A new sensitive molecular marker for Aspergillus’ Calmodulin gene detection in biological samples, used as a supplementary diagnosis for invasive Aspergillosis (IA)/ Um novo marcador molecular sensível para a detecção do gene Calmodulin em amostras biológicas do Aspergillus, utilizado como diagnóstico suplementar para a Aspergilose invasiva (IA)

Introduction: Aspergillosis is caused by the fungi of Aspergillus genus. After inhalation, Aspergillus’ conidia can invade the tracheal bronchus and lungs, resulting in airway colonization, inflammatory granuloma and invasive aspergillosis (IA), which is most likely to occur in neutropenic and immunosuppressed patients. Presently, IA has been associated with COVID-19 in patients admitted to intensive care units (ICU) for longer periods of time. Objective: The objective of this is to design a new molecular marker for detection of Aspergillus spp. in biological samples, in order to develop a new technique for IA diagnosis which is faster, more efficient and safer. Methodology: The primer was designed in silico using conserved sequences of the Calmodulin gene. After confirming the results in silico, in vitro evaluation was performed using the PCR technique. Results: The designed primer showed high specificity for the Aspergillus species. Conclusion: In this study the standardized PCR reaction with the designed marker proved to be safely utilized as a diagnostic method for IA.  The development of a test to aid in the diagnosis of IA is of great importance, since traditional methods are in turn time consuming and generally confused with other diseases. Early diagnosis contributes to faster treatment initiation and increasing the patient's chance of survival. We can conclude that the standardized PCR with the designed primer can be used safely in the development of a diagnostic test for IA, being of low cost, and accessible to patients treated by the public health system. A Patent application for this molecular marker has been submitted, with the number BR1020190281294

Portal vein thrombosis in children and adolescents: 20 years experience of a pediatric hepatology reference center

CONTEXT: Portal vein thrombosis refers to a total or partial obstruction of the blood flow in this vein due to a thrombus formation. It is an important cause of portal hypertension in the pediatric age group with high morbidity rates due to its main complication - the upper gastrointestinal bleeding. OBJECTIVE: To describe a group of patients with portal vein thrombosis without associated hepatic disease of the Pediatric Hepatology Clinic of the Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil with emphasis on diagnosis, presentation form and clinical complications, and the treatment of portal hypertension. METHODS: This is a descriptive study of a series of children and adolescents cases assisted from January 1990 to December 2010. The portal vein thrombosis diagnosis was established by ultrasound. RESULTS: Of the 55 studied patients, 30 (54.5%) were male. In 29 patients (52.7%), none of the risk factors for portal vein thrombosis was observed. The predominant form of presentation was the upper gastrointestinal bleeding (52.7%). In 20 patients (36.4%), the initial manifestation was splenomegaly. During the whole following period of the study, 39 patients (70.9%) showed at least one episode of upper gastrointestinal bleeding. The mean age of patients in the first episode was 4.6 ± 3.4 years old. The endoscopic procedure carried out in the urgency or electively for search of esophageal varices showed its presence in 84.9% of the evaluated patients. The prophylactic endoscopic treatment was performed with endoscopic band ligation of varices in 31.3% of patients. Only one died due to refractory bleeding. CONCLUSIONS: The portal vein thrombosis is one of the most important causes of upper gastrointestinal bleeding in children. In all non febrile children with splenomegaly and/or hematemesis and without hepatomegaly and with normal hepatic function tests, it should be suspect of portal vein thrombosis. Thus, an appropriate diagnostic and treatment approach is desirable in an attempt to reduce morbidity and mortality