Cultural Competence Interventions in European Healthcare: A Scoping Review.

Europe is undergoing rapid social change and is distinguished by its cultural superdiversity. Healthcare is facing an increasing need for professionals to adapt to this environment. Thus, the promotion of cultural competence in healthcare has become a priority. However, the training being developed and their suitability for the European context are not well known. The aim of this qualitative study has been to map the scientific literature in order to comprehend the current state of research on this topic. For this purpose, we conducted a systematic scoping review of the empirical publications focused on cultural competence interventions for healthcare professionals in European countries. The search was conducted in eight thematic (PsycINFO, MedLine, and PubPsych) and multidisciplinary databases (Academic Search Ultimate, E-Journals, Scopus, ProQuest, and Web of Science) to identify relevant publications up to 2023. Results were presented qualitatively. Out of the initial 6506 records screened, a total of 63 publications were included. Although the interventions were implemented in 23 different European countries, cultural competence interventions have not been widely adopted in Europe. Significant heterogeneity was observed in the conception and operacionalización of cultural competence models and in the implementation of the interventions. The interventions have mostly aimed at improving healthcare for minority population groups and have focused on the racial and ethnic dimensions of the individual. Future research is needed to contribute to the conceptual development of cultural competence to design programs tailored to European superdiversity. This scoping review has been registered in OSF and is available for consultation.

Determinación del conocimiento sobre lactancia materna en puérperas internadas en el Hospital Zonal General de Agudos Dr. A. Balestrini, Ciudad Evita, La Matanza / Determination of knowledge about breastfeeding in postpartum women hospitalized at the Hospital Zonal General Agudos Dr. A. Balestrini, Ciudad Evita, La Matanza

Resumen Introducción: la superioridad de la leche humana (LH) por sobre cualquier otro alimento en los primeros seis meses de vida, ya ha quedado bien demostrado a través de numerosos estudios científicos. Resulta importante investigar e indagar sobre el grado de conocimientos previos con los que cuentan las madres, con el fin de definir abordajes para futuras intervenciones. Objetivo: determinar el nivel de conocimiento sobre lactancia humana que poseen las madres puérperas que se encuentran en el área de internación de maternidad del H.Z.G.A Dr. A. Balestrini, Ciudad Evita, provincia de Buenos Aires. Materiales y método: estudio observacional, descriptivo y transversal. Realizado entre los meses de febrero y mayo inclusive del año 2021. Se estimó el conocimiento sobre LH a 134 puérperas que se encontraban internadas en la sala de maternidad a través de una entrevista estructurada realizada a pie de cama por licenciadas en Nutrición. Resultados: la media de edad fue de 25,8 (DE±5,5) años. El promedio de hijos fue 2,3. Más del 80% reconocía los beneficios de la LH para los recién nacidos. Sin embargo, solamente el 35,8% reconocía los beneficios de la LH para la madre. El 48,5% contestó que no existían riesgos para el recién nacido respecto del consumo de leche de vaca (LV). Las creencias populares más prevalentes fueron "el dolor durante la lactancia es normal" y "me quedé sin leche". Conclusión: se reconocían las prácticas generales de la lactancia como su exclusividad hasta los 6 meses y continuación hasta los dos años. Por otro lado, se observó que las mujeres identificaron los beneficios que otorga la LH al bebé y la superioridad de la misma sobre la LV. Sin embargo, esto no sucedió con aquellos beneficios de la LH para las puérperas y el riesgo del uso de la LV en el recién nacido.

Abstract Introduction: the superiority of breast milk (BM) over any other food in the first six months of life has already been well demonstrated through numerous scientific studies. It is important to research and inquire about the degree of prior knowledge that mothers have in order to define approaches for future interventions. Objective: to determine the level of knowledge about breastfeeding among postpartum mothers in the maternity ward of the H.Z.G.A. Dr. A. Balestrini, Ciudad Evita, province of Buenos Aires. Materials and method: observational, descriptive and cross-sectional study, carried out between February and May 2021. Knowledge about BF was estimated to 134 puerperal women, who were hospitalized in the maternity ward, through a structured interview conducted at the bedside by graduates in Nutrition. Results: the mean age was 25,8 (SD±5.5) years. The average number of children was 2.3. More than 80% recognized the benefits of BF for the newborns. However, only 35.8% recognized the benefits of BF for the mother. 48.5% answered that there were no risks for the newborn with respect to cow's milk consumption (CM). The most prevalent popular beliefs were "pain during breastfeeding is normal" and "I ran out of milk". Conclusion: it was evidenced that the exclusivity of BM up to 6 months and its continuation up to two years were recognized. On the other hand, it was observed that women identified the benefits granted by BM to the baby and its superiority over CM. However, this didn't happen with the benefits of BM for postpartum women and the risk of using CM in the newborn.

Prognostic value of ΔSYNTAX% score in octogenarians undergoing percutaneous coronary intervention / 老年心脏病学杂志（英文版）

OBJECTIVES@#To verify whether incomplete revascularisation (IR), quantified using the rSYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) score and ΔSYNTAX% score, could predict short- (in-hospital mortality) and long-term outcomes (12-month mortality) in octogenarians undergoing percutaneous coronary intervention (PCI).@*METHODS & RESULTS@#A retrospective analysis of 665 consecutive octogenarian patients presenting for PCI to a UK centre was performed. The baseline SYNTAX and rSYNTAX scores were assessed from angiographic images. ΔSYNTAX% score was calculated (ΔSYNTAX% = ((SYNTAX - rSYNTAX)/SYNTAX) × 100%)) to measure the relative completeness of revascularisation. Kaplan-Meier analysis assessed survival at 12 months by tertiles of rSYNTAX and ΔSYNTAX% scores. Increasing ΔSYNTAX% score was associated with reduced in-hospital mortality (P = 0.017), and improved survival benefit (log rank 14.8, P = 0.001) at 12 months.@*CONCLUSIONS@#Enhancing the completeness of revascularisation in octogenarians selected to undergo PCI is associated with a lower in-hospital mortality and a survival benefit at 12 months.

Psychological Contract Breach and Outcomes: A Systematic Review of Reviews.

A psychological contract is a set of individual beliefs that a person has about the reciprocal obligations and benefits established in an exchange relationship, such as an employment relationship in an organizational setting. A psychological contract breach is a subjective experience referred to the perception of one of the parties that the other has failed to adequately fulfill its obligations and promises. Breaches have been systematically connected to employees' attitudes and behaviors that hamper the employment relationship. Despite its apparent clarity, some relevant topics about psychological contract breach, psychological contract fulfillment and the relationships with their consequences still remain unclear. The main objective of this review of reviews is to conduct a review of reviews on psychological contract breaches, considering both systematic reviews and metanalytical papers with the purpose of synthesizing the evidence to date under the psychological contract theory. Using the SPIDER tool, our systematic review of reviews focuses on: (a) Sample; (b) Phenomenon of Interest; (c) Design; (d) Evaluation; and (e) Research type. Finally, only eight systematic reviews and meta-analyses met the inclusion criteria. Of the eight reviews included, seven were meta-analyses while the other was a systematic quantitative review. This study describes the available empirical research on psychological contract breaches and fulfillment and summarizes the meta-analytical evidence on their relationships with attitudinal and behavioral outcomes, as well as the role of potential moderator variables. Due to the methodological caveats of the reviews themselves and of the primary studies they were based on, our conclusions about the impact of psychological contract breaches on outcomes still remain tentative.

Tetraspanin CD82 restrains phagocyte migration but supports macrophage activation.

Phagocytes migrate into tissues to combat infection and maintain tissue homeostasis. As dysregulated phagocyte migration and function can lead to inflammation or susceptibility to infection, identifying molecules that control these processes is critical. Here, we show that the tetraspanin CD82 restrains the migration of neutrophils and macrophages into tissues. Cd82 -/- phagocytes exhibited excessive migration during in vivo models of peritoneal inflammation, superfusion of CXCL1, retinopathy of prematurity, and infection with the protozoan parasite L. mexicana. However, with the latter, while Cd82 -/- macrophages infiltrated infection sites at higher proportions, cutaneous L. mexicana lesions were larger and persisted, indicating a failure to control infection. Analyses of in vitro bone-marrow-derived macrophages showed CD82 deficiency altered cellular morphology, and impaired gene expression and metabolism in response to anti-inflammatory activation. Altogether, this work reveals an important role for CD82 in restraining phagocyte infiltration and mediating their differentiation in response to stimulatory cues.

Tetraspanin CD53 controls T cell immunity through regulation of CD45RO stability, mobility, and function.

T cells depend on the phosphatase CD45 to initiate T cell receptor signaling. Although the critical role of CD45 in T cells is established, the mechanisms controlling function and localization in the membrane are not well understood. Moreover, the regulation of specific CD45 isoforms in T cell signaling remains unresolved. By using unbiased mass spectrometry, we identify the tetraspanin CD53 as a partner of CD45 and show that CD53 controls CD45 function and T cell activation. CD53-negative T cells (Cd53-/-) exhibit substantial proliferation defects, and Cd53-/- mice show impaired tumor rejection and reduced IFNγ-producing T cells compared with wild-type mice. Investigation into the mechanism reveals that CD53 is required for CD45RO expression and mobility. In addition, CD53 is shown to stabilize CD45 on the membrane and is required for optimal phosphatase activity and subsequent Lck activation. Together, our findings reveal CD53 as a regulator of CD45 activity required for T cell immunity.

Leukocyte Tetraspanin CD53 Restrains α3 Integrin Mobilization and Facilitates Cytoskeletal Remodeling and Transmigration in Mice.

The importance of tetraspanin proteins in regulating migration has been demonstrated in many diverse cellular systems. However, the function of the leukocyte-restricted tetraspanin CD53 remains obscure. We therefore hypothesized that CD53 plays a role in regulating leukocyte recruitment and tested this hypothesis by examining responses of CD53-deficient mice to a range of inflammatory stimuli. Deletion of CD53 significantly reduced neutrophil recruitment to the acutely inflamed peritoneal cavity. Intravital microscopy revealed that in response to several inflammatory and chemotactic stimuli, absence of CD53 had only minor effects on leukocyte rolling and adhesion in postcapillary venules. In contrast, Cd53-/- mice showed a defect in leukocyte transmigration induced by TNF, CXCL1 and CCL2, and a reduced capacity for leukocyte retention on the endothelial surface under shear flow. Comparison of adhesion molecule expression in wild-type and Cd53-/- neutrophils revealed no alteration in expression of ß2 integrins, whereas L-selectin was almost completely absent from Cd53-/- neutrophils. In addition, Cd53-/- neutrophils showed defects in activation-induced cytoskeletal remodeling and translocation to the cell periphery, responses necessary for efficient transendothelial migration, as well as increased α3 integrin expression. These alterations were associated with effects on inflammation, so that in Cd53-/- mice, the onset of neutrophil-dependent serum-induced arthritis was delayed. Together, these findings demonstrate a role for tetraspanin CD53 in promotion of neutrophil transendothelial migration and inflammation, associated with CD53-mediated regulation of L-selectin expression, attachment to the endothelial surface, integrin expression and trafficking, and cytoskeletal function.

Tetraspanin CD53 Promotes Lymphocyte Recirculation by Stabilizing L-Selectin Surface Expression.

Tetraspanins regulate key processes in immune cells; however, the function of the leukocyte-restricted tetraspanin CD53 is unknown. Here we show that CD53 is essential for lymphocyte recirculation. Lymph nodes of Cd53-/- mice were smaller than those of wild-type mice due to a marked reduction in B cells and a 50% decrease in T cells. This reduced cellularity reflected an inability of Cd53-/- B and T cells to efficiently home to lymph nodes, due to the near absence of L-selectin from Cd53-/- B cells and reduced stability of L-selectin on Cd53-/- T cells. Further analyses, including on human lymphocytes, showed that CD53 stabilizes L-selectin surface expression and may restrain L-selectin shedding via both ADAM17-dependent and ADAM17-independent mechanisms. The disruption in lymphocyte recirculation in Cd53-/- mice led to impaired immune responses dependent on antigen delivery to lymph nodes. Together these findings demonstrate an essential role for CD53 in lymphocyte trafficking and immunity.

Sclerotherapy for Venous Malformations of Head and Neck: Systematic Review and Meta-Analysis / 신경중재치료의학

We performed a systematic review and meta-analysis of studies performing sclerotherapy for treatment of venous malformations (VMs) of the face, head and neck. It is our hope that data from this study could be used to better inform providers and patients regarding the benefits and risks of percutaneous sclerotherapy for treatment of face, head and neck VMs. We searched PubMed, MEDLINE, and EMBASE from 2000–2018 for studies evaluating the safety and efficacy of percutaneous sclerotherapy of neck, face and head VMs. Two independent reviewers selected studies and abstracted data. The primary outcomes were complete and partial resolution of the VM. Data were analyzed using random-effects meta-analysis. Thirty-seven studies reporting on 2,067 patients were included. The overall rate of complete cure following percutaneous sclerotherapy with any agent was 64.7% (95% confidence interval [CI], 57.4–72.0%). Sodium tetradecyl sulfate had the lowest complete cure rate at 55.5% (95% CI, 36.1–74.9%) while pingyangmycin had the highest cure rate at 82.9% (95% CI, 71.1–94.7%). Overall patient satisfaction rates were 91.0% (95% CI, 86.1–95.9%). Overall quality of life improvement was 78.9% (95% CI, 67.0–90.8%). Overall permanent morbidity/mortality was 0.8% (95% CI, 0.3–1.3%) with no cases of mortality. Our systematic review and meta-analysis of 37 studies and over 2,000 patients found that percutaneous sclerotherapy is a very safe and effective treatment modality for treatment of VMs of the head, neck and face.

Using Inquiry-Based Learning to Enhance Immunology Laboratory Skills.

A challenge in teaching immunology in the undergraduate laboratory is to encompass the many varied skills that need to be applied when performing an investigative study of such a complex area. It requires background knowledge, data analysis skills, critical thinking, and design capacities to include relevant controls and applications of particular techniques to answer a research question. It also requires strong technical skills. One such approach is to use inquiry-based learning which allows students a more proactive and integrative role in their learning. In one of our final year immunology units we have incorporated an inquiry-based exercise that runs across four 5-hour sessions. Students are given two cornerstone immunology techniques (ELISA and a flow cytometry-based cytokine bead array), which they use to formulate a study investigating inflammation. Stage one is to design the experiment with some guidance from teaching staff, stage two is to perform the experiment, and then finally students are required to analyze the data, apply appropriate statistics, and write a report outlining their findings. This approach provides students ownership of the process and allows them the opportunity to investigate a real-world problem rather than just attempting to obtain the expected "correct answer." Feedback from both students and staff has been positive with strong engagement and high quality reports produced.

Dendritic Cell Migration and Antigen Presentation Are Coordinated by the Opposing Functions of the Tetraspanins CD82 and CD37.

This study supports a new concept where the opposing functions of the tetraspanins CD37 and CD82 may coordinate changes in migration and Ag presentation during dendritic cell (DC) activation. We have previously published that CD37 is downregulated upon monocyte-derived DC activation, promotes migration of both skin and bone marrow-derived dendritic cells (BMDCs), and restrains Ag presentation in splenic and BMDCs. In this article, we show that CD82, the closest phylogenetic relative to CD37, appears to have opposing functions. CD82 is upregulated upon activation of BMDCs and monocyte-derived DCs, restrains migration of skin and BMDCs, supports MHC class II maturation, and promotes stable interactions between T cells and splenic DCs or BMDCs. The underlying mechanism involves the rearrangement of the cytoskeleton via a differential activation of small GTPases. Both CD37(-/-) and CD82(-/-) BMDCs lack cellular projections, but where CD37(-/-) BMDCs spread poorly on fibronectin, CD82(-/-) BMDCs are large and spread to a greater extent than wild-type BMDCs. At the molecular level, CD82 is a negative regulator of RhoA, whereas CD37 promotes activation of Rac-1; both tetraspanins negatively regulate Cdc42. Thus, this study identifies a key aspect of DC biology: an unactivated BMDC is CD37(hi)CD82(lo), resulting in a highly motile cell with a limited ability to activate naive T cells. By contrast, a late activated BMDC is CD37(lo)CD82(hi), and thus has modified its migratory, cytoskeletal, and Ag presentation machinery to become a cell superbly adapted to activating naive T cells.

Chemical and Sensory Quality Preservation in Coated Almonds with the Addition of Antioxidants.

Almonds provide many benefits such as preventing heart disease due to their high content of oleic fatty acid-rich oil and other important nutrients. However, they are susceptible to oxidation reactions causing rancidity during storage. The objective of this work was to evaluate the chemical and sensory quality preservation of almonds coated with carboxymethyl cellulose and with the addition of natural and synthetic antioxidants during storage. Four samples were prepared: almonds without coating (C), almonds coated with carboxymethyl cellulose (CMC), almonds coated with CMC supplemented with peanut skins extract (E), and almonds coated with CMC and supplemented with butylhydroxytoluene (BHT). Proximate composition and fatty acid profile were determined on raw almonds. Almond samples (C, CMC, E and BHT) were stored at 40 °C for 126 d. Lipid oxidation indicators: peroxide value (PV), conjugated dienes (CD), volatile compounds (hexanal and nonanal), and sensory attributes were determined for the stored samples. Samples showed small but significant increases in PV, CD, hexanal and nonanal contents, and intensity ratings of negative sensory attributes (oxidized and cardboard). C had the highest tendency to deterioration during storage. At the end of storage (126 d), C had the highest PV (3.90 meqO2 /kg), and BHT had the lowest PV (2.00 meqO2 /kg). CMC and E samples had similar intermediate PV values (2.69 and 2.57 meqO2 /kg, respectively). CMC coating and the addition of natural (peanut skin extract) and synthetic (BHT) antioxidants provide protection to the roasted almond product.

Tetraspanin CD37 contributes to the initiation of cellular immunity by promoting dendritic cell migration.

Previous studies on the role of the tetraspanin CD37 in cellular immunity appear contradictory. In vitro approaches indicate a negative regulatory role, whereas in vivo studies suggest that CD37 is necessary for optimal cellular responses. To resolve this discrepancy, we studied the adaptive cellular immune responses of CD37(-/-) mice to intradermal challenge with either tumors or model antigens and found that CD37 is essential for optimal cell-mediated immunity. We provide evidence that an increased susceptibility to tumors observed in CD37(-/-) mice coincides with a striking failure to induce antigen-specific IFN-γ-secreting T cells. We also show that CD37 ablation impairs several aspects of DC function including: in vivo migration from skin to draining lymph nodes; chemo-tactic migration; integrin-mediated adhesion under flow; the ability to spread and form actin protrusions and in vivo priming of adoptively transferred naïve T cells. In addition, multiphoton microscopy-based assessment of dermal DC migration demonstrated a reduced rate of migration and increased randomness of DC migration in CD37(-/-) mice. Together, these studies are consistent with a model in which the cellular defect that underlies poor cellular immune induction in CD37(-/-) mice is impaired DC migration.

Condiciones y medio ambiente de trabajo de los trabajadores del Hospital referente de área Vicente Agüero de Jesús María: 2011 / Conditions and working environment of workers in the area relating Hospital Vicente Jesús María Agüero: 2011

En las últimas décadas se han producido cambios significativos en las condiciones de trabajo y medio ambiente de trabajo (CyMAT) en la mayoría de los sectores y particularmente en salud, muchos de los cuales propiciaron la precarización de las condiciones de trabajo y la vulnerabilidad del empleo. En el país, el deficiente monitoreo de las CyMAT del personal de salud, ha condicionado negativamente la formulación de políticas y planes que favorezcan el desarrollo y la gestión de los Recursos Humanos en salud. El presente trabajo tiene como propósito indagar sobre las condiciones en que realizan su tarea los trabajadores del segundo nivel de atención de salud en Jesús María; partiendo del reconocimiento de una crisis de los recursos humanos en salud, lo cual trae aparejado consecuencias negativas para los sistemas de salud, a la vez que impone condiciones de trabajo inadecuadas en el sector. La investigación se plantea, como objetivo, reconocer las especificidades de las Condiciones y Medio Ambiente de Trabajo (CyMAT) de los trabajadores del Hospital referente de área Vicente Agüero de Jesús María y como objetivos específicos describir las condiciones de trabajo en el Hospital Vicente Agüero de la ciudad de Jesús María; caracterizar el ambiente de trabajo. Se desarrolló un estudio exploratorio, de corte transversal, donde se aplicó una encuesta previamente validada.

SUMMARY: In recent decades have been produced changes in working conditions and environment in most sectors, particularly in health many of which led to the precarious working conditions and employment vulnerability. In Argentina, the poor monitoring of health and safety in health care workers, has negatively conditioned the formulation of policies and plans that support the development and management of health human resources. This research aims to investigate the conditions under which workers perform their tasks in a public hospital belonging to the second level of health care, based on the recognition of a human resource crisis in health, which caused to negative consequences for health systems, as well as poor working conditions imposed on the sector. The study was conducted to recognize the specificities of Working Conditions and Environment (CyMAT) of workers in the referring Hospital Vicente Agüero located in the city of Jesus Maria. Specific objectives were aimed to describe the working conditions and characterize the working environment.

Condiciones y medio ambiente de trabajo de los trabajadores del Hospital referente de área Vicente Ag³ero de Jesús María: 2011 / Conditions and working environment of workers in the area relating Hospital Vicente Jesús María Ag³ero: 2011

En las últimas décadas se han producido cambios significativos en las condiciones de trabajo y medio ambiente de trabajo (CyMAT) en la mayoría de los sectores y particularmente en salud, muchos de los cuales propiciaron la precarización de las condiciones de trabajo y la vulnerabilidad del empleo. En el país, el deficiente monitoreo de las CyMAT del personal de salud, ha condicionado negativamente la formulación de políticas y planes que favorezcan el desarrollo y la gestión de los Recursos Humanos en salud. El presente trabajo tiene como propósito indagar sobre las condiciones en que realizan su tarea los trabajadores del segundo nivel de atención de salud en Jesús María; partiendo del reconocimiento de una crisis de los recursos humanos en salud, lo cual trae aparejado consecuencias negativas para los sistemas de salud, a la vez que impone condiciones de trabajo inadecuadas en el sector. La investigación se plantea, como objetivo, reconocer las especificidades de las Condiciones y Medio Ambiente de Trabajo (CyMAT) de los trabajadores del Hospital referente de área Vicente Ag³ero de Jesús María y como objetivos específicos describir las condiciones de trabajo en el Hospital Vicente Ag³ero de la ciudad de Jesús María; caracterizar el ambiente de trabajo. Se desarrolló un estudio exploratorio, de corte transversal, donde se aplicó una encuesta previamente validada.(AU)

SUMMARY: In recent decades have been produced changes in working conditions and environment in most sectors, particularly in health many of which led to the precarious working conditions and employment vulnerability. In Argentina, the poor monitoring of health and safety in health care workers, has negatively conditioned the formulation of policies and plans that support the development and management of health human resources. This research aims to investigate the conditions under which workers perform their tasks in a public hospital belonging to the second level of health care, based on the recognition of a human resource crisis in health, which caused to negative consequences for health systems, as well as poor working conditions imposed on the sector. The study was conducted to recognize the specificities of Working Conditions and Environment (CyMAT) of workers in the referring Hospital Vicente Ag³ero located in the city of Jesus Maria. Specific objectives were aimed to describe the working conditions and characterize the working environment.(AU)

Tetraspanins in cellular immunity.

Tetraspanins are a superfamily of integral membrane proteins involved in the organization of microdomains that consist of both cell membrane proteins and cytoplasmic signalling molecules. These microdomains are important in regulating molecular recognition at the cell surface and subsequent signal transduction processes central to the generation of an efficient immune response. Tetraspanins, both immune-cell-specific, such as CD37, and ubiquitously expressed, such as CD81, have been shown to be imp-ortant in both innate and adaptive cellular immunity. This is via their molecular interaction with important immune cell-surface molecules such as antigen-presenting MHC proteins, T-cell co-receptors CD4 and CD8, as well as cytoplasmic molecules such as Lck and PKC (protein kinase C). Moreover, the generation of tetraspanin-deficient mice has enabled the study of these proteins in immunity. A variety of tetraspanins have a role in the regulation of pattern recognition, antigen presentation and T-cell proliferation. Recent studies have also begun to elucidate roles for tetraspanins in macrophages, NK cells (natural killer cells) and granulocytes.

[Hepatoportal sclerosis associated with portal vein thrombosis in children: report of 3 cases]. / Esclerose hepatoportal associada à trombose de veia porta em crianças: relato de três casos.

Hepatoportal sclerosis is the term used to name a clinicopathological condition responsible for non-chirrotic portal hypertension. A three cases report of children with hepatoportal sclerosis is presented associated with portal vein thrombosis. The first two patients presented as main complaint upper digestive hemorrhage and the third one was admitted for investigation of hepatosplenomegaly. The ultrasonographic exam revealed alterations indicative of extrahepatic portal vein thrombosis in the three cases. The patients underwent liver biopsy for they had presented altered liver enzymes. The main histological findings were: subintimal sclerosis, portal fibrosis and telangiectases of the intrahepatic venous branches, consistent with the diagnosis of hepatoportal sclerosis. The three patients showed good evolution, being the hemorrhage controlled in the first two cases through esclerotherapy of esophageal varices.