Use of mosquito repellents to protect against Zika virus infection among pregnant women in Brazil.

OBJECTIVES: To evaluate the use of repellents among pregnant women as a protective measure against infection with the Zika virus. STUDY DESIGN: Pregnant women (n = 177) were interviewed between November 2016 and February 2017 at Basic Health Units in the city of Propriá, state of Sergipe, Brazil. Two units were located in rural areas and eight in urban regions. METHODS: Data were analysed using descriptive statistical methods, the Chi-squared test or Fisher's exact test and odds ratios. The independent variables were grouped by analysis of the main components, and adherence to the use of the repellent was analysed by the logistic regression method. RESULTS: A total of 100 women reported using repellents at the time of the interview (56%). The use of repellents was greater among women with higher levels of education (83%) than those with only high school (68%) or elementary school (36%) education. Women assisted by the income transfer programme (Bolsa Família) presented a 2.27 times greater chance of not using repellents compared with pregnant women who were not receiving benefits of the programme. Regarding the logistic regression model, we observed that low economic and social conditions of pregnant women, as well as their lack of advice, had a negative effect on the use of repellents. CONCLUSIONS: Repellents were generally used as a preventive measure in pregnant women with higher levels of schooling and fewer children. The relatively high cost of repellents was the main reason for non-use.

Analysis of Model for End-Stage Liver Disease (MELD) score in a liver transplantation waiting list.

BACKGROUND: The Model for End-Stage Liver Disease (MELD) was introduced in 1999 to quantify the 3-month prognosis of cirrhotic patients after a transjugular intrahepatic portosystemic shunt (TIPS). Because of the imbalance between organ donors and patients on the waiting list, the MELD was adopted by the United States in 2002 to allocate liver grafts for transplantation. Preliminary results have indicated a reduction in waiting list deaths and an increase in transplantation rates for candidates. Seeking to find a new model to predict death on the waiting list and after liver transplantation, retrospective studies have examined MELD scores in waiting list patients. The aim of this study was to analyze the MELD scores of patients on the liver waiting list for comparisons between transplanted patients. PATIENTS AND METHODS: A retrospective study was performed analyzing 131 registrations of 127 orthotopic liver transplant (OLT) patients (4 underwent retransplantation) grafted between November 2000 and January 2006, excluding 24 patients: 2 had urgent retransplantations due to hepatic artery thrombosis and 22 had incomplete data. These patients were divided into 3 groups: group I (transplanted patients)-53 patients underwent 55 OLT; group II-29 patients who died on the waiting list; group III-patients on the waiting list including 23 patients still waiting as of the date of the study. RESULTS: The main indication for OLT was hepatitis C virus cirrhosis (50.50%), followed by alcoholic liver cirrhosis (23.30%), cryptogenic cirrhosis (12.60%), autoimmune hepatitis (5.80%), hepatitis B virus cirrhosis (4.85%), and primary biliary cirrhosis (2.91%). Group I: MELD score 15.62 (range, 6-39) on admission to the list, and 18.87 (range, 7-39) at transplantation. The mean waiting time for OLT was 478.39 days (range, 2-1270 days). The 38 patients who survived underwent 39 OLT (1 retransplantation). The MELD score at entrance to the list was 14.62 (range, 7-30) and at transplantation, 17.70 (range, 7-39). The mean time between admission to the list and transplantation was 505.37 days (range, 6-1270 days). The 15 patients who died had received 16 OLT (1 retransplantation). Their MELD scores were 17.80 (range, 6-39) and 21.81 (range, 9-39) at admission to the list and at transplantation, respectively, with a mean time on the waiting list of 417.93 days (range, 2-872 days). Group II: 29 patients died before OLT, at a mean age of 52.60 years (range, 22-67 years). Their MELD score was 19.24 (range, 7-45), and the interval between admission to the waiting list and death was 249.55 days (range, 3-1247 days). Group III: 23 patients still active on the OLT waiting list at the time of study displayed a mean MELD score of 13.65 (range, 6-28) and 354.30 days (range, 2-905 days) waiting until the moment. In conclusion, MELD score at the time of admission to the waiting list was higher among those patients who died either awaiting a liver graft (19.24) or after OLT (17.80) compared with those who survived after OLT (14.60) or are still awaiting OLT (13.65).

Metástase óssea de hepatocarcinoma / Bone metastasis of hepatocellular carcinoma

O Hepatocarcinoma (HCC) é o quinto tumor sólido mais comum em todo o mundo e a terceira maior causa de mortalidade por câncer. A incidência do HCC não é uniforme, variando de acordo com a prevalência das doenças hepáticas subjacentes numa determinada região. Está bem estabelecido que as infecções crônicas pelo vírus B e C e a doença hepática alcoólica estão relacionadas ao HCC. O HCC pode ser diagnosticado em pacientes sem sinais clínicos de descompensação da doença hepática. A presença de metástase óssea está relacionada à doença mais avançada, comprometendo o prognóstico e a sobrevida destes pacientes (AU)

Relato de 7 casos de pacientes portadores de Hepatite B em acompanhamento no Ambulatório de Hepatologia do Hospital do Servidor Público Municipal / Report of 7 cases of patients with hepatitis B Hepatology Outpatient Clinic of the Hospital do Servidor Publico Municipal

Vários estudos têm demonstrado a preocupação em relação ao HBV devido a sua evolução para formas crônicas e o aparecimento de hepatocarcinoma. Hoje temos um novo arsenal de medicamentos para diminuir a carga viral dos portadores HBV quando em atividade replicativa, sendo a carga viral extremamente importante, num futuro próximo os genótipos também orientarão para o prognóstico (AU)

Insuficiência hepática aguda: etiologia e evolução clínica / Acute liver failure: etiology and clinical

A Insuficiência Hepática Aguda é uma condição grave associada à coagulopatia e alteração mental em pacientes sem doença hepática prévia. Pode ser causada por diversos agentes, tais como, vírus, auto-imunidade e drogas. A Hepatite Aguda B pode se apresentar sob a forma de doença grave e a indicação de transplante hepático deve ser considerada (AU)

Metástase óssea de hepatocarcinoma

O Hepatocarcinoma (HCC) é o quinto tumor sólido mais comum em todo o mundo e a terceira maior causa de mortalidade por câncer. A incidência do HCC não é uniforme, variando de acordo com a prevalência das doenças hepáticas subjacentes numa determinada região. Está bem estabelecido que as infecções crônicas pelo vírus B e C e a doença hepática alcoólica estão relacionadas ao HCC. O HCC pode ser diagnosticado em pacientes sem sinais clínicos de descompensação da doença hepática. A presença de metástase óssea está relacionada à doença mais avançada, comprometendo o prognóstico e a sobrevida destes pacientes

Relato de 7 casos de pacientes portadores de Hepatite B em acompanhamento no Ambulatório de Hepatologia do Hospital do Servidor Público Municipal

Vários estudos têm demonstrado a preocupação em relação ao HBV devido a sua evolução para formas crônicas e o aparecimento de hepatocarcinoma. Hoje temos um novo arsenal de medicamentos para diminuir a carga viral dos portadores HBV quando em atividade replicativa, sendo a carga viral extremamente importante, num futuro próximo os genótipos também orientarão para o prognóstico

Insuficiência hepática aguda: etiologia e evolução clínica

A Insuficiência Hepática Aguda é uma condição grave associada à coagulopatia e alteração mental em pacientes sem doença hepática prévia. Pode ser causada por diversos agentes, tais como, vírus, auto-imunidade e drogas. A Hepatite Aguda B pode se apresentar sob a forma de doença grave e a indicação de transplante hepático deve ser considerada

Effect of the aqueous extract of Hyptis pectinata on liver mitochondrial respiration.

Some studies have indicated that mitochondria may be the target organelle of plants. We therefore decided to assess the effects of the aqueous extract of Hyptis pectinata leaves on liver mitochondrial respiratory function in vitro. Eight rat livers were subjected to isolation of mitochondria by differential centrifugation. In an adequate medium, the plant extract was added at different concentrations. The analyzed data were: state 3, state 4 and respiratory control ratio (RCR). H. pectinata extract caused a statistically significant decrease in state 3 (at 0.05, 0.1 and 0.2 mg/mg protein) and RCR (at 0.05, 0.1 and 0.2 mg/mg protein). Respiratory state 4 was not altered by the increasing concentrations. In conclusion, the aqueous extract of H. pectinata leaves may not injure the mitochondrial inner membrane but decreases significantly the oxidative phosphorylation.

Efeitos do extrato aquoso da hyptis pectinata sobre a regeneraçäo hepática após hepatectomia parcial de 70 por cento: resultados preliminares / Effects of the aqueous extract of hyptis pectinata on liver regeneration after 70 percent partial hepatectomy: preliminary results

O uso de plantas medicinais tem aumentado bastante na populaçäo mundial. O objetivo desta pesquisa é avaliar os efeitos do extrato aquoso das folhas da Hyptis pectinata, popularmente conhecida como "sambacaitá" ou "canudinho", sobre a regeneraçäo hepática após hepatectomia parcial de 70 por cento. Foram utilizados 24 ratos, divididos em 4 grupos: grupo OS, em que se realizou operaçäo simulada e aplicaçäo oral de água destilada por 4 dias; grupo OSD200, também submetido à laparotomia com manipulaçäo do fígado e aplicaçäo de 200 mg de extrato/Kg de animal durante o mesmo período; grupo HP, hepatectomizado a 70 por cento após 4 dias de aplicaçäo por via oral de água destilada; e grupo HPD200, hepatectomizado a 70 por cento após 4 dias de administraçäo de 200 mg extrato/Kg de animal. Foram dosadas fosfatase alcalina, bilirrubina total e as aminotransferases e estudou-se o estado III da funçäo mitocondrial. O grupo OSD200, quando comparado ao OS, apresentou reduçäo significativa da fosfatase alcalina. O grupo HPD200, em comparaçäo ao HP, teve reduçäo estatisticamente significativa no nível da AST e do estado III da funçäo mitocondrial.

[Splenic cyst. Review of the literature and report of 2 cases]. / Cisto esplênico. Revisão da literatura e relato de dois casos.

Splenic cysts are rare lesions. By 1978, only 651 cases had been reported. Over the years, the management of splenic cysts has changed with advances in surgical techniques. The traditional treatment of these lesions has been splenectomy. The recognition of the post splenectomy complications has led to emphasis on conservation of splenic tissue. Nowadays, the tendency is to use splenic salvage techniques: partial splenectomy, partial splenic decapsulation and laparoscopic assistance. The purpose of this paper is to review the literature, and to report two cases of splenic cysts that were treated by the conservative method.