ABSTRACT Introduction: Lipodystrophy is an important complication of HIV and has different clinical manifestations, such as lipoatrophy of the face, buttocks, and limbs and accumulation of fat in the abdominal and cervical regions. Lipodystrophy has aesthetic and psychosocial consequences, stigmatizing and affecting patients’ quality of life. The objective is to evaluate the epidemiology and treatments performed in patients treated at the HIV-related Lipodystrophy Outpatient Clinic at Hospital das Clínicas da Faculdade de Medicina de Botucatu. Method: The study was conducted retrospectively, with port analysis of patients treated between June 2012 and December 2019, at Hospital das Clínicas da Faculdade de Medicina de Botucatu, in Botucatu, S P, Brazil. Results: The medical records of 153 individuals were analyzed, 79 male and 74 female patients. The mean age was 45.6 years. The referrals came from 48 cities in four states. Caucasian patients accounted for 74.5% of the consultations. The complaint of facial lipodystrophy was reported by 52.9% of the patients. The most common invasive procedure was facial filling with polymethylmethacrylate (PMMA) in 62 patients. Gluteal implants were the most common surgery on six occasions. Conclusion: The data found show a higher proportion of female patients with complaints of lipodystrophy when compared to general data of patients with HIV. The white race was predominant, and the main complaint of lipodystrophy was facial atrophy. Facial filling with PMMA was the most common procedure.

RESUMO Introdução: A lipodistrofia é uma importante complicação do HIV e apresenta diferentes manifestações clínicas, como lipoatrofia de face, glúteos e membros, e acúmulo de gordura em região abdominal e cervical. A lipodistrofia apresenta consequências estéticas e psicossociais, que são estigmatizantes e afetam a qualidade de vida dos pacientes. O objetivo é avaliar a epidemiologia e os tratamentos realizados nos pacientes atendidos no Ambulatório de Lipodistrofia relacionada ao HIV do Hospital das Clínicas da Faculdade de Medicina de Botucatu. Método: O estudo foi realizado de maneira retrospectiva, com análise de portuário dos pacientes atendidos entre junho de 2012 e dezembro de 2019, no Hospital das Clínicas da Faculdade de Medicina de Botucatu, em Botucatu, S P, Brasil. Resultados: Os prontuários de 153 indivíduos foram analisados, sendo 79 pacientes do sexo masculino e 74 do sexo feminino. A média de idade foi 45,6 anos. Os encaminhamentos tiveram origem de 48 cidades, de quatro estados. Pacientes da raça branca totalizaram 74,5% dos atendimentos. A queixa de lipodistrofia de face foi referida por 52,9% dos pacientes. O procedimento invasivo mais realizado foi o preenchimento facial com polimetilmetacrilato (PMMA), em 62 pacientes. A inclusão de implantes glúteos foi a cirurgia mais realizada, em seis ocasiões. Conclusão: Os dados encontrados mostram maior proporção de pacientes do sexo feminino com queixa de lipodistrofia, quando comparados a dados gerais de pacientes com HIV. A raça branca foi predominante e a principal queixa de lipodistrofia foi a atrofia facial. O preenchimento facial com PMMA foi o procedimento mais realizado.

ABSTRACT Purpose: To evaluate the impact of submersion of the microsurgical anastomosis suture area using saline (0.9% NaCl) in an experimental laboratory during the training of medical students and resident physicians. Methods: Wistar rats (n = 10) were selected to have the two femoral arteries sectioned and anastomosed end-to-end under optical magnification. They were randomly divided, so that on one side suturing was performed under submersion with saline, and the contralateral side was kept dry during the procedure. The surgical times, as well as the patency within 30 min and 72 h of the procedure, were evaluated. Results: Six male Wistar rats survived the surgical anesthetic procedure, with the average initial weight of 243.3 g and the average artery diameter of 0.86 mm, with average time of 15.67 min for the submerged technique and 20.50 min for the dry technique (p = 0.03). The failure rates were 17 and 50% for the submerged group and the dry one, respectively (p = 0.62). Conclusions: Submerged microvascular suture does not compromise the patency of the vessel or increase the time of anastomosis. Therefore, it is a strategy that can be applied by the surgeon according to his/her technical preferences.

Abstract Purpose: To compare the polypropylene mesh (Marlex®) to Vicryl®, Parietex composite® and Ultrapro® meshes to assess the occurrence of adhesions in the intraperitoneal implantation. Methods: Sixty Wistar rats were allocated into three groups: PP+V, in which all the animals received a polypropylene and a Vicryl® mesh; PP+PC, with the implantation of polypropylene and Parietex composite® meshes and PP+UP, in which there was implantation of polypropylene and Ultrapro®. Macroscopic analysis was performed 28 days later to assess the percentage of mesh area affected by adhesion. Results: in the PP+ V group, the Vicryl® mesh showed lower adhesion formation (p=0.013). In the PP+PC, there were no differences between polypropylene and Parietex composite® (p=0.765). In the PP+UP group, Ultrapro® and polypropylene meshes were equivalent (p=0.198) . Conclusion: All the four meshes led to adhesions, with the Vicryl® mesh showing the least potential for its formation.