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BACKGROUND: Sleeve gastrectomy (SG) has been used as a multipurpose surgical procedure for the treatment of obesity. OBJECTIVES: The present study aimed to assess the effects of SG on the metabolic and inflammatory profile and renin-angiotensin system (RAS) expression in the white adipose tissue of male rats with obesity induced by a high-fat diet. METHODS: Male Wistar rats were treated with a standard diet or high-fat diet and submitted to SG or sham surgery. The glycemic and lipid profiles and gene expression of inflammatory markers and RAS components in adipose tissue were evaluated. RESULTS: SG led to weight loss, decreased adiposity (p < 0.01) and a reduction in plasma glucose (p < 0.05), C-peptide (p < 0.05), insulin (p < 0.001) and total cholesterol (p < 0.05) levels. In addition, SG led to a decrease in the expression of tumor necrosis factor-alpha (TNF-α) (p < 0.01), interleukin- 6 (IL-6) (p < 0.001), angiotensinogen (AGT) (p < 0.001) and angiotensin converting enzyme (ACE) (p < 0.05) and increased the expression of angiotensin converting enzyme 2 (ACE2) (p < 0.05) in white adipose tissue. No statistically significant differences were observed for AT1 (p = 0.10) and Mas (p = 0.22) receptors. CONCLUSION: This study showed that SG leads to weight loss and improves metabolic parameters. Changes in the expression of RAS components and of inflammatory molecules in adipose tissue seem to play a role the before beneficial effects of the SG.

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Aim: The present study aimed to analyze the expression of IL6, UCP1 and SIRT1 in adipose tissue (WAT and BAT) in association to clinical, metabolic and anthropometric parameters in obese humans. Methods: WAT and BAT samples from obese patients (n=27) were collected. IL6, UCP1 and SIRT1 markers were measured by qRT-PCR. The association between IL6, UCP1 and SIRT1 mRNA expression and anthropometric and clinical parameters were evaluated, using appropriate statistical tests. Results: Our results demonstrated that high levels of IL6 are associated with altered glucose levels in the WAT (p=0.01). In contrast, high levels of IL6 in the BAT were associated with decreased % fat (p=0.01) and fat weight (p=0.02) and increased mVO2 (p=0.02) and VO2 (p=0.02). For UCP1, a higher expression in the BAT was observed when compared to the WAT (p=0.0001). This gene expression was associated with lower values of BMI (p=0.03), % fat (P=0.02) and fat weight (P=0.02) and increased mVO2 (p=0.041) and VO2 (p=0.001). In the WAT, decreased levels of SIRT1 were associated with increased fat weight (p=0.02); in the BAT, associations were found for % fat (p=0.018) and mVO2 (p=0.03). Conclusion: These results reveal different characteristics in the biological actions between WAT and BAT in obese humans. Increased levels of IL6, UCP1 and SIRT1 in the BAT were associated with metabolic parameters improvements.

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OBJECTIVE: The aim of this study is to assess whether C1772T and G1790A hypoxia-inducible factor-1 (HIF-1)α polymorphisms are associated with risk of oral lichen planus (OLP). MATERIAL AND METHODS: Restriction fragment length polymorphism analysis was used to investigate HIF-1α C1779T and G1790A polymorphisms in 32 OLP and 88 individuals without OLP. RESULTS: The frequency of the CC, TT, GA, and AA genotypes was higher in patients with OLP. Notably, individuals carrying the C and A, and T and A haplotypes showed a significant association OLP risk. CONCLUSIONS: Our study demonstrated that the C1772T and G1790A polymorphisms of HIF-1α gene increased the risk of OLP. C1772T and G1790A polymorphisms of HIF-1α gene had differing patterns of allelic imbalance in the normal samples and subsequent chronic lesions. Further studies are necessary to elucidate the HIF-1α pathway in OLP, which would facilitate the development of novel therapeutic strategies for the prevention and treatment of OLP. CLINICAL RELEVANCE: These results, in conjunction with previous studies, suggest that HIF-1α may play important roles in the chronicity of oral mucosa lesions of OLP patients. Taken together, we suggest that HIF-1α polymorphisms enhance its target genes, thereby altering the microenvironment and supporting sequential release of inflammatory mediators or cellular events in OLP. It appears unlikely that inhibition of a single proinflammatory mediator will prove useful in clinical practice, but several ways to reprogram mediators engaged in a wide array of roles simultaneously are encouraging.

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O objetivo desse estudo foi compreender os fatores determinantes da prática transfusional de concentrado de hemácias em cirurgias eletivas do aparelho digestivo em quatro unidades hospitalares em Montes Claros, Minas Gerais, Brasil. Foi realizado um estudo descritivo, analítico e retrospectivo através do levantamento de dados em prontuários clínicos de quatro unidades hospitalares de onde foram catalogados os dados de pacientes a partir de junho de 2007 a dezembro de 2008, referentes às cirurgias citadas. Os resultados evidenciaram 81 casos, sendo 42 por cento do gênero feminino e 58 por cento do masculino. A idade média foi de 55,5 anos (±19,11 anos). As enfermidades de base reportadas mais comuns foram os processos neoplásicos (42 por cento). Desses 81 pacientes, 38 (47 por cento) foram hemotransfundidos no pré-operatório imediato, 28 (18 por cento) foram transfundidos no transcirúrgico e 37 (45,7 por cento) no pós-operatório imediato. Na análise univariada houve diferenças entre a prática transfusional pré-cirúrgica interinstitucional. Na fase cirúrgica houve relação entre a prática transfusional com a citação de motivos, fator RH (Rhesus), prática institucional e doença de base. Na fase pós-cirúrgica não foram demonstradas relações. Em todas as fases, não houve associação da prática transfusional com os tipos de procedimentos cirúrgicos, com o índice ASA (American Society of Anesthesiology) e valores de hemoglobina e hematócrito. Concluindo, esse estudo revelou que a prática transfusional foi heterogênea entre instituições hospitalares, careceu de valores laboratoriais específicos, relacionou-se com a patologia de base mas não com o tipo de procedimento cirúrgico e foi norteada pelo critério de escolha do profissional.

The objective of this study was to understand the determinative factors for packed red cell transfusions in elective digestive tract surgeries in four hospital units in Montes Claros, Minas Gerais, Brazil. Retrospective analyses were performed by collecting data from the clinical records of patients submitted to elective digestive tract surgeries from June 2007 to December 2008 at these four hospital units. Eighty-one cases (42 percent females and 58 percent males) were included in this study. The average age was 55.5 years old (Standard deviation ± 19.11 years). The commonest reported underlying disease was neoplasia (42 percent). Of these patients, 38 (47 percent) were transfused in the immediate preoperative period, 28 (34.6 percent) during the surgery and 37 (45.7 percent) in the immediate postoperative period. In the univariate analysis, there was an association between the data of transfusions and the different institutions. In the surgical phase, there were correlations between transfusion and the reason for transfusion, RH factor (Rhesus), institutional policy and the underlying disease. In the postoperative phase, no association was identified. In all phases, there were not correlations between the type of surgical procedures, ASA index (American Society of Anesthesiology), and hemoglobin and hematocrit values. Therefore, this study demonstrated that the blood transfusions in elective digestive tract surgeries were heterogeneous between hospitals and were not related to specific laboratorial values; they were associated to the underlying pathology, but not with the type of surgical procedure and generally followed the criteria of the healthcare specialist.

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Os bezoares resultam na ingestão de materiais inorgânicos ou orgânicos não digeríveis que formam uma massa em trato gastrintestinal, normalmente no estômago. Os tricobezoares são formados a partir da ingestão de cabelos. São geralmente encontrados em adolescentes do sexo feminino, especialmente com depressão ou retardo mental. A remoção é obrigatória pelo risco de complicações potencialmente fatais. Este trabalho apresenta o caso de um grande tricobezoar gástrico em uma jovem de 14 anos. A paciente foi submetida à laparotomia, durante a qual uma sólida massa de cabelo foi completamente retirada por gastrotomia anterior. O período pós-operatório foi sem intercorrências e com acompanhamento psiquiátrico adequado.

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A anatomia endoscópica do bulbo duodenal é controvérsa, o que motivou os autores correlacionarem o achado endoscópico com o laparoscópico. Foram estudados 8 pacientes portadores de colelitíase de indicaçäo cirúrgica eletiva. Na mesa de cirurgia, após a anestesia geral, cada paciente foi colocado em decúbito lateral esquerdo e introduzido o pan-endoscópico eletrônico até o bulbo duodenal. Neste, foi traçada uma linha imaginágia de um vértice ao outro e à esquerda desta linha injetado azul-de-metileno com cateter de escleroterapia, até formar pequeno "botäo" azulado. Posicionando o paciente em decúbito dorsal, realizado o pneumoperitônio, foram introduzidos os quatro trocartes abdominai para realizar a colescistectomia; foi passada a ótica laparoscópica de zero grau pelo trocarte da regiäo epigástrica, por ser esta a que permitiu melhor identificaçäo do bulbo duodenal e sua relaçöes anatômicas. Após inventário laparoscópico minucioso, foi facilmente reconhecido o local da punçäo endoscópica, que ficou corado com o azul e foi identificado como sendo a parede anterior

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