Background and Objectives:There is a lack of consensus about the optimal noninvasive strategy for patients with suspected choledocholithiasis. Two previous systematic reviews used different methodologies not based on pretest probabilities that demonstrated no statistically significant difference between Endoscopic ultrasound (EUS) and magnetic resonance cholangiopancreatography (MRCP) for the detection of choledocholithiasis. In this article, we made a comparison of the diagnostic ability of EUS and MRCP to detect choledocholithiasis in suspected patients.Methods:We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations with all published randomized prospective trials. We performed the systemic review using MedLine, EMBASE, Cochrane, LILACS, and Scopus reviews through May 2015. We identified eight randomized, prospective, blinded trials comparing EUS and MRCP. All the patients were submitted to a gold standard method. We calculated the study-specific variables and performed analyses using aggregated variables such as sensitivity, specificity, prevalence, positive predictive value (PPV) and negative predictive value (NPV), and accuracy.Results:Five hundred and thirty eight patients were included in the analysis. The pretest probability for choledocholithiasis was 38.7. The mean sensitivity of EUS and MRCP for detection of choledocholithiasis was 93.7 and 83.5, respectively; the specificity was 88.5 and 91.5, respectively. Regarding EUS and MRCP, PPV was 89 and 87.8, respectively, and NPV was 96.9 and 87.8, respectively. The accuracy of EUS and MRCP was 93.3 and 89.7, respectively.Conclusions:For the same pretest probability of choledocholithiasis, EUS has higher posttest probability when the result is positive and a lower posttest probability when the result is negative compared with MRCP.

Background: To investigate the available data on the treatment of early colorectal cancer (CRC), either endoscopically or surgically.Methods: Two independent reviewers searched MEDLINE, EMBASE, CENTRAL COCHRANE, LILACS and EBSCO for articles published up to August 2015. No language or dates filters were applied.Inclusion criteria were studies with published data about patients with early colonic or rectal cancer undergoing either endoscopic resection (i.e., mucosectomy or submucosal dissection) or surgical resection (i.e., open or laparoscopic). Extracted data items undergoing meta-analysis were en bloc resection rate, curative resection rate, and complications. A complementary analysis was performed on procedure time. The risk of bias among studies was evaluated with funnel-plot expressions, and sensitivity analyses were carried out whenever a high heterogeneity was found. The risk of bias within studies was assessed with the Newcastle score.Results: A total of 12,819 articles were identified in the preliminary search. After applying inclusion and exclusion criteria, three cohort studies with a total of 768 patients undergoing endoscopic resection and 552 patients undergoing surgical resection were included. The en bloc resection rate risk difference was −11% Conclusions: According to the current available data, the treatment of early CRC by surgical resection is associated with higher curative resection rates and higher en bloc resection rates, despite of higher complications rates, as compared to endoscopic resection. Shorter procedure times are associated with the endoscopic methods of treatment, however high heterogeneity levels limit this conclusion.

Objetivos: Avaliar a qualidade de vida relacionada à saúde dos pacientes acometidos pelo Covid -19, através do instrumento SF-36. Métodos: Estudo transversal e observacional realizado entre os meses de janeiro e agosto de 2021. A amostra foi constituída por 221 participantes, com base na aplicação do questionário SF-36, avaliando-se a qualidade de vida em oito domínios naqueles pacientes atendidos pelo Instituto de Promoção e de Assistência à Saúde de Servidores do Estado de Sergipe – IPESAÚDE, diagnosticados com o Covid-19 mediante teste RT-PCR positivo e que tenham sido cadastrados e acompanhados pelo projeto “Monitora Corona”. O nível de significância estatística adotado foi de 0,05 e o software utilizado o R Core Team 2021. Resultados: Um total de 221 pacientes foram incluídos no estudo. Destes, 63,8% eram do sexo feminino, com idade média de 43,6 anos. Os domínios apontaram os determinados valores: Capacidade Funcional - 68,5 DP (desvio-padrão); Limitação por Aspectos Físicos - 48,9 DP; Dor - 55,5 DP; Estado Geral de Saúde - 54,9 DP; Vitalidade - 50,5 DP; Aspectos Sociais - 53,5 DP; Limitação por Aspectos Emocionais - 43,4 DP; Saúde Mental - 54,3 DP. Considerações finais: Na amostra avaliada, a maioria dos pacientes foram constituidos por mulheres adultas jovens com a qualidade de vida e saúde mental significativamente alteradas pela infecção pelo SARS-CoV-2 e seu tratamento. Diante o exposto, sugere-se necessidade de enfrentamento das repercussões negativas da saúde mental com propostas de organização e implementação de serviços de atenção à saúde da população.

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Lung age is increased in patients with morbid obesity, suggesting premature damage and accelerated lung aging, as evidenced by the discrepancy between chronological age and lung age. The determination of lung age might become a new tool for understanding pulmonary function results, for patients as well as for health professionals, in relation to obesity control.