Doença hepática gordurosa não alcoólica e cirurgia bariátrica: uma revisão abrangente

sem informaçãoNonalcoholic fatty liver disease (NAFLD) has been increasingly diagnosed worldwide and is now recognized as a source of public health concern. It comprises a wide spectrum of histological features that range from simple steatosis to severe forms of fibros1353277295sem informaçãosem informaçãosem informaçã

Management of pancreaticopleural fistulas secondary to chronic pancreatitis

sem informaçãoPancreaticopleural fistula is a rare complication of chronic pancreatitis. To describe pancreaticopleural fistula due to chronic pancreatitis and perform an extensive review of literature on this topic. Comprehensive narrative review through online rese303225228sem informaçãosem informaçãosem informaçã

Predictors for weight loss failure following roux-en-y gastric bypass

Weight loss failure is a widely recognized occurrence following Roux-en-Y gastric bypass. This study aims to identify predictors associated with weight loss failure. It is a retrospective cohort which enrolled 187 subjects who underwent RYGB. Comparisons were made between patients' features at baseline and 24 months after surgery. A weight loss failure rate of 11.2% was found. Advanced age and diabetes were statistically associated with failure. The results found were close to previous reports. As weight loss failure represents an important concern, there is the possibility to perform revisional surgeries, which may emphasize the restrictive or malabsorptive characteristics of RYGB, leading to varied results. It is reinforced that weight loss cannot be used as the unique outcome to evaluate the success of surgery.Weight loss failure is a widely recognized occurrence following Roux-en-Y gastric bypass. This study aims to identify predictors associated with weight loss failure. It is a retrospective cohort which enrolled 187 subjects who underwent RYGB. Comparisons514328330sem informaçãosem informaçã

Prevalência do câncer de vesícula biliar em pacientes submetidos à colecistectomia: experiência do Hospital de Clínicas da Faculdade de Ciências Médicas da Universidade Estadual de Campinas - UNICAMP

sem informaçãoTo evaluate the prevalence of gallbladder carcinoma in patients submitted to cholecystectomy for chronic cholecystitis at the University Hospital of the State University of Campinas. we conducted a retrospective prevalence study through the analysis of h443252256sem informaçãosem informaçãosem informaçã

Cirurgia bariátrica em indivíduos com déficits cognitivos graves: relato de dois casos

sem informaçãoBariatric surgery has become the gold-standard treatment for refractory morbid obesity. Obesity is frequently associated with certain syndromes that include coexisting cognitive deficits. However, the outcomes from bariatric surgery in this group of indiv13618488sem informaçãosem informaçãosem informaçã

Socio-Economic Discrimination and Processes of Securitisation as Catalysts of Radicalisation among Franco-Maghrebis

In recent years, Western Europe has been gripped by a wave of terrorist attacks, perpetrators have been exclusively home-grown radicalised jihadists of European birth and nationality; a large proportion of which were of second or third generation North African (Maghrebi) origin. This emerging trend is placed into a wider continuation of historical susceptibilities among Maghrebis and their link to ethno-political and religious radicalisation and in some cases, transnational terrorism and Jihadism. This study examines how disproportionate socio-economic discrimination coupled with securitised media portrayals and domestic political debates have acted as radicalisation catalysts of this diaspora present in abundance across France and other EU member-states. This body of research also considers the impact and relevance of emerging geo-political influences such as a resurgent French far-right and a shift in modern jihadist narratives. This shift from direct to structural violence has enabled a renewed ideological penetration and tangible resonance among Europe’s Muslims of immigrant origin; many of whom reside within impoverished and disadvantaged urban peripheries. Susceptibility to radical narratives arising from the converging dilemmas of deprivation, discrimination and grievance have formed the basis for one of the most pressing threats to international security and social wellbeing for generations

Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals: a cross-sectional study

Nonalcoholic fatty liver disease (NAFLD) has become a public health concern. It encompasses a wide spectrum of histological abnormalities and has close relationships with insulin resistance and type 2 diabetes mellitus (T2DM). This study sought to compare13417983sem informaçãosem informaçã

Respiratory evaluation through volumetric capnography among grade III obese and eutrophic individuals: a comparative study

sem informaçãoExcess trunk body fat in obese individuals influences respiratory physiological function. The of this study were to compare volumetric capnography findings (VCap) between severely obese patients and normal-weight subjects and to assess whether there is a1372177183sem informaçãosem informaçãosem informaçã

Complement Activation in Patients With Probable Systemic Lupus Erythematosus and Ability to Predict Progression to American College of Rheumatology-Classified Systemic Lupus Erythematosus.

ObjectiveTo evaluate the frequency of cell-bound complement activation products (CB-CAPs) as a marker of complement activation in patients with suspected systemic lupus erythematosus (SLE) and the usefulness of this biomarker as a predictor of the evolution of probable SLE into SLE as classified by the American College of Rheumatology (ACR) criteria.MethodsPatients in whom SLE was suspected by lupus experts and who fulfilled 3 ACR classification criteria for SLE (probable SLE) were enrolled, along with patients with established SLE as classified by both the ACR and the Systemic Lupus International Collaborating Clinics (SLICC) criteria, patients with primary Sjögren's syndrome (SS), and patients with other rheumatic diseases. Individual CB-CAPs were measured by flow cytometry, and positivity rates were compared to those of commonly assessed biomarkers, including serum complement proteins (C3 and C4) and autoantibodies. The frequency of a positive multianalyte assay panel (MAP), which includes CB-CAPs, was also evaluated. Probable SLE cases were followed up prospectively.ResultsThe 92 patients with probable SLE were diagnosed more recently than the 53 patients with established SLE, and their use of antirheumatic medications was lower. At the enrollment visit, more patients with probable SLE were positive for CB-CAPs (28%) or MAP (40%) than had low complement levels (9%) (P = 0.0001 for each). In probable SLE, MAP scores of >0.8 at enrollment predicted fulfillment of a fourth ACR criterion within 18 months (hazard ratio 3.11, P < 0.01).ConclusionComplement activation occurs in some patients with probable SLE and can be detected with higher frequency by evaluating CB-CAPs and MAP than by assessing traditional serum complement protein levels. A MAP score above 0.8 predicts transition to classifiable SLE according to ACR criteria

Real world costs and cost-effectiveness of Rituximab for diffuse large B-cell lymphoma patients: a population-based analysis.

BackgroundCurrent treatment of diffuse-large-B-cell lymphoma (DLBCL) includes rituximab, an expensive drug, combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy. Economic models have predicted rituximab plus CHOP (RCHOP) to be a cost-effective alternative to CHOP alone as first-line treatment of DLBCL, but it remains unclear what its real-world costs and cost-effectiveness are in routine clinical practice.MethodsWe performed a population-based retrospective cohort study from 1997 to 2007, using linked administrative databases in Ontario, Canada, to evaluate the costs and cost-effectiveness of RCHOP compared to CHOP alone. A historical control cohort (n = 1,099) with DLBCL who received CHOP before rituximab approval was hard-matched on age and treatment intensity and then propensity-score matched on sex, comorbidity, and histology to 1,099 RCHOP patients. All costs and outcomes were adjusted for censoring using the inverse probability weighting method. The main outcome measure was incremental cost per life-year gained (LYG).ResultsRituximab was associated with a life expectancy increase of 3.2 months over 5 years at an additional cost of $16,298, corresponding to an incremental cost-effectiveness ratio of$61,984 (95% CI $34,087-$135,890) per LYG. The probability of being cost-effective was 90% if the willingness-to-pay threshold was $100,000/LYG. The cost-effectiveness ratio was most favourable for patients less than 60 years old ($31,800/LYG) but increased to $80,600/LYG for patients 60-79 years old and$110,100/LYG for patients ≥ 80 years old. We found that post-market survival benefits of rituximab are similar to or lower than those reported in clinical trials, while the costs, incremental costs and cost-effectiveness ratios are higher than in published economic models and differ by age.ConclusionsOur results showed that the addition of rituximab to standard CHOP chemotherapy was associated with improvement in survival but at a higher cost, and was potentially cost-effective by standard thresholds for patients <60 years old. However, cost-effectiveness decreased significantly with age, suggesting that rituximab may be not as economically attractive in the very elderly on average. This has important clinical implications regarding age-related use and funding decisions on this drug