Sorafenib for Treatment of Hepatocellular Carcinoma: A Survival Analysis From the South American Liver Research Network.

GOALS: We aim to describe the efficacy, safety profile, and variables associated with survival in patients with hepatocellular carcinoma (HCC) treated with sorafenib in South America. BACKGROUND: Sorafenib has been shown to improve survival in patients with advanced HCC. There are few data on sorafenib use for HCC in South America. STUDY: We performed a retrospective analysis of HCC cases treated with sorafenib from 8 medical centers in 5 South American countries, between January 2010 and June 2017. The primary endpoint was overall survival (OS), which was defined as time from sorafenib initiation to death or last follow-up. Risk factors for decreased OS were assessed using Cox proportional hazard regression and log-rank tests. RESULTS: Of 1336 evaluated patients, 127 were treated with sorafenib and were included in the study. The median age of individuals was 65 years (interquartile range, 55 to 71) and 70% were male individuals. Median OS in all patients was 8 months (interquartile range, 2 to 17). Variables associated with survival on multivariate analysis were platelets >/<250,000 mm (2 vs. 8 mo, P=0.01) and Barcelona Clinic Liver Cancer (BCLC) stage (A/B, 13 vs. C/D, 6 mo; P=0.04). In a subanalysis of patients with BCLC stage C, platelets >/<250,000 mm were also independently associated with survival (2 vs. 5.5 mo, P=0.03). Patients lived longer if they experienced any side effects from sorafenib use (11 vs. 2 mo, P=0.009). Patients who stopped sorafenib because of side effects had shorter survival compared with patients who were able to tolerate side effects and continue treatment (7.5 vs. 13 mo, P=0.01). CONCLUSIONS: Pretreatment elevation of platelets and advanced BCLC stage were independently associated with poor survival on sorafenib in a South American cohort.

[Nosocomial urinary tract infection: an analysis beyond urinary catheterization]. / Epidemiología de las infecciones urinarias asociadas a catéter y no asociadas a catéter en un hospital universitario de tercer nivel.

INTRODUCTION: Nosocomially acquired urinary tract infections (NAUTI) represent an important public health issue, but its characteristics when they are not catheter associated (CA-UTI) or when they take place outside intensive care units (ICU) are poorly understood. OBJECTIVES: To determine the patients' characteristics, etiology and antimicrobial susceptibility of NAUTI, both CA-UTI and no CA-UTI, in general ward and ICU. METHODS: We conducted a retrospective analytic cross-sectional study, between 2009 and 2013, in a third level universitary hospital. All NAUTI episodes were identified, classifying them as CA-UTI and no CA-UTI. RESULTS: We included 253 episodes of NAUTI, being CA-UTI (60,9%) more frequent than no CA-UTI. A 37,4% of no CA-UTI and 59,7% of CA-UTI were identified in ICU. The most frequently isolated microorganisms were Escherichia coli, Klebsiella pneumoniae and Enterococcus sp. A 19% of extended spectrum betalactamase producing gram negative bacilli were found, without differences between groups. CONCLUSION: Patients's comorbidities, microorganisms associated to NAUTI and its antimicrobial susceptibility were similar in CA-UTI and no CA-UTI, as in general ward and ICU.

Kikuchi-Fujimoto disease and systemic lupus erythematosus.

Kikuchi-Fujimoto disease, or histiocytic necrotizing lymphadenitis, is an infrequent idiopathic disorder. It has been associated with autoimmune disorders, of which systemic lupus erythematosus is the most outstanding. The basis of its diagnosis relies on the histological examination of lymph nodes, which typically reveals necrosis surrounded by histiocytes with crescentic nucleus, immunoblasts and plasma cells, and absence of neutrophils. We report the case of a 27-year-old Argentinian female patient without any relevant past medical history to demonstrate the correlation between Kikuchi-Fujimoto disease and systemic lupus erythematosus.

Epidemiología de las infecciones urinarias asociadas a catéter y no asociadas a catéter en un hospital universitario de tercer nivel / Nosocomial urinary tract infection: an analysis beyond urinary catheterization

Resumen Introducción: Las infecciones urinarias asociadas a la atención de la salud (ITU-AAS) representan un importante problema sanitario, siendo poco conocidas sus características cuando no están asociadas a cateterización urinaria u ocurren fuera de unidades de cuidados intensivos (UCI). Objetivos: Determinar las características de los pacientes con ITU-AAS, etiología y susceptibilidad antimicrobiana de las mismas, tanto asociadas a catéter (ITU-C) como no asociadas a catéter (ITU-noC), en UCI y en sala general. Materiales y Métodos: Se realizó un estudio analítico retrospectivo de corte transversal entre 2009 y 2013 en un hospital universitario de tercer nivel. Se identificaron todos los episodios de ITU-AAS, diferenciándolas en ITU-C e ITU-noC. Resultados: Se incluyeron 253 episodios de ITU-AAS, siendo más frecuentes las ITU-C (60,9%) respecto a ITU-noC. Un 37,4% de ITU-noC y 59,7% de ITU-C ocurrieron en UCI. Los microorganismos aislados más frecuentemente fueron Escherichia coli, Klebsiella pneumoniae y Enterococcus sp. El 19% de los bacilos gramnegativos fueron productores de β-lactamasa de espectro extendido, siendo su frecuencia similar en ambos grupos. Conclusión: Las co-morbilidades de los pacientes con ITU-AAS, los agentes etiológicos responsables y sus correspondientes espectros de sensibilidad, fueron similares en los grupos de ITU-C e ITU-noC, tanto en sala general como en UCI.

Introduction: Nosocomially acquired urinary tract infections (NAUTI) represent an important public health issue, but its characteristics when they are not catheter associated (CA-UTI) or when they take place outside intensive care units (ICU) are poorly understood. Objectives: To determine the patients' characteristics, etiology and antimicrobial susceptibility of NAUTI, both CA-UTI and no CA-UTI, in general ward and ICU. Methods: We conducted a retrospective analytic cross-sectional study, between 2009 and 2013, in a third level universitary hospital. All NAUTI episodes were identified, classifying them as CA-UTI and no CA-UTI. Results: We included 253 episodes of NAUTI, being CA-UTI (60,9%) more frequent than no CA-UTI. A 37,4% of no CA-UTI and 59,7% of CA-UTI were identified in ICU. The most frequently isolated microorganisms were Escherichia coli, Klebsiella pneumoniae and Enterococcus sp. A 19% of extended spectrum betalactamase producing gram negative bacilli were found, without differences between groups. Conclusion: Patients's comorbidities, microorganisms associated to NAUTI and its antimicrobial susceptibility were similar in CA-UTI and no CA-UTI, as in general ward and ICU.

O fenômeno da estigmatização dos imigrantes haitianos em Lajeado no Rio Grande do Sul / The phenomenon of the stigmatization of haitian immigrants in Lajeado in Rio Grande do Sul

O presente artigo é produto de uma pesquisa cujo cerne principal buscou compreender o fenômeno da estigmatização que imigrantes haitianos residentes no município de Lajeado, na região do Vale do Taquari, no Rio Grande do Sul, recebem por parte de moradores locais estabelecidos. A pesquisa pretendia compreender em que medida os haitianos são estigmatizados por alguns moradores estabelecidos em Lajeado e quais são as formas de estigma que surgem neste processo. Tal pesquisa utilizou-se para a coleta de dados, instrumentos qualitativos entre eles a observação participante, entrevistas semiestruturadas individuais e também em grupo com moradores locais estabelecidos de todos os estratos sociais, assim como informações vinculadas pela mídia local através de matérias de jornais e programas de rádio.

This article is the product of a research that the main core is to understand the stigmatisation that Haitian immigrants residents in Lajeado in the region of Taquari Valley, Rio Grande do Sul receives by local residents established. The survey seeks to understand how the Haitians are stigmatized by some locals established in Lajeado and what are the forms of stigma that arise in this process. This research used as data collection, qualitative instruments including participant observation, individual semi-structured interviews and with group with local residents established, as well as information linked by local media through newspaper reports and radio programs.

O fenômeno da estigmatização dos imigrantes haitianos em Lajeado no Rio Grande do Sul / The phenomenon of the stigmatization of haitian immigrants in Lajeado in Rio Grande do Sul

O presente artigo é produto de uma pesquisa cujo cerne principal buscou compreender o fenômeno da estigmatização que imigrantes haitianos residentes no município de Lajeado, na região do Vale do Taquari, no Rio Grande do Sul, recebem por parte de moradores locais estabelecidos. A pesquisa pretendia compreender em que medida os haitianos são estigmatizados por alguns moradores estabelecidos em Lajeado e quais são as formas de estigma que surgem neste processo. Tal pesquisa utilizou-se para a coleta de dados, instrumentos qualitativos entre eles a observação participante, entrevistas semiestruturadas individuais e também em grupo com moradores locais estabelecidos de todos os estratos sociais, assim como informações vinculadas pela mídia local através de matérias de jornais e programas de rádio.(AU)

This article is the product of a research that the main core is to understand the stigmatisation that Haitian immigrants residents in Lajeado in the region of Taquari Valley, Rio Grande do Sul receives by local residents established. The survey seeks to understand how the Haitians are stigmatized by some locals established in Lajeado and what are the forms of stigma that arise in this process. This research used as data collection, qualitative instruments including participant observation, individual semi-structured interviews and with group with local residents established, as well as information linked by local media through newspaper reports and radio programs.(AU)

Molecular methods confirm the presence of the alien mussel Perna viridis Linnaeus, 1758 (Bivalvia, Mytilidae) in Southern Brazil

The mussel Perna viridis, commonly known as the green mussel, is native from the Indo-Pacific region and has been introduced in various sites around the globe. In Brazil, the species has already been recorded in Rio de Janeiro and Ceará states. With the aim of assessing the presence of mussels in the southern region of the country, 14 individuals were collected in the Paranaguá Estuarine Complex, Paraná. The mussels were found attached at a depth of 2 meters on the artificial structure of Ponta do Poço Marina. The DNA was extracted using a commercial kit, the COI gene was amplified through PCR by the primers forward dgLCO-1490 and reverse dgHCO-2198, sequenced by the Sanger method, assembled in CLC Genomics Workbench, and the species was identified through the BOLD Systems. The phylogenetic tree was built on MEGA11 using 28 sequences from three species within the genus Perna. Therefore, the present study represents the first to confirm the occurrence of the exotic species Perna viridis in Brazil through molecular identification and characterizes the third Brazilian state where the mollusk has been recorded. This indicates that Brazilian coastline provides optimal environmental conditions for the establishment and development of the P. viridis

El mejillón Perna viridis, comúnmente conocido como mejillón verde, es nativo de la región del Indo-Pacífico y ha sido introducido en varios lugares alrededor del mundo. En Brasil, la especie ya ha sido registrada en los estados de Río de Janeiro y Ceará. Con el objetivo de evaluar la presencia de mejillones en la región sur del país, se recolectaron 14 individuos en el Complejo Estuarino de Paranaguá, Paraná. Los mejillones fueron encontrados fijados a una profundidad de 2 metros en la estructura artificial de la Marina Ponta do Poço. El ADN fue extraído utilizando un kit comercial, el gen COI fue amplificado mediante PCR con los cebadores forward dgLCO-1490 y reverse dgHCO-2198, secuenciados mediante el método Sanger, ensamblados en CLC Genomics Workbench, y la especie fue identificada a través de los Sistemas BOLD. El árbol filogenético fue construido en MEGA11 utilizando 28 secuencias de tres especies dentro del género Perna. Por lo tanto, el presente estudio representa el primero en confirmar la presencia de la especie exótica Perna viridis en Brasil mediante identificación molecular y caracteriza al tercer estado brasileño donde el molusco ha sido registrado. Esto indica que el litoral brasileño proporciona condiciones ambientales ideales para el establecimiento y desarrollo del P. viridis.

O mexilhão Perna viridis, comumente conhecido como mexilhão-verde, é nativo da região do Indo-Pacífico e foi introduzido em vários locais ao redor do mundo. No Brasil, a espécie já foi registrada nos estados do Rio de Janeiro e Ceará. Com o objetivo de avaliar a presença de mexilhões na região sul do país, foram coletados 14 indivíduos no Complexo Estuarino de Paranaguá, Paraná. Os mexilhões foram encontrados fixados a uma profundidade de 2 metros na estrutura artificial da Marina Ponta do Poço. O DNA foi extraído usando um kit comercial, o gene COI foi amplificado por PCR pelos primers forward dgLCO-1490 e reverse dgHCO-2198, sequenciados pelo método Sanger, montados no CLC Genomics Workbench, e a espécie foi identificada através dos Sistemas BOLD. A árvore filogenética foi construída no MEGA11 usando 28 sequências de três espécies dentro do gênero Perna. Portanto, o presente estudo representa o primeiro a confirmar a ocorrência da espécie exótica Perna viridis no Brasil através de identificação molecular e caracteriza o terceiro estado brasileiro onde o molusco foi registrado. Isso indica que o litoral brasileiro fornece condições ambientais ideais para o estabelecimento e desenvolvimento do P. viridis.