BackgroundEarly exposure to obesity favors greater risks of cardiovascular factors such as dyslipidemia.ObjectivesTo establish the prevalence of dyslipidemia, and to evaluate its association with nutritional status of the adolescents attended at the ambulatory of the Adolescent Health Studies Center of the University Hospital Pedro Ernesto.MethodsThis is a cross-sectional, observational study, the sample of which was of convenience, consisting of adolescents from 12 to 18 years old of both genders. The lipid profile was evaluated, along with its association with the anthropometric indicators: body mass index and waist circumference. For statistical analysis, a significance level of 5% was used.ResultsA total of 239 adolescents, 104 boys (43.5%) and 135 girls (56.5%) were evaluated and, of these, 52 (21.8%) were eutrophic, 60 (25.1%) overweight, and 127 (53.1%) obese. Obeseadolescents had significantly lower mean values of HDL-cholesterol (44.7 mg/dl vs 53.9 mg/dl; p < 0.001) and higher triglycerides (109.6 mg/dl vs 87.3 mg/dl; p = 0.01). The changes with higher prevalence were low HDL-cholesterol (50.6%), hypercholesterolemia (35.1%), and hypertriglyceridemia (18.4%). A negative association of HDL-cholesterol with body mass index and a positive association of triglycerides with body mass index could be observed, even after adjustment for gender and skin color.ConclusionThis study demonstrated high prevalence of dyslipidemia among adolescents. In view of the significant association between lower levels of HDL-cholesterol and increased triglycerides with overweight, the control of these factors should receive attention, with the precocious diagnosis of the dyslipidemia being important, mainly if it is associated with another cardiovascular risk, to develop effective intervention strategies.

Objetivo: analisar as ligas acadêmicas de medicina (LAM) estruturadas e em funcionamento em instituição de ensino superior como estratégias de ensino e aprendizagem, considerando o perfil e verificar se as atividades promovidas pelas LAM estão alinhadas com a medicina baseada em evidências.Métodos: estudo descritivo, do tipo transversal, aprovado pelo Comitê de Ética da Faculdade de Ciências Médicas e da Saúde de Juiz de Fora. Participaram como sujeitos da pesquisa estudantes do último ano de medicina e médicos recém-formados no ano de 2018. Essa amostragem não probabilística teve como finalidade a avaliação da influência das LAM na formação médica.Resultados: oito (5,9%) entrevistados não participaram de qualquer LAM. Observou-se que 31 (24,2%), 49 (38,3%) e 38 (29,7%) participaram de uma, duas ou três LAM, respectivamente. A maioria participou de LAM do terceiro ao oitavo período, porém em todos os períodos houve participação de algum aluno. Para 50 (39,1%) entrevistados, as LAM ajudaram de alguma forma para confirmar a escolha da área da residência, já para 53 (41,4%) deles, elas ajudaram na exclusão da área para a residência. Nota-se, ainda, que 117 (91,4%) dos que participaram de LAM acharam a experiência válida para a formação acadêmica.Conclusões: a maior parte dos alunos atualmente participam de ligas; há enorme interesse em participar de diretoria de LAM e estágios extracurriculares; as LAM contribuem para a escolha da futura especialidade; os estudantes veem necessidade na regulamentação das LAM; a avaliação global é de que a experiência é válida para a formação médica. O tema ligas acadêmicas é de enorme relevância atualmente em virtude da extensa participação dos estudantes nessas atividades. A educação em saúde visa compreender a importância dessas entidades para garantir o maior êxito possível no ensino, na pesquisa e na extensão.

Objective  To review the main acute complications of inflammatory bowel disease in order to present the state of the art of their respective diagnosis and treatment. Methods  A bibliographic search was conducted in Medline database using the following keywords: “inflammatory bowel disease”, “Colitis Ulcerative”, “Crohn Disease”, “emergency” among others that had their variation evaluated by the MESH. Articles from the last 10 years conducted with humans, written in Portuguese or English, and published in journals with impact factor greater than 1 were selected. Results  After carrying out the search phrase and selecting the filters, 20 articles were selected to be included in the research. The most common acute complications were evaluated, focusing on their current propaedeutic and management aspects. Conclusion  Most emergencies related to inflammatory bowel disease should be treated non-operatively firstly, prioritizing patient hemodynamic state. In selected cases of life-threatening complications emergent operative treatment are mandatory. The timing of procedure is the most important aspect. As general rule, in Crohn’s Disease, operative treatment should be postponed as much as possible and the resection as small as possible. In case of ulcerative rectocolitis, if the hemodynamic state of the patient allows, proctocolectomy should be expedited with curative intention.

Hiatal hernia is a rare postoperative complication of esophagectomy in the treatment of esophageal cancer. Although rare, its incidence increased after the establishment of minimally invasive surgical techniques. The patient is usually oligosymptomatic, and the diagnosis is made in the late postoperative period, during outpatient follow-up. The initial presentation of hiatus hernia with hemodynamic instability is a rare condition that has never been described in the literature before. In the following report, we address the clinical picture, diagnosis, and treatment for this condition, discussing the main nuances of the literature.

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Objective: To assess the predictive value of preoperative serum laboratory test results for identifying choledocholithiasis and reduce the use of cholangioresonance and its inherent costs. Methods: Patients aged 21-69 years who underwent preoperative cholangioresonance examination at our institute were included. Patients with a history of fluctuating jaundice or biliary pancreatitis, bile duct dilatation on ultrasonography, and elevated levels of canalicular enzymes (alkaline phosphatase >100U/L and gamma-glutamyl transferase >50U/L) underwent cholangioresonance-guided surgery. Cases of choledocholithiasis confirmed by cholangioresonance were compared with those without choledocholithiasis. Serum laboratory data were evaluated and the diagnostic capabilities of these examinations were analyzed. Results: A total of 104 patients were included. For detecting choledocholithiasis using alkaline phosphatase, the cut-off point was 78U/L, sensitivity was 97.6% (95%CI: 87.4-99.9), and specificity was 72.6% (95%CI: 59.8-83.1). In the binary logistic regression analysis, age (OR= 0.92; 95%CI: 0.86-0.98) and alkaline phosphatase level (OR= 1.02; 95%CI: 1.01-1.05) were selected for the final model. Conclusion: Serum alkaline phosphatase levels may aid preoperative diagnosis of asymptomatic choledocholithiasis. After a global clinical assessment of the patient, serum laboratory findings may contribute to a reduction in cholangioresonancerelated heathcare costs.

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O presente estudo tem como objetivo verificar através de um estudo observacional das linhas de grampeamento em 284 pacientes no per e pós-operatório de cirurgia bariátrica submetidos à “by pass” simplificado de maneira sistematizada. A análise do estudo foi de 2012 à 2016 onde a idade dos pacientes variou entre 18 e 61 anos. Foram encontrados 17 pacientes com vazamento das linhas de sutura durante o “Blue test” no ato operatório e que foram sobresuturados e não fistulizaram no pós-operatório e em todos os outros da amostra não foram feitas linhas de sutura de reforço. Nos demais 267 pacientes 4 apresentaram fístula digestiva em anastomose gastrojejunal e todas por deiscência da sutura mecânica no final da linha de grampeamento da anastomose. Houve um óbito na amostra e os demais casos tiveram evolução satisfatória com período de internação que variou entre 15 e 36 dias usando nutrição parenteral total e cobertura com antibióticos, além de suporte intensivo.