Intravenous overload of fluids and sodium may contribute to the lower infusion of enteral nutrition in critically ill patients.

Objective: To evaluate the effects of intravenous infusion of fluids and sodium on the first day of admission on infusion of enteral nutrition in the first 5 days in intensive care patients.

Methods: A prospective cohort study was conducted with critical nonsurgical patients admitted for at least 5 days who were on mechanical ventilation and receiving enteral nutrition. The amount of intravenous fluids and sodium infused on the first day and the volume of enteral nutrition infused in the first 5 days were investigated.

Facial nerve hemangioma in the middle ear.

Facial nerve hemangioma is a rare and benign vascular tumor, and accounts for 0.7% of intratemporal tumors. We report the second case described in the literature of a facial nerve hemangioma in its tympanic segment.

Retinal nerve fiber layer analysis in cocaine users.

Cocaine is a well-known factor of tissue ischemia and may be related to thinning of the inner retinal layers. The present study aimed to evaluate and determine whether cocaine users show retinal nerve fiber layer (RNFL) thinning by means of spectral-domain optical coherence tomography. A group of 17 cocaine users and 18 non-users were recruited for complete ophthalmologic examination.

A simple test to assess the emotional status of smokers.

Background And Aims: Smokers exhibit a high prevalence of psychological abnormalities, and these factors may contribute to smoking initiation, its maintenance, and quitting difficulties. This study reports the development of a scale aiming at evaluating the emotional status of smokers in face of tobacco.

Methods: Levels of Anxiety, Depression, Perceived Stress, Self-esteem, and Loneliness of 120 smokers (age: 54.

Vaginal progesterone is as effective as cervical cerclage to prevent preterm birth in women with a singleton gestation, previous spontaneous preterm birth, and a short cervix: updated indirect comparison meta-analysis.

Background: An indirect comparison meta-analysis published in 2013 reported that both vaginal progesterone and cerclage are equally efficacious for preventing preterm birth and adverse perinatal outcomes in women with a singleton gestation, previous spontaneous preterm birth, and a sonographic short cervix. The efficacy of vaginal progesterone has been challenged after publication of the OPPTIMUM study. However, this has been resolved by an individual patient-data meta-analysis (Am J Obstet Gynecol.

Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix: a meta-analysis of individual patient data.

Background: The efficacy of vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix has been questioned after publication of the OPPTIMUM study.

Objective: To determine whether vaginal progesterone prevents preterm birth and improves perinatal outcomes in asymptomatic women with a singleton gestation and a midtrimester sonographic short cervix.

Study Design: We searched MEDLINE, EMBASE, LILACS, and CINAHL (from their inception to September 2017); Cochrane databases; bibliographies; and conference proceedings for randomized controlled trials comparing vaginal progesterone vs placebo/no treatment in women with a singleton gestation and a midtrimester sonographic cervical length ≤25 mm.

Yolk sac primary tumor of mediastino: a rare case in a young adult.

Germ cell tumors are rare neoplasms that mostly occur in the gonads, although they can also affect other body sites, especially the anterior mediastinum (50 to 70% of all extragonadal germ cell tumors). We report a case of a primary mediastinal yolk sac tumor, a rare and aggressive germ cell tumors subtype. This was a 38-year-old man who was admitted to Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", complaining about dyspnea and dry cough for 1 year.

Giant esophageal epiphrenic diverticulum: presentation and treatment.

Epiphrenic diverticulum is a rare disease associated with esophageal motor disorders that is usually asymptomatic and has a well-established surgical indication. We report a case of giant epiphrenic diverticulum in a 59-year-old symptomatic woman who was diagnosed after underwent complementary exams. Because of her symptoms, the surgical treatment was chosen, and esophageal diverticulectomy was performed along with laparoscopic cardiomyotomy and anterior partial fundoplication.

The therapeutic challenge of giant splenic artery aneurysm: a case repport.

Giant splenic artery aneurysm is a rare condition that represents an eminent life threatening for the patient, requiring, therefore, urgent surgical correction. A 61-year-old woman, former smoker, hypertensive, hypercholesterolemic and multipara sought our service because of a large tumor in the mesogastrium, which was an abdominal ultrasound finding. Despite the size of the tumor, the patient was asymptomatic.

Intrapancreatic accessory spleen.

An asymptomatic 79-year-old woman, with incidental finding on abdominal ultrasound of a solid nodule in the tail of the pancreas. Magnetic resonance imaging showed a 12mm solid tumor. The suggested diagnosis was pancreatic neuroendocrine tumor.

Vaginal progesterone decreases preterm birth and neonatal morbidity and mortality in women with a twin gestation and a short cervix: an updated meta-analysis of individual patient data.

Objective: To assess the efficacy of vaginal progesterone for the prevention of preterm birth and neonatal morbidity and mortality in asymptomatic women with a twin gestation and a sonographic short cervix (cervical length ≤ 25 mm) in the mid-trimester.

Methods: This was an updated systematic review and meta-analysis of individual patient data (IPD) from randomized controlled trials comparing vaginal progesterone with placebo/no treatment in women with a twin gestation and a mid-trimester sonographic cervical length ≤ 25 mm. MEDLINE, EMBASE, POPLINE, CINAHL and LILACS (all from inception to 31 December 2016), the Cochrane Central Register of Controlled Trials, Research Registers of ongoing trials, Google Scholar, conference proceedings and reference lists of identified studies were searched.

The destruction complex of beta-catenin in colorectal carcinoma and colonic adenoma.

Objective: To evaluate the destruction complex of beta-catenin by the expression of the proteins beta-catetenin, adenomatous polyposis coli, GSK3β, axin and ubiquitin in colorectal carcinoma and colonic adenoma.

Methods: Tissue samples from 64 patients with colorectal carcinoma and 53 patients with colonic adenoma were analyzed. Tissue microarray blocks and slides were prepared and subjected to immunohistochemistry with polyclonal antibodies in carcinoma, adjacent non-neoplastic mucosa, and adenoma tissues.

Initial experience with hysteroscopic tubal occlusion (Essure®).

Objective: To evaluate results of early tubal occlusions performed by hysteroscopy (Essure®).

Methods: This prospective study included 38 patients, 73.7% of them were white, mean age 34.

Vaginal progesterone decreases preterm birth ≤ 34 weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta-analysis including data from the OPPTIMUM study.

Objective: To evaluate the efficacy of vaginal progesterone administration for preventing preterm birth and perinatal morbidity and mortality in asymptomatic women with a singleton gestation and a mid-trimester sonographic cervical length (CL) ≤ 25 mm.

Methods: This was an updated systematic review and meta-analysis of randomized controlled trials comparing the use of vaginal progesterone to placebo/no treatment in women with a singleton gestation and a mid-trimester sonographic CL ≤ 25 mm. Electronic databases, from their inception to May 2016, bibliographies and conference proceedings were searched.

Microalbuminuria in non diabetic population as an marker of nephropathy.

Introduction: Years before the progression to diabetes mellitus type II patients can get by with a pre-diabetes called period. The pathogenesis involved pre-diabetes is insulin resistance Objective: This paper discusses the frequency of microalbuminuria in non-diabetic population, but with increased metabolic risk, and attempts to assess whether there is any correlation of microalbuminuria with data from glucose metabolism.

Methods: A total of 132 nondiabetic patients who presented one or more risk factors for changes in glucose metabolism were included in the study: arterial hypertension; obesity; first-degree relatives with diabetes; individuals of Hispanic-American, Asian and African-American ethnicities; mothers of newborns who are large for gestational age (LGA) or who had gestational diabetes; serum measurements in fasting HDL cholesterol 250 mg/dL.

Update on the 2012 Brazilian Society of Rheumatology Guidelines for the treatment of rheumatoid arthritis: position on the use of tofacitinib.

In 2014, tofacitinib, a target-specific, synthetic disease modifying anti rheumatic drug (DMARD) and a selective inhibitor of Janus kinase (JAK) was approved for use in Brazil. This position paper aims to update the recommendations of the Brazilian Society of Rheumatology (SBR) on the treatment of rheumatoid arthritis (RA) in Brazil, specifically regarding the use of target-specific synthetic DMARDs. The method of this recommendation consisted of a literature review of scientific papers held on the Medline database.

Acromioclavicular dislocation: postoperative evaluation of the coracoclavicular ligaments using magnetic resonance.

Objective: To radiologically evaluate the healing of the coracoclavicular ligaments after surgical treatment for acromioclavicular dislocation.

Methods: Ten patients who had undergone surgical treatment for acromioclavicular dislocation via a posterosuperior route at least one year earlier were invited to return for radiological assessment using magnetic resonance. This evaluation was done by means of analogy with the scale described in the literature for studying the healing of the anterior cruciate ligament of the knee and for measuring the healed coracoclavicular ligaments.

Perinatal outcomes in women over 40 years of age compared to those of other gestations.

Objective: To clarify if older pregnant women were more likely to have adverse perinatal outcomes when compared to women at an ideal age to have a child.

Methods: The groups were divided according to age groups: under 20 years, ≥20 to <40 years, and ≥40 years.

Results: During the period from January 1st, 2008, to December 31st, 2008, there were 76 births from patients younger than 20 years and 91 births from patients aged 40 years or over.

Axillary lymph nodes in breast cancer patients: sonographic evaluation.

Axillary staging of patients with early-stage breast cancer is essential in the treatment planning. Currently such staging is intraoperatively performed, but there is a tendency to seek a preoperative and less invasive technique to detect lymph node metastasis. Ultrasonography is widely utilized for this purpose, many times in association with fine-needle aspiration biopsy or core needle biopsy.

Hemodynamic monitoring in the intensive care unit: a Brazilian perspective.

Objective: In Brazil, there are no data on the preferences of intensivists regarding hemodynamic monitoring methods. The present study aimed to identify the methods used by national intensivists, the hemodynamic variables they consider important, the regional differences, the reasons for choosing a particular method, and the use of protocols and continued training.

Methods: National intensivists were invited to answer an electronic questionnaire during three intensive care events and later, through the Associação de Medicina Intensiva Brasileira portal, between March and October 2009.

Premalignant and malignant lesions in endometrial polyps in patients undergoing hysteroscopic polypectomy.

Objective: To evaluate the incidence of premalignant lesions and cancer in endometrial polyps, in patients undergoing hysteroscopic polypectomy.

Methods: The results of 1,020 pathological examinations of patients submitted to hysteroscopic polypectomy were analyzed, as well as their diagnostic and surgical hysteroscopy findings. As to their menstrual status, 295 (28.

[Hysteroscopic appearance of the endometrial cavity after endometrial ablation].

Purpose: To examine the aspect of the uterine cavity after hysteroscopic endometrial ablation, to determine the prevalence of synechiae after the procedure, and to analyze the importance of hysteroscopy during the postoperative period.

Methods: The results of the hysteroscopic exams of 153 patients who underwent outpatient hysteroscopy after endometrial ablation due to abnormal uterine bleeding of benign etiology during the period from January 2006 to July 2011 were retrospectively reviewed. The patients were divided into two groups: HIST≤60 (n=90) consisting of patients undergoing the exam 40-60 days after the ablation procedure, and the group HIST>60 (n=63) consisting of patients undergoing the exam between 61 days and 12 months after the procedure.

Twelve years of scientific production on Medline by Latin American spine surgeons.

Background: Despite the small contribution of LA in the Science Citation Index (SCI), a growing contribution by LA research to international literature has been observed in recent years.

Study Design: Systematic review.

Purpose: To evaluate the scientific contribution of Latin American (LA) Spine Surgeons in the last decade.

[Perinatal and pediatric follow up of children with increased nuchal translucency and normal karyotype].

Purpose: To analyze the perinatal and pediatric outcome of fetuses that showed nuchal translucency (NT) above the 95th percentile (P95) and a normal karyotype in order to obtain data allowing better maternal prenatal counseling.

Methods: fetuses from a tertiary obstetric service with an NT above P95 and a normal karyotype were analyzed between 2005 and 2011. We analyzed gestational ultrasound follow-up, fetal and postnatal echocardiography (ECHO), weight, length and Apgar score at birth, and neuropsychomotor development by the Ages and Stages Questionnaire (ASQ) up to July 2012.

Hysteroscopic sterilization of patient with intrauterine device Mirena®.

Tubal sterilization is the definitive procedure most often used worldwide to control fecundity. Laparoscopic ligature is safe, but invasive and with possible surgical and anesthetic risks. The hysteroscopic approach enables tubal occlusion at outpatient's setting without the need of incisions or anesthesia.