Thoracic injuries in general are of great importance due to their high incidence and high mortality. Thoracic impalement injuries are rare but severe due to the combination of cause, effect and result. This study's primary objective is to report the case of a young man who was impaled by a two-wheeled horse carriage shaft while crashing his motorcycle in a rural zone. An EMT-B ferry was called at the crash scene and a conscious patient was found, sustaining a severe impalement injury to the left hemithorax, suspended over the floor by the axial skeleton with the carriage shaft coming across his left chest. As a secondary objective, a literature review of thoracic impalement injuries is performed. Cases of thoracic impalement injury require unique and individualized care based on injury severity and affected organs. Reported protocols for managing impalement injuries are entirely anecdotal, with no uniformity on impaled patient's approach and management. In penetrating trauma, it is essential not to remove the impaled object, so that possible vascular lesions remain buffered by the object, avoiding major bleeding and exsanguination haemorrhage. Severed impaled thoracic patients should be transferred to a specialist centre for trauma care, as these lesions typically require complex multidisciplinary treatment. High-energy thoracic impalement injuries are rare and hold a high mortality rate, due to the complexity of trauma and associated injuries such as thoracic wall and lung lesions. Modern medicine still seems limited in cases of such seriousness, not always with satisfactory results.

Introduction:Inguinal hernia is one of the most frequent surgical diseases. Currently, with the advantages of minimally invasive surgery, new questions arise: what will be the best approach for correction of inguinal hernia? Is there real benefit to the robotic approach? Objective:To compile results of the published studies that used the robot-assisted technique in the repair of inguinal hernia, analyzing its limitations, complications and comparing it with those of the pre-existing techniques. Method:The review was performed from the Medline database with the following descriptors: (inguinal hernia repair OR hernioplasty OR hernia) AND (robot OR robotic OR robotic assisted) being retrieved 391 articles. After verification of the titles and abstracts, we identified eight series of cases congruent with the objectives of this review. Three reviewers participated in the extraction and selection of results. Results:Comparative studies showed an increase in surgical time in relation to the open and videolaparoscopic approach. The complications present similar rates with the other repair routes. Conclusion:This technique has been shown to be effective for the correction of inguinal hernia, but the benefits of using robotic surgery are unclear. So, there is a need for randomized studies comparing laparoscopic to robotic repair

Intussusception is the invagination of a bowel segment into another immediately adjacent, causing obstruction, and the etiology can be benign, malignant, or idiopathic. The diagnosis may be obtained by ultrasound scans, or computed tomography imaging that can detect characteristics findings. Small bowel obstruction due to intussusception of inverted Meckel's diverticulum is a rare condition that usually constitutes a challenging diagnosis in adulthood. The surgical management in adults is often performed by en bloc resection without reduction attempts. We report a case of CASE REPORTS a middle-aged man with acute intestinal obstruction due to an ileo-ileal intussusception of inverted Meckel's diverticulum with a lipoma that was managed by laparoscopy. Worthy of note is the very scarce number of case reports on this exceeding uncommon association.

Foram encontradas na literatura médica duas revisões sistemáticas. Uma específica sobre o tema, envolvendo 9.795 mulheres, no ano de 2013 [14] . Outra revisão sistemática de 2014 [15] , avaliando 5 estudos, foi realizada analisando a associação da apneia com os desfechos perinatais, os quais envolveram o desenvolvimento de diabetes gestacional [15] . Foi atualizado na época a última revisão sistemática de 2014, com a adição de 5 novos estudos, adicionando na análise 954 554 gestantes. Portanto, Torna-se viável a realização da atual revisão, uma vez que, apresenta-se na literatura novos estudos populacionais com amostras significativas que podem aumentar o escopo e a elucidação da associação.Palavras-chave: síndromes de apneia do sono ou apneia do sono obstrutiva ou hipopneias do sono ou respiração, desordem do sono, diabetes gestacional.

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