Abstract Background: Chronic hepatitis B is a major cause of cirrhosis, and the natural history of the disease has several clinical stages that should be thoroughly understood for the implementation of proper treatment. Nonetheless, curing the disease with antiviral treatment remains a challenge. Aims: To describe the clinical course, response to treatment, and poor prognostic factors in 247 hepatitis B virus chronic infection patients treated in a tertiary hospital in Brazil. Methods: This was a retrospective and observational study, by analyzing the medical records of HBV infected patients between January 2000 and January 2015. Results: Most patients were male (67.2%) and 74.1% were HBeAg negative. Approximately 41% had cirrhosis and 8.5% were hepatitis C virus coinfected. The viral load was negative after two years on lamivudine, entecavir and tenofovir in 86%, 90.6%, and 92.9% of the patients, respectively. The five-year resistance rates for lamivudine, adefovir, entecavir, and tenofovir were 57.5%, 51.8%, 1.9%, and 0%, respectively. The overall seroconversion rates were 31.2% for HBeAg and 9.4% for HBsAg. Hepatocellular carcinoma was diagnosed in 9.7% of patients, liver transplantation was performed in 9.7%, and overall mortality was 10.5%. Elevations of serum alanine aminotransferase (p = 0.0059) and viral load (p < 0.0001) were associated with progression to liver cirrhosis. High viral load was associated with progression to hepatocellular carcinoma (p < 0.0001). Significant risk factors associated with death were elevated alanine aminotransferase (p = 0.0039), liver cirrhosis (p < 0.0001), high viral load (p = 0.007), and hepatocellular carcinoma (p = 0.0008). HBeAg positive status was not associated with worse outcomes, and treatment may have been largely responsible. Conclusions: Elevations of viral load and serum alanine aminotransferase may select patients with worse prognosis, especially progression to cirrhosis and hepatocellular carcinoma, which were strongly association with death.

RESUMO: Objetivou-se, com a pesquisa, avaliar os efeitos clínicos e microscópicos da associação do omento de coelho com a membrana amniótica (AM) canina, na ceratoplastia lamelar em coelhos. Dois grupos foram constituídos: um recebeu enxerto de omento alógeno livre, recoberto por AM (grupo OM- graft); o outro recebeu enxerto de AM contendo células mesenquimais derivadas do omento (grupo OM-cell). Manifestações clínicas foram avaliadas em diferentes tempos de pós-operatórios. Após as avaliações clínicas, coelhos foram submetidos à eutanásia e córneas foram colhidas para histopatologia e imunohistoquímica (Ki-67, marcador de proliferação). Relativamente às manifestações clínicas, ambos os grupos apresentaram sinais de quemose, blefarospasmo, secreção ocular, hiperemia e opacidade/edema. Neovascularização foi observada no grupo OM-cell. Avaliações à histopatologia mostraram que uma amostra de OM-cell apresentou ilhas de epitélio dentro do estroma. Aos 30 dias de pós-operatório, observou-se reepitelização corneal completa, em OM-graft e OM-cell. O grupo OM-cell apresentou mais células positivas para Ki-67. O omento livre e suas células, associados à AM, contribuíram para a reparação corneal, que se completou após 30 dias de ceratoplastia lamelar.

ABSTRACT: The objective of this research was to evaluate the clinical and microscopic effects in rabbits of lamellar keratoplasty using allogeneic omentum associated with canine amniotic membrane (AM). Rabbits were divided into two groups: one received the allogeneic free omental graft covered with the AM (OM-graft group), while the other received the AM graft containing omental mesenchymal cells (OM-cell group). Clinical signs were evaluated on different postoperative days. After the clinical assessments, the rabbits were euthanized and their corneas were obtained for histopathology and immunohistochemistry (Ki-67, marker for proliferation). Both groups showed chemosis, blepharospasm, eye discharge, hyperemia, and corneal opacity/edema. Neovascularization was observed in the OM-cell group. Histopathological evaluation revealed epithelial islands within the stroma of OM-cell samples. Thirty days after surgery, complete corneal re-epithelialization had occurred in both groups. The OM-cell group showed more Ki-67 positive cells. The free omentum and its cells, combined with the AM, contributed to corneal repair, a process that was completed 30 days after lamellar keratoplasty.

RESUMO O carcinoma hepatocelular é uma neoplasia de importância global e associada a altos índices de mortalidade. Recentes avanços no diagnóstico e tratamento da doença tornaram necessárias que se atualizassem as recomendações sobre o manejo da doença. Para definir as recomendações sobre o diagnóstico e tratamento do carcinoma hepatocelular, a Sociedade Brasileira de Hepatologia organizou uma reunião monotemática em João Pessoa (PB). Todos expositores foram solicitados a fazer uma revisão sistemática da literatura e apresentar os temas relacionados a fatores de risco para o desenvolvimento de carcinoma hepatocelular, métodos para rastreamento, diagnóstico radiológico e sistemas de estadiamento da doença, tratamentos curativos e paliativos e carcinoma hepatocelular em fígado não cirrótico. Após o encontro, todos os expositores se reuniram para discussão dos tópico e elaboração dessas recomendações. O texto resultante foi ainda submetido a avaliação e aprovação por todos membros da Sociedade através de sua homepage. O documento atual é a versão final que contêm as recomendações da Sociedade Brasileira de Hepatologia.

ABSTRACT Hepatocellular carcinoma is a malignancy of global importance and is associated with a high rate of mortality. Recent advances in the diagnosis and treatment of this disease make it imperative to update the recommendations on the management of the disease. In order to draw evidence-based recommendations concering the diagnosis and management of hepatocellular carcinoma, the Brazilian Society of Hepatology has sponsored a single-topic meeting in João Pessoa (PB). All the invited pannelists were asked to make a systematic review of the literature and to present topics related to the risk factors for its development, methods of screening, radiological diagnosis, staging systems, curative and palliative treatments and hepatocellular carcinoma in noncirrhotic liver. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of those recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present paper is the final version of the reviewed manuscript containing the recommendations of the Brazilian Society of Hepatology.

O objetivo do estudo foi determinar se o anel de tensão capsular (ATC), isoladamente ou associado à implantação de uma lente intraocular, poderia diminuir a ocorrência de opacificação da cápsula posterior (OCP) após a cirurgia de catarata por facoemulsificação em cães. Para tanto, cães portadores de catarata imatura ou madura foram avaliados, perfazendo um total de vinte olhos. Em todos os animais, foram excluídas quaisquer doenças oftálmicas e sistêmicas concomitantes. Os olhos foram selecionados aleatoriamente para receber o anel (ATC) isolado ou em associação com a lente. Flaremetria a laser e avaliações clínicas foram realizadas aos 2, 7, 14, 21, e 28 dias de pós-operatório. Fotografias foram tomadas aos 28 e a seguir a cada 30 dias, até os 180 dias. Os resultados mostraram inflamação mais importante nos olhos com IOL, embora, entre os parâmetros avaliados, apenas nas sinéquias houve diferença estatisticamente significativa. No entanto, em ambas as técnicas, quase nenhuma OCP ocorreu até o momento final das avaliações. Tais resultados sugerem que os anéis de tensão capsular (ATC) podem ser úteis na prevenção da opacidade capsular pós-operatória, sem complicações decorrentes

The purpose of the study was to determine whether capsular tension ring (CTR) alone or associated with the implantation of an intraocular lens (IOL) could decrease the occurrence of posterior capsular opacification (PCO) after phacoemulsification cataract surgery in dogs. Twenty eyes of client-owned dogs with immature or mature cataracts were included in this study. In all the animals, any ophthalmic or systemic concurrent disease was excluded. The eyes were randomly selected to receive CTR alone or in association with the IOL. Laser flaremetry and clinical evaluations were conducted on post-operative days 2, 7, 14, 21 and 28. Fundus photographs were taken at the 28th and then every 30 days, up to 180 days. The results showed more inflammatory response on eyes with IOLs, although among the parameters evaluated, solely the synechiae showed significant statistical differences. Nevertheless, in both techniques almost no PCOs occurred at the end of the evaluations. These results suggest that the CTRs can be useful in the prevention of the post-operative capsular opacities, with minor complications