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INTRODUCTION: Experience accumulated over the last decades suggests nonoperative management (NOM) of civilian gunshot liver injuries can be safely applied in selected cases. This study aims to compare the outcomes of selective NOM versus operative management (OM) of patients sustaining gunshot wounds (GSW) to the liver. METHODS: A registry-based retrospective cohort analysis was performed for the period of 2008 to 2016 in a Brazilian trauma referral. Patients aged 16-80 years sustaining civilian GSW to right-sided abdominal quadrants and liver injury were included. Baseline data, vital signs, grade of liver injury, associated injuries, injury severity scores, blood transfusion requirements, liver- and non-liver-related complications, length-of-stay (LOS), and mortality were retrieved from individual registries. RESULTS: A total of 54 patients were eligible for analysis, of which 37 underwent NOM and 17 underwent OM. The median age was 25 years and all were male. No statistically significant differences were observed between groups regarding patients' demographics, injury scores, grade of liver injury and associated lesions. NOM patients tended to sustain higher-grade injuries (86.5% vs 64.7%; p = 0.08), and failure of conservative management was recorded in two (5.4%) cases. The rate of complications was 48% with no between-group statistically significant difference. Blood transfusion requirements were significantly higher in the OM group (58.8% vs 21.6%; p = 0.012). The median LOS was seven days. No deaths were recorded. CONCLUSION: Patients with liver GSW who are haemodynamically stable and without peritonitis are candidates for NOM. In this study, NOM was safe and effective even in high-grade injuries.

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Diaphragmatic hiatal hernia is a potential complication of oesophagectomy in cancer patients. Over the past decades, laparoscopy has become the preferred approach to repairing this condition due to the reduced morbidity, faster recovery and shorter hospital stay when compared with traditional open surgery. The development of robotic technology has added to the benefits of minimally invasive approaches, offering potential technical advantages and overcoming some limitations of traditional laparoscopic techniques when performing complex procedures. We present the first report of a robotic post-oesophagectomy hiatal hernia repair.

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The neuropathological examination of postmortem human brain tissue is an essential resource for the definitive diagnosis and research on neurodegenerative diseases. Due to the growing need of donated brains to supply the Brain Banks, the understanding of the factors associated with the consent for the donation in our context is an important aspect of the process of brain donation. The verbal answers and the donation consent rate were evaluated in three groups: 30 relatives of patients who underwent verification of the cause of death, 14 patients assisted at a neurology ambulatory outpatient clinic, and 18 patients' relatives. The donation consent rates were of 46.6, 92.8 and 88.8 %, respectively. The main reasons for refusal were the disagreement with the autopsy, philosophical and religious issues, objections from other family members, and the consideration of the wishes of the deceased. The consent was specially motivated by the interest in the advances of scientific knowledge, altruistic reasons and the personal experiences with the disease. Factors as the emotional fragility at the moment of death, the beliefs, family matters, and the lack of knowledge are key elements in the donation process. Future goals include the establishment of a brain donor program with the support of academic institutions, hospitals, scientists, community, patient's associations and autopsy assistants. Approaching patients and relatives in specialized ambulatories clinic during assistance is probably the most efficient mean of obtaining brains for research.

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O consumo de café tem sido associado ao menor risco de diabetes tipo 2 (DM2). Evidências epidemiológicas sugerem que o alto consumo de café pode reduzir o risco de diabetes mellitus. O presente trabalho teve como objetivo avaliar o efeito de tinturas de café torrado e moído nos níveis plasmáticos de colesterol, trigliceróis e glicose em ratos diabéticos. A indução do diabetes foi realizada através da administração intraperitoneal de aloxano e as tinturas foram elaboradas utilizando café torrado e moído. Após 30 dias de tratamento, foram realizadas determinações bioquímicas. As tinturas de café solúvel promoveram aumento nos níveis de colesterol e as percentagens de redução das concentrações de glicose e triacilglicerídeo variaram entre 20 e 24% e entre 51 a 57%, respectivamente. A partir dos resultados obtidos, concluiu-se que os tratamentos com o café solúvel sustentam a hipótese de que o café está associado ao menor risco de DM2.

The consumption of coffee has been associated with a lower risk of type 2 diabetes (DM). Epidemiological evidence suggests that high consumption of coffee may reduce the risk of diabetes. The aim of this study was to assess the effects of a tincture (hydroethanolic extract) of roasted and ground coffee on plasma levels of cholesterol, triglycerides and glucose in diabetic rats. The diabetes was induced by intraperitoneal administration of alloxan. The induced diabetic rats were then treated for 30 days by gavage with various doses of the coffee tincture. After the treatment, biochemical blood tests were carried out on the rats. The coffee tincture provoked moderately increased levels of cholesterol, but the concentrations of glucose and triglycerides were reduced by 20-24% and 51-57%, respectively. From these results, it was concluded that the treatment with coffee extract supports the hypothesis that coffee is associated with a lower risk of type 2 DM.

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