This nationally representative study of inpatients in the United States provides evidence that diabetic patients with an operatively treated ankle fracture are likely to have worse results than non-diabetic patients with regard to postoperative complications, mortality, rate of non-routine discharge, length of hospital stay, and total hospital charges.

Introdução: Os efeitos da desnutrição intra-uterina dependem da fase de desenvolvimento em que está o feto ou o órgão, sendo tanto mais intensos e permanentes quanto mais precocemente ocorrer e mais tarde se iniciar a recuperação nutricional. Objetivos: Avaliar alterações no intestino delgado diante da desnutrição intra-uterina e após a lactação em filhotes de ratas Wistar submetidas à restrição dietética na gestação e comparar com o grupo controle. Material e métodos: As ratas prenhes foram divididas em dois grupos; o grupo controle recebeu dieta ad libitum enquanto o grupo com restrição alimentar recebeu 50% dessa dieta. Ao nascimento as ninhadas foram avaliadas quanto ao número de filhotes e ao peso. Os filhotes foram sacrificados em até 24 horas após o nascimento e avaliados individualmente. Na morfometria do intestino delgado estudou-se: altura total da mucosa, altura da vilosidade, espessura da vilosidade e altura do enterócito. Após a lactação as mesmas medidas foram realizadas e comparadas entre os grupos. Resultados: Ao nascimento, o peso individual, o comprimento do corpo e o do intestino foram menores no grupo com restrição alimentar. Tais resultados mantiveram-se após a lactação, exceto o comprimento do corpo, que se mostrou semelhante nos dois grupos. À morfometria observou-se, após o nascimento, que todas as variáveis estudadas foram significativamente menores no grupo de filhotes de mães com restrição alimentar. Após a lactação houve recuperação da espessura da vilosidade, porém as demais variáveis permaneceram menores. Discussão e conclusões: A restrição de 50% da dieta materna durante a gestação leva a baixo ganho de peso e produz conceptos menores, com menor comprimento do intestino em relação a grupo controle e morfometria microscópica revelando medidas menores estatisticamente significativas. A maioria dessas alterações se mantém após a lactação e apresenta uma correlação positiva com o peso dos animais. Desnutrição Ratos Intestino delgado abstract Background: The effects of in-uterus malnutrition depend on the developmental stage of the fetus or the organ, being more intense and permanent the earlier it happens and the later the nutritional recovery occurs. Objectives: Evaluate the changes in the small bowel regarding in-uterus malnutrition and after lactation in Wistar rats´ pups that underwent pregnancy in dietary restriction and compare them to a control group. Material and method:The pregnant dams were divided into two groups; the control group received ad libitum diet whereas the food deprivation group had 50% of that intake. At birth, the litters were evaluated on the number of pups and their weight. Twenty-four hours after delivery, part of them was sacrificed and evaluated one at a time. In the intestine, the total height of the mucosa, the height of the villi, the height of the enterocyte and the thickness of the villi were studied by means of microscopic morphometry. The same measures were applied after lactation and the results were compared between groups. Results: After delivery...

We describe a rare occurrence of congenital peribronchial myofibroblastic tumor of the lung presenting in early fetal life. A female patient in the 24th week of gestation who presented with polyhydramnios was admitted for examination. Ultrasound examination revealed a mass compromising the lungs. Because the intrauterine fetal death was revealed by the ultrasound, delivery was induced. Necropsy revealed a pulmonary lesion compromising the left lower pulmonary lobe together with hepatomegaly. Microscopic analysis of the lung showed a lesion with a storiform arrangement of spindle cells with focal peribronchial distribution. Hepatic architecture was diffusely altered by fibrotic tissue. Immunohistochemical analysis on the pulmonary lesion showed high vimentin positivity in the fusocellular components, pointing to the mesenchymal nature of the lesion. Significant differentiation of smooth muscle tissue, as indicated by high HHF35 positivity, was also observed. Electron microscopy on the pulmonary lesion revealed elongated cells with some cytoplasmatic processes, a finding that is also compatible with mesenchymal differentiation.

Malnutrition in dams causes alterations in the liver, thymus, and other internal organs of newborn offspring. Significant changes in thymuses were found using human monoclonal antibodies that cross-react with rat proteins, a novel finding in the literature.

BACKGROUND: Mesenteric thrombosis related to trauma is an uncommon entity and has poor prognosis when have low flow and hemorrhagic shock. It usually presents with a challenging diagnosis and high mortality rates, despite appropriate treatment. CASE REPORT: Patient with blunt trauma was admitted and initial treatment, complementary exams showed ribs and humerus fractures. Computerized tomography showed aerial distension in small bowels along with gastric stasis and hidropneumothorax. The patient had hypotension during clinical observation and cardiopulmonary arrest, responding to reanimation. Taken to surgery for damage control, it was found extensive necrosis of right colon, which was excised and performed primary anastomosis. He was admitted in the intensive care unit, evolving with oliguria, miosis, convulsion, and pulseless electric activity, dying three days after hospital admission. CONCLUSION: Although uncommon, mesenteric ischemia with venous thrombosis might be secondary to systemic hypotension, frequently followed by fatal outcomes.