Aspects Towards the Anastomotic Healing in Crohn's Disease: Clinical Approach and Current Gaps in Research.

Anastomotic leakage is a major complication in gastrointestinal and colorectal surgery and its occurrence increases morbidity and mortality. Its incidence is even higher in Crohn's disease surgeries. Several authors have identified factors involved in the pathophysiology of anastomotic leak in the literature, aiming to reduce its occurrence and, therefore, improve its surgical treatment. Surgical technique is the most discussed topic in studies on guiding the performance of side-to-side stapled anastomosis. Preoperative nutritional therapy also has been shown to reduce the risk of anastomotic leakage. Other factors remain controversial - immunomodulator use and biologic therapy, antibiotics, and gut microbiota - with studies showing a reduction in the risk of complication while other studies show no correlation. Although mesenteric adipose tissue has been related to disease recurrence, there is no evidence in the literature that it is related to a higher risk of anastomotic leakage. Further exploration on this topic is necessary, including prospective research, to support the development of techniques to prevent anastomotic leakage, in this way benefiting the inflammatory bowel disease patients who have to undergo a surgical procedure.

Effects of hydrological regime and connectivity on the interannual variation in taxonomic similarity of periphytic algae.

The aim of this study was to analyze the effects of flood pulses (intensity) on the richness and composition of periphytic algae in lentic environments of the Upper Paraná River floodplain, over a six-year period. Other factors, such as connectivity of the environments with the main channel of the river and the availability of substrate for the periphyton, were also evaluated. For qualitative analyses, periphyton community was sampled from adult petioles of Eichhornia azurea Kunth taken from the littoral regions of the lakes studied. A total of 457 taxa of periphytic algae, distributed within 141 genera and 10 classes, were registered in the four environments. The greatest richness of periphytic algae was observed in connected floodplain lakes, especially in 2007 and during high water periods. In both connected and disconnected lakes, richness correlated positively with water levels of the Paraná River. Richness was also positively correlated with the number of taxa of aquatic macrophytes. The specific composition of periphytic algae differed between high and low water periods, and between connected and disconnected lakes. Therefore, among the considered variables, it is evident that flood pulse constitutes the principal force acting on periphytic algae communities of the floodplain, followed by the degree of connectivity and the presence of aquatic macrophytes.

Effects of hydrological regime and connectivity on the interannual variation in taxonomic similarity of periphytic algae / Efeito do regime hidrológico e da conectividade na similaridade taxonômica de algas perifíticas: variação interanual

The aim of this study was to analyze the effects of flood pulses (intensity) on the richness and composition of periphytic algae in lentic environments of the Upper Paraná River floodplain, over a six-year period. Other factors, such as connectivity of the environments with the main channel of the river and the availability of substrate for the periphyton, were also evaluated. For qualitative analyses, periphyton community was sampled from adult petioles of Eichhornia azurea Kunth taken from the littoral regions of the lakes studied. A total of 457 taxa of periphytic algae, distributed within 141 genera and 10 classes, were registered in the four environments. The greatest richness of periphytic algae was observed in connected floodplain lakes, especially in 2007 and during high water periods. In both connected and disconnected lakes, richness correlated positively with water levels of the Paraná River. Richness was also positively correlated with the number of taxa of aquatic macrophytes. The specific composition of periphytic algae differed between high and low water periods, and between connected and disconnected lakes. Therefore, among the considered variables, it is evident that flood pulse constitutes the principal force acting on periphytic algae communities of the floodplain, followed by the degree of connectivity and the presence of aquatic macrophytes.

Este trabalho visou analisar o efeito do pulso de inundação (intensidade) sobre a riqueza e composição de algas perifíticas, ao longo de seis anos, em ambientes lênticos da planície de inundação do Alto Rio Paraná. A influência da conectividade dos ambientes com a calha principal do rio e disponibilidade de substratos para a comunidade de algas perifíticas também foi avaliada. Para análise, a comunidade perifítica foi amostrada de pecíolos adultos de Eichhornia azurea Kunth, retirados da região litorânea das lagoas estudadas. Considerando os quatro ambientes, foram registrados 457 táxons de algas, distribuídos em 141 gêneros e 10 classes. A maior riqueza de algas perifíticas foi observada em lagoas conectadas, com destaque para o ano de 2007 e para o período de águas altas. A riqueza apresentou correlação positiva, nas lagoas conectadas e não conectadas, com nível hidrométrico do Rio Paraná. Também esteve correlacionada positivamente com o número de táxons de macrófitas aquáticas. A composição de algas perifíticas diferiu entre os períodos de águas altas e águas baixas e entre lagoas conectadas e não conectadas. Ficou evidente que, dentre as variáveis consideradas, o pulso de inundação constitui a principal função de força atuando sobre a comunidade de algas perifíticas na planície, seguido pelo grau de conectividade e presença de macrófitas aquáticas.