Assessing Nutritional Deficiencies in Bariatric Surgery Patients: A Comparative Study of Roux-en-Y Gastric Bypass versus Sleeve Gastrectomy.

Obesity is a worldwide epidemic, and bariatric surgery is considered the primary treatment for long-term weight loss and managing obesity-related health issues. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most performed procedures. Nutritional deficiencies are a significant concern following bariatric surgery and can have serious consequences. This study aims to compare the incidence of nutritional deficiencies in patients undergoing RYGB and SG. A retrospective analysis was conducted on the nutritional status of 505 consecutive patients who underwent either RYGB or SG between January and December 2019. Data were collected regarding vitamin B12, folic acid, vitamin D, calcium, PTH, magnesium, hemoglobin, iron, ferritin, and transferrin at preoperative, 6-month, and 12-month intervals post-surgery. The RYGB group showed significantly higher excess weight loss. Vitamin B12, hemoglobin, and ferritin levels were consistently higher in the SG group throughout the study. Vitamin D deficiency was prevalent, with no significant difference between the groups. Vitamin B12 deficiency was significantly more common in the RYGB group (6 months: 17.46% vs. 4.69%, p < 0.001; 12 months: 16.74% vs. 0.93%, p < 0.001). Despite differences in their mechanisms, bariatric surgeries were associated with nutritional deficiencies. It is crucial to efficiently assess, prevent, and manage these deficiencies tailored to each surgical procedure.

Pelvic Ewing Sarcoma: The Great Mimicker.

Ewing sarcoma is the most common malignant bone tumor of the pelvis in children and young adults. Even with aggressive treatment, its survival rate is amongst the poorest. Classical presentation may not be the rule. It may simulate clinically, imagiologically and histopathologically other nonmalignant entities. Therefore, its suspicion should not be overlooked. We report two cases of pelvic Ewing sarcoma: the first mimicking eosinophilic granuloma, and the second mimicking osteomyelitis. In the latter, we also report an atypical finding of its natural history: an initial response to antibiotic and anti-inflammatory treatment. In both cases, we highlight the possibility of an inconclusive percutaneous bone biopsy and the importance of immunochemistry and cytogenetics for the definitive diagnosis.

Pelvic Ewing Sarcoma: The Great Mimicker / Sarcoma de Ewing pélvico: o grande imitador

Abstract Ewing sarcoma is the most common malignant bone tumor of the pelvis in children and young adults. Even with aggressive treatment, its survival rate is amongst the poorest. Classical presentation may not be the rule. It may simulate clinically, imagiologically and histopathologically other nonmalignant entities. Therefore, its suspicion should not be overlooked. We report two cases of pelvic Ewing sarcoma: the first mimicking eosinophilic granuloma, and the second mimicking osteomyelitis. In the latter, we also report an atypical finding of its natural history: an initial response to antibiotic and anti-inflammatory treatment. In both cases, we highlight the possibility of an inconclusive percutaneous bone biopsy and the importance of immunochemistry and cytogenetics for the definitive diagnosis.

Resumo O sarcoma de Ewing é o tumor ósseo maligno da pelve mais comum em crianças e adultos jovens. Mesmo com tratamento agressivo, sua taxa de sobrevivência está entre as piores. A apresentação clássica pode não ser a regra. Ele pode simular clinicamente, imaginologicamente e histopatologicamente outras entidades não malignas. Portanto, sua suspeita não deve ser negligenciada. Relatamos dois casos de sarcoma pélvico: o primeiro imitando granuloma eosinofílico e o segundo imitando osteomielite. Neste último, também relatamos um achado atípico de sua história natural: uma resposta inicial ao antibiótico e ao tratamento anti-inflamatório. Em ambos os casos, destacamos a possibilidade de uma biópsia óssea percutânea inconclusiva e a importância da imunoquímica e da citogenética para o diagnóstico definitivo.

Preliminary Evaluation of the Application of Algae-Based Biostimulants on Almond.

To improve almond performance under water limitations, the use of algae-based biostimulants may become a useful tool to reduce drought stress. However, besides possible effects on plant behavior, changes in fruit characteristics must also be considered. In this work, a preliminary study on the effect of two levels of an Ascophyllum nodosum-based biostimulant in the chemical characteristics of fruits from rain-fed cv. Marinada almond trees was carried out. The use of the recommended manufacturer's dosage resulted in a decreased content of soluble sugars and proteins when compared to the use of half the recommended dosage and the control assays (water only). Similarly, and although no significant differences were recorded, the content of bioactive compounds (ortho-diphenols, total phenolics, and flavonoids) tended to increase in non-treated trees. Finally, sensory analysis of treated and non-treated fruits did not record any changes in the perceived attributes, showing that no negative effects on consumers' acceptance will be caused by the application of this product. Long-term studies are needed to further confirm these results, also aimed at the monitoring of leaf gas exchange and water status parameters of trees.

Vitamin B Complex Deficiency After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy-a Systematic Review and Meta-Analysis.

Bariatric surgery, although an effective method, still has complications, like nutritional deficiencies. Our aim was to summarize the evidence on the frequency of complex B vitamin deficiencies in studies comparing Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). We included 25 studies for qualitative synthesis and 21 studies for quantitative synthesis. Relevant data was extracted, including proportion of patients with deficiency and mean serum vitamin values in 3 different timeframes. B12 and folate were the most prevalent deficiencies. B12 deficiency was more common after RYGB and folate serum mean levels were higher after RYGB. SG causes less nutrient deficiency and is therefore a better technique from this point of view. More studies are needed on B2, B3, and B6 vitamins to draw better conclusions.

tDCS application over the STG improves the ability to recognize and appreciate elements involved in humor processing.

The superior temporal gyrus (STG) has been found to play a crucial role in the recognition of actions and facial expressions and may, therefore, be critical for the processing of humorous information. Here we investigated whether tDCS application to the STG would modulate the ability to recognize and appreciate the comic element in serious and comedic situations of misfortune. To this aim, the effects of different types of tDCS stimulation on the STG were analyzed during a task in which the participants were instructed to categorize various misfortunate situations as "comic" or "not comic". Participants underwent three different tDCS conditions: Anodal-right/Cathodal-left; Cathodal-right/Anodal-left; Sham. Images depicting people involved in accidents were grouped into three categories based on the facial expression of the victim: angry or painful (Affective); bewildered and funny (Comic); and images that did not contain the victim's face (No Face). An improvement in mean reaction times in response to both the Comic and No Face stimuli was observed following Anodal-left/Cathodal-right stimulation when compared to sham stimulation. This suggests that this stimulation type reduced the reaction times to socio-emotional complex scenes, regardless of facial expression. The Anodal-right/Cathodal-left stimulation reduced the mean reaction times for Comic stimuli only, suggesting that specifically the right STG may be involved in facial expression recognition and in the appreciation of the comic element in misfortunate situations. These results suggest a functional hemispheric asymmetry in STG response to social stimuli: the left STG might have a role in a general comprehension of social complex situations, while the right STG may be involved in the ability to recognize and integrate specific emotional aspects in a complex scene.

Educação básica política e gestão da escola / Basic education policy and school management

Neste volume Sofia Lerche Vieira discute, aprofunda e amplia as reflexões acerca da legislação e da política educacional brasileira e de como ela se efetiva na prática da gestão dos sistemas e das escolas. Inova ao incluir na análise aspectos relacionados a indicadores educacionais e sua utilização na avaliação de resultados e no planejamento de políticas públicas.

Gestão, avaliação e sucesso escolar: recortes da trajetória cearense / Management, evaluation and school success: flashes from Ceará's history

O artigo analisa elementos de políticas educacionais adotadas no Estado do Cea-rá, Brasil, em período recente. Faz-se breve retrospectiva a iniciativas adotadas entre 1995 e 2002, com ênfase em medidas implementadas entre 2003 e 2006. O estudo detém-se sobre os temas da gestão, avaliação e sucesso escolar, aprofundando questões relativas aos sistemas de avaliação no país e no estado. São apresentadas idéias em torno da "gestão por resultados", uso de indicadores na definição de prioridades e difusão de uma cultura de avaliação no interior do sistema educacional.

The article analyses education policies taken on by schools in the State of Ceará, Brazil, from 1995 to 2006, concentrating in the period of 2003-2006. The key issues are education management, evaluation and school success. The study presents ideas about the assessment systems at the state and national levels; "management by results"; the use of indicators in the definition of priorities; and, the diffusion of an evaluation culture within the education system.

Estado e politica de formacao de magisterio

O estudo discute a formacao do magisterio como uma questao de Estado e de politica educacional. Procede a uma reconstrucao do tema a partir do passado, mostrando que os problemas atuais tem raizes encravadas na sociedade brasileira. Sao analisados dados sobre 'funcoes docentes', constatando-se que no periodo 1994-96 houve aumento de professores de ensino fundamental com formacao de primeiro grau (incompleta e completa) e de segundo grau completa e reducao daqueles com formacao de terceiro grau completa. Sao discutidas iniciativas dos anos 90 sobre a materia, inclusive o Fundo de Manutencao e Desenvolvimento do Ensino Fundamental e de Valorizacao de Magisterio e a nova Lei de Diretrizes e Bases da Educacao Nacional. Finalmente, sao apontados elementos de uma agenda para politica de formacao do magisterio.