A total of 149 patients admitted for elective colorectal surgery were randomly allocated to receive preoperative mechanical bowel preparation (group 1) or no mechanical bowel preparation (group 2). All patients received antimicrobial prophylaxis with cephalothin and metronidazole. The overall incidence of wound infection was 17.4 per cent (24 per cent for group 1, 12 per cent for group 2) and that of dehiscence 7.4 per cent (10 per cent for group 1, 5 per cent for group 2). The incidence of wound infection was significantly higher in group 1 (P < 0.05) but that of anastomotic dehiscence did not differ significantly between groups. Mechanical bowel preparation is unnecessary and may be harmful in terms of preventing wound infection and anastomotic dehiscence in patients undergoing elective colorectal surgery.
Incidence of low-grade dysplasia in ATZ was low. Restorative proctocolectomy with total mucosectomy of the anal canal and handsewn IPAA is recommended for patients with preoperative diagnosis of ulcerative colitis and concurrent cancer or dysplasia. Frequent follow-up with biopsies is recommended for patients with incidental finding of cancer or high-grade dysplasia after restorative proctocolectomy and stapled IPAA with preservation of ATZ. For persistent or recurrent low-grade dysplasia, we recommend a completion mucosectomy.
Symptomatic inflammation of the retained mucosa occurred in 32 (14.7 percent) patients. Nine (4.1 percent) patients had inflammation of the anal canal alone, and 23 (10.6 percent) had pouchitis in addition. The need for treatment occurred in 28 (12.9 percent) of the total ((2.3 percent) patients with anal canal inflammation and 23 (10.6 percent) with anal canal inflammation plus pouchitis).
Os profissionais da área de saúde estão expostos a vários tipos de riscos ocupacionais, sendo o de maior impacto o risco biológico, devido ao contato direto com material orgânico potencialmente contaminado. A manutenção da situação vacinal atualizada é uma das ferramentas que devem ser empregadas neste contexto, além da adoção de medidas universais de biossegurança, sendo a educação fundamental neste processo. Avaliamos a situação vacinal e a percepção sobre risco biológico dos discentes da Faculdade de Medicina da UFJF em estudo observacional transversal (n = 136 alunos). Oitenta e nove alunos (65,4%) referiram estar com o cartão vacinal atualizado. Noventa e sete alunos (71,3%) receberam o esquema da hepatite B, e 99 (72,8%) o do tétano. Oitenta e seis 86 alunos (63,2%) declararam ter recebido orientação sobre imunização durante o curso. Setenta e três alunos (53,7%) já foram expostos a material potencialmente contaminado em suas atividades acadêmicas, e 97 deles (71,3%) usam equipamentos de proteção individual (EPI) nestas. Identificamos falhas na imunização (hepatite B e tétano), expondo os discentes a riscos desnecessários. A orientação relativa à imunização se mostrou insuficiente. A significativa taxa de exposição a risco biológico e o insatisfatório uso de EPIs verificados demandam maior atenção, a fim de prevenir acidentes.
Objective: to establish the epidemiological profile of ostomized patients treated at the Health Care Service for Ostomy Patients in Juiz de Fora and region (SASPO/JF) and to quantify the pathologies that led to the stoma as well as the ostomy-related complications. Method: a retrospective study was carried out with the analysis of 496 medical records of patients registered at HCSOP/JF over 30 years and who remained in at the service in June 2018. The following variables were considered: age, sex, pathology that led to the stoma, type, time, location and complications of stomas. Results: 53.43% were male patients and 46.57% female. The average age was 56.24 years among men and 58.40 years among women. Eight patients had two types of ostomies simultaneously and a total of 504 ostomies were as follows: 340 colostomies (67.46%), 117 ileostomies (23.21%) and 47 urostomies (9.33%). Additionally, 47.65% of the colostomies and 76.92% of the ileostomies were temporary, while all urostomies were permanent. In 70.24% of cases, the reason for making the stoma was malignancy. There were 277 stomas with one or more complications (54.96%). Conclusions: most of the ostomized patients were over 50 years old and the main diagnosis that led to the stoma was malignancy. Ileostomies had a higher percentage of complications than colostomies and urostomies and, for all types of stomas, the most frequent complication was dermatitis.
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