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• Fatigue performace of cast components is mainly affected by porosity. • An alternative fatigue procedure that accounts the effect of porosity was developed. • The model presented an average logarithmic error below 2% and absolute below 16%. • The required porosity parameters can be obtained by computed tomography. • In high series sectors, a statistical store with fracture surface data could be used. Porosity is one of the main parameters in the fatigue life of cast alloys as it affects both crack initiation and propagation phases. However, most fatigue assessments present a lack of accuracy as they only consider the effect of the initial pore on the fatigue limit. Therefore, in the present study, first, the effect of the main porosity characteristics on the crack initiation and propagation phases is evaluated. Then, an alternative fatigue assessment model is proposed and implemented for Low Pressure Die Casting (LPDC) A356-T6 aluminium alloy. The model accounts for the effect of the initial pore size and distance to surface on the initiation phase as well as fractographic porosity and average pore size on the fracture surface on the propagation phase. Finally, the model was validated by means of experimental tests. Results have shown that the proposed model is able to qualitatively predict the scatter trend of samples tested at the same load. In addition, the model presents high quantitative accuracy in life estimation with an average logarithmic error below 2% and an absolute average error below 16%. [ABSTRACT FROM AUTHOR]

Graphene materials (GMs) are deeply studied as nanoreinforcements of polymer matrices, especially for epoxy matrices. Here, we analyze the effect of GMs on the transport properties of a poly(bisphenol A-co-epichlorohydrin) resin. In particular, we focus on the effect of the morphology, chemical composition and structure of different GMs obtained by varying the reduction temperature of the thermal/exfoliation treatment of graphite oxide synthesized by a modified Hummers method. The dispersion degree of the GMs was studied by microscopy techniques, showing a strong dependence on the specific surface area and chemical composition of the graphene material. The transport properties imposed different requirements on GMs. The thermal conductivity benefited from a high aromatic restoration. Meanwhile, the electrical conductivity required the right balance of filler/matrix interaction and aromatic restoration. [ABSTRACT FROM AUTHOR]

GMO control laboratories in the EU routinely monitor the presence and content of genetically modified organisms (GMOs) in food and feed products collected from the EU market. As the vast majority of GMOs comprize genetically modified plants, most control samples have a plant-based origin. For the first time, a pilot proficiency test was organised requiring the analysis of GMOs in a meat matrix. Meat pâté, a product in which soybean is occasionally identified, was spiked with GM soybean event MON89788, homogenised by mixing, aliquoted in sachets and frozen. The assigned value was determined by two independent expert laboratories. Several DNA extraction methods were tested and proved to be insufficient for the removal of PCR inhibitors present in the DNA extracts, resulting in a GM content underestimated by at least 30%. This problem was solved either by using hot-start qPCR chemistry or by applying the same method in a digital PCR format. A total of 52 laboratories participated in the study. They were requested to verify the presence of any GM soybean in the test item and to quantify the GM event(s) identified by their method of choice. All but one laboratory identified the MON89788 soybean event present in the pâté matrix. The majority of the quantitative results reported were below the assigned value, but did not deviate more than 50% from it. This study demonstrated the proficiency of most GMO control laboratories for the analysis of GMOs in a meat-based product. It also shows that method optimisation for GMO analysis in meat products is nevertheless advisable. • DNA extraction from meat-based materials cannot completely remove PCR inhibitors. • PCR inhibition is alleviated by use of either hot-start qPCR or droplet digital PCR. • EU control laboratories are competent for GMO analysis in meat-based products. [ABSTRACT FROM AUTHOR]

The aim of this meta-analysis was to analyse the effectiveness of submucosal injection of dexamethasone to control the postoperative signs and symptoms resulting from impacted third molar surgery. An electronic search was conducted, without restriction on date or language, in the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science databases until June 2015 . The eligibility criteria included non-randomized or randomized clinical trials in humans. After the search and selection process, eight articles were included. The fixed-effects or random-effects model, depending on heterogeneity, was built on the inverse-variance method used. The estimations of intervention were expressed as the mean difference (MD) in millimetres. The results of this meta-analysis suggest that the submucosal injection of dexamethasone presents a reduction in the postoperative signs and symptoms resulting from impacted third molar surgery, especially those associated with oedema and pain. In relation to trismus, the meta-analysis showed no statistically significant difference between dexamethasone and the placebo solution. [ABSTRACT FROM AUTHOR]

Three groups of Aeromonas strains isolated from Finland lakes experiencing cyanobacterial blooms could not be assigned to any known species of this genus on the basis of 16S rRNA and rpoD gene sequences. The Multilocus Phylogenetic Analysis (MLPA) of the concatenated sequence of seven genes ( gyrB , rpoD , recA , dnaJ , gyrA , dnaX and atpD ; 4093 bp) showed that the three groups of strains did not cluster with any known Aeromonas spp. and formed three independent lineages. This was confirmed by performing the analysis with their closest relatives using 15 genes (the latter 7 and cpn60 , dnaK , gltA , mdh , radA , rpoB , tsf , zipA ; 8751 bp). Furthermore, ANI results between the genomes of the type strains of the three potential new species and those of their close relatives were all <96% which is the previously proposed cutoff value for differentiating species within this genus. The in silico DDH values of the three type strains of the new species also showed a similarity <70% with the most closely related species indicating they belong to different taxa. The three groups of strains could be differentiated from each other and from other known Aeromonas species on the basis of several phenotypic characters. This polyphasic study revealed that the 3 groups of strains represent 3 novel Aeromonas species for which the names Aeromonas aquatica sp. nov. (type strain AE235 T = CECT 8025 T = LMG 26712 T ), Aeromonas finlandiensis sp. nov. (type strain 4287D T = CECT 8028 T = LMG 26709 T ) and Aeromonas lacus sp. nov. (type strain AE122 T = CECT 8024 T = LMG 26710 T ) are proposed. [ABSTRACT FROM AUTHOR]

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Abstract: Four Aeromonas strains (S1.2T, EO-0505, TC1 and TI 1.1) isolated from moribund fish in Spain showed a restriction fragment length polymorphism (RFLP) pattern related to strains of Aeromonas salmonicida and Aeromonas bestiarum but their specific taxonomic position was unclear. Multilocus sequence analysis (MLSA) of housekeeping genes rpoD, gyrB, recA and dnaJ confirmed the allocation of these isolates to an unknown genetic lineage within the genus Aeromonas with A. salmonicida, A. bestiarum and Aeromonas popoffii as the phylogenetically nearest neighbours. Furthermore, a strain biochemically labelled as Aeromonas hydrophila (AH-3), showing a pattern of A. bestiarum based on 16S rDNA-RFLP, also clustered with the unknown genetic lineage. The genes rpoD and gyrB proved to be the best phylogenetic markers for differentiating these isolates from their neighbouring species. Useful phenotypic features for differentiating the novel species from other known Aeromonas species included their ability to hydrolyze elastin, produce acid from l-arabinose and salicin, and their inability to produce acid from lactose and use l-lactate as a sole carbon source. A polyphasic approach using phenotypic characterization, phylogenetic analysis of the 16S rRNA gene and of four housekeeping genes, as well as DNA–DNA hybridization studies and an analysis of the protein profiles by MALDI-TOF-MS, showed that these strains represented a novel species for which the name Aeromonas piscicola sp. nov. is proposed with isolate S1.2T (=CECT 7443T, =LMG 24783T) as the type strain. [Copyright &y& Elsevier]

Abstract: Current bioartificial extra-corporeal systems are bioreactors where cells are separated from the surrounding media by porous polymeric membranes. The present work focuses on the design of membranes that allow the differential diffusion of plasma metabolites and proteins such as immunoglobulin (IgG). This design will improve catabolites removal and reduce possible immune response and virus infection. We demonstrate the feasibility to synthesize the hydrogels confined to the macroporous structure of membranes by radiation-induced in situ polymerization. The hollow-fiber membranes were soaked in aqueous monomeric solution, rinsed and irradiated while submerged in oil. This procedure confined the hydrogel to the void internal volume of the pores of the membrane. Hydrogels of polyacrylamide and polyHEMA were synthesized this way by irradiation at 10kGy. Hydraulic permeability and diffusion of glucose, albumin and IgG were measured in these hydrogel-filled membranes. Polyacrylamide 0.5M showed the best compromise between albumin diffusion (1.2×10−7 cm2/s) and HSA/IgG selectivity (2.2). [Copyright &y& Elsevier]

Taenia solium is endemic in the Andean region of Ecuador. The recent rediscovery of Taenia saginata in humans urges to reconsider some assumptions in relation to the epidemiology of the taeniosis/cysticercosis complex in this country.Therefore, data were compiled on the infection of both tapeworms in man and animals in Pichincha and Imbabura provinces in the Andean region, north of Quito. On post mortem inspection 3 out of 806 (0.37%) carcasses had T. saginata metacestodes, however, 35 sera out of 869 (4.03%) showed circulating antigen in a monoclonal antibody-based sandwich ELISA (Ag-ELISA). Porcine cysticercosis was detected in 15 out of 2896 (0.52%) carcasses and 93 out of 1032 serum samples (9.01%) were positive in Ag-ELISA. In humans, 4.99% (215 out of 4306) cases of antigen positives were found, whereas coprological examination of 1935 stools resulted in 30 positive cases (1.55%). The limited number of adult tapeworms (29) that were collected does not allow firm conclusions on the proportion of each species, but in total 21 specimen were identified as T. saginata and 8 as T. solium. These data have been discussed in view of the epidemiology of human cysticercosis. [Copyright &y& Elsevier]

This paper reports on a combined experimental and theoretical study on the size dependency of tension strength of clear wood at loading parallel to fiber direction. The fracture behavior of the tested softwood specimens was found to be rather brittle with low precursory activity and a statistical variation of the strength. The distribution of the strength values can be well fitted with a Weibull distribution distinguished by a shape parameter ρ∼8−10. A significant dependency of the mean strength of the material on the cross-sectional size of the specimens was obtained. The range of load redistribution in clear wood subjected to tension parallel to fiber was assessed by the theoretical concept of fiber bundle models for fiber composites. Hereby the macroscopic behavior was modelled in terms of the microscopic damage process. [Copyright &y& Elsevier]

Abstract: Renal failure after orthotopic liver transplantation (OLT) is a common complication (ranging from 12% to 70%) associated with worse outcomes, particularly when it requires renal replacement therapy (RRT). Renal dysfunction is a common scenario among waiting list patients. It can lead to a worse prognosis after OLT, due to an increased incidence of postoperative renal failure. The aim of this study was to analyze the incidence of renal failure after OLT, its relationship to pretransplant renal dysfunction, and its impact on outcomes. We analyzed data collected prospectively from 152 consecutive OLTs in 139 patients performed by the same team from March 2003 to November 2007. Exclusion criteria for 34 cases included transplantation due to acute liver failure, combined liver-kidney transplantation, retransplantation, and patients who died up to 2 days posttransplantation. Based on creatinine clearance (CCr) calculated at the time of OLT, the 118 patients were classified in two groups: group I, normal pre-OLT renal function (CCr ≥ 70 mL/min) versus group II, pre-OLT renal failure (CCr < 70 mL/min). Each group was analyzed according to the development of post-OLT renal failure, being classified as subgroup A (normal renal function post-OLT), subgroup B (mild renal impairment post-OLT—serum creatinine level between 2.0 and 3.0 mg/dL or doubled basal value up to 3.0 mg/dL) versus subgroup C (severe renal impairment post-OLT—serum creatinine level ≥ 3.0 mg/dL or utilization of RRT). The overall incidence of post-OLT renal impairment was 41.52% with RRT in 22 patients (18.64%). Group II patients showed a greater incidence of post-OLT renal failure when compared with other patients (P < .05), but without a statistical difference when compared according to RRT requirement. Comparison of average hospital stay was similar between groups I and II, and also among its subgroups (A, B, and C, respectively). There was no statistical difference in early (30-day) and 1-year survival rates between groups I and II. Comparing all subgroups for early and 1-year survival, we observed that patients who developed severe renal failure post-OLT (subgroups I-C and II-C) showed worse outcomes compared with other patients (subgroups I-A, I-B, II-A, and II-B), respectively 95.29% versus 69.69% and 86.95% versus 41.66% for early and 1-year survivals (P < .001). In conclusion, our findings suggested that patients who developed severe renal failure post-OLT, independent of pretransplant renal function, showed worse outcomes. [Copyright &y& Elsevier]

Abstract: Background: The Model for End-Stage Liver Disease (MELD) was introduced in 1999 to quantify the 3-month prognosis of cirrhotic patients after a transjugular intrahepatic portosystemic shunt (TIPS). Because of the imbalance between organ donors and patients on the waiting list, the MELD was adopted by the United States in 2002 to allocate liver grafts for transplantation. Preliminary results have indicated a reduction in waiting list deaths and an increase in transplantation rates for candidates. Seeking to find a new model to predict death on the waiting list and after liver transplantation, retrospective studies have examined MELD scores in waiting list patients. The aim of this study was to analyze the MELD scores of patients on the liver waiting list for comparisons between transplanted patients. Patients and Methods: A retrospective study was performed analyzing 131 registrations of 127 orthotopic liver transplant (OLT) patients (4 underwent retransplantation) grafted between November 2000 and January 2006, excluding 24 patients: 2 had urgent retransplantations due to hepatic artery thrombosis and 22 had incomplete data. These patients were divided into 3 groups: group I (transplanted patients)—53 patients underwent 55 OLT; group II—29 patients who died on the waiting list; group III—patients on the waiting list including 23 patients still waiting as of the date of the study. Results: The main indication for OLT was hepatitis C virus cirrhosis (50.50%), followed by alcoholic liver cirrhosis (23.30%), cryptogenic cirrhosis (12.60%), autoimmune hepatitis (5.80%), hepatitis B virus cirrhosis (4.85%), and primary biliary cirrhosis (2.91%). Group I: MELD score 15.62 (range, 6–39) on admission to the list, and 18.87 (range, 7–39) at transplantation. The mean waiting time for OLT was 478.39 days (range, 2–1270 days). The 38 patients who survived underwent 39 OLT (1 retransplantation). The MELD score at entrance to the list was 14.62 (range, 7–30) and at transplantation, 17.70 (range, 7–39). The mean time between admission to the list and transplantation was 505.37 days (range, 6–1270 days). The 15 patients who died had received 16 OLT (1 retransplantation). Their MELD scores were 17.80 (range, 6–39) and 21.81 (range, 9–39) at admission to the list and at transplantation, respectively, with a mean time on the waiting list of 417.93 days (range, 2–872 days). Group II: 29 patients died before OLT, at a mean age of 52.60 years (range, 22–67 years). Their MELD score was 19.24 (range, 7–45), and the interval between admission to the waiting list and death was 249.55 days (range, 3–1247 days). Group III: 23 patients still active on the OLT waiting list at the time of study displayed a mean MELD score of 13.65 (range, 6–28) and 354.30 days (range, 2–905 days) waiting until the moment. In conclusion, MELD score at the time of admission to the waiting list was higher among those patients who died either awaiting a liver graft (19.24) or after OLT (17.80) compared with those who survived after OLT (14.60) or are still awaiting OLT (13.65). [Copyright &y& Elsevier]

Abstract: There are various options to help overcome the organ shortage, including performing transplants using grafts from marginal donors with characteristics previously described as unacceptable because of the high risk of graft failure. Nowadays, expanded criteria donors for liver transplantation (OLT) is a strategy used routinely by many teams. Some donor features have been suggested to jeopardize initial function or survival; when these features are aggregated, they may impact prognosis. The aim of this study was to evaluate the impact of donor risk factors on early patient survival and retransplantation. Donor risk factors were considered to be older than 60 years, body mass index > 30, serum sodium level > 155 mEq/L, cold ischemia time > 12 hours, and intensive care unit stay > 4 days. We prospectively recorded data from 139 patients who underwent 152 OLT from March 2003 to May 2007. Patients were classified into four groups: I, no risk factors; II, one risk factor; III, two risk factors; IV, three or more risk factors. Retransplantation or OLT due to acute liver failure was considered to be an exclusion criterion. Early overall survival rate was 83.76%; 12 retransplantations were required (10.25%). Comparing the four groups, patient survivals (P = .41) and retransplantation rates (P = .518) were similar. In conclusion, cumulative risk factors showed no impact on early (30-day) recipient survival and or on the necessity of retransplantation after OLT. [Copyright &y& Elsevier]

Graphene oxide (GO) can be produced through diverse synthetic routes in large quantities that lead to clear differences in the resulting graphene morphology and properties. Here, we analysed the effect of several thermally reduced graphene oxides (TRGOs), at two different concentrations, on the electrical and mechanical properties of epoxy resin nanocomposites. Natural graphite was oxidised using two methods, Brodie (GO-B) and Hummers (GO-H), and, then, thermally reduced at different temperatures, 700, 1000, and 2000 °C. Intrinsic graphene properties, such as remaining oxygen groups, specific surface area, and aspect ratio, among others, have a profound effect on the final properties of the nanocomposite. The dispersion state was heavily influenced by the specific surface area and the remaining oxygen groups on the graphene. Meanwhile, the electrical and mechanical properties showed a strong and opposite dependency with the reduction temperature, with low temperatures resulting in flakes with high reinforcing characteristics and high temperatures in flakes with high electrical conductivity performance. Finally, TRGOs synthesised via Hummers and reduced at low temperatures appeared to be more suited as reinforcing particles, while TRGOs synthesised via Brodie were more effective as electrically conductive nanofillers. [ABSTRACT FROM AUTHOR]

Abstract: Neurocysticercosis is recognised as an important but neglected cause of epilepsy in developing countries where the parasite occurs. Data on the transmission dynamics of the parasite in endemic areas are scarce. Individuals living in these areas are likely to be highly exposed to the parasite, but relatively few of them develop active infections. The present study aimed to describe and gain insights into changes in antibody responses and infection patterns related to age and/or gender in a south Ecuadorian rural population by combining antibody and antigen serological data with demographic characteristics. In 25% of the population, antibodies to Taenia solium cysticerci were detected whilst 2.9% had circulating parasite antigens. The proportion of antibody-positive individuals increased significantly until the age of 40years to become stable in older individuals. A rule-based simulation model was developed to explain these variations and to reflect the dynamics of exposure to, and transmission of, the parasite. In contrast, the proportion of people presenting circulating parasite antigens, reflecting an active infection, was significantly higher in people older than 60years. Immunosenescence could explain such an observation since a weaker immune system in the elderly would facilitate the establishment and maintenance of viable cysticerci compared with fully immunocompetent younger individuals. This work points out the role of the immune system in the development of cysticercosis within an exposed population and highlights new essential issues in understanding the transmission dynamics of the parasite, its incidence and the resulting immunological response at a population level. [Copyright &y& Elsevier]

Abstract: Introduction: Early graft dysfunction has a negative impact on allograft and patient survivals, evolving to retransplantation or death in the majority of cases. The outcome of a second liver transplant is usually worse than the first procedure. Considering the increasing number of recipients on the waiting list, and the discrepancy between the number of accessible donors and recipients, we sought to analyze the results of retransplantation at our institution and at those within the State of Sao Paulo. Methods: We reviewed the data of 419 deceased donor transplants on 367 patients from June 2005 to April 2010. Twenty-three patients underwent retransplantation due primary nonfunction (PNF) or early graft dysfunction. The following variables were studied: age, gender, disease that lead to the first transplant, Model for End-Stage Liver Disease (MELD) score on the day before the retransplantation, intensive care unit (ICU) length of stay, and duration of orotracheal intubation (OTI). We compared our patient survival at 30 days and 1 year with that of other patients undergoing retransplantation due to PNF in the Sao Paulo State during the same period. Results: The majority of patients were females (60.87%), with a mean age of 44.6 years. The etiology that led to our first transplantation was cirrhosis due to hepatitis C virus (HCV; n = 6), followed by acute liver failure, (n = 5). The average of ICU stay was 15.08 days (range, 5–45). The mean MELD score was 34.43 (range, 19–50). The survival was 73.92% and 60.78% at 30 days and 1 year postretransplantation, respectively, whereas for São Paulo State, it was 63.04% and 51.63%, respectively. [Copyright &y& Elsevier]

Abstract: Total hepatectomy with temporary portocaval shunt was employed as a bridging procedure before liver transplantation, in the setting of fulminant hepatic failure with “toxic liver syndrome”; acute, severe, and extensive liver necrosis associated with cardiovascular shock and acute renal failure with or without respiratory failure. This procedure sought to improve metabolic acidosis and hemodynamic instability related to advanced liver necrosis. The aim of this study was to report our experience with three patients who underwent total hepatectomy and protocaval shunt, followed by liver transplantation (two-stage procedure). [Copyright &y& Elsevier]

Abstract: Since July 2006, the liver graft allocation has been changed from the waiting time to the Model for End-stage Liver Disease (MELD), prioritizing the sickest patients, who have a higher risk of dying on the waiting list, and sometimes in such poor clinical condition that it compromises transplantation outcomes. The aim of this study was to analyze the impact of a MELD score ≥ 30 on 30-day survival after liver transplantation (OLT). We prospectively collected the data on 178 liver transplants on 163 patients performed from March 2003 to August 2007. The subjects were divided in two groups according to their MELD scores: group 1, MELD ≥ 30 (n = 15) and group 2, MELD < 30 (n = 96). The groups were compared with regard to hospital and intensive care unit (ICU) length of stay, intraoperative blood products transfusion, early survival (30 days), and need for retransplantation. We excluded, patients with prioritization criteria, those receiving extra points for any special situation, and six other patients without significant data for MELD calculation (of whom only one has died after transplantation). Patients under a “special situation” were those with hepatocelular carcinoma, hepatopulmonary syndrome, and metabolic diseases, who initially received a MELD/PELD score 20, and 24, and 29. The mean MELD score at group I was 34 (range, 30 to 42), and for group II it was 16 (range, 6 to 29). Group I displayed a mean hospital length of stay of 24 days (4 to 155), with 12.60 days (ranges, 1 to 103) in the ICU versus 15.55 (range, 1 to 48) and 5.13 (range, 1 to 45) days, respectively, for group II. The need for blood component transfusions were greater in group I; 25.28% of patients in group II did not receive any transfusion during the entire inpatient period. There were nine retransplants in group II, and none in group I. The 30-day survivals were 93.3% for group I and 84.37% for group II. Besides the increased complexity of these sickest patients, there was no negative impact on early survival rates. [Copyright &y& Elsevier]

Abstract: Livers from marginal donors are increasingly used for transplantation due to the shortage of donor organs. The definition of a marginal donor remains unclear; prediction of organ function is a challenge. In the literature the use of steatotic livers has been associated with poor liver function or even primary dysfunction of the allograft. Tekin et al created a scoring system that classifies a donor as marginal or nonmarginal, using a mathematical model based on donor age and steatosis degree. The aims of this study were to apply the Tekin method to identify marginal and nonmarginal donors and evaluate the influence of the cold ischemia time (CIT) on allograft evolution. We retrospectively reviewed deceased donor liver transplantations performed from October 1995 to March 2006, namely, 177 adult liver transplantations in 163 patients. Fifty-five were excluded due to retransplantation (14) or insufficient data (41). Donor age and macrovesicular steatosis were evaluated according to the mathematical formula proposed by Tekin et al, classifying the donors as marginal versus nonmarginal. The authors also analyzed the CIT, 3-month mortality, and development of primary nonfunction or primary dysfunction. The median donor age was 38.9 years (range, 6–71). The postreperfusion biopsy specimen showed moderate to intense steatosis (>30%) in 14.75% of specimens, with no steatosis or mild steatosis in 85.25%. Sixty-one grafts (50%) developed primary graft dysfunction (PGD): 10 grafts, with primary nonfunction (PNF); and 51 with initial poor function (IPF). Using the criteria provided by Tekin et al, we obtained 41 marginal and 81 nonmarginal allografts. The marginal group showed 61.9% PGD, compared with 59.2% of PGD by the nonmarginal group. The CIT was greater than 12 hours in 5 marginal group transplants and 4 PGD cases (80%). Of the nonmarginal allografts, the CIT was greater than 12 hours in 29.6%, with 75% PGD. The 3-month graft survival rate was 80% in the marginal group with ischemia time more than 12 hours: 86.1% of the same group when CIT was less than 12 hours, and 82.7% in the nonmarginal group. In contrast, when we analyzed the occurrance of allograft dysfunction, the 3-month mortality rate was 34% among, grafts with dysfunction, whereas, in those without initial dysfunction, it was 4.1%. In conclusion, the score suggested by Tekin et al that classifies the donors as ideal (nonmarginal) or marginal was not able to predict initial primary dysfunction. [Copyright &y& Elsevier]

Abstract: Knowledge of the arterial vascular anatomy of the liver is important for orthotopic liver transplantation (OLT) because the lack of an adequate arterial blood supply results in biliary and parenchymal complications or graft loss. A number of reports have shown a relationship between aberrations of graft arteries and an increased incidence of early or late complications. Recent studies suggest no differences unless multiple anastomoses are required. The aim of this study was to report the incidence of aberrant hepatic arterial anatomy and its impact on vascular and biliary complications. We retrospectively reviewed data of 90 OLT performed on 82 patients, including 4 who underwent retransplantation from March 2003 to March 2006. The means recipient age was 52.47 years and 49 were men. The main caval vein reconstruction technique was piggyback (n = 55; 61.2%). The biliary reconstruction was performed by an end-to-end choledocho-choledocho anastomosis in 83 cases (92.3%) with choledocho-jejunal anastomosis (Roux-in-Y) in 7 cases (7.7%). Aberrant arterial anatomy was noted in 20 liver grafts (22.2%), namely, accessory right hepatic artery (n = 6; 6.6%), accessory left (n = 10; 11%), both accessory right and left (n = 3; 3.3%), and hepatic common artery from mesenteric artery (n = 1; 1.1%). Among the transplantations of grafts with aberrant arterial anatomy, 2 cases (10%) developed hepatic artery thrombosis (HAT) and 4 (20%) biliary complications. The rate of HAT and biliary complications among grafts with normal arterial anatomy was 3 and 8 cases (4.2% and 11.42%), respectively. Despite a greater number of complications among OLT with aberrant arterial anatomy, the Fisher test showed no significant relationship between HAT or biliary complications and aberrant arterial anatomy. [Copyright &y& Elsevier]

Abstract: The treatment of end-stage liver disease includes transplantation as a life-saving procedure although it has serious complications of hepatic artery thrombosis, liver dysfunction, or primary nonfunction, which frequently lead to the need for retransplantation. According to various reports, the incidence of retransplantation is around 10%. Given the critical organ shortage, the chance for a second transplant remains a controversial discussion in medical, ethical, and economic grounds because patient and graft survival rates after retransplantation are lower than those for primary transplantations. We retrospectively reviewed all of the urgent liver retransplants from October 2001 to February 2005 (52 months) by analyzing the number of retransplants, blood group, time between first and second liver transplantation, age, sex, and mortality. Data were obtained from the Transplantation System, State of Sao Paulo Health Secretariat. Among 1252 liver transplants performed during this period, 98 (7.82%) were urgent retransplantations. The primary procedure employed 955 (76.28%) deceased donors and 297 (23.72%) living donors. All 98 retransplants were performed using an organ from the pool of deceased donors. The retransplant rate was acceptable according to the literature, although we observed high rates of early mortality (<60 days), leading to a discussion of which patients had a better chance of survival and the best time to perform the second transplantation to use this scarce and precious resource in the best possible way. [Copyright &y& Elsevier]

Four Aeromonas strains from clinical and environmental samples differed from known species on the basis of rpoD gene sequence. Multilocus phylogenetic analysis and in silico DNA-DNA hybridization confirmed them as four new species even though their 16S rRNA gene sequence similarity with their closest relatives was >98.7%, as occurred for other Aeromonas spp. [ABSTRACT FROM AUTHOR]

Abstract: A survey on porcine trichinellosis was organised in Ecuador between 2000 and 2003. Blood samples were taken in slaughterhouses (study 1, n =2000; study 2, n =331) and in a remote village where pigs are free roaming (study 3, n =646) and examined by ELISA using excretory/secretory (E/S) antigens. Seven samples (0.35%) in study 1 and none of the samples of study 2 were serologically positive. Thirty-seven (5.72%) village pigs tested positive by E/S ELISA in study 3. Sero-positive results by the E/S ELISA in study 1 were confirmed by ELISA using β-tyvelose antigen, and by immunoblot. Muscle samples taken from pigs slaughtered in the abattoir (study 2) and from animals that showed a positive serology in study 3 were examined by trichinoscopy and artificial digestion. These techniques failed to demonstrate the presence of muscle larvae. The results of this survey need confirmation, but suggest that Trichinella is present in Ecuador; however, prevalence and parasite burdens are likely to be very low. The likelihood of detecting trichinellosis are higher in traditional settings than in pigs raised on improved farms. [Copyright &y& Elsevier]

: BackgroundTransplantectomy has been the conventional therapy for symptomatic failed grafts left in situ (FGLIS). Graft intolerance syndrome (GIS) is a common complication after withdrawal of inmmunosuppresion. Our group first reported transvascular ethanol embolization (TVEE) as an alternative for the management of GIS.: ObjectiveOur goal was to evaluate the efficacy and safety of TVEE in a large series of patients with symptomatic FGLIS.: Patients and methodsFrom January 1989 to December 2001, 944 patients received cadaveric renal transplants in our center. During this period, 59 patients with FGLIS underwent TVEE (50 ± 7 years, 71% men, 15% diabetics). TVEE was performed using a transfemoral approach. A balloon occlusion catheter was inflated in the renal artery before ethanol injection (10–12 cc). The position of coils completed the procedure. No systematic prophylatic antibiotic or steroid treatment was administered.: ResultsThe main indication for TVEE was GIS (51 patients, 86%). TVEE was initially successful in 39 patients (66%). A second TVEE, which was performed in 9 of 20 unresolved cases, was successful in six. After a second TVEE, the efficacy increased to 76%. The most frequent complication was postembolization syndrome (62%), which was manifested by fever, local pain, and inflammation that generally resolved in 48–72 hours. No major complications or deaths were observed. One of four patients underwent transplantectomy. Histologic examination of the removed graft showed renal tissue necrosis (10 cases) and pyonephrosis (4 cases).: ConclusionsTVEE, a safe and effective technique, may be considered as the treatment of choice for symptomatic FGLIS. [Copyright &y& Elsevier]