Current treatments of primary sclerosing cholangitis

Primary Sclerosing Cholangitis (PSC) is a chronic cholestatic disease characterized by hepatic inflammation and obliterative fibrosis, resulting in both intra- and extra-hepatic bile duct strictures. End-stage liver disease and bile duct carcinoma represent frequent complications. Incidence and prevalence of PSC in USA have been recently estimated as 0.9 per 100,000 person-years, and 1-6 per 100,000 person-years, respectively. Major diagnostic criteria include the presence of multifocal strictures, beadings of bile ducts, and compatible biochemical profile, once excluded secondary causes of cholangitis. Since the aetiology of PSC remains poorly defined, medical therapy is currently limited to symptom improvement and prolonged survival. Ursodeoxycholic acid (UDCA), corticosteroids and immunosuppressants have been proposed alone or in combination to improve the clinical outcome. In selected cases, surgical or endoscopic procedures need to be considered. Orthotopic liver transplantation (OLT) is at the moment the only definitive approach although disease relapse has been reported. In this article the state of the art in PSC treatment and future promises in this field are reviewe

Pré-tratamento com água e doses de ácido indolbutírico para estaquia herbácea de pitangueiras Pre-treatments with water and indole butyric acid dosis for herbaceous cuttings of Surinam cherry

No Brasil, a maioria dos pomares de pitangueira (Eugenia uniflora) é formada por mudas do tipo pé-franco, o que torna os plantios com baixa uniformidade genética. A propagação vegetativa via estaquia é uma alternativa viável para propagação de diversas espécies frutíferas, podendo ser utilizada também com as espécies nativas, proporcionando a formação de pomares homogêneos, com a produção de mudas com alta sanidade, além de antecipar a produção. Nesse contexto, conduziu-se um estudo visando à multiplicação vegetativa da pitangueira, em que se testou a estaquia herbácea a partir de estacas coletadas de plantas matrizes jovens e adultas, submetidas a três períodos de imersão em água (0, 24 ou 48 horas), além da aplicação de doses de ácido indolbutírico (0, 2000, 4000 e 6000mg L-1). Foram avaliadas a sobrevivência (%), a retenção e a emissão foliar (n&deg; folhas/ estaca), a calogênese (%) e enraizamento das estacas (%). Ao final do experimento, avaliou-se massa fresca e seca de parte aérea e raiz, número de folhas e área foliar. O delineamento experimental foi o completamente casualizado, com três repetições de dez plantas por tratamento para os parâmetros não destrutivos e três repetições de cinco plantas por tratamento para os parâmetros destrutivos. A estaquia herbácea foi eficiente para produzir mudas de pitangueira, especialmente quando utilizadas estacas oriundas de plantas jovens sem necessidade de pré-lavagem nem adição de auxinas exógenas.<br>In Brazil, most of the Surinam cherry (Eugenia uniflora) orchards is formed by ungrafted plants, which makes the plantations have low genetic uniformity. The vegetative minicutting propagation is a viable alternative for the propagation of several fruit species, and can also be used with native species providing the formation of orchards with homogeneous populations of plants, with production of seedlings with high health and accelerated propagation process. In this context, a study for the multiplication of Surinam cherry was conduced with herbaceous cuttings, taken from young and adult mother plants, immersed in indole butyric acid doses (0, 2000, 4000 and 6000mg L-1), in three different water periods (0, 24 or 48 hours). Survival rate (%), leaf retention and emission (No. leaves /cutting), callus rate (%) and rooting (%) were evaluated. At the end of the experiment, were also evaluated fresh and dry weight of shoot and root, leaf number and leaf area. The experiment has a completely randomized design with three replications of ten plants per treatment for nom destructive and three replications of five plants per treatment for the destrutive parameters. The herbaceous cuttings were efficient to produce seedlings of Surinam cherry, particularly when using cuttings derived from seedlings in the absence of the immersion in water and exogenous auxin