Characterization of the Effect of a Novel Production Technique for 'Not from Concentrate' Pear and Apple Juices on the Composition of Phenolic Compounds.

The consumption of 'not-from-concentrate' (NFC) fruit juices can be a convenient and enjoyable way to incorporate the nutritional benefits and flavors of fruits into one's diet. This study will focus on the effect of production of juices from apple and pear fruits, by using centrifugal decanter and tangential filtration, on the profile of polyphenols as a valuable source of bioactive compounds. Likewise, by-products from the juice industry were characterized in order to understand the high-value-added potential based on their composition of polyphenols. Briefly, apple and apple juice showed great contents of chlorogenic acid (0.990 ± 0.021 mg/g of DW), the dihydrochalcone phloridzin (1.041 ± 0.062 mg/g of DW), procyanidins (0.733 ± 0.121 mg/g of DW) and quercetin derivatives (1.501 ± 0.192 mg/g of DW). Likewise, the most abundant compounds in pear and pear juices were chlorogenic acid (0.917 ± 0.021 mg/g of DW), caffeoylquinic acid (0.180 ± 0.029 mg/g of DW), procyanidins (0.255 ± 0.016 mg/g of DW) and quercetin derivatives (0.181 ± 0.004 mg/g of DW). Both temperature and tangential speed affect the amount of phenolic compounds in fruit juices, highlighting the need to control the technological process to obtain a more nutritious/healthier beverage. Overall, NFC juices arise as a better option when compared with concentrated juices. Furthermore, the higher yield of phenolic compounds found in fruit pomace clearly open new ways for upcycling this fruit by-product as a high-value-added ingredient.

In Vitro Cyto- and Genotoxicity Assessment of Antibacterial Paints with Triclosan and Isoborneol.

Surfaces with antimicrobial properties are gaining notoriety as an efficient method to avoid surface contamination. Self-disinfecting paints are a promising strategy towards cleaner indoor environments by preventing the colonization of walls with microorganisms. However, its widespread use needs an appropriate toxicological safety evaluation due to the potential for biological disturbance associated to its biocidal activity. In this work, the cyto- and genotoxic assessment of two self-disinfecting paints containing the antimicrobial substances triclosan (TCS) and isoborneol (ISB) is performed. HaCaT and A549 cell lines models were selected for the in vitro assessment. To evaluate the cytotoxicity, tests by direct contact and on extracts obtained from leaching were performed following ISO 10993, whereas the genotoxicity was assessed by comet assay and cytokinesis-block micronucleus (CBMN) assay. The results showed low levels of cyto- and genotoxicity under the models and conditions tested, indicating that these substances have commercial potential.

Cardiomiopatia periparto associada à síndrome do QT longo e síncope por taquicardia ventricular polimórfica: relato de caso / Peripartum cardiomyopathy associated with long QT syndrome and polymorphic ventricular tachycardia syncope: a case report

A cardiomiopatia periparto é uma causa rara de insuficiência cardíaca no período entre o último mês de gestação e os cinco meses após o parto. A síndrome do QT longo caracteriza-se pelo atraso da repolarização ventricular e pode se manifestar com síncope e morte súbita devido a um tipo de taquicardia ventricular polimórfica conhecida como torsades de pointes. Descrição do caso: J.S., 26 anos, sexo feminino, natural e procedente de São Paulo. Paciente puérpera - 40º dia (G3P3A0), procurou o pronto-socorro com queixa de síncope durante amamentação e dispneia em moderados esforços. Durante a avaliação no PS, evoluiu para desconforto torácico e agitação psicomotora, sendo notada taquicardia ventricular não sustentada no monitor cardíaco ( torsades de pointes), que foi controlada com cardioversão elétrica e sulfato de magnésio intravenoso. O eletrocardiograma mostrou ritmo sinusal, alteração difusa da repolarização ventricular e intervalo QTc de 580 ms. O ecocardiograma mostrou disfunção sistólica moderada, com fração de ejeção do ventrículo esquerdo de 43% à custa de hipocinesia difusa. Após avaliação da equipe de arritmologia chegou-se ao diagnóstico de cardiomiopatia periparto associado à síndrome do QT longo. Foi iniciado tratamento otimizado para insuficiência cardíaca e implantado cardiodesfibrilador por causa de episódios recorrentes de arritmia durante a internação. Discussão: A cardiomiopatia periparto é uma doença rara, porém, tem taxa de mortalidade elevada, entre 18% e 56%. A paciente descrita satisfez os quatro critérios para o diagnóstico: sintomas de insuficiência cardíaca nos primeiros 5 meses depois do parto, ausência de cardiomiopatia prévia, etiologia desconhecida e disfunção sistólica com FEVE < 45%. A síndrome do QT longo é uma doença genética de apresentações variáveis. Os fatores que desencadeiam as taquiarritmias são situações de instabilidade elétrica por hiperatividade do sistema simpático e também situações raras, como a cardiomiopatia periparto. Em casos de arritmias ventriculares graves, o tratamento é o implante de cardiodesfibrilador. Conclusão: A associação da cardiomiopatia periparto com a síndrome do QT longo é rara. A gravidade associada a essas condições torna importante o diagnóstico precoce e tratamento imediato pelo potencial risco de morte associado a ambas as condições clínicas

Peripartum cardiomyopathy is a rare cause of heart failure during the period between the last month of pregnancy and five months after delivery. Long QT syndrome is characterized by a delay in ventricular repolarization and may manifest with syncope and sudden death due to a type of polymorphic ventricular tachycardia known as torsades de pointes. Case description: J.S., 26-years-old, female, born and residing in São Paulo, Puerperal - 40th day (G3C3A0), went to the emergency room complaining of syncope during breastfeeding and dyspnea on moderate exertion. During evaluation in the ER, the patient developed thoracic discomfort and psychomotor agitation, with non-sustained ventricular tachycardia on the cardiac monitor (torsades de pointes), which was controlled with electrical cardioversion and intravenous magnesium sulfate. The electrocardiogram showed sinus rhythm, diffuse alteration of ventricular repolarization and QTc interval of 580 ms. The echocardiogram showed moderate systolic dysfunction, with a left ventricular ejection fraction of 43% influenced by diffuse hypokinesia. After evaluation by the arrhythmology team, the diagnosis of peripartum cardiomyopathy associated with long QT syndrome was made. Optimized treatment for heart failure was initiated and a cardioverter-defibrillator was implanted due to recurrent episodes of arrhythmia during hospitalization. Discussion: Peripartum cardiomyopathy is a rare disease, but it has a high mortality rate, between 18% and 56%. The patient described met the 4 diagnostic criteria: symptoms of heart failure in the first 5 months after delivery, absence of prior cardiomyopathy, unknown etiology, and systolic dysfunction with LVEF<45%. Long QT syndrome is a genetic disease of varying presentations. The factors that trigger the tachyarrhythmias are situations of electrical instability due to sympathetic system hyperactivity and rare situations, such as peripartum cardiomyopathy. In cases of severe ventricular arrhythmias, the treatment is a cardioverter-defibrillator implant. Conclusion: The association of peripartum cardiomyopathy with long QT syndrome is rare. The severity associated with these conditions points out early diagnosis and immediate treatment important because of the potential risk of death associated with both clinical conditions

Oleaginous yeasts for sustainable lipid production-from biodiesel to surf boards, a wide range of "green" applications.

A growing world population and a growing number of applications for vegetable oils are generating an increasing demand for these oils, causing serious environmental problems. A sustainable lipid production is then fundamental to address these problems. Oleaginous yeasts are a promising solution for sustainable lipid production, but, with the current knowledge and technology, they are still not a serious alternative in the market. In this review, the potential of these yeasts is highlighted and a discussion is made mainly focused on the economics of the oleaginous yeast oil production and identification of the key points to be improved to achieve lower production costs and higher income. Three main stages of the production process, where costs are higher, were identified. To render economically feasible the production of oils using oleaginous yeasts, a reduction in production costs must occur in all stages, lipid yields and productivities must be improved, and production must be targeted to high-value product applications.

Optimization of lipid extraction from the oleaginous yeasts Rhodotorula glutinis and Lipomyces kononenkoae.

The constant growing demand for vegetable oil for biodiesel and food is raising many environmental concerns about the sustainability of its production based on crops. Oleaginous yeasts show great potential to end with those concerns due to their high lipid productivity in small areas. To evaluate their productivity in lipids, an efficient and reproducible extraction process should be used. As no standard extraction process is available for the extraction of yeast lipids, an optimized extraction process is presented. In this work, the lipids extraction process for the yeasts Rhodotorula glutinis and Lipomyces kononenkoae is optimized using bead beating for cell rupture and introducing adaptations of the two most used extraction methods (Bligh and Dyer and Folch). For Rhodotorula g. the optimum extraction conditions are obtained by the Bligh and Dyer method applying 4.8 cycles of 47 s with 0.7 g of glass beads. For Lipomyces k. the optimum extraction conditions make use of the Folch method applying seven cycles of 42 s with 0.54 g of glass beads. These results reinforce the idea that, for each yeast, different extraction processes may be needed to correctly determine the lipid yield. The extraction procedure was further evaluated with less harmful solvents. Toluene was tested as a possible substitute of chloroform, and ethanol as a possible substitute of methanol. With the optimized extraction process, better results for Lipomyces k. were obtained using toluene and ethanol, while for Rhodotorula g. toluene proved to be a valid substitute of chloroform but ethanol is far less effective than methanol.

Implementation of integration strategies between primary care units and a regional general hospital in Brazil to update and connect health care professionals: a quasi-experimental study protocol.

BACKGROUND: Better communication among field health care teams and points of care, together with investments focused on improving teamwork, individual management, and clinical skills, are strategies for achieving better outcomes in patient-oriented care. This research aims to implement and evaluate interventions focused on improving communication and knowledge among health teams based on points of care in a regional public health outreach network, assessing the following hypotheses: 1) A better-working communication process between hospitals and primary health care providers can improve the sharing of information on patients as well as patients' outcomes. 2) A skill-upgrading education tool offered to health providers at their work sites can improve patients' care and outcomes. METHODS/DESIGN: A quasi-experimental study protocol with a mixed-methods approach (quantitative and qualitative) was developed to evaluate communication tools for health care professionals based in primary care units and in a general hospital in the southern region of São Paulo City, Brazil. The usefulness and implementation processes of the integration strategies will be evaluated, considering: 1) An Internet-based communication platform that facilitates continuity and integrality of care to patients, and 2) A tailored updating distance-learning course on ambulatory care sensitive conditions for clinical skills improvements. The observational study will evaluate a non-randomized cohort of adult patients, with historical controls. Hospitalized patients diagnosed with an ambulatory care sensitive condition will be selected and followed for 1 year after hospital discharge. Data will be collected using validated questionnaires and from patients' medical records. Health care professionals will be evaluated related to their use of education and communication tools and their demographic and psychological profiles. The primary outcome measured will be the patients' 30-day hospital readmission rates. A sample size of 560 patients was calculated to fit a valid logistic model. In addition, qualitative approaches will be used to identify subjective perceptions of providers about the implementation process and of patients about health system use. DISCUSSION: This research project will gather relevant information about implementation processes for education and communication tools and their impact on human resources training, rates of readmission, and patient-related outcomes.

Relato de Inovação Pedagógica na Abordagem da Ecologia Médica / Report of Pedagogical Innovation in the Medical Ecology Approach

RESUMO Este artigo relata a inovação pedagógica na abordagem da Ecologia Médica no curso de Medicina da Universidade Severino Sombra (USS) por meio do conteúdo programático da disciplina Sistema de Integração Curricular e Comunitária I, descrevendo suas contribuições para a formação de médicos com visão ampliada de saúde, conscientes da interface entre saúde e meio ambiente.

ABSTRACT This article reports the pedagogical innovation in the approach of the Medical Ecology topic of the undergraduate course in medicine at the Severino Sombra University (USS). This approach was implemented through the syllabus of the subject Curricular and Community Integration System I, describing the contributions toward medical training with a broadened view of health, conscious of the interface between health and the environment.

Thermal comfort assessment of a surgical room through computational fluid dynamics using local PMV index.

BACKGROUND: Studies concerning indoor thermal conditions are very important in defining the satisfactory comfort range in health care facilities. OBJECTIVE: This study focuses on the evaluation of the thermal comfort sensation felt by surgeons and nurses, in an orthopaedic surgical room of a Portuguese hospital. METHODS: Two cases are assessed, with and without the presence of a person. Computational fluid dynamic (CFD) tools were applied for evaluating the predicted mean vote (PMV) index locally. RESULTS: Using average ventilation values to calculate the PMV index does not provide a correct and enough descriptive evaluation of the surgical room thermal environment. As studied for both cases, surgeons feel the environment slightly hotter than nurses. The nurses feel a slightly cold sensation under the air supply diffuser and their neutral comfort zone is located in the air stagnation zones close to the walls, while the surgeons feel the opposite. It was observed that the presence of a person in the room leads to an increase of the PMV index for surgeons and nurses. That goes in line with the empirical knowledge that more persons in a room lead to an increased heat sensation. CONCLUSIONS: The clothing used by both classes, as well as the ventilation conditions, should be revised accordingly to the amount of persons in the room and the type of activity performed.

O Universitário Transformador na comunidade: a experiência da USS / The social Transformer Student in the community: the experience of USS

Relato da experiência de atuação precoce dos alunos do primeiro ao terceiro período do curso de Medicina na comunidade em bairro periférico do município de Vassouras (RJ) . Visitam-se famílias, momento em que o acadêmico desempenha uma função de acordo com o período em que está matriculado e seu grau de conhecimento. Ao término das atividades, nas quais é priorizado o uso de tecnologia leve, alunos e docentes discutem a situação de saúde dos moradores e planejam ações. Esta experiência representa a incorporação de novas práticas educativas, centradas no aluno, que tem estimulada a autonomia e uma postura proativa em busca de soluções para problemas. Colabora para a compreensão pelo aluno do seu papel de transformador social por meio de ações de promoção de saúde e incentivo ao empoderamento da comunidade, e contribui para melhorar os indicadores de saúde e, consequentemente, a qualidade de vida das pessoas. Esta inserção contribui para a formação de médicos valorizadores da Atenção Primária à Saúde, imprescindível para a resolução dos agravos mais prevalentes na população.

This article reports on the experience of first and second year student doctors engaging with a community in the outskirts of Vassouras, in Rio de Janeiro state, Brazil. Families are visited by the students, who assumes a given duty depending on his level of medical training and knowledge. At the end of the activities, which focus on using light technology, the students and teachers discuss the health of the residents and plan actions. This experience represents the incorporation of new student-centered learning practices, that encourage independent, proactive behavior toward problem solving. This experience contributes to the student's understanding of his role in social transformation through actions that promote health and encourage community empowerment, improving health indicators and, consequently, quality of life. This early insertion into the community helps ensure an education that values primary health care by doctors, essential for solving the most prevalent diseases among the population.

Appendicitis: what does really make the difference between private and public hospitals?

BACKGROUND: Appendicitis is one of the most common surgical emergencies and is also a time-sensitive condition. Delays in treatment increase the risk of appendiceal perforation (AP), and thus AP rates have been used as a proxy to measure access to surgical care. It is very well known that in Brazil there are big differences between the public and private healthcare systems. Those differences can reflect in the treatment of what are considered simple cases, like appendicitis. As far as we know, it has no known links to behavioral or social risk factors, and has only one treatment option--appendectomy. The purpose of this study was to compare treatment received by Brazilian people, both by those who depend on the public and private healthcare system, and how it affects their outcome. METHODS: Data was collected from the records of all patients submitted to appendectomy, in a public and in a private Sao Paulo city's hospitals, during January to April of 2010. RESULTS: Patients admitted by the public hospital present symptoms for a longer period of time than those treated by the private one. It took a significantly higher amount of time for the patients from the public hospital undergo surgery, and their length of stay is also significantly higher. CONCLUSIONS: Appendicitis in a public scenario is associated with increased time from onset of symptoms to operative intervention and the main reason is the delayed presentation. Clinical polices for abdominal pain should be instituted by the public healthcare system, based on population education, healthcare professionals training and establishment of strategies that can speed the diagnosis process up.

Impacto do uso da pinça seladora ou do bisturi harmônico nos desfechos intra-hospitalares e no custo de procedimentos de tireoidectomia / Impact of the use of vessel sealing or harmonic scalpel on intra-hospital outcomes and the cost of thyroidectomy procedures

OBJETIVOS: Analisar tempo cirúrgico, tempo de internação, sangramento, escore de dor no período pós-operatório e custo referente aos procedimentos de tireoidectomia com utilização de pinça seladora ou bisturi harmônico, comparando-os à técnica convencional. MÉTODOS: Análise retrospectiva das tireoidectomias, realizadas entre 2007 e 2010, pela técnica convencional e com uso de pinça seladora ou bisturi harmônico. Foram analisados: gênero, idade, diagnóstico principal e tipo de procedimento. Os desfechos analisados foram: duração do procedimento, tempo de permanência hospitalar, necessidade de transfusão de hemoderivados, dor e custo da internação. As conclusões foram baseadas em um nível de significância de 5%, e as análises estatísticas foram realizadas utilizando o software R. RESULTADOS: Para o desfecho "duração da cirurgia", o uso da pinça seladora resultou em aumento médio de, aproximadamente, 47 minutos, quando comparado à técnica convencional (p<0,001) e o uso do bisturi harmônico levou à redução média de, aproximadamente, 32 minutos, quando comparado à técnica convencional (p<0,001). Não houve diferença estatisticamente significativa entre os grupos quanto ao uso de hemoderivados e escore de dor. Procedimentos que utilizaram pinça seladora ou bisturi harmônico apresentaram custo superior quando comparados àqueles com a técnica convencional. CONCLUSÃO: O uso do bisturi harmônico mostrou-se favorável na redução do tempo cirúrgico, porém não foi observada redução no tempo de hospitalização. O custo do procedimento foi mais alto em relação à técnica convencional. O uso da pinça seladora não trouxe vantagens com relação aos desfechos, e o custo do procedimento foi maior quando comparado à técnica convencional.

OBJECTIVES: To analyze the operative time, length of hospitalization and cost, as well as the bleeding and pain observed during the postoperative period, of thyroidectomy procedures using vessel sealing, harmonic scalpel or the conventional technique. METHODS: Retrospective analysis of thyroidectomies performed between 2007 and 2010 using either the conventional technique or minimally invasive techniques involving vessel sealing or a harmonic scalpel. Gender, age, primary diagnosis and procedure type were analyzed. The outcomes analyzed included the length of the procedure, length of hospital stay, need for blood product transfusions, pain and cost of hospitalization. The findings were based on a significance level of 5%, and statistical analyses were performed using the R software. RESULTS: The use of the vessel sealing increased the duration of the surgery by approximately 47 minutes compared to the conventional technique (p<0.001), and the use of the harmonic scalpel decreased the duration of the surgery by approximately 32 minutes compared to the conventional technique (p<0.001). No statistically significant difference was found between the groups regarding the use of blood products and pain score. Procedures involving vessel sealing or a harmonic scalpel cost more than those using the conventional technique. CONCLUSION: The use of harmonic scalpel was favorable in terms of reducing the surgical time, but there was no reduction in hospitalization time. The cost of the procedure was higher than that of the conventional technique. The use of vessel sealing offered no advantages in terms of the outcomes assessed, and the cost of the procedure was greater than that of the conventional technique.

Impact of the use of vessel sealing or harmonic scalpel on intra-hospital outcomes and the cost of thyroidectomy procedures.

OBJECTIVES: To analyze the operative time, length of hospitalization and cost, as well as the bleeding and pain observed during the postoperative period, of thyroidectomy procedures using vessel sealing, harmonic scalpel or the conventional technique. METHODS: Retrospective analysis of thyroidectomies performed between 2007 and 2010 using either the conventional technique or minimally invasive techniques involving vessel sealing or a harmonic scalpel. Gender, age, primary diagnosis and procedure type were analyzed. The outcomes analyzed included the length of the procedure, length of hospital stay, need for blood product transfusions, pain and cost of hospitalization. The findings were based on a significance level of 5%, and statistical analyses were performed using the R software. RESULTS: The use of the vessel sealing increased the duration of the surgery by approximately 47 minutes compared to the conventional technique (p<0.001), and the use of the harmonic scalpel decreased the duration of the surgery by approximately 32 minutes compared to the conventional technique (p<0.001). No statistically significant difference was found between the groups regarding the use of blood products and pain score. Procedures involving vessel sealing or a harmonic scalpel cost more than those using the conventional technique. CONCLUSION: The use of harmonic scalpel was favorable in terms of reducing the surgical time, but there was no reduction in hospitalization time. The cost of the procedure was higher than that of the conventional technique. The use of vessel sealing offered no advantages in terms of the outcomes assessed, and the cost of the procedure was greater than that of the conventional technique.

Sialoendoscopia: relato dos dois primeiros casos tratados no Brasil, no Hospital Israelita Albert Einstein / Sialoendoscopy: report of the first two cases treated in Brazil, at Albert Einstein Jewish Hospital

Introdução: A sialoendoscopia é um procedimento endoscópico realizado nas glândulas salivares maiores submandibular e parótida, com finalidade diagnóstica e, principalmente, terapêutica. Desenvolvida pelo Prof. Francis Marchal, no final da década de 1990, passou a ser utilizada em diversos países da Europa, da América do Norte e da Ásia. Método: Este é um relato dos dois primeiros pacientes com doença inflamatória calculosa das glândulas salivares maiores submetidos à sialoendoscopia no Brasil, no Hospital Israelita Albert Einstein. Relatos dos Casos: Caso 1 - Paciente do sexo masculino, com 37 anos, com quadro de sialoadenite recidivante de glândula submandibular esquerda, após tentativa malsucedida de papilotomia do ducto de Wharton para retirada do cálculo; Caso 2 - Paciente do sexo masculino, com 57 anos, com sialoadenite calculosa obstrutiva de glândula parótida direita, persistente após parotidectomia subtotal. Em ambos os casos, o diagnóstico de cálculo salivar foi confirmado, seguindo-se a retirada bem sucedida com o uso de um ?basket? acoplado ao sialoendoscópio. O primeiro doente teve alta no mesmo dia e o segundo, no dia seguinte, com resolução completa dos sintomas. Conclusão: Neste relato preliminar, a experiência inicial com estes dois casos operados em nossa Instituição é encorajadora, especialmente no segundo paciente, que havia sido submetido a uma tentativa infrutífera de resolução de seu quadro obstrutivo através de uma parotidectomia convencional. Este procedimento, minimamente invasivo, oferece uma nova opção para a abordagem de doenças não-neoplásicas das glândulas salivar maiores, com baixíssima morbidade operatória e bons resultados funcionais imediatos, com preservação das glândulas afetadas.

Background: Sialoendoscopy is an endoscopic procedure performed in the major salivary glands submandibular and parotid, with diagnostic as well as therapeutic intent. It wasdescribed by Prof. Francis Marchal, at the end of the 1990´s, and was used in several countries of Europe, North America and Asia since thereafter. Method: This is a report of the two first cases with sialolithiasis of the major salivary glands submitted to sialoendoscopy in Brazil, at Albert Einstein Jewish Hospital. Case Reports: Case 1 - 37 year-old male, with recurrent sialolithiasis of the left submandibular gland, after unsuccessful attempt to extract the Stone with a papilotomy of the Wharton?s duct; Case 2 - 57 yearold male, with obstructive sialolithiasis of the right parotid gland, persistent even after a subtotal parotidectomy. In both cases, the diagnosis of sialolithiasis was confirmed by sialoendoscopy, with a subsequent successful endoscopic extraction of the Stones with baskets. The first patient was discharged on the same day of the procedure, whereas the second patient was discharged on the first postoperative Day, with complete resolution of their symptoms. Conclusion: In this preliminary report, the initial experience with these two cases operated on at our Institution is encouraging, especially regarding the second patient, who was previously submitted to a failed attempt to cure his disease with a conventional parotidectomy. This procedure, which is minimally invasive, offers a new option for the management of non-neoplastic diseases of the major salivary glands, with very low morbidity and very good initial results, with preservation of the affected glands.

Robot-assisted radical prostatectomy in Brazil: preliminary results / Resultados iniciais da prostatectomia radical robô-assistida no Brasil

Purpose: To report the initial experience on robot-assisted radical prostatectomy in Brazil. Methods: From March 2008 to March 2009, a hundred patients were treated with robot-assisted radical prostatectomy. Patients demographic data, as well as perioperative results of the procedures, are described in this study. Results: Patients mean age and mean PSA were 58 years and 7.58 ng/ml, respectively. All procedures were performed through transperitoneal approach, with a mean bleeding of 480 mL and surgical time of 298 minutes. A surgical margin affected by cancer was present in 16% of the cases. There were four complications: bleeding requiring transfusion (two cases), rectal perforation corrected on the spot and inadequate functioning of the robot. There was no conversion to another access or obit occurrences in this caseload. Conclusions: Robot-assisted prostatectomy is a reality in Brazil and the results herein presented demonstrate that this procedure can be safely performed. Long-term follow-up is still necessary to assess the oncological and functional outcomes.

Objetivo: Relatar a experiência inicial de prostatectomia radical robô-assistida realizada no Brasil. Métodos: No período de março de 2008 a março de 2009, cem pacientes foram tratados com a prostatectomia radical robô-assistida. Os dados demográficos dos pacientes, assim como os resultados perioperatórios dos procedimentos, são descritos neste estudo. Resultados: A média de idade e PSA dos pacientes foi de 58 anos e 7,58 ng/ml, respectivamente. Todos os procedimentos foram realizados por via transperitoneal, com sangramento médio foi de 480 ml e tempo cirúrgico de 298 minutos. A presença de margem cirúrgica comprometida por câncer ocorreu em 16% dos casos. Ocorreram quatro complicações: sangramento com necessidade de transfusão (dois casos), perfuração retal corrigida no ato e funcionamento inadequado do robô. Não houve conversão para outro acesso ou óbitos nesta casuística. Conclusões: A prostatectomia robótica é uma realidade no Brasil e os resultados apresentados demonstram que este procedimento pode ser realizado com segurança. Seguimento a longo prazo ainda é necessário para avaliar os resultados oncológicos e funcionais.

Mammaplasty combining vertical and transverse approaches through a vertical incision.

An adjustable vertical marking is described for vertical mammaplasty in mild and moderate hypertrophy or ptosis of the breast. A vertical rectangular flap with the pedicle supported at the inframammary fold provides fullness for the upper or the lower pole of the breast. It is fixed over the pectoralis aponeurosis along the upper pole to the base of the pedicle. Length, width, and thickness of the vertical rectangular flap change regarding the extent of breast ptosis and hypertrophy. Two transverse triangular flaps, dissected in the lower pole of the breast, are supported on the inferior half of the vertical pillars at the incision margins. The criss-crossing of the triangular flaps creates a transverse support sling, avoiding the downward displacement of the breast. The vertical flap is applied in conjunction with the triangular flap to attempt to achieve projection and support for the breast with long-term stabilization of the mammary cone. Resection of mammary tissue is performed transversely just above the pedicle of the vertical flap.

Cinco anos de hérnia inguinal no H.U / Five years of inguinal hernia at H.U

Os autores fazem um estudo retrospectivo sobre hérnia inguinal, no período de 1985 a 1990, levando em consideraçäo dados epidemiológicos e técnicas cirúrgicas utilizadas no Serviço de Cirurgia do Abdomen do H.U. - UFJF, contando o estudo com 100 casos.

Experiência da cirurgia biliar no H.U. - UFJF / Surgery of the biliary tract in the H.U - UFJF

Os autores realizaram um estudo retrospectivo de 100 pacientes submetidos a cirurgia primária sobre o trato biliar abrangendo um período de 8 anos de experiência no H.U. da U.F.J.F. Destacam a idade, cor e sexo dos pacientes, bem como a sua procedênciaa, sintomatologia mais comum, o tempo de doença a propedêutica pré-operatória, o diagnóstico, cirurgia, complciaçöes no pós-operatório,o tempo de permanência hospitalar e o número de gestaçöes

Cisto peritoneal: relato de um caso / Peritoneal cyst: report of a case

Os autores apresentam um caso de cisto peritonial que ocupava o espaço retroperitonial em um adulto internado no H.U. da UFJF no ano de l986. Destacam a história e incidência, patologia, etiologia e classificaçäo, o diagnóstico, o diagnóstico deferencial, tratamento e prognóstico dessa rara patologia