Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery最新文献

{"title":"Inflammatory bowel diseases in Brazil: journey of doctors who care for patients. What is the importance?","authors":"Marcela Maria Silvino Craveiro, Lígia Yukie Sassaki, Eduardo Garcia Vilela, Rogério Saad Hossne","doi":"10.1590/0102-67202025000023e1892","DOIUrl":"https://doi.org/10.1590/0102-67202025000023e1892","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel diseases (IBDs), represented by Crohn's disease and ulcerative colitis, are conditions whose epidemiological rates are increasing worldwide.</p><p><strong>Background: </strong>The study of IBDs and the treatment of patients with these conditions are a daily challenge for specialist doctors.</p><p><strong>Background: </strong>Understanding the profile of the doctors who treat these patients and their difficulties during treatment is essential.</p><p><strong>Background: </strong>Many adversities are related to health policies, such as access to medications and complementary tests, which compromises the adequate treatment of these patients.</p><p><strong>Background: </strong>Inflammatory bowel diseases are chronic inflammatory conditions of a recurrent nature, whose incidence and prevalence rates have increased worldwide. It is known that early diagnosis and short start of the correct indicated treatment alter the natural history of the disease, preventing complications; hence, it is necessary to know the profile of the doctors who treat these patients in Brazil and especially to understand the difficulties in care and evaluate them in relation to other variables.</p><p><strong>Background: </strong>This study showed the profile of physicians who treat inflammatory bowel disease (IBD) patients, through their registration in the Brazilian Inflammatory Bowel Disease Study Group. In addition to analyzing the physician's profile and their difficulties, the main aspects that hinder both the diagnosis and treatment of the disease, attributed to external factors, were listed. Therefore, more effective public health policies should be planned and expanded, aiming at growth and adaptation focused on IBDs.</p><p><strong>Background: </strong>Inflammatory bowel diseases (IBDs) are chronic inflammatory conditions of a recurrent nature, whose incidence and prevalence rates have increased worldwide.</p><p><strong>Aims: </strong>The aim of this study was to profile the doctors who treat patients with IBDs in Brazil and to understand and analyze the journey and importance of this care.</p><p><strong>Methods: </strong>This is a cross-sectional study that descriptively and inferentially analyzed the pre-existing database of the Brazilian Inflammatory Bowel Disease Study Group and through this observed the reality of care for Crohn's disease and ulcerative colitis, in the country.</p><p><strong>Results: </strong>In the descriptive analysis, we found results regarding the physicians' profile such as specialty, number of patients treated with these diseases and their difficulties in accessing medications, complementary exams, and multidisciplinary team. In the statistical analysis regarding the Human Development Index of the states, the significant results were related to workplace, difficulty in accessing medications, and referral to other specialists. Regarding the association of variables with medical demographics, the","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1892"},"PeriodicalIF":1.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventive correction of fibrinolysis with epsilon aminocaproic acid detected by thromboelastometry during liver transplantation.","authors":"José Carlos Rodrigues Nascimento, Luiz Henrique Freitas, Daniel Vieira Pinto, Antônia Lima Souza, Cristhyane Costa Aquino, Denise Teixeira Santos, Rogean Rodrigues Nunes","doi":"10.1590/0102-67202025000022e1891","DOIUrl":"https://doi.org/10.1590/0102-67202025000022e1891","url":null,"abstract":"<p><strong>Background: </strong>Orthotopic liver transplantation (OLT) is a highly complex procedure.</p><p><strong>Background: </strong>OLT can be difficult to control intraoperative bleeding in patients with coagulopathies.</p><p><strong>Background: </strong>OLT may result in a high need for transfusion of blood products.</p><p><strong>Background: </strong>Epsilon aminocaproic acid (EACA) can reduce the need for transfusion of Hood products.</p><p><strong>Background: </strong>EACA can be safe with regard to complications such as thrombosis.</p><p><strong>Background: </strong>A total of 105 patients were assessed for eligibility, and 55 were excluded. The remaining 50 patients were randomized, of which 24 patients were allocated to the intervention group and the other 26 to the saline placebo group. In the analysis of the fibrinolytic and hemostatic coagulation profile by rotational thromboelastometry, fibrinolysis was significantly less frequent in patients treated with epsilon aminocaproic acid (p<0.001) compared to those in the placebo group during the anhepatic phase. In the other analyses using thromboelastometry assays such as extrinsic pathway thromboelastometry (EXTEM) (clotting time [CT], clot formation time, alpha angle, amplitude of clot firmness 10 min after CT [A10], and maximum clot firmness [MCF]) and fibrinogen-specific thromboelastometry (FIBTEM) (A10 and MCF), there was no significant difference nor postoperative complications in both groups.</p><p><strong>Background: </strong>Some studies have shown that epsilon aminocaproic acid (EACA) inhibits the binding of plasminogen to lysine residues on the surface of fibrin and prevents conversion of plasminogen to plasmin and the degradation of glycoprotein Ib receptors, thus preserving platelet function. Although EACA did not reduce blood product transfusion, the drug effectively treated all cases and was not associated with any complications of increased risk of hepatic artery and vein thrombosis or mortality within 3 months after orthotopic liver transplantation (OLT). These results support the safety of EACA as the antifibrinolytic drug of choice in OLT. However, future studies involving larger randomized clinical trials and higher doses are needed to further investigate the results.</p><p><strong>Background: </strong>Orthotopic liver transplantation (OLT) is a highly complex procedure, which can be difficult to control intraoperatively in patients with coagulopathies.</p><p><strong>Aims: </strong>The aim of this study was to evaluate the prophylactic administration of epsilon aminocaproic acid (EACA) to reduce the need for transfusion of blood products and its relevance for thrombosis.</p><p><strong>Methods: </strong>Patients were randomized into two groups: one group received EACA (20 mg/kg/h) before surgical incision until the end of OLT and a control group received a similar volume of 0.9% saline solution. Blood was collected to analyze fibrinolysis and coagulation disorders u","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1891"},"PeriodicalIF":1.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatoduodenectomy with vascular reconstruction versus chemotherapy alone in patients with locally advanced pancreatic cancer: a systematic review.","authors":"Adriano Carneiro da Costa, Vitoria Alessandra Duarte, Fernando Santa Cruz, Mohamed Ali Chaouch, Jayant Kumar, Isabella Reccia, Álvaro Antonio Bandeira Ferraz, Nagy Habib","doi":"10.1590/0102-67202025000021e1890","DOIUrl":"10.1590/0102-67202025000021e1890","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cancer is still a terrifying condition that has a high mortality rate due to its rapid progression and treatment complexity. However, there is still no consensus on what the gold standard of treatment for locally advanced pancreatic cancer (LAPC) is.</p><p><strong>Aims: </strong>The aim of this study was to review the current evidence-based data on treatment strategies for LAPC, comparing pancreatoduodenectomy with vascular reconstruction (PDVR) and chemotherapy alone (CA).</p><p><strong>Methods: </strong>This systematic review was performed according to the PRISMA 2020 guidelines. Overall survival (OS) was the primary endpoint, while progression-free survival (PFS) was the secondary endpoint. The included studies were published between 2013 and 2023.</p><p><strong>Results: </strong>A total of 16 relevant papers were found in the literature search. The median PFS duration for CA varied from 3.22 to 11.7 months, whereas the median overall survival (mOS) varied from 5.95 to 23.0 months. The mOS ranged from 12.7 to 24.9 months and the median PFS time ranged from 8.5 to 22.5 months for patients submitted to neoadjuvant therapy followed by PDVR.</p><p><strong>Conclusions: </strong>LAPC presents worse outcomes when patients are submitted to CA with gemcitabine only, or when patients undergo upfront PDVR.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1890"},"PeriodicalIF":1.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Siewert II esophagogastric junction cancer: total gastrectomy or esophagectomy?","authors":"Durval Renato Wohnrath, Raphael de Oliveira E Silva, Raphael Leonardo Cunha Araujo","doi":"10.1590/0102-67202025000019e1888","DOIUrl":"10.1590/0102-67202025000019e1888","url":null,"abstract":"<p><strong>Background: </strong>The surgical approach for esophagogastric junction cancers (EJC), Siewert II, has been controversial regarding margin control, reconstruction, and lymphadenectomy extension. Therefore, predicting the need for total/subtotal esophagectomy and proximal gastrectomy (TEPG) or total gastrectomy with distal esophagectomy (TGDE) can be challenging, with each direction usually excluding the other. Historically, complication rates for TEPG are higher, affecting further systemic treatment and long-term outcomes.</p><p><strong>Aims: </strong>The aim of this study was to describe a surgical strategy for approaching tumors such as Siewert II EGJ, with the intraoperative decision to perform total gastrectomy with lymphadenectomy D2 or esophagectomy with lymphadenectomy based on intraoperative frozen sections.</p><p><strong>Methods: </strong>All patients underwent laparotomy, beginning with greater curvature detachment while preserving the right gastroepiploic, right and left gastric arteries; dissection of the esophageal hiatus for node harvesting; and transection of the distal esophagus and its frozen section. TGDE was preferred if the proximal margin of the distal esophagus was negative; TEPG and gastric tube reconstruction were performed through transhiatal access if the margin was positive.</p><p><strong>Results: </strong>Among 38 Siewert II patients, 26 (69%) underwent TGDE and 12 (31%) underwent TEPG, regardless of the trend toward higher complication rates, positive margins, and shorter overall survival in the TEPG group, no statistically significant differences were detected.</p><p><strong>Conclusions: </strong>Although no significant differences in morbidity between the two procedures were noted, type II errors could be a possible cause. This study suggests that unnecessary esophagectomies can be avoided without jeopardizing surgical or oncologic outcomes by opting for a less morbid procedure.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1888"},"PeriodicalIF":1.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variables related to locoregional and distant recurrence in esophageal cancer.","authors":"Sarah Fonseca, Igor Gabriel Silva Ramos, Felipe Antonio Boff Maegawa, Pedro Luiz Serrano Uson Junior, Francisco Tustumi","doi":"10.1590/0102-67202025000020e1889","DOIUrl":"10.1590/0102-67202025000020e1889","url":null,"abstract":"<p><strong>Background: </strong>Esophageal cancer remains one of the most aggressive malignancies of the gastrointestinal tract, with high rates of recurrence and mortality despite curative-intent surgery and adjuvant therapies. Identifying factors associated with recurrence is crucial for improving outcomes and guiding personalized treatment.</p><p><strong>Aims: </strong>The aim of this study was to evaluate pretreatment and treatment-related variables associated with recurrence in patients with esophageal cancer undergoing surgical resection.</p><p><strong>Methods: </strong>This retrospective study analyzed data from patients with stage I-III esophageal carcinoma who underwent esophagectomy between 2000 and 2025, using the Fundação Oncocentro de São Paulo (FOSP) database. Clinical, histological, and treatment-related variables were evaluated. Disease-free survival and recurrence patterns were assessed using Cox proportional hazards models and Fine-Gray subdistribution hazard models.</p><p><strong>Results: </strong>A total of 2,057 patients were included, with a mean follow-up of 36.5 months (±44.8). In the multivariate analysis, advanced tumor stage (stage II: HR 1.68, 95%CI 1.21-2.33; stage III: HR 3.23, 95%CI 2.29-4.56; both p<0.01), location (middle esophagus: HR 1.31, 95%CI 1.11-1.54; p=0.001; upper esophagus: HR 1.54, 95%CI 1.21-1.96; p<0.001), and histological subtype (rare histologies: HR 2.17, 95%CI 1.35-3.49; p=0.001) were associated with worse disease-free survival. Multimodal therapy improved disease-free survival (HR 0.40, 95%CI 0.24-0.66) in stage III tumors. Squamous cell carcinoma was independently associated with locoregional recurrence (SHR 1.52, 95%CI 1.05-2.20; p=0.027). For distant recurrence, squamous cell carcinoma showed a protective effect (SHR 0.52, 95%CI 0.31-0.88; p=0.015), while high tumor grade (grade II: SHR 3.65, 95%CI 1.98-6.72; p<0.001) was associated with an increased risk. Multimodal treatments influenced recurrence patterns but did not independently predict outcomes after adjustment.</p><p><strong>Conclusions: </strong>Tumor stage, location, and histology were strong predictors of disease-free survival after surgery for esophageal cancer. Histological subtypes significantly influenced recurrence patterns. Squamous cell carcinoma was associated with a higher risk of locoregional recurrence but a lower risk of distant metastasis compared to adenocarcinoma. Multimodal therapy demonstrated a protective effect in stage III disease.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1889"},"PeriodicalIF":1.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ERRATUM.","authors":"","doi":"10.1590/0102-67202025000010e1879ERRATUM","DOIUrl":"10.1590/0102-67202025000010e1879ERRATUM","url":null,"abstract":"<p><p>[This corrects the article doi: 10.1590/0102-67202025000010e1879].</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1879ERRATUM"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective longitudinal and comparative observational study between gastric bypass surgery and sleeve gastrectomy: 5-year post-operative follow-up.","authors":"Admar Concon Filho, Sergio Henrique Bastos Damous, Jose Pinhata Otoch, Matheus Borges Coronado, Idiberto José Zotarelli Filho, Manoel Passos Galvão Neto, Vítor Ottoboni Brunaldi, Everson Luiz Almeida Artifon","doi":"10.1590/0102-67202025000016e1885","DOIUrl":"10.1590/0102-67202025000016e1885","url":null,"abstract":"<p><strong>Background: </strong>Among the 2.0 billion overweight individuals in the world, Brazil ranks fifth in the number of obese people, therefore requiring treatment options for obesity.</p><p><strong>Aim: </strong>The aim of this study was to compare the percentage of total body weight loss (%TWL), change in body mass index (BMI), percentage of excess weight loss (%EWL), incidence of reflux esophagitis, and occurrence of Barrett's esophagus in obese patients undergoing gastric bypass (Roux-en-Y gastric bypass [RYGB]) and sleeve gastrectomy (SG), both techniques by videolaparoscopy.</p><p><strong>Methods: </strong>The study included 100 consecutive patients who underwent RYGB and SG techniques, totaling 200 patients, and were followed up for 60 months, from June 2013 to July 2018.</p><p><strong>Results: </strong>The frequency of gastroesophageal reflux disease (GERD) was lower in RYGB patients (p<0.05). At 60 months, the %EWL was 77.4±13.3 kg (RYGB) versus 80.5±17.5 kg (SG) (p<0.05). The BMI data were statistically significantly different between groups after 5 years (28.5±3.9 kg/m2 in RYGB and 31.9±5.3 kg/m2 in SG groups, p<0.05). During the follow-up, the RYGB showed higher %EWL compared to the SG (at 60 months, 80.1% vs. 59.1%, respectively, p<0.05). The %TWL was 30% for the RYGB and 19.7% for the SG (p<0.05). The RYGB had a lower frequency of reflux esophagitis and Barrett's esophagus.</p><p><strong>Conclusions: </strong>The RYGB technique showed greater absolute weight loss, %TWL, BMI reduction, and %EWL in higher obesity classes compared to the SG technique. Additionally, RYGB had a lower frequency of reflux esophagitis and Barrett's esophagus.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1885"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of surgical glue and sutures in the aponeurosis synthesis of the abdominal wall in Wistar rats.","authors":"Carlos Alberto Lima Utrabo, Cesar Roberto Busato, Adriana Yuriko Koga, Janete Machozeki, Mirian Guimarães, Danilo Beltrame, Elcio Machinski, Leandro Cavalcante Lipinski","doi":"10.1590/0102-67202025000012e1881","DOIUrl":"10.1590/0102-67202025000012e1881","url":null,"abstract":"<p><strong>Background: </strong>Adequate closure of the abdominal wall determines the success of the surgery.</p><p><strong>Aims: </strong>The aim of this study was to study the healing of the abdominal wall of rats by comparing the use of surgical glue (2-octyl cyanoacrylate) with polypropylene 3.0 thread and poliglecaprone 3.0 thread.</p><p><strong>Methods: </strong>A total of 60 Wistar rats were divided into two groups: Group 30 and Group 90. Each group was subdivided into three subgroups, surgical glue subgroup (C1), polypropylene subgroup (C2), and poliglecaprone subgroup (C3). An incision was made in the aponeurosis of the abdominal wall while maintaining the integrity of the parietal peritoneum. The 3 subgroups of 10 animals were euthanized on the 30th and 90th postoperative days. The abdominal wall fragments were submitted to macroscopic, histological, and tensiometric analysis.</p><p><strong>Results: </strong>Macroscopic analysis did not show any abnormality. Tensiometry on the 30th postoperative day showed a mean rupture tension of 30.98N in subgroup C1, 27.90N in subgroup C2, and 23.90N in subgroup C3. On the 90th postoperative day, the mean rupture tension was 30.05N in subgroup C1, 44.42N in subgroup C2, and 34.78N in subgroup C3.</p><p><strong>Conclusions: </strong>The synthesis of the abdominal aponeurosis performed with surgical glue (2-octyl cyanoacrylate) showed adequate resistance to rupture tension to maintain its integrity when compared with the synthesis with polypropylene thread or poliglecaprone thread, with both methods being equally effective.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1881"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASSOCIATION BETWEEN AFFECTIVE TEMPERAMENT AND MORBID OBESITY IN BARIATRIC SURGERY CANDIDATES: A CASE-CONTROL STUDY.","authors":"Alexandre Karam Joaquim Mousfi, Sivan Mauer, Paulo Afonso Nunes Nassif, Marcos Fabiano Sigwalt, Ronaldo Mafia Cuenca, Orlando Jorge Martins Torres","doi":"10.1590/0102-67202025000015e1884","DOIUrl":"10.1590/0102-67202025000015e1884","url":null,"abstract":"<p><strong>Background: </strong>Affective temperaments are part of the spectrum of mood disorders and comprise the concepts of hyperthymia, dysthymia and cyclothymia. Numerous studies have demonstrated a strong relationship between obesity and mood disorders.</p><p><strong>Aims: </strong>The objective of the present study was to evaluate the frequency of affective temperaments in morbidly obese individuals and controls and to establish a possible association between affective temperaments and morbid obesity.</p><p><strong>Methods: </strong>The study evaluated 106 cases (morbidly obese) and one hundred controls (non-obese). To assess affective temperaments, the Temperament Evaluation in Memphis Pisa and San Diego - Rio de Janeiro TEMPS-Rio de Janeiro scale was applied. Depressive symptoms were assessed using the Hamilton Depression Rating Scale, anxiety symptoms using the Hamilton Anxiety Rating Scale and manic symptoms using the Young Mania Rating Scale. For univariate and multivariate analysis, logistic regression models were adjusted.</p><p><strong>Results: </strong>The presence of at least one affective temperament was 74.5% in the morbidly obese group and 63% in the non-obese group. When comparing the two groups, the statistical analysis of the age subgroup of individuals aged 50 years or over showed an odds ratio of 2.56 (1.07-6.09) for hyperthymic temperament.</p><p><strong>Conclusions: </strong>In the age group of 50 years or more, cases of morbid obesity are significantly more likely (2.56 times) to occur in individuals with a hyperthymic temperament. Among the three types of affective temperaments evaluated, only hyperthymia could be a risk factor for morbid obesity.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1884"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IMPACT OF SLEEVE GASTRECTOMY ON THE NEUTROPHIL-TO-LYMPHOCYTE RATIO AND THE PLATELET-TO-LYMPHOCYTE RATIO AND ITS RELATIONSHIP WITH POSTOPERATIVE WEIGHT LOSS.","authors":"Tiago Cavalcanti Iwanaga, Fernando Santa-Cruz, Álvaro Antonio Bandeira Ferraz, Flávio Kreimer","doi":"10.1590/0102-67202025000013e1882","DOIUrl":"10.1590/0102-67202025000013e1882","url":null,"abstract":"<p><strong>Background: </strong>Obesity represents a chronic pro-inflammatory status that contributes to accelerated atherosclerosis and cell aging. Besides the widely used C-reactive protein and ferritin, other inflammatory markers have gained attention, such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), which are related with the degree of inflammation in various pathological conditions, including obesity and its comorbidities.</p><p><strong>Aims: </strong>To compare and monitor the levels of NLR and PLR before and after sleeve gastrectomy (SG).</p><p><strong>Methods: </strong>Retrospective study that included a total of 622 patients with obesity who underwent SG as primer bariatric surgery in our center. Data regarding the presence of comorbidities, including type 2 diabetes (T2D), high blood pressure (HBP) and non-alcoholic fatty liver disease (NAFLD), variations in body weight and body mass index (BMI), and biochemical markers of inflammation, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and C-reactive protein (CRP) were gathered. Values of NLR and PLR were correlated with weight loss and prognosis of comorbidities within the postoperative period.</p><p><strong>Results: </strong>The sample was predominantly female (79.3%) with average age 36.91±10.04 years, with comorbidities including HBP (25.1%), T2D (8.0%), and NAFLD (80.1%). Patients with HBP showed reduced NLR and CRP post-intervention, while those with T2D experienced decreased CRP but increased PLR. Correlation analysis found no significant correlation between BMI/weight changes and NLR but significant correlation with PLR. Post-surgery, NLR decreased for previously NAFLD patients, and PLR increased.</p><p><strong>Conclusions: </strong>According to the results, patients with obesity present a significant decrease in NLR and an increase in PLR after SG.</p>","PeriodicalId":72298,"journal":{"name":"Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery","volume":"38 ","pages":"e1882"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}