Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2016-12-19T12:51:25Z No. of bitstreams: 2 Dissertação - Adriana Pereira Furtado - 2016.pdf: 1065102 bytes, checksum: 9ce62b4242f473d0c226f85af827b0f1 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-12-27T12:33:56Z (GMT) No. of bitstreams: 2 Dissertação - Adriana Pereira Furtado - 2016.pdf: 1065102 bytes, checksum: 9ce62b4242f473d0c226f85af827b0f1 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-12-27T12:33:56Z (GMT). No. of bitstreams: 2 Dissertação - Adriana Pereira Furtado - 2016.pdf: 1065102 bytes, checksum: 9ce62b4242f473d0c226f85af827b0f1 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-09-30 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / There are currently a large number of canine related cancers, with mammary tumors having the highest incidence in bitches. Although histopathological examination is recommended as a definitive diagnosis, cytopathology has shown good levels of cyto-histopathological concordance. The screen study had the purpose of verifying the accuracy of cytopathological examination in the diagnosis of breast neoplasms in bitches, whose method implies a safer, less invasive procedure and a fast result. It was carried out in the Animal Pathology Sector of the Veterinary and Zootechnical School of the Federal University of Goiás and in a veterinary clinic in the city of Goiânia, Goiás. The cytopathological and histopathological diagnosis of 43 bitches with malignant mammary neoplasias was analyzed. The cytological exams were performed by applying the fine needle aspiration method and the results were analyzed using the histopathological diagnosis as confirmatory. The histopathological classification used was that recommended by the World Health Organization for canine mammary tumors and updated by Goldschmidt in 2001. This study revealed an accuracy of more than 90% of the cytopathological examination. The most frequent malignant mammary neoplasia diagnosed in the histopathology was the complex carcinoma (22%). The efficacy of 1% Methylene Blue dye on Sentinel Lymph node marking was assessed during the mastectomy procedure, and this was shown to be excellent for such labeling. Regarding foci of regional or distant metastases, it was found that tumors considered more malignant such as anaplastic carcinoma and micropapillary carcinoma formed more metastases than the other histological types. / Atualmente há uma grande casuística de neoplasias relacionadas à espécie canina, sendo as mamárias as de maior incidência nas cadelas. Embora o exame histopatológico seja recomendado como diagnóstico definitivo, a citopatologia tem demonstrado bons níveis de concordância cito-histopatológica. O estudo em tela teve finalidade de verificar a acurácia do exame citopatológico no diagnóstico de neoplasias mamárias em cadelas, cujo método implica em procedimento mais seguro, pouco invasivo e de rápido resultado. Foi realizado no Setor de Patologia Animal da Escola de Veterinária e Zootecnia da Universidade Federal de Goiás e em uma clínica veterinária da cidade de Goiânia, Goiás. Analisou-se o diagnóstico citopatológico e histopatológico de 43 cadelas com neoplasias mamárias malignas. Os exames citológicos foram realizados aplicando-se o método de punção aspirativa por agulha fina e os resultados foram analisados usando o diagnóstico histopatológico como confirmatório. A classificação histopatológica utilizada foi a recomendada pela Organização Mundial da Saúde para tumores mamários caninos e atualizada por Goldschmidt em 2001. Este estudo revelou uma acurácia de mais de 90% do exame citopatológico. A neoplasia mamária maligna mais frequente diagnosticada na histopatologia foi o carcinoma complexo (22%). Foi avaliada a eficácia do corante Azul de Metileno a 1% na marcação do Linfonodo Sentinela durante o procedimento de mastectomia, e este se mostrou excelente para tal marcação. Quanto aos focos de metástases regionais ou distantes, viu-se que tumores considerados mais malignos como o carcinoma anaplásico e o carcinoma micropapilares formaram mais metástases que os demais tipos histológicos.

The thesis evaluates the results of experimental protocol involving the fertility sparing treatment procedure in early stage cervical carcinoma (LAP I protocol). Sentinel lymph node detection and experimental extirpation of afferent channels using laparoscopy and its technical aspects were analysed in prospective group of 85 women. The oncologic results and early/late morbidity show that established surgical procedures can be considered safe with minimal morbidity, provided that the indication criteria are met. The second part analyses the results of 148 women with no further pregnancy plans suffering from cervical tumors less than 2 cm in size with invasion less than half of the stroma (LAP II protocol). The oncological results in our defined group are very good and comparable to 'standard' procedure of modified radical hysterectomy type B or C with lower morbidity. In the separate section the thesis analyses the possibilities of laparoscopy in endometrial cancer treatment including the potentials of use of sentinel lymph node detection and technical aspects of laparoscopy in obese women. Currently the biggest controversy is the use of laparoscopy in malignant ovarian tumors. Our oncogynaecological study group at FN Motol prefers the laparotomic approach and we chose to include the set of advanced...

The thesis evaluates the results of experimental protocol involving the fertility sparing treatment procedure in early stage cervical carcinoma (LAP I protocol). Sentinel lymph node detection and experimental extirpation of afferent channels using laparoscopy and its technical aspects were analysed in prospective group of 85 women. The oncologic results and early/late morbidity show that established surgical procedures can be considered safe with minimal morbidity, provided that the indication criteria are met. The second part analyses the results of 148 women with no further pregnancy plans suffering from cervical tumors less than 2 cm in size with invasion less than half of the stroma (LAP II protocol). The oncological results in our defined group are very good and comparable to 'standard' procedure of modified radical hysterectomy type B or C with lower morbidity. In the separate section the thesis analyses the possibilities of laparoscopy in endometrial cancer treatment including the potentials of use of sentinel lymph node detection and technical aspects of laparoscopy in obese women. Currently the biggest controversy is the use of laparoscopy in malignant ovarian tumors. Our oncogynaecological study group at FN Motol prefers the laparotomic approach and we chose to include the set of advanced...

Made available in DSpace on 2016-01-26T12:51:37Z (GMT). No. of bitstreams: 1 newtonbordin_tese.pdf: 2102625 bytes, checksum: c010c20492698be8a7290a7a377973b4 (MD5) Previous issue date: 2012-05-25 / Although lymphedema resulting from the treatment of breast cancer is secondary lymphedema, it follows the same diagnostic and treatment criteria as other types of lymphedema. Its prevalence varies from 7% to more than 50% of patients submitted to surgery depending on the surgical approach and associated treatment employed. Main: objectives of this study were to evaluate the efficacy of mechanical lymphatic drainage in reducing the volume of lymphedematous limbs after breast cancer treatment and identify the optimal time of treatment. Patients and Method: From July 2007 to July 2008, twenty-five patients with lymphedema resulting from breast cancer treatment were enrolled in this study by order of arrival at the Godoy Clinic. The ages of the patients ranged from 42 to 86 years old (mean: 55.6 years). Diagnosis of lymphoedema was made clinically and confirmed by volumetry. Lymphedema was confirmed with a difference in volume between the patient s arms of more than 200 ml. Exclusion criteria were the presence of active infection, joint problems including immobility due to neurological involvement or any clinical condition in which physical exercises are contraindicated, such as heart failure and advanced active cancer. This study was divided into two stages with all patients being evaluated by water-displacement volumetry before and after activities. In phase I (n = 25) the patients were submitted to one hour of activities and phase II (n = 13) patients were submitted to three hours of activities with volumetry being carried out every hour. The RAGodoy® electromechanical device, which makes 15 to 25 passive flexion and extension movements of the elbow joint per minute, was used for mechanical lymphatic drainage. The t-test with a Bonferroni alpha correction of 0.008 was used for statistical analysis and an alpha error of 5% (p-value &#8804; 0.05) was considered significant. The study was approved by the Research Ethics Committee of the Medical School in Sao Jose do Rio Preto. Results: The reduction in volume was significant in Phase I (one hour treatment: p < 0.001), with the initial mean weight being 2026.4 and final weight being 1967.2 (mean loss of 59.2 grams). In Phase II (three hours activities), the reductions were significant in the first and second hours (p <0.0005 and 0.002, respectively). However, no statically significant difference was seen using a Bonferroni alpha correction of 0.008 (p-value = 0.01) between the second and third hour. Conclusion: In conclusion the use of the device reduces the volume of lymphedematous limbs; it is most effective in the first hour, but provides significant reductions for a maximum of two hours. / O lindedema pós-câncer de mama enquadra-se no tipo secundário de linfedema e segue os mesmos padrões diagnósticos e terapêuticos dos demais tipos de linfedema. Sua prevalência varia entre 7% a mais de 50% das pacientes submetidas ao tratamento cirúrgico, dependendo da abordagem cirúrgica realizada e dos tratamentos complementares empregados. Objetivo: O objetivo deste estudo foi avaliar a eficácia da drenagem linfática mecânica na redução de volume dos membros linfedematosos pós-tratamento câncer de mama e a identificação do tempo ideal de tratamento. Pacientes e Método: De julho 2007 a julho de 2008, 25 pacientes com linfedema pós-tratamento de câncer de mama foram avaliadas neste estudo, selecionadas por ordem de chegada, na Clínica Godoy. A idade das pacientes variou entre 42 a 86 anos e a idade média foi de 55,6 anos. O diagnóstico do linfedema foi clínico e confirmado por volumetria. O linfedema foi confirmado quando a diferença de volume era maior que 200 ml entre os membros. Considerou-se como critério de exclusão a presença de infecção ativa, problemas articulares envolvendo a imobilidade devido a comprometimento neurológico ou qualquer condição clínica com contraindicação para atividade física como a insuficiência cardíaca e o câncer em atividade. O estudo foi dividido em duas fases sendo que todas pacientes realizaram a volumetria por técnica de deslocamento de água antes a após a atividade. Na fase I (n = 25) as pacientes realizaram uma hora de atividade e na fase II (n = 13) as pacientes realizaram três horas de atividade, sendo feito a volumetria ao final de cada hora. O dispositivo eletromecânico RAGodoy®, que faz de 15 a 25 movimentos de flexão e extensão passivas da articulação do cotovelo, foi usado para a drenagem mecânica do membro. Para análise estatística foi usado o teste-t com correção alfa de Bonferroni = 0,008, considerando erro alfa de 5% (valor p&#8804; 0,05) como significativo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Medicina de São Jose do Rio Preto-SP. Resultados: A redução do volume foi significativa na Fase I (uma hora de tratamento: p < 0,001), sendo a média do peso inicial de 2026,4g e final de 1967,2g (perda média de 59,2 g). Na Fase II (três horas de atividade) as reduções foram significativas na primeira e segunda horas (p < 0,0005 e p < 0,002, respectivamente). Entretanto, entre a segunda e terceira hora, a diferença não foi estatisticamente significativa. Conclusões: Conclui-se que o dispositivo mecânico reduz o volume de membro linfedematoso durante sua aplicação, sendo mais eficaz na primeira hora mas proporciona redução significativa quando usado por até duas horas.

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