Introduction: obesity is a major public health issue, linked to chronic stress and metabolic dysregulation. While biological mechanisms of sedentary behavior in obesity are well known, epigenetic factors, particularly those involving the NR3C1 gene, remain unclear, especially in genes related to the regulation of chronic stress and metabolism, such as NR3C1. Objective: this study aimed to investigate the methylation profile of the NR3C1 gene in obese individuals with physical inactivity. Methods: this cross-sectional study included 119 adult volunteers with obesity (BMI ≥30) who accessed public primary health care services. Individuals using glucocorticoids were excluded. Socioeconomic, health, and lifestyle data were collected using structured questionnaires, and depressive symptoms were assessed using the Beck Depression Inventory (BDI-II). Peripheral blood samples were collected in the morning for cortisol quantification and molecular analysis of the NR3C1 gene via pyrosequencing. Multivariate Poisson regression was applied to identify factors associated with physical inactivity. Results: poisson multivariate regression analysis with robust variance showed that physical inactivity was associated with NR3C1 gene hypermethylation at CpGs 44, 45, and 46 in obese individuals and showed that physical inactivity was associated with low cortisol in the obese population. Conclusion: this study suggests an association between a sedentary lifestyle and changes in NR3C1 gene methylation in obese individuals. The association between physical inactivity and low cortisol levels strengthens the hypothesis that a sedentary lifestyle may involve epigenetic action in the dysregulation of the HPA axis of stress adaptation in obese individuals.

Introduction: Binge eating disorders and behaviors (BEDB) are frequently associated with multiple comorbid conditions, including obesity, metabolic disorders, and cardiovascular diseases, which often result in significant functional impairment and impose a substantial health burden. Given the clinical and public health relevance of these associations, this study aimed to estimate the lifetime, 12-month, and 30-day prevalence of BEDB—encompassing bulimia nervosa (BN), binge eating disorder (BED), and any binge eating disorders/behaviors (ABEDB)—while also examining their associations with chronic somatic conditions and sociodemographic characteristics. Methods: The study utilized data from the São Paulo Megacity Mental Health Survey, a population-based study comprising a representative sample of 2,942 adult residents of the São Paulo metropolitan area. Diagnoses were assessed using the Composite International Diagnostic Interview (CIDI 3.0), administered via face-to-face interviews, to determine lifetime, 12-month, and 30-day prevalence rates of DSM-IV-defined BN, BED, and ABEDB. Additional data included demographics and anthropometric measures (weight, height) as well as self-reported chronic health conditions, such as autoimmune disorders, neck/back pain, headaches, other chronic pain, brain/cardiovascular diseases, hypertension, chronic pulmonary disease, diabetes or glucose intolerance and gastrointestinal ulcer. Statistical analysis employed cross-tabulations to assess prevalence distributions by sociodemographic variables and comorbidity with chronic conditions and overweight, while bivariate analyses and Poisson’s regression models (STATA 17.0) evaluated associations, with significance set at p< 0.05. Results: The lifetime, 12-month, and 30-day prevalence estimates were, respectively, 2.0% (SE 0.3), 0.9% (SE 0.2), and 0.4% (SE 0.1) for BN; 4.7% (SE 0.3), 1.8% (SE 0.3), and 1.2% (SE 0.2) for BED; and 9.0% (SE 0.5), 3.4% (SE 0.4), and 2.0% (SE 0.3) for ABEDB. Women presented significantly higher BEDB rates, except for 12-month BN. Although prevalence was consistently higher among younger cohorts for all eating-related conditions, age-related differences reached statistical significance only for lifetime ABEDB. No significant differences emerged based on marital status, education, or income. Comorbidity analyses revealed that lifetime BN was most prevalent among individuals with gastrointestinal ulcers (8.2%, SE 2.8), headaches (3.5%, SE 0.6), neck/back pain (3.3%, SE 0.6), and hypertension (3.1%, SE 0.7). Lifetime BED showed elevated rates in those with chronic pulmonary disease (13.2%, SE 6.0), arthritis/rheumatism (10.0%, SE 2.1), gastrointestinal ulcers (9.2%, SE 2.6), neck/back pain (8.9%, SE 1.3), other chronic pain (7.7%, SE 1.2), and headaches (6.6%, SE 0.9). Similarly, lifetime ABEDB was most prevalent among respondents reporting gastrointestinal ulcers (18.1%, SE 3.1), neck/back pain (14.0%, SE 1.9), headaches (12.8%, SE 1.2), and other chronic pain (11.7%, SE 1.5). Conclusion: Binge eating disorders and behaviors are more prevalent among women and demonstrate high comorbidity with chronic health conditions, particularly gastrointestinal, musculoskeletal, and pain-related disorders. These findings highlight the need for integrated public health strategies and clinical interventions to address the dual burden of BEDBs and chronic somatic conditions, ensuring comprehensive care for affected individuals.

Introduction: we report a case of a 6-year-old boy with chronic constipation due to an imperforate anus and poor adherence to outpatient treatment, who developed a severe sigmoid volvulus requiring Hartmann’s procedure. Objective: the main objective of this report is to contribute to knowledge about a rare condition in children, with few descriptions in the literature. Methods: the study is characterized as a case report, based on the clinical evaluation, medical records, and surgical descriptions of a 6-year-old male patient. Associated with the report, medical databases (PUBMED, LILACS) were searched for reviews and case reports about sigmoid volvulus in children and its relationship with anorectal anomaly, including aspects of diagnosis and treatment. Results: patient, male, 6-years-old, with a history of anoplasty due to an imperforate anus, developed over the years with chronic constipation and multiple fecal impactions removal. After the last procedure, he presented prostration and abdominal pain, with an image diagnosis of sigmoid volvulus. The patient underwent laparotomy, with visualization of extensive necrosis and the option of performing segment resection and colostomy. Conclusion: sigmoid volvulus is a rare condition in children and needs to be quickly identified so that earlier interventions can prevent advanced outcomes.

Introduction: Chronic stress, sociodemographic characteristics, and nutritional status can negatively affect heart rate variability (HRV), especially in active-duty military personnel, resulting in altered cardiac autonomic modulation. Objective: The aim of this study was to relate cardiac autonomic modulation in active-duty military personnel with chronic stress, sociodemographic characteristics, and nutritional status. Methods: A cross-sectional study was conducted in military personnel from the state of Espírito Santo with 71 participants over 18 years of age from August to November 2022. The analysis of autonomic modulation of heart rate was performed using the Kubios® software. For this analysis, individuals remained in the supine position for 25 minutes. HRV indices were calculated using linear methods in the time and frequency domains. Statistical differences were found between men and women in the variable SDNN (standard deviation of the mean of all normal RR intervals) (p=0.006), RMSSD (square root of the mean of the squares of the differences between successive normal RR intervals) (p=0.028). Between the different BMI (body mass index) ranges mean RR (mean of consecutive RR intervals) (p=0.007) and mean HR (mean heart rate) (p=0.015) and in the different age groups SI (Baevsky stress index) (p=0.001), SDNN (p=0.003), RMSSD (p=0.004). Results: There was an association between body mass index (BMI) and mean RR interval (Mean RR). People with obesity tend to have a higher mean heart rate, while those with overweight generally have a longer mean RR interval. These differences indicate distinct patterns in cardiac autonomic regulation according to nutritional status. Conclusion: There was an influence of nutritional status on cardiac autonomic modulation in active military public agents, but there is no relationship with chronic stress suffered by this population.

This document reinforces the importance of physical activity and active lifestyle habits to improve health and prevent chronic diseases. While the role of physical activity in preventing cardiovascular disease, obesity, and mental health problems is well researched, this note highlights an underrepresented area: musculoskeletal health, particularly back health. Musculoskeletal disorders, especially low back pain, are the leading cause of disability worldwide. Despite this, research on musculoskeletal problems remains insufficient compared to other health problems. This reflection calls for further studies and educational interventions to promote musculoskeletal health, advocating for a holistic approach that integrates physical, psychological, and social well-being. Activities such as yoga, Pilates, and Thai chi, which emphasize body awareness and postural control, are suggested as effective strategies for maintaining musculoskeletal health.

Introduction: the World Health Organization classifies Non-Communicable Diseases as the leading cause of global mortality, with 71% of deaths associated with malignant neoplasms. In 2020, approximately 19.3 million new cancer cases and 10 million cancer-related deaths were reported worldwide, with the Americas accounting for 20.9% of global incidence. In Brazil, the National Cancer Institute estimates 704,000 new cancer cases for the 2023-2025 period, with breast and prostate cancers representing 15% of the new cases each. Age over 50 years, genetic factors, family history, and others are risk factors for breast cancer. Objective: to evaluate the trend of incompleteness in the variables of the Hospital Cancer Registry for cases of malignant breast neoplasms across all hospitals in the Oncology Care Network of Espírito Santo. Methods: this is a retrospective time-series study using secondary data from the Tumor Registration Forms of the Hospital Cancer Registries of the Oncology Care Network of Espírito Santo between 2000 and 2020. Data incompleteness was classified as excellent (<5%), good (5%-10%), regular (10%-20%), poor (20%-50%), and very poor (>50%), based on the percentage of missing information. The Mann–Kendall test was used to assess temporal trends, and the Friedman test was applied to evaluate the quality classifications of the historical series. Results: a total of 16,587 breast cancer cases were recorded in the Hospital Cancer Registries of Espírito Santo between 2000 and 2020. The variables alcohol use (p<0.001), smoking (p<0.001), family history of cancer (p<0.001), and marital status (p<0.001) showed a statistically significant decreasing trend in incompleteness. On the other hand, variables related to diagnosis/treatment and tumor characteristics exhibited a lower trend of incompleteness over time, with an increase in completeness. These variables included the type of diagnostic exam performed (p=0.03), previous diagnoses and treatments (p=0.008), key diagnostic bases for the tumor (p<0.001), tumor laterality (p=0.008), and presence of more than one primary tumor (p=0.01). Conclusion: the scores for the epidemiological variables in the Hospital Cancer Registries of women with breast cancer in Espírito Santo were predominantly classified as “excellent” in terms of completeness. However, clinically important variables, such as Tumor, Node, Metastasis staging, showed a decline in completeness throughout most of the historical series.

Backgroung: Restrictive Brazilian legislation allows abortion in exceptional cases, such as pregnancy resulting from a sexual crime. However, little is known about women who give up on having an abortion after receiving approval for the procedure. Objective: To verify the association between religion and abandonment of legal abortion in women with pregnancies resulting from sexual violence. Method: Cross-sectional study with 941 women with pregnancy due to sexual crime treated at the Pérola Byington Hospital, São Paulo, Brazil, from August 1994 to December 2012. The cases were grouped according to whether or not they gave up on abortion. The study variables were age, education, race/color, marital status, gestational age, religion, aggressor and type of intimidation. Odds Ratio and Wald chi-square test (χ2W) were calculated. Logistic regression adjusted by analyzing the variables with stepwise backward analysis was used. Data analyzed using SPSS15.0 software. Research approved by the Ethics and Research Committee with opinion nº 6767, CAAE nº 00957512.3.0000.5505. Results: In 92 cases (9.8%) the legal abortion was abandoned and in 849 (90.2%) the abortion was completed. Women who declared religion and who were raped by a known aggressor gave up abortion almost 2.5 times more often (OR=2.46; p<0.001). Those who declared they had no religion and had low education were 13 times more likely to give up on abortion (OR=13.23; p=0.017). Women without low education and who declared religion were 16 times more likely to give up on abortion (OR=16.32; p=0.014). Those who declared having a religion and were victims of known aggressors gave up on abortion 16 times more than those who had no religion (OR=16.32; p=0.014) Conclusion: The results suggest that religious beliefs can influence the abandonment of legal abortion in certain subpopulations of women.

Introduction: chronic pancreatitis in children is a rare condition with multiple etiological factors organized into four groups: obstructive, toxic, related to systemic diseases and hereditary. Despite a gap in the literature, pancreatic diversion has been shown to be effective in managing symptoms and preserving exocrine and endocrine pancreatic function. Objective: this article seeks to demonstrate the improvement in quality of life in patients with chronic pancreatitis with significant anatomical alterations through monitoring and evaluation after undergoing early surgical approach with pancreatic diversion. Methods: retrospective analysis of 5 cases of pancreatitis treated at the Pediatric Surgery Unit of São Paulo University Medical School Children’s Institute using the Puestow technique together with a brief review of the etiologies presented. Results: all children survived the pancreatic diversion procedure, with 1 case presenting a pancreatic fistula, with good postoperative evolution and no sequelae observed during follow-up. Conclusion: surgical intervention with pancreatic diversion has proven to be an effective treatment, capable of alleviating pain and preventing complications associated with pancreatic insufficiency.

Introduction: Bariatric surgery effectively reduces body weight and remiss diseases associated with obesity. However, it may cause short- and long-term postoperative complications that can change lifestyle habits. Objective: To evaluate short-term changes in the quality of life of patients undergoing bariatric surgery. Methods: This observational prospective cohort study was conducted in three stages: preoperative and two and six postoperative months. It was carried out at the outpatient clinic of a bariatric surgery program of a university hospital in the Brazilian Southeast. The World Health Organization Quality of Life Bref was used. Data analysis: Kruskal-Wallis test; T-test for unpaired samples, p≤0.05. Results: The sample consisted of 60 patients, most of whom were women. The postoperative period showed an increase in physical health scores, reduced social relations and environment ones, and unchanged psychological ones. The mean number of diseases associated with obesity and the number of daily medications decreased but the number of patients who used psychotropic drugs after surgery increased, showing less weight loss. Conclusion: Patients showed improved physical health but reported negative impacts on social relationships and the environment after the bariatric surgery. Comorbidities and medication use decreased but the number of patients using psychotropic drugs increased.

Introduction: among the main causes of death, the stroke representing a public health problem that is difficult to control, with high death rates. Analysis of mortality patterns reveals risk factors and pre-existing conditions that increase the risk of cerebrovascular diseases, highlighting the importance of tracing the regional epidemiological profile. Objective: evaluating the temporal trends in the mortality coefficient and proportional mortality due to stroke in the populations of the states of Rio Grande do Norte and Paraíba, in the Northeast region of Brazil. Methods: a time series study analyzed secondary data on deaths from stroke in adults in the states of Paraíba and Rio Grande do Norte, from 2004 to 2023. The data was extracted from the Unified Health System database. Joinpoint regression, annual percentage changes and annual averages with 95% confidence intervals were used. Results: in the state of Paraíba, the highest number of deaths occurred in females with 1,5206 deaths (51.3%) and in the age group 65 years or older with 22,238 deaths (75.0%). In the state of Rio Grande do Norte, the majority of deaths were registered among females with 9,558 deaths (51.2%) and in the age group 65 years or older with 14,092 (75.4%). Conclusion: in the period analyzed from 2004 to 2023, the state of Paraíba maintained the highest mortality coefficients compared to Rio Grande do Norte. However, proportional mortality showed a reversal in 2023, with Rio Grande do Norte excelling, especially in the 65 and over age group.