1%) patients presented complications related to the surgical wound, hematoma and wound infection being the most frequent, with six (10.5%) cases each. Twenty-four (42.1%) patients had some degree of facial nerve dysfunction in the postoperative period, Brackman-House grade III being the most frequent, in 11 cases (19.3%). Surgical time and lymphadenectomy were associated with clinical complications. The main variables that showed an association with surgical complications were tumor size, longer surgical time, reoperation, and perioperative crystalloid infusion volume. Conclusion: parotid neoplasms present a differentiated profile in the elderly population, especially Warthin's tumor and squamous cell carcinoma. Hematoma and infection of the operative wound and facial nerve lesions were the most prevalent complications in the postoperative period.
DOI: 10.6084/m9.figshare.6991904
title: Surgical treatment of extravasation injuries: experience of the Hospital das Clínicas, Faculty of Medicine, University of São Paulo.

description: ABSTRACT Objective: to report the experience of the Division of Plastic Surgery of the Hospital das Clínicas of the Medical School of the University of São Paulo in the treatment of cutaneous lesions due to accidental extravasation of drugs. Methods: we included patients with lesions due to extravasation of drugs over a period of 18 months. We retrospectively evaluated the following parameters: age, diagnoses during hospitalization and comorbidities, serum levels of albumin and hemoglobin, place of hospitalization, drug involved, anatomic segment affected, therapeutic management and death during hospitalization. Results: we followed-up 14 patients. The main drug involved was noradrenaline (21%). All patients underwent debridement of tissue necrosis. Three patients were submitted to flaps after preparation of the wound bed with negative pressure therapy, with good results. Seven patients had no definitive treatment of their lesions due to lack of clinical conditions. Conclusion: in patients with favorable clinical conditions, the definitive treatment with flaps was adequate for cases of wounds due to extravasation of drugs in the subcutaneous tissue when there was exposure of noble structures.
DOI: 10.6084/m9.figshare.6991904.v1
title: Surgical treatment of extravasation injuries: experience of the Hospital das Clínicas, Faculty of Medicine, University of São Paulo.

description: ABSTRACT Objective: to report the experience of the Division of Plastic Surgery of the Hospital das Clínicas of the Medical School of the University of São Paulo in the treatment of cutaneous lesions due to accidental extravasation of drugs. Methods: we included patients with lesions due to extravasation of drugs over a period of 18 months. We retrospectively evaluated the following parameters: age, diagnoses during hospitalization and comorbidities, serum levels of albumin and hemoglobin, place of hospitalization, drug involved, anatomic segment affected, therapeutic management and death during hospitalization. Results: we followed-up 14 patients. The main drug involved was noradrenaline (21%). All patients underwent debridement of tissue necrosis. Three patients were submitted to flaps after preparation of the wound bed with negative pressure therapy, with good results. Seven patients had no definitive treatment of their lesions due to lack of clinical conditions. Conclusion: in patients with favorable clinical conditions, the definitive treatment with flaps was adequate for cases of wounds due to extravasation of drugs in the subcutaneous tissue when there was exposure of noble structures.
DOI: 10.6084/m9.figshare.7101803
title: Colonoscopy complications: experience with 8968 consecutive patients in a single institution.

description: ABSTRACT Objective: to evaluate the incidence, epidemiological characteristics, diagnosis and evolution of patients who returned to the emergency care units of the Albert Einstein Hospital in São Paulo/SP with signs and symptoms suggestive of colonoscopy complications up to 30 days after the procedure. Methods: we conducted a retrospective, uni-institutional study of patients submitted to colonoscopy in 2014 who returned to the Emergency department (ED) within 30 days after the procedure. Results: 8968 patients underwent colonoscopies, 95 (1.06%) of whom had complaints related to possible complications. Most of the procedures were elective ones. Minor complications (nonspecific abdominal pain/distension) were frequent (0.49%) and most of the patients were discharged after consultation at the ED. Severe complications were less frequent: perforation (0.033%), lower gastrointestinal bleeding (0.044%), and intestinal obstruction (0.044%). ED consultations in less than 24 hours after the procedure was associated with a higher index of normal colonoscopies (p=0.006), more diagnosis of fever (p=0.0003) and dyspeptic syndrome (p=0.043), and less diagnosis of colitis/ileitis (p=0.015). The observation of fever in patients treated at the ED was associated with the diagnosis of polyps at colonoscopy (p=0.030). Conclusion: the data corroborate the safety of the colonoscopy exam and points to a reduction in major complications rates.
DOI: 10.6084/m9.figshare.7101803.v1
title: Colonoscopy complications: experience with 8968 consecutive patients in a single institution.

description: ABSTRACT Objective: to evaluate the incidence, epidemiological characteristics, diagnosis and evolution of patients who returned to the emergency care units of the Albert Einstein Hospital in São Paulo/SP with signs and symptoms suggestive of colonoscopy complications up to 30 days after the procedure. Methods: we conducted a retrospective, uni-institutional study of patients submitted to colonoscopy in 2014 who returned to the Emergency department (ED) within 30 days after the procedure. Results: 8968 patients underwent colonoscopies, 95 (1.06%) of whom had complaints related to possible complications. Most of the procedures were elective ones. Minor complications (nonspecific abdominal pain/distension) were frequent (0.49%) and most of the patients were discharged after consultation at the ED. Severe complications were less frequent: perforation (0.033%), lower gastrointestinal bleeding (0.044%), and intestinal obstruction (0.044%). ED consultations in less than 24 hours after the procedure was associated with a higher index of normal colonoscopies (p=0.006), more diagnosis of fever (p=0.0003) and dyspeptic syndrome (p=0.043), and less diagnosis of colitis/ileitis (p=0.015). The observation of fever in patients treated at the ED was associated with the diagnosis of polyps at colonoscopy (p=0.030). Conclusion: the data corroborate the safety of the colonoscopy exam and points to a reduction in major complications rates.
DOI: 10.6084/m9.figshare.7185956.v1
title: Vascular trauma in the Amazon: updating the challenge.

description: ABSTRACT Objective: to evaluate the epidemiological data of patients operated on due to vascular trauma at a referral hospital in Pará state, to determine the variables that increase the risk of death, and to make a comparative analysis with the results previously published by the same institution. Methods: an analytical retrospective study was performed through data collection from patients operated due to vascular injuries, between March 2013 and March 2017. Demographic and epidemiological data, such as the mechanism and topography of the lesion, distance between the trauma site and the hospital, and type of treatment and complications, were analyzed. Multivariate analysis and logistic regression studies were performed, to evaluate significant dependence between some variables and death occurrence. Results: two hundred and eighty eight patients with 430 lesions were studied; 92.7% were male, 49.7% were between 25 and 49 years old; 47.2% of all injuries were caused by firearm projectiles; 47.2% of the lesions were located in the upper limbs, 42.7% in the lower limbs, 8% in the cervical region, 3.1% in the thoracic region, and 0.7% in the abdominal region; 52.8% of the patients were hospitalized for seven days or less. Amputation was required in 6.9% of patients and there was mortality in 7.93% of the cases. Conclusion: distances greater than 200km were associated with prolonged hospitalization and greater probability of limb amputation. Significant correlation between death occurrence and arterial injury, vascular injury in the cervical region, and vascular injury in the thoracic region was found.
DOI: 10.6084/m9.figshare.7185956
title: Vascular trauma in the Amazon: updating the challenge.

description: ABSTRACT Objective: to evaluate the epidemiological data of patients operated on due to vascular trauma at a referral hospital in Pará state, to determine the variables that increase the risk of death, and to make a comparative analysis with the results previously published by the same institution. Methods: an analytical retrospective study was performed through data collection from patients operated due to vascular injuries, between March 2013 and March 2017. Demographic and epidemiological data, such as the mechanism and topography of the lesion, distance between the trauma site and the hospital, and type of treatment and complications, were analyzed. Multivariate analysis and logistic regression studies were performed, to evaluate significant dependence between some variables and death occurrence. Results: two hundred and eighty eight patients with 430 lesions were studied; 92.7% were male, 49.7% were between 25 and 49 years old; 47.2% of all injuries were caused by firearm projectiles; 47.2% of the lesions were located in the upper limbs, 42.7% in the lower limbs, 8% in the cervical region, 3.1% in the thoracic region, and 0.7% in the abdominal region; 52.8% of the patients were hospitalized for seven days or less. Amputation was required in 6.9% of patients and there was mortality in 7.93% of the cases. Conclusion: distances greater than 200km were associated with prolonged hospitalization and greater probability of limb amputation. Significant correlation between death occurrence and arterial injury, vascular injury in the cervical region, and vascular injury in the thoracic region was found.
DOI: 10.6084/m9.figshare.19961916
title: Anesthetic therapy for acute pain relief after laparoscopic cholecystectomy: systematic review.

description: ABSTRACT Inappropriate therapy of postoperative pain in laparoscopic cholecystectomy may lead to late mobilization, patient dissatisfaction, delayed hospital discharge, and chronic pain development. Our objective was to identify the best therapeutic strategy available to the anesthesiologist for the acute postoperative pain of patients submitted to elective laparoscopic cholecystectomy. This is a systematic review that included 36 complete articles indexed in the Medline, Scopus, Web of Science and LILACS databases, with a five-year time cut (2012 to 2016), resulting from controlled and randomized studies that were submitted to qualitative analysis. In a proposal for multimodal analgesia, it is important to consider the contraindications, adverse effects, dose and optimal timing of interventions. Non-opioid drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs)/cyclooxygenase-2 (COX-2) inhibitors, gabapentin/pregabalin, N-methyl-D-aspartate (NMDA) receptor antagonists, and others. Opioids may be used at low doses associated with multimodal therapy or are restricted to cases where non-opioid multimodal analgesia is insufficient. We conclude that there is no consensus as to the best analgesic strategy to be implemented in the acute postoperative pain of laparoscopic cholecystectomy, which requires its applicability in an individualized way, based on the scientific evidence found in the literature. As contribution to medical learning and practice, we point out the theoretical enrichment of the analgesic drug options available for the therapy of postoperative pain in patients submitted to elective laparoscopic cholecystectomy, and alert the team to consider the adverse effects of the interventions implemented.
DOI: 10.6084/m9.figshare.19961916.v1
title: Anesthetic therapy for acute pain relief after laparoscopic cholecystectomy: systematic review.

description: ABSTRACT Inappropriate therapy of postoperative pain in laparoscopic cholecystectomy may lead to late mobilization, patient dissatisfaction, delayed hospital discharge, and chronic pain development. Our objective was to identify the best therapeutic strategy available to the anesthesiologist for the acute postoperative pain of patients submitted to elective laparoscopic cholecystectomy. This is a systematic review that included 36 complete articles indexed in the Medline, Scopus, Web of Science and LILACS databases, with a five-year time cut (2012 to 2016), resulting from controlled and randomized studies that were submitted to qualitative analysis. In a proposal for multimodal analgesia, it is important to consider the contraindications, adverse effects, dose and optimal timing of interventions. Non-opioid drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs)/cyclooxygenase-2 (COX-2) inhibitors, gabapentin/pregabalin, N-methyl-D-aspartate (NMDA) receptor antagonists, and others. Opioids may be used at low doses associated with multimodal therapy or are restricted to cases where non-opioid multimodal analgesia is insufficient. We conclude that there is no consensus as to the best analgesic strategy to be implemented in the acute postoperative pain of laparoscopic cholecystectomy, which requires its applicability in an individualized way, based on the scientific evidence found in the literature. As contribution to medical learning and practice, we point out the theoretical enrichment of the analgesic drug options available for the therapy of postoperative pain in patients submitted to elective laparoscopic cholecystectomy, and alert the team to consider the adverse effects of the interventions implemented.
DOI: 10.6084/m9.figshare.6991784.v1
title: Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) through a single port: alternative delivery for the control of peritoneal metastases.

description: ABSTRACT Peritoneal carcinomatosis is the natural course of gastrointestinal, gynecologic, and primary peritoneal neoplasms. In recent years, our understanding of carcinomatosis has changed; it is no longer considered a disseminated condition, but rather a disease confined to the peritoneum. Thus, the combination of cytoreductive surgery and intraperitoneal chemotherapy has become the cornerstone of control of peritoneal metastases. Traditionally, intraperitoneal chemotherapy is delivered in the form of liquid solutions. However, a new mode of chemotherapy delivery to the abdominal cavity has arisen as an alternative to the conventional method. In Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC), the liquid solution is aerosolized into a spray, potentiating the distribution and penetration of the chemotherapeutic agent intraperitoneally. The present study aims to describe a novel form of this innovative surgical technique performed for the first time in Brazil, in a modification of the technique originally described for PIPAC: delivery through a single-port device.
DOI: 10.6084/m9.figshare.6991784
title: Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) through a single port: alternative delivery for the control of peritoneal metastases.

description: ABSTRACT Peritoneal carcinomatosis is the natural course of gastrointestinal, gynecologic, and primary peritoneal neoplasms. In recent years, our understanding of carcinomatosis has changed; it is no longer considered a disseminated condition, but rather a disease confined to the peritoneum. Thus, the combination of cytoreductive surgery and intraperitoneal chemotherapy has become the cornerstone of control of peritoneal metastases. Traditionally, intraperitoneal chemotherapy is delivered in the form of liquid solutions. However, a new mode of chemotherapy delivery to the abdominal cavity has arisen as an alternative to the conventional method. In Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC), the liquid solution is aerosolized into a spray, potentiating the distribution and penetration of the chemotherapeutic agent intraperitoneally. The present study aims to describe a novel form of this innovative surgical technique performed for the first time in Brazil, in a modification of the technique originally described for PIPAC: delivery through a single-port device.
DOI: 10.6084/m9.figshare.7244447
title: Association between the Alvarado score and surgical and histopathological findings in acute appendicitis.

description: ABSTRACT Objective: to compare the results of the Alvarado score with the surgical findings and the results of the histopathological examination of the appendix of patients operated on for acute appendicitis. Methods: we conducted an observational study with a cross-sectional design of 101 patients aged 14 years and over undergoing emergency appendectomy. The evaluation comprised the Alvarado score, gender, age, ethnicity and time of evolution. We obtained data regarding the surgical aspect of the appendix, postoperative complications and the result of the histopathological examination. The pre-established confidence interval was 95%. We calculated sensitivity, specificity, positive and negative predictive values of the score, and performed an analysis through the ROC curve. Results: we found a statistically significant (p=0.002) association between the Alvarado score and the diagnostic confirmation using a cutoff score of six or greater, with a sensitivity of 72% and a specificity of 87.5%. A score greater than or equal to six showed a greater tendency to present more advanced stages of acute appendicitis in both surgical and histopathological findings when compared with a score lower than six. Males presented greater chances of complications when compared with females (p=0.003). Conclusion: the Alvarado score proved to be a good method for diagnostic screening in acute appendicitis, since scores greater than or equal to six are associated with a higher probability of diagnostic confirmation and more advanced stages of the acute disease.
DOI: 10.6084/m9.figshare.7244447.v1
title: Association between the Alvarado score and surgical and histopathological findings in acute appendicitis.

description: ABSTRACT Objective: to compare the results of the Alvarado score with the surgical findings and the results of the histopathological examination of the appendix of patients operated on for acute appendicitis. Methods: we conducted an observational study with a cross-sectional design of 101 patients aged 14 years and over undergoing emergency appendectomy. The evaluation comprised the Alvarado score, gender, age, ethnicity and time of evolution. We obtained data regarding the surgical aspect of the appendix, postoperative complications and the result of the histopathological examination. The pre-established confidence interval was 95%. We calculated sensitivity, specificity, positive and negative predictive values of the score, and performed an analysis through the ROC curve. Results: we found a statistically significant (p=0.002) association between the Alvarado score and the diagnostic confirmation using a cutoff score of six or greater, with a sensitivity of 72% and a specificity of 87.5%. A score greater than or equal to six showed a greater tendency to present more advanced stages of acute appendicitis in both surgical and histopathological findings when compared with a score lower than six. Males presented greater chances of complications when compared with females (p=0.003). Conclusion: the Alvarado score proved to be a good method for diagnostic screening in acute appendicitis, since scores greater than or equal to six are associated with a higher probability of diagnostic confirmation and more advanced stages of the acute disease.
DOI: 10.6084/m9.figshare.7244450
title: Well-differentiated tireoid carcinoma: epidemiological profile, surgical results and oncological response.

description: ABSTRACT Objective: to know the epidemiological profile of patients undergoing surgery for well-differentiated thyroid carcinoma at the Cassiano Antônio Moraes University Hospital of the Federal University of Espírito Santo, as well as the oncological results and the main postoperative complications. Methods: we conducted a cross-sectional, retrospective study of patients with well-differentiated thyroid carcinoma (WDTC) operated from January 2008 to December 2015. Results: During the study period, 95 of the 353 patients undergoing surgical treatment of the thyroid gland had WDTC. Papillary carcinoma was the most frequent (91.57%). Total thyroidectomy not associated with cervical emptying was the most frequent surgical procedure (65.26%). Postoperative complications occurred in 6.31% of patients, hematoma being the most frequent. The mean follow-up time was 36.9 months. Relapse occurred in four patients (4.21%), being locoregional in all cases. The prognostic factors analyzed, such as gender, age, tumor size, lymph node involvement, staging, type of surgery, histology and complementary iodine therapy did not show statistical significance. Conclusion: papillary carcinoma was the most common thyroid malignant neoplasm, affecting women in the 49-year-old age group more frequently. Loco-regional recurrence occurred in four patients. Hematoma was the most frequent complication.
DOI: 10.6084/m9.figshare.7244450.v1
title: Well-differentiated tireoid carcinoma: epidemiological profile, surgical results and oncological response.

description: ABSTRACT Objective: to know the epidemiological profile of patients undergoing surgery for well-differentiated thyroid carcinoma at the Cassiano Antônio Moraes University Hospital of the Federal University of Espírito Santo, as well as the oncological results and the main postoperative complications. Methods: we conducted a cross-sectional, retrospective study of patients with well-differentiated thyroid carcinoma (WDTC) operated from January 2008 to December 2015. Results: During the study period, 95 of the 353 patients undergoing surgical treatment of the thyroid gland had WDTC. Papillary carcinoma was the most frequent (91.57%). Total thyroidectomy not associated with cervical emptying was the most frequent surgical procedure (65.26%). Postoperative complications occurred in 6.31% of patients, hematoma being the most frequent. The mean follow-up time was 36.9 months. Relapse occurred in four patients (4.21%), being locoregional in all cases. The prognostic factors analyzed, such as gender, age, tumor size, lymph node involvement, staging, type of surgery, histology and complementary iodine therapy did not show statistical significance. Conclusion: papillary carcinoma was the most common thyroid malignant neoplasm, affecting women in the 49-year-old age group more frequently. Loco-regional recurrence occurred in four patients. Hematoma was the most frequent complication.