RESUMO O 35º Congresso Brasileiro de Cirurgia foi marcado por discussões inovadoras para a educação cirúrgica no país. Pela primeira vez, o Colégio Brasileiro de Cirurgiões incluiu a Cirurgia Global na pauta principal do congresso, proporcionando uma oportunidade única de repensar como as habilidades cirúrgicas são ensinadas a partir de uma perspectiva de saúde pública. Essa discussão nos leva a considerar por que e como o ensino da Cirurgia Global deve ser expandido no Brasil. Embora pesquisadores e instituições brasileiras tenham contribuído para a expansão do campo desde 2015, as iniciativas de educação em Cirurgia Global ainda são incipientes em nosso país. Basear-se em estratégias bem-sucedidas pode ser um ponto de partida para promover a área entre os profissionais de cirurgia nacionais. Neste editorial, discutimos potenciais estratégias para expandir as oportunidades de educação em Cirurgia Global e propomos uma série de recomendações a nível nacional. º país vez congresso pública Brasil 2015 Basearse Basear se bemsucedidas bem sucedidas nacionais editorial nacional 201 20 2

ABSTRACT The 35th Brazilian Congress of Surgery marked a turning point for surgical education in the country. For the first time, the Brazilian College of Surgeons included Global Surgery on the main congressional agenda, providing a unique opportunity to rethink how surgical skills are taught from a public health perspective. This discussion prompts us to consider why and how Global Surgery education should be expanded in Brazil. Although Brazilian researchers and institutions have contributed to the fields expansion since 2015, Global Surgery education initiatives are still incipient in our country. Relying on successful strategies can be a starting point to promote the area among national surgical practitioners. In this editorial, we discuss potential strategies to expand Global Surgery education opportunities and propose a series of recommendations at the national level. th country time agenda perspective Brazil 2015 practitioners editorial level 201 20 2

ABSTRACT Purpose: Illicit cosmetic injections remain highly prevalent and can cause serious complications, including death. We aimed to explore existing literature regarding the use of illicit cosmetic injections globally. Methods: We searched six databases with no language restriction from inception to 2022. We included all articles focused on adult patients of any gender who received any illicit cosmetic injection. Screening and data extraction followed standards from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews guidelines. Results: After screening 629 abstracts and 193 full texts, 142 citations were included. We identified articles from 28 countries and three multi-country studies. Most were from high-income (75.3%) and upper-middle-income countries (21.8%). Of all patients whose gender identity was described, 49.9% were transgender women, and 40.8% were cisgender women. The anatomic regions most frequently injected were the buttocks (35%) and the breast (13.3%). The most frequently described complications were granuloma (41.5%), dermatological problems (41.5%), infection (35.9%), and pulmonary complications (34.5%). Conclusions: We observed the impact of illicit silicone injections, particularly on cisgender women and transgender individuals. Existing barriers must be addressed, including healthcare prejudice and inadequate knowledge about care for gender minorities. This will require educating at-risk groups and enhancing policies to regulate these procedures. Purpose death globally Methods 2022 injection MetaAnalysis Meta Analysis guidelines Results 62 19 texts 14 2 multicountry multi country studies highincome high income 75.3% 753 75 3 (75.3% uppermiddleincome upper middle 21.8%. 218 21.8% . 21 8 (21.8%) 499 49 9 49.9 408 40 40.8 35% 35 (35% 13.3%. 133 13.3% 13 (13.3%) 41.5%, 415 41.5% , 41 5 (41.5%) 35.9%, 359 35.9% (35.9%) 34.5%. 345 34.5% 34 (34.5%) Conclusions individuals addressed minorities atrisk at risk procedures 202 6 1 75.3 7 (75.3 21.8 (21.8% 4 49. 40. (35 13.3 (13.3% 41.5 (41.5% 35.9 (35.9% 34.5 (34.5% 20 75. (75. 21. (21.8 (3 13. (13.3 41. (41.5 35. (35.9 34. (34.5 (75 (21. ( (13. (41. (35. (34. (7 (21 (13 (41 (34 (2 (1 (4

ABSTRACT Purpose: To evaluate the gender distribution of first and last authors with Brazilian surgical affiliations in PubMed-indexed surgical journals. Methods: Data from eligible surgical journals were retrieved using Scimago Journal & Country Rank 2021 and manually reviewed. Manuscripts published from 2018 to 2022 were included if at least one author was affiliated with a Brazilian institution and a surgical specialty. Results: Data from 340 eligible surgical journals were included. We analyzed first and last authors’ forenames of 1,881 manuscripts. Women comprised 16.7% of the first and 12.4% of the last authors. Analyzing the differences in gender trends in authorship across the five Brazilian regions, we found that the South had the highest representation, while the Midwest and North showed the lowest, respectively. Obstetrics and gynecology featured the highest percentage of women-first authors, whereas orthopedics had the lowest. For the last authorship, pediatric surgery showed the highest, with hand surgery having the lowest representation. Male first authors were 1.9 times more likely to engage in international collaborations. Conclusions: This study suggests the persistent underrepresentation of Brazilian women in surgical journal authorship. Local policy changes should be considered to encourage greater diversity and inclusivity in surgical research. Purpose PubMedindexed PubMed indexed Methods 202 reviewed 201 specialty Results 34 1881 1 881 1,88 manuscripts 167 16 7 16.7 124 12 4 12.4 regions representation respectively womenfirst 19 9 1. collaborations Conclusions research 20 3 188 88 1,8 16. 12. 2 18 8 1,

ABSTRACT Purpose: Research in high-income countries has extensively documented the non-operative management of spleen injuries in children, resulting in low splenectomy rates (5%). However, there is a lack of literature on this topic in low- and-middle-income countries (LMICs), including Brazil. This scoping review analyzed pediatric spleen trauma research trends in Brazil and the United States of America (USA). Methods: Search strategy was conducted across five databases, considering articles published in English or Portuguese from January 1968 to 2023 that reported spleen injury in patients younger than 18 years old in Brazil or the USA. Two pairs of independent reviewers screened the title and the abstract, followed by a full-text review. Results: The total of 7,150 studies was identified, of which 295 were eligible for data extraction. Most papers (98.64%, 301) originated from the USA, while only 1.36% (4) were from Brazil. In addition, 46.44% (137) articles reported intrabdominal injury, including splenic trauma, 16.27% (48) liver and spleen injury, and 37.29% (110) reported isolated spleen injury. The operative rate for spleen injury was 11.33% in American studies (40,812/359,926) compared to 98.57% (137/139) in Brazilian studies. Conclusions: Brazil contributed only with four studies on pediatric splenic trauma over two decades. Future studies should explore the incidence and management of splenic trauma in LMICs. Purpose highincome high income nonoperative non children 5%. 5 5% . (5%) However andmiddleincome middle LMICs, LMICs , (LMICs) USA (USA) Methods databases 196 202 1 abstract fulltext full text Results 7150 7 150 7,15 identified 29 extraction 98.64%, 9864 98 64 (98.64% 301 136 36 1.36 4 (4 addition 4644 46 44 46.44 137 (137 1627 16 27 16.27 48 (48 3729 37 37.29 110 (110 1133 11 33 11.33 40,812/359,926 40812359926 40 812 359 926 (40,812/359,926 9857 57 98.57 137/139 137139 139 (137/139 Conclusions decades (5% (LMICs (USA 19 20 715 15 7,1 2 98.64% 986 9 6 (98.64 30 13 3 1.3 ( 464 46.4 (13 162 16.2 372 37.2 (11 113 11.3 40,812/359,92 4081235992 81 35 92 (40,812/359,92 985 98.5 137/13 13713 (137/13 (5 71 7, 98.64 (98.6 1. 46. (1 16. 37. 11. 40,812/359,9 408123599 8 (40,812/359,9 98. 137/1 1371 (137/1 98.6 (98. 40,812/359, 40812359 (40,812/359, 137/ (137/ (98 40,812/359 4081235 (40,812/359 (9 40,812/35 408123 (40,812/35 40,812/3 40812 (40,812/3 40,812/ 4081 (40,812/ 40,812 408 (40,812 40,81 (40,81 40,8 (40,8 40, (40, (40