Background: The pyogenic liver abscess has an incidence of 1.1/1,000 habitants. Mortality can reach 100%. The use of less invasive procedures diminish morbidity and hospital stay. Aim: Identify risk factors in patients who underwent percutaneous drainage guided by ultrasound as treatment. Method: Were analyzed 10 patients submitted to the method. Epidemiological characteristics, laboratory markers and imaging exams (ultrasound and CT) were evaluated. Results: The majority of the patients were men with mean age of 50 years old. Liver disease, alcoholism and biliary tract disease were the most common prodromes. Abdominal pain (90%), fever (70%) and jaundice (40%) were the most common clinical manifestations. Mortality of 20% was observed in this series. Hypoalbuminemia and days of hospitalization had a statistically significant positive association with death. Conclusion: The pyogenic liver abscess has subacute evolution which makes the diagnosis difficult. Image exams have high sensitivity in diagnosis, particularly computed tomography. Percutaneous drainage associated with antibiotic therapy is safe and effective therapeutic resource.

Objective : to identify the main risk factors associated with the development of complications in patients with acute appendicitis. Methods: we conducted a case-control study of 402 patients with acute appendicitis hospitalized in a secondary hospital, divided into two groups: the control group, with 373 patients who progressed without postoperative complications (Group 1) and the study group, with 29 patients who presented complications (Group 2). We evaluated demographic data, signs and symptoms of the disease, imaging tests and hospitalization data. Results: factors associated with complications were fever, radiological and sonographic changes, abrupt positive decompression and diarrhea. Migration of pain, nausea, vomiting and abrupt positive decompression were the findings that were significantly more frequent in both groups (p = 0.05). The duration of signs and symptoms in days in group 2 was significantly higher than in group 1, with a median of three days for the group with complications (p = 0.05). Conclusion: alterations in imaging, fever, diarrhea, positive abrupt decompression, duration of symptoms and lower age are associated with a higher frequency of complications in acute appendicitis, which reinforces the importance of anamnesis, physical examination and indication of complementary exams in the approach of these patients.

Background : The liver is the most injured organ in abdominal trauma. Currently, the treatment in most cases is non-operative, but surgery may be necessary in severe abdominal trauma with blunt liver damage, especially those that cause uncontrollable bleeding. Despite the damage control approaches in order to achieve hemodynamic stability, many patients develop hypovolemic shock, acute liver failure, multiple organ failure and death. In this context, liver transplantation appears as the lifesaving last resource Aim : Analyze the use of liver transplantation as a treatment option for severe liver trauma. Methods : Were reviewed 14 articles in the PubMed, Medline and Lilacs databases, selected between 2008-2014 and 10 for this study. Results : Were identified 46 cases undergoing liver transplant after liver trauma; the main trauma mechanism was closed/blunt abdominal trauma in 83%, and severe trauma (>grade IV) in 81 %. The transplant can be done, in this context, performing one-stage procedure (damaged organ removed with immediate transplantation), used in 72% of cases. When the two-stage approach is performed, end-to-side temporary portacaval shunt is provided, until new organ becomes available to be transplanted. If two different periods are considered - from 1980 to 2000 and from 2000 to 2014 - the survival rate increased significantly, from 48% to 76%, while the mortality decreased from 52% to 24%. Conclusion : Despite with quite restricted indications, liver transplantation in hepatic injury is a therapeutic modality viable and feasible today, and can be used in cases when other therapeutic modalities in short and long term, do not provide the patient survival chances.

HEADINGSColostomy. Surgical procedures. Postoperative. Complications. ABSTRACT -Background:The restoration of intestinal continuity is an elective procedure that is not free of complications; on the contrary, many studies have proven a high level of morbidity and mortality. It is multifactorial, and has factors inherent to the patients and to the surgical technique. Aim: To identify epidemiological features of patients that underwent ostomy closure analyzing the information about the surgical procedure and its arising complications. Method: It was realized a retrospective analysis of medical records of patients who underwent ostomy closure over a period of seven years (2009)(2010)(2011)(2012)(2013)(2014)(2015). Results: A total of 39 patients were included, 53.8% male and 46.2% female, with mean age of 52.4 years. Hartmann´s procedure and ileostomy were the mainly reasons for restoration of intestinal continuity, representing together 87%. Termino-terminal anastomosis was performed in 71.8% of cases, by using mainly the manual technique. 25.6% developed complications, highlighting anastomotic leakage; there were three deaths (7.6%). The surgical time, the necessity of ICU and blood transfusion significantly related to post-operative complications. Conclusion: It was found that the majority of the patients were male, with an average age of 52 years. It was observed that the surgical time, the necessity of blood transfusion and ICU were factors significantly associated with complications. RESUMO -

Background: The search for less traumatic surgical procedures without compromising efficacy and safety, together with the technological advances and greater experience of the teams, led to the development of operative techniques with increasingly smaller incisions, the so-called “minimally invasive surgeries”. Aim: To evaluate the technical aspects and results of single port cholecystectomy. Method: Were analyzed 170 patients between 18-74 years submitted to videolaparoscopic cholecystectomies by single port, regardless of elective or urgent indication, without restriction of patient selection. Results: Among the 170 operations, 158 were exclusively performed by single port, and the conversion rate was 7% (inclusion of other accessory trocars or conversion to multiportal). Conversion to open surgery occurred in three cases (1.76%). The mean surgical time was 67.97 min, showing a marked decrease when was reached close to 50 cases and a stabilization after 100 surgeries. The overall complication rate was 10%, with minor complications such as: incisional pain, hematomas, granulomas, port access hernias (9.41%). Conclusion: Single port cholecystectomy can, after standardization and surgical team training, be a safe surgical procedure associated with a recognized aesthetic advantage.

Background: Acute appendicitis is one of the most common causes of abdominal pain, accounting for about one-third of patients presenting at emergency services with acute abdomen. A high degree of suspicion is essential for diagnosis. Aim: Evaluate the correlation between the Alvarado score and the tomographic and Intraoperative findings of patients with acute appendicitis. Methods: Descriptive, cross-sectional, retrospective study using data obtained from the Internment Management System of all hospitalized patients with acute appendicitis from June 2014 to June 2015. Data were analyzed and Statistics generated through the Epi Info 7.0 program. Results: 240 patients were evaluated. Of these, 150(62.5%) were male and 90(37.5%) were female, with a mean age of 28.6years. The exclusive clinical diagnosis was performed in 42 patients(17.4%). The relationship between the positive Alvarado score and the tomographic findings was evaluated, being considered positive in the presence of two or more findings. The positive association between Positive Alvarado Score and the presence of tomographic findings was obtained, with Odds Ratio of 1.665 and P=0.1805. The association between the intraoperative findings and the positive Alvarado score was evaluated, in which 8(11.11%) patients were in the edematous phase(Odds Ratio=0,8182 P=0,6474), 31(43,05%) were phlegmonous(Odds Ratio=0,8128, P=0,4655), 15(20.83%) in the gangrenous phase(Odds Ratio=0,9175, P=0,8028) and 18(25%) in the perforated phase(Odds Ratio=1,7949, P=0,1278). Conclusion: There is a positive association between Alvarado score and the presence of tomographic findings, as well as the association between positive Alvarado score and perforation phase.

to both the organ and the recipient at the time of transplant. Serum transaminases, histological changes of the liver and animal survival were assessed. Oxidative stress, inflammatory responses and hepatocellular damage were also quantified. Result: A significant survival benefit was not achieved when CD47mAb400 was administered to the donor alone. However, CD47mAb400 administration to both the donor and recipient increased animal survival after. The CD47mAb400 treated group showed lower serum transaminases, bilirubin, oxidative stress, TUNEL staining, caspase-3 activity and proinflammatory cytokine expression of TNF-a, IL-1b and IL-6. Conclusion: CD47 blockade with CD47mAb400 administered both to the donor and the recipient reduced liver graft IRI in a rat liver transplantation model. This may translate to decreased liver dysfunction and increased survival of liver transplant recipients.

COVID-19 ainda é uma nova doença, envolvida na pandemia que nos assola desde 2020. Apresenta 4 estágios: 1°)Infecção do trato respiratório superior com febre, fadiga muscular e dor; 2°)Dispnéia e pneumonia; 3°)Quadro clínico hiperinflamatório-tempestade de citocinas e 4°)Desfecho por óbito ou recuperação do paciente, com possíveis sequelas em sua recuperação. Na Região Nordeste, existem Estados com baixíssimo Índice de Desenvolvimento Humano (IDH), onde doenças preponderam e sucumbem à desfechos indesejáveis. Assim, o objetivo deste estudo foi traçar o perfil epidemiológico das internações e óbitos por COVID-19 no Nordeste, no ano de 2020. Foi realizado estudo epidemiológico, descritivo, de série temporal, com dados secundários do Sistema de Informação do SUS-DATASUS, que foram tabulados em planilha EXCEL e exportados ao Bioestat 5.3 para análise estatística. Os resultados demonstraram predomínio das internações em: Pernambuco (21,58%), Ceará (20,33%) e Bahia (19,45%); sexo masculino-teve 53,53% das notificações e feminino-44,33%; raça/cor parda - mais registrada (54%); escolaridade-predominância de ausência de preenchimento (40,67%); faixa etária - acima de 60 anos (55,83%); proporções de óbitos por hospitalizações: Maranhão (45,8%), Ceará (40,2%) e Alagoas (39,1%). O alto número de óbitos em hospitalizações por COVID-19 em 2020, reforça que é primordial gestões de políticas públicas mais eficientes, com coordenação, embasamento teórico consistente, gerenciamento de recursos, atuação em medidas preventivas e melhoria no tratamento, que inclua melhoria das medidas tomadas durante a internação, visando redução desse percentual assustador de óbitos frente às hospitalizações.