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Article ; Online: Intraoperative, sociodemographic, and postoperative parameters in individuals undergoing bariatric surgery.

Lira, Lyrian Lorena Freire / Cavalcante, Karyne Costa / Freire, Thyago Trisotto / Takagi, Isadora Miyuki / Oliveira, Caio Márcio Barros de / Moura, Ed Carlos Rey / Leal, Plinio da Cunha

Revista da Associacao Medica Brasileira (1992)

2023 Volume 69, Issue 11, Page(s) e20230535

Abstract: Objective: This study aimed to comparatively analyze sociodemographic data and postoperative parameters of patients undergoing bypass and sleeve surgeries in a private hospital in São Luís, MA.: Methods: The study was descriptive, prospective, ... ...

Abstract	Objective: This study aimed to comparatively analyze sociodemographic data and postoperative parameters of patients undergoing bypass and sleeve surgeries in a private hospital in São Luís, MA. Methods: The study was descriptive, prospective, observational, and comparative, with a quantitative approach between August 2020 and July 2021. We analyzed 74 participants of both genders, aged between 18 and 70 years, with 31 undergoing Roux-en-Y gastric bypass surgery and 43 undergoing sleeve gastrectomy surgery. In the postoperative period, sociodemographic characteristics, surgery and anesthesia duration, pain levels, adverse effects, weight loss, and complications from the surgical procedure were analyzed. Results: Males predominated in Roux-en-Y gastric bypass and females in sleeve gastrectomy surgery. Clinical characteristics regarding self-declared ethnicity, age and place of birth, education, and marital status were similar between the studied groups. Roux-en-Y gastric bypass had an average surgery time of 112.14±10.06 min and sleeve gastrectomy 91.11±23.69 min, with a significant difference (p<0.001). Regarding anesthesia time, gastric bypass averaged 160.36±13.99 min and sleeve gastrectomy 154.88±29.10 min, with no statistical difference between groups (p=0.335). Nausea, vomiting, and drowsiness were more common in Sleeve gastrectomy, with no significant difference (p=0.562). Roux-en-Y gastric bypass showed a higher rate of weight loss from 1 month after surgery (14.2±4.15) and more variation in body mass index within 3 months after surgery (32.17±4.76). Complications occurred in a small number of patients. Conclusion: The two surgical techniques proved effective in delivering the best results for patients, with the group undergoing bypass showing statistically significant weight loss from 1 month after the surgical procedure.
MeSH term(s)	Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Bariatric Surgery/adverse effects ; Gastrectomy/adverse effects ; Gastrectomy/methods ; Gastric Bypass/adverse effects ; Gastric Bypass/methods ; Laparoscopy/methods ; Obesity, Morbid/surgery ; Obesity, Morbid/complications ; Postoperative Complications/etiology ; Prospective Studies ; Retrospective Studies ; Treatment Outcome ; Weight Loss
Language	English
Publishing date	2023-10-27
Publishing country	Brazil
Document type	Journal Article ; Observational Study
ZDB-ID	731969-1
ISSN	1806-9282 ; 0104-4230 ; 0004-5241 ; 0102-843X
ISSN (online)	1806-9282
ISSN	0104-4230 ; 0004-5241 ; 0102-843X
DOI	10.1590/1806-9282.20230535
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Article ; Online: Impact of deep resection of endometriosis in the pelvis on urodynamic parameters.

Farias, Jardel Cavalcante de / Nascimento, Maria do Desterro Soares Brandão / Leal, Plínio da Cunha / Oliveira, Caio Márcio Barros de / Moura, Ed Carlos Rey

Acta cirurgica brasileira

2023 Volume 38, Page(s) e386323

Abstract: Purpose: To evaluate the effects of deep resection of endometriosis in the posterior pelvic region on urodynamic parameters.: Methods: A prospective observational study conducted with female patients diagnosed with deep pelvic endometriosis before ... ...

Abstract	Purpose: To evaluate the effects of deep resection of endometriosis in the posterior pelvic region on urodynamic parameters. Methods: A prospective observational study conducted with female patients diagnosed with deep pelvic endometriosis before and after endometriosis resection surgery. Clinical history, image exams, the Female Lower Urinary Tract Symptoms questionnaire, urodynamic examination, cystometry, and voiding study were evaluated. Results: Patients aged 30-39 years old, operative duration of 132.5 minutes, and 2.7 days of hospital stay. Uroflowmetry and cystometry showed tendency for an increase after the surgery in the flow duration, time to maximum flow, and first voiding desire and decreased residual volume and maximum cystometric capacity. Opening, maximum urinary flow, and maximum flow pressure decreased at T1, and the closing parameters increased, although statistically non significant. The variables decreased at T1 in the urodynamic, except for detrusor overactivity. Although we observed a reasonable number of low bladder compliance and abnormal bladder sensation, the results were maintained at T1. General scores for filling and incontinence showed a significant decrease after surgery. Conclusions: A significant response in the patient's perception of urinary function was demonstrated after surgery. It is observed that the surgical procedure did not affect the uroflowmetric and cystometric characteristics of the evaluated patients.
MeSH term(s)	Humans ; Female ; Adult ; Endometriosis/surgery ; Urodynamics/physiology ; Urinary Bladder/surgery ; Urinary Bladder, Overactive ; Pelvis/surgery
Language	English
Publishing date	2023-12-01
Publishing country	Brazil
Document type	Observational Study ; Journal Article
ZDB-ID	2012156-8
ISSN	1678-2674 ; 1678-2674
ISSN (online)	1678-2674
ISSN	1678-2674
DOI	10.1590/acb386323
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Article ; Online: Improved quality of life (EHP-30) in patients with endometriosis after surgical treatment.

Nogueira Neto, João / Melo, Vinicius Gonçalves / Lima, Luna Carolina Silva / Costa, Miguel Vinicius Lima Reis / Silva, Leonardo Carvalho / Gomes, Lyvia Maria Rodrigues de Sousa / Freire, Glaúcia Iraúna de Melo / Leal, Plinio da Cunha / Oliveira, Caio Marcio Barros de / Moura, Ed Carlos Rey

Revista da Associacao Medica Brasileira (1992)

2023 Volume 69, Issue 8, Page(s) e20230316

Abstract: Objective: This study aimed to evaluate the quality of life of patients with endometriosis before and after surgical treatment.: Methods: An observational, longitudinal, and prospective study was conducted with 102 women with pelvic pain and ... ...

Abstract	Objective: This study aimed to evaluate the quality of life of patients with endometriosis before and after surgical treatment. Methods: An observational, longitudinal, and prospective study was conducted with 102 women with pelvic pain and endometriosis that was unimproved by clinical treatment and indicated for surgical treatment. The patients' quality of life was assessed using the 30-item Endometriosis Health Profile (EHP-30) questionnaire before and 3 and 6 months after surgery. The statistical tests were analyzed using the Statistical Package for Social Sciences version 17.0, and the Friedman test was used. Results: There was a reduction in EHP-30 scores 3 and 6 months after surgery compared to before surgery, as well as 6 months after surgery compared to 3 months after surgery, in the central questionnaire (PART 1) and in Sections A, B, C, E, and F (p<0.0001). For Section D, there was a reduction in scores 6 months after surgery compared to before surgery (p<0.0001). Conclusion: Surgical treatment of endometriosis improves quality of life in several areas assessed by the EHP-30 questionnaire.
MeSH term(s)	Humans ; Female ; Endometriosis/surgery ; Quality of Life ; Prospective Studies ; Pelvic Pain/etiology ; Pelvic Pain/surgery ; Surveys and Questionnaires
Language	English
Publishing date	2023-08-14
Publishing country	Brazil
Document type	Observational Study ; Journal Article
ZDB-ID	731969-1
ISSN	1806-9282 ; 0104-4230 ; 0004-5241 ; 0102-843X
ISSN (online)	1806-9282
ISSN	0104-4230 ; 0004-5241 ; 0102-843X
DOI	10.1590/1806-9282.20230316
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Article ; Online: Hypertonic glucose in the treatment of low back pain: A randomized clinical trial.

Pereira Pires, Jose Alberto / Rey Moura, Ed Carlos / Oliveira, Caio Marcio Barros de / Vieira Dibai-Filho, Almir / Soares Brandão Nascimento, Maria do Desterro / da Cunha Leal, Plinio

Medicine

2023 Volume 102, Issue 38, Page(s) e35163

Abstract: Background: Chronic low back pain (LBP) is defined as pain lasting longer than 3 months and is one of the conditions with the most significant social impact. Treatment is complex and includes proliferative agents used in prolotherapy. The mechanism is ... ...

Abstract	Background: Chronic low back pain (LBP) is defined as pain lasting longer than 3 months and is one of the conditions with the most significant social impact. Treatment is complex and includes proliferative agents used in prolotherapy. The mechanism is not known, but osmotic agents (hypertonic solutions of dextrose or glucose) cause cellular rupture and an inflammatory response that releases cytokines and growth factors that lead to scarring and reinnervation. Methods: Patients with chronic LBP (>12 weeks) who were non-traumatic and unresponsive to at least 1 month of physical therapy were selected. All patients were followed up at a return visit at 1, 3, and 6 months for pain assessment using validated pain questionnaires and scales. Results: Nineteen patients were included in the conservative group and 19 in the glucose group, with the majority being women (57.9%). The patients were between 47 and 59 years of age (39.5%), mixed race (76.33%), married or in a committed relationship (73.7%), and had completed the study for 5.2 years. Overall mean body mass index was 27.3 ± 4.4 kg/m 2 and was higher in the conservative group (28.0 ± 4.7 kg/m 2 ). The groups showed differences in Visual Analog Scale scores, with median and amplitude values close to each other between the time points evaluated and increasing values in the glucose group, which had significantly higher values for this scale at the third evaluation ( P = .031). When comparing the Rolland-Morris scale scores between the groups, there was a significant difference only in the 3-m assessment ( P = .021). In the follow-up assessment, both groups showed significant improvement between T0 and the other assessment time points ( P < .05) in all evaluations. Conclusion: Both groups significantly improved on the evaluated scales during follow-up. Overall, no effects were attributable to the glucose components or the prolotherapy protocol.
MeSH term(s)	Humans ; Female ; Male ; Low Back Pain/drug therapy ; Physical Therapy Modalities ; Pain Measurement ; Prolotherapy/methods ; Glucose/therapeutic use ; Treatment Outcome
Chemical Substances	Glucose (IY9XDZ35W2)
Language	English
Publishing date	2023-10-25
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000035163
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Article ; Online: Assessment of pain and quality of life in patients undergoing cardiac surgery: a cohort study.

Viana, Luciano Beltrão Dos Reis / Oliveira, Eduardo José Silva Gomes de / Oliveira, Caio Márcio Barros de / Moura, Ed Carlos Rey / Viana, Luiz Henrique Lopes / Nina, Vinícius José da Silva / Farkas, Emily / Leal, Plinio da Cunha

Revista da Associacao Medica Brasileira (1992)

2023 Volume 69, Issue 3, Page(s) 473–478

Abstract: Objective: This study aimed to evaluate postoperative pain and quality of life in patients undergoing median sternotomy.: Methods: A cohort study was carried out on a sample of 30 patients who underwent elective cardiac surgery by longitudinal median ...

Abstract	Objective: This study aimed to evaluate postoperative pain and quality of life in patients undergoing median sternotomy. Methods: A cohort study was carried out on a sample of 30 patients who underwent elective cardiac surgery by longitudinal median sternotomy. Patients were interviewed at Intensive Care Unit discharge and hospital discharge, when the Visual Numeric Scale and the Brief Pain Inventory were applied, and 2 weeks after hospital discharge, when the World Health Organization Quality of Life-Bref questionnaire was administered. The normality of the results was analyzed by the Shapiro-Wilk test, and Wilcoxon Rank Sum and McNemar tests were utilized for the analysis of numerical and categorical variables. For correlation between numerical variables, Spearman's linear correlation test was applied. To compare numerical variables, Mann-Whitney U and Kruskal-Wallis tests were applied. Differences between groups were considered significant when the p-value was <0.05. Results: Between Intensive Care Unit and hospital discharge, there was a reduction in median pain intensity assessed by the Visual Numeric Scale from 5.0 to 2.0 (p<0.001), as well as in eight Brief Pain Inventory parameters: worst pain intensity in the last 24 h (p=0.001), analgesic relief (p=0.035), and pain felt right now (p=0.009); and in interference in daily activities (p<0.001), mood (p=0.017), ability to walk (p<0.001), relationship with other people (p=0.005), and sleep (p=0.006). Higher pain intensity at Intensive Care Unit discharge was associated with worse performance in the psychological domain of quality of life at out-of-hospital follow-up. Conclusion: Proper management of post-sternotomy pain in the Intensive Care Unit may imply better quality of life at out-of-hospital follow-up.
MeSH term(s)	Humans ; Quality of Life/psychology ; Cohort Studies ; Pain Measurement/methods ; Cardiac Surgical Procedures/adverse effects ; Pain, Postoperative/etiology
Language	English
Publishing date	2023-02-20
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	731969-1
ISSN	1806-9282 ; 0104-4230 ; 0004-5241 ; 0102-843X
ISSN (online)	1806-9282
ISSN	0104-4230 ; 0004-5241 ; 0102-843X
DOI	10.1590/1806-9282.20221655
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Article ; Online: Tranexamic acid effects in postoperative bleeding outcomes in laparoscopic sleeve gastrectomy: a controlled study.

Brito, Roger Moura de / Oliveira, Caio Márcio Barros de / Moura, Ed Carlos Rey / Campelo, Giuliano Peixoto / Lima, Roclides Castro / Fe, Ciro Sousa de Moura / Sousa, Tércio Maia / Oliveira, Eduardo José Silva Gomes de / Dibai Filho, Almir Vieira / Leal, Plínio da Cunha

Acta cirurgica brasileira

2022 Volume 37, Issue 7, Page(s) e370702

Abstract: Purpose: To demonstrate through a controlled study whether the use of tranexamic acid in bariatric surgeries is effective for bleeding control.: Methods: Prospective, comparative, and double-blind study performed with patients from 18 to 65 years old ...

Abstract	Purpose: To demonstrate through a controlled study whether the use of tranexamic acid in bariatric surgeries is effective for bleeding control. Methods: Prospective, comparative, and double-blind study performed with patients from 18 to 65 years old submitted to bariatric surgery. The selected patients received venous tranexamic acid (TXA) during the induction of anesthesia or not (CG). The anesthesia and thromboprophylaxis protocols were similar among the groups. For statistical analysis, the χ2 and analysis of variance tests were performed at a significance level of p < 0.05, using the statistical program SPSS 21.0®. Results: Sixty-one patients were included in the study, 31 in the control group and 30 in the TXA group (GTXA). In the intraoperative period, the bleeding volume was greater in the CG than in the GTXA. In the postoperative period, the tranexamic acid group had a higher value hematocrit, absence of surgical reoperations due to bleeding complications, and shorter hospitalization time than the control group. Conclusions: The use of tranexamic acid was effective in reducing bleeding rates and of hospital stay length, in addition to demonstrating the clinical safety of its use, for not having been associated with any thromboembolic events.
MeSH term(s)	Adolescent ; Adult ; Aged ; Anticoagulants/therapeutic use ; Antifibrinolytic Agents/therapeutic use ; Blood Loss, Surgical/prevention & control ; Gastrectomy ; Humans ; Laparoscopy/adverse effects ; Middle Aged ; Postoperative Hemorrhage/drug therapy ; Postoperative Hemorrhage/etiology ; Postoperative Hemorrhage/prevention & control ; Prospective Studies ; Tranexamic Acid/therapeutic use ; Venous Thromboembolism/complications ; Venous Thromboembolism/drug therapy ; Venous Thromboembolism/prevention & control ; Young Adult
Chemical Substances	Anticoagulants ; Antifibrinolytic Agents ; Tranexamic Acid (6T84R30KC1)
Language	English
Publishing date	2022-10-10
Publishing country	Brazil
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2012156-8
ISSN	1678-2674 ; 1678-2674
ISSN (online)	1678-2674
ISSN	1678-2674
DOI	10.1590/acb370702
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Article ; Online: Quality of life and psychological comorbidities in patients with migraine and hypertension.

Ribeiro, Thamires Sales / Almeida, Luciana Salles Branco de / Rodrigues, Vandilson Pinheiro / Oliveira, Caio Marcio Barros de / Moura, Ed Carlos Rey / Naves, Luciana Maia Moura / Lima Neto, Lidio Gonçalves / Moreira, Leonardo Victor Galvão / Pereira, Emanuel Cabral / Leal, Plínio da Cunha

Revista da Associacao Medica Brasileira (1992)

2022 Volume 68, Issue 9, Page(s) 1156–1160

MeSH term(s)	Comorbidity ; Humans ; Hypertension/epidemiology ; Migraine Disorders/epidemiology ; Migraine Disorders/psychology ; Quality of Life/psychology
Language	English
Publishing date	2022-10-13
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	731969-1
ISSN	1806-9282 ; 0104-4230 ; 0004-5241 ; 0102-843X
ISSN (online)	1806-9282
ISSN	0104-4230 ; 0004-5241 ; 0102-843X
DOI	10.1590/1806-9282.20220724
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Article ; Online: Comparison of tranexamic acid and stapling line reinforcement in laparoscopic sleeve gastrectomy in postoperative bleeding outcomes.

Brito, Roger Moura de / Oliveira, Caio Márcio Barros de / Moura, Ed Carlos Rey / Campelo, Giuliano Peixoto / Lima, Roclides Castro de / Servin, Elizabeth Teixeira Noguera / Gomes, Lyvia Maria Rodrigues de Sousa / Fe, Ciro Sousa de Moura / Oliveira, Eduardo José Silva Gomes de / Leal, Plínio da Cunha

Brazilian journal of anesthesiology (Elsevier)

2022 Volume 73, Issue 3, Page(s) 361–363

MeSH term(s)	Humans ; Tranexamic Acid ; Postoperative Hemorrhage/prevention & control ; Gastrectomy ; Laparoscopy ; Obesity, Morbid/surgery ; Treatment Outcome ; Retrospective Studies ; Surgical Stapling
Chemical Substances	Tranexamic Acid (6T84R30KC1)
Language	English
Publishing date	2022-11-13
Publishing country	Brazil
Document type	Letter
ISSN	2352-2291
ISSN (online)	2352-2291
DOI	10.1016/j.bjane.2022.10.006
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Article ; Online: Use of hypertonic glucose (10%) in the prevention of postoperative adhesions in rats.

Nogueira Neto, João / Carmo, Alexandra de Oliveira do / Lima, Laura Sales Carvalho / Gomes, Lyvia Maria Rodrigues de Sousa / Moura, Ed Carlos Rey / Oliveira, Caio Marcio Barros de / Raymundo, Thiers Soares / Melo, George Castro Figueira de / Leal, Plinio da Cunha

Acta cirurgica brasileira

2021 Volume 36, Issue 5, Page(s) e360504

Abstract: Purpose: To evaluate the efficacy of hypertonic glucose (10%), alone or in combination with the corticoid dexamethasone, to prevent peritoneal adhesion following hysterectomy in rats.: Methods: Forty-two adult rats underwent hysterectomy with ... ...

Abstract	Purpose: To evaluate the efficacy of hypertonic glucose (10%), alone or in combination with the corticoid dexamethasone, to prevent peritoneal adhesion following hysterectomy in rats. Methods: Forty-two adult rats underwent hysterectomy with peritoneal lavage: G1 - glucose (10%); G2 - glucose (10%) and dexamethasone 3 mg·kg-1; and G3 - physiological saline (PS) 0.9%. Results: In the macroscopic analysis after 14 days, G1 had a median score of 1, G2 of 1, and G3 of 2.5 (p < 0.0001), G3 compared to G1 and G2. There was no difference between groups after 28 days. In the microscopic analysis, the median vascular proliferation after 14 days was 2 for G1, 1 for G2, and 3 for G3 (p = 0.0037, G3 vs. G1 and G2). After 28 days, G1 showed a median vascular proliferation score of 2, G2 of 2.5, and G3 of 3 (p < 0.0001, G3 vs. G1 and G2). Regarding the inflammatory reaction after 14 days, G1 had a median score of 2, G2 of 1, and G3 of 3 (p = 0.7916). After 28 days, G1 had a median score of 0.5 (0-1.75), G2 of 1.5, and G3 of 2.5 (p < 0.0001, G3 vs. the others and G2 vs. G1). In the evaluation of fibrosis after 14 days, G1 had a median score of 1, G2 of 1, and G3 of 2.5 (p < 0.0001, G3 vs. G1and G2). After 28 days, G1 had a median fibrosis score of 1, G2: 2, and G3: 2.5 (p < 0.0001), G3 vs. the others andG2 vs. G1). Conclusions: The use of hypertonic glucose (10%) solution seems to reduce macroscopic and microscopic pelvic adhesions.
MeSH term(s)	Animals ; Female ; Glucose ; Rats
Chemical Substances	Glucose (IY9XDZ35W2)
Language	English
Publishing date	2021-06-25
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2012156-8
ISSN	1678-2674 ; 1678-2674
ISSN (online)	1678-2674
ISSN	1678-2674
DOI	10.1590/ACB360504
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Article ; Online: Combined spinal-epidural anesthesia for abdominoplasty and liposuction in Limb-Girdle Muscular Dystrophy: case report.

Leal, Plinio da Cunha / Lima, Wildney Leite / Oliveira, Eduardo José Silva Gomes de / Oliveira, Caio Márcio Barros de / Gomes, Lyvia Maria Rodrigues de Sousa / Servin, Elizabeth Teixeira Noguera / Moura, Ed Carlos Rey

Brazilian journal of anesthesiology (Elsevier)

2021 Volume 71, Issue 3, Page(s) 299–301

Abstract: We report the anesthetic management with combined spinal-epidural in a patient with limb-girdle muscular dystrophy type 2A, submitted to abdominoplasty and liposuction. The patient had onset of symptoms at 8 years old, diagnosed by muscular biopsy, ... ...

Abstract	We report the anesthetic management with combined spinal-epidural in a patient with limb-girdle muscular dystrophy type 2A, submitted to abdominoplasty and liposuction. The patient had onset of symptoms at 8 years old, diagnosed by muscular biopsy, presenting muscle weakness in the scapular and pelvic girdles, with reduced mobility. We performed monitorization with noninvasive blood pressure, oximeter, thermometer, and electrocardiogram. In the postoperative period, she showed no clinical signs of rhabdomyolysis, myotonia, or adverse effects, maintaining hemodynamic stability. The anesthesia technique allowed spontaneous ventilation, monitoring of clinical parameters close to physiological conditions and used smaller doses of medication, reducing related risks.
MeSH term(s)	Abdominoplasty ; Anesthesia, Epidural ; Anesthesia, Spinal ; Child ; Female ; Humans ; Lipectomy ; Muscular Dystrophies, Limb-Girdle
Language	English
Publishing date	2021-04-03
Publishing country	Brazil
Document type	Case Reports
ISSN	2352-2291
ISSN (online)	2352-2291
DOI	10.1016/j.bjane.2021.02.046
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