RESUMO: A obesidade é uma doença relevante nos dias atuais e de grande impacto na saúde da população mundial, sendo o Bypass Gástrico em Y-de-Roux amplamente utilizada no tratamento cirúrgico da obesidade mórbida, entretanto esta técnica não é isenta de complicações. A úlcera duodenal perfurada no segmento excluso em pacientes submetidos ao Bypass Gástrico em Y-de-Roux é uma patologia rara sendo encontrado na literatura apenas 21 casos no mundo. Existem evidências que o segmento excluso mantem-se produtor de ácidos gástricos sem a neutralização do alimento, Este relato de caso trata-se de uma paciente com história de Bypass Gástrico em Y-de-Roux hà 5 anos, que apresentou quadro de dor abdominal após uso prolongado de AINE, sendo encaminhada para videolaparoscopia. Foi diagnosticado úlcera duodenal perfurada em segmento excluso e o tratamento definitivo procedeu em seguida, sendo realizado ulcerorrafia e omentoplastia. Palavras-chave: Obesidade mórbida. Bypass gástrico em Y-de-Roux laparoscópico. Úlcera duodenal perfurada. Úlcerorrafia. Reparo laparoscópico. ABSTRACT: Obesity is an important disease in the present day and of great impact on the health of the world population, being the Roux-en-Y gastric bypass widely used in the surgical treatment of morbid obesity, however this technique is not without complications. The perforated duodenal ulcer in the excluded segment in patients undergoing Roux-en-Y gastric bypass is a rare disease being found worldwide in the literature only 21 cases. There is evidence that the excluded segment keeps producing gastric acid without food neutralization. This case report it is a patient with a history of Roux-en-Y gastric bypass 5 years before, who presented abdominal pain after prolonged use of NSAIDs, being referred to laparoscopy. It was diagnosed perforated duodenal ulcer in excluded segment and thereafter definitive treatment, being fulfilled ulcerorrafia and omentoplasty.
BACKGROUND: Airway inflammation, acknowledged as an important feature of asthma, can be assessed by the examination of induced sputum. OBJECTIVE: To determine the pattern of inflammatory cells in induced sputum from stable steroid-naïve asthmatics, in Florianópolis, Santa Catarina. METHOD: The induced sputum from 34 asthmatics using exclusively inhaled bronchodilators on demand was examined. The patients’ clinical characteristics were obtained at visit 1, and sputum was induced at visit 2. Differential cell count was performed on Giemsa-stained cytospins. Sputum was considered to be eosinophilic if there were ³ 3% eosinophils, and neutrophilic if there were ³ 65% neutrophils. RESULTS: Results are expressed by median and interquartile range. The total cell count was 3.4 (3.7) x 10(6) cells/ml, and cell viability was 80.0 (16.4) %. The proportion of neutrophils was 14.4 (22.1) %, of eosinophils 6.4 (17.2) %, of macrophages 60.3 (37.5) %, and of lymphocytes 1.1 (1.2) %. Eosinophilic sputum was observed in 24 subjects (70.6%); none of them had neutrophilic sputum. There were no significant differences between the eosinophilic and non-eosinophilic groups concerning the measured clinical outcomes, total cell count and proportions of cells in the sputum, except for the proportion of eosinophils (14.4 [19.3] vs 0.4 [1.1], p < 0.001). CONCLUSIONS: In our environment, steroid-naïve asthmatics present a higher proportion of sputum eosinophils, as compared to the established reference values. The clinical and physiological parameters analyzed were unable to predict the presence of eosinophilic inflammation of the airways
Cuidadosamente preparado em parceria com a Comissão de Endocrinologia do Esporte e Exercício da Sociedade Brasileira de Endocrinologia e Metabologia, esse é um livro que reúne os principais especialistas em fisiologia e fisiopatologia em ambas as áreas. Sucesso de vendas em sua 1ª edição, o guia ganha uma 2ª edição totalmente revista e atualizada, contemplando conteúdos inéditos sobre anabolizantes, ética médica e a inter-relação entre nutrição, atividade física e suplementação no contexto da pandemia de COVID-19. Os 30 capítulos desse novo volume mantêm não apenas a linguagem acessível e objetiva da edição de estreia, como também o propósito de servir de fonte de informações de alto nível científico para a prevenção de doenças e melhoria da qualidade de vida da população.
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