TEACHING MODEL FOR EVALUATION OF THE ABILITY AND COMPETENCE PROGRESS IN ENDOSUTURE IN SURGICAL SKILL LABORATORY.

Background: Laparoscopic manual suturing is probably the most difficult skill to be acquired in minimally invasive surgery. However, laparoscopic exercise endo-sutures can be learned with a simulator and are of great practical importance and clinical applicability, absorbing concepts that are immediately transferred to the operating room.

Aim: To assess the progression of skills competence in endo-sutures through realistic simulation model of systematized education.

Distribution of Ocular Component Measures and Refraction in Brazilian School Children.

Purpose: To describe ocular component values and refraction in 6-17-year-old school children in Campinas, Brazil.

Methods: To obtain a representative sample, a total of 1100 6-17-year-old public school students in Campinas, Brazil, were randomly selected and divided into groups according to median ages 6 years (range 5-7 years), 10 years (range 9-11 years), 14 years (range 13-15 years), and 17 years (range 16-18 years). Cycloplegic autorefraction and ocular biometry were performed on each child.

LONG-TERM POSTOPERATIVE ENDOSCOPIC FINDINGS AFTER GASTRIC BYPASS PROCEDURE: a co-occurrence analysis.

Background: A multitude of endoscopic findings post-gastric bypass procedures have been previously reported in the literature, but to our knowledge, no present rules exist that could guide clinicians regarding which findings should be actively sought, once an initial finding is identified.

Objective: To identify co-occurrence patterns among endoscopic findings of patients having undergone past gastric bypass procedure.

Methods: Our registry involves all consecutive patients undergoing an upper endoscopic evaluation after a gastric bypass procedure.

Controversies in Reduction Mammoplasty: Being A "Clean" Operation, Does It Mandate Antibiotic Prophylaxis?

Background: Considered a clean operation, breast surgery has surgical site infection (SSI) rates ranging from 4% to 18%, higher than the reference value for clean surgery (<3.4%). The aim of this study was to measure the incidence of SSI in patients undergoing reduction mammoplasty with and without antibiotic prophylaxis, comparing the results and defining the value of antibiotic prophylaxis.

Chest drainage teaching and training for medical students. Use of a surgical ex vivo pig model.

Purpose: Implement a constructivist approach in thoracic drainage training in surgical ex vivo pig models, to compare the acquisition of homogeneous surgical skills between medical students.

Methods: Experimental study, prospective, transversal, analytical, controlled, three steps. Selection, training, evaluation.

Endoscopic treatment of food intolerance after a banded gastric bypass: inducing band erosion for removal using a plastic stent.

Background And Study Aims: Ring complications after a banded Roux-en-Y gastric bypass (RYGB) are usually managed surgically. The aim of this study was to analyze the safety and effectiveness of endoscopic removal of noneroded rings after banded-RYGB, by inducing intragastric erosion of the ring using a self-expandable plastic stent (SEPS).

Patients And Methods: A total of 41 patients with banded RYGB who had noneroded rings and food intolerance were prospectively enrolled.

Preadmission Application of 2% Chlorhexidine Gluconate (CHG): Enhancing Patient Compliance While Maximizing Skin Surface Concentrations.

Objective: Surgical site infections (SSIs) are responsible for significant morbidity and mortality. Preadmission skin antisepsis, while controversial, has gained acceptance as a strategy for reducing the risk of SSI. In this study, we analyze the benefit of an electronic alert system for enhancing compliance to preadmission application of 2% chlorhexidine gluconate (CHG).

Obesity prevalence and metabolic syndrome in a park users.

Unlabelled: Background -Overweight and obesity are associated with metabolic syndrome and abdominal obesity, thereby increasing the risk of type 2 diabetes mellitus and cardiovascular diseases. In Brazil, there are still no precise data on the prevalence of these disorders, especially among individuals who carry out some kind of physical activity in public spaces and there are no education and prevention programs for obesity.

Aim: To investigate the prevalence of metabolic syndrome and obesity among park users.

C-REACTIVE PROTEIN IN DIABETIC PATIENTS BEFORE GASTRIC BYPASS AS A POSSIBLE MARKER FOR POSTOPERATIVE COMPLICATION.

Background: Obesity and type 2 diabetes mellitus are associated to inflammatory state, which can be set off by the adipose tissue, once it is a metabolically active organ that can cause a chronic mild inflammatory state.

Aim: To evaluate the correlation between preoperative C-reactive protein and postoperative complications risk in obese patients (grades II and III) after Roux-en-Y gastric bypass, with and without type 2 diabetes mellitus.

Methods: Between 2008 and 2013 were analysed 209 patients (107 with diabetes), presenting body mass index >40 kg/m2 or >35 kg/m2 with comorbidities.

SURGICAL TREATMENT OF SEVERE OBESITY IN TEENS: LATE RESULTS.

Background: In children is estimated that the prevalence of overweight and obesity has increased up to five times in developed countries and up to four in developing countries. In Brazil, the proportion of children and adolescents who are overweight also increased from approximately 4.1% to 13.

Endoscopic Management of Massive Hemorrhage 12 h Post Laparoscopic Roux-en-Y Gastric Bypass.

Background: Acute (<24 h) staple line bleeding is not common but a known complication after bariatric surgery at a rate of 1-3%. In most cases, acute postoperative bleeding is mild and can be managed conservatively. Nonetheless, there are times when massive hemorrhage is encountered.

Gastrobronchial Fistula in Sleeve Gastrectomy and Roux-en-Y Gastric Bypass--A Systematic Review.

Gastrobronchial fistula (GBF) is a rare surgical complication after bariatric surgery. We aimed to identify the clinical aspects of GBF and establish diagnostic and treatment strategies. A literature search was conducted in December 2013, in the PubMed electronic database.

ANTIBIOTIC PROPHYLAXIS IN BARIATRIC SURGERY: a continuous infusion of cefazolin versus ampicillin/sulbactam and ertapenem.

Background: The incidence of surgical site infection in bariatric patients is significant and the current recommendations for antibiotic prophylaxis are sometimes inadequate. Objective: The aim of this study was to analyze the effect of three prophylactic antibiotic regimens on the incidence of surgical site infection.

Methods: A prospective, cross-sectional study was conducted between January 2009 and January 2013 in which 896 Roux-en-Y gastric bypasses were performed to treat obesity.

Metabolic and endocrinological factors related to nephrolithiasis pre and post multiple techniques of bariatric surgery: a sistematic review.

Introduction: Despite of benefits of bariatric surgery for obesity treatment, the procedure may be related to some complications.

Aim: Analyze studies to address the relation between nephrolithiasis and bariatric surgery.

Methods: Ten papers about this theme were selected from 2005-2013 in Pubmed, describing the relation of nephrolithiasis or their risk factors with several types of bariatric surgery.

Altered coronary artery calcium scores before bariatric surgery.

Introduction: Obesity is an important cause of cardiovascular disease, especially coronary artery disease. Severely obese patients are particularly prone to this risk. The coronary artery calcium (CAC) score is a strong predictor of coronary heart disease and provides incremental information beyond traditional risk factors.

Antibiotic prophylaxis in bariatric surgery with continuous infusion of cefazolin: determination of concentration in adipose tissue.

Background: The aim of this study was to evaluate the concentration of cefazolin in adipose tissue of patients undergoing bariatric surgery.

Methods: Eighteen patients undergoing bariatric surgery were evaluated during the period from October 2011 to May 2012. All patients had a dosage schedule of antibiotic prophylaxis with cefazolin administered as follows: first, 2 g in anesthetic induction, followed by continuous infusion of 1 g diluted in 250 ml of saline solution.

Metabolic surgery, weight regain and diabetes re-emergence.

Introduction: The poor success of clinical treatment of Type 2 Diabetes Mellitus (T2DM2) increased interest in metabolic surgery, which has been considered a promising alternative for the control of obese or non-obese diabetics. However, there is still no long-term follow-up to evaluate the duration of diabetes remission, and if weight regain would be associated to recurrence.

Aim: 1) To describe the results of diabetic patients with a BMI < 30 and < 35 kg/m² submitted to the following types of metabolic surgery: ileal interposition and sleeve gastrectomy, Roux-en-Y gastric bypass (RYGB), adjustable gastric banding, duodeno-jejunal exclusion and duodeno-jejunal bypass; 2) to evaluate the possible relapse of diabetes after occurrence of weight regain on long-term after bariatric surgery.

Revision surgery for treatment of weight regain after Roux-en-Y gastric bypass.

Background: This study aims to evaluate results on revision surgery for weight regain after gastric bypass, based on surgical technique and follow-up.

Methods: This study is a retrospective analysis of 29 patients who presented weight regain on follow-up after more than 5 years, divided into four groups according to revision surgery type: group 1 (n = 9) includes patients who underwent an increase in the length of the alimentary limb to 200 cm; group 2 (n = 13) are patients who underwent an increase in the length of the alimentary limb and placing of a silicon ring; group 3 (n = 2) are patients who underwent an increase in the length of the alimentary limb and gastric plication, and group 4 (n = 5) are patients who underwent gastric plication and placing of a silicon ring.

Results: The average preoperative weight before revision surgery was 117.

Improvement of schistosomal portal hypertensive colopathy after surgical treatment.

Context: Data on vascular alterations in patients with hepatosplenic schistosomiasis and portal hypertensive colopathy and changes in these after surgery to decrease portal hypertension are limited.

Objective: The purpose of this study was to analyse the alterations of portal hypertensive colopathy previously and 6-12 months after splenectomy and gastric devascularization.

Methods: Twelve patients with hepatosplenic schistosomiasis who also had upper gastrointestinal bleeding were studied prospectively.

Association of human papillomavirus genomic sequences by polymerase chain reaction in gastric carcinomas in Brazil.

Objective: To investigate the prevalence of human papillomavirus (HPV) in patients with gastric cancer and compare with a control group.

Study Design: Forty paraffin samples of gastric cancer and 40 endoscopic normal mucosa and peripheral blood controls were subjected to examination by polymerase chain reaction for the L1 gene of HPV. The extracted DNA was amplified in 2 reaction systems using 2 pairs of primers: MY09/MY11 and GP+5/GP+6.

Skeletonized versus pedicled internal thoracic artery and risk of sternal wound infection after coronary bypass surgery: meta-analysis and meta-regression of 4817 patients.

It is suggested that the internal thoracic artery (ITA) harvesting technique influences the incidence of sternal wound infection (SWI) after coronary artery bypass graft (CABG). To determine if there is any real difference between skeletonized vs pedicled ITA, we performed a meta-analysis to determine if there is any real difference between these two established techniques in terms of SWI. We performed a systematic review using MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles to search for studies that compared the incidence of SWI after CABG between skeletonized vs pedicled ITA until June 2012.

Endoscopic dilation of gastrojejunal anastomosis after gastric bypass.

Introduction: Roux-en-Y gastric bypass may result in stenosis of the gastrojejunal anastomosis. There is currently no well-defined management protocol for this complication.

Aim: Through systematic review, to analyze the results of endoscopic dilation in patients with stenosis, including complication and success rates.

Influence of the inversion of the portal/splenic vein diameter in the results of the surgical treatment of schistossomotic portal hypertension.

Objective: To evaluate the morbidity and mortality in surgical treatment of schistosomal portal hypertension in patients with inversion of the Portal/Splenic Vein diameter ratio.

Methods: We conducted a retrospective cross-sectional study of patients undergoing surgical treatment of portal hypertension in the period between September 1993 and January 2004. The study population was divided into two groups: a) Inversion--splenic vein diameter greater than or equal to portal vein's--and b) control group (portal vein diameter greater than the splenic vein's).

Prediction of severe complications and death in superobese patients undergoing open gastric bypass with the Recife Score.

Context: Superobese patients who undergo gastric bypass have a greater incidence of complications. The greater incidence of comorbidity in this group leads to a higher surgical risk, and a need for special care. By analyzing the risk factors identified in the preoperative period, scoring them, constructing a score and assessing the occurrence of serious complications and death, we will have elements to identify which patients are at greater risk.