Gestação após gastroplastia para tratamento de obesidade mórbida: série de casos e revisão da literatura

Objetivo: relatar a evolução de uma série de casos de gestação em mulheres previamente submetidas à cirurgia de bypass gástrico para tratamento de obesidade grave. Métodos: cinco casos consecutivos de gravidez após gastroplastia ocorridos entre 2001 e 2004 foram avaliados. As pacientes tinham idade entre 30 e 34 anos e todas haviam sido submetidas à cirurgia de Capella. Aspectos clínicos, laboratoriais e do acompanhamento materno e fetal foram considerados, durante o período gestacional e após o parto. Foi realizada revisão da literatura internacional, por meio das bases de dados MEDLINE e Web of Science, utilizando os seguintes unitermos: gastroplasty, gastric bypass surgery, bariatric surgery e pregnancy. Resultados: todas as gestações observadas foram únicas e não ocorreram complicações obstétricas, durante o seguimento pré-natal e parto. Também não houve registro de recém-nascidos prematuros ou de baixo peso ao nascimento. Conclusão: nossos dados sugerem que a gravidez após gastroplastia é segura para a mãe e feto. Entretanto, em virtude do limitado volume de informação disponível sobre o tema, investigações adicionais são necessárias para estabelecer recomendações apropriadas com relação ao seguimento dessas gestações _________________________________________________ABSTRACT Purpose: we report a small series of pregnant women who underwent gastric bypass surgery for severe obesity, with a review of the literature on this topic. Methods: five consecutive cases of pregnancy after gastroplasty between 2001 and 2004 were evaluated, and clinical, laboratory and therapeutic features were considered. Patients were 30 to 34 years old and all had been submitted to gastroplasty by the Capella technique. The outcomes for both the pregnant woman and the fetus were evaluated. A search of the English language literature was done through MEDLINE and Web of Science databases with the following terms: gastroplasty, gastric bypass surgery, bariatric surgery, and pregnancy. Results: all 5 pregnancies were singleton. No major obstetric complications were observed and there were no premature or lowbirth weight infants. Conclusion: our data suggest that pregnancy following gastroplasty is safe for mother and fetus. However, since information about this topic is limited, further investigations are required to establish appropriate recommendations concerning the follow-up of these pregnancies

Gestação após gastroplastia para tratamento de obesidade mórbida: série de casos e revisão da literatura

relatar a evolução de uma série de casos de gestação em mulheres previamente submetidas à cirurgia de bypass gástrico para tratamento de obesidade grave. Métodos: cinco casos consecutivos de gravidez após gastroplastia ocorridos entre 2001 e 2004 foram avaliados. As pacientes tinham idade entre 30 e 34 anos e todas haviam sido submetidas à cirurgia de Capella. Aspectos clínicos, laboratoriais e do acompanhamento materno e fetal foram considerados, durante o período gestacional e após o parto. Foi realizada revisão da literatura internacional, por meio das bases de dados MEDLINE e Web of Science, utilizando os seguintes unitermos: gastroplasty, gastric bypass surgery, bariatric surgery e pregnancy. Resultados: todas as gestações observadas foram únicas e não ocorreram complicações obstétricas, durante o seguimento pré-natal e parto. Também não houve registro de recém-nascidos prematuros ou de baixo peso ao nascimento. Conclusão: nossos dados sugerem que a gravidez após gastroplastia é segura para a mãe e feto. Entretanto, em virtude do limitado volume de informação disponível sobre o tema, investigações adicionais são necessárias para estabelecer recomendações apropriadas com relação ao seguimento dessas gestações

De repente, tudo mudou de lugar: refletindo sobre metamorfose urbana e gentrificação em Mossoró-RN

This study aims at solidifying the theoretical bases to provide, above all, an explanation for this phenomenon which currently happens, with a scenario of social, political, economic and cultural transformations worldwide in medium cities. Nevertheless, because it has different dimensions from its transformation axes, gentrification comes with change, but also with the introduction of a new purpose in the space using and occupation, outlining in this context the identity of places from the formation of centralities with the presence of flows with social and economic dynamicsThe current forms of geographic space appropriation show the directions of the senses and ideological profile which recreates the meanings and uses of content and materials from descriptions of a historical past. However, today there is an economic context in the urban space which refers to a search of strategies for change, i.e., the acquisition of parameter aimed at meeting the demands of the relationship between capital and labor, which ends up overriding some actions for the specification of the transformation methods within the urban space to be explained by new needs and also by the agents from the value adding to their interests and investments. Thus, we assume that the appreciation/gentrification of urban spaces may or may not result from the building of a public space, since the dialogic structure as a place of political interaction externalize conflicts and disagreements in general; it keeps segregating spaces. As new spaces are transformed, the access to them tends to happen with particular restriction, whereas some places like parks, shopping malls, high-rise and horizontal condos are the scene for major professional and family events. In this context, the gentrification process is used to designate interventions in the urban environment, in certain city spaces which are considered central to public and private investments. A historical place is permitted to be presented as a scenario, a stage full of attractions, through the transformation process. Studying gentrification consists of an analysis of the underlying interests in the transformation of these areas, and especially of the assessment of the interest level in the private sector to partner in order to modify the landscape. Gentrification results from the transformation processes of capital, which influences the efforts and investments application in order to establish and achieve optimal economic growth, focusing on a location socio-culturally centered in the urban space. Thus, the urban social structure develops in the light of some questions that relate not only the cities growth but also environmental conditions it provides in cities like Mossoro, State of Rio Grande do Norte, Brazil 2005 a 2011.

Da colônia ao shopping: um estudo da evolução tipológica da arquitetura hospitalar em Natal

A conceptual discussion on architectural type and its role in theory and practice supports the construction of an analytical tool used for recognizing the typological evolution of hospital architecture in Western societies. The same tool is applied to analyze the typological evolution of hospital architecture in Natal, Brazil, through a sample of eighteen hospitals built in the city since the beginnings of 20th century. The conclusion is that typological evolution in Natal is almost the same as occidental one, except for a few singularities that can be explained by local social and economic development