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

A travessia do trágico no romance d A Pedra do Reino de Ariano Suassuna

The present work seeks to investigate and discuss about the Greek Tragedy s elements at Ariano Suassuna s romance called τ Romance d A Pedra do Reino e o Principe do Sangue do Vai e Volta, connecting it directly to mythic, epic, poetic, and romances aspects at his work. The romance has as the protagonist the backcountry Pedro Dinis Quaderna. Quaderna is a character which is simultaneously popular, elitist, enigmatic, naive, and an intellectual man that has a great erudition. Quaderna is a character that seeks, by using the Literature, to reestablish a Brazilian backcountry kingdom which he s supposedly the king, always trying to empathizes the Brazilian northeast region like if it was a nation apart. By impressing a national personality to the Brazilian northeast , Quaderna tries to become an epic poet just like Homer, denoting a strong influence of the Epopee. Quaderna, just like many characters of Greek Tragedy, has at his family past time a lot of tragic circumstances. These facts that ocurred to his relativos like the your uncle Pedro Sebastião Garcia Barreto s death, the disappearement of his cousin Sinésio, and the contest between the brothers Arésio and Sinésio, and others aspects, remind us remarkable influences, beyond the Epopee, of the Greek Tragedy. By reading the romance we may notice many similarities between Quaderna s trajectory and Greek Tragedy heroes. To make an analysis about the tragic aspects at Suassuna s work, we need to dialogue with many theoreticals that have written about the tragic and comparate with many parts of Suassuna s with classics character s texts of Greek Tragedy. At the following chapters we seek to provide romance s elementaries notions, as well as tragic notions, the dialogue with mythics aspects and the tragic and epic aplicability at Suassuna s work