ABSTRACT Introduction: Existing literature presents varying perspectives on the impact of COVID-19 on liver transplant recipients. However, no research has specifically investigated the role of gender differences in the manifestation of COVID-19 among liver transplant recipients. This study aims to examine the effects of COVID-19 on liver transplant recipients, with a focus on gender differences in disease presentation and progression. Methods: Conducted as a multicenter historical cohort study, this research collected patient records through an online questionnaire. Assessing COVID-related mortality was the main objective. Additionally, demographic, clinical, and laboratory data pertaining to disease presentation and progression were collected. Results: The study included a total of 283 patients, of whom 76 were female and 206 were male. The median follow-up period for males was 99 days (IQR 38-283), while for females, it was 126 days (IQR 44-291). A higher prevalence of cardiovascular disease was observed in males (p=0.002). Females frequently experienced a loss of smell (p=0.021), whereas males commonly exhibited fever (p=0.031). Levels of ALT and gamma-glutamyl transferase were significantly elevated in males (p=0.008 and 0.004, respectively). Although there was a trend towards increased mortality in males, it did not reach statistical significance. Conclusion: This study is the first attempt to investigate gender differences in COVID-19 among liver transplant recipients. Our findings highlight the need for a comprehensive and personalised approach to treating this patient population and underscore the importance of further elucidating the disease presentation in these individuals. Introduction COVID19 COVID 19 COVID-1 recipients However Methods questionnaire COVIDrelated related objective Additionally demographic clinical Results 28 patients 7 20 male followup follow up 9 IQR 38283, 38283 38 , 38-283) females 12 44291. 44291 44 291 . 44-291) p=0.002. p0002 p p=0.002 0 002 (p=0.002) p=0.021, p0021 p=0.021 021 (p=0.021) p=0.031. p0031 p=0.031 031 (p=0.031) gammaglutamyl gamma glutamyl p=0.008 p0008 008 (p=0.00 0004 004 0.004 respectively. respectively respectively) significance Conclusion individuals COVID1 1 COVID- 2 3828 3 38-283 4429 4 29 44-291 p000 p=0.00 00 (p=0.002 p002 p=0.02 02 (p=0.021 p003 p=0.03 03 (p=0.031 (p=0.0 000 0.00 382 38-28 442 44-29 p00 p=0.0 (p=0.02 (p=0.03 (p=0. 0.0 38-2 44-2 p0 p=0. (p=0 0. 38- 44- p=0 (p= p= (p

RESUMO Introdução: A literatura existente apresenta perspectivas variadas sobre o impacto da COVID-19 em receptores de transplante de fígado. No entanto, nenhuma pesquisa investigou especificamente o papel das diferenças de gênero na manifestação da COVID-19 entre os receptores de transplante de fígado. Este estudo pretende examinar os efeitos da COVID-19 em receptores de transplante de fígado, com foco nas diferenças de gênero na apresentação e progressão da doença. Métodos: Conduzida como um estudo de coorte histórico multicêntrico, esta pesquisa coletou registros de pacientes por meio de um questionário on-line. O principal objetivo foi avaliar a mortalidade relacionada à COVID. Além disso, foram coletados dados demográficos, clínicos e laboratoriais relativos à apresentação e progressão da doença. Resultados: O estudo incluiu um total de 283 pacientes, sendo 76 do sexo feminino e 206 do sexo masculino. O período médio de acompanhamento para os homens foi de 99 dias (IQR 38-283), enquanto para as mulheres foi de 126 dias (IQR 44-291). Foi observada uma maior prevalência de doença cardiovascular nos homens (p=0,002). As mulheres frequentemente apresentavam perda de olfato (p=0,021), enquanto os homens geralmente apresentavam febre (p=0,031). Os níveis de ALT e gama-glutamil transferase foram significativamente elevados nos homens (p=0,008 e 0,004, respectivamente). Embora tenha havido uma tendência de aumento da mortalidade nos homens, ela não alcançou significância estatística. Conclusão: Este estudo é a primeira tentativa de investigar as diferenças de gênero na COVID-19 entre os receptores de transplante de fígado. Nossos achados destacam a necessidade de uma abordagem abrangente e personalizada para tratar essa população de pacientes e ressaltam a importância de elucidar melhor a apresentação da doença nesses indivíduos. Introdução COVID19 COVID 19 COVID-1 fígado entanto Métodos multicêntrico online. online on line. line on-line disso demográficos Resultados 28 7 20 masculino 9 IQR 38283, 38283 38 , 38-283) 12 44291. 44291 44 291 . 44-291) p=0,002. p0002 p p=0,002 0 002 (p=0,002) p=0,021, p0021 p=0,021 021 (p=0,021) p=0,031. p0031 p=0,031 031 (p=0,031) gamaglutamil gama glutamil p=0,008 p0008 008 (p=0,00 0004 004 0,004 respectivamente. respectivamente respectivamente) estatística Conclusão indivíduos COVID1 1 COVID- 2 3828 3 38-283 4429 4 29 44-291 p000 p=0,00 00 (p=0,002 p002 p=0,02 02 (p=0,021 p003 p=0,03 03 (p=0,031 (p=0,0 000 0,00 382 38-28 442 44-29 p00 p=0,0 (p=0,02 (p=0,03 (p=0, 0,0 38-2 44-2 p0 p=0, (p=0 0, 38- 44- p=0 (p= p= (p

Abstract In this study, we report the occurrence of multisystemic inflammatory syndrome among 64 children (2 deaths) with recent severe acute respiratory syndrome-related coronavirus 2 (SARS-COV-2) infections in the northeast region of Brazil. The major clinical symptoms and signs reported were exanthema (60.9%), abdominal pain (56.3%), nausea and vomiting (46.9%), diarrhea (37.5%), and dyspnea (37.5%). Laboratory findings revealed that the levels of C-reactive protein (75.0%), hemoglobin (51.6%), D-dimer (48.4%), lymphocytes (43.8%), LDH (45.3%), AST (42.2%), ALT (51.6%), and ferritin (48.4%) were above the reference values for a given age and gender. The clinical findings were similar to those observed in Kawasaki disease, although it represents a separate entity, emphasizing the need for proactive surveillance and early treatment.

Resumo Introdução A goiaba é um fruto amplamente utilizado como alimento e é considerada planta medicinal em países tropicais e subtropicais. Pesquisas têm mostrado que o fruto contém constituintes químicos com abrangente uso clínico. Além disso, a maior parte das substâncias utilizadas no tratamento contra câncer foi isolada a partir de produtos naturais. Objetivo Avaliar o potencial citotóxico, mutagênico, antimutagênico e quimioprotetor da fruta liofilizada de Psidium guajava, a goiaba, in vivo. Método A citotoxicidade, a mutagenicidade e a antimutagenicidade foram avaliadas em três diferentes dosagens (0,625, 1,25 e 2,50 g/kg) de goiaba. Resultados Os resultados mostraram que a goiaba não apresentou atividade citotóxica e mutagênica no ensaio de micronúcleo em sangue periférico e que não houve alterações nos valores de ALT e AST, indicando ausência de toxicidade hepática. Nos animais tratados com a goiaba, a dose de 0,625 mg/kg significativamente reduziu os danos induzidos pela doxorrubicina. Conclusão Esses resultados mostraram que o consumo de goiaba é seguro e capaz de proteger o material genético de alterações genômicas.

Abstract Background Guava is a fruit widely used as food and is considered a medicinal plant in the tropical and subtropical countries. Scientific research has shown that the fruit contains chemical constituents with comprehensive clinical use. In addition, most of the substances used in cancer treatment have been isolated from natural products. Objective To evaluate the cytotoxic, mutagenic, antimutagenic, and chemoprotective potential of the freeze-dried fruit of Psidium guajava, guava, in vivo. Method Cytotoxicity, mutagenicity, and antimutagenicity were evaluated in three different dosages (0.625, 1.25, 2.50 g/kg) of guava. Results The results show that guava does not present cytotoxic 2 and mutagenic activity in the micronucleus assay in peripheral blood and there were no alterations in ALT and AST values showing the absence of hepatic toxicity. In animals treated with guava, the dose of 0.625 mg/kg significantly reduced the damage induced by doxorubicin. Conclusion These results show that guava consumption is safe as it is also capable of protecting the genetic material from changes.

Abstract Purpose: To investigate the effects of capsiate treatment on hepatic hyperplasia in partially hepatectomized rats. Methods: The animals were divided into a Capsiate group (CPH), a Capsiate Post-Partial Hepatectomy group (CPPH) and a Partial Hepatectomy Control group (PH). CPH and CPPH animals received 60 mg/kg/day Capsiate for 30 days. Next, the rats underwent partial hepatectomy. CPPH animals continued to receive treatment for 48 h after partial hepatectomy. Liver tissue and intracardiac blood samples were obtained 24 or 48 h after PH. Results: Capsiate treatment interfered with hepatic parameters, reducing the number of mitoses and apoptosis and increasing blood ALT and alkaline phosphatase concentrations. Conclusion: Capsiate treatment preceding hepatic surgery may compromise the initial period of postoperative recovery.

The aim of this study was to investigate the effect of bark extract Bathysa cuspidata (BCE) in the reconstitution of hepatic parenchyma and stroma after dysfunction induced by the CCl4. Liver lesions were induced by intraperitoneal administration of CCl4 (1 mL/kg) every 48 h for 12 days. The animals were treated with B. cuspidata extract (BCE) administered by gavage for another 12 days. Forty-nine rats were randomized into seven treatment groups with seven animals receiving CCl4, BCE (200, or 400 mg/kg) and the vehicle DMSO alone, or in different combinations. The extract alone showed no evidence of hepatic toxicity. In general, rats acutely exposed to CCl4 without the treatment with BCE presented high ALT and AST serum levels and high tissue content of lipid hydroperoxides, malondialdehyde, and lipid droplets. BCE administration, especially at 400 mg/kg attenuated significantly all these parameters. Furthermore, the antioxidant activities of the enzymes superoxide dismutase and catalase were significantly increased in the groups receiving this extract. These results showed that the extract of B. cuspidata stem bark stimulated the antioxidant defense system and reduced the morphological and functional liver damage in Wistar rats previously exposed to CCl4.

Objetivo Avaliar as alterações pulmonares e hepáticas em dois modelos experimentais de cirrose hepática pelo uso de tetracloreto de carbono intraperitoneal (CCl4) e ligadura de ducto biliar. Métodos Vinte e quatro ratos machos Wistar foram divididos em grupo controle (CO) e experimental (EX). Foram avaliadas as transaminases hepáticas (AST, ALT, FA), gasometria arterial (PaO2, PCO2 e SatO2) e a lipoperoxidação através de TBARS (substâncias que reagem ao ácido tiobarbitúrico) e por quimiluminescência. Também foi avaliada a atividade antioxidante da enzima superóxido dismutase e a histologia do tecido pulmonar e hepático. Resultados Nas enzimas hepáticas (AST, ALT e FA), bem como na PaO2 foram observadas diferenças significativas (P≤0,05) entre os grupos CO vs EX em ambos modelos. Os níveis de TBARS, quimiluminescência e a atividade da enzima superóxido dismutase encontram-se aumentados nos grupos CCl4 e ligadura de ducto biliar: CO vs EX (P≤0,05). Na análise histológica do pulmão observamos um aumento na espessura da parede da artéria pulmonar e uma redução no diâmetro no modelo CCl4: CO vs EX, e no modelo de ligadura de ducto biliar podemos observar uma redução da espessura e aumento no diâmetro da parede da artéria pulmonar. Conclusão Ambos os modelos experimentais provocaram dano hepático, além de causar alterações na parede da artéria pulmonar contribuindo na redução das trocas gasosas.

Context To evaluate lung and liver changes in two experimental models using intraperitoneal carbon tetrachloride (CCl4) and bile duct ligation (BDL). Methods Twenty-four male Wistar rats were divided into a control group (CO) and an experimental group (EX). We evaluated the liver transaminases (AST, ALT, AP), arterial blood gases (PaO2, PCO2 and SpO2) and lipid peroxidation by TBARS (substances that react to thiobarbituric acid) and chemiluminescence. We also evaluated the antioxidant enzyme superoxide dismutase (SOD) and histology of lung tissue and liver. Results There were significant differences in AST, ALT, ALP and PaO2 between CO group and EX group (P<0.05). The levels of TBARS, chemiluminescence and activity of enzyme superoxide dismutase were increased to different degrees in the CCl4 groups: CO and in the BDL -EX (P<0.05, respectively). In the lung histology, an increase in the wall thickness of the pulmonary artery and a diameter reduction in the CCl4 animal model were observed: comparing CO group with EX group, we observed a reduction in thickness and an increase in the diameter of the artery wall lung. Conclusion Both experimental models have caused liver damage and alterations in the artery wall that are associated with major changes in pulmonary gas exchange.

OBJETIVO: Avaliar os efeitos da oxigenoterapia hiperbárica (OH) como método preventivo da lesão de isquemia e reperfusão (LIR) do fígado. MÉTODOS: Trinta e dois ratos machos Wistar foram distribuídos em quatro grupos de oito animais cada: A - laparotomia e manipulação hepática, B - isquemia e reperfusão hepática, C - pré-tratamento com OH por 60 minutos seguido de isquemia e reperfusão hepática e D - pré-tratamento com ar ambiente a 2,5 atmosferas absolutas por 60 minuto e isquemia e reperfusão hepática. Dosagens seriadas de AST, ALT e DHL foram realizadas. A pressão intra arterial foi monitorizada continuamente. O grau de infiltração leucocitária no fígado e pulmões foi inferido pela dosagem de mieloperoxidade tecidual. RESULTADOS: O nível sérico de AST, ALT e DHL aumentou em todos animais. Os animais expostos a OH apresentaram níveis de ALT e infiltração leucocitária hepática maior que os demais. A OH apresentou efeitos hemodinâmicos negativos durante a reperfusão hepática. CONCLUSÃO: O pré-condicionamento hepático por oxigenoteraia hiperbárica agrava a lesão de isquemia e reperfusão hepática em ratos.

PURPOSE: To evaluate the effects of hyperbaric oxygen (HO) therapy in the protection against liver ischemia/reperfusion injury. METHODS: Thirty-two male Wistar rats were divided into four groups of eight animals each: group A - laparotomy and liver manipulation, group B - liver ischemia and reperfusion, group C - HO pretreatment for 60 min followed by liver ischemia and reperfusion, and group D - pretreatment with ambient air at 2.5 absolute atmospheres for 60 min followed by liver ischemia and reperfusion. Plasma was assayed for aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH). Intra-arterial blood pressure was monitored continuously. Myeloperoxidase activity in the liver and lung was assessed 30 min after reperfusion. RESULTS: Plasma AST, ALT and LDH increased after reperfusion in all animals. Plasma ALT values and myeloperoxidase activity in the liver parenchyma were higher in HO-pretreated animals than in groups A, B and D. HO had a negative hemodynamic effect during liver reperfusion. CONCLUSION: Liver preconditioning with hyperbaric oxygen therapy aggravated liver ischemia/reperfusion injury in rats as demonstrated by plasma ALT and liver myeloperoxidase activity.

Some clear dissimilarities occur among the varieties of Cryptococcus neoformans but there are few studies about the differences among individual yeast antioxidant enzymes. The total superoxide dismutase (SOD) activities and the copper, zinc-depend SOD (Cu,ZnSOD) and manganese-dependent SOD (MnSOD) isoenzymes of five reference C. neoformans strains belonged to A, B, C, AD and D serotypes (<A HREF="/img/revistas/mioc/v101n1/a21t1.jpg">Table I</A>) and other nine C. neoformans isolates (<A HREF="/img/revistas/mioc/v101n1/a21t2.jpg">Table II</A>) were determined. There were significant differences (p < 0.01 and p < 0.05) in total SOD activity among the varietie gattii (serotype C) and the other varieties. Cu,ZnSOD showed difference (p < 0.05) between A and D serotypes. These results point out a variety and serotype-independent SOD activity in C. neoformans reference strains and the other isolates that were evaluated.

JUSTIFICATIVA E OBJETIVOS: A despeito dos benefícios do uso de hipnossedativos em Unidades de Terapia Intensiva pós-operatórias, não existe consenso sobre regime de uso ou quantificação da sedação. Este estudo avaliou o uso de sedativos e seus efeitos sobre o tempo de permanência na unidade pós-operatória do Hospital das Clínicas de São Paulo. MÉTODO: Oitenta e três pacientes que receberam sedação contínua foram estudados quanto aos agentes utilizados e respectivas doses, bem como os seguintes tempos: admissão-início da sedação (T INI), sedação (T SED), término da sedação-extubação (T EXT) e extubação-alta (T ALT). Avaliaram-se ainda a classificação da ASA e o nível da sedação pela escala de Ramsay. Os dados foram submetidos à ANOVA. RESULTADOS: Apenas os pacientes que receberam fentanil foram avaliados (n = 80). Destes, 34 receberam outro sedativo. T INI foi de 123,4 ± 369, T SED de 852,5 ± 1242,3, T EXT de 241,1 ± 156,6 e T ALT de 1433 ± 1734,4 minutos. Não houve diferença quanto à dose de sedativos segundo classificação da ASA (p = 0,11). Contudo, T ALT foi maior nos pacientes mais graves (p < 0,001). Pressão diastólica e Ramsay elevaram-se durante o decorrer da sedação (p < 0,001 e 0,028, respectivamente). CONCLUSÕES: O fentanil, complementado ou não por outros agentes, mostrou-se adequado quanto à qualidade da sedação e estabilidade hemodinâmica em terapia intensiva pós-operatória.

BACKGROUND AND OBJECTIVES: Despite the established benefits of sedatives in postoperative ICUs, there is no agreement on the optimal sedative regimen or the best way to evaluate sedation depth. This retrospective study aimed at evaluating sedative approaches and their effects on ICU stay in our Hospital. METHODS: Eighty-three continuously sedated patients were studied according to agent and doses used at the following moments: admission-start sedation (T INI), sedation (T SED), end of sedation-extubation (T EXT) and extubation-discharge (T DIS). In addition, ASA physical status and level of sedation according to Ramsay's score were registered. Data were submitted to ANOVA. RESULTS: Only patients receiving fentanyl were evaluated (N=80). From these, 34 have received another sedative. T INI was 123.4 ± 369, T SED was 852.5 ± 1242.3, T EXT was 241.1 ± 156.6 and T DIS was 1433 ± 1734.4 minutes. There were no differences on sedation doses versus ASA status (p = 0.11). Nevertheless, T DIS was higher in more critically ill patients (p < 0.001). Diastolic pressure and Ramsay score increased during sedation (p < 0.001 and 0.028, respectively). CONCLUSIONS: Fentanyl, complemented or not by other agents, was adequate for sedation and hemodynamic stability during postoperative intensive care.

JUSTIFICATIVA Y OBJETIVOS: A despecho de los beneficios del uso de hipnosedativos en Unidades de Terapia Intensiva pós-operatorias, no existe consenso sobre régimen de uso o cuantificación de la sedación. Este estudio evaluó el uso de sedativos y sus efectos sobre el tiempo de permanencia en la unidad pós-operatoria del Hospital de Clínicas de São Paulo. MÉTODO: Ochenta y tres pacientes que recibieron sedación continua fueron estudiados cuanto a los agentes utilizados y respectivas dosis, bien como los siguientes tiempos: admisión-início de la sedación (T INI), sedación (T SED), término de la sedación-extubación (T EXT) y extubación-alta (T ALT). Se evaluaron aún la clasificación de la ASA y el nivel de la sedación por la escala de Ramsay. Los datos fueron sometidos a la ANOVA. RESULTADOS: Apenas los pacientes que recibieron fentanil fueron evaluados (n = 80). De éstos, 34 recibieron otro sedativo. T INI fue de 123,4 ± 369, T SED de 852,5 ± 1242,3, T EXT de 241,1 ± 156,6 y T ALT de 1433 ± 1734,4 minutos. No hubo diferencia cuanto a la dosis de sedativos segundo clasificación de la ASA (p = 0,11). Sin embargo, T ALT fue mayor en los pacientes más graves (p < 0,001). Presión diastólica y Ramsay se elevaron durante el transcurrir de la sedación (p < 0,001 y 0,028, respectivamente). CONCLUSIONES: El fentanil, complementado o no por otros agentes, se mostró adecuado cuanto a la calidad de la sedación y estabilidad hemodinámica en terapia intensiva pós-operatoria.

To determine the hepatic profiles due to Toxoplasma gondii infection in rabbits, 15 animals were divided in three groups of five animals each. The first and second groups were inoculated subcutaneously with 10(6) and 10³ tachyzoites of T. gondii respectively, while the third was left as control. Blood samples were taken on days 0, 4, 8, e 11 after inoculation (DAI). Livers of each rabbit was analyzed in other to observed lesions. Hepathomegaly was observed in all of the infected groups, independently of the dose used, where was observed a significant increase of AST e ALT at 8th DAI. Tachyzoites were observed in all infected animals, and were reisolated in 90% of livers bioassed in mice. Histopathology was consisted by diffuse infiltration inflammatory, consisted mainly by lymphocytes at sinusoids e portal space. The increase of AST and ALT during acute toxoplasmosis in rabbits was justified by presence of tachyzoites in tissue smears associated with gross and histopathologic lesions

O óleo de copaíba é um óleo-resina empregado como fitoterápico na região Amazônica. Sua utilização se faz de forma empírica e pouco se conhece à respeito de seus efeitos sobre os sistemas orgânicos. Objetivo: Verificar os níveis séricos de aminotransferases, bilirrubinas e gama-glutamil transpeptidase após a administração do óleo. Métodos: Foram utilizados 20 ratos Wistar, machos, pesando entre 250 e 300g, distribuídos em 2 grupos: Grupo Cop (n=10) submetidos diariamente à gavagem com administração de 0,63ml/kg do óleo, por 5 dias; Grupo P (n=10), animais nos quais nenhuma substância foi administrada. Ao sexto dia, em ambos os grupos, procedeu-se anestesia inalatória e obtenção de 3ml de sangue da VCI para dosagem dos níveis séricos de ALT, AST, bilirrubinas e GGT. Resultados: Os resultados obtidos com o GCop foram comparados com os do GP e analisados estatisticamente pelo teste t -Student. O GCop apresentou níveis de ALT, AST e GGT significantemente mais baixos que o GP (p<0,01), enquanto os níveis de BT elevaram-se às custas da fração direta. Conclusão: O óleo de copaíba altera os níveis das aminotransferases, bilirrubinas e GGT, sem alterar os níveis da fração indireta.

Copaiba oil is a oil-resin used as a phytotherapic in Amazon region in a folkloric way. This use is empirical and little is known about its effect in the organic systems. Objective: To determine serum levels of aminotransferases, bilirrubins and gama-glutamyl transpeptidase after copaiba oil administration. Methods: Male Wistar rats (n=20) divided in two groups of 10 animals: Group Cop which received a daily oral administration of copaiba oil, 0.63ml/kg, during 5 days; Group P in which any substance was administrated. In the sixth day the animals of both groups were submitted to inalatory anesthesia, laparotomy and collection of blood samples (3ml) from inferior vena cava for the determination of serum aminotransferases, bilirrubins and gama-glutamyl transpeptidase levels. Results: The results were compared between groups and analyzed by t-Student test. Group Cop showed AST, ALT and GGT levels significantly decreased when compared with Gruop P (p<0.01), while total bilirrubins levels increased by its direct fraction. Conclusion: Copaiba oil can alter serum levels of aminotransferases, bilirrubins and gama-glutamyl transpeptidase, showing a possible interaction between this substance and liver, but this considerations require posterior evalutaion.