Transient Elastography in Acute Cellular Rejection Following Liver Transplantation: Systematic Review.

BACKGROUND: Transient elastography (TE) is a noninvasive technique that measures liver stiffness. When an inflammatory process is present, this is shown by elevated levels of stiffness. Acute cellular rejection (ACR) is a consequence of an inflammatory response directed at endothelial and bile epithelial cells, and it is diagnosed through liver biopsy. This is a systematic review of the viability of TE in ACR following liver transplantation. METHODS: The Cochrane Library, Embase, and Medline PubMed databases were searched and updated to November 2016. The MESH terms used were "Liver Transplantation," "Graft Rejection," "Elasticity Imaging Techniques" (PubMed), and "Elastography" (Cochrane and Embase). RESULTS: Seventy studies were retrieved and selected using the PICO (patient, intervention, comparison or control, outcome) criteria. Three prospective studies were selected to meta-analysis and evaluation. A total of 33 patients with ACR were assessed with TE. One study showed a cutoff point of >7.9 kPa to define graft damage and <5.3 kPa to exclude graft damage (receiver operating characteristic 0.93; P < .001). Another study showed elevated levels of liver stiffness in ACR patients. However, in this study, no cutoff point for ACR was suggested. The final prospective study included 27 patients with ACR at liver biopsy. Cutoff points were defined as TE > 8.5 kPa, moderate to severe ACR, with a specificity of 100% and receiver operating characteristic curve of 0.924. The measurement of TE < 4.2 kPa excludes the possibility of any ACR (P = .02). CONCLUSIONS: TE may be an important tool for the severity of ACR in patients following liver transplantation. Further studies should be performed to better define the cutoff points and applicability of the exam.

Characterization of tomato leaf curl purple vein virus, a new monopartite New World begomovirus infecting tomato in Northeast Brazil.

A new begomovirus species was identified from tomato plants with upward leaf curling and purple vein symptoms, which was first identified in the Piaui state of Northeast (NE) Brazil in 2014. Tomato leaf samples were collected in 2014 and 2016, and PCR with degenerate primers revealed begomovirus infection. Rolling circle amplification and restriction enzyme digestion indicated a single genomic DNA of ~ 2.6 kb. Cloning and sequencing revealed a genome organization similar to DNA-A components of New World (NW) bipartite begomoviruses, with no DNA-B. The complete nucleotide sequence had the highest identity (80%) with the DNA-A of Macroptilium yellow spot virus (MacYSV), and phylogenetic analyses showed it is a NW begomovirus that clusters with MacYSV and Blainvillea yellow spot virus, also from NE Brazil. Tomato plants agroinoculated with a dimeric clone of this genomic DNA developed upward leaf curling and purple vein symptoms, indistinguishable from those observed in the field. Based on agroinoculation, this virus has a narrow host range, mainly within the family Solanaceae. Co-inoculation experiments with tomato severe rugose virus and tomato mottle leaf curl virus, the two predominant begomoviruses infecting tomato in Brazil, revealed a synergistic interaction among these begomoviruses. The name Tomato leaf curl purple vein virus (ToLCPVV) is proposed for this new begomovirus.

Detecção molecular e isolamento de Mycoplasma spp. em psitacídeos no estado de Pernambuco, Brasil / Molecular detection and isolation of Mycoplasma spp. in psittacines in Pernambuco state, Brazil

Objetivou-se com este estudo investigar a ocorrência de Mycoplasma spp., Mycoplasma galissepticum (MG) e Mycoplasma synoviae (MS) em psitacídeos de cativeiro localizado no estado de Pernambuco, Brasil. Foram estudadas 85 aves provenientes do Parque Estadual Dois Irmãos, localizado no estado do Pernambuco, Brasil. De cada psitacídeo analisado foram obtidas três amostras por meio de swabs da cloaca, palato e conjuntiva totalizando 255 amostras. As amostras coletadas foram submetidas à extração de DNA e à reação em cadeia da polimerase (PCR), sendo as positivas submetidas ao isolamento em ágar Frey. O DNA de Mycoplasma spp. foi detectado em 16,47% (14/85) dos psitacídeos estudados. Das 255 amostras analisadas, 6,66% (17/255) foram positivas para a presença de Mycoplasma spp., sendo 41,18% (7/17) provenientes da conjuntiva, 35,29% (6/17) do palato e 23,53% (4/17) da cloaca. Nenhuma amostra foi positiva para MG ou MS na PCR. Os resultados obtidos permitem confirmar a presença do DNA de Mycoplasma spp. em conjuntiva, palato e cloaca nas aves estudadas. Foram detectadas colônias semelhantes a membros da classe Mollicutes em 17,64% das amostras (3/17). Esse é o primeiro relato da presença de Mycoplasma spp. em psitacídeos de cativeiro no Nordeste do Brasil.

The aim of this study was to investigate the occurrence of Mycoplasma spp., Mycoplasma galissepticum (MG) and Mycoplasma synoviae (MS) in captive psittacines. Eighty-five wild birds from Parque Estadual Dois Irmãos, Pernambuco state, northeastern Brazil, were used. From each psittacid analyzed three samples were obtained through cloaca, palate and conjunctiva swabs, totaling 255 samples. Samples collected were submitted to DNA extraction and Polimerase Chain Reaction (PCR). Mycoplasma spp. DNA was detected in 16.47% (14/85) of psittacines studied. From 255 samples, 6.66% (17/255) were positive for Mycoplasma spp.: 41.18% (7/17) of positivity in conjunctiva, 35.29% (6/17) in palate and 23.53% (4/17) in cloaca. There was no positive sample for MG or MS in PCR. Similar colonies were found for members of the Mollicutes Class in 17.64% of the samples (3/17). The results confirmed Mycoplasma spp. DNA in conjunctiva, palate and cloaca from the wild birds analyzed. This is the first record of Mycoplasma spp. in captive psittacines from northeastern Brazil.

Characterization of tomato yellow vein streak virus, a begomovirus from Brazil.

Tomato yellow vein streak virus (ToYVSV) is a tentative begomovirus (Family Geminiviridae) species that seriously affects tomato and potato production in Brazil. Here, we have determined the genomic and biological characteristics of a ToYVSV isolate (Ba3) from a potato plant sampled in Rio Grande do Sul State, Brazil. The DNA-A nucleotide sequence of Ba3 and another previously reported ToYVSV isolate share 89.7% sequence identity. These ToYVSV isolates should be classified as a new species in that they are most closely related to Soybean blistering mosaic virus with which they share only approximately 80% identity. Cloned constructs containing 1.5 mer copies of the ToYVSV genomic components were found, by biolistic bombardment, to be infectious in at least 11 plant species in 2 families (Solanaceae and Malvaceae). Symptoms on tomato and potato plants were identical to those originally observed on field-infected plants. ToYVSV was also sap-transmissible from Nicotiana benthamiana to N. benthamiana and tomato, but not to potato plants.

Referências hematológicas para a jararaca de rabo branco (Bothrops leucurus) recém capturadas da natureza / Hematological references for wild recently-caught white-tailed lancehead (Bothrops leucurus)

The hematological values for the specie Bothrops leucurus, recently captured from nature, were determined from blood samples of 29 snakes (11 males and 18 females). The performed hematological tests were: total red blood cell count (TRBCC), total white blood cell count (TWBCC), total trombocyte blood cell count (TTBCC); packed cell volume (PCV); hemoglobin content; and mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC). The mean values for TRBCC was 4.23cellsx10(5)/mm³, for TWRCC was 8.92cellsx10³/mm³ and for TTBCC was 8.60cellsx10³/mm³. The mean for packed cell volume was 22.3 percent. The intraerythrocytic hemoparasite Hepatozoon sp was found on 58.6 percent of the studied animals.

[Thrombolytic therapy in deep venous thrombosis. Initial clinical experience]. / Terapia trombolítica em trombose venosa profunda. Experiência clínica inicial.

Four cases of proximal deep venous thrombosis treated with streptokinase and tissue plasminogen activator are reported. Therapy monitorization was performed by ultrasonography with color Doppler and thrombolytic agents were used by venous infusion. There was complete lysis in two cases, and the mean rate of venous recanalization was 88%. Reversible hemorrhagic complications were observed in two patients, and late ultrasonographic control (after six months) demonstrated venous insufficiency in one case.

[Mesenteric venous thrombosis after azygos-portal disconnection with splenectomy for the treatment of bleeding esophageal varices in mansonian schistosomiasis. Three cases reports]. / Trombose mesentérica após a desconexão ázigo-portal com esplenectomia para o tratamento das varizes esofageanas sangrantes na esquistossomose mansônica, relato de três casos.

The consequence of an acute mesenteric venous thrombosis following porta-azygos disconnection for the treatment of bleeding esophageal varices due to mansonian schistosomiasis has not been well defined in the literature. The clinical manifestations reported were fever, spasmodic abdominal pain associated with food intake. We treated three patients with thrombosis of the portal-mesenteric trunk following porta-azygos disconnection and adopted a conservative clinical approach in two patients while one had to have a surgical small bowel ressection.

Liver anatomy applied to the placement of transjugular intrahepatic portosystemic shunts.

PURPOSE: To study the vascular and biliary liver anatomy and its relevance to the creation of a transjugular intrahepatic portosystemic shunt (TIPS). MATERIALS AND METHODS: Acrylic casts of 25 normal human livers (necropsy specimens) were obtained. The anatomy of the hepatic veins, portal vein, hepatic artery, and bile ducts and the relationship of structures of the portal triad were evaluated. Diameters of the vessels and distances and relative position of the structures were recorded. Special attention was given to the puncture path used for TIPS. RESULTS: One right hepatic vein (RHV) was seen in 16 cases, two RHVs in one, and an accessory RHV in six. All were posterior to the portal bifurcation. The mean distance between the RHV and the portal bifurcation was 4.4 cm. In 13 cases, the path for TIPS puncture was free of major vascular and biliary structures. In 12 cases, portal, biliary, and/or arterial structures were seen in the puncture path. CONCLUSION: TIPS puncture should be performed in the postero-inferior aspect of the right portal trunk or at the posterior aspect of the bifurcation of the portal vein. Knowledge of the vascular liver anatomy is imperative to create the TIPS safely.

[Splenic abscess: report of 8 cases and review of the literature]. / Abscesso esplênico: relato de oito casos e revisão da literatura.

Eight patients with splenic abscess are reported. Etiological factors were sepsis, mainly due to endocarditis. Diagnosis was made by ultrasonography and computed tomography scans. Splenectomy was performed in four cases, transcutaneous drainage in three and abscess puncture in one case. Mortality was 12.5% (1/8). Since the introduction of US and CT scans early diagnosis and treatment was possible by which the mortality decreased.

[Portal thrombosis: early complication of azygo-portal disconnection in the treatment of bleeding esophageal varices]. / Trombose portal: complicação precoce da desconexão ázigo-portal no tratamento das varizes esofagianas sangrantes.

The authors studied 30 patients with bleeding from esophageal varices due to portal hypertension. They underwent the disconnection of portal and azygos veins and splenectomy. The immediate postoperative complications were: portal thrombosis in four patients (13.3%); subphrenic abscess in two (6.6%); pulmonary embolism in one (3.3%) and esophageal perforation in one (3.3%). The manifestations of portal thrombosis were ascites, and fever (without leukocytosis). One patient with portal thrombosis who had intractable ascite was submitted to peritoneovenous shunting.