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Genotype E of hepatitis B virus (HBV) has not been described in Brazil and is found mainly in Africa. Genotype A is the most prevalent in Brazil, and genotypes B, C, D, and F have already been reported. We report here an HBV genotype E-infected patient and some characterization of surface (S) protein, DNA polymerase (P) and precore/core (preC/C) coding regions based on the viral genome. The patient is a 31-year-old black man with chronic hepatitis B who was born and raised in Angola. He has been followed by a hepatologist in São Paulo, Brazil, since November 2003, and he is a frequent traveler to Latin America, Africa, and Europe. In 2003, he was diagnosed with HBV infection and started treatment with lamivudine with the later addition of adefovir dipivoxil. No known risk factor was identified. Serologically, he is HBsAg and anti-HBe positive, but HBeAg and anti-HBs negative. DNA sequence analysis of the S/P region confirmed that this patient is infected with genotype E, subtype ayw4. The preC/C region showed G1896A and G1899A mutations but no mutations in the basal core promoter. Nucleotide substitutions common in genotype E were also observed (C1772, T1858 and A1757). Although this is not an autochthonous case and there is no evidence of further spread, the description of this case in Brazil highlights the current risk of viral genotypes spreading with unprecedented speed due to constant travel around the world.

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:22:03Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:40:14Z : No. of bitstreams: 1 2-s2.0-33847656226.pdf: 463933 bytes, checksum: 44602f6a6287e821877ae208206bf343 (MD5) Made available in DSpace on 2014-05-27T11:22:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-12-01 Hereditary hemochromatosis is a disorder of iron metabolism characterized by increased iron intake and progressive storage and is related to mutations in the HFE gene. Interactions between thalassemia and hemochromatosis may further increase iron overload. The ethnic background of the Brazilian population is heterogeneous and studies analyzing the simultaneous presence of HFE and thalassemia-related mutations have not been carried out. The aim of this study was to evaluate the prevalence of the H63D, S65C and C282Y mutations in the HFE gene among 102 individuals with alpha-thalassemia and 168 beta-thalassemia heterozygotes and to compare them with 173 control individuals without hemoglobinopathies. The allelic frequencies found in these three groups were 0.98, 2.38, and 0.29% for the C282Y mutation, 13.72, 13.70, and 9.54% for the H63D mutation, and 0, 0.60, and 0.87% for the S65C mutation, respectively. The chi-square test for multiple independent individuals indicated a significant difference among groups for the C282Y mutation, which was shown to be significant between the beta-thalassemia heterozygote and the control group by the Fisher exact test (P value = 0.009). The higher frequency of inheritance of the C282Y mutation in the HFE gene among beta-thalassemic patients may contribute to worsen the clinical picture of these individuals. In view of the characteristics of the Brazilian population, the present results emphasize the need to screen for HFE mutations in beta-thalassemia carriers. Departamento de Biologia Instituto de Biociências Universidade do Estado de São Paulo, 15054-000 Sao Jose do Rio Preto, SP Departamento de Microbiologia Instituto de Ciências Biomédicas Universidade de São Paulo, São Paulo, SP Departamento de Gastroenterologia Faculdade de Medicina Universidade de São Paulo, São Paulo, SP Departamento de Saúde Coletiva e Epidemiologia Faculdade de Medicina de São Jose do Rio Preto, Sao Jose do Rio Preto, SP Departamento de Patologia Clínica Hospital Israelita Albert Einstein, São Paulo, SP

SPE3D is a surgery planning environment developed within TLEMsafe project [1] (funded by the European Commission FP7). It enables the operator to plan a surgical procedure on the customized musculoskeletal (MS) model of the patient's lower limbs, send the modified model to the biomechanical analysis module, and export the scenario's parameters to the surgical navigation system. The personalized patient-specific three-dimensional (3-D) MS model is registered with 3-D MRI dataset of lower limbs and the two modalities may be visualized simultaneously. Apart from main planes, any arbitrary MRI cross-section can be rendered on the 3-D MS model in real time. The interface provides tools for: bone cutting, manipulating and removal, repositioning muscle insertion points, modifying muscle force, removing muscles and placing implants stored in the implant library. SPE3D supports stereoscopic viewing as well as natural inspection/manipulation with use of haptic devices. Alternatively, it may be controlled with use of a standard computer keyboard, mouse and 2D display or a touch screen (e.g. in an operating room). The interface may be utilized in two main fields. Experienced surgeons may use it to simulate their operative plans and prepare input data for a surgical navigation system while student or novice surgeons can use it for training.

We present a human-computer interface that enables the operator to plan a surgical procedure on the musculoskeletal (MS) model of the patient's lower limbs, send the modified model to the bio-mechanical analysis module, and export the scenario parameters to the surgical navigation system. The interface provides the operator with tools for: importing customized MS model of the patient, cutting bones and manipulating/removal of bony fragments, repositioning muscle insertion points, muscle removal and placing implants. After planning the operator exports the modified MS model for bio-mechanical analysis of the functional outcome. If the simulation result is satisfactory the exported scenario data may be directly used during the actual surgery. The advantages of the developed interface are the possibility of installing it in various hardware configurations and coherent operation regardless of the devices used. The hardware configurations proposed to be used with the interface are: (a) a standard computer keyboard and mouse, and a 2-D display, (b) a touch screen as a single device for both input and output, or (c) a 3-D display and a haptic device for natural manipulation of 3-D objects. The interface may be utilized in two main fields. Experienced surgeons may use it to simulate their intervention plans and prepare input data for a surgical navigation system while student or novice surgeons can use it for simulating results of their hypothetical procedure. The interface has been developed in the TLEMsafe project (www.tlemsafe.eu) funded by the European Commission FP7 program.

Occult hepatitis B virus (HBV) infection has been reported among patients with hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC). Our aim was to evaluate the presence of occult HBV infection in patients with HCV-related liver cirrhosis (LC) with or without HCC in São Paulo, Brazil. Serum and liver tissue samples from 50 hepatitis B surface antigen-negative patients with HCV-related LC who underwent liver transplantation at the University of São Paulo School of Medicine Hospital from 1993 to 2004 were divided into groups with LC only (N = 33) and with LC plus HCC (N = 17). HBV DNA was assayed for serum and paraffin-embedded liver tissue (tumoral and non-tumoral) using real time PCR and only 1 case with HCC had HBV DNA-positive serum. All liver samples were negative. HCV genotype 3 was detected in 17/39 (43.7%) cases. In conclusion, using a sensitive real time PCR directed to detect HBV variants circulating in Brazil, occult hepatitis B infection was not found among HCV-positive cirrhotic patients and was rarely found among HCV-positive HCC patients. These results are probably related to the low prevalence of HBV infection in our population. Furthermore, we have also shown that HCV genotype 3 is frequently found in Brazilian cirrhotic patients, particularly when they also have HCC. More studies involving a large number of cases should be carried out to confirm these data and to further characterize Brazilian HCV genotype isolates to elucidate genetic features that might be related to its carcinogenic potential.