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BACKGROUND: Prolonged donor hepatectomy time may be implicated in early and late complications of liver transplantation. AIM: To evaluate the impact of donor hepatectomy time on outcomes of liver transplant recipients, mainly early allograft dysfunction. METHODS: This multicenter retrospective study included brain-dead donors and adult liver graft recipients. Donor-recipient matching was obtained through a crossover list. Clinical and laboratory data were recorded for both donors and recipients. Donor hepatectomy, cold ischemia, and warm ischemia times were recorded. Primary outcome was early allograft dysfunction. Secondary outcomes included need for retransplantation, length of intensive care unit and hospital stay, and patient and graft survival at 12 months. RESULTS: From January 2019 to December 2021, a total of 243 patients underwent a liver transplant from a brain-dead donor. Of these, 57 (25%) developed early allograft dysfunction. The median donor hepatectomy time was 29 (23-40) min. Patients with early allograft dysfunction had a median hepatectomy time of 25 (22-38) min, whereas those without it had a median time of 30 (24-40) min (P = 0.126). CONCLUSION: Donor hepatectomy time was not associated with early allograft dysfunction, graft survival, or patient survival following liver transplantation.

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Brain death triggers an inflammatory cascade that damages organs before procurement, adversely affecting the quality of grafts. This randomized clinical trial aimed to compare the efficacy of liraglutide compared to placebo in attenuating brain death-induced inflammation, endoplasmic reticulum stress, and oxidative stress. We conducted a double-blinded, placebo-controlled, randomized clinical trial with brain-dead donors. Fifty brain-dead donors were randomized to receive subcutaneous liraglutide or placebo. The primary outcome was the reduction in IL-6 plasma levels. Secondary outcomes were changes in other plasma pro-inflammatory (IL-1ß, interferon-γ, TNF) and anti-inflammatory cytokines (IL-10), expression of antiapoptotic ( BCL2 ), endoplasmic reticulum stress markers ( DDIT3/CHOP , HSPA5/BIP ), and antioxidant ( superoxide dismutase 2 , uncoupling protein 2 ) genes, and expression TNF, DDIT3, and superoxide dismutase 2 proteins in liver biopsies. The liraglutide group showed lower cytokine levels compared to the placebo group during follow-up: Δ IL-6 (-28 [-182, 135] vs. 32 [-10.6, 70.7] pg/mL; p = 0.041) and Δ IL-10 (-0.01 [-2.2, 1.5] vs. 1.9 [-0.2, 6.1] pg/mL; p = 0.042), respectively. The administration of liraglutide did not significantly alter the expression of inflammatory, antiapoptotic, endoplasmic reticulum stress, or antioxidant genes in the liver tissue. Similar to gene expression, expressions of proteins in the liver were not affected by the administration of liraglutide. Treatment with liraglutide did not increase the organ recovery rate [OR = 1.2 (95% CI: 0.2-8.6), p = 0.82]. Liraglutide administration reduced IL-6 and prevented the increase of IL-10 plasma levels in brain-dead donors without affecting the expression of genes and proteins related to inflammation, apoptosis, endoplasmic reticulum stress, or oxidative stress.

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OBJECTIVE: To examine the association between donor plasma cytokine levels and the development of primary graft dysfunction of organs transplanted from deceased donors. METHODS: Seventeen deceased donors and the respective 47 transplant recipients were prospectively included in the study. Recipients were divided into two groups: group 1, patients who developed primary graft dysfunction; and group 2, patients who did not develop primary graft dysfunction. Donor plasma levels of TNF, IL-6, IL-1ß, and IFN-γ assessed by ELISA were compared between groups. RESULTS: Sixty-nine organs were retrieved, and 48 transplants were performed. Donor plasma cytokine levels did not differ between groups (in pg/mL): TNF, group 1: 10.8 (4.3 - 30.8) versus group 2: 8.7 (4.1 - 33.1), p = 0.63; IL-6, group 1: 1617.8 (106.7 - 5361.7) versus group 2: 922.9 (161.7 - 5361.7), p = 0.56; IL-1ß, group 1: 0.1 (0.1 - 126.1) versus group 2: 0.1 (0.1 - 243.6), p = 0.60; and IFN-γ, group 1: 0.03 (0.02 - 0.2) versus group 2: 0.03 (0.02 - 0.1), p = 0.93). Similar findings were obtained when kidney transplants were analyzed separately. CONCLUSION: In this sample of transplant recipients, deceased donor plasma cytokines TNF, IL-6, IL-1ß, and IFN-γ were not associated with the development of primary graft dysfunction.

OBJETIVO: Examinar a associação entre os níveis de citocinas no plasma do doador e o desenvolvimento de disfunção primária do enxerto de órgãos transplantados a partir de doadores falecidos. MÉTODOS: Foram incluídos no estudo de forma prospectiva 17 doadores falecidos e os respectivos 47 pacientes receptores de transplante. Os receptores foram divididos em dois grupos: grupo 1, de pacientes que desenvolveram disfunção primária do enxerto, e grupo 2, de pacientes que não desenvolveram disfunção primária do enxerto. Os níveis de TNF, IL-6, IL-1ß, e IFN-γ, avaliados por meio de ELISA, foram comparados entre os grupos. RESULTADOS: Obtiveram-se 69 órgãos, sendo realizados 48 transplantes. Os níveis plasmáticos de citocinas nos doadores não diferiram entre os grupos (em pg/mL): TNF no grupo 1, com 10,8 (4,3 - 30,8) versus no grupo 2, com 8,7 (4,1 - 33,1), com valor de p = 0,63; IL-6 no grupo 1: 1.617,8 (106,7 - 5.361,7) versus no grupo 2: 922,9 (161,7 - 5.361,7), com p = 0,56; IL-1ß, no grupo 1: 0,1 (0,1 - 126,1) versus no grupo 2: 0,1 (0,1 - 243,6), com p = 0,60; e IFN-γ, no grupo 1: 0,03 (0,02 - 0,2) versus no grupo 2: 0,03 (0,02 - 0,1), p = 0,93). Obtivemos resultados similares ao examinar separadamente os casos de transplante renal. CONCLUSÃO: Nesta amostra de receptores de transplante, os níveis plasmáticos das citocinas TNF, IL-6, IL-1ß e IFN-γ nos doadores não se associaram com o desenvolvimento de disfunção primária do enxerto.

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RESUMO Objetivo: Examinar a associação entre os níveis de citocinas no plasma do doador e o desenvolvimento de disfunção primária do enxerto de órgãos transplantados a partir de doadores falecidos. Métodos: Foram incluídos no estudo de forma prospectiva 17 doadores falecidos e os respectivos 47 pacientes receptores de transplante. Os receptores foram divididos em dois grupos: grupo 1, de pacientes que desenvolveram disfunção primária do enxerto, e grupo 2, de pacientes que não desenvolveram disfunção primária do enxerto. Os níveis de TNF, IL-6, IL-1β, e IFN-γ, avaliados por meio de ELISA, foram comparados entre os grupos. Resultados: Obtiveram-se 69 órgãos, sendo realizados 48 transplantes. Os níveis plasmáticos de citocinas nos doadores não diferiram entre os grupos (em pg/mL): TNF no grupo 1, com 10,8 (4,3 - 30,8) versus no grupo 2, com 8,7 (4,1 - 33,1), com valor de p = 0,63; IL-6 no grupo 1: 1.617,8 (106,7 - 5.361,7) versus no grupo 2: 922,9 (161,7 - 5.361,7), com p = 0,56; IL-1β, no grupo 1: 0,1 (0,1 - 126,1) versus no grupo 2: 0,1 (0,1 - 243,6), com p = 0,60; e IFN-γ, no grupo 1: 0,03 (0,02 - 0,2) versus no grupo 2: 0,03 (0,02 - 0,1), p = 0,93). Obtivemos resultados similares ao examinar separadamente os casos de transplante renal. Conclusão: Nesta amostra de receptores de transplante, os níveis plasmáticos das citocinas TNF, IL-6, IL-1β e IFN-γ nos doadores não se associaram com o desenvolvimento de disfunção primária do enxerto.

ABSTRACT Objective: To examine the association between donor plasma cytokine levels and the development of primary graft dysfunction of organs transplanted from deceased donors. Methods: Seventeen deceased donors and the respective 47 transplant recipients were prospectively included in the study. Recipients were divided into two groups: group 1, patients who developed primary graft dysfunction; and group 2, patients who did not develop primary graft dysfunction. Donor plasma levels of TNF, IL-6, IL-1β, and IFN-γ assessed by ELISA were compared between groups. Results: Sixty-nine organs were retrieved, and 48 transplants were performed. Donor plasma cytokine levels did not differ between groups (in pg/mL): TNF, group 1: 10.8 (4.3 - 30.8) versus group 2: 8.7 (4.1 - 33.1), p = 0.63; IL-6, group 1: 1617.8 (106.7 - 5361.7) versus group 2: 922.9 (161.7 - 5361.7), p = 0.56; IL-1β, group 1: 0.1 (0.1 - 126.1) versus group 2: 0.1 (0.1 - 243.6), p = 0.60; and IFN-γ, group 1: 0.03 (0.02 - 0.2) versus group 2: 0.03 (0.02 - 0.1), p = 0.93). Similar findings were obtained when kidney transplants were analyzed separately. Conclusion: In this sample of transplant recipients, deceased donor plasma cytokines TNF, IL-6, IL-1β, and IFN-γ were not associated with the development of primary graft dysfunction.

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Brain death (BD) is associated with a systemic inflammation leading to worse graft outcomes. This study aimed to compare plasma cytokine values between brain-dead and critically ill patients, including septic and non-septic controls, and evaluate cytokine release kinetics in BD. Sixteen brain-dead and 32 control patients (16 with and 16 without sepsis) were included. Plasma cytokines were measured by magnetic bead assay after the first clinical exam consistent with BD and every 6 hours thereafter, and at the time of study entry in the control group. The values for IL-8 and IFN-γ were higher in brain-dead and septic patients than in non-septic patients [IL-8: 80.3 (18.7-169.6) vs. 68.2 (22.4-359.4) vs. 16.4 (9.2-42.7) pg/mL; P = 0.006; IFN-γ: 2.8 (1.6-6.1) vs. 3.4 (1.2-9.0) vs. 0.5 (0.5-1.8) pg/mL; P = 0.012]. TNF showed a clear tendency to increase in brain-dead patients [2.7 (1.0-4.8) vs. 1.0 (1.0-5.6) vs. 1.0 (1.0-1.0) pg/mL; P = 0.051], and IL-6 values were higher in brain-dead patients than in non-septic controls [174.5 (104.9-692.5) vs. 13.2 (7.3-38.6) pg/mL; P = 0.002]. These differences remained even after excluding brain-dead patients who also had sepsis ( n = 3). IL-1ß and IL-10 values increased from baseline to time point 2 (∼6 hours later) [IL-1ß: 5.39 (1.93-16.89) vs. 7.11 (1.93-29.13) pg/mL; P = 0.012; IL-10: 8.78 (3.62-16.49) vs. 15.73 (5.49-23.98) pg/mL; P = 0.009]. BD-induced and sepsis-induced plasma cytokine values were similarly high, and both were higher than the observed in non-septic critically ill patients.

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BACKGROUND: Vitamin D insufficiency is linked to several common inflammatory disorders. Brain death (BD) causes a massive catecholamine release, leading to intense inflammatory activity. We aimed to evaluate vitamin D serum levels in brain-dead individuals in comparison to critically ill patients without BD to assess the correlation between vitamin D and cytokine levels. METHODS: Sixteen brain-dead patients and 32 critically ill controls were prospectively enrolled. Blood samples from 25 brain-dead patients from a previous study were also used for vitamin D quantification. Plasma TNF, IL-1ß, IL-6, IL-8, IL-10, IFN-γ and serum vitamin D levels were compared using Student's t-test or one-way ANOVA. Spearman's test was used to assess the correlation between vitamin D and cytokine levels. RESULTS: Mean vitamin D levels were 16.4 ±â€¯7.9 ng/mL, with 52 patients (71.2%) classified as vitamin D deficient (serum levels < 20 ng/mL). Vitamin D levels were similar in 41 brain-dead patients as compared to control subjects (15.6 ±â€¯6.9 ng/mL vs 17.4 ±â€¯9.0 ng/mL; p = 0.383). Moderate direct correlations were observed between vitamin D and IL-8, IL-10, and IFN-γ in the prospective group of 16 brain-dead patients (IL-8: r = 0.5, p = 0.049; IL-10 r = 0.67, p = 0.005; IFN-γ r = 0.6, p = 0.015). Vitamin D was inversely correlated with IL-6 (r = -0.36, p = 0.044) in critically ill controls. CONCLUSIONS: Vitamin D serum levels were similarly low in brain-dead and critically ill patients. In brain-dead patients, vitamin D serum levels correlated with plasma IL-8, IL-10 and IFN-γ.

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INTRODUCTION: Sex workers (SWs) are vulnerable to HIV, hepatitis, and syphilis coinfection. METHODS: A cross-sectional study was conducted in Tubarão, Laguna, and Imbituba, Southern Brazil. We surveyed 147 SWs using face-to-face interviews and blood sampling for serological evaluation. RESULTS: Prevalence of hepatitis B (HBV) was 23.1%, syphilis 19.7%, hepatitis C (HCV) 8.8%, and HIV 8.8%. Of 13 HIV-infected patients, 3 were co-infected with HCV, 4 with syphilis, and 5 with HBV. CONCLUSIONS: SWs had high HIV infection rates, and coinfection with viral hepatitis and syphilis.

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BACKGROUND: Skin cancer is the most common neoplasm in Brazil, with increasing incidence in recent decades. Data on the incidence of squamous cell carcinoma are scarce in southern Santa Catarina. OBJECTIVE: To establish epidemiological data on squamous cell carcinoma in Tubarão, State of Santa Catarina. METHODS: A cross-sectional review was conducted on anatomical pathology reports, positive for squamous cell carcinoma of the skin, found in the local laboratories. A convenience sampling method was used for data collection, since all the pathology reports from the local laboratories between 1999 and 2009 were included. The collected variables included year of diagnosis, age, gender, city of origin, tumor site, histological type and subtype, lesion size, margin involvement and relapse. RESULTS: In total, 1,437 case reports were identified, most frequently in individuals between 70 and 79 years old. Patient morbidity was 69.5 per 100,000 population for the year 1999, and 136.7 per 100,000 population for the year 2009, which represents a 50 percent increase. The face was the most affected area and the most common histological subtype was the well-differentiated tumor. CONCLUSION: There were 1,437 reports of squamous cell carcinoma of the skin between 1999 and 2009, with a significant increase in patient morbidity. There was an association between male gender and location on the lip and ear, and between females and the occurrence of squamous cell carcinoma of the skin on the nose, and upper and lower limbs. There was a prevalence of margin involvement after resection in 18% of lesions.

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BACKGROUND: Skin cancer is the most common neoplasm in Brazil, with increasing incidence in recent decades. Data on the incidence of squamous cell carcinoma are scarce in southern Santa Catarina. OBJECTIVE: To establish epidemiological data on squamous cell carcinoma in Tubarão, State of Santa Catarina. METHODS: A cross-sectional review was conducted on anatomical pathology reports, positive for squamous cell carcinoma of the skin, found in the local laboratories. A convenience sampling method was used for data collection, since all the pathology reports from the local laboratories between 1999 and 2009 were included. The collected variables included year of diagnosis, age, gender, city of origin, tumor site, histological type and subtype, lesion size, margin involvement and relapse. RESULTS: In total, 1,437 case reports were identified, most frequently in individuals between 70 and 79 years old. Patient morbidity was 69.5 per 100,000 population for the year 1999, and 136.7 per 100,000 population for the year 2009, which represents a 50 percent increase. The face was the most affected area and the most common histological subtype was the well-differentiated tumor. CONCLUSION: There were 1,437 reports of squamous cell carcinoma of the skin between 1999 and 2009, with a significant increase in patient morbidity. There was an association between male gender and location on the lip and ear, and between females and the occurrence of squamous cell carcinoma of the skin on the nose, and upper and lower limbs. There was a prevalence of margin involvement after resection in 18% of lesions.

FUNDAMENTOS: O câncer da pele é a neoplasia mais frequente no Brasil, com incidência crescente nas últimas décadas. Na Região Sul de Santa Catarina os dados sobre a incidência de carcinoma espinocelular são escassos. OBJETIVO: Estabelecer dados epidemiológicos do carcinoma espinocelular em Tubarão (SC). MÉTODOS: Foi realizado estudo transversal com revisão dos laudos anatomopatológicos positivos para o carcinoma espinocelular dos laboratórios de Tubarão, SC amostragem por conveniência, e as variáveis coletadas foram: ano do diagnóstico, idade, sexo, cidade de origem, local da lesão, grau de diferenciação, diâmetro da lesão, comprometimento de margem e ocorrência de recidiva. RESULTADOS: Identificaram-se 1.437 laudos com diagnóstico de carcinoma espinocelular, com maior frequência na faixa etária entre 70 e 79 anos. Foi calculado o coeficiente de morbidade para carcinoma espinocelular de 69,5 em 1999 e 136,7/100.000 habitantes para 2009, acarretando aumento de 50%. A região de face foi a mais acometida e o subtipo histológico mais comum foi o bem diferenciado. CONCLUSÃO: Ocorreram 1.437 laudos de carcinoma espinocelular entre 1999 e 2009, com aumento significativo da morbidade. Houve associação entre sexo masculino e a localização em lábio e orelha, e entre sexo feminino e ocorrência de carcinoma espinocelular no nariz, membros superiores e inferiores. Houve prevalência de margens comprometidas após ressecção em 18% das lesões.

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Introdução: Os acidentes e a violência no Brasil configuram problema de saúde pública de grande magnitude e transcendência, que tem provocado forte impacto na morbi-mortalidade da população. O objetivo deste estudo foi avaliar a mortalidade por causas externas em Tubarão (SC) no ano de 2009. Métodos: Trata-se de um estudo epidemiológico com delineamento transversal. Os casos foram compostos por 100% dos óbitos registrados por causas externas no Instituto Médico Legal (IML) do Município de Tubarão (SC) no ano de 2009. Resultados: Ocorreram 213 óbitos por causas externas, correspondendo a 20% do número de óbitos no ano de 2009. A maior prevalência é decorrente dos acidentes de trânsito. Houve associação estatisticamente significativa entre acidente de trânsito e morte por trauma cranioencefálico (p<0,001). A BR-101 e a Rodovia SC-438 foram os locais com maior número de vítimas por acidentes de trânsito, com 70% e 21%, respectivamente. Por estar situado entre a BR-101, uma das rodovias mais movimentadas do Estado de Santa Catarina e do Brasil, o Município de Tubarão apresenta elevado índice de morte por acidente de trânsito, sendo responsável por 46,7% dos acidentes por causas externas. Quanto às vítimas, mais de 80% eram do gênero masculino, jovens e de baixa escolaridade. Em relação ao suicídio, 74% ocorreram entre os homens, sendo que 44,4% por enforcamento. Conclusões: O perfil das vítimas foi de homens jovens, residentes em municípios vizinhos, sendo a principal causa os acidentes de trânsito (46,7%) cuja principal lesão é o trauma cranioencefálio.

Introduction: Accidents and violence in Brazil constitute a public health problem of great magnitude and importance, as they have had a strong impact on morbidity and mortality rates. The aim of this study was to assess mortality from external causes in the city of Tubarão, SC in 2009. Methods: This is a cross-sectional epidemiological study. The cases were composed of all (100%) of the deaths from external causes registered in the Legal Medical Institute of Tubarão in 2009. Results: There were 213 deaths from external causes, accounting for 20% of the number of deaths in 2009. The highest prevalence is a result of traffic accidents. There were significant associations between traffic accidents and death from head injury (p <0.001). The BR-101 and SC-438 highways are the places with the highest number of fatalities from traffic accidents, with 70% and 21%, respectively. As it is located around the BR-101, one of the busiest highways in the state of Santa Catarina and Brazil, Tubarão has a high death rate from traffic accidents, accounting for 46.7% of accidents due to external causes. Over 80% of the victims were poorly educated young males. In relation to suicide, 74% occurred among men and 44.4% by hanging. Conclusions: The profile of the victims was young men, living in neighboring cities, the main cause being traffic accidents (46.7%) whose primary injury is head trauma.

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