Assessment of The Addition of Epinephrine to Intra-articular Bupivacaine for the Control of Acute Pain in Patients underwent to Anterior Cruciate Ligament Reconstruction.

 To evaluate postoperative pain, using the visual analog scale (VAS), in patients undergoing anterior cruciate ligament reconstruction (ACLR) and receiving intra-articular anesthetic solutions.  The present is a randomized clinical trial with a sample of 48 patients divided into 4 groups: Group I (n = 12) - 20 mL of saline solution (control); Group II (n = 12) - 20 mL of 0.5% bupivacaine; Group III (n = 12) - 20 mL of 0.

Microbiologic characteristics and antibiotic resistance rates of diabetic foot infections.

Purpose: the purpose of this research was to identify the sociodemographic and microbiological characteristics and antibiotic resistance rates of patients with diabetic foot infections, hospitalized in an emergency reference center.

Methods: it was an observational and transversal study. The sociodemographic data were collected by direct interview with the patients.

Morphometric analysis of dendritic cells from anal mucosa of HIV-positive patients and the relation to intraepithelial lesions and cancer seen at a tertiary health institution in Brazil.

Purpose: To morphometrically quantify CD1a+ dentritic cells and DC-SIGN+ dendritic cells in HIV-positive patients with anal squamous intraepithelial neoplasia and to evaluate the effects of HIV infection, antiretroviral therapy and HPV infection on epithelial and subepithelial dendritic cells.

Methods: A prospective study was performed to morphometrically analyze the relative volume of the dendritic cells and the relationship between anal intraepithelial neoplasia and cancer in HIV-positive patients from the Tropical Medicine Foundation of Amazonas, Brazil. All patients were submitted to biopsies of anorectal mucosa to perform a classic histopathological and immunohistochemical analysis, employing antibodies against CD1a and DC-SIGN for the morphometric quantification of dendritic cells.

Performance of p16INK4a immunocytochemistry as a marker of anal squamous intraepithelial lesions.

Background: Protein p16(INK4a) immunocytochemistry (ICCp16) has the potential to reveal lesions at risk of progression to anal cancer. This study examined measures of diagnostic validity of ICCp16 in HIV-positive patients treated at the Tropical Medicine Foundation of Amazonas in the coloproctology outpatient clinic.

Methods: One hundred ninety HIV-positive patients were consecutively enrolled in 2007 and 2008.

Anal cancer precursor lesions in HIV-positive and HIV-negative patients seen at a tertiary health institution in Brazil.

Purpose: To investigate the prevalence of anal squamous intraepithelial lesions (ASIL) or anal cancer in patients attended at the Tropical Medicine Foundation of Amazonas.

Methods: 344 patients consecutively attended at the institution, in 2007/2008, were distributed in the following strata according to presence/abscense of at risk conditions for anal cancer: Group 1 - HIV-positive men-who-have-sex-with-men (101); Group 2 - HIV-positive females (49); Group 3 - patients without any at risk condition for anal cancer (53); Group 4 - HIV-positive heterosexual men (38); Group 5 - HIV-negative patients, without anoreceptive sexual habits, but with other at risk conditions for anal cancer (45); Group 6 - HIV-negative men-who-have-sex-with-men (26); and Group 7 - HIV-negative anoreceptive females (32). The histopathological results of biopsies guided by high-resolution anoscopy were analyzed by frequentist and bayesian statistics in order to calculate the point-prevalence of ASIL/cancer and observe any eventual preponderance of one group over the other.

Needlescopic versus laparoscopic cholecystectomy. A prospective study of 60 patients.

Purpose: To test the hypothesis that needlescopic cholecystectomies (NC) offer superior outcomes in comparison to common laparoscopic cholecystectomies (LC).

Methods: Sixty consecutive patients with gallbladder disease undergoing either LC or NC were evaluated with respect to differences in operative time, frequency of per-operative incidents, post-operative pain, late postoperative symptoms, length of scars and level of postoperative satisfaction.

Results: Mean operative time was similar in both groups.

High-resolution anoscopy in the diagnosis of anal cancer precursor lesions in renal graft recipients.

Background: Renal graft recipients are one of the population groups known to be at high risk of developing anal cancer. This study investigated the presence of subclinical anal squamous intraepithelial lesions and the diagnostic ability of high-resolution anoscopy in detecting these lesions in renal graft recipients followed-up in Manaus.

Methods: In a cross-sectional study, 50 renal graft recipients were interviewed and submitted to high-resolution anoscopy with biopsies of acetowhite lesions or of the anal transition zone mucosa when acetowhitening was absent.

[Anal cytology as a screening method for early detection of anal cancer: are hydrophilic cotton smears really unsatisfactory?].

Purpose: To test the ability of analpaps performed with cotton swab smears to produce satisfactory cytologic readings as compared to traditional sampling materials.

Methods: 318 consecutive patients were examined at the Ambulatório Araújo Lima of Hospital Universitario Getúlio Vargas in the Anal Cancer Prevention Week and were sampled for the performance of analpap. 180 of these patients were randomly sorted to be sampled by either one of the following materials: cytologic brush, dacron swab or cotton swab.