Bacterial cellulose to reinforce urethrovesical anastomosis. A translational study

Abstract Purpose: To evaluate the efficacy of the cellulosic exopolysaccharide membrane (CEM) as a urethral reinforcement for urethrovesical anastomosis. Methods: Twenty eight rabbits were submitted to urethrovesical anastomosis with or without CEM reinforcement. The animals were divided into 4 groups: C7, CEM7, C14 and CEM14: (C= only anastomosis or CEM = anastomosis + CEM), evaluated after 7 weeks, and 14 weeks. The biointegration and biocompatibility of CEM were evaluated according to stenosis, fistula, urethral wall thickness, urethral epithelium, rate of inflammation and vascularization. Results: Between the two experimental groups, the difference in the number of stenosis or urinary fistula was not statistically significant. The morphometric analysis revealed preservation of urethral lumen, well adhered CEM without extrusion, a controlled inflammatory process and implant vascularization. The urothelium height remained constant over time after CEM reinforcement and the membrane wall was thicker, statistically, after 14 weeks. Conclusion: The absence of extrusion, stenosis or urinary fistula after 14 weeks of urethrovesical anastomosis demonstrates cellulosic exopolysaccharide membrane biocompatibility and biointegration with tendency to a thicker wall.

The biopolymer sugarcane as filling material of critical defects in rats

PURPOSE: To evaluate the effects of particulate (granule-shaped) SCB on bone repair relating it to its biocompatibility and bone neoformation. METHODS: Thirty Wistar rats were submitted to a one 7-mm-diameter defect and divided equally into three experimental groups, with two different postoperative times of evaluation, 90 and 120 days. Each calvaria defect was filled up with clot (control group), particulated autogenous bone or granulated SCB. Five animals of each group were assessed at 90 and 120 days after surgery. In these two periods, histological and histometric analysis were obtained. RESULTS: The clot group showed a bone resorption trend while the autogenous bone group a bone repair trend. However in the SCB group, the critical defect filled up only with fibrous connective tissue and presented none bone neoformation. CONCLUSION : The sugarcane biopolymer when used in critical size defects was a biocompatible material and proved to be a good material to fill bone cavities, keeping them as uniform areas filled with soft tissue and avoiding the tissue shrinkage.

Hepatitis B and C infections in systemic lupus erythematosus patientes

OBJECTIVE: determine the seroprevalence of HBV and HCV in SLE patients attended at the University Hospital fromOctober 2009 to July 2010. METHOD: the serological markers for HBV (HBsAg, anti-HBc total and anti-HBs) andHCV (anti-HCV) were investigated by enzyme-linked immunosorbent assay (ELISA). In HBsAg and/or anti-HBc totaland anti-HCV positive samples were analyzed for HBV-DNA and HCV-RNA by PCR. RESULTS: one hundred andsixty-nine SLE patients were studied and the prevalence of anti-HBc total was 10.1% (17/169) and all were negative forHBV-DNA. The anti-HCV was present in 1.8% (3/169) and only one was HCV-RNA positive, presenting a viral load of212.000 copies/mL. CONCLUSIONS: considering the absence of data on HBV in SLE patients in Brazil, the prevalencefound in this study was high when compared to that reported in the general population in the same geographical area.With regard to the seroprevalence of HCV, it was lower than that observed in other Brazilian SLE patients.

OBJETIVO: determinar a soroprevalência do HBV e HCV em pacientes com LES atendidos em Hospital Universitáriode Outubro de 2009 a Julho de 2010. MÉTODO: pesquisaram-se os marcadores sorológicos para o HBV (HBsAg,anti-HBc total e anti-HBs) e HCV (anti-HCV) através de ensaio imunoenzimático (ELISA). Nas amostras HBsAg e/ouanti-HBc total e anti-HCV positivas foram pesquisados o HBV-DNA e HCV-RNA, pela reação em cadeia da polimerase(PCR). RESULTADOS: 169 pacientes lúpicos foram estudados e a prevalência do anti-HBc total foi 10,1% (17/169),com negatividade para o HBV-DNA. O anti-HCV esteve presente em 1,8% (3/169) dos pacientes e em apenas um oHCV-RNA foi positivo, com carga viral de 212.000 cópias/mL. CONCLUSÃO: em virtude da inexistência de outrostrabalhos brasileiros que relatem a prevalência do HBV em pacientes lúpicos, verificou-se que a prevalência encontradana pesquisa foi superior a da população local. Com relação à soroprevalência do HCV, esta foi menor do que a verificadaem pacientes lúpicos brasileiros.

HBV and HCV serological markers in patients with the hepatosplenic form of mansonic schistosomiasis / Marcadores sorológicos do VHB e VHC em pacientes com esquistossomose mansônica na forma hepatoesplênica

CONTEXT: Blood transfusion is one of the major risk factors for the transmission of the hepatitis B (HBV) and C (HCV) viruses. However, there are no reports describing the endoscopic transmission of these viruses in patients with the hepatosplenic form of schistosomiasis. OBJECTIVE: To estimate the prevalence of serological markers of HBV and HCV in patients with the hepatosplenic form of schistosomiasis and evaluate the possible risk factors associated with these infections. METHODS: A cross-sectional study was conducted on 230 patients with hepatosplenic form of schistosomiasis who attended a university hospital in Recife, Northeastern Brazil, from February to August 2008. The patients answered a standardized questionnaire about risk factors. Serum samples were analyzed for anti-HBc total, anti-HBs, HBsAg, and anti-HCV using enzyme-linked immunosorbent assays. Univariate analysis and multiple logistic regression were performed. RESULTS: The prevalence was 30 percent for anti-HBc total and/or HBsAg and 7.4 percent for anti-HCV. There was a higher frequency of the serological markers in females and in patients aged .50 years. A significant association was detected between the presence of anti-HCV and the receipt of six or more blood transfusions. There was no association of history and number of digestive endoscopies with the serological markers analyzed. CONCLUSIONS: We observed a higher prevalence of serological markers for HBV and a lower prevalence of anti-HCV. Our results indicate that females and patients of an advanced age are the most affected categories and that patients that received multiple transfusions are at a higher probability of HCV infection.

CONTEXTO: A transfusão sanguínea destaca-se entre os fatores de risco implicados na transmissão dos vírus das hepatites B (VHB) e C (VHC); entretanto não há relatos da transmissão endoscópica destes vírus em pacientes com esquistossomose na forma hepatoesplênica. OBJETIVO: Estimar a prevalência dos marcadores sorológicos do VHB e VHC em pacientes com esquistossomose hepatoesplênica e avaliar os possíveis fatores de risco associados a essas infecções. MÉTODOS: Estudo do tipo transversal, com 230 pacientes com esquistossomose hepatoesplênica atendidos em um Hospital Universitário de Recife, PE, Brasil, no período de fevereiro a agosto de 2008. Os pacientes responderam a um questionário padronizado sobre os fatores de risco. Nas amostras de soro foram pesquisados o anti-HBc total, o anti-HBs, o HBsAg e o anti-VHC por ensaio imunoenzimático. As análises estatísticas utilizadas foram a univariada e a regressão logística múltipla. RESULTADOS: Encontrou-se prevalencia de 30 por cento para anti-HBc total e/ou HBsAg e 7,4 por cento para o anti-VHC. Houve maior frequencia de pacientes positivos do sexo feminino e idade .50 anos para os marcadores analisados. Verificou-se associação significativa entre a presenca do anti-HCV e a categoria de seis ou mais transfusões. Nao foi constatada associação do antecedente e numero de endoscopias digestivas com os marcadores sorologicos analisados. CONCLUSÕES: Constatou-se maior prevalência de marcadores sorológicos do VHB e menor prevalência para o anti-VHC. Evidenciou-se o sexo feminino e paciente de idade avançada como as categorias mais atingidas e maior probabilidade da infecção pelo VHC em pacientes politransfundidos.

Soroprevalência da hepatite C em pacientes com esquistossomose / Seroprevalence of hepatitis C in schistosomiasis patients

Objetivo: pesquisar o anti-HCV em portadores de esquistossomose mansônica. Método: foram testadas amostras de soro de 184 pacientes atendidos no Ambulatório de Gastroenterologia do Hospital das Clínicas da Universidade Federal de Pemambuco, empregando-se o ELISA de 3ª geração (Wiener) de acordo com as instruções do fabricante. Resultados: detectou-se resultado positivo para o anti-HCV em 22 pacientes, revelando uma prevalência de 11,9%. Entre os co-infectados de ambos os sexos, 90,9% apresentaram aforma hepatoesplênica da esquistossomose e 54,5% já havia recebido transfusão sangüínea. Analisando-se o passado de endoscopia digestiva, todos os pacientes co-infectados do sexo masculino e 81,8% do sexo feminino foram submetidos ao procedimento. Conclusões: foi alta a prevalência do anti-HCV em portadores de esquistossomose, a história de transfusão sangüínea e principalmente endoscopia digestiva mostraram-se como prováveis fontes de infecção.

Objective: to research the anti-HCV antibody prevalence in patients diagnosed with mansonic schistosomiasis. Methos: serum sample of 184 patients attending the Gastroenterology Clinics of Hospital das Clínicas da Universidade Federal de Pernambuco were tested for anti-HCV by a third generation ELISA (Wiener@) according to the manufacturer's instructions. Results: a positive resultfor anti-HCV was detected in 22 patients, establishing a prevalence of 11.9%. Among coinfected ofboth sexes, 90.9% had presented hepatosplenic schistosomiasis and 54.5% had had blood transfusion. Analyzing the endoscopy in the past, all coinfected male patients and 81.8% of coinfected females had undergone endoscopy previously. Conclusions: the prevalence of anti-HCV in schistosomiasis patients was high. B/ood transfusion and particularly digestive endoscopy were shown as probable infection sources.