Introduction: Roux-en-Y gastric bypass demonstrates high efficacy in reversing vitamin D deficiency and improving the lipid profile in obese patients, thereby reducing cardiovascular risks. The high prevalence of dyslipidemia and cardiovascular risk associated with obesity constitute a serious public health problem, a scenario significantly exacerbated by vitamin D deficiency. Objective: To evaluate the correlation between serum vitamin D levels and the lipid profile in patients with obesity undergoing Roux-en-Y gastric bypass. Methods: A retrospective study in which data were collected at baseline (0) and at 6 and 12 months postoperatively during the periods 2018–2019 and 2021–2022. All patients underwent Roux-en-Y gastric bypass. Patients were divided into Group 1 (pre-pandemic) and Group 2 (post-pandemic). Preoperatively, participants were classified according to vitamin D status as sufficient, deficient, or insufficient. Data were organized in Excel 2010, with variables described using frequencies. Longitudinal variability was assessed using Generalized Estimating Equations (GEE), and Pearson's correlation was used, with a significance level of p<0.05. Results: The study evaluated 246 patients who underwent gastric bypass (100 in Group 1 and 146 in Group 2). Preoperative vitamin D deficiency affected approximately 48% to 50% of the patients. At 6 and 12 months post-surgery, the vast majority of patients showed improvement in vitamin D levels. Conclusion: Roux-en-Y gastric bypass is highly effective in reversing vitamin D deficiency and optimizing the lipid profile. Both conditions improve in parallel due to weight loss and overall metabolic improvement, reinforcing the importance of continuous monitoring.
INTRODUCTION: Energy-drink consumption has increased substantially in recent decades, especially among young people and athletes, because of the drinks’ stimulant effects. Concern has also grown regarding their cardiovascular effects, particularly QT-interval prolongation, which is a marker of risk for severe arrhythmias such as torsades de pointes. Studies have reported conflicting findings on this relationship; we therefore proposed a systematic analysis of the available data. METHOD: This systematic review used the PRISMA protocol and the PICOS framework to select and analyze studies. PubMed, Cochrane, Scopus, Elsevier, UpToDate, and Google Scholar were searched for clinical trials and experimental and observational studies published from 2014 to 2024 that analyzed the relationship between energydrink consumption and changes in the QT/QTc interval. Study quality was also assessed using the Cochrane and Newcastle–Ottawa tools. RESULTS: Eighty-two studies were identified, of which 12 met the inclusion criteria. Eight studies indicated QT-interval prolongation after energy-drink consumption, seven found no significant change, and only one reported QT-interval shortening. Prolongation was more evident in studies evaluating high doses (>900 mL) of these beverages. DISCUSSION: The quantity and quality of the product appear to be the most important factors in energy-drink consumption. Although most healthy individuals do not experience relevant adverse effects, frequent or high-volume consumption may still pose a risk, especially to individuals with heart disease. Despite the difficulty of conducting a more specific analysis of the topic, the findings make clear that consumption may increase the risk of severe arrhythmias. Other factors, including the duration of consumption and monitoring, may also have influenced the results. CONCLUSION: Excessive energy-drink consumption may prolong the QT interval and increase the risk of potentially fatal arrhythmias. The findings also demonstrate the importance of new controlled studies to deepen understanding of long-term cardiovascular effects.
INTRODUCTION: Energy-drink consumption has increased substantially in recent decades, especially among young people and athletes, because of the drinks’ stimulant effects. Concern has also grown regarding their cardiovascular effects, particularly QT-interval prolongation, which is a marker of risk for severe arrhythmias such as torsades de pointes. Studies have reported conflicting findings on this relationship; we therefore proposed a systematic analysis of the available data. METHOD: This systematic review used the PRISMA protocol and the PICOS framework to select and analyze studies. PubMed, Cochrane, Scopus, Elsevier, UpToDate, and Google Scholar were searched for clinical trials and experimental and observational studies published from 2014 to 2024 that analyzed the relationship between energydrink consumption and changes in the QT/QTc interval. Study quality was also assessed using the Cochrane and Newcastle–Ottawa tools. RESULTS: Eighty-two studies were identified, of which 12 met the inclusion criteria. Eight studies indicated QT-interval prolongation after energy-drink consumption, seven found no significant change, and only one reported QT-interval shortening. Prolongation was more evident in studies evaluating high doses (>900 mL) of these beverages. DISCUSSION: The quantity and quality of the product appear to be the most important factors in energy-drink consumption. Although most healthy individuals do not experience relevant adverse effects, frequent or high-volume consumption may still pose a risk, especially to individuals with heart disease. Despite the difficulty of conducting a more specific analysis of the topic, the findings make clear that consumption may increase the risk of severe arrhythmias. Other factors, including the duration of consumption and monitoring, may also have influenced the results. CONCLUSION: Excessive energy-drink consumption may prolong the QT interval and increase the risk of potentially fatal arrhythmias. The findings also demonstrate the importance of new controlled studies to deepen understanding of long-term cardiovascular effects.
INTRODUCTION: Article 217-A of the Brazilian Penal Code defines sexual intercourse or another sexual act with a person younger than 14 years as a crime. Experiences during childhood and adolescence influence personality development. Rape of a vulnerable person therefore causes a range of psychological and physical consequences for victims, one of which may be an unintended pregnancy. Abortion is legally permitted in this situation but still faces restrictions that favor unsafe procedures. This study surveyed data on pregnancies resulting from rape of vulnerable persons in Brazil’s Central-West Region, quantifying live births and abortions. METHOD: Data were obtained from the ‘Monitoring Panels of the Department of Epidemiologic Analysis and Noncommunicable Disease Surveillance’ on the GovBR website. Search filters were found under the ‘Live Births’ subsection of the ‘Births’ section and covered reference years 2021–2024, the Central-West Region, and maternal ages 0–14 years. A Ministry of Health platform was used to collect abortion data with the following filters: hospitalizations in the Central-West Region; ICD10 morbidity list categories ‘spontaneous abortion,’ ‘abortion for medical reasons,’ and ‘other pregnancies ending in abortion’; age up to 14 years; and the period from 2021 to 2024. RESULTS: Between 2021 and 2024, 4,658 live births resulting from rape of vulnerable persons were recorded in the Central-West Region. Mato Grosso had the highest concentration of cases. In total, 438 pregnancies ended in abortion, with the highest number of cases recorded in 2022. DISCUSSION: The survey indicates alarming numbers of rapes of vulnerable persons that resulted in pregnancy. The lack of assistance for this child population is evident and constitutes a violation of human rights. CONCLUSION: The circumstances faced by these girls are alarming. It is therefore essential to discuss this issue and, above all, to question and promote public policies that give it greater visibility.
INTRODUCTION: Postural orthostatic tachycardia syndrome (POTS) is a form of chronic dysautonomia characterized by an abnormal increase in heart rate (≥30 bpm) during the first minutes after assuming an upright position, without a significant decrease in blood pressure. It primarily affects young women and causes symptoms such as fatigue, palpitations, dizziness, orthostatic intolerance, and cognitive dysfunction. Its pathophysiology involves cerebral hypoperfusion, sympathetic hyperactivity, hypovolemia, autoimmunity, and dysregulation of the renin–angiotensin–aldosterone system. During the COVID-19 pandemic, the syndrome gained prominence because cases increased markedly after infection, particularly in the context of long COVID. Studies indicate that approximately 14% of infected individuals experience persistent symptoms for weeks or months, and POTS is one of the main postviral manifestations reported. This association has been attributed to autonomic dysfunction triggered by the viral inflammatory response, even after mild or asymptomatic disease. METHOD: This systematic review searched PubMed and SciELO from 2020 to 2024 using the terms ‘POTS,’ ‘COVID,’ and ‘post-COVID POTS.’ Human studies published in Portuguese or English that addressed POTS secondary to SARS-CoV-2 infection were included. The PRISMA protocol was followed for study selection and data analysis. RESULTS: Fifty-one studies were included, of which 25 reported POTS cases. The main symptoms were palpitations (up to 93%), fatigue, dyspnea, and brain fog. Most patients were women aged 30 to 40 years who had experienced mild COVID-19. A frequent association with autoimmune diseases was also observed. DISCUSSION: The findings reinforce the role of postviral autonomic dysfunction as a central mechanism of POTS. Its predominance among women and association with autoimmunity suggest that hormonal and immunologic factors contribute to susceptibility. Treatment includes nonpharmacologic measures and, in selected cases, beta-blockers, ivabradine, and fludrocortisone. CONCLUSION: Post-COVID-19 POTS is a relevant and frequently underdiagnosed syndrome with major effects on function and quality of life. Further longitudinal studies are needed to clarify its mechanisms and guide effective treatment.
