Noninvasive Assessment of Portal Hypertension.

The progressive use of noninvasive tests (NITs) has changed the way hepatologists diagnose and manage patients with chronic liver disease, mainly because of their easiness to use and the ability to be repeated during follow-up. Liver stiffness measurement is the NIT with more scientific evidence. NITs have demonstrated to be useful to detect not only liver fibrosis but also the presence of clinically significant portal hypertension. Moreover, current evidence supports they can also be useful to evaluate the prognosis of patients with chronic liver disease.

Assessment of Modulating Effect of the Experimental Drug Astrabionorm on Synthesis of Proinflammatory Cytokine IL-1ß and Anti-Inflammatory Cytokine IL-10 in the Splenic Red Pulp Cells in a Mouse Model of Sepsis.

An indirect immunohistochemical method was used to study the production of proinflammatory (IL-1ß) and anti-inflammatory (IL-10) cytokines in the spleen cells of mature male C57BL/6 mice with an experimental model of sepsis and during treatment with a drug based on formic acid aldehyde (Astrabionorm). Clinical isolates of two strains of Pseudomonas aeruginosa were used. In the red pulp of the spleen, interleukin-positive cells represented by mononuclear forms were identified, as well as differences in the intensity of immunohistochemical staining of these cells for the studied interleukins in the two models used. A modulating role of the drug in the production of interleukins by the splenic red pulp cells during sepsis is assumed.

Non-invasive assessment of esophageal varices: Status of today.

With increasing burden of compensated cirrhosis, we desperately need non-invasive methods for assessment of clinically significant portal hypertension. The use of liver and spleen stiffness measurement helps in deferring unnecessary endoscopies for low risk esophageal varices. This would reduce cost and patient discomfort. However, these special techniques may not be feasible at remote areas where still we need only biochemical parameters. More prospective studies validating the non-invasive risk prediction models are definitely needed.

Pediatric splenic infarction: Assessment of associated clinical conditions and outcome.

Pediatric splenic infarction (SI) is rare yet clinically significant. Publications regarding this complication are mostly limited to case reports. This is a retrospective study examining SI etiology, clinical presentation, management, and outcomes among children. Twenty-two patients (median age: 7.9 years) were included, mostly with pre-existing hematological diseases. Splenomegaly (72%), thrombocytopenia, and anemia were common. Most of the patients did not receive antithrombotic therapy yet only two patients experienced recurrences. During follow up 36% of patients died, however no fatalities were attributed to thrombotic or bleeding complications.

Bulk RNA-seq Assessment of Murine Spleen Using a Portable MinION Sequencing Device.

Comprehensive profiling of the transcriptome reflects the dynamic changes in complex regulator interactions between genes and proteins in the pathological processes of autoimmune disease. To enable real-time adaptive sampling and run rapid sequencing with maximal expected readings of 50 Gb of data with accessibility to clinicians, basic researchers, and even students, a portable and affordable sequencing device, MinION, was employed in our laboratory for both basic and clinical studies. Here, the workflow of bulk RNA-seq in murine spleen using MinION is introduced. The methodology of both laboratory library preparation and the establishment of a bioinformatic pipeline are included in this chapter.

Histopathological and immunophenotypical assessment of canine primary splenic lymphoma according to the World Health Organization / Avaliação histopatológica e imunofenotípica segundo a classificação da Organização Mundial da Saúde do linfoma esplênico primário em cães

Although there are several studies addressing multicentric lymphoma in dogs, data regarding splenic lymphoma remains scarce. The diagnosis of splenic lymphoma using the World Health Organization (WHO) classification system can aid prognostic characterization of splenic lymphoma. The aim of this study was to evaluate the most common histological types of splenic lymphoma in dogs from Brazil according to the WHO classification. We assessed 33 cases of splenic lymphoma diagnosed by histopathologic and immunohistochemical (IHC) analysis submitted to VETPAT- Pathology Laboratory, Campinas-SP, Brazil. IHC was performed using antibodies against CD3 for T-cell and CD79α for B-cell identification . Mean age of patients with splenic lymphoma was 9.8 years. The most affected breeds were mixed breed dogs (33%) followed by Pit bulls and Yorkshires (9.0%). The most prevalent histological type was marginal zone B-cell lymphoma (60.7%) followed by diffuse large B-cell lymphoma (12.1%) and lymphoblastic T-cell lymphoma (12.1%). Histological and immunohistochemical characterization of splenic lymphoma is important due to the high prevalence of indolent lymphomas such as marginal zone, which may be less aggressive and thus have different prognostic and distinct forms of treatment when compared to high-grade lymphomas.(AU)

Embora existam diversos estudos a respeito do linfoma multicêntrico em cães, os dados sobre linfoma esplênico primário são escassos. O diagnóstico do linfoma esplênico utilizando a classificação da Organização Mundial da Saúde (OMS) pode melhorar a caracterização da doença. O objetivo do estudo foi avaliar os principais tipos de linfoma esplênico primário em cães no Brasil de acordo com a classificação da OMS. Foram avaliados 33 casos de linfoma esplênico diagnosticados por histopatologia e imuno-histoquímica submetidos ao Laboratório de Patologia Veterinária (VETPAT, Campinas/SP). A imuno-histoquímica foi realizada utilizando os anticorpos CD3 para linfomas T, CD79α para linfomas B. A média de idade dos pacientes com linfoma esplênico foi de 9,8 anos. Os animais sem raça definida (SRD) foram os mais acometidos (33%) seguidos de PitBulls e Yorkshire (9,0%). O tipo histológico mais comum foi o linfoma de zona marginal representando 60,7% dos casos seguido do linfoma difuso de grandes células B (12,1%) e linfoma linfoblástico T (12,1%). A caracterização histopatológica e imuno-histoquímica do linfoma esplênico é importante devido à alta prevalência de linfomas indolentes como o linfoma de zona marginal, que devido ao seu comportamento indolente apresenta prognóstico e tratamento distintos quando comparado aos linfomas de alto grau.(AU)

Avaliação ultra-sonográfica de nódulos sideróticos esplênicos em pacientes esquistossomóticos com hipertensão portal / Ultrasonographic assessment of splenic siderotic nodules in schistosomal patients with portal hypertension", "_i": "en

OBJETIVO: Medir a sensibilidade e a reprodutibilidade da ultra-sonografia na detecção de nódulos sideróticos esplênicos em pacientes esquistossomóticos, tendo a ressonância magnética como padrão de referência. MATERIAIS E MÉTODOS: Na primeira fase do trabalho, 21 pacientes portadores de esquistossomose na forma hepatoesplênica com diagnóstico de nódulos sideróticos à ressonância magnética foram submetidos a avaliação ultra-sonográfica para a determinação da sensibilidade do método. Na segunda fase, com o objetivo de avaliar a reprodutibilidade da ultra-sonografia na detecção e na quantificação de nódulos sideróticos (A: 1-5 nódulos; B: 6-20 nódulos; C: mais de 20 nódulos), outros 30 pacientes esquistossomóticos foram submetidos a avaliação ultra-sonográfica de forma cega e independente por dois observadores. A reprodutibilidade foi medida por meio da concordância entre os observadores e do teste kappa. RESULTADOS: A sensibilidade da ultra-sonografia foi de 95,2 por cento (intervalo de confiança a 95 por cento [77,3 por cento; 99,2 por cento]). A concordância entre ultra-sonografia e ressonância magnética para a detecção de nódulos sideróticos foi de 96,7 por cento (intervalo de confiança a 95 por cento [82,8 por cento; 99,9 por cento]). Para a classificação dos nódulos conforme a sua quantificação, o índice kappa demonstrou concordância interobservador substancial (kappa = 0,67). CONCLUSÃO: A ultra-sonografia é um método que apresenta elevada sensibilidade e boa precisão para a avaliação de nódulos sideróticos esplênicos.

OBJECTIVE: To evaluate ultrasound sensitivity and reproducibility as compared with magnetic resonance imaging as the gold standard in the detection of splenic siderotic nodules in schistosomal patients. MATERIALS AND METHODS: Initially, 21 patients with hepatosplenic schistosomiasis and diagnosed with splenic siderotic nodules by magnetic resonance imaging were ultrasonographically evaluated for determining the method sensitivity. In a second phase, the method reproducibility in the detection and quantification of siderotic nodules (A: 1-5 nodules; B: 6-20 nodules; C: > 20 nodules) was evaluated in 30 patients who were submitted to ultrasonography blindly and independently assessed by two observers. Interobserver agreement was measured by kappa statistics. RESULTS: Ultrasound sensitivity was 95.2 percent (95 percent confidence interval [77.3 percent; 99.2 percent]). Intermethod agreement in the detection of siderotic nodules was 96.7 percent (95 percent confidence interval [82.8 percent; 99.9 percent]). For classification of nodules according to their quantification, the kappa test demonstrated a statistically significant interobserver agreement (kappa = 0.67). CONCLUSION: Ultrasonography is highly sensitive and accurate in the assessment of splenic siderotic nodules in schistosomal patients.