ABSTRACT Objective: Identifying significant fibrosis is crucial to evaluate the prognosis and therapeutic interventions in patients with nonalcoholic fatty liver disease (NAFLD). We assessed the performance of acoustic radiation force impulse (ARFI) elastography, APRI, FIB-4, Forns, NFS and BARD scores in determining liver fibrosis in severe obesity. Subjects and methods: A prospective study included 108 patients undergoing bariatric surgery. Liver biopsy specimens were obtained intraoperatively and classified according to the NAFLD Activity Score. Patients were assessed with serological markers and shear wave velocity of the liver was measured with the Siemens S2000 ultrasound system preoperatively. Optimal cut-off values were determined using the area under the receiver operating characteristic curves (AUROC). Results: In the entire cohort prevalence of NAFLD was 80.6%, steatohepatitis 25.9% and significant fibrosis 19.4%. The best tests for predicting significant fibrosis were FIB-4 and Forns scores (both AUROC 0.78), followed by APRI (AUROC 0.74), NFS (AUROC 0.68), BARD (AUROC 0.64) and ARFI (AUROC 0.62). ARFI elastography was successful in 73% of the patients. Higher body mass index (BMI) correlated with invalid ARFI measurements. In patients with BMI < 42 kg/m2, ARFI showed 92.3% sensitivity and 82,6% specificity for the presence of significant fibrosis, with AUROC 0.86 and cut-off 1.32 m/s. Conclusions: FIB-4 and Forns scores were the most accurate for the prediction of significant fibrosis in bariatric patients. Applicability and accuracy of ARFI was limited in individuals with severe obesity. In patients with BMI < 42 kg/m2, ARFI elastography was capable for predicting significant fibrosis with relevant accuracy.

The evolution in the knowledge of tuberculosis' physiopathology allowed not only a better understanding of the immunological factors involved in the disease process, but also the development of new laboratory tests, as well as the establishment of a histological classification that reflects the host's ability to contain the infectious agent. At the same time, the increasing bacilli resistance led to alterations in the basic tuberculosis treatment scheme in 2009. This article critically examines laboratory and histological investigations, treatment regimens for tuberculosis and possible adverse reactions to the most frequently used drugs.

Cutaneous tuberculosis (CTB) is the result of a chronic infection by Mycobacterium tuberculosis, M. ovis and occasionally by the Calmette-Guerin bacillus. The clinical manifestations are variable and depend on the interaction of several factors including the site of infection and the host's immunity. This article revises the current knowledge about this disease's physiopathology and immunology as well as detailing the possible clinical presentations.

O Brasil destaca-se no cenário mundial como um dos maiores produtores de manga (Mangifera indica L.). No entanto, perdas significativas são observadas em todas as etapas da cadeia produtiva, sobretudo na comercialização varejista, sendo estas correlacionadas em quase sua totalidade à incidência de doenças fúngicas. Neste sentido, objetivou-se com este trabalho determinar a incidência natural de Lasiodiplodia theobromae, agente causal da podridão peduncular, e aspectos da qualidade pós-colheita de mangas 'Tommy Atkins', comercializadas no mercado atacadista da Empresa Paraibana de Abastecimento e Serviços Agrícolas (EMPASA) de Campina Grande-PB. Para a determinação da incidência natural da doença, coletaram-se 40 frutos no estádio de maturação 'de vez', de quatro diferentes estabelecimentos de comercialização, que foram encaminhados ao Laboratório de Fitopatologia (CCA/UFPB). Após sanificação, os frutos foram mantidos sob condições ambientes (28 ± 2 ºC e UR 75 ± 6%) por oito dias, determinando-se o aparecimento dos primeiros sintomas e sinais do patógeno. As características de qualidade foram determinadas através da coleta de 10 frutos de cada estabelecimento de comercialização da EMPASA. Os frutos foram transportados ao Laboratório de Biologia e Tecnologia Pós-Colheita (CCA/UFPB), onde foram avaliados quanto aos teores de Sólidos Solúveis (SS), Acidez Titulável (AT), Relação SS/AT e pH. Os dados foram submetidos à análise de variância, e as médias, comparadas pelo teste de Tukey, a 5% de probabilidade. A manga comercializada no mercado atacadista da EMPASA de Campina Grande apresentou baixo conteúdo de SS e elevada AT, caracterizando fruto no início da maturação. Os frutos apresentaram 88,9% de incidência natural de podridão peduncular no oitavo dia de armazenamento, o que compromete a qualidade do produto no varejo, constituindo-se em uma causa das elevadas perdas pós-colheita.

Brazil stands out as one of the largest producers of mango (Mangifera indica L.) in the world. However, significant losses are observed in all stages of production chain, mainly in the retail market, which are correlated almost entirety to incidence of fungal diseases. In this way, the objective of this study was to determine the incidence of natural infection of Lasiodiplodia theobromae, causal agent of stem-end rot, and postharvest quality of 'Tommy Atkins' mangos, traded in the wholesale market of the Central de Abastecimento (EMPASA) from Campina Grande, Paraíba State, Brazil. To determine natural incidence of the disease it was collected 40 fruits at mature-green maturity stage from four different wholesale marketing stores at EMPASA that were sent to Laboratory of Phytopathology (CCA/UFPB). After sanitization, fruits were kept at room conditions (28 ± 2 ºC and RH 75 ± 6%) during eight days, determining first symptoms and signals of the pathogen. The characteristics of quality were determined by collecting 10 fruits from each wholesale marketing store. Fruits were transported to the Laboratory of Biology and Postharvest Technology (CCA/UFPB), where it was evaluated Soluble Solids (SS), Titratable Acidity (TA), SS/TA, and pH. Data were subjected to variance analysis of and means compared by the Tukey test at 5% of probability. Mango commercialized in the wholesale market of EMPASA, Campina Grande, showed low SS and high TA contents characterizing fruit at the beginning of maturation. Fruits showed 88.9% of natural incidence of stalk rot in the eighth day of storage, which is deleterious for retail quality of fruits, characterizing a causal factor for the higher postharvest losses.

A psoríase é doença crônica que afeta a pele e, eventualmente, as articulações. A terapia biológica age bloqueando citocinas inflamatórias implicadas na patogênese da doença, dentre elas o fator de necrose tumoral alfa. Este também tem papel na defesa do hospedeiro contra o Mycobacterium tuberculosis. Relata-se um caso de psoríase com boa resposta ao infliximabe, porém com desenvolvimento de tuberculose esplênica durante o tratamento.

Psoriasis is a chronic inflammatory disease affecting the skin and occasionally the joints. The biological agents have been engineered to target a specific step in the inflammatory cascade that leads to psoriasis, including tumor necrosis factor, which has a central role in the host defense against Mycobacterium tuberculosis. This is a case report about a psoriatic patient who presented splenic tuberculosis during treatment with infliximab.