A exenteração pélvica (EP) é uma técnica cirúrgica radical, indicada para tumores avançados de colo de útero e reto, dentre outros. Nesse estudo realizou-se uma revisão sistemática da literatura, com foco em artigos científicos publicados na última década (2003-2013) sobre as repercussões emocionais da EP para a população feminina. Foram localizados 59 artigos nas bases PsycINFO, PubMed, LILACS e SciELO, usando como descritores “exenteração pélvica”, “fatores emocionais”, “sexualidade”, “depressão” e “ansiedade”. Destes, seis artigos (cinco empíricos e um de revisão de literatura) foram considerados para análise, baseada no tema, objetivos do estudo, metodologia e principais resultados e conclusões. Predominou o delineamento quantitativo, com o emprego de instrumentos estruturados em pacientes alemãs, norte-americanas, egípcias e dinamarquesas. Quanto ao tema, destacou-se a qualidade de vida. Os principais achados e conclusões referem-se ao abalo emocional vivido por essas mulheres devido às alterações da imagem corporal após a cirurgia, principalmente pelo uso das ostomias.

Pelvic exenteration (PE) is a radical surgery mostly indicated for advanced cancers of uterus, cervix, and rectum, among others. In this study, a systematic review of the literature was carried out, focusing on scientific papers published in the past decade (2003-2013) about emotional repercussions of PE for female population. A total of 59 articles were found on PubMed, LILACS, SciELO and PsycInfo databases, using the following descriptors: “pelvic exenteration”, “emotional factors”, “sexuality”, “depression” and “anxiety”. Six articles (five empirical and one literature review) were considered for analysis, based on the theme, objectives, methodology, main results, and conclusions. A quantitative research design was predominant; data were collected using structured instruments with German, American, Egyptian and Danish patients. Emphasis was given to quality of life. Main findings and conclusions refer to emotional impact experienced by these women because of changes in their body image after surgery, which included the use of ostomies.

ABSTRACT PURPOSE: To evaluated the role of oxidative stress on aging process in patients submitted to carotid endarterectomy. METHODS: Twenty patients were divided into two groups: older group (≥ 70 years old); and the younger group (< 70 years old). We evaluated the reactive oxygen species (ROS) concentration, nicotinamide adenine dinucleotide phosphate (NADPH)-oxidase, superoxide dismutase (SOD) and catalase (CAT) activities as so as nitrite levels in fragments of carotid arteries harvested during carotid endarterectomy for treatment of high grade carotid stenosis. RESULTS: We observed a higher levels of ROS and NADPH oxidase activity in the older group (p<0.05). Furthermore, the nitrite concentration was lower in the older group (14.55 ± 5.61 x 10-3 versus 26.42 ± 8.14 x 10-3 µM; p=0.0123). However, the activities of antioxidant enzymes (CAT and SOD) were similar in both the groups. CONCLUSIONS : Arterial aging is associated with increased concentrations of oxygen species and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity as so as nitrite reduction in human carotid artery specimens. Maybe therapies that block NADPH oxidase activity and enhance nitrite stores would be a good strategy to reduce the effect of oxidative stress in arterial aging.

INTRODUÇÃO: A expectativa de vida da população tem aumentado nos últimos anos, como também houve progressão da incidência de neoplasias primárias e secundárias do fígado. A medicina vem acompanhando esse processo, mas ainda há receios quanto ao uso de tratamentos cirúrgicos agressivos em pacientes idosos, especialmente no que tange à cirurgia do fígado. OBJETIVO: Analisar a influência da idade na morbimortalidade de pacientes submetidos à ressecção hepática. MÉTODOS: Revisão bilbliográfica através dos sites do PubMed, Scielo e Bireme, com os descritores "elderly", "hepatectomy", "hepatic resection", "postoperative complications", "morbidity", "mortality". Foram selecionados os trabalhos que compararam os resultados de hepatectomia entre grupos de pacientes jovens e idosos. CONCLUSÃO: A idade não é fator predisponente à piora dos resultados na ressecção hepática.

INTRODUCTION: Life expectancy of the population has increased in recent years as a result of human development, leading to an increase in the incidence of primary and secondary neoplasms of the liver. Medicine has been following this process, but there is still fear of aggressive surgical treatment in elderly patients, especially concerning to liver surgery. AIM: To analyze the influence of age on the morbidity and mortality of patients undergoing liver resection. METHOD: Literature review of scientific articles available in PubMed, Scielo and Bireme database with "elderly", "hepatectomy," "hepatic resection," "postoperative complications", "morbidity", "mortality". It was selected studies that compared the results of hepatectomy between groups of young and elderly patients. CONCLUSION: Age is not a predisposing factor for the worsening of results in liver resection.

The authors report a case of adenomyoma of papilla of Vater in a young adult, a rare pathology in this age and site. The commonest clinical findings are abdominal pain, dyspepsia and jaundice, as in this case in which the patient referred these symptoms for several months. The diagnosis is usually difficult before surgery, because the radiological and endoscopic appearances are difficult to interpret, since they may only show obstruction and enlargement of the biliary tract; in this way, the endoscopic biopsy may be useful. In the present case the computed tomography, abdominal scan and intraoperative cholangiography only demonstrated obstruction and enlargement of the biliary tract, without the presence of gallstones. The treatment is usually lesion resection according to its size, performing the total resection in those cases of extensive involvement of the digestive tract, as it was performed in this case, due to the dimension of the lesion and its malignant appearance. The patient was discharged from hospital on the thirteenth postoperative day, with a histological diagnosis of adenomyoma of papilla of Vater. Three months after the procedure the patient was asymptomatic.