El trasplante de hígado es un procedimiento plausible, efectivo y seguro en pacientes con hemofilia: caso clínico / Liver transplantation in hemophilia A: report of one case

Due to blood derivative requirements, many patients with hemophilia were exposed to Hepatitis C virus infection (HCV) before the availability of HCV testing. We report a 46-year-old male with Hemophilia A with a hepatitis virus C infection since 2004 causing a cirrhosis. Due to a hepatopulmonary syndrome, he received a liver allograph using a factor VIII replacement protocol, after eradicating the virus C. He had a good postoperative evolution, and no more factor VIII was required after transplantation until his last assessment.

Diarrea poscolecistectomía: ¿un problema frecuente? / Postcholecystectomy diarrhea is a frequent problem?

Resumen Introducción: La colecistectomía laparoscópica es una de las intervenciones quirúrgicas más frecuentes en nuestro país. La diarrea poscolecistectomía es una entidad poco reconocida, con una prevalencia descrita entre el 0,9 y 35,6%, sin embargo, en Chile esto no ha sido claramente definido. Objetivo: Determinar la prevalencia y características de la diarrea poscolecistectomía laparoscópica electiva en una muestra de pacientes chilenos. Material y métodos: Se aplicó una encuesta telefónica estructurada sobre consistencia y frecuencia de deposiciones, entre 4 y 6 meses después de la intervención, a los pacientes adultos operados de colecistectomía laparoscópica electivamente entre diciembre de 2014 y marzo de 2015. Se definió como «diarrea poscolecistectomía¼ la presencia de deposiciones líquidas o inusualmente disgregadas que hubiesen comenzado posteriormente a la intervención y se estableció el término de «diarrea prolongada¼ como la duración de síntomas mayor de 4 semanas. Resultados: Se encuestó a 100 pacientes (73% de mujeres). La prevalencia global de diarrea poscolecistectomía fue del 35% (n = 35). La prevalencia de pacientes con diarrea prolongada fue del 15% (n = 15). En el grupo con diarrea prolongada, se observó resolución completa de esta en el 57% de los pacientes (n = 8) en un plazo medio de 99 ± 29 días. Conclusión: La diarrea poscolecistectomía es una entidad frecuente en nuestra población, con una alta prevalencia dentro de los primeros 28 días posteriores a la intervención. En la mayoría de los pacientes se resuelve en los primeros 6 meses.

Abstract Introduction: Laparoscopic cholecystectomy (LC) is one of the most common surgical procedures in our country. Postcholecystectomy diarrhea is an unrecognized entity, with a reported prevalence between 0.9 and 35.6%, nonetheless in Chile this has not been clearly defined. Objective: To determine the prevalence and characteristics of diarrhea following elective laparoscopic cholecystectomy in our institution. Material and methods: A structured questionnaire about consistency and defecation frequency was applied to adult patients summited to an elective LC between December 2014 and February 2015, by a telephone survey within 4 and 6 months after the surgical procedure. Postcholecystectomy diarrhea was defined as the presence of liquid or unusually disrupted faecal material beginning after LC. Persistent diarrhea was established when diarrhea continued for a period longer than four weeks. Results: One hundred patients were included (73% women). The overall prevalence of postcholecystectomy diarrhea was 35% (n = 35). The prevalence of patients with persistent diarrhea was 15% (n = 15). In the group of patients with persistent diarrhea, complete resolution was observed on 57% of the cases (n = 8) within an average period of 99 ± 29 days. Conclusion: Post cholecystectomy diarrhea is a frequent condition in our population, with a high prevalence within the first 28 days after LC. In most patients it resolved within 6 months.

Avaliação de dor e qualidade de vida de pacientes com fibromialgia / Evaluation of pain and quality of life of fibromyalgia patients

RESUMO JUSTIFICATIVA E OBJETIVOS: Sabe-se que a fibromialgia é uma síndrome musculoesquelética caracterizada por dor crônica e generalizada. Considerando que a dor é um sintoma que traz implicações diretas na vida dos pacientes acometidos, o objetivo deste estudo foi avaliar a dor e a qualidade de vida de pacientes com fibromialgia para melhor compreender a correlação entre essas variáveis. MÉTODOS: Estudo transversal com 45 mulheres, com idade entre 30 e 55 anos, em tratamento estável no último mês que antecedeu a seleção, sendo excluídas as que estavam em tratamento fisioterapêutico, faziam uso de recursos auxiliares da marcha e/ ou tinham doenças reumatológicas autoimunes ou relevantes comorbidades sem controle. A avaliação foi realizada através de ficha de entrevista, Questionário de Impacto da Fibromialgia, Índice de Dor Generalizada e escala analógica visual. Os dados foram analisados através dos testes de Correlação de Pearson e t de Student, aceitando-se níveis de significância estatística acima de 95%. RESULTADOS: foram observados elevados valores no Questionário de Impacto da Fibromialgia, Índice de Dor Generalizada e escala analógica visual além de uma correlação linear entre os índices de dor e qualidade de vida. CONCLUSÃO: A dor está associada à diminuição da qualidade de vida de fibromiálgicos.

ABSTRACT BACKGROUND AND OBJECTIVES: It is known that fibromyalgia is a musculoskeletal syndrome characterized by chronic and widespread pain. Considering that pain has direct implications on affected patients' lives, this study aimed at evaluating pain and quality of life of fibromyalgia patients to better understand the correlation between such variables. METHODS: Cross-sectional study with 45 females aged between 30 and 55 years, in stable treatment in the month previous to selection, being excluded those under physiotherapeutic treatment, using walking aids and/or with autoimmune rheumatologic diseases or relevant uncontrolled comorbidities. Patients were evaluated with interview records, Fibromyalgia Impact Questionnaire, Widespread Pain Index and visual analog scale. Data were analyzed by Pearson Correlation and Student t tests, with statistical significance above 95%. RESULTS: There have been high scores in Fibromyalgia Impact Questionnaire, Widespread Pain Index and visual analog scale, in addition to linear correlation between pain scores and quality of life. CONCLUSION: Pain is associated to impaired quality of life of fibromyalgia patients.

Use of direct and iterative solvers for estimation of SNP effects in genome-wide selection

The aim of this study was to compare iterative and direct solvers for estimation of marker effects in genomic selection. One iterative and two direct methods were used: Gauss-Seidel with Residual Update, Cholesky Decomposition and Gentleman-Givens rotations. For resembling different scenarios with respect to number of markers and of genotyped animals, a simulated data set divided into 25 subsets was used. Number of markers ranged from 1,200 to 5,925 and number of animals ranged from 1,200 to 5,865. Methods were also applied to real data comprising 3081 individuals genotyped for 45181 SNPs. Results from simulated data showed that the iterative solver was substantially faster than direct methods for larger numbers of markers. Use of a direct solver may allow for computing (co)variances of SNP effects. When applied to real data, performance of the iterative method varied substantially, depending on the level of ill-conditioning of the coefficient matrix. From results with real data, Gentleman-Givens rotations would be the method of choice in this particular application as it provided an exact solution within a fairly reasonable time frame (less than two hours). It would indeed be the preferred method whenever computer resources allow its use.

Use of ridge regression for the prediction of early growth performance in crossbred calves

The problem of multicollinearity in regression analysis was studied. Ridge regression (RR) techniques were used to estimate parameters affecting the performance of crossbred calves raised in tropical and subtropical regions by a model including additive, dominance, joint additive or "profit heterosis" and epistatic effects and their interactions with latitude in an attempt to model genotype by environment interactions. A software was developed in Fortran 77 to perform five variant types of RR: the originally proposed method; the method implemented by SAS; and three methods of weighting the RR parameter lambda. Three mathematical criteria were tested with the aim of choosing a value for the lambda coefficient: the sum and the harmonic mean of the absolute Student t-values and the value of lambda at which all variance inflation factors (VIF) became lower than 300. Prediction surfaces obtained from estimated coefficients were used to compare the five methods and three criteria. It was concluded that RR could be a good alternative to overcome multicollinearity problems. For all the methods tested, acceptable prediction surfaces could be obtained when the VIF criterion was employed. This mathematical criterion is thus recommended as an auxiliary tool for choosing lambda.

Infecçäo de ferida na cirurgia das vias biliares do idoso / Biliary tract wand infection an the elderly

Os autores analisaram, retrospectivamente, no período de 1977 a 1989, 793 cirurgias sobre a vesícula e vias biliares em um hospital universitário. Noventa e oito destes procedimentos foram realizados em pacientes acima de 60 anos. Avaliaram-se três grupos de cirurgias: colecistectomia (grupo I - 589 casos). colecistectomia com colangiografia pré-operatória(grupo II - 127 caso) e colecistectomia com exploraçäo de vias biliares (grupo III - 77 casos). Nos pacientes acima de 60 anos, obteve-se um índice de infecçäo de ferida 8.5 por cento (p<0,05),12.5 por cento (p<0,05) e 4,3 por cento (p>0,05 por cento), dos grupos I, II, III respectivamente. Concluem os autores que, da análise de sua casuística, o fator idade influenciou estatisticamente na incidência de infecçäo de ferida operatória nas colecistectomias simples, acompanhadas ou näo de colangiografia intra-operatória. Näo se observou valores estatisticamente significativos ao se relacionar a idade com o procedimento de exploraçäo de vias-biliares