Introduction:The Mean Platelet Volume (MPV) is a platelet activation biomarker that has been recently correlated with disease activity in SLE. We aimed to evaluate the MPV in patients with SLE comparing it with healthy individuals, to study the correlation between MPV and SLE Disease Activity Index (SLEDAI) in SLE patients and to analyze possible correlation between MPV and Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), and complement components C3 and C4.Methods:This is a cross-sectional study in which 81 patients with SLE according to the American College of Rheumatology (ACR) diagnostic classification criteria and 58 healthy controls were included. Active disease was defined as SLEDAI>0.Results:Patients with active SLE had decreased MPV when compared to inactive disease group (10.0±0.7fL vs. 10.7±1.0fL, p=0.005, respectively) and when compared to control group (10.9±1.0fL, p<0.001). Our study found a weak negative correlation between the SLEDAI and the MPV (r=-0.29, p=0.009). There was no correlation between MPV and CRP, ESR, C3 and C4. Also, no correlation between SLEDAI and CRP, ESR, C3 and C4 was found.Conclusion: MPV decreases in patients with active SLE and is inversely correlated with SLEDAI.

BACKGROUND: The development of an incisional hernia is a common complication following laparotomy. It also has an important economic impact on healthcare systems and social security budget. The mesh reinforcement of the abdominal wall was an important advancement to increase the success of the repairs and reduce its long-term recurrence. The two most common locations for mesh placement in ventral hernia repairs include the premuscular (onlay technique) and retromuscular planes (sublay technique). However, until now, there is no consensus in the literature about the ideal location of the mesh. AIM: The aim of this study was to compare the two most common incisional hernia repair techniques (onlay and sublay) with regard to the complication rate within the first 30 days of postoperative care. METHOD: This study analyzes 115 patients who underwent either onlay or sublay incisional hernia repairs and evaluates the 30-day postoperative surgical site occurrences and hernia recurrence for each technique. RESULTS: We found no difference in the results between the groups, except in seroma formation, which was higher in patients submitted to the sublay technique, probably due to the lower rate of drain placement in this group. CONCLUSION: Both techniques of mesh placement seem to be adequate in the repair of incisional hernias, with no major difference in surgical site occurrences.

BACKGROUND: The laparoscopic approach for inguinal hernia repair has been widely used since its introduction in the 1990s. As a step in the procedure, the surgeon must access the preperitoneal space through an incision in the peritoneum, creating an adequate dissection for mesh placement. At the end of the procedure, the peritoneal flap must be closed to avoid adhesions. There are several methods to close the peritoneum. AIMS: The aim of this study was to propose a simple method for closing the peritoneal flap, using titanium clips, exposing its advantages and disadvantages. METHODS: Description of the peritoneum flap closure technique, using titanium clips, in the last 15 years. RESULTS: The pneumoperitoneum was reduced to a pressure of 7 mmHg; then, the two edges of the peritoneal flap were approximated together and, with the aid of a Maryland grasper, were kept together; titanium clips were used to close the flap. The process is repeated along the entire peritoneal incision until it is completely closed. CONCLUSIONS: The use of titanium clips proved to be a fast, inexpensive, and effective method for closing the peritoneal flap in videolaparoscopic inguinal hernioplasties, with no major or recurrent complications reported. Therefore, it is an effective and safe method for the closure of the peritoneal defect.

e16535 Background: Despite low- and middle-income countries representing 80% of esophageal cancer global burden, TNM staging is based on data from the Worldwide Esophageal Cancer Collaboration (WECC) that is mainly composed of patients from developed countries. Notably, 87.8% of patients staged after neoadjuvant chemoRT in the WECC were from North America or Europe and only 0.09% (N = 7) from Latin America (LA), raising questions about its applicability. We wanted to see if the characteristics of patients undergoing neoadjuvant chemoradiation in LA were representative of patients in the WECC. Methods: We retrospectively identified patients with esophageal adenocarcinoma (EAC) and squamous cell carcinoma (ESCC) who underwent chemoRT at Hospital de Clínicas de Porto Alegre (HCPA), an academic hospital in southern Brazil, and compared their clinicopathological features, treatments and outcomes data with WECC patients. WECC data were extracted from previous publications. Results: Compared to WECC, there were no differences in age (ESCC: 61±7.7 vs. 61±9.4, P = 0.91; EAC: 62±7.2 vs. 61±9.8, P = 0.67) and sex (female: 30.0% vs. 33.2%, P = 0.64; 30.8% vs. 11.6%, P = 0.06). However, we found statistically significant differences in histology (ESCC: 79.4% vs. 26.5%, P < 0.001), PS 0/1/≥2 (ESCC: 24/70/6% vs. 50.6/41.7/7.7%, P = 0.002; EAC: 38.5/61.5/0% vs. 34.9/61.5/3.6%, P = 0.91), active tobacco use (62% vs 27.8%, P < 0.001; 38.5% vs. 15.7%, P < 0.001), weight loss (8.4±5.8Kg vs. 2.6±6Kg, P < 0.001; 14.0±11.6Kg vs. 3,6±7,1Kg, P < 0.001), location (upper/middle/lower: 0/30/70% vs. 16.3/46.6/37.1%, P < 0.001; 0/0/100% vs. 0.7/3/96.3%, P = 0.63) and lymphadenectomy extension ( > 20 resected lymph nodes: 8.6% vs. 38.1%, P < 0.001; 0% vs. 37.9%, P = 0.027). There were no statistically significant differences in pathologic stage (Table) or overall survival in 30 days and 1 year from treatment decision (97.7% vs 98%, P = 0.69; 74.7% vs 75%, P = 0.78). Conclusions: Despite clinically significant differences in presentation were found, they did not implicate worse prognosis in this analysis. [Table: see text]

BackgroundSystemic lupus erythematosus (SLE) is a multisystem inflammatory autoimmune disease that evolves with periods of remission and exacerbation activity, whose intensity can be measured by the SLEDAI. This tool is complex and has limitations. The mean platelet volume (MPV) is a marker of platelet activation and has been shown to be associated with inflammation, which makes it a potential biomarker to aid in the assessment of disease activity in SLE.ObjectivesTo evaluate VPM in SLE patients at the active and inactive stages according SLEDAI and assess a possible correlation between VPM with SLEDAI, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), complement 3 (C3), and complement 4 (C4).MethodsThis cross-sectional study consisted of 40 patients with SLE, according to American College of Rheumatology (ACR) classification criteria, that were evaluated in Rheumatology Clinic of the Hospital de Clínicas de Porto Alegre in the second half of 2015. Interview during medical consultation and medical chart review were used to collect demographic, clinical and laboratory data. Disease activity was assessed with SLEDAI and chronicity was assessed with SLICC damage index (SDI). The blood count and platelets are measured in automation equipment Sysmex XE 5000. Platelets are analyzed by impedance, and the mean platelet volume is an index calculated by the machine when the examination of platelets. VSG was carried out by automated method by capillary photometry kinetics, PCR and C3 and C4 complement were determined in automation by immunoturbidimetry with intensification of reaction particles. Comparisons between groups were made with t-test or Mann-Whitney test.ResultsAll patients studied were female, 25 (62.5%) were classified as European-derived, mean age was 42.7±12.6 years and the average age at diagnosis was 29.9±9.9 years. At the time of the study, the median (IQR) for SLEDAI was 1.50 (0.0,4.0) and for SDI was 0.0 (0.0,1.0). Patients were divided into two groups (SLEDAI=0 and SLEDAI>0). The VPM had an inverse significant correlation with SLEDAI (r=-0.38; p=0.01). However, the MVP did not correlate significantly with ESR, CRP, C3 and C4. Patients were divided into two groups (SLEDAI=0 and SLEDAI>0) and the results for classification criteria were similar, but lymphopenia was most prevalent in group SLEDAI>0.ConclusionsThere is a correlation between the VPM and the SLEDAI in our SLE patients, making it a possible tool to be used in the evaluation of disease activity.ReferencesCeylan B, Fincanci M, Yardimci C, Eren G, Tozalgan U, Muderrisoglu C, Pasaoglu E. Can mean platelet volume determine the severity of liver fibrosis or inflamation in patients with chronic hepatitis B? European Journal of Gastroenterology & Hepatology 2013, Vol 25 No. 5.Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47–58.Review.Yavuz S, Ece A. Mean platelet volume as an indicator of disease activity in juvenile SLE. Clin Rheumatol. 2014...