RESUMO:Objetivo: Desenvolver e aplicar modelo de baixo custo para treinamento de dissecção venosa para acadêmicos de Medicina. Métodos: O modelo foi elaborado com custo fixo de 35 reais (10,5 dólares) e mais 50 centavos a cada reposição, tendo sido aprovados por 6 cirurgiões vinculados ao curso de Medicina da Universidade de Fortaleza e utilizados durante curso teórico prático. Os alunos responderam a um teste pré e pós-atividade, foram avaliados durante a prática através de check list e responderam questionário de percepção sobre o modelo. Resultados: Foi notado crescimento teórico, porém, percebeu-se a necessidade de mais treinamento procedural, o que é viável com nosso modelo de baixo custo. Em relação aos questionários de percepção, 91,95% dos alunos concordaram que os modelos mantinham boa correlação anatômica, 89,96% que o material utilizado é de boa qualidade, 95,40% que o modelo permitiu o aprendizado da dissecção venosa e 96,55% que o modelo pode ser utilizado para ensino do procedimento, números que reafirmam a eficácia e viabilidade do modelo. Conclusões: É possível a criação de modelo realista, de boa qualidade e viável para o ensino, apenas com materiais de baixo custo para treinamento de dissecção venosa.Descritores: Materiais de ensino; Dissecação/educação; Treinamento por simulação; Estudantes de medicina. ABSTRACT: Objective:We aim to develop and apply a low cost model for venous dissection training for medical students. Methods: The model was elaborated with a fixed cost of 35 reais (10,5 dollars) and 50 cents at each replacement, and was approved by 6 surgeons tied to the Medicine course of the Universidade de Fortaleza and used during practical theoretical course. The students answered a pre and post activity test, were evaluated during the practice through check list and answered the perception questionnaire about the model. Results: We noticed a theoretical growth, however, we noticed the need for more procedural training, which is feasible with our low cost model. Regarding the perception questionnaires, 91.95% of the students agreed that the models maintained good anatomical correlation, 89.96% that the material used was of good quality, 95.40% that the model allowed the learning of the venous dissection and 96.55% that the model can be used for teaching the procedure, numbers that reaffirm the effectiveness and feasibility of the model. Conclusions: It is possible to create a realistic model, of good quality and feasible for teaching, only with low cost materials for venous dissection training.

Introdução: A reforma curricular nos cursos de Medicina levou a uma redução da carga horária reservada às disciplinas do ciclo básico, como a Anatomia, sendo o monitor indispensável na inserção de melhorias para a disciplina. Objetivo: Avaliar o papel dos monitores no ensino da Anatomia, segundo a perspectiva do aluno. Casuística e Métodos: Estudo observacional, com abordagem quantitativa e qualitativa, desenvolvido com alunos do 4º semestre do curso de medicina da Universidade de Fortaleza, Fortaleza - Ceará / Brasil, com preenchimento de um questionário semiestruturado, padronizado com questões objetivas e subjetivas na escala Likert. Resultados: Constatou-se que a maioria dos alunos frequenta a monitoria presencial em sala de aula e, para estes alunos, esclarecer dúvidas é a principal função do monitor de anatomia. Ademais, o comprometimento com a monitoria é a característica do monitor mais valorizada pelos alunos. Destaca-se ainda que os alunos consideraram que os aplicativos de mensagens instantâneas são ferramentas essenciais para tirar dúvidas e que é mais confortável tirar dúvidas com o monitor do que com o professor. Conclusão: Conclui-se, então, que a vivência da monitoria melhorou o desempenho dos alunos na disciplina de anatomia e o uso de metodologias ativas mostrou-se relevante para a transmissão e a consolidação do conhecimento.

Objective  To correlate the patient's clinical data and the Alvarado's Score as predictors of acute appendicitis. Methods  This is an observational, descriptive and prospective study performed at a public urgency and emergency hospital in the city of Fortaleza, Ceará, between July and December 2016, with 34 patients undergoing open appendectomy with ages between 18 and 70 years. Statistical analysis was performed using the SPSS program. Results  The following statistical correlations were performed: number of days with abdominal pain until the operative event and degree of inflammation according to a macroscopic analysis of the appendix, Alvarado's Score and number of days with abdominal pain until the operative event, Alvarado's Score and degree of inflammation according to a macroscopic analysis of the appendix, number of days with abdominal pain until the operative event, and number of days of hospitalization in the postoperative period, degree of inflammation according to amacroscopic analysis of the appendix, number of days of hospitalization in the postoperative period and Alvarado's Score, and number of days of hospitalization in the postoperative period; the first five correlations were statistically significant ( p < 0.05). Conclusion  The use of this Alvarado's Score in health services emerges as a tool for the diagnosis of acute appendicitis.

Introduction  Mucocele of the appendix is defined as the obstructive dilatation of the vermiform appendix by the abnormal accumulation of mucinous substance in its lumen. Imaging tests may be useful, but they commonly fail to evidence the etiology in question. Regarding the therapeutic approach, there are different options for treatment. Appendectomy was routinely used in simple cystadenomas, with good results. However, in cases of neoplasias, more aggressive resection is necessary, and the therapeutic course of choice is the right hemicolectomy. Case report  Patient presented to the surgery outpatient clinic with magnetic resonance imaging presenting an adnexal cyst of about 11.0 × 4.5 cm on the right. The patient had pain in the right iliac fossa for 6 months. Due to the radiological finding and persistence of the clinical picture, videolaparoscopy was performed, and an appendicular mass suggestive of mucocele was identified. A laparoscopic appendectomy was performed, with no signs of mucus extravasation. Histopathological analysis confirmed the diagnosis. Discussion  Mucocele is rarely diagnosed effectively in the preoperatively. In this context, imaging tests do rarely evidence such etiology. Given the importance of preoperative diagnosis for the definition of conduct, it is essential that this condition be always taken into account as a diagnostic hypothesis.

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Anorectal hemangioma is one of the rarest causes of lower gastrointestinal bleeding, but is often neglected and confused in the differential diagnosis. The clinical examination is a turning point for a correct diagnosis and management of patients, thus avoiding unnecessary procedures. The treatment of choice for this condition is surgical and intraoperative bleeding is the main complication of this therapy. The present case reports a 25-year old patient with a history of bleeding from the age of 13, being diagnosed with anorectal hemangioma, and surgically treated with resection of the affected segment and with wound synthesis by marsupialization, with a good progression postoperatively.