Abstract: Introduction: Lesbian, gay, bisexual, transvestite, and transgender (LGBT) people are affected by prejudice and psychological, physical, and/or sexual violence due to their sexual orientation. Objective: To analyze the association between violence, drug use, and suicide in LGBT people. Method: We interviewed 316 LGBT people from two cities of the Brazilian Northeast by means of a structured instrument. This included questions about sociodemographic data, sexual orientation, type of violence, type and quantity of drugs consumed, and suicide. Results: There was a positive association between physical violence and anabolic consumption (p = .001) and tranquilizers (p = .012). In relation to psychological and verbal violence, there was a positive association with the use of tranquilizers (p = .021) and negative with the use of amphetamines (p = .027). Suicide attempts were associated with having experienced physical (p = .03) and sexual (p = .037) violence. Drug use, especially ecstasy, cocaine, marijuana, and tranquilizers, was also associated with suicide attempts (p = .002, p = .031, p < .001, p < .001, respectively). The participants who had already attempted suicide were more vulnerable to experience violence and consume drugs within 30 days prior to the interview (p < .001). Discussion and conclusion: Psychological/verbal violence showed to be associated with the use of amphetamines, while physical violence was associated with a higher consumption of tranquilizers and anabolic steroids. Suicide attempts were more common among participants who had suffered physical violence and who were users of substances such as ecstasy, cocaine, marijuana, and tranquilizers.

Resumen: Introducción: Las personas lesbianas, gays, bisexuales, travestis y transexuales (LGBT) se ven afectadas por juicios y violencia psicológica, física y/o sexual debido a su orientación sexual. Objetivo: Analizar la asociación entre violencia, uso de drogas y suicidio en personas LGBT. Método: Entrevistamos a 316 personas LGBT de dos ciudades del Noreste brasileño por medio de un instrumento estructurado. Esto incluyó preguntas sobre datos sociodemográficos, orientación sexual, tipo de violencia, tipo y cantidad de drogas consumidas y suicidio. Resultados: Se encontró una asociación positiva entre la violencia física y el consumo de anabólicos (p = .001) y tranquilizantes (p = .012). En relación con la violencia psicológica y verbal, hubo una asociación positiva con el uso de tranquilizantes (p = .021) y negativa con el uso de anfetaminas (p = .027). Los intentos de suicidio se asociaron con la violencia física (p = .03) y sexual (p = .037). El consumo de drogas, especialmente éxtasis, cocaína, marihuana y tranquilizantes, se asoció también con intentos de suicidio (p = .002, p = .031, p < .001, p < .001, respectivamente). Los participantes que ya habían intentado suicidarse eran más vulnerables a experimentar violencia y consumir drogas dentro de los 30 días previos a la entrevista (p < .001). Discusión y conclusión: La violencia psicológica/verbal se asoció con el uso de anfetaminas, mientras que la violencia física se asoció con un mayor consumo de tranquilizantes y esteroides anabólicos. Los intentos de suicidio fueron más comunes entre los participantes que habían sufrido violencia física y que consumían sustancias como el éxtasis, la cocaína, la marihuana y los tranquilizantes.

RESUMO Objetivo: relatar uma série de casos de cirurgia bariátrica robótica no tratamento da obesidade no Brasil. Métodos: foram avaliados pacientes submetidos à cirurgia bariátrica robótica no Instituto Garrido, e realizada comparação com grupo submetido à cirurgia laparoscópica convencional. Resultados: foram analisados 45 pacientes, com média de idade de 39,44 anos, sendo 34 do sexo feminino, com média de IMC inicial de 41,26Kg/m2. Dentre as cirurgias realizadas, 91,11% foram bypass gástrico em Y de Roux, enquanto 8,89% foram do tipo gastrectomia vertical. A média de tempo total de cirurgia foi de 158 (±56,54) minutos, com tempo médio de docking de 7,93 (±3,9) minutos e tempo de console 113,0 (±41,4) minutos. A média de dor apresentada na recuperação pós-anestésica foi de 2,61 (±3,30) pontos, em escala de 0 a 10, com quatro pacientes apresentando sinais leves de náusea, respondendo bem ao tratamento medicamentoso. Somente um paciente necessitou internação em UTI por um período de dois dias após a cirurgia, devido à cardiopatia prévia. Em dois casos ocorreram hérnia incisional em sítio de trocater, tratados cirurgicamente, sem posteriores complicações. Na comparação entre os grupos de cirurgia robótica versus laparoscópica, foram selecionados 45 pacientes para cada grupo. O tempo operatório foi significativamente mais longo na via robótica, sendo a maior parte das outras variáveis equivalentes, inclusive controle pós-operatório de comorbidades. Conclusão: a cirurgia bariátrica robótica é um procedimento seguro, com resultados comparáveis à cirurgia laparoscópica.

ABSTRACT Objective: to report a series of cases of robotic bariatric surgery in the treatment of obesity in Brazil. Methods: we evaluated patients undergoing robotic bariatric surgery at the Garrido Institute and compared them with a group submitted to conventional laparoscopic surgery. Results: we analyzed 45 patients, with a mean age of 39.44 years, of which 34 were female, with an initial mean BMI of 41.26kg/m2. Among the procedures performed, 91.11% were Roux-en-Y gastric bypass, while 8.89% were sleeve gastrectomy. The mean total surgery time was 158 (±56.54) minutes, with mean docking time of 7.93 (±3.9) minutes, and console time 113.0 (±41.4) minutes. The average pain presented in the post anesthetic recovery was 2.61 (±3.30) points on a scale of 0 to 10; four patients presented with mild signs of nausea, responding well to drug treatment. Only one patient needed ICU admission for a period of two days after surgery due to previous cardiopathy. In two cases, there was an incisional hernia at the trocar site, which were surgically treated without further complications. In the comparison between robotic versus laparoscopic surgery groups, 45 patients were selected for each group. Operative time was significantly longer in the robotic surgery group, with most other variables being equivalent, including postoperative control of comorbidities. Conclusion: robotic bariatric surgery is a safe procedure, with results comparable to laparoscopic surgery.

Abstract Introduction: Chylothorax is a lymphatic extravasation into pleural cavity and its incidence is 0.25%-5.3% in children undergoing cardiac surgery. Objective: To evaluate the incidence of chylothorax in pediatrics patients operated, linking it in each surgical intervention. Evaluate treatment types and efficiency. Methods: Retrospective study using medical records of children undergoing cardiac surgery in the Hospital do Coração between 2004 and 2014. For statistical analysis, qualitative variables by absolute frequency and relative frequency; quantitative variables, by median of 25 and 75 percentiles, as they did not present normal distribution (Shapiro-Wilk, P<0.05). The Chi-square test was used for the association between type of treatment and result. The adopted confidence level was 95%. Results: Incidence of chylothorax was 2.1% (0.9% in intracardiac surgery, 1.7% correction of patent ductus arteriosus and aortic coarctation, 8.3% Glenn's surgery, 11.8% total cavopulmonary surgery and 3% in others). Among treatments, fasting associated with total parenteral nutrition (TPN) resolved 51% of the cases. Hypoglossal diet had failed treatment and surgical referral in 22% of the cases. Fasting with TPN associated with octreotide had success in the treatment of chylothorax in a period exceeding 15 days in 78% of cases, and 3.7% were referred for surgery. Conclusion: According to the results, incidence of chylothorax was 2.18%. Treatment with fasting and TPN leads to resolutions in 86.5%, and the association with octreotide was successful in 85.1% of cases, showing an efficient option, while the treatment with hypoglossal diet had therapeutic failure in 22% of the cases in which it was used.