DIMINISHED HAND GRIP STRENGTH AND CIRRHOSIS: PREVALENCE AND ASSOCIATED FACTORS

ABSTRACT Background: Sarcopenia is a syndrome characterized by progressive and generalized loss of muscle mass and strength, observed to varying degrees in patients with various chronic conditions. In cirrhotic patients, it reflects protein-energy malnutrition due to metabolic protein imbalance and is associated with worsened prognosis and reduced post-liver transplantation survival. Objective: To evaluate the epidemiological distribution of diminished hand grip (HG) strength in cirrhotic patients at an outpatient clinic of Santa Casa de Misericórdia in Vitória-ES, Brazil, seeking its association with liver function and cirrhosis complications. Methods: Cross-sectional, epidemiological, and single-center study. A questionnaire was administered to patients and HG strength was measured using a dynamometer, with three interval measures taken for 3 seconds each. Results: The study’s total population was 64 cirrhotic patients, with a mean age of 58 years and alcohol as the most prevalent etiology. Reduced HG strength was defined based on two reference values: using cutoff point 1, reduced HG strength was identified in 33 patients (51.6%); according to cutoff point 2, 23 (35.9%) had reduced HG strength. The study showed that, among the parameters observed, there was an association between the female gender and diminished HG strength in both cutoff points. Additionally, it was noted that patients with a score of 15 or more on the Model for End-Stage Liver Disease (MELD) had decreased HG strength at cutoff point 2. The study showed no association between decreased HG strength and the occurrence of cirrhosis complications in the population studied. Conclusion: In our study, we obtained a diminished HG strength variation of 35-52%, which was related to higher MELD scores, suggesting an association with worse clinical outcomes. Therefore, the presence of reduced muscle strength in cirrhotic patients may be linked to prognostic factors and should be valued as clinical data in the management of these patients

WHIPPLE’s DISEASE: A CASE REPORT

Male, 46 years old, with arthralgia, abdominal pain, weight loss, diarrhea and inappetence. An upper digestive endoscopy was performed, which showed the duodenal bulb with diffuse whitish stippling. The anatomopathological examination of the duodenum showed positive periodic acid-Schiff, confirming the diagnosis of Whipple's disease. In view of the findings, treatment with sulfamethoxazole and trimethoprim was initiated, with significant improvement in symptoms. Whipple's disease is a rare pathology, as a consequence it presents a difficult diagnosis and the ideal treatment of the pathology is still not completely elucidated. Thus, clinical studies with greater scientific impact are needed to aid in the diagnosis and define the preferential approach to the condition.Masculino, 46 anos, com artralgia, dor abdominal, perda de peso, diarreia e inapetência. Realizada endoscopia digestiva alta que evidenciou bulbo duodenal apresentando pontilhado esbranquiçado difuso. Ao anatomopatológico de duodeno evidenciado periodic acid-Schiff positivos, firmando-se o diagnóstico de Doença de Whipple. Diante dos achados, iniciou-se o tratamento com sulfametoxazol+trimetropina, com melhora significativa dos sintomas. A Doença de Whipple é uma patologia rara, como consequência apresenta um difícil diagnóstico e o tratamento ideal da patologia ainda não é completamente elucidado. Assim, são necessários estudos clínicos com maior impacto científico para auxiliar no diagnóstico e definir a conduta preferencial diante do quadro.&nbsp

Efetividade do tratamento não farmacológico na abordagem da doença do Refluxo Gastroesofágico : Effectiveness of non-pharmacological treatment in addressing Gastroesophageal Reflux disease

Objetivo: Analisar e verificar a efetividade do tratamento não farmacológico na abordagem inicial da DRGE. Método: Este trabalho será realizado no ambulatório de gastroenterologia do Hospital da Santa Casa de Misericórdia de Vitória (HSCMV), serão selecionados pacientes diagnosticados com DRGE em abordagem inicial não farmacológica para a doença. Será observado após um período de um mês, o resultado dessa intervenção, de modo que, possa ser analisado e correlacionado o grau de dedicação do paciente com o resultado obtido com a terapia não farmacológica e a necessidade de utilizar Inibidores da Bomba de Prótons (IBP) para episódios sintomáticos da DRGE. Resultado: É esperado uma melhora nos sintomas da DRGE nos pacientes em fase inicial do tratamento, realizando apenas mudanças no estilo de vida do paciente, sem que haja a necessidade da terapia farmacológica com IBP. Conclusão: Pacientes que realizam todas as mudanças no estilo de vida tendem a utilizar menos inibidor de bomba de prótons. No entanto, novos trabalhos precisam ser realizados para confirmar tais achados.Objetivo: Analisar e verificar a efetividade do tratamento não farmacológico na abordagem inicial da DRGE. Método: Este trabalho será realizado no ambulatório de gastroenterologia do Hospital da Santa Casa de Misericórdia de Vitória (HSCMV), serão selecionados pacientes diagnosticados com DRGE em abordagem inicial não farmacológica para a doença. Será observado após um período de um mês, o resultado dessa intervenção, de modo que, possa ser analisado e correlacionado o grau de dedicação do paciente com o resultado obtido com a terapia não farmacológica e a necessidade de utilizar Inibidores da Bomba de Prótons (IBP) para episódios sintomáticos da DRGE. Resultado: É esperado uma melhora nos sintomas da DRGE nos pacientes em fase inicial do tratamento, realizando apenas mudanças no estilo de vida do paciente, sem que haja a necessidade da terapia farmacológica com IBP. Conclusão: Pacientes que realizam todas as mudanças no estilo de vida tendem a utilizar menos inibidor de bomba de prótons. No entanto, novos trabalhos precisam ser realizados para confirmar tais achados

From chromosomes to genome:Insights into the evolutionary relationships and biogeography of old world Knifefishes (Notopteridae; Osteoglossiformes)

In addition to its wide geographical distribution, osteoglossiform fishes represent one of the most ancient freshwater teleost lineages; making it an important group for systematic and evolutionary studies. These fishes had a Gondwanan origin and their past distribution may have contributed to the diversity present in this group. However, cytogenetic and genomic data are still scarce, making it difficult to track evolutionary trajectories within this order. In addition, their wide distribution, with groups endemic to different continents, hinders an integrative study that allows a globalized view of its evolutionary process. Here, we performed a detailed chromosomal analysis in Notopteridae fishes, using conventional and advanced molecular cytogenetic methods. Moreover, the genetic distances of examined species were assessed by genotyping using diversity arrays technology sequencing (DArTseq). These data provided a clear picture of the genetic diversity between African and Asian Notopteridae species, and were highly consistent with the chromosomal, geographical, and historical data, enlightening their evolutionary diversification. Here, we discuss the impact of continental drift and split of Pangea on their recent diversity, as well as the contribution to biogeographical models that explain their distribution, highlighting the role of the Indian subcontinent in the evolutionary process within the family

Emerging patterns of genome organization in Notopteridae species (Teleostei, Osteoglossiformes) as revealed by Zoo-FISH and Comparative Genomic Hybridization (CGH)

Abstract Notopteridae (Teleostei, Osteoglossiformes) represents an old fish lineage with ten currently recognized species distributed in African and Southeastern Asian rivers. Their karyotype structures and diploid numbers remained conserved over long evolutionary periods, since African and Asian lineages diverged approximately 120 Mya. However, a significant genetic diversity was already identified for these species using molecular data. Thus, why the evolutionary relationships within Notopteridae are so diverse at the genomic level but so conserved in terms of their karyotypes? In an attempt to develop a more comprehensive picture of the karyotype and genome evolution in Notopteridae, we performed comparative genomic hybridization (CGH) and cross-species (Zoo-FISH) whole chromosome painting experiments to explore chromosome-scale intergenomic divergence among seven notopterid species, collected in different African and Southeast Asian river basins. CGH demonstrated an advanced stage of sequence divergence among the species and Zoo-FISH experiments showed diffuse and limited homology on inter-generic level, showing a temporal reduction of evolutionarily conserved syntenic regions. The sharing of a conserved chromosomal region revealed by Zoo-FISH in these species provides perspectives that several other homologous syntenic regions have remained conserved among their genomes despite long temporal isolation. In summary, Notopteridae is an interesting model for tracking the chromosome evolution as it is (i) ancestral vertebrate group with Gondwanan distribution and (ii) an example of animal group exhibiting karyotype stasis. The present study brings new insights into degree of genome divergence vs. conservation at chromosomal and sub-chromosomal level in representative sampling of this group