Objective  To evaluate the serum concentrations of vitamin D and their relation with inflammatory bowel diseases. Methods  This is a quantitative and descriptive study, with individuals assisted by the interdisciplinary ambulatory of Inflammatory Bowel Disease of the Family and Community Health Unit of Itajaí/SC from September 2015 to October 2016. Socioeconomic data, life habits, and biochemical tests were collected, with the use of clinical indexes of classification of the disease activity: Harvey-Bradshaw Index (Crohn's Disease) and Partial Mayo Score (Chronic Nonspecific Ulcerative Colitis). Results  Of the 60 patients evaluated, 57% ( n = 34) had Crohn's Disease and 43% ( n = 26) had Chronic Nonspecific Ulcerative Colitis. According to disease activity, 75% ( n = 45) were in the remission phase, 13% ( n = 8) had mild activity, and 9% ( n = 5) had moderate activity. Regarding vitamin D, 63% ( n = 38) had deficiency of this vitamin and 37% ( n = 22) presented sufficiency. With the association of serum vitamin D concentrations and disease activity, we observed statistical significance among the variables ( p = 0.005). Regarding biochemical exams, the majority of patients with fecal calprotectin elevation presented vitamin D deficiency ( p = 0.025). Statistically significant correlation between HSV and vitamin D ( p = 0.0001) was found. Conclusion  According to the findings of this study, vitamin D deficiency is related to the clinical and laboratory activity of inflammatory bowel diseases.

The authors describe the case of a palpable epigastric mass associated with dyspeptic symptoms in a young female patient with no previous pathologic history. Imaging studies demonstrated the presence of a gastric foreign body with an "entangled appearance". The patient underwent laparotomy and gastrotomy for removal of a trichobezoar weighing 1,950 grams. Keywords: Bezoars; Gastric dilatation; Gastric outlet obstruction; Dyspepsia.Os autores descrevem um caso de massa abdominal epigástrica palpável associada a sintomas dispépticos em uma paciente jovem sem antecedentes patológicos. Estudos por imagem evidenciaram corpo estranho gástrico de "aspecto enovelado". A paciente foi submetida a gastrotomia via laparotomia, com retirada de um tricobezoar de 1.950 gramas. Unitermos: Bezoares; Dilatação gástrica; Obstrução da saída gástrica; Dispepsia. AbstractResumo

Anorectal Melanoma is a rare and very aggressive tumor that should be part of the range of differential diagnoses of colorectal diseases. Today, the main discussion on the topic is about the best treatment, whether it should be more conservative or more aggressive. In order to review the main points on the subject, the authors report a case of a patient treated at the Coloproctology Service at the São Lucas Hospital, PUCRS.
O melanoma anorretal é uma patologia de baixa frequência, porém de agressividade expressiva, devendo fazer parte da gama de diagnósticos diferenciais do Coloproctologista. A principal discussão sobre o tema versa hoje sobre a melhor forma de tratamento, seja mais invasivo ou mais conservador. A fim de revisar os principais pontos sobre o assunto, relataremos o caso de uma paciente atendida no Serviço de Coloproctologia do Hospital São Lucas da PUCRS

BACKGROUND: Patients with inflammatory bowel disease (IBD) vaccinated for hepatitis B have a low success rate in achieving protective antibody levels. The main factors suggested for this are IBD itself and the use of immunosuppressive drugs. OBJECTIVE: To evaluate the concentration of anti-HBs antibodies and to verify factors associated with the effectiveness of hepatitis B vaccination in patients with IBD. METHODS: This is a prospective, consecutive, observational, descriptive and analytical, non-randomized, qualitative study that evaluated the levels of anti-HBs antibodies in IBD patients at the Interdisciplinary Inflammatory Bowel Disease Clinic of the Family and Community Health Unit of UNIVALI - Itajaí, Santa Catarina. RESULTS: Thirty-six patients were vaccinated against hepatitis B virus (HBV), of which 29 were female. The average age was 46.2 years. Regarding the type of IBD, twenty-four patients had Crohn’s disease and the duration of inflammatory bowel disease was 74 months. Fifteen patients were on concomitant immunosuppressive therapy. The effective response rate to HBV vaccine was 72.2%, verified by anti-HBs titration ≥10 UI/L. Statistical analysis revealed a negative response to vaccination in patients with Crohn’s disease and immunosuppressive drugs. CONCLUSION: The success rate of HBV immunization in IBD patients is low compared to the general population. Type of disease and use of immunosuppressive drugs appear to influence the vaccine response.

RESUMO: Introdução: a miíase é uma afecção causada pela presença de larvas de moscas em órgãos ou tecidos do homem e de outros animais. Sua localização preferida em humanos é na pele, com ocorrências descritas nas cavidades naturais. Seu tratamento é baseado na remoção mecânica das larvas e no desbridamento cirúrgico de tecidos desvitalizados. Objetivo: descrição do caso de um paciente com prolapso retal associado à infestação por miíase, discutindo sua incidência, sintomatologia e tratamento. Relato do caso: L.C.S, 36 anos, masculino, com prolapso retal há um ano. Habitante de região rural, com baixo nível sócio-econômico, não possuía banheiros ou qualquer tipo de saneamento básico em sua residência. Ao exame proctológico, evidenciava-se prolapso retal edemaciado, com áreas cavitárias com necrose, secreção purulenta e grande quantidade de larvas de míiase. Realizou-se retirada mecânica das larvas com posterior debridamento cirúrgico. Optou-se pela confecção de uma colostomia em alça do sigmóide, devido à extensa área cruenta com lesão esfincteriana interna. Conclusões: O acometimento da miíase retal em prolapsos é raro, e deve ser prontamente diagnosticado e tratado. Um simples exame proctológico é fundamental para este fim. Salienta-se a necessidade contínua da educação em saúde, bem como se enfatiza a importância dos hábitos de higiene na população.