Search

Purpose Among the several methods to measure 222Rn in water, the liquid scintillation counting (LSC) technique is one of the most sensitive and widely used when analysing non-saline waters by liquid extraction, providing excellent accuracy, precision and low-level detection limits. When using the liquid scintillation counter Tri-Carb 3170 TR/SL (Perkin-Elmer) it is not possible to make an automatic determination of the alpha/beta discrimination parameter, being necessary to evaluate the pulse decay discriminator (PDD) value manually to the 222Rn determination. In this work, we describe the steps to perform the calibration of that type of equipment. Methods The method consists in the preparation of standard samples from a 226Ra certified standard solution and the adjustment of the PDD value by hand until the percentage of alpha events reaches a plateau of a near-constant fraction of total events. The process consists in taking several measures between PDD 80 and 200 with 15 min counting time each. Within the plateau, the alpha/beta ratio was used to determine the plateau final range as well as the optimum PDD value. After that, the calibration standards and blanks were measured and the region of interest (ROI) was established by finding the maximum value for the figure of merit (FOM) in the upper and lower limits. Results The optimal PDD value of 148 was established by the alpha/beta ratio, and after that, it was possible to measure 226Ra standards to perform the calibration. An efficiency of (9.758±0.035) × 10–1 was obtained. In routine measurements, a detection limit of about 0.50 Bq L–1 is achieved for a 120 min counting time. To evaluate the uncertainty budget, the uncertainties of the net count rate, the efficiency, the sample amount and the decay correction factor were considered. Conclusions A method was developed for the calibration of LSC Tri-Carb 3170 TR/SL with the optimization of the PDD using a 226Ra standard solution. The acquisition to obtain the plot of the variation of the events fraction in each window (alpha and beta) in function of PDD allowed to evaluate a plateau where the fraction of events was at a minimum. Afterwards, it was possible to measure the set of 226Ra standards after the equilibrium with 222Rn and determine the efficiency for 222Rn with a detection limit of about 0.50 Bq L–1 in routine analyses.

O envelhecimento populacional é um fato que requer atenção por parte de todos os setores da sociedade. Uma vez que se enfatiza a prática de atividade física, emerge nesse contexto a figura do atleta na terceira idade e a importância da fisioterapia desportiva. Levanta-se a questão norteadora: Como a fisioterapia desportiva pode auxiliar os atletas na terceira idade? Este artigo tem por objetivo geral fazer uma revisão de literatura sobre a atuação da fisioterapia desportiva em atletas na terceira idade. A metodologia escolhida foi a revisão sistemática da literatura, em que a tessitura textual se deu por meio da consulta às bases de dados e outros textos relacionados ao tema em questão, entre os meses de agosto de 2018 e março de 2022. Trata-se de uma revisão fundamentada nas bases de dados PEDro, MedLine, Lilacs, Scielo. Foram utilizadas as palavras-chave “idoso”, “atletas”, “fisioterapia” e seus correspondentes em inglês. Os resultados permitiram incluir 09 trabalhos escritos entre 2018 e 2021. Concluiu-se que a importância da fisioterapia desportiva em atletas na terceira idade está relacionado com a promoção da saúde e com a prevenção de lesões desportivas e reabilitação, sabendo-se que o fisioterapeuta atua tanto no tratamento dos atletas, quanto na elaboração de programas específicos para melhoria do desempenho físico, prevenção de lesões e reabilitação.

El envejecimiento de la población es un hecho que requiere la atención de todos los sectores de la sociedad. Una vez enfatizada la práctica de actividad física, emerge en este contexto la figura del deportista en la vejez y la importancia de la fisioterapia deportiva. Surge la pregunta orientadora: ¿Cómo puede ayudar la fisioterapia deportiva a los deportistas en la vejez? El objetivo general de este artículo es revisar la literatura sobre la realización de fisioterapia deportiva en deportistas de edad avanzada. La metodología escogida fue la revisión sistemática de la literatura, en la que se realizó la textura textual consultando bases de datos y otros textos relacionados con el tema en cuestión, entre los meses de agosto de 2018 y marzo de 2022 revisión basada en PEDro, MedLine, Lilacs, bases de datos Scielo. Se utilizaron las palabras clave “ancianos”, “atletas”, “fisioterapia” y sus correspondientes en inglés. Los resultados permitieron la inclusión de 09 trabajos escritos entre 2018 y 2021. Se concluyó que la importancia de la fisioterapia deportiva en deportistas senior está relacionada con la promoción de la salud y la prevención de lesiones deportivas y la rehabilitación, sabiendo que el fisioterapeuta actúa tanto en el tratamiento de deportistas y en el desarrollo de programas específicos de mejora del rendimiento físico, prevención de lesiones y rehabilitación.

L’invecchiamento della popolazione è un dato che richiede attenzione da parte di tutti i settori della società. Una volta sottolineata la pratica dell’attività fisica, emerge in questo contesto la figura dell’atleta in età avanzata e l’importanza della fisioterapia sportiva. Sorge la domanda guida: in che modo la fisioterapia sportiva può aiutare gli atleti in età avanzata? L’obiettivo generale di questo articolo è quello di rivedere la letteratura sulle prestazioni della fisioterapia sportiva negli atleti anziani. La metodologia scelta è stata la revisione sistematica della letteratura, in cui la tessitura testuale è stata effettuata consultando banche dati e altri testi attinenti al tema in questione, tra i mesi di agosto 2018 e marzo 2022. una revisione basata su PEDro, MedLine, Lillà, database Scielo. Sono state utilizzate le parole chiave “anziani”, “atleti”, “fisioterapia” e i loro corrispondenti in inglese. I risultati hanno consentito l’inclusione di 09 articoli scritti tra il 2018 e il 2021. Si è concluso che l’importanza della fisioterapia sportiva negli atleti senior è correlata alla promozione della salute e alla prevenzione degli infortuni sportivi e alla riabilitazione, sapendo che il fisioterapista agisce sia nel trattamento di atleti e nello sviluppo di programmi specifici per migliorare le prestazioni fisiche, la prevenzione degli infortuni e la riabilitazione.

Population aging is a fact that requires attention from all sectors of society. Once the practice of physical activity is emphasized, the figure of the athlete in old age and the importance of sports physiotherapy emerges in this context. The guiding question arises: How can sports physiotherapy help athletes in old age? The general objective of this article is to review the literature on the performance of sports physiotherapy in elderly athletes. The methodology chosen was the systematic review of the literature, in which the textual texture was carried out by consulting databases and other texts related to the topic in question, between the months of August 2018 and March 2022 a review based on PEDro, MedLine, Lilacs, Scielo databases. The keywords “idoso”, “atletas”, “fisioterapia” and their correspondents in English were used. The results allowed the inclusion of 09 papers written between 2018 and 2021. It was concluded that the importance of sports physiotherapy in senior athletes is related to health promotion and the prevention of sports injuries and rehabilitation, knowing that the physiotherapist acts both in the treatment of athletes and in the development of specific programs to improve physical performance, injury prevention and rehabilitation.

Die Alterung der Bevölkerung ist eine Tatsache, die die Aufmerksamkeit aller Bereiche der Gesellschaft erfordert. Sobald die Ausübung körperlicher Aktivität betont wird, wird in diesem Zusammenhang die Figur des Sportlers im Alter und die Bedeutung der Sportphysiotherapie deutlich. Es stellt sich die Leitfrage: Wie kann Sportphysiotherapie Sportlern im Alter helfen? Das allgemeine Ziel dieses Artikels ist es, die Literatur zur Durchführung von Sportphysiotherapie bei älteren Sportlern zu sichten. Die gewählte Methodik war die systematische Literaturrecherche, bei der die Texttextur durch Konsultation von Datenbanken und anderen themenbezogenen Texten zwischen den Monaten August 2018 und März 2022 durchgeführt wurde eine Überprüfung auf der Grundlage von PEDro, MedLine, Flieder, Scielo-Datenbanken. Verwendet wurden die Schlagworte „ältere Menschen“, „Athleten“, „Physiotherapie“ und deren Entsprechungen in englischer Sprache. Die Ergebnisse ermöglichten die Einbeziehung von 09 Arbeiten, die zwischen 2018 und 2021 geschrieben wurden. Es wurde der Schluss gezogen, dass die Bedeutung der Sportphysiotherapie bei Seniorensportlern mit der Gesundheitsförderung und der Prävention von Sportverletzungen und der Rehabilitation zusammenhängt, da bekannt ist, dass der Physiotherapeut sowohl bei der Behandlung von als auch bei der Behandlung von Sportverletzungen tätig ist Athleten und bei der Entwicklung spezifischer Programme zur Verbesserung der körperlichen Leistungsfähigkeit, Verletzungsprävention und Rehabilitation.

Le vieillissement de la population est un fait qui requiert l’attention de tous les secteurs de la société. Dès lors que la pratique de l’activité physique est mise en avant, la figure de l’athlète dans la vieillesse et l’importance de la kinésithérapie sportive émergent dans ce contexte. La question directrice se pose : comment la physiothérapie sportive peut-elle aider les athlètes âgés ? L’objectif général de cet article est de faire une revue de la littérature sur la performance de la kinésithérapie sportive chez les sportifs âgés. La méthodologie choisie a été la revue systématique de la littérature, dans laquelle la texture textuelle a été réalisée en consultant des bases de données et d’autres textes liés au sujet en question, entre les mois d’août 2018 et mars 2022 une revue basée sur PEDro, MedLine, Lilacs, bases de données Scielo. Les mots-clés « personnes âgées », « athlètes », « physiothérapie » et leurs correspondants en anglais ont été utilisés. Les résultats ont permis l’inclusion de 09 articles rédigés entre 2018 et 2021. Il a été conclu que l’importance de la kinésithérapie sportive chez les sportifs seniors est liée à la promotion de la santé et à la prévention des blessures sportives et à la rééducation, sachant que le kinésithérapeute agit à la fois dans le traitement des athlètes et dans le développement de programmes spécifiques pour améliorer la performance physique, la prévention des blessures et la réadaptation.

O trabalho ininterrupto pode provocar problemas nas esferas física, psicológica e social para os empregados. A competitividade nos vários setores acaba por exigir a produtividade; em decorrência, o profissional, por um lado se empenha para a consecução dos objetivos da empresa, por outro, esquece-se de sua própria saúde. Danos são causados à saúde em geral e os afastamentos para tratamento são uma constante. Sob esta ótica, a Ergonomia e a Ginástica laboral, como parte de um plano fisioterapêutico, se configuram como grandes aliadas aos trabalhadores para minimizar os danos que se apresentam à sua saúde. Assim, o objetivo deste artigo é fazer uma revisão de literatura acerca dos benefícios advindos da Ergonomia e da prática Ginástica Laboral. Para tanto, a metodologia escolhida foi a revisão de literatura, em que a construção o texto se deu através da consulta às bases de dados e outros textos relacionados ao tema em questão. Os resultados evidenciaram que a ergonomia estuda, desenvolve e aplica regras e normas que viabilizam a organização do trabalho de modo que seja compatível com as características físicas e psíquicas do funcionário. A ginástica laboral também tem se mostrado como favorável no ambiente de trabalho de modo a contribuir para a melhoria das condições psíquicas e sociais dos funcionários. Conclui-se que a Ergonomia e a Ginástica Laboral, quando implementadas, promovem a melhoria da qualidade da saúde dos funcionários.

Introduction: Hepatocellular carcinoma (HCC) has been associated to non-alcoholic fatty liver disease (NAFLD). We sought to investigate the immunoexpression of several glycolytic metabolism-associated markers in patients with HCC associated to NAFLD and associate these factors to their clinical-pathological characteristics. Methods: We evaluated 35 HCC specimens from 21 patients diagnosed with non-alcoholic steatohepatitis (NASH) undergoing liver resection (12 patients), liver transplantation (8 patients), or both (1 patient). Histological features, clinical aspects, demographic and biochemical data, as well as the immunohistochemical reactivity for monocarboxylate transporters 1, 2, and 4; their chaperone CD147; carbonic anhydrase IX; and glucose transporter-1 (GLUT1) were assessed. Results: Metabolic-associated cirrhosis was present in 12 of the 21 patients (8 child A and 4 child B scores). From 9 patients without cirrhosis, 3 presented NASH F3 and 6 NASH F2. Sixteen (76%) had diabetes mellitus, 17 (81%) arterial hypertension, and 19 (90%) body mass index above 25 kg/m2; 8 (38%) had dyslipidemia. From 35 nodules, steatosis was found in 26, ballooning in 31 nodules, 25 of them diagnosed as steatohepatitic subtype of HCC. MCT4 immunoexpression was associated with extensive intratumoral fibrosis, advanced clinical stages, and shorter overall survival. GLUT1 was noticeable in nodules with extensive intratumoral steatosis, higher intratumoral fibrosis, and advanced clinical stages. Immunohistochemical expression of the metabolic biomarkers MCT4 and GLUT1 was higher in patients with Barcelona-clinic liver cancer B or C. GLUT1 correlated with higher degree of steatosis, marked ballooning, intratumoral fibrosis, and higher parenchymal necroinflammatory activity. Conclusion: Our data indicate that the expression of the glycolytic phenotype of metabolic markers, especially GLUT1 and MCT4, correlates with a more severe course of HCC occurring in NASH patients.

BACKGROUND Cardiovascular disease is the main cause of death in metabolic-associated fatty liver disease, and gut microbiota dysbiosis is associated with both of them. AIM To assess the relationship between gut dysbiosis and cardiovascular risk (CVR) in an experimental model of steatohepatitis. METHODS Adult male Sprague-Dawley rats were randomized to a control group (n = 10) fed a standard diet and an intervention group (n = 10) fed a high-fat choline-deficient diet for 16 wk. Biochemical, molecular, hepatic, and cardiac histopathology. Gut microbiota variables were evaluated. RESULTS The intervention group had a significantly higher atherogenic coefficient, Castelli’s risk index (CRI)-I and CRI-II, interleukin-1β, tissue inhibitor of metalloproteinase-1 (all P < 0.001), monocyte chemoattractant protein-1 (P = 0.005), and plasminogen activator inhibitor-1 (P = 0.037) than the control group. Gene expression of miR-33a increased (P = 0.001) and miR-126 (P < 0.001) decreased in the intervention group. Steatohepatitis with fibrosis was seen in the intervention group, and heart computerized histological imaging analysis showed a significant decrease in the percentage of cardiomyocytes with a normal morphometric appearance (P = 0.007), reduction in the mean area of cardiomyocytes (P = 0.037), and an increase of atrophic cardiomyocytes (P = 0.007). There were significant correlations between the cardiomyocyte morphometry markers and those of progression and severity of liver disease and CVR. The intervention group had a lower Shannon diversity index and fewer changes in the structural pattern of gut microbiota (both P < 0.001) than controls. Nine microbial families that are involved in lipid metabolism were differentially abundant in intervention group and were significantly correlated with markers of liver injury and CVR. CONCLUSION The study found a link between gut dysbiosis and significant cardiomyocyte abnormalities in animals with steatohepatitis.

Introducción: El tacrolimo es uno de los inmunosupresores más utilizados en pacientes postrasplante hepático y suele existir una amplia variación en su nivel sérico. Es fundamental evaluar el tiempo medio para alcanzar el nivel sérico (NS) objetivo de tacrolimo después del trasplante de hígado, ya que los niveles muy bajos aumentan las posibilidades de rechazo del injerto y los niveles muy altos se asocian con toxicidad. Metodología: Estudio observacional de cohorte retrospectivo realizado en el Hospital de Clínicas de Porto Alegre. Se incluyeron pacientes trasplantados de hígado entre diciembre de 2012 y diciembre de 2017 en uso de tacrolimo oral. Los pacientes que alcanzaron un nivel sérico entre 6 y 8 ng/mL durante el mes 1 posterior al trasplante se consideraron un nivel sérico objetivo. Resultados: el 78% (67/87) de los pacientes alcanzaron el NS objetivo dentro de los 10 días posteriores al trasplante hepático. Los pacientes que experimentaron rechazo más de 1 año después del trasplante tardaron alrededor de 9 días en alcanzar el SL objetivo durante la hospitalización-índice frente a los 7 días de los pacientes que no experimentaron rechazo. Conclusión:Nuestro estudio, al considerar valores objetivo terapéuticos entre 6-8 ng/mL en pacientes postrasplante hepático inmediato, mostró que esta población realizó un tiempo promedio que parece determinar un buen pronóstico ya que en menos de 2 semanas el 78% de los pacientes alcanzaron el objetivo de NS cercano al recomendado.

Introduction: Tacrolimus is one of the most used immunosuppressants in patients after liver transplantation and there is often a wide variation in its serum level. Assessing the mean time to reach the target serum level of tacrolimus after liver transplantation is critical, as very low levels increase with chances of graft rejection and very high levels are associated with toxicity. Methodology:Observational, retrospective cohort study conducted at Hospital de Clínicas de Porto Alegre. Liver transplant patients between December 2012 and December 2017 using oral tacrolimus were included. Patients who reached a serum level between 6–8 ng/mL during month 1 post-transplant were considered as target serum levels. Results: 78% (67/87) of patients reached the target serum level within 10 days after liver transplantation. Patients who experienced rejection over 1 year after transplantation took around 9 days to reach the target serum level during the index hospital stay. Patients who did not present rejection reached target serum level within 7 days after starting the immunosuppressant. Conclusion: Our work, considering therapeutic target values between 6–8 ng/mL in patients after immediate liver transplantation, demonstrated that this population performed a mean time that seems to determine a good prognosis, since in less than 2 weeks 78% of patients reached target serum level close to what was recommended.

Introduction and aim: Drug-induced liver injury (DILI) manifests as a spectrum of clinical presentations that carries morbidity and mortality. Patients with chronic liver disease (CLD), particularly hospitalized, are at high risk for developing DILI. We aimed to investigate the use of potentially hepatotoxic drugs (PHD) in patients with CLD in a tertiary university hospital. Materials and methods: Adult (≥ 18 years-old) with CLD admitted to the hospital from January 2016 to December 2018 were evaluated regarding PHD, assessing the risk of DILI and liver enzymes behavior after exposure. Results: From 931 hospitalized patients with CLD, 291 (31.3%) were exposed to hepatotoxic drugs during their hospitalization. Of those, 244 (83.8%) were cirrhotic. The most frequent causes of liver disease were hepatitis C (41.2%), followed by alcohol (13.2%), hepatitis C/alcohol (11.7%) and non-alcoholic fatty liver disease (5.8%). Decompensated cirrhosis (46.7%) was the main reason for hospital admission. The most often prescribed PHD were antibiotics (67.7%), cardiovascular drugs (34.4%), neuromodulators (26.1%) and anesthetics (19.9%). After exposure, 113 patients (38.8%) presented significant elevated liver enzymes. Surprisingly, PHD were more often prescribed in GI/Liver unit (48.8%) followed by emergency/intensive care unit (28.5%). A total of 65 patients (22%) died, however in neither case was it possible to safely infer causal relationship among PHD, liver enzymes and death. Conclusion: PHD prescription is frequent in patients with CLD even in a tertiary university hospital and in the gastroenterology and hepatology department, exposing these patients to an additional risk.

This study presents a linear approach that defines the water retention on organic substrates, namely composts and coir. Different substrates are used as sampling material for the experimental data. Results of this experiment show that based on recurring decimal logarithms, from analytical exponential expressions, using only two water retention experimental points, it is possible to define a linear water retention relation for a substrate between − 0.1 kPa and − 10 kPa matric potential values. Due to the low number of parameters involved in this empirical approach a more rapid and accurate determination of substrate water retention. Results indicate that there is a high agreement between the experimental and the prediction values (R2 = 0.953). Moreover, the precision and the simplicity of this method applied to several different organic substrates can contribute to its generalization. Due to its simplicity, it can be easily applied to a high number of cases. As an example, a well-known important application of this approach is on the application of tensiometers.

Obesity is key to liver steatosis development and progression. Transcranial direct current stimulation (tDCS) is a promising tool for eating disorders management but was not yet evaluated in steatosis. This study investigated tDCS’ effects on liver steatosis and inflammation in an experimental obesity model. Male Wistar rats (60 days-old) were randomly allocated (n = 10/group) as follows: standard-diet/sham tDCS (SDS), standard-diet/tDCS (SDT), hypercaloric-cafeteria-diet/sham tDCS (HDS), and hypercaloric-cafeteria-diet/tDCS (HDT). After 40 days of diet, animals received active or sham tDCS for eight days and were euthanized for liver fat deposition and inflammation analysis. HDS and HDT animals showed cumulative food consumption, total liver lipid deposits, IL-1β, TNF-α levels, IL-1β/IL-10 and TNF-α/IL-10 ratios significantly higher than the SDS and SDT groups (p p p p p p

BACKGROUND Hepatitis C virus (HCV) infection is a public health concern worldwide. Several factors, including genetic polymorphisms, may be evolved in the progression of HCV infection to liver diseases. Interferon lambdas (IFNLs) modulate the immune response during viral infections. IFNLs induce antiviral activity, interfering in the viral replication by promoting the expression of several genes that regulate immunological functions. The interferon lambda-4 (IFNL4) rs12979860 polymorphism, which is characterized by a C to T transition in intron 1, is associated with spontaneous and treatment-induced clearance of HCV infection and may play a role in the development of HCV-associated liver diseases, including hepatocellular carcinoma (HCC). AIM To investigate the association of IFNL4 rs12979860 polymorphism with fibrosis, cirrhosis, and HCC in patients with chronic HCV infection. METHODS This study was comprised of 305 chronic HCV-infected patients (53 fibrosis, 154 cirrhosis, and 98 HCC cases). The control group was comprised of 260 HCV-negative healthy individuals. The IFNL4 rs12979860 polymorphism was genotyped using the TaqMan assay. Fibrosis was diagnosed based on liver biopsy findings, while cirrhosis was diagnosed through clinical, laboratory, anatomopathological, and/or imaging data. HCC was diagnosed through imaging tests, tumor, and/or anatomopathological markers. RESULTS The T allele was observed in the three groups of patients (fibrosis, cirrhosis, and HCC) at a significantly higher frequency when compared with the control group (P = 0.047, P < 0.001, and P = 0.01, respectively). Also, genotype frequencies presented significant differences between the control group and cirrhosis patients (P < 0.001) as well as HCC patients (P = 0.002). The risk analysis was performed using the codominant and dominant T allele models. In the codominant model, it was observed that the CT genotype showed an increased risk of developing cirrhosis in comparison with the CC genotype [odds ratio (OR) = 2.53; 95% confidence interval (CI): 1.55-4.15; P < 0.001] as well as with HCC (OR = 2.54; 95%CI: 1.44-4.56; P = 0.001). A similar result was observed in the comparison of the TT vs CC genotype between the control group and cirrhosis group (OR = 2.88; 95%CI: 1.44-5.77; P = 0.001) but not for HCC patients. In the dominant T allele model, the CT + TT genotypes were associated with an increased risk for progression to cirrhosis (OR = 2.60; 95%CI: 1.63-4.19; P < 0.001) and HCC (OR = 2.45; 95%CI: 1.42-4.31; P = 0.001). CONCLUSION These findings suggest that the T allele of IFNL4 rs12979860 polymorphism is associated with the development of cirrhosis and HCC in chronic HCV-infected patients.

Intraoperative blood salvage (IBS) with autologous blood transfusion is controversial in liver transplantation (LT) for hepatocellular carcinoma (HCC). This study evaluated the role of IBS usage in LT for HCC. In a retrospective cohort study at a single center from 2002 to 2018, the outcomes of LT surgery for HCC were analyzed. Overall survival and disease-free survival of patients who received IBS were compared with those who did not receive IBS. Cancer recurrence, length of hospital stay, post-transplant complications, and blood loss also were evaluated. The primary aim of this study was to evaluate overall mid-term and long-term survival (4 and 6 years, respectively). Of the total 163 patients who underwent LT for HCC in the study period, 156 had complete demographic and clinical data and were included in the study. IBS was used in 122 and not used in 34 patients. Ninety-five (60.9%) patients were men, and the mean patient age was 58.5 ± 7.6 years. The overall 1-year, 5-year, and 7-year survival in the IBS group was 84.2%, 67.7%, and 56.8% vs. 85.3%, 67.5%, and 67.5% in the non-IBS group (p = 0.77). The 1-year, 5-year, and 7-year disease-free survival in the IBS group was 81.6%, 66.5%, and 55.4% vs. 85.3%, 64.1%, and 64.1% in the non-IBS group (p = 0.74). For patients without complete HCC necrosis (n = 121), the 1-year, 5-year, and 7-year overall survival rates for those who received IBS (n = 95) were 86.2%, 67.7%, and 49.6% vs. 84.6%, 70.0%, and 70.0% for 26 patients without IBS (p = 0.857). For the same patients, the 1-year, 5-year, and 7-year disease-free survival in the IBS group was 84.0%, 66.8%, and 64.0% vs. 88.0%, 72.8%, and 72.8% in the non-IBS group (p = 0.690). IBS does not appear to be associated with worse outcomes in patients undergoing LT for HCC, even in the presence of viable HCC in the explant. There seems to be no reason to contraindicate the use of IBS in LT for HCC.

Larisse Longo,1,2 Jéssica Tonin Ferrari,2 Pabulo Henrique Rampelotto,2,3 Gustavo Hirata Dellavia,4 Amanda Pasqualotto,2 Claudia P Oliveira,5 Carlos Thadeu Schmidt Cerski,1,4,6 Themis Reverbel da Silveira,2 Carolina Uribe-Cruz,1,2 Mário Reis Álvares-da-Silva1,2,4,7 1Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; 2Experimental Laboratory of Hepatology and Gastroenterology, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; 3Graduate Program in Pharmaceutical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; 4School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; 5Department of Gastroenterology (LIM07), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; 6Unit of Surgical Pathology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; 7Division of Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, BrazilCorrespondence: Larisse Longo Email larisselongo@hotmail.comBackground/Aim: The interactions between the gut and liver have been described in the progression of non-alcoholic steatohepatitis (NASH). The aim of this study was to develop an experimental nutritional model of NASH simulating metabolic changes occurring in humans.Materials and Methods: Adult male Sprague Dawley rats were randomized into two groups: controls (standard diet) and intervention (high-fat and choline-deficient diet) for 16 weeks, each experimental group with 10 animals. Biochemical analysis, hepatic lipid content, microRNAs, inflammatory, gut permeability markers and gut microbiota were measured.Results: Animals in the intervention group showed significantly higher delta Lee index (p=0.017), abdominal circumference (p< 0.001), abdominal adipose tissue (p< 0.001) and fresh liver weight (p< 0.001), as well as higher serum levels of alanine aminotransferase (p=0.010), glucose (p=0.013), total cholesterol (p=0.033), LDL cholesterol (p=0.011), and triglycerides (p=0.011), and lower HDL cholesterol (p=0.006) compared to the control group. Higher TLR4 (p=0.041), TLR9 (p=0.033), MyD88 (p=0.001), Casp1 (p< 0.001), NLPR3 (p=0.019), liver inflammation index interleukin (IL)-1β/IL10 (p< 0.001), IL6/IL10 (p=0.002) and TNFα/IL10 (p=0.001) were observed in the intervention group, and also lower permeability markers Ocln (p=0.003) and F11r (p=0.041). Gene expression of miR-122 increased (p=0.041) and miR-145 (p=0.010) decreased in the intervention group. Liver steatosis, inflammation and fibrosis, along with collagen fiber deposition increment (p< 0.001), were seen in the intervention group. Regarding gut microbiota, Bray-Curtis dissimilarity index and number of operational taxonomic units were significantly different (p< 0.001) between the groups. Composition of the gut microbiota showed a significant correlation with histopathological score of NAFLD (r=0.694) and index IL-1β/IL-10 (r=0.522).Conclusion: This experimental model mimicking human NASH demonstrated gut and liver interaction, with gut microbiota and intestinal permeability changes occurring in parallel with systemic and liver inflammation, miRNAs regulation and liver tissue damage.Keywords: fatty liver disease models, fibrosis, gut microbiota, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis

Background & Aims: Information on safety and efficacy of systemic treatment in patients with hepatocellular carcinoma (HCC) under dialysis are limited due to patient exclusion from clinical trials. Thus, we aimed to evaluate the rate, prevalence, tolerability, and outcome of sorafenib in this population. Methods: We report a multicenter study comprising patients from Latin America and Europe. Patients treated with sorafenib were enrolled; demographics, dose modifications, adverse events (AEs), treatment duration, and outcome of patients undergoing dialysis were recorded. Results: As of March 2018, 6156 HCC patients were treated in 44 centres and 22 patients were concomitantly under dialysis (0.36%). The median age was 65.5years, 40.9% had hepatitis C, 75% had Child-Pugh A, and 85% were Barcelona Clinic Liver Cancer-C. The median time to first dose modification, treatment duration and overall survival rate were 2.4months (interquartile ranges [IQR], 0.8-3.8), 10.8months (IQR, 4.5-16.9), and 17.5months (95% CI, 7.2-24.5), respectively. Seventeen patients required at least 1 dose modification. The main causes of first dose modification were asthenia/worsening of Eastern Cooperative Oncology Group-Performance Status and diarrhoea. At the time of death or last follow-up, four patients were still on treatment and 18 had discontinued sorafenib: 14 were due to tumour progression, 2 were sorafenib-related, and 2 were non-sorafenib-related AE. Conclusions: The outcomes observed in this cohort seem comparable to those in the non-dialysis population. Thus, to the best of our knowledge, this is the largest and most informative dataset regarding systemic treatment outcomes in HCC patients undergoing dialysis.