WHO Safety Surgical Checklist implementation evaluation in public hospitals in the Brazilian Federal District.

The World Health Organization (WHO) created the WHO Surgical Safety Checklist to prevent adverse events in operating rooms. The aim of this study was to analyze WHO checklist implementation in three operating rooms of public hospitals in the Brazilian Federal District. A prospective cross-sectional study was performed with pre- (Period I) and post (Period II)-checklist intervention evaluations.

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).

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.

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.

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.

Food tolerance in patients submitted to gastric bypass: the importance of using an integrated and interdisciplinary approach.

Background: Under the restrictive component, patients undergoing gastric bypass may have food intolerance with or without complications.

Methods: This study used quantitative, analytical, observational methodology with patients submitted to Roux-en-Y gastric bypass without the placement of a ring at Hospital Universitário do Rio Grande do Norte in the city of Natal, Brazil between July 2005 and August 2010. Out of 176 patients monitored after surgery by the interdisciplinary team, 47 took part in the study.

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.

Gastric bypass in the treatment of type 2 diabetes in patients with a BMI of 30 to 35 kg/m2.

Background: Type 2 diabetes mellitus (T2DM) and class I obesity, which are pandemics of considerable socioeconomic importance, require new treatment modalities due to inadequate control through normal clinical conduct. The aim of the present study was to assess the efficacy and safety of Roux-en-Y gastric bypass (RYGB) in the control of T2DM in patients with a body mass index (BMI) of 30 to 35 kg/m(2).

Methods: An observational, retrospective study was carried out at the Universidade Federal de Pernambuco-Brazil.

Analysis of plasma citrulline and intestinal morphometry in mice with hepatosplenic schistosomiasis.

Background: Portal hypertension in the mucosa of the intestine and the presence of granulomas in the wall of this organ can alter digestive function in patients with schistosomiasis. Citrulline is a potential marker of intestinal function in some diseases that affect the morphometry of the mucosa because of its close association with enterocytes. The aims of the present study were to determine serum citrulline concentrations in mice with hepatosplenic schistosomiasis, analyze the morphologic repercussions for the mucosa of the small intestine, correlate citrulline concentrations with morphometric changes in the intestinal mucosa, and evaluate the effect of splenectomy on citrulline concentration.

Treatment of ring slippage after gastric bypass: long-term results after endoscopic dilation with an achalasia balloon (with videos).

Background: Silastic rings are used in gastric bypass procedures for the treatment of obesity, but ring slippage may lead to gastric pouch outlet stenosis (GPOS). Conventional management has been ring removal through abdominal surgery.

Objective: To describe a novel, safe, minimally invasive, endoscopic technique for the treatment of GPOS caused by ring slippage after gastric bypass.

Translumenal endoscopic drainage of abdominal abscess due to early migration of adjustable gastric band.

We describe the case of early band migration that developed into intraabdominal infection treated by natural orifice translumenal endoscopic surgery. A 40-year-old man was seen 4 years after gastric band placement. He complained of epigastric pain and fever.

Obstructive sleep apnea-hypopnea syndrome--the role of bariatric and maxillofacial surgeries.

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a complex disease with multifactorial etiology. It is marked by the occurrence of apnea and hypopnea events caused by repeated obstructions of the upper airways. OSAHS is strongly associated with obesity, and the prevalence of this disease in morbidly obese patients is very high.

Evaluation of risk factors in superobese patients submitted to conventional Fobi-Capella surgery.

Background: Obesity is one of the worlds greatest health problems. The Roux-en-Y gastric bypass is the gold standard treatment for severe obesity. Surgery in obese patients has an acceptable level of morbidity and mortality.

Gastrobronchial fistula as a rare complication of gastroplasty for obesity: a report of two cases.

Gastrobronchial fistula is a rare condition as a complication following bariatric surgery. The management of this condition requires the active participation of a pulmonologist, who should be familiar with aspects of the main types of bariatric surgery. Herein, we report the cases of two patients who presented recurrent subphrenic and lung abscess secondary to fistula at the angle of His for an average of 19.

An experimental study of the electrical activity of the bypassed stomach in the Roux-en-Y gastric bypass.

Background: Surgical options for morbid obesity are diverse, and the Roux-en-Y gastric bypass, initially described by Fobi has gained popularity. Knowledge about the physiology of the bypassed stomach is limited because this newly produced segment of the stomach is inaccessible to endoscopic or contrast radiological studies.

Aim: To evaluate the myoelectric activity of the bypassed stomach and its reply to the feeding.

Evaluation of splenomegaly in the hepatosplenic form of mansonic schistosomiasis.

This study was aimed to evaluate splenomegaly in patients with the hepatosplenic (HS) form of mansonic schistosomiasis (MS), analyzing the size and weight of the spleen and their relationships with patients' gender and age. Between October, 1993 to July, 1998, 78 patients with the HS form of MS had undergone splenectomy as treatment of choice for bleeding due to portal hypertension, at Hospital das Clínicas, Pernambuco, Brazil. By means of abdominal palpation, the excess spleen felt below the left costal edge was measured, and the weight was obtained after splenectomy along with the histopathological analysis.

[Lymphoma in patients harboring hepatosplenic mansonic schistosomiasis].

Background: Correlation between infectious agents and linfoproliferative diseases are more stablished, over all virus and bacteria, through the activation of linfocytes.

Aim: To describe six new cases, of a series of 254 patients (2,36%) with mansonic schistosomiasis, in the hepatosplenic form.

Methods: Six patients will be described, amongst the 254 carriers of mansonic schistosomiasis, in the hepatosplenic form, followed in the last 13 years.

Surgical site infection in patients submitted to digestive surgery: risk prediction and the NNIS risk index.

Background: Some problems have been reported with the power of the National Nosocomial Infection Surveillance (NNIS) risk index to predict the risk of surgical site infections (SSI) for specific procedures.

Objectives: To develop an alternative risk prediction index for SSI and to compare the performance with the NNIS index.

Methods: A prospective cohort study was carried out with all (609) patients submitted to digestive tract surgery in 2 general teaching hospitals in the city of São Paulo, Brazil, from August 2001 through March 2002.