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to evaluate esophageal dysmotility (ED) and the extent of Barrett's esophagus (BE) before and after laparoscopic Nissen fundoplication (LNF) in patients previously diagnosed with BE and ED.

twenty-two patients with BE diagnosed by upper gastrointestinal (GI) endoscopy with biopsies and ED diagnosed by conventional esophageal manometry (CEM) were submitted to a LNF, and followed up with clinical evaluations, upper GI endoscopy with biopsies and CEM, for a minimum of 12 months after the surgical procedure.

sixteen patients were male (72.7%) and six were females (27.3%). The mean age was 55.14 (± 15.52) years old. and the mean postoperative follow-up was 26.2 months. The upper GI endoscopy showed that the mean length of BE was 4.09 cm preoperatively and 3.91cm postoperatively (p=0.042). The evaluation of esophageal dysmotility through conventional manometry showed that the preoperative median of the lower esophageal sphincter resting pressure (LESRP) was 9.15 mmHg and 13.2 mmHg postoperatively (p=0.006). The preoperative median of the esophageal contraction amplitude was 47.85 mmHg, and 57.50 mmHg postoperatively (p=0.408). Preoperative evaluation of esophageal peristalsis showed that 13.6% of the sample presented diffuse esophageal spasm and 9.1% ineffective esophageal motility. In the postoperative, 4.5% of patients had diffuse esophageal spasm, 13.6% of aperistalsis and 22.7% of ineffective motor activity (p=0.133).

LNF decreased the BE extension, increased the LES resting pressure, and increased the amplitude of the distal esophageal contraction; however, it was unable to improve ED.

LNF decreased the BE extension, increased the LES resting pressure, and increased the amplitude of the distal esophageal contraction; however, it was unable to improve ED.

to assess the socioeconomic and demographic profiles of patients hospitalized with a diagnosis of diabetic foot in a tertiary hospital in Belem-PA, Brazil, as well as to evaluate risk factors for lower limb amputations in such patients, classifying them according to the Wagner and PEDIS classifications.

we conducted a descriptive, cross-sectional, unicentric, and analytical study carried out through a structured questionnaire.

the study consisted of 57 patients, aged between 48 and 84 years old, 66.7% being male. The average income ranged between one and three (61.4%) minimum wages and below one minimum wage (31.6%). Type II Diabetes Mellitus was predominant (86.0%). Concerning comorbidities, arterial hypertension displayed the highest proportion (62.3%), followed by dyslipidemia (52.8%). Smokers comprised 35.1% of the sample. Infectious diabetic foot (50.9%) and mixed diabetic foot (49.1%) were the most common. Of the 20 patients with previous amputation, 90% had undergone minor amputation, and 10%, major ones. Callosity (92.6%) was the most prevalent deformity. Fifty-four (94.7%) patients underwent surgery, those being debridement (24.1%), minor amputation (37.0%) and major amputation (38.9%). check details During hospitalization, 78.9% of individuals did not require ICU stay. Hospitalization time varied between three and 59 days, and 78.9% of hospitalized patients did not progress to death, but 43.1% of patients submitted to major amputations died.

patients with diabetic foot followed-up have a low socioeconomic profile; most of them underwent surgical procedures, whether major or minor, due to the higher prevalence of infectious diabetic foot and/or non-adherence to non-operative treatment.

patients with diabetic foot followed-up have a low socioeconomic profile; most of them underwent surgical procedures, whether major or minor, due to the higher prevalence of infectious diabetic foot and/or non-adherence to non-operative treatment.

to analyze the survival in juvenile melanoma.

retrospective study conducted by hospital record review and cancer records of patients aged 0 to 19 years, with histologically proven melanoma and treated between 1997 and 2017 at the Erasto Gaertner Hospital in Curitiba-PR.

the sample comprised 24 patients, female (62.5%), mean 14.14 ± 4.72 years old, with head and neck melanoma (37.5%), chest (25%) and extremities. (20.8%). Signs and symptoms at diagnosis were increased lesion size (25%), bleeding (20.8%) and pruritus (16.6%). There was a Breslow II and IV index and Clark IV level, with a statistical tendency between Breslow IV and death (p = 0.127), and significance between Clark V and death (p = 0.067). Nine (37.5%) patients had metastases, six (25%) with distant metastases died (p = 0.001), five were girls (20.8%). Surgery was the standard treatment and chemotherapy the most used adjuvant (37.5%). The average time between diagnosis and death was 1.3 ± 1.2 years and survival were 3.7 ± 3.2 years.

there was a delay in diagnosis, high morbidity and mortality and average survival less than five years.

there was a delay in diagnosis, high morbidity and mortality and average survival less than five years.

Implant surface decontamination is a challenging procedure for therapy of peri-implant disease. This study aimed to compare the effectiveness of decontamination on oral biofilm-contaminated titanium surfaces in ErYAG laser, Er, CrYSGG laser, and plastic curette.

For oral biofilms formation, six participants wore an acrylic splint with eight titanium discs in the maxillary arch for 72 hours. A total of 48 contaminated discs were distributed among four groups untreated control; decontamination with plastic curettes; Er, CrYSGG laser; and ErYAG laser irradiation. Complete plaque removal was estimated using naked-eye and the time taken was recorded; the residual plaque area was measured and the morphological alteration of the specimen surface was observed by scanning electron microscopy. The total bacterial load and the viability of adherent bacteria were quantified by live or dead cell labeling with fluorescence microscopy.

The mean treatment time significantly decreased based on the treatment used in the following order ErYAG, Er, CrYSGG laser, and plastic curettes (234.9±25.4 sec, 156.1±12.7 sec, and 126.4±18.6 sec, P=0.000). The mean RPA in the Er, CrYSGG laser group (7.0±2.5%) was lower than ErYAG and plastic curettes groups (10.3±2.4%, 12.3±3.6%, p=0.023). The viable bacteria on the titanium surface after Er, CrYSGG laser irradiation was significantly lower compared to the decontamination with plastic curette (P=0.05) but it was not significantly different from the ErYAG laser irradiation.

We found that ErYAG laser and Er, CrYSGG laser irradiation were effective methods for decontaminations without surface alterations.

We found that ErYAG laser and Er, CrYSGG laser irradiation were effective methods for decontaminations without surface alterations.