Fatores associados à insuficiência renal aguda pós-transplante hepático

OBJECTIVE: To evaluate the prevalence and the risk factors associated to the development of acute renal failure in patients submitted to liver transplant, at Hospitalde Clínicas de Porto Alegre from September 1996 to September 1998.PATIENTS AND METHODS: 36 patients that developed acute renal failure after liver transplant (group 1) were compared to those who did not develop acute renalfailure after liver transplant (group 2). The following factors were analyzed prior to surgery: etiology of the renal failure, classification of Child-Pugh, diabetes mellitus,and creatinine levels; during surgery: duration of warm ischemia, duration of surgery, duration of anesthesia; CHAD type of portocaval anastomosis; and after surgery: creatinine levels, infections, need for dialysis, duration of stay at the intensive care unit, cyclosporine levels, need for another intervention, and mortality. All data were evaluated during the first 7 days after surgery, with the exception of chronic renal failure and mortality, which were evaluated during a 3-month period.RESULTS: The prevalence of acute renal failure was high (approximately 49%). The presence of previous diabetes mellitus (P=0.03), the CHAD units used duringsurgery (P=0.046), the duration of stay at the intensive care unit (P=0.01), the surgical technique (P=0,04), and the need for another intervention (P=0.02), were allsignificantly associated to the development of acute renal failure after liver transplant in our sample. There was a significant level of mortality among patients that developed acute renal failure (P=0.02).CONCLUSIONS: We concluded that acute renal failure is a significant cause of mortality among patients submitted to hepatic transplant when associated to multiplerisk factors. OBJETIVO: A prevalência e os fatores de risco associados ao desenvolvimento de IRA nos pacientes submetidos a transplante no Hospital de Clínicas de Porto Älegre (HCPA) no período de setembro/96 a setembro/98.PACIENTES E MÉTODOS: Foram comparados os pacientes que desenvolveram IRA (grupo 1) com os que não desenvolveram (grupo 2). Foram analisados no préoperatório: etiologia da isuficiência hepática, classificação de Child-Pugh, diabete melito (DM) e nível de creatinina; no trans-operatório: tempo de isquemia quente, tempo cirúrgico, tempo de anestesia, unidades de concentrado de hemácias (CHAD), tipo de anastomose porto-cava; e no pós-operatório: níveis de creatinina, infecções, necessidades de diálise, permanência na unidade de tratamento intensivo (UTI), níveis de ciclosporina, reintervenções e mortalidade. Todos os dados foram avaliados nos primeiros 7 dias de pós-operatório, com exceção de insuficiência renal crônica e mortalidade avaliados por 3 meses.RESULTADOS: A prevalência de IRA foi elevada, sendo de aproximadamente 49%. Verificamos que a presença de DM prévia (P = 0,03), unidades de CHAD utilizados no trans-operatório (p = 0,046), o tempo de internação na UTI (P = 0,001), técnica cirúrgica (P = 0,04) e necessidade de reintervenção cirúrgica (P = 0,02) estiveram associados significativamente com o desenvolvimento de IRA no pós-operatório de TxH em nossa amostra. Os pacientes que desenvolveram IRA apresentaram uma significativa mortalidade (P = 0,02). Concluímos que a IRA é uma causa significativa de mortalidade nos pacientes submetidos à transplante hepático estando associada a múltiplos fatores de risco

Síndrome de Caroli e carcinomatose peritoneal

Caroli’s syndrome is an uncommon disease, and it is characterized by the presenceof cystic dilation of the intrahepatic biliary tree, and of congenital fibrosis. It may act asa premalignant condition, and in some cases it may develop into cholangiocarcinoma.We report a case of Caroli’s syndrome that was diagnosed in a 37 year old male, andwich was diagnosed along with the development of peritoneal carcinomatosis ofunknown origin. The relevant literature is reviewed as well.A Síndrome de Caroli é uma entidade incomum caracterizada pela presença dedilatações císticas da árvore biliar intra-hepática e fibrose hepática congênita. Podecomportar-se como condição pré-maligna, evoluindo em alguns casos paracolangiocarcinoma. Relatamos um caso diagnosticado em paciente do sexo masculinode 37 anos de idade, complicado por carcinomatose peritoneal de sítio desconhecidoe revisamos a literatura

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Fatores associados à insuficiência renal aguda pós-transplante hepático

OBJECTIVE: To evaluate the prevalence and the risk factors associated to the development of acute renal failure in patients submitted to liver transplant, at Hospitalde Clínicas de Porto Alegre from September 1996 to September 1998.PATIENTS AND METHODS: 36 patients that developed acute renal failure after liver transplant (group 1) were compared to those who did not develop acute renalfailure after liver transplant (group 2). The following factors were analyzed prior to surgery: etiology of the renal failure, classification of Child-Pugh, diabetes mellitus,and creatinine levels; during surgery: duration of warm ischemia, duration of surgery, duration of anesthesia; CHAD type of portocaval anastomosis; and after surgery: creatinine levels, infections, need for dialysis, duration of stay at the intensive care unit, cyclosporine levels, need for another intervention, and mortality. All data were evaluated during the first 7 days after surgery, with the exception of chronic renal failure and mortality, which were evaluated during a 3-month period.RESULTS: The prevalence of acute renal failure was high (approximately 49%). The presence of previous diabetes mellitus (P=0.03), the CHAD units used duringsurgery (P=0.046), the duration of stay at the intensive care unit (P=0.01), the surgical technique (P=0,04), and the need for another intervention (P=0.02), were allsignificantly associated to the development of acute renal failure after liver transplant in our sample. There was a significant level of mortality among patients that developed acute renal failure (P=0.02).CONCLUSIONS: We concluded that acute renal failure is a significant cause of mortality among patients submitted to hepatic transplant when associated to multiplerisk factors. OBJETIVO: A prevalência e os fatores de risco associados ao desenvolvimento de IRA nos pacientes submetidos a transplante no Hospital de Clínicas de Porto Älegre (HCPA) no período de setembro/96 a setembro/98.PACIENTES E MÉTODOS: Foram comparados os pacientes que desenvolveram IRA (grupo 1) com os que não desenvolveram (grupo 2). Foram analisados no préoperatório: etiologia da isuficiência hepática, classificação de Child-Pugh, diabete melito (DM) e nível de creatinina; no trans-operatório: tempo de isquemia quente, tempo cirúrgico, tempo de anestesia, unidades de concentrado de hemácias (CHAD), tipo de anastomose porto-cava; e no pós-operatório: níveis de creatinina, infecções, necessidades de diálise, permanência na unidade de tratamento intensivo (UTI), níveis de ciclosporina, reintervenções e mortalidade. Todos os dados foram avaliados nos primeiros 7 dias de pós-operatório, com exceção de insuficiência renal crônica e mortalidade avaliados por 3 meses.RESULTADOS: A prevalência de IRA foi elevada, sendo de aproximadamente 49%. Verificamos que a presença de DM prévia (P = 0,03), unidades de CHAD utilizados no trans-operatório (p = 0,046), o tempo de internação na UTI (P = 0,001), técnica cirúrgica (P = 0,04) e necessidade de reintervenção cirúrgica (P = 0,02) estiveram associados significativamente com o desenvolvimento de IRA no pós-operatório de TxH em nossa amostra. Os pacientes que desenvolveram IRA apresentaram uma significativa mortalidade (P = 0,02). Concluímos que a IRA é uma causa significativa de mortalidade nos pacientes submetidos à transplante hepático estando associada a múltiplos fatores de risco

Síndrome de Caroli e carcinomatose peritoneal

Caroli’s syndrome is an uncommon disease, and it is characterized by the presenceof cystic dilation of the intrahepatic biliary tree, and of congenital fibrosis. It may act asa premalignant condition, and in some cases it may develop into cholangiocarcinoma.We report a case of Caroli’s syndrome that was diagnosed in a 37 year old male, andwich was diagnosed along with the development of peritoneal carcinomatosis ofunknown origin. The relevant literature is reviewed as well.A Síndrome de Caroli é uma entidade incomum caracterizada pela presença dedilatações císticas da árvore biliar intra-hepática e fibrose hepática congênita. Podecomportar-se como condição pré-maligna, evoluindo em alguns casos paracolangiocarcinoma. Relatamos um caso diagnosticado em paciente do sexo masculinode 37 anos de idade, complicado por carcinomatose peritoneal de sítio desconhecidoe revisamos a literatura