-Background -The prevalence and consequences of occult HBV infection in patients with chronic liver disease by HCV remain unknown. Aims -To evaluate the prevalence of occult HBV infection in a population of HCV-infected patients with hepatocellular carcinoma. Methods -The serum samples were tested for HBV DNA by nested PCR and liver tissue analysis was carried out using the immunohistochemical technique of 66 HBsAg-negative patients: 26 patients with chronic hepatitis by HCV (group 1), 20 with hepatocellular carcinoma related to chronic infection by HCV (group 2) and 20 with negative viral markers for hepatitis B and C (control group). Results -Occult HBV infection was diagnosed in the liver tissue of 9/46 (19.5%) HCV-infected patients. Prevalence of occult B infection was evaluated in the HCV-infected patients with and without hepatocellular carcinoma, and there were seven (77.7%) of whom from group 2, conferring a 35% prevalence of this group. No serum sample was positive for HBV DNA in the three groups. Conclusion -Occult infection B is frequently detected in liver tissue of HCV-infected patients, especially in cases of hepatocellular carcinoma. However large studies are needed to confi rm that co-infection could determine a worse progress of chronic liver disease in this population.

RESUMO -Racional -Os vírus das hepatites B (VHB) e C (VHC) e da imunodefi ciência humana (HIV) utilizam a mesma rota de transmissão, sendo a prevalência de VHB e VHC em pacientes infectados pelo HIV maior do que aquela encontrada na população em geral. Objetivo -Determinar a prevalência de marcadores para hepatites B e C em uma população de pacientes com HIV, bem como os fatores de risco envolvidos.

-Context -No effective treatment is available for nonalcoholic steatohepatitis in nowadays. Objectives -To develop a model of nonalcoholic steatohepatitis induced by a methionine and choline deficient diet, as well as to evaluate the role of metformin, vitamin E and simvastatin in the nonalcoholic steatohepatitis progression. Methods -The study analyzed prospectively 50 Wistar rats for a 90-day period and divided them into five groups of 10 rats. One group was given standard rat diet and the others received the methionine and choline deficient diet. Among the four groups that received this diet, one received saline 0,9% and the others received metformin, vitamin E or simvastatin. After the study period, the animals were sacrificed and their blood was collected for biochemical analysis. The livers were removed for lipoperoxidation analysis and for the histological examinations. Results -The methionine and choline deficient diet was able to induce steatosis in 100% of the animals and nonalcoholic steatohepatitis in 27 (69.2%). The alanine aminotransferase levels were significantly higher in the simvastatin group. The aspartate aminotransferase levels were also higher in the simvastatin group, but were statistically significant only in relation to the standard diet group. When lipoperoxidation values were compared, the groups that received standard rat diet and methionine and choline deficient with vitamin E presented significantly lower rates than the others. The presence of fibrosis was significantly smaller in the group receiving vitamin E. Conclusions -The diet used was able to induce steatosis and nonalcoholic steatohepatitis. Besides vitamin E showed to reduce the liver oxidative stress, as well as the fibrosis development. HEADINGS -Vitamin E. Fatty liver. Rats.

RESUMO -Racional -O estado de ativação imune provocado pelo vírus da hepatite C pode agir deleteriamente em indivíduos portadores do vírus da imunodeficiência humana, favorecendo a destruição mais rápida dos linfócitos CD4. Por outro lado, a recuperação imune observada após o início da terapia antiretroviral pode ser parcialmente embotada em indivíduos co-infectados pelo vírus da hepatite C. Objetivo -Avaliar o impacto da co-infecção pelo vírus da hepatite C na imunidade celular dos pacientes infectados pelo vírus da imunodeficiência humana. Métodos -Foram avaliados pacientes co-infectados por ambos os vírus, atendidos prospectivamente no Ambulatório de Gastroenterologia do Hospital Nossa Senhora da Conceição, Porto Alegre, RS (grupo 1 -385 pacientes), e monoinfectados pelo vírus da imunodeficiência humana cujos dados foram obtidos através da revisão dos prontuários do Serviço de Infectologia do mesmo Hospital (grupo 2 -198 pacientes). Foram avaliados dados demográficos (gênero, raça, idade), contagem de células CD4 e CD8, relação CD4/CD8 e carga viral do vírus da imunodeficiência humana. O nível de significância adotado foi de 5%. Resultados -Não houve diferença estatisticamente significativa quando avaliados os valores médios da contagem de células CD4 (374,7 ± 215,7 x 357,5 ± 266,0), CD8 (1.512,4 ± 7.274,6 x 986,7 ± 436,4) e da carga viral do vírus da imunodeficiência humana (83.744,2 ± 190.292,0 x 104.464,0 ± 486.880,5), respectivamente nos grupos 1 e 2, bem como na proporção de pacientes com relação CD4/CD8 menor que 1. Conclusão -A co-infecção por estes vírus não trouxe impacto negativo relevante em relação aos monoinfectados pelo vírus da imunodeficiência humana e as características de imunidade foram semelhantes.

The development of robotic systems for surgery started in the 1980s, motivated by the US army's requirement of surgical procedures in combat areas with the surgeon in a distant place (telepresence). But the first human application of robotic surgery occurred in a robotic surgery, years later.Cardiac surgeons were attracted by the robotic techniques due to the potential reduction in the invasive character of the procedures. This results in reduced trauma, fast recovery and low cost of surgery. Robotic systems were developed, allowing totally thoracoscopic cardiac surgery for myocardial revascularization and multi-site pacemaker implant in selected cases. Support systems for videothoracoscopic also exist and may give support to internal thoracic artery harvesting, mitral valve reconstruction correction of congenital heart defects. We have used the AESOP ® system, with HERMES ® voice control, to harvest the internal thoracic arteries, trans-thoracic implantation of left ventricular electrodes and to correct congenital heart defects.In spite of scientific enthusiasm relating to robotic surgery, there is no clear evidence of superiority of this technique if compared to conventional procedures in terms of results. The same is true with the cost of the procedures as even if a single robotic surgery is less expensive, the initial investment for a complete robotic system (console, video control, instruments) can only be compensated with many procedures. But there is no doubt that robotic surgery will have a place in the future of surgery, providing telepresence of the surgeon, allowing teaching and training and performing less invasive surgical procedures. Descriptors: Robotics. Cardiac surgical procedures, methods. Surgical procedures, minimally invasive. Resumo