II Consensus of the Brazilian Nutrology Association on DHA recommendations during pregnancy, lactation and childhood

Objective: To update of the consensus of the Brazilian Association of Nutrology regarding DHA consumption and supplementation during pregnancy, lactation and childhood. Methods: Scientific articles published until 2022 were reviewed in Pubmed/Medline, SciELO and Lilacs databases. Results: Considering the information obtained, the authors drafted the consensus, which was approved by the Brazilian Association of Nutrology board. Conclusions: The recommendations of the Brazilian Nutrology Association are presented based on scientific evidence

A mutilação genital feminina como um problema de saúde pública em Portugal

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Referencial de educação para a saúde

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Endoscopic treatment of choledochal cyst type III

BACKGROUND: Todani type III cysts are not very common disease. Endoscopically the choledochocele is not a challenging diagnosis. Sometimes biliary stone disease is associated and events of cholangitis and pancreatitis may occur. Normally these patients are referred for surgical treatment, mainly because there is a widespread concept that choledocal cysts are very prone to develop neoplasia and must be resected. Nevertheless surgical resection is not free of morbidity. The chance for neoplasia in such cases seems to be related to the presence of pancreaticobiliary reflux towards the common bile duct. AIM: To report a case of endoscopic treatment of choledochal cyst type III with literature review. CASE REPORT: Young man with recurrent abdominal pain, fever and hyperamylasemia. An ERCP showed pancreaticobiliary maljunction and calculus impaction. Papillotomy was performed and complete biliary clearance was achieved. Amylase contents in the common bile duct was measured and normal. Due to absence of pancreatiobiliary reflux, a second endoscopic approach was performed and a wide communication between choledochocele and duodenum was done with diathermy (using the papillotome). The patient recovering was uneventful and in 30 months follow-up he remains asymptomatic. CONCLUSION: Since pancreatobiliary reflux is not present, surgical approach of the diverticulum seemed to be not necessary. Endoscopic drainage of choledococele was a good option for conservative treatment

Assessment of bacterial translocation in obstructive jaundice using Tc-99m Escherichia coli

In obstructive jaundice, the passage of bacteria and endotoxins through the intestine wall to reach the systemic circulation is associated with septicemia, renal failure and pulmonary dysfunction. The aim of this work was to investigate bacterial translocation utilizing 99mTc-E.coli in an experimental model of obstructive jaundice. The levels of bilirubin in rats that were subjected to ligature of the bile duct were significantly increased when compared to control animals (p < 0.001). The biodistribution results did not show any translocation of 99mTc-E.coli to the mesenteric lymphatic nodules, liver, spleen or lungs of the rats that suffered ligature of the bile duct (p > 0.05). The evaluation of the intestinal permeability using "per os" administration of 99mTc-DTPA showed 1.61 ± 0.57% and 1.39 ± 0.72% of radioactivity in the urine of the control and jaundice animals, respectively. The histological analysis of the distal wall of the ileum showed that the covering epithelium and the crypt were morphologically preserved in both groups. The seven-day period after the ligature of the bile duct may not have been long enough to promote modifications in intestinal wall to occur so as to permit the passage of Tc-99m E.coli

Animal-to-human transmission of Mycobacterium pinnipedii

Research letterExtract: Mycobacterium pinnipedii, the known causative agent of tuberculosis (TB) in marine mammals, was only recognised as a member of the Mycobacterium tuberculosis complex in 2003 [1] and is believed to cause TB in several species, including nonmarine mammals [2, 3] and even humans [4]. The assumption of zoonotic transmission has been strongly reinforced by a disruptive study published in 2014 by a team of archaeologists from Tübingen, Germany [5]. Based on archaeological and genomic investigations on millennial human skeletons, the authors implicated sea mammals infected with M. pinnipedii as a source of New World human TB. Considering that this phenomenon pre-dates the human migrations to South America by several centuries, they refuted the previous scientific hypothesis of TB driven by human contact [6].info:eu-repo/semantics/publishedVersio