The aim of this study is to evaluate if a gel of bacterial cellulose gel can revert the loss of anal resting pressure after anorectum sphincter injury in rat model, elected as a model to simulate fecal incontinence. Thirty-nine animals were equally divided into three groups: Control (CG), Sphincter injury plus Saline injection (SG) and Sphincter injury plus Bacterial Cellulose Gel injection (BCG). Anal pressure at rest was assessed for all animal in the three groups using anorectum manometry. Saline and Gel groups were subject to anorectum sphincter injury to reduce the anal pressure at rest. Fifteen days later Saline or Gel was injected into the anorectum, according to their groups. Sixty days later first manometry, the anorectum of all animals were removed and processed histologically. The CG group showed maintenance of their mean anorectal resting pressure levels; SG presented a fall in their mean anorectal resting pressure. The BCG presented a significant elevation of the mean anorectal resting pressure levels, surpassing the pressure of CG. The gel of bacterial cellulose remained at the injection site and was neovascularized, colonized by fibroblasts and dense conjunctive tissue. Those data suggest that BC can be used as a future filling agent treatment for fecal incontinence in clinical trial protocols.

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Background The most prevalent autoinflammatory syndromes (AIS) with an identified genetic defect are: Familial Mediterranean Fever (FMF); Tumoral necrosis fator (TNF) Receptor Associated Periodic Syndrome (TRAPS); Pediatric Granulomatous Arthritis (PGA); Cryopyrin Associated Periodic Syndromes (CAPS); and Mevalonate Kinase Deficiency (MKD) 1-3. Objectives The objective of this Brazilian multicenter study was to determine the prevalence of identifiable genetic defects in patients with a clinical suspicion of AIS from the five regions of the country. Methods A cross-sectional multicenter study was performed and included 102 patients from 22 Pediatric Rheumatology centers. All patients had a clinical diagnosis of one of the following disorders: CAPS, TRAPS, FMF, MKD and PGA. One of the five AIS-related genes (CIAS1, TNFRSF1A, MEFV, MVK and NOD2) was evaluated in each patient by direct DNA sequencing, based on the most probable clinical suspect. The DNA fragments were directly sequenced and all mutations detected were confirmed in a second PCR product amplification followed by sequencing. Results The clinical diagnoses of the 102 patients were: CAPS in 28 patients, TRAPS in 31, FMF in 17, MKD in 17 and PGA in 9. Of the 102 patients, 28 (27%) had a confirmed genetic diagnosis by evaluation of only one gene per patient: 6/28 (21%) CAPS patients, 7/31 (23%) TRAPS, 3/17 (18%) FMF, 4/17 (24%) MKD and 8/9 (89%) PGA. Seven (37%) of the different 19 mutations identified were novel, such as T433I and K173E (CIAS1), G87S and D122H (TNFRSF1A), A21V (MVK), and D512H and Y563H (NOD2). One TRAPS patient was homozygous for the G87S mutation. Conclusions We have found that approximately one third of the Brazilian patients with a clinical suspicion of AIS have a confirmed genetic diagnosis. References Jesus AA, Oliveira JB, Hilario MO et al. Pediatric hereditary autoinflammatory syndromes. J Pediatr (Rio J) 2010;86:353-66. Glaser RL, Goldbach-Mansky R. The spectrum of monogenic autoinflammatory syndromes: understanding disease mechanisms and use of targeted therapies. Curr Allergy Asthma Rep 2008;8:288-98. Masters SL, Simon A, Aksentijevich I, Kastner DL. Horror autoinflammaticus: the molecular pathophysiology of autoinflammatory disease. Annu Rev Immunol 2009;27:621-68. Disclosure of Interest None Declared

Objective To evaluate the morbidity and mortality related to the surgical procedure of loop ileostomy closure, in a reference service in coloproctology, as well as possible variables that may be related to a higher frequency of complications. Methods A retrospective study evaluated 66 procedures of loop ileostomy closure, performed between December 2005 and December 2017, at the coloproctology service of Barão de Lucena Hospital, in Recife, Brazil. Results There were complications in 20 (30.3%) patients, 11 of whom were classified as grade I (Clavien-Dindo), and 9 of whom were classified as grade II to V. In 7.6% of the cases, one or more surgical reassessments were required. Mortality was 1.5%. There was no statistical relevance in the correlation of the studied variables with the occurrence of complications. Conclusion Loop ileostomy closure presents an important morbidity, reaching more than 30%, although mortality is low. The analyzed variables did not show significant statistics for a higher occurrence of complications.

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