Human polyclonal anti-hepatitis B surface antigen immunoglobulin reduces the frequency of acute rejection after liver transplantation for chronic hepatitis B

BACKGROUND: Use of polyclonal anti-hepatitis B surface antigen immunoglobulin (HBIg) has been shown to reduce hepatitis B virus (HBV) recurrence after liver transplantation (LT) and to decrease the frequency of acute cellular rejection (ACR). However, the protective role of HBIg against ACR remains controversial, since HBV infection has been also associated with a lower incidence of ACR. AIM: To assess the relationship between HBIg immunoprophylaxis and the incidence of rejection after LT. METHODS: 260 patients (158 males, 43 ± 14 years old) submitted to LT were retrospectively evaluated and divided into three groups, according to the presence of HBsAg and the use of HBIg. Group I was comprised of HBsAg-positive patients (n = 12) that received HBIg for more than 6 months. Group II was comprised of HBsAg-positive patients that historically have not received HBIg or have been treated irregularly for less than 3 months (n = 10). Group III was composed of 238 HBsAg-negative subjects that have not received HBIg. RESULTS: HBIg-treated patients (group I) had significantly less ACR episodes, when compared to group II and III. No differences between groups II and III were observed. CONCLUSIONS: Long-term HBIg administration contributes independently to reduce the number of ACR episodes after LT.

Confluent peripheral multiple mononeuropathy associated to acute hepatitis B: a case report

A thirty three year-old, male patient was admitted at the Hospital of the São Paulo University School of Medicine, at the city of São Paulo, Brazil, with complaint of pains, tingling and decreased sensibility in the right hand for the last four months. This had progressed to the left hand, left foot and right foot, in addition to a difficulty of flexing and stretching in the left foot. Tests were positive for HBeAg, IgM anti-HBc and HBsAg, thus characterizing the condition of acute hepatitis B. The ALT serum level was 15 times above the upper normal limit. Blood glucose, cerebral spinal fluid, antinuclear antibodies (ANA) and anti-HIV and anti-HCV serum tests were either normal or negative. Electroneuromyography disclosed severe peripheral neuropathy with an axon prevalence and signs of denervation; nerve biopsy disclosed intense vasculitis. The diagnosis of multiple confluent mononeuropathy associated to acute hepatitis B was done. This association is not often reported in international literature and its probable cause is the direct action of the hepatitis B virus on the nerves or a vasculitis of the vasa nervorum brought about by deposits of immune complexes.

Produção de sideróforo pela bactéria Bacillus megaterium

Os agentes quelantes, como é o caso do EDTA, são utilizados numa ampla variedade de indústrias como a indústria têxtil, da pasta de papel, alimentar, de cosméticos ou de detergentes. Contudo, os agentes complexantes sintéticos, habitualmente usados, não são biodegradáveis, pelo que a sua acumulação no meio ambiente constitui motivo de preocupação. Deste modo, existe um interesse crescente na substituição destes compostos por compostos similares biodegradáveis sendo, deste modo, ambientalmente amigáveis. Alguns microrganismos são capazes de produzir moléculas com capacidade de captar metais. Um desses exemplos são os sideróforos: compostos produzidos por bactérias, fungos e plantas gramíneas, com capacidade de formar quelatos muito estáveis com o ferro. A presente dissertação teve como objetivo estudar o efeito de diferentes condições culturais e nutricionais na produção de sideróforo pela bactéria Bacillus megaterium. A avaliação da produção de sideróforo, utilizando o método colorimétrico Chrome Azurol S (CAS), durante o crescimento da bactéria, em meio de cultura deficiente em ferro, na presença de 5 ou de 20 g/L de glucose, mostrou que o início da sua produção ocorre, durante a fase exponencial de crescimento, não está relacionada com a esporulação e não é afetada pela concentração de glucose. Contudo, o crescimento da bactéria na presença de diferentes fontes de carbono (glicerol, frutose, galactose, glucose, manose, lactose, maltose ou sacarose) evidenciou que a produção de sideróforo é afetada pelo tipo de fonte de carbono. O crescimento na presença de glicerol promoveu a maior produção de sideróforo; efeito inverso foi observado na presença de manose. A bactéria B. megaterium, quando crescida na presença de frutose, galactose, glucose, lactose, maltose ou sacarose, produziu concentrações similares de sideróforo. O aumento da concentração de arginina, no meio de cultura, não aumentou a produção de sideróforo. A agitação apresentou um efeito positivo na produção de sideróforo; o crescimento em condições estáticas atrasou e diminuiu a produção de sideróforo. Em conclusão, o glicerol parece constituir uma fonte de carbono alternativa, aos monossacáridos e dissacáridos, para a produção de sideróforo. A agitação apresenta um efeito positivo na produção de sideróforo pela bactéria B. megaterium ATCC 19213.

Primary cutaneous cryptococcosis due to Cryptococcus neoformans var. gattii serotype B, in an immunocompetent patient

The authors report a male patient, a seller with no detected immunosuppression, with an extensive ulcerated skin lesion localized on the left forearm, caused by Cryptococcus neoformans var. gattii serotype B. Oral treatment with fluconazole was successful. A review of the literature showed the rarity of this localization in HIV-negative patients. In contrast, skin lesions frequently occurs in HIV-positive patients, with Cryptococcus neoformans var. neoformans serotype A predominating as the etiological agent. In this paper, the pathogenicity of C. neoformans to skin lesions in patients immunocompromised or not, is discussed, showing the efficacy of fluconazole for the treatment of these processes.

A produção de ânforas de tipo lusitana 2 dos fornos de olaria (Pinheiro, Álcácer do Sal)

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Seroprevalence of hepatitis B virus infection in individuals with clinical evidence of hepatitis in Goiânia, Goiás: detection of viral DNA and determination of subtypes

The presence of serological markers for hepatitis B virus (HBsAg, anti-HBc IgM and Anti-HBc total) was investigated in the serum of 1,396 individuals who had clinical suspect of hepatitis. It was observed that 50.7% of the individuals were positive and, from the total of the studied individuals, 14.5% were positive for HBsAg. From these, 8.5% were also positive for anti-HBc IgM. The analysis in relation to gender showed a higher seroprevalence index among male individuals (p < 0.0001). It was observed the occurrence of subtypes adw2 (62.7%), ayw3 (23.5%), ayw2 (9.8%) and adw4 (3.9%). The viral DNA was detected in 61 (33.9%) HBsAg positive samples and in one sample positive only for anti-HBc total. These results indicate an important incidence of the HBV infection in this population, and reinforce previous studies regarding this virus in the central west region of Brazil.