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Micro-aeration was shown to improve anaerobic digestion (AD) processes, although oxygen is known to inhibit obligate anaerobes, such as syntrophic communities of bacteria and methanogens. The effect of micro-aeration on the activity and microbial interaction in syntrophic communities, as well as on the potential establishment of synergetic relationships with facultative anaerobic bacteria (FAB) or aerobic bacteria (AB), was investigated. Anaerobic sludge was incubated with ethanol and increasing oxygen concentrations (0-5% in the headspace). Assays with acetate or H2/CO2 (direct substrates for methanogens) were also performed. When compared with the controls (0% O2), oxygen significantly decreased substrate consumption and initial methane production rate (MPR) from acetate or H2/CO2. At 0.5% O2, MPR from these substrates was inhibited 30-40%, and close to 100% at 5% O2. With ethanol, significant inhibition (>36%) was only observed for oxygen concentrations higher than 2.5%. Oxygen was consumed in the assays, pointing to the stimulation of AB/FAB by ethanol, which helped to protect the syntrophic consortia under micro-aerobic conditions. This highlights the importance of AB/FAB in maintaining functional and resilient syntrophic communities, which is relevant for real AD systems (in which vestigial O2 amounts are frequently present), as well as for AD systems using micro-aeration as a process strategy. KEY POINTS: •Micro-aeration impacts syntrophic communities of bacteria and methanogens. •Oxygen stimulates AB/FAB, maintaining functional and resilient consortia. •Micro-aeration studies are critical for systems using micro-aeration as a process strategy.

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Introduction Trapeziectomy and suture-button suspensionplasty (SBS) are a novel option to treat end-stage trapeziometacarpal (TMC) osteoarthritis. Our purpose is to evaluate our outcomes with this technique and in this setting, with a minimum of 18 months of follow-up. Materials and Methods Twenty-eight patients were included, operated between 2016 and 2018. We recorded demographic data, preoperative Eaton stage, follow-up and operative times. The patients completed the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire and tip pinch, key pinch, and grip strength were measured. First metacarpal subsidence was calculated, and postoperative complications were documented. Results The average follow-up was 34 months. The mean QuickDASH was 32 at the final follow-up. The average strength results were 20 kg for grip, 3.6 kg for tip pinch, and 4.2 kg for key pinch. The rate of first ray subsidence was 10.7%. We encountered three complications: a hardware intolerance, a second metacarpal fracture, and a suture rupture. There was one reoperation to remove an implant. Conclusion Trapeziectomy and SBS functional results are similar to other techniques, with less subsidence of the first ray and allowing for early mobilization and fast recovery. This procedure is a safe and promising option in the treatment of TMC osteoarthritis, with good medium-term outcomes.

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BACKGROUND: Sporophila nigricollis, popularly known as Yellow-bellied Seedeater, is a commonly trafficked bird in Brazil. This study describes the complete mitogenome of the species and its phylogenetic position. METHODS AND RESULTS: DNA sample was sequenced on MiSeq (Illumina®) sequencer. Reads were assembled to reference using Geneious. A total of 11,740 paired sequence reads were used to produce the complete mitochondrial DNA sequence with average coverage of 176x. The mitogenome was found to be circular in shape and consisted of 16,777 base pairs. The mitochondrial genome was annotated with MITOS and verified with ExPASy. Its structure contains two ribosomal RNA (rRNA) genes, 22 transporter RNA (tRNA) genes, 13 protein-coding genes (PCGs) and one control region. Twelve of the 13 PCGs have ATG as start codon. Seven of the 13 PCGs contain a TAA stop codon. Most of the tRNA genes and PCGs are encoded on the heavy strand. Phylogenetic analyses were conducted with MEGA using the maximum likelihood method. Sporophila nigricollis grouped together with other Thraupidae species. CONCLUSION: This study presents the first complete mitogenome of Sporophila nigricollis and can be useful for research on evolution, ecology and conservation of this species.

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A decreased posterior tibial slope has been associated with an increased risk of posterior cruciate ligament failure, anterior knee pain, and premature knee osteoarthritis. Trauma is a common cause of osseous genu recurvatum. Surgical management is recommended to correct the tibial slope and prevent knee pain and osteoarthritis progression. This article discusses our preferred treatment using a proximal tibial opening-wedge osteotomy for surgical management of genu recurvatum secondary to significant anterior tibial slope.

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Knowledge on the nutritional and sensory characteristics of wild meat provides a better basis for its use as food, ultimately expanding studies in gastronomy areas and stimulating the development of new products. This review aims to present information on the use of wild meat, with a focus on collared peccaries (Pecari tajacu). The biological characteristics of collared peccaries are discussed, with a focus on the main aspects of their meat. Collared peccary meat has excellent nutritional value due to its high protein levels (18.25%), unsaturated fatty acids (51.6-57.8%), and tenderness, similar to other domestic animals, thereby stimulating the interest of a new product market. Despite the demand for this product, collared peccary meat is scarce and not readily available for commercialization. Further, public policies are needed to encourage the management of this species to add value to the development of a production chain.

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INTRODUCTION: Several osteotomies of the first metatarsal have been described for treatment of hallux valgus but chevron osteotomy is one of the most common and well-established procedure for treating this deformity. Although there is a trend towards considering bilateral surgery there is lack of publications addressing bilateral treatment in ambulatory units. The aim of this study is to analyze results of bilateral and unilateral distal chevron osteotomies associated with lateral soft tissue release as ambulatory procedures. MATERIALS AND METHODS: A retrospective review was made about the patients treated at our ambulatory unit over a period of five years. Initially, general information as patient's satisfaction's rate and return to normal activity's time and evaluation of standardized follow-up charts and records made by the surgeon were recorded. Secondly, the hallux metatarsophalangeal interphalangeal scale developed by the American Orthopedic Foot & Ankle Society was used. RESULTS: A total of 194 patients with 230 feet operated were included in this study. We found 29 patients that didn't meet the inclusion criteria and were excluded. The unilateral group was composed by 139 feet and the bilateral group by 52 feet. The improvement between preoperative and discharge clinical and radiographic results was significant independently in both groups. A total of 14% of complications were found in our study, 19% in the unilateral group and 12% at the bilateral group. None of them required revision surgery. CONCLUSION: Bilateral distal chevron osteotomies, associated with lateral soft tissue release, are safe and effective ambulatory procedures. It was found a satisfactory deformity correction in moderate HV. Both patients that underwent unilateral and bilateral procedures had similar clinical and radiological outcomes with no increase in complications or return to normal activity time. With this study it was demonstrated that bilateral chevron osteotomies can be performed as ambulatory procedures.

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The purpose of the present study was to compare the results of patients operated with trapeziectomy and ligament reconstruction and tendon interposition (LRTI) using flexor carpi radialis tendon versus trapeziectomy followed by suspension of the first metacarpal to the second metacarpal using a Mini TightRope® suture button (suture button suspension: SBS). A single-center prospective randomized controlled trial was performed, comparing 37 patients with SBS and 39 with LRTI. All surgeries were performed by the same fellowship-trained hand surgeon. Patients were assessed by an independent observer at 40 months' follow-up. Pre- and postoperative strength, trapezial space ratio (TSR), range of motion, QuickDASH and visual analogue pain score were recorded. Both procedures improved functional parameters of pain, key strength, tip strength and grip strength while maintaining range of motion, without significant differences. In the SBS group, TSR decreased by 17%, compared to 28% in the LRTI group. The mean operative time was shorter in SBS (63 vs 91 minutes; p < 0.0001), as was immobilization time (2 vs 6 weeks; p < 0.0001), and patients resumed normal activity sooner (10 vs 12 week; p = 0.0138) and required less physical therapy (19.3 vs 13.1 weeks; p < 0.0001). We believe that our results are related to the hypothesis suggested by biomechanical studies that revealed better initial load bearing profile and maintenance of trapezial space following serial loading in cadaver models.

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There is increasing pressure on global agricultural systems due to higher food demand, climate change, and environmental concerns. The design of nanostructures is proposed as one of the economically viable technological solutions that can make agrochemical use (fertilizers and pesticides) more efficient through reduced runoff, increased foliar uptake and bioavailability, and decreased environmental impacts. However, gaps in knowledge about the transport of nanoparticles across the leaf surface and their behavior in planta limit the rational design of nanoparticles for foliar delivery with controlled fate and limited risk. Here, the current literature on nano-objects deposited on leaves is reviewed. The different possible foliar routes of uptake (stomata, cuticle, trichomes, hydathodes, necrotic spots) are discussed, along with the paths of translocation, via the phloem, from the leaf to the end sinks (mature and developing tissues, roots, rhizosphere). This review details the interplays between morphological constraints, environmental stimuli, and physical-chemical properties of nanoparticles influencing their fate, transformation, and transport after foliar deposition. A metadata analysis from the existing literature highlighted that plant used for testing nanoparticle fate are most often dicotyledon plants (75%), while monocotyledons (as cereals) are less considered. Correlations on parameters calculated from the literature indicated that nanoparticle dose, size, zeta potential, and affinity to organic phases correlated with leaf-to-sink translocation, demonstrating that targeting nanoparticles to specific plant compartments by design should be achievable. Correlations also showed that time and plant growth seemed to be drivers for in planta mobility, parameters that are largely overlooked in the literature. This review thus highlights the material design opportunities and the knowledge gaps for targeted, stimuli driven deliveries of safe nanomaterials for agriculture.

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Background Percutaneous scaphoid osteosynthesis is an attractive and increasingly popular option, as a treatment for acute scaphoid fractures in selected cases, and as an alternative to conservative treatment. The purpose of this study is to assess the radiographic positioning of the screw in percutaneous scaphoid fixation, taking into consideration the surgeons' experience, and the difference between volar and dorsal approaches. Methods We retrospectively assessed patients undergoing percutaneous scaphoid fixation from 2013 to 2019. Inclusion criteria are as follows: (1) scaphoid waist fractures (Herbert's B2), (2) a minimum of 18 years of age and a maximum of 55 years of age, (3) dominant hand, (4) manual work, (5) minimum follow-up time of 6 months, and (6) without associated lesions. Criteria for correct positioning are as follows: (1) on the axis or parallel to the scaphoid axis with a maximum deviation of 1.5 mm volar/dorsal, (2) without proximal/dorsal prominence, (3) correct scaphoid alignment/reduction, and (4) absence of threads in the fracture site. Radiographs were evaluated separately by a hand surgeon, a general orthopaedic surgeon, and an orthopaedic resident. Results With a total of 39 patients, a dorsal approach was performed in 10 patients and a palmar approach in 29 patients. We verified a very good interobserver reliability. The hand surgeon's team correctly positioned 15 (83.3%, 15/18), while the other team did 9 correctly (42.9%, 9/21). Comparing teams according to the approach used, the dorsal approach did not show a statistical difference, while the same was not true for the volar approach ( p < 0.05). Conclusion This points to a positive impact on the team's experience in the positioning of the screws, and therefore in the benefit of treatment by teams dedicated to the area, while daring to suggest that less-experienced surgeons should utilize the dorsal approach.

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INTRODUCTION: The majority of patients with ankle injuries undergo radiological examinations of the foot, ankle or both. The objective of this study was in the first place to validate the Ottawa Ankle Rules (OARs) for the population of our centre. Secondly, an attempt was made to identify parameters that contribute to improve the specificity of the method, with a view to reduce the need for patients to be exposed to radiation as well as optimizing the expenses of the Emergency Ward (EW). MATERIALS AND METHODS: This was a prospective study conducted during a 9-month period. The study population included 148 patients, in 54 (36%) of the patients a fracture was present on the exams performed. Patients were submitted to a sequential protocol in the EW with a form completion, evaluation of OARs, application of the Visual Analog Pain Scale (VAS) and radiographic exams. RESULTS: We found a sensitivity of OARs in ankle injuries of 100%, specificity of 26% and in midfoot injuries of 100% and 62% respectively. All patients with fractures had a VAS of 5 or more points in any of the tested sites. With the VAS criterium, we found a significant increase of global specificity (38% vs 15%), as well as when applied only to the ankle (26% to 47%) or to midfoot trauma (62% to 67%). In both, there would have been a 100% reduction of CT scans. Patients with a fracture or with fractures who required surgical treatment had a mean VAS significantly higher than patients with no fracture or fractures submitted to conservative treatment respectively. Although there was a lower percentage of fractures in the group of injuries in Work Accidents (31% vs 37% Sports Activity and 38% Leisure Activity), there was a statistically significant increase in the sum of average VAS in Accidents at Work vs Leisure Activities and vs Sports Activities. CONCLUSION: We seek to confirm the usefulness of OARs for our population and we investigated strategies to further reduce the need for unnecessary radiographs. The introduction of parameters for grading pain and adapting to the context of the accident seem promising.

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In this study, we found that cell cycle arrest induced by alpha-factor mating pheromone (G1), hydroxyurea (S) or nocodazole (G2/M) was associated to increased lipid droplet (LD) content. To identify novel cell cycle genes involved in LD homeostasis, we screened a deletion library for strains with altered LD levels. Among the mutants related to mitotic cell cycle, we found 24 hits that displayed a significantly higher LD content. Ontology mapping showed that neither a biological process nor a specific cell cycle phase was enriched among the hits. We decided to further study the role of SWI4 on LD homeostasis as it is involved in G1/S transition, a stage where lipolysis is active. The high LD content of swi4Δ mutant was not due to inhibition of lipolysis, but due to an increase in triacylglycerol (TAG) synthesis. In addition, deletion of the AMP kinase gene SNF1 or inhibition of TORC1 activity, both known regulators of LD homeostasis, further increased the LD content of a swi4Δ mutant. These findings highlight a role of the cell cycle regulator SWI4 in the coordination of lipid metabolism which is independent of the TORC1 and SNF1/AMPK pathways.

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The protein phosphatase Sit4 has been shown to be required for lipogenesis and resistance against the acetyl-CoA carboxylase inhibitor soraphen A. Since Sit4 is also required for biosynthesis of Elongator dependent tRNA modifications such as 5-methoxycarbonylmethyluridine (mcm5U), we investigated the relevance of tRNA modifications in lipogenesis and soraphen A response. While sit4 and Elongator (elp3) mutants copy defects in mcm5U formation and stress sensitivity, they do not share soraphen A sensitivity and low lipid droplet (LD) phenotypes. In contrast to sit4, we found elp3 mutants to display partial soraphen A resistance and a high LD phenotype. Screening a collection of tRNA modification mutants additionally identified the tRNA pseudo-uridine synthase gene DEG1 to be required for soraphen A sensitivity. Since deg1 and elp3 share high LD and soraphen A resistance phenotypes, these are likely caused by translational defects. In support of this notion, we observe overexpression of tRNAGlnUUG suppresses lipolysis defects of deg1 mutants. Hence, the sit4 mutation results in a composite defect including tRNA modification deficiency and loss of Snf1 kinase dephosphorylation, which induce opposite effects on LD regulation. Importantly, however, the Snf1 kinase regulatory defects of the phosphatase mutant dominate over effects on LD regulation imposed by loss of the tRNA modification alone.

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As unidades de alimentação e nutrição são responsáveis pelo fornecimento de refeições balanceadas e dentro de condições higienicossanitárias satisfatórias. Com este estudo, objetivou-se avaliar as boas práticas de fabricação na unidade de alimentação e nutrição de uma organização militar da cidade de Belém - PA, usando como critério avaliativo a aplicação de um checklist adaptado da Portaria nº 854/SELOM. Foram avaliados 158 itens subdivididos em 5 categorias, tendo como alternativa para os itens observados: (1) conforme; (2) não conforme e (3) não se aplica., classificando a UAN de acordo com os critérios de pontuação da Portaria: (Grupo 1) 76 a 100%; (Grupo 2) 51 a 75%; e (Grupo 3) 0 a 50%. A avaliação identificou 100% de conformidade para as categorias manipuladores e documentação e de não conformidades para as categorias edificações e instalações: 17,8%; equipamentos, moveis e utensílios: 4,8% e produção e transporte de alimentos: 12,5%. De acordo com os resultados, a UAN obteve 87,9% de adequação, considerando o total de itens aplicáveis, e, por meio do critério estabelecido, ficou classificada no Grupo 1. A correção das inadequações é necessária para garantir a qualidade e a segurança na produção de refeições oferecidas pela unidade.

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Acetyl-CoA carboxylase (Acc1p) is a key enzyme in fatty acid biosynthesis and is essential for cell viability. To discover new regulators of its activity, we screened a Saccharomyces cerevisiae deletion library for increased sensitivity to soraphen A, a potent Acc1p inhibitor. The hits identified in the screen (118 hits) were filtered using a chemical-phenotype map to exclude those associated with pleiotropic drug resistance. This enabled the identification of 82 ORFs that are genetic interactors of Acc1p. The main functional clusters represented by these hits were "transcriptional regulation", "protein post-translational modifications" and "lipid metabolism". Further investigation of the "transcriptional regulation" cluster revealed that soraphen A sensitivity is poorly correlated with ACC1 transcript levels. We also studied the three top unknown ORFs that affected soraphen A sensitivity: SOR1 (YDL129W), SOR2 (YIL092W) and SOR3 (YJR039W). Since the C18/C16 ratio of lipid acyl lengths reflects Acc1p activity levels, we evaluated this ratio in the three mutants. Deletion of SOR2 and SOR3 led to reduced acyl lengths, suggesting that Acc1p is indeed down-regulated in these strains. Also, these mutants showed no differences in Snf1p/AMPK activation status and deletion of SNF1 in these backgrounds did not revert soraphen A sensitivity completely. Furthermore, plasmid maintenance was reduced in sor2Δ strain and this trait was shared with 18 other soraphen A sensitive hits. In summary, our screen uncovered novel Acc1p Snf1p/AMPK-independent regulators.

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O trabalho busca avaliar o impacto do aumento do número de médicos sobre as taxas de mortalidade infantil, por doenças infectoparasitárias e total. Para este fim, utiliza o método diferenças em diferenças com dados para os anos de 2012 (anterior ao programa) e 2014 (posterior ao lançamento do programa). Os resultados demonstram que os municípios que aderiram ao programa tiveram redução das taxas de mortalidade, com exceção da taxa de mortalidade infantil, apesar do número de vagas autorizadas não impactar negativamente as taxas de mortalidade. Assim, o aumento do número de médicos não é suficiente para causar impactos positivos na saúde, sendo necessários investimentos em infraestrutura e qualificação dos profissionais.

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The acyl-CoA-binding proteins (ACBP) constitute a family of conserved proteins that bind acyl-CoA with high affinity and protect it from hydrolysis. Thus, ACBPs may have essential roles in basal cellular lipid metabolism. The genome of the insect Rhodnius prolixus encodes five ACBP genes similar to those described for other insect species. The qPCR analysis revealed that these genes have characteristic expression profiles in insect organs, suggesting that they have specific roles in insect physiology. Recombinant RpACBP-1 was able to bind acyl-CoA in an in vitro gel-shift assay. Moreover, heterologous RpACBP-1 expression in acb1Δ mutant yeast rescued the multi-lobed vacuole phenotype, indicating that RpACBP-1 acts as a bona fide acyl-CoA-binding protein. RpACBP-1 knockdown using RNAi caused triacylglycerol accumulation in the insect posterior midgut and a reduction in the number of deposited eggs. The amount of stored triacylglycerol was reduced in flight muscle, and the incorporation of fatty acids in cholesteryl esters was increased in the fat body. These results showed that RpACBP-1 participates in several lipid metabolism steps in R. prolixus.

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BACKGROUND: Several risk factors influence survival after liver transplantation (LT). Some research has demonstrated a relationship between soluble tumor necrosis factor receptors (sTNFRs) and worse clinical liver disease outcomes, but there are no data showing an association between sTNFRs and outcomes after LT. The primary aim of this study was to determine whether an association exists between perioperative sTNFRs and renal dysfunction or mortality after LT. METHODS: Data were collected prospectively from 122 patients submitted to deceased-donor orthotopic LT. Blood samples were collected at seven different perioperative times and analyzed by ELISA. The statistical analysis included univariate analysis followed by logistic regression. The predictive value of significant variables was assessed using ROC curves. RESULTS: One-month and 1-year LT survivals were 91% and 81%, respectively. Increased levels of soluble tumor necrosis factor receptor 1 (sTNF-R1) after 24h of graft perfusion were associated with postoperative Renal Replacement Therapy (RRT) (OR 1.25) and 1-year mortality (OR 1.1). RRT was associated with 30-day and 1-year LT mortality, with OR 19.78 and 45.45, respectively. CONCLUSION: A higher sTNF-R1 level measured 24h after graft perfusion is an independent predictor of RRT and 1-year mortality after LT.

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INTRODUCTION: Liver transplantation is the best therapeutic option for end-stage liver disease. Non-selective beta-blocker medications such as propranolol act directly on the cardiovascular system and are often used in the prevention of gastrointestinal bleeding resulting from HP. The effects of propranolol on cardiovascular system of cirrhotic patients during liver transplantation are not known. OBJECTIVE: Evaluate the influence of propranolol used preoperatively on cardiac index during the anhepatic phase of liver transplantation. METHOD: 101 adult patients (73 male [72.2%]) who underwent cadaveric donor orthotopic liver transplantation by piggyback technique with preservation of the retrohepatic inferior vena cava performed at Hospital das Clinicas, Federal University of Minas Gerais were evaluated. There was no difference in severity between groups by the MELD system, p = 0.70. The preoperative use of propranolol and the cardiac index outcome were compared during the anhepatic phase of liver transplantation in 5 groups (I: increased cardiac index, II: cardiac index reduction lower than 16%, III: cardiac index reduction equal to or greater than 16% and less than 31%, IV: cardiac index reduction equal to or greater than 31% and less than 46%, V: cardiac index reduction equal to or greater than 46%). RESULTS: Patients in group I (46.4%) who received propranolol preoperatively were statistically similar to groups II (60%), III (72.7%), IV (50%) and V (30.8%), p = 0.57. CONCLUSION: The use of propranolol before transplantation as prophylaxis for gastrointestinal bleeding may be considered safe, as it was not associated with worsening of cardiac index in anhepatic phase of liver transplantation. .

INTRODUÇÃO: O transplante hepático (TH) é a melhor opção terapêutica para doença hepática em estágio terminal (DHET). As medicações betabloqueadoras não seletivas, como o propranolol, atuam diretamente no sistema cardiovascular (SCV) e são frequentemente usadas na prevenção de hemorragia digestiva decorrente da HP. Os efeitos do propranolol no SCV de cirróticos durante o TH não são conhecidos. OBJETIVO: Avaliar a influência do uso pré-operatório do propranolol no índice cardíaco (IC) durante a fase anepática do TH. MÉTODO: Avaliaram-se 101 pacientes adultos (73 homens, 72,2%) submetidos a transplante ortotópico de fígado doador cadáver, pela técnica de piggyback com preservação da veia cava inferior retro-hepática, feito no Hospital das Clínicas da Universidade Federal de Minas Gerais. Não houve diferença de gravidade pelo sistema MELD entre os grupos, p = 0,70. Foram comparados o uso pré-operatório de propranolol com o desfecho do IC durante a fase anepática do TH em cinco grupos (I: aumento do IC; II: redução do IC inferior a 16%; III: redução do IC igual a ou maior do que 16% e menor do que 31%; IV: redução do IC igual a ou maior do que 31% e menor do que 46%;V: redução do IC igual a ou maior do que 46%). RESULTADOS: Pacientes que fizeram uso pré-operatório de propranolol no grupo I (46,4%) foram estatisticamente semelhantes aos dos grupos II (60%), III (72,7%), IV (50%) e V (30,8%), p = 0,57. CONCLUSÃO: O propranolol no pré-transplante, como profilaxia para hemorragia digestiva, pode ser considerado seguro, pois não se associou à pioria do IC na fase anepática do TH. .

INTRODUCCIÓN: El trasplante hepático (TH) es la mejor opción terapéutica para la enfermedad hepática en estado terminal. Los betabloqueantes no selectivos, como el propranolol, actúan directamente en el sistema cardiovascular y a menudo son usadas en la prevención de la hemorragia digestiva proveniente de la hipertensión portal. Los efectos del propranolol en el sistema cardiovascular de cirróticos durante el TH no se conocen. OBJETIVO: Evaluar la influencia del uso preoperatorio del propranolol en el índice cardíaco (IC) durante la fase anhepática del TH. MÉTODO: Se estudiaron 101 pacientes adultos (73 hombres [72,2%]) sometidos a trasplante ortotópico de hígado de donante cadáver, por la técnica de piggyback con preservación de la vena cava inferior retrohepática, en el Hospital das Clínicas de la Universidad Federal de Minas Gerais. No hubo diferencia respecto a la gravedad por el sistema Meld entre los grupos (p = 0,70). Se comparó el uso preoperatorio del propranolol con el resultado del IC durante la fase anhepática del TH en 5 grupos (i: aumento del IC; ii: reducción del IC < 16%; iii: reducción del IC ≥ 16% y < 31%; iv: reducción del IC ≥ 31% y < 46%;v: reducción del IC ≥ 46%). RESULTADOS: El número de pacientes que usaron el propranolol en el preoperatorio en el grupo i (46,4%) fue estadísticamente similar a los grupos ii (60%), iii (72,7%), iv (50%) y v (30,8%), p = 0,57. CONCLUSIÓN: El propranolol en el pretrasplante, como profilaxis para la hemorragia digestiva, puede ser considerado seguro porque no se asoció con el empeoramiento del IC en la fase anhepática del TH. .

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INTRODUCTION: Liver transplantation (LT) is the best therapeutic option for end-stage liver disease (ESLD). Non-selective beta-blocker medications such as propranolol act directly on the cardiovascular system (CVS) and are often used in the prevention of gastrointestinal bleeding resulting from HP. The effects of propranolol on CVS of cirrhotic patients during LT are not known. OBJECTIVE: Evaluate the influence of propranolol used preoperatively on cardiac index (CI) during the anhepatic phase of LT. METHOD: 101 adult patients (73 male [72.2%]) who underwent cadaveric donor orthotopic liver transplantation by piggyback technique with preservation of the retrohepatic inferior vena cava performed at Hospital das Clinicas, Federal University of Minas Gerais were evaluated. There was no difference in severity between groups by the MELD system, p=0.70. The preoperative use of propranolol and the CI outcome were compared during the anhepatic phase of LT in 5 groups (I: increased CI, II: CI reduction lower than 16%, III: CI reduction equal to or greater than 16% and less than 31%, IV: CI reduction equal to or greater than 31% and less than 46%, V: CI reduction equal to or greater than 46%). RESULTS: Patients in group I (46.4%) who received propranolol preoperatively were statistically similar to groups II (60%), III (72.7%), IV (50%) and V (30.8%), p=0.57. CONCLUSION: The use of propranolol before transplantation as prophylaxis for gastrointestinal bleeding may be considered safe, as it was not associated with worsening of CI in anhepatic phase of LT.

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INTRODUCTION: Liver transplantation is the best therapeutic option for end-stage liver disease. Non-selective beta-blocker medications such as propranolol act directly on the cardiovascular system and are often used in the prevention of gastrointestinal bleeding resulting from HP. The effects of propranolol on cardiovascular system of cirrhotic patients during liver transplantation are not known. OBJECTIVE: Evaluate the influence of propranolol used preoperatively on cardiac index during the anhepatic phase of liver transplantation. METHOD: 101 adult patients (73 male [72.2%]) who underwent cadaveric donor orthotopic liver transplantation by piggyback technique with preservation of the retrohepatic inferior vena cava performed at Hospital das Clinicas, Federal University of Minas Gerais were evaluated. There was no difference in severity between groups by the MELD system, p=0.70. The preoperative use of propranolol and the cardiac index outcome were compared during the anhepatic phase of liver transplantation in 5 groups (I: increased cardiac index, II: cardiac index reduction lower than 16%, III: cardiac index reduction equal to or greater than 16% and less than 31%, IV: cardiac index reduction equal to or greater than 31% and less than 46%, V: cardiac index reduction equal to or greater than 46%). RESULTS: Patients in group I (46.4%) who received propranolol preoperatively were statistically similar to groups II (60%), III (72.7%), IV (50%) and V (30.8%), p=0.57. CONCLUSION: The use of propranolol before transplantation as prophylaxis for gastrointestinal bleeding may be considered safe, as it was not associated with worsening of cardiac index in anhepatic phase of liver transplantation.

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