Significance of Basal Cell Carcinomas Exhibiting Intravascular Invasion.

ABSTRACT: Intravascular invasion of tumor cells can be associated with metastasis in many cancers. Basal cell carcinomas (BCCs), however, rarely metastasize; therefore, the clinical impact of intravascularly invasive BCC (IVBCC) is currently unclear. Because of these facts and the rarity of IVBCC, questions have arisen on whether IVBCC truly exists. We present 4 cases of IVBCC: one case with obvious tumor islands within immunolabeled blood vessels in the context of advanced disease and 3 cases found incidentally during Mohs micrographic surgery. We discuss the difficulty in studying IVBCC, the idea that it could be due to artifact, and the lack of direct clinical-pathological correlation. Given these challenges, we propose diagnostic criteria for IVBCC to decrease ambiguity for pathological diagnosis. Such criteria may facilitate further studies on the clinical significance of IVBCC.

Modeling the Accuracy of Three Detection Methods of Grapevine leafroll-associated virus 3 During the Dormant Period Using a Bayesian Approach.

Grapevine leafroll-associated virus 3 (GLRaV-3) has a worldwide distribution and is the most economically important virus that causes grapevine leafroll disease. Reliable, sensitive, and specific methods are required for the detection of the pathogen in order to assure the production of healthy plant material and control of the disease. Although different serological and nucleic acid-based methods have been developed for the detection of GLRaV-3, diagnostic parameters have not been established, and there is no gold standard method. Therefore, the main aim of this work was to determine the sensitivity, specificity, and likelihood ratios of three commonly used methods, including one serological test (double-antibody sandwich enzyme-linked immunosorbent assay [DAS-ELISA]) and two nucleic acid-based techniques (spot and conventional real-time reverse transcription-polymerase chain reaction [RT-PCR]). Latent class models using a Bayesian approach have been applied to determine diagnostic test parameters and to facilitate decision-making regarding diagnostic test selection. Statistical analysis has been based on the results of a total of 281 samples, which were collected during the dormant period from three different populations. The best-fit model out of the 49 implemented models revealed that DAS-ELISA was the most specific method (value = 0.99) and provided the highest degree of confidence in positive results. Conversely, conventional real-time RT-PCR was the most sensitive method (value = 0.98) and produced the highest degree of confidence in negative results. Furthermore, the estimation of likelihood ratios showed that in populations with low GLRaV-3 prevalence the most appropriate method could be DAS-ELISA, while conventional real-time RT-PCR could be the most appropriate method in medium or high prevalence populations. Combining both techniques significantly increases detection accuracy. The flexibility and power of Bayesian latent class models open new possibilities for the evaluation of diagnostic tests for plant viruses.

Simplified reaction kinetics, models and experiments for glyphosate degradation in water by the UV/H2O2 process.

A simplified mathematical model to describe the oxidative degradation of glyphosate employing hydrogen peroxide and UV radiation was developed based on a sequence of predominant reactions. The kinetics obtained include all the required significant variables. Consequently, not only were concentration dependencies examined but also the influence of a detailed spatial description of the radiation field was included as part of the modeling. The kinetic parameters were obtained by comparing the simulation concentrations obtained with the model with the experimental values gathered in the laboratory reactor, employing a multiparameter non-linear regression analysis. In addition, the potential of the H2O2/UV process for treating water polluted with a commercial formulation, which was the glyphosate monoisopropylamine salt plus some additives, was studied. The glyphosate and TOC (total organic carbon) conversions reached were close to 80% and 70% respectively at 12 h (0.66 h actual exposure to radiation). It has been shown that a simple reaction scheme for the degradation of glyphosate acid and glyphosate isopropylamine salt from a commercial formulation can represent with good accuracy the performance of both reacting systems. In addition, the degradation procedure allowed a clear reduction of the toxicity of the glyphosate in the formulation over Vibrio fischeri at the end of the experiments. For this reason, reaching complete mineralization might not be necessary.

Accuracy and precision of as-received implant torque wrenches.

STATEMENT OF PROBLEM: Previous implant torque evaluation did not determine if the target value fell within a confidence interval for the population mean of the test groups, disallowing determination of whether a specific type of wrench met a standardized goal value. PURPOSE: The purpose of this study was to measure both the accuracy and precision of 2 different configurations (spring style and peak break) of as-received implant torque wrenches and compare the measured values to manufacturer-stated values. MATERIAL AND METHODS: Ten wrenches from 4 manufacturers, representing a variety of torque-limiting mechanisms and specificity of use (with either a specific brand or universally with any brand of implant product). Drivers were placed into the wrench, and tightening torque was applied to reach predetermined values using a NIST-calibrated digital torque wrench. Five replications of measurement were made for each wrench and averaged to provide a single value from that instrument. The target torque value for each wrench brand was compared to the 95% confidence interval for the true population mean of measured values to see if it fell within the measured range. RESULTS: Only 1 wrench brand (Nobel Biocare) demonstrated the target torque value falling within the 95% confidence interval for the true population mean. For others, the targeted torque value fell above the 95% confidence interval (Straumann and Imtec) or below (Salvin Torq). CONCLUSIONS: Neither type of torque-limiting mechanism nor designation of a wrench to be used as a dedicated brand-only product or to be used as a universal product on many brands affected the ability of a wrench to deliver torque values where the true population mean included the target torque level.

Effectiveness evaluation of glyphosate oxidation employing the H(2)O(2)/UVC process: toxicity assays with Vibrio fischeri and Rhinella arenarum tadpoles.

The H(2)O(2)/UVC process was applied to the photodegradation of a commercial formulation of glyphosate in water. Two organisms (Vibrio fischeri bacteria and Rhinella arenarum tadpoles) were used to investigate the toxicity of glyphosate in samples M(1,) M(2), and M(3) following different photodegradation reaction times (120, 240 and 360 min, respectively) that had differing amounts of residual H(2)O(2). Subsamples of M(1), M(2), and M(3) were then used to create samples M(1,E), M(2,E) and M(3,E) in which the H(2)O(2) had been removed. Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activities were measured in tadpoles to determine possible sub-lethal effects. In V. fischeri, M(1,E), which was collected early in the photodegradation process, caused 52% inhibition, while M(3,E), which was collected at the end of the photodegradation process, caused only 17% inhibition. Survival of tadpoles was 100% in samples M(2), M(3), and in M(1,E), M(2,E) and M(3,E). The lowest percentages of enzymatic inhibition were observed in samples without removal of H(2)O(2): 13.96% (AChE) and 16% (BChE) for M(2), and 24.12% (AChE) and 13.83% (BChE) for M(3). These results show the efficiency of the H(2)O(2)/UVC process in reducing the toxicity of water or wastewater polluted by commercial formulations of glyphosate. According to the ecotoxicity assays, the conditions corresponding to M(2) (11 ± 1 mg a.e. L(-1) glyphosate and 11 ± 1 mg L(-1) H(2)O(2)) could be used as a final point for glyphosate treatment with the H(2)O(2)/UV process.

Biodegradation of pesticide-contaminated wastewaters from a formulation plant employing a pilot scale biobed.

In this work, a pilot biobed was built up to treat pesticide-contaminated wastewaters discharged from a formulation plant. The pre-treated wastewater was spiked with additional pesticides in order to simulate a scenario of higher contamination: glyphosate, atrazine, imidacloprid, prometryn and carbendazim were added to reach a final Total Organic Carbon (TOC) concentration of 70 mg L-1. An Intermediate Bulk Container (IBC) was filled with a biomixture of soil and foxtail millet stubble (50:50% v v-1), and 200 l of the wastewater was added to the system recycling tank. The recirculation to the IBC was established for 12 h. After that (Day 0), the recirculation was turned on during the assay only to maintain the moisture for 180 days. Biomixture and wastewater samples were taken periodically to analyse pesticides and phytotoxicity in both matrices. In addition, hydrolytic and phenoloxidase activities, total bacteria and yeast and fungi communities were determined in the biomixture. The designed pilot scale biobed allowed to treat wastewaters with high concentration of pesticides reaching a complete removal of glyphosate, AMPA, atrazine, carbendazim and prometryn at 180 days. A good degradation percentage of the recalcitrant imidacloprid was achieved (60%) and the biomixture showed enough biological activity to continue treating additional wastewater. The root elongation index from the germination test showed low toxicity on day 180 both in biomixture and wastewater. The millet stubble resulted an appropriate lignocellulosic material to be used in biobeds to treat a wide variety of pesticides. The application of the seed germination test proved to be a low cost and simple tool to determine the end point of the process.

Carbapenems versus ciprofloxacin/metronidazole for decreasing complications and hospital stay following complicated acute appendicitis surgery: A prospective cohort in an Ecuadorian population.

BACKGROUND: After appendectomy due to complicated acute appendicitis (CAA), there are some alternatives as antibiotic scheme: ciprofloxacin/metronidazole; as well as monoscheme based on carbapenems: ertapenem, meropenem, and imipenem. AIM: This study aims to prove the efficacy of carbapenems versus ciprofloxacin/metronidazole in CAA post-operative management in terms of preventing complications during post-operative period and decreasing hospital stay. MATERIALS AND METHODS: This was an observational, analytical, longitudinal, and prospective cohort study (March 2014-November 2016). Patients were classified into two groups, according to the prescribed antibiotic scheme: some carbapenems or ciprofloxacin/metronidazole. RESULTS: Ninety-eight patients were enrolled. There was an requirement for antibiotic therapy rotation only in the ciprofloxacin/metronidazole (7/49, 14.3%; p = 0.004). Carbapenems reached a mean hospital stay of 4.45 days, in contrast with ciprofloxacin/metronidazole, 8.29 days (p = 0.020). In post-surgical follow-up, there were more cases of curative resolution in the group in the carbapenems group (35/49 vs. 15/49 p < 0.001) as well as a greater number of cases with some late infection in the ciprofloxacin/metronidazole group (1/49 vs. 10/49, p = 0.010). CONCLUSION: In the post-operative management of CAA, carbapenems represent an important indication to be considered as first-line antibiotic therapy.

ANTECEDENTES: Tras la cirugía por apendicitis aguda complicada existen varias alternativas de esquema antibiótico, entre las que destacan ciprofloxacino/metronidazol, o bien monoterapia con algún carbapenémico, como ertapenem, meropenem e imipenem. OBJETIVO: Determinar la eficacia de los carbapenémicos en comparación con ciprofloxacino/metronidazol en el manejo posquirúrgico de la apendicitis aguda complicada, en términos de prevención de complicaciones durante el ­posoperatorio y de reducción de la estancia hospitalaria. MÉTODO: Estudio observacional, analítico, longitudinal, prospectivo y de cohorte, de marzo de 2014 a noviembre de 2016. Los pacientes fueron clasificados en dos grupos según el esquema antibiótico prescrito: un carbapenémico o ciprofloxacino/metronidazol. RESULTADOS: Se seleccionaron 98 pacientes. Solo hubo necesidad de rotación de antibiótico en el grupo de ciprofloxacino/metronidazol (7 de 49, 14.3%; p = 0.004). En el grupo de carbapenémico, la media de estancia hospitalaria fue de 4.45 días, y en el grupo de ciprofloxacino/metronidazol fue de 8.29 días (p = 0.020). En el seguimiento posquirúrgico hubo más casos de resolución curativa en el grupo de carbapenémico (35 de 49 vs. 15 de 49; p < 0.001), así como un mayor número de casos con alguna infección tardía en el grupo de ciprofloxacino/metronidazol (1 de 49 vs. 10 de 49; p < 0.001). CONCLUSIÓN: En el manejo posquirúrgico de la apendicitis aguda complicada, los carbapenémicos representan una importante indicación que debe considerarse como antibioticoterapia de primera línea.

Direct sample preparation methods for the detection of Plum pox virus by real-time RT-PCR.

Direct systems to process plant materials allowed high-throughput testing of Plum pox virus (PPV) by real-time reverse transcription (RT)-PCR without nucleic acids purification. Crude plant extracts were diluted in buffer or spotted on membranes to be used as templates. Alternatively, immobilized PPV targets were amplified from fresh sections of plant tissues printed or squashed onto the same supports, without extract preparation. Spot real-time RT-PCR was validated as a PPV diagnostic method in samples collected during the dormancy period and showed high sensitivity (93.6%), specificity (98.0%), and post-test probability (97.9%) towards sharka disease. In an analysis of 2919 Prunus samples by spot real-time RT-PCR and DASI-ELISA 90.8% of the results coincided, demonstrating high agreement (k = 0.77 +/- 0.01) between the two techniques. These results validate the use of immobilized PPV targets and spot real-time RT-PCR as screening method for largescale analyses.

A versatile optoelectronic aid for low vision patients.

The purpose of this work is to describe a versatile optoelectronic aid for low vision rehabilitation based on reconfigurable hardware. This aid is easily adaptable to diverse pathologies (with different associated processing tasks) and to the progression of the visual impairment. This platform has a mobile configuration that uses a see-through head-mounted display (Nomad). We have implemented different types of vision enhancement on this versatile platform, and briefly summarize here their computational costs (in terms of hardware resource requirements). We have evaluated two representative capabilities of this aid (Augmented View and digital zoom) with measurements of visual acuity, contrast sensitivity and visual field. We have tested the Nomad head-mounted display and the Augmented View modality, in eight subjects with retinitis pigmentosa: the digital zoom was tested in six low vision subjects and nine normally-sighted subjects. We show that the Nomad display with Augmented View configuration does not impair the residual vision; and that there is an increase in visual acuity (VA) with the digital zoom configuration. The major advantage of this platform is that it can easily embed different image processing tasks and since it is based on a FPGA device, it can be specifically configured to tasks requiring real-time processing.

Tissue-Print and Squash Capture Real-Time RT-PCR Method for Direct Detection of Citrus tristeza virus (CTV) in Plant or Vector Tissues.

Direct systems to process samples allow high-throughput testing or identification of Citrus tristeza virus (CTV) by the sensitive real-time reverse transcription coupled to polymerase chain reaction (RT-PCR) neither with extract preparation nor nucleic acid purification. Immobilized CTV targets are amplified from fresh sections of plant tissues or squashes of fresh or already caught vectors onto paper, nitrocellulose, or positively charged nylon membranes. The printed or squashed support can be stored or mailed at room temperature. These validated user-friendly methods are recommended by IPPC-FAO standard for CTV diagnosis, detection, and identification. The methods are safe, not under current quarantine regulations because they do not involve any risk of introduction of exotic CTV isolates or vectors and are discrete and useful for epidemiological studies or screening for large-scale analyses. In this chapter, tissue-printing and squashing capture methods for direct sample preparation without extract preparation or nucleic acid extraction and purification were coupled with validated real-time RT-PCR detection protocols based on TaqMan chemistry for CTV detection.

INTESTINAL MALROTATION IN PATIENTS UNDERGOING BARIATRIC SURGERY.

Background: Intestinal malrotation is a rare congenital anomaly. In adults is very difficult to recognize due to the lack of symptoms. Diagnosis is usually incidental during surgical procedures or at autopsy. Aim: To review the occurrence and recognition of uneventful intestinal malrotation discovered during regular cases of bariatric surgeries. Methods: Were retrospectively reviewed the medical registry of 20,000 cases undergoing bariatric surgery, from January 2002 to January 2016, looking for the occurrence of intestinal malrotation and consequences in the intraoperative technique and immediate evolution of the patients. Results: Five cases (0,025%) of intestinal malrotation were found. All of them were males, aging 45, 49, 37,52 and 39 years; BMI 35, 42, 49, 47 and 52 kg/m2, all of them with a past medical history of morbid obesity. The patient with BMI 35 kg/m2 suffered from type 2 diabetes also. All procedures were completed by laparoscopic approach, with no conversions. In one patient was not possible to move the jejunum to the upper abdomen in order to establish the gastrojejunostomy and a sleeve gastrectomy was performed. In another patient was not possible to fully recognize the anatomy due to bowel adhesions and a single anastomosis gastric bypass was preferred. No leaks or bleeding were identified. There were no perioperative complications. All patients were discharged 72 h after the procedure and no immediate 30-day complications were reported. Conclusion: Patients with malrotation can successfully undergo laparoscopic bariatric surgery. May be necessary changes in the surgical original strategy regarding the malrotation. Surgeons must check full abdominal anatomical condition prior to start the division of the stomach.

Racional: Má-rotação intestinal é rara anomalia congênita em adultos de difícil reconhecimento devido à falta de sintomas. O diagnóstico é feito geralmente incidentalmente durante procedimentos cirúrgicos ou durante autópsia. Objetivo: Verificar a ocorrência e reconhecimento não eventual da má-rotação intestinal durante operações bariátricas sequenciais. Métodos: Retrospectivamente foram analisados os prontuários médicos de 20.000 casos de operações bariátricas de janeiro 2002 a janeiro de 2016, procurando por ocorrência de má-rotação intestinal, sua interferência na técnica operatória aplicada e a evolução imediata no pós-operatório. Resultados: Foram encontrados cinco casos (0.025%) de má-rotação intestinal em homens com idades de 37, 39, 45, 49 e 52 anos e IMC de 35, 42, 49, 47 e 52 kg/m2. O paciente com IMC de 35 kg/m2 também sofria de diabete melito tipo 2. Todos os procedimentos foram realizados através de laparoscopia, sem conversões. Em um paciente não foi possível mover o jejuno para o abdome superior a fim de realizar gastrojejunostomia; foi, então, realizada gastrectomia vertical. Em outro paciente, não foi possível reconhecer totalmente a anatomia devido às aderências intestinais e foi decidido realizar bypass gástrico com anastomose única. Nenhum vazamento ou sangramento foi identificado. Não houve nenhuma complicação pós-operatória. Todos os pacientes foram liberados 72 h após o procedimento e nenhuma complicação foi notificada nos primeiros 30 dias. Conclusão: A cirurgia bariátrica laparoscópica pode ser realizada com sucesso em pacientes com má-rotação. Mudanças talvez sejam necessárias com relação à anomalia. Os cirurgiões devem verificar toda a condição anatômica abdominal antes de iniciar a secção gástrica.

[Vascular by-pass surgery infection incidence and risk factors at the Juan Canalejo Hospital in Corunna within the 2000-2002 period]. / Incidencia y factores de riesgo de las infecciones quirurgicas de by-pass vasculares en el Hospital Juan Canalejo de a Corunã en el período 2000-2002.

BACKGROUND: Vascular by-pass surgery is being used increasingly more frequently on elderly patients entailing several risk factors. Surgical infections in these procedures are a devastating complication which is related to high morbility and death rates. This study is aimed at ascertaining the incidence of surgical infections among patients having undergone a by-pass procedure with vascular prostheses, the risk factors associated thereto and the type or prosthesis entailing a lower infection rate. METHODS: A retrospective cohort study was conducted at the Vascular Surgery Unit of the Juan Canalejo University Hospital throughout the 2000-2002 period. The Disease Control Center infection criteria were those applied. The frequency measurements calculated were cumulative incidence and relative risk as an association measurement. The statistical tests employed were the Chi-square and the Chi-square trend tests, the Student's-T for univariate analysis and logic regression for the multi-variate analysis. RESULTS: The cumulative incidence rate for the 2000-2002 period was 22.6% to 12.1%. The most frequent microorganisms were Staphylococcus aureus, meticilin-resistant Staphylococcus aureus, Staphylococcus epidermidis, and Escherichia coli. The risk factors related to infection found were female sex (RR=1.8) anesthetic risk >2 (RR=1.7) and patient implanted with sapheneous vein vascular prosthesis (RR=3.8). CONCLUSIONS: The risk factors identified were the female sex, anesthetic risk and the type of prosthesis used, all of which condition infection-related complication in by-pass surgery.

Human-inspired sound environment recognition system for assistive vehicles.

OBJECTIVE: The human auditory system acquires environmental information under sound stimuli faster than visual or touch systems, which in turn, allows for faster human responses to such stimuli. It also complements senses such as sight, where direct line-of-view is necessary to identify objects, in the environment recognition process. This work focuses on implementing human reaction to sound stimuli and environment recognition on assistive robotic devices, such as robotic wheelchairs or robotized cars. These vehicles need environment information to ensure safe navigation. APPROACH: In the field of environment recognition, range sensors (such as LiDAR and ultrasonic systems) and artificial vision devices are widely used; however, these sensors depend on environment constraints (such as lighting variability or color of objects), and sound can provide important information for the characterization of an environment. In this work, we propose a sound-based approach to enhance the environment recognition process, mainly for cases that compromise human integrity, according to the International Classification of Functioning (ICF). Our proposal is based on a neural network implementation that is able to classify up to 15 different environments, each selected according to the ICF considerations on environment factors in the community-based physical activities of people with disabilities. MAIN RESULTS: The accuracy rates in environment classification ranges from 84% to 93%. This classification is later used to constrain assistive vehicle navigation in order to protect the user during daily activities. This work also includes real-time outdoor experimentation (performed on an assistive vehicle) by seven volunteers with different disabilities (but without cognitive impairment and experienced in the use of wheelchairs), statistical validation, comparison with previously published work, and a discussion section where the pros and cons of our system are evaluated. SIGNIFICANCE: The proposed sound-based system is very efficient at providing general descriptions of the environment. Such descriptions are focused on vulnerable situations described by the ICF. The volunteers answered a questionnaire regarding the importance of constraining the vehicle velocities in risky environments, showing that all the volunteers felt comfortable with the system and its performance.

Real-time multiplex RT-PCR for the simultaneous detection of the five main grapevine viruses.

A real-time multiplex RT-PCR has been developed for the simultaneous detection and identification of the major RNA viruses that infect grapevines (Grapevine fanleaf virus, Arabis mosaic virus, Grapevine leafroll-associated virus 1, Grapevine leafroll-associated virus 3 and Grapevine fleck virus). Serial dilutions of infected plant extracts were tested using the new method, and the results were compared with those obtained using a commercially available ELISA and real-time singleplex RT-PCR. The two real-time RT-PCR versions detected up to the same level of dilution and were at least 10,000 times more sensitive than the ELISA. In addition, 158 grapevine plants collected in a survey of the Protected Designation of Origin in Alicante, Spain were compared using the three methods. The results of the molecular methods were very similar, with only four discordant results, and both were able to detect many more infected plants than the ELISA. The high prevalence of Grapevine fleck virus, Grapevine leafroll-associated virus 3 and Grapevine fanleaf virus suggests that the main pathways of viral introduction are infected plant material that has escaped controls and/or uncontrolled traffic of propagating plant material. Real-time multiplex RT-PCR could be used to facilitate a better control of grapevine viruses.

INTESTINAL MALROTATION IN PATIENTS UNDERGOING BARIATRIC SURGERY / MÁ ROTAÇÃO INTESTINAL EM PACIENTES SUBMETIDOS À CIRURGIA BARIÁTRICA

ABSTRACT Background: Intestinal malrotation is a rare congenital anomaly. In adults is very difficult to recognize due to the lack of symptoms. Diagnosis is usually incidental during surgical procedures or at autopsy. Aim: To review the occurrence and recognition of uneventful intestinal malrotation discovered during regular cases of bariatric surgeries. Methods: Were retrospectively reviewed the medical registry of 20,000 cases undergoing bariatric surgery, from January 2002 to January 2016, looking for the occurrence of intestinal malrotation and consequences in the intraoperative technique and immediate evolution of the patients. Results: Five cases (0,025%) of intestinal malrotation were found. All of them were males, aging 45, 49, 37,52 and 39 years; BMI 35, 42, 49, 47 and 52 kg/m2, all of them with a past medical history of morbid obesity. The patient with BMI 35 kg/m2 suffered from type 2 diabetes also. All procedures were completed by laparoscopic approach, with no conversions. In one patient was not possible to move the jejunum to the upper abdomen in order to establish the gastrojejunostomy and a sleeve gastrectomy was performed. In another patient was not possible to fully recognize the anatomy due to bowel adhesions and a single anastomosis gastric bypass was preferred. No leaks or bleeding were identified. There were no perioperative complications. All patients were discharged 72 h after the procedure and no immediate 30-day complications were reported. Conclusion: Patients with malrotation can successfully undergo laparoscopic bariatric surgery. May be necessary changes in the surgical original strategy regarding the malrotation. Surgeons must check full abdominal anatomical condition prior to start the division of the stomach.

RESUMO Racional: Má-rotação intestinal é rara anomalia congênita em adultos de difícil reconhecimento devido à falta de sintomas. O diagnóstico é feito geralmente incidentalmente durante procedimentos cirúrgicos ou durante autópsia. Objetivo: Verificar a ocorrência e reconhecimento não eventual da má-rotação intestinal durante operações bariátricas sequenciais. Método: Retrospectivamente foram analisados os prontuários médicos de 20.000 casos de operações bariátricas de janeiro 2002 a janeiro de 2016, procurando por ocorrência de má-rotação intestinal, sua interferência na técnica operatória aplicada e a evolução imediata no pós-operatório. Resultados: Foram encontrados cinco casos (0.025%) de má-rotação intestinal em homens com idades de 37, 39, 45, 49 e 52 anos e IMC de 35, 42, 49, 47 e 52 kg/m2. O paciente com IMC de 35 kg/m2 também sofria de diabete melito tipo 2. Todos os procedimentos foram realizados através de laparoscopia, sem conversões. Em um paciente não foi possível mover o jejuno para o abdome superior a fim de realizar gastrojejunostomia; foi, então, realizada gastrectomia vertical. Em outro paciente, não foi possível reconhecer totalmente a anatomia devido às aderências intestinais e foi decidido realizar bypass gástrico com anastomose única. Nenhum vazamento ou sangramento foi identificado. Não houve nenhuma complicação pós-operatória. Todos os pacientes foram liberados 72 h após o procedimento e nenhuma complicação foi notificada nos primeiros 30 dias. Conclusões: A cirurgia bariátrica laparoscópica pode ser realizada com sucesso em pacientes com má-rotação. Mudanças talvez sejam necessárias com relação à anomalia. Os cirurgiões devem verificar toda a condição anatômica abdominal antes de iniciar a secção gástrica.