EDNA FRASSON DE SOUZA MONTERO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Virtual reality simulator versus box-trainer to teach minimally invasive procedures: A meta-analysis(2019) GUEDES, Hugo Goncalo; FERREIRA, Zemia Maria Camara Costa; LEAO, Layra Ribeiro de Sousa; MONTERO, Edna Frasson Souza; OTOCH, Jose Pinhata; ARTIFON, Everson Luiz de AlmeidaBackground: To evaluate the effectiveness of virtual reality simulator (VRS) training compared to box-trainer training (BT) for learning outcomes in minimally invasive surgery (MIS) techniques. Materials and Methods: A systematic review of the literature was performed using CENTRAL, MEDLINE, EMBASE, Scopus, CINAHL, LILACS. The primary outcomes were time to perform MIS and performance score in MIS. After being selected, the articles were evaluated for methodological quality and risk of bias. The results were evaluated for quality of evidence and meta-analysis was performed. Results: 20 randomized clinical trials were included in the qualitative analysis and 14 were used in the meta-analysis. VRS training was more efficient than BT training (P < 0.00001, 95% CI: 35.08 to -25.01) when evaluating participant time needed to complete the peg task. In descriptive analysis, VRS training was better than BT training in participant performance score to perform MIS. There was no statistical difference in the meta-analysis in the time needed to perform surgery, time to complete basic or advanced tasks and performance score for basic or advanced tasks. Conclusions: VRS training was better than BT training in participant performance scores when performing MIS and in the time needed to complete the basic task of peg transfer. In all other outcomes, regardless of the student's level of experience or type of activity, the two forms of training were equivalent.
conferenceObject Prevention of Fascial Dehiscence with Prophylactic Onlay Mesh in Emergency Laparotomy: A Randomized Trial(2019) LIMA, Helber V.; RASSLAN, Roberto; DAMOUS, Sergio H.; TIBERIO, Lima M.; BERNINI, Celso de Oliveira; MONTERO, Edna F.; UTIYAMA, Edivaldo M.- Comparative Systematic Review of Fixation Methods of the Coracoid and Conjoined Tendon in the Anterior Glenoid to Treat Anterior Shoulder Instability(2019) GARCIA JR., Jose Carlos; AMARAL, Felipe Machado do; BELCHIOR, Renan Juhasz; CARVALHO, Lucas Queiroz de; MARKARIAN, Gregory George; MONTERO, Edna Feasson de SouzaBackground: Coracoid process transfer for the treatment of recurrent glenohumeral dislocations is a safe and reliable procedure; however, there is no consensus as to which is the best method, the Bristow or Latarjet procedure. Purpose: To analyze the results of coracoid process transfer for the treatment of recurrent glenohumeral dislocations and to compare the results of this transfer between the Bristow and Latarjet techniques. Study Design: Systematic review; Level of evidence, 4. Methods: The databases surveyed for this review included J-STAGE; Cochrane Bone, Joint and Muscle Trauma Group Specialized Register; Cochrane Controlled Register of Trials; MEDLINE; Ovid; Embase; Google Scholar; and CINAHL. Inclusion criteria consisted of (1) studies related to anterior glenohumeral dislocations treated with transfer of the coracoid process to the anterior glenoid rim and (2) studies that could provide data to perform at least 1 meta-analysis or other statistical evaluation. Titles and abstracts were reviewed for inclusion; thereafter, outcomes and the risk of bias were extracted. Statistical analyses were performed according to the nature of the data. When possible, the 95% CI was included. Results: Of the 779 studies found, 63 were able to provide data assessing 3395 shoulders. There were no randomized, blinded, or double-blinded trials. The recurrence of dislocations was assessed in 41 studies that used the Bristow technique (n = 2346 shoulders; percentage redislocations [mean +/- SE], 1.00% +/- 0.20%) and 18 studies that used the Latarjet technique (n = 930 shoulders; percentage redislocations, 2.13% +/- 0.49%) (P = .04). The mean loss of external rotation was 12.91 degrees for the Bristow procedure (n = 1440 shoulders) and 11.70 degrees for the Latarjet procedure (n = 243 shoulders). The mean quality-of-life outcome scores were as follows for the Bristow and Latarjet procedures, respectively: Rowe score, 92.06 and 89.33; Western Ontario Shoulder Instability Index score, 16.44% and 19.68%; Japanese Orthopaedic Association score, 93.28 and 92.00; and American Shoulder and Elbow Surgeons score, 91.00 and 89.90. Conclusion: Transferring the coracoid to the anteroinferior border of the glenoid through the subscapularis tendon is effective, regardless of the technique. When comparing the Bristow and Latarjet techniques, the recurrence of dislocations was the only outcome that could undergo a meta-analysis, and it presented a statistically significant difference in favor of the Bristow procedure. All other outcomes presented no clinically significant differences between their effect sizes. More studies presenting better methodology are still needed to achieve more robust conclusions.
- Continuous peritoneal lavage with vacuum perito-neostomy: an experimental study(2019) RODRIGUES, Adilson Costa; SAAD, Karen Ruggeri; SAAD, Paulo Fernandes; OTSUKI, Denise Aya; SANTOS, Luana Carla dos; RASSLAN, Samir; MONTERO, Edna Frasson de Souza; UTIYAMA, Edivaldo M.OBJECTIVE: Despite advances in diffuse peritonitis treatment protocols, some cases develop unfavorably. With the advent of vacuum therapy, the use of laparostomy to treat peritonitis has gained traction. Another treatment modality is continuous peritoneal lavage. However, maintaining this technique is difficult and has been associated with controversial results. We propose a new model of continuous peritoneal lavage that takes advantage of the features and benefits of vacuum laparostomy. METHOD: Pigs (Landrace and Large White) under general anesthesia were submitted to laparostomy through which a multiperforated tube was placed along each flank and exteriorized in the left and lower right quadrants. A vacuum dressing was applied, and intermittent negative pressure was maintained. Peritoneal dialysis solution (PDS) was then infused through the tubes for 36 hours. The stability of peritoneostomy with intermittent infusion of fluids, the system resistance to obstruction and leakage, water balance, hemodynamic and biochemical parameters were evaluated. Fluid disposition in the abdominal cavity was analyzed through CT. RESULTS: Even when negative pressure was not applied, the dressing maintained the integrity of the system, and there were no leaks or blockage of the catheters during the procedure. The aspirated volume by vacuum laparostomy was similar to the infused volume (9073.5 +/- 1496.35 mL versus 10165 +/- 235.73 mL, p=0.25), and there were no major changes in hemodynamic or biochemical analysis. According to CT images, 60 ml/kg PDS was sufficient to occupy all intra-abdominal spaces. CONCLUSION: Continuous peritoneal lavage with negative pressure proved to be technically possible and may be an option in the treatment of diffuse peritonitis.
- Hypertonic saline and pentoxifylline enhance survival, reducing apoptosis and oxidative stress in a rat model of strangulated closed loop small bowel obstruction(2019) SCAPINI, Gustavo; RASSLAN, Roberto; CAYUELA, Natalie Chaves; GOES, Miguel Angelo; KOIKE, Marcia Kiyomi; UTIYAMA, Edivaldo Massazo; MONTERO, Edna Frasson de Souza; RASSLAN, SamirOBJECTIVES: Intestinal obstruction has a high mortality rate when therapeutic treatment is delayed. Resuscitation in intestinal obstruction requires a large volume of fluid, and fluid combinations have been studied. Therefore, we evaluated the effects of hypertonic saline solution (HS) with pentoxifylline (PTX) on apoptosis, oxidative stress and survival rate. METHODS: Wistar rats were subjected to intestinal obstruction and ischemia through a closed loop ligation of the terminal ileum and its vessels. After 24 hours, the necrotic bowel segment was resected, and the animals were randomized into four groups according to the following resuscitation strategies: Ringer's lactate solution (RL) (RL-32 ml/kg); RL+ PTX (25mg/kg); HS+ PTX (HS, 7.5%, 4 ml/kg), and no resuscitation (IO-intestinal obstruction and ischemia). Euthanasia was performed 3 hours after resuscitation to obtain kidney and intestine samples. A malondialdehyde (MDA) assay was performed to evaluate oxidative stress, and histochemical analyses (terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling [TUNEL], Bcl-2 and Bax) were conducted to evaluate kidney apoptosis. Survival was analyzed with another series of animals that were observed for 15 days. RESULTS: PTX in combination with RL or HS reduced the MDA levels (nmol/mg of protein), as follows: kidney IO=0.42; RL=0.49; RL+ PTX=0.31; HS+ PTX=0.34 (p<0.05); intestine: IO=0.42; RL=0.48; RL+ PTX=0.29; HS + PTX=0.26 (p<0.05). The number of labeled cells for TUNEL and Bax was lower in the HS+ PTX group than in the other groups (p<0.05). The Bax/Bcl-2 ratio was lower in the HS+ PTX group than in the other groups (p<0.05). The survival rate on the 15 th day was higher in the HS+ PTX group (77%) than in the RL+ PTX group (11%). CONCLUSION: PTX in combination with HS enhanced survival and attenuated oxidative stress and apoptosis. However, when combined with RL, PTX did not reduce apoptosis or mortality.
- Reply letter to: Letter to the editor on the article ""Virtual reality simulator versus box-trainer to teach minimally invasive procedures: A meta-analysis""(2019) GUEDES, H. G.; FERREIRA, Z. M. C. C.; LEAO, L. R. S.; MONTERO, E. F. S.; OTOCH, J. P.; ARTIFON, E. L. A.
conferenceObject Assessment of Left Ventricle Myocardial Deformation in a Hemorrhagic Shock Swine Model by Two-Dimension Speckle Tracking Echocardiography(2019) VASCONCELLOS, Henrique Doria De; SAAD, Karen S.; OTSUKI, Denise A.; SAAD, Paulo; CIUFFO, Luisa; ARMSTRONG, Anderson C.; LIMA, Joao A.; MONTERO, Edna F.