Purpose: To develop and test a model of teaching by means of an abdominal cavity simulator. Methods: This study had two stages: development of a teaching model and an experimental prospective study that aimed to evaluate the residents' competence. The participants were divided into 3 groups: first-year resident, second-year resident, and senior surgeon. The two groups of resident physicians received training in the simulator, under instructor supervision for skill acquisition, according to the model proposed in first stage. The surgeons did not receive this intervention. The correlations and associations were verified through simple and multiple linear regressions. The learning curves were analysed using Cox regression models. The impact of the epidemiological characteristics was tested. Results: All residents reached the maximum score at the end of 16 steps and were comparable to the experimental (p<0.001). Conclusion:Residents who underwent training using the methodology of the proposed teaching model, which is based on realistic simulation, acquired proficiency in the accomplishment of endosutures in up to 16 hours of training in the laboratory. IIPhD, Centro Universitário Unichristus, Fortaleza-CE, Brazil. Conception, design and intellectual content of the study; critical revision; approved the final version.

Background: Because there are several reports associations between affective (AD) and bipolar disorder (BD) and suicide, the research develops a discussion of risk factors that influence the occurrence of suicide attempts in patients with BD. Objectives:To relate risk factors present in patients with bipolar disorder who committed suicide or some suicide attempt. Methods:A survey was made in Scopus with the keyword "bipolar" and the terms "suicide" and "attempted"and "risk factors" from Medical Subject Headings (MeSH). We use only Scopus as the data source, and the statistical information available in tables and graphs provided from this source. Results:Frequently the AD and BD were associated with suicide occurrence in the studies included in this review. They identified the main risk factors for suicide the previous suicide attempt and hopelessness. The main risk factors for nonfatal suicidal behavior included family history of suicide, early onset of bipolar disorder, extent of depressive symptoms, increasing severity of affective episodes, the presence of mixed affective states, rapid cycling, comorbid Axis I disorders, and abuse of alcohol or drugs. The suicide rate in this disorder reaches three times compared with other mental illnesses, and there are several risk factors: 3:1 ratio of suicide in men compared to women, but in females a greater number of attempts are observed. 25% of persons consume alcohol prior to suicidal attempt. The studies relate these factors and show how they can pose a risk to the carrier of the disorder. There are other risk factor for BD discussed on this review. IntroductionBipolar affective disorder (BD) is characterized by episodes of depression and hypomania and / or mania. BD has been responsible for the higher rate of suicidal behavior compared to any other mental disorder [1,2]. It is a potentially lethal disease with a high risk of suicide completed, which again is associated with a history of suicide attempts [2]. During life, about 61% of patients with BD experiencing suicidal ideation, 25% to 56% will attempt suicide, and between 10% and 19% die from suicide2. Several studies suggest that previous suicide attempts of bipolar patients may indicate that they are over than 50% more likely to complete suicide [2]. A better understanding of the characteristics and risk factors related to suicide attempts is the first step to prevent future attempts and early detection of risk patients [1,2].Suicide is a tragic potential outcome for patients with bipolar disorder, and unfortunately, this event is not uncommon. Twenty-five percent to 50% of all bipolar patients have been found to attempt suicide at leart once in their lifetime, with 11% to 19% of bipolar patients eventually dying of suicide and standardized mortality ratio for suicide of 12.3 [3-7].There is evidence that suicide rates among mood disorder patients are more than 20-fold higher than in the general population and that suicidal behavior is much more lethal in bipolar disorder than in the general populati...

It is estimated that over 800 000 people die by suicide and that there are many suicide attempts for each death. Young people are among those most affected. The numbers differ between countries, but it is the low-and middle-income countries that bear most of the global suicide burden, with an estimated 75% of all suicides occurring in these countries. The importance of each risk factor and the way it is classified will depend on each context. These factors can contribute to suicidal behaviours directly but can also contribute indirectly by influencing individual susceptibility to mental disorders. From the analysis of the rate of suicide, the numbers of suicide preventions successful with the number of hospitalizations and hospitalized for attempted suicide, it becomes possible to determine a path in order to create social change in three important factors to be followed to be fulfilled: knowledge (scientific and practical), public support (political will) and a social strategy, showing up as a national response to achieve the goals of suicide prevention.

Objetivo: por meio dessa revisão sistemática qualitativa, objetivamos esclarecer qual o papel atual do endoscopista no volvo colônico. Métodos: a pesquisa da literatura foi realizada via PUBMED on-line bancos de dados de janeiro de 2004 a maio de 2017 com os termos "Intestinal Volvulus"[MeSH], "Colonoscopy"[Majr] e adult [MeSH]. Resultados: inicialmente, as estratégias de pesquisa acima mencionadas resultaram em 23 referências. Depois, com base nos critérios de elegibilidade, foram excluídas 12 referências, e 11 foram incluídas. Conclusão: desde a introdução da distorção endoscópica na década de 1940, essa abordagem, juntamente com a ressecção subsequente, tornou-se a principal modalidade terapêutica. A descompressão endoscópica é aceita como o tratamento primário do volvo colônico, no entanto, se houver suspeita de gangrena ou perfuração, pacientes com volvo colônico devem ser submetidos à cirurgia de emergência.