Correction to: Abstracts : 29th European Congress of Pathology

In Poster Sessions, the first-author name was missing from the authorship group originally listed for Abstract PS-13-001 (page S176), entitled "Gastric carcinoma with lymphoid stroma: Analysis of microsatellite instability and Epstein-Barr virus status". The correct authorship group is shown above.

De Mello's Single Incision for Combined Liver-kidney Transplantation, Keeping the Kidney Retroperitoneal: A Case Report

The combined liver-kidney transplantation (cLKT) is the procedure of choice for patients with end-stage liver and kidney disease. In cLKT we can usually accommodate the grafts in two different ways, varying the kidney placement. The retroperitoneal kidney implant has some advantages, such as the easy access or avoiding vascular complications. We propose a new single incision, not yet reported, maintaining an extraperitoneal kidney, with excellent surgical field for cLKT and possible reduction of the impact of wound complications.

Gender Difference Among Admitted Patients with Bipolar Disorder in a Psychiatric Service During a Three-year Period

Introduction

Gender differences in bipolar disorder are becoming apparent, but have been less studied compared with major depression. The presentation, clinical features, course and evolution of bipolar disorder differ between men and women. Research data on these differences will help determine whether gender is important in influencing illness variables.

Objectives

Determine whether men and women with bipolar disorder have statistical significant differences in socio-demographic and clinical data.

Methods

Charts of all patients with a diagnosis of bipolar disorder admitted in the Coimbra Hospital and Universitary Center over a three-year period (between 2013 and 2015) were reviewed to gather data on socio-demographic, clinical and psychopathological variables to assess differences across genders. Statistical analysis of data with “SPSS21”.

Results

During a three-year period, 189 patients were admitted with bipolar disorder, the majority were female patients, with ages between 21 and 84 years old. The authors will analyse if there is any statistical significant difference between gender in the rate of bipolar I or II diagnoses, age at onset, symptom presentation, delay in diagnoses, number of depressive, or manic episodes, hospitalisations, involuntarily admissions, number of suicide attempts, co-morbidity rates, negative life events, family history and treatment options. Sociodemograpic characteristics will also be analysed.

Conclusion

Gender differences in bipolar disorder is a controversial issue in the literature. The importance of gender on the course and outcome in bipolar disorder has been widely acknowledged. The limited data suggest that the prevalence is similar between sexes but that the course of illness may be different.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Ect Combined with Clomipramine and rTMS in an OCD Patient with Secondary Severe Depression

Introduction

Obsessive-compulsive disorder (OCD) has high rates of comorbidity with mood disorders, mainly major depressive disorder (MDD). Symptoms of depression are usually secondary to severe and disabling OCD. Electroconvulsive therapy (ECT) has been an effective and well tolerated therapeutic alternative in the management of refractory MDD. Other neuromodulation techniques, such as repetitive transcranial magnetic stimulation (rTMS), have well known efficacy in MDD and also have shown positive results, in clinical trials, treating other psychiatric disorders such as OCD.

Objectives/aims

To determine the efficacy of combining rTMS, ECT and clomipramine in the treatment of severe OCD with comorbid severe MDD.

Methods

The authors report a case of a 54-year-old male patient diagnosed with severe OCD for 23 years. He has been submitted to several drug treatments and intensive cognitive-behavioural therapy (CBT) always with poor response. The patient was admitted in the beginning of 2016 in our inpatient unit. Besides continuing drug treatment (clomipramine IV) and CBT, he was submitted to 12 ECT sessions during one month (3 sessions per week) and to daily sessions of rTMS during the following month.

Outcome measures were obtained using Y-BOCS for OCD and HAM-D for depression.

Results

Our patient responded to ECT with mood improvement after session 4 to full euthymic state at the final session. He also responded well to rTMS with Y-BOCS score reduction.

Conclusion

Combined ECT and rTMS treatment with clomipramine IV and CBT was effective in our patient with a severe form of both disorders (OCD and MDD).

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Resposta imunológica a antígenos de Hysterothylacium deardorffoverstreetorum de peixes teleósteos

RESUMO Anisaquidose é uma doença provocada por parasitos da família Anisakidae e se caracteriza por manifestações gastrointestinais e alérgicas. O Anisakis simplex é o parasito mais patogênico ao homem e altamente alergênico. Porém, outros anisaquídeos também são danosos aos humanos, mas é desconhecida a imunogenicidade dessas larvas. O objetivo deste trabalho foi avaliar o potencial imunogênico do parasito Hysterothylacium deardorffoverestreetorum (HD) em modelo murino. Camundongos da linhagem BALB/c foram divididos em três grupos experimentais e receberam as preparações antigênicas obtidas de larvas de HD: extrato bruto de larvas (EBH), extrato secretado/ excretado de larvas (ESH) e extrato bruto de larvas após excreção/secreção (EEH). Amostras séricas foram obtidas em diferentes dias após imunização para determinação dos níveis de anticorpos específicos pelo ensaio imunoenzimático (ELISA). Os resultados demonstram aumento na produção de imunoglobulina (Ig) G após a segunda imunização, com aumento progressivo após a terceira imunização. Já em relação à IgE, a reatividade foi mais tardia, demonstrando aumento progressivo após a terceira imunização. Foi avaliada a imunidade celular por meio da intradermorreação, como resultado estatisticamente significativo em relação ao controle utilizado. Este experimento é a primeira descrição da potencialidade patogênica desse parasito em mamíferos e representa um avanço no diagnóstico da anisaquidose humana.

REUTILIZAÇÃO DA SOBRA DE ÁGUA PERMEADA E DE REJEITO DE UMA CENTRAL DE TRATAMENTO DE ÁGUA POR OSMOSE REVERSA DE UMA UNIDADE DE HEMODIÁLISE HOSPITALAR

Esse trabalho trata da possibilidade de reutilizar a água do rejeito e a sobra da água permeada proveniente de um sistemade Osmose Reversa, OR, da unidade de hemodiálise do Hospital das Clínicas de Ribeirão Preto (HCRP-USP). O estudo foi feito por meio de levantamento estrutural com plantas físicas e ‘layout’do local, fazendo visitas a esse local para analisar a qualidade e verificar a quantidade de água utilizada no mesmo e, principalmente, do estudo das características bacteriológicas e físico-químicas da água a ser reaproveitada. O resultado obtido das análises da sobra de água permeada e do rejeito mostrou que é possível reutilizar a sobra de água permeada diretamente na caixa central do HCRP-USP, pois esse procedimento não altera a qualidade da água de abastecimento do hospital, sendo somente de 0,73 % dediluição. Com a instalação do sistema de reaproveitamento da sobra de água permeada o HCRP-USP passou a ter uma economia em volume de água de 575 m3/mês. O custo total de implantação do sistema não passou de 5.809,43 reais, ou seja, com pouquíssimo recurso financeiro o hospital obteve uma grande economia no insumo água.

Development of an optimized AAV2/5 gene therapy vector for Leber congenital amaurosis owing to defects in RPE65

Leber congenital amaurosis is a group of inherited retinal dystrophies that cause severe sight impairment in childhood; RPE65-deficiency causes impaired rod photoreceptor function from birth and progressive impairment of cone photoreceptor function associated with retinal degeneration. In animal models of RPE65 deficiency, subretinal injection of recombinant adeno-associated virus (AAV) 2/2 vectors carrying RPE65 cDNA improves rod photoreceptor function, and intervention at an early stage of disease provides sustained benefit by protecting cone photoreceptors against retinal degeneration. In affected humans, administration of these vectors has resulted to date in relatively modest improvements in photoreceptor function, even when retinal degeneration is comparatively mild, and the duration of benefit is limited by progressive retinal degeneration. We conclude that the demand for RPE65 in humans is not fully met by current vectors, and predict that a more powerful vector will provide more durable benefit. With this aim we have modified the original AAV2/2 vector to generate AAV2/5-OPTIRPE65. The new configuration consists of an AAV vector serotype 5 carrying an optimized hRPE65 promoter and a codon-optimized hRPE65 gene. In mice, AAV2/5-OPTIRPE65 is at least 300-fold more potent than our original AAV2/2 vector.

Preparation and characterization of electrical conductive PVA based materials for peripheral nerve tube-guides

Peripheral nerve regeneration is a serious clinical problem. Presently, there are several nerve tube-guides available in the market, however with some limitations. The goal of this work was the development of a biomaterial with high electrical conductivity to produce tube-guides for nerve regeneration after neurotmesis injuries whenrver an end-to-end suture without tension is not possible. A matrix of poly(vinyl alcohol) (PVA) was used loaded with the following electrical conductive materials: COOH-functionalized multiwall carbon nanotubes (MWCNTs), poly(pyrrole) (PPy), magnesium chloride (MgCl2 ), and silver nitrate (AgNO3 ). The tube-guide production was carried out by a freezing/thawing process (physical crosslinking) with a final annealing treatment. After producing the tube-guide for nerve regeneration, the physicochemical characterization was performed. The most interesting results were achieved by loading PVA with 0.05% of PPy or COOH- functionalized CNTs. These tubes combined the electrical conductivity of carbon nanotubes (CNTs) and PPy with the biocompatibility of PVA matrix, with potential clinical application for nerve regeneration. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1981-1987, 2016.

Behavioural variability and motor performance: Effect of practice specialization in front crawl swimming

The aim was to examine behavioural variability within and between individuals, especially in a swimming task, to explore how swimmers with various specialty (competitive short distance swimming vs. triathlon) adapt to repetitive events of sub-maximal intensity, controlled in speed but of various distances. Five swimmers and five triathletes randomly performed three variants (with steps of 200, 300 and 400m distances) of a front crawl incremental step test until exhaustion. Multi-camera system was used to collect and analyse eight kinematical and swimming efficiency parameters. Analysis of variance showed significant differences between swimmers and triathletes, with significant individual effect. Cluster analysis put these parameters together to investigate whether each individual used the same pattern(s) and one or several patterns to achieve the task goal. Results exhibited ten patterns for the whole population, with only two behavioural patterns shared between swimmers and triathletes. Swimmers tended to use higher hand velocity and index of coordination than triathletes. Mono-stability occurred in swimmers whatever the task constraint showing high stability, while triathletes revealed bi-stability because they switched to another pattern at mid-distance of the task. Finally, our analysis helped to explain and understand effect of specialty and more broadly individual adaptation to task constraint.

N–methyl–D–aspartate antagonists in depression–15 years after the first ketamine clinical study what has changed?

Introduction

In the last decades, multiple studies have suggested evidences of disturbances within the glutamate system in depressed patients. The first clinical study using ketamine in depression treatment was conduct fifteen years ago. Since then several studies tried to understand the mechanisms underlying the antidepressant effects of ketamine, as well as discover new drugs with better pharmacodynamic profiles.

Objectives/aims

Review the literature on the role of glutamate system in depression and novel approaches with glutamate N–methyl–D–aspartate receptor antagonists in depression.

Methods

Search and review of scientific literature on PubMed database with the keywords.

“major depressive disorder”, “depression”, “ketamine”, “glutamate”, “NMDA”, “neuroplasticity”.

Results

Abnormalities of the glutamate clearance at synaptic space and astrocytic dysfunction associated with glutamate metabolism have been associated with depressive symptomatology. In depressed patients, reduced levels of glutamate have been described by magnetic resonance spectroscopy in multiple cortical areas, amygdala and hippocampus, supportting the hypothesis of glutamate system involvement in the neurobiology of depression. Indeed, in the last 15 years, multiple clinical studies using ketamine provided some evidence that glutamate N–methyl–D–aspartate receptor antagonism could be an approach for refractory forms of depression. However, regardless all of the evidences, no drug targeting specifically the glutamate system has been approved for depression treatment.

Conclusions

The glutaminergic system plays a role in the pathophysiology of depression, why it's a possible therapeutic target. So, it's of utmost importance that future studies keep the focus in this area, looking for new drugs active in this system.

Disclosure of interest

The authors have not supplied their declaration of competing interest.