A case of low-g-glutamyltranspetidase cholestasis associated with ubiquitinspecific peptidase 53 (USP53) gene mutation in a Brazilian child is described. Transient jaundice and hypocholia started at the age of 10 days. Liver enzymes, total bilirubin, and total bile acids were elevated at presentation. During follow-up, he developed cholelithiasis treated with cholecystectomy, and an intracranial hemorrhage resolved with full recovery. At last, evaluation at the age of 18 months, he was not jaundiced and had normal liver tests, but experienced from moderate pruritus despite treatment with rifampicin and ursodeoxycholic acid. A genetic study revealed novel homozygous mutations c.1687_1688delinsC p.Ser563Profsà 25 in the USP53 gene. His parents carried the same heterozygous mutation in the USP53 gene.

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Serological surveys based on a planned sampling on bovine viral diarrhea virus (BVDV) infection in Brazilian cattle herds are scarce. A cross-sectional study was carried out to determine herd- and animal-level seroprevalences and to identify risk factors associated with herd-level seroprevalence for BVDV infection in the State of Paraíba, Northeastern Brazil, from September 2012 to January 2013. The state was divided into three sampling strata, and for each stratum, the prevalence of herds infected with BVDV and the prevalence of seropositive animals was estimated by a two-stage sampling survey. In total, 2443 animals were sampled from 478 herds. A virus-neutralization test was used for BVDV antibody detection. A herd was considered positive when at least one seropositive animal was detected. The herd- and animal-level prevalences in the State of Paraíba were 65.5% (95% confidence interval (CI) = 61.1-69.7%) and 39.1% (95% CI = 33.1-45.6%), respectively. The frequency of seropositive animals per herd ranged from 10 to 100% (median of 50%). The risk factors identified were as follows: more than six calves aged ≤12 months (odds ratio (OR) = 3.72; 95% CI = 2.08-6.66), animal purchasing (OR = 1.66; 95% CI = 1.08-2.55), pasture rental (OR = 2.15; 95% CI = 1.35-3.55), and presence of veterinary assistance (OR = 2.04; 95% CI = 1.10-3.79). Our findings suggest that the implementation of control and prevention measures among farmers, with the aim of preventing dissemination of the agent in the herds, is necessary. Special attention should be given to addressing the identified risk factors, such as sanitary control prior to animal purchasing and to discourage the pasture rental, as well as to encourage the vaccination in the herds.

Patient: Male, 66-year-old Final Diagnosis: Secondary sclerosing cholangitis Symptoms: Jaundice Medication: — Clinical Procedure: — Specialty: Critical Care Medicine • Infectious Diseases Objective: Rare disease Background: The incidence of abnormal liver function, mainly aspartate aminotransferase and alanine aminotransferase elevations, in patients with COVID-19 is not uncommon, but persistent liver damage after the acute phase of the disease is uncommon and has been recently recognized as a new entity named post-COVID-19 cholangiopathy. Case Report: We report a clinical case with progressive cholestatic disease following severe COVID-19. AST and ALT peaked at hospital admission and while its serum concentration went down, bilirubin and cholestatic liver enzymes started to increase, reaching the maximum at day 122. Magnetic resonance imaging (MRI) revealed a diffuse irregularity of intra- and extrahepatic bile ducts, with multiple focal strictures alternating with mild focal dilations of the biliary tree, suggesting a sclerosing cholangiopathy. A transjugular liver biopsy showed a prominent bile ductular reaction, cholangiocyte injury, inflammatory infiltrate rich in neutrophils, biliary infarctions, marked cholestasis, and portal fibrosis, suggesting the diagnosis of post-Covid-19 secondary sclerosing cholangitis. The patient evolved with a continuous deterioration of liver functions, but liver transplantation was not performed due to his poor clinical condition. Conclusions: Post-COVID-19 SSC is a severe disease with no effective clinical treatment and has liver transplantation as the only treatment for a few selected patients.

The aim of the present study was to determine the seroprevalence of infection by the bovine viral diarrhea virus (BVDV) on family farms, as well as to study the risk factors associated with the infection. In total, 319 blood serum samples were collected from cattle, of reproductive age (>24 months) in 24 herds from 11 cities of the brejo microregion in Pernambuco. The samples were subjected to the seroneutralization test to detect anti-BVDV antibodies. In order to identify the risk factors associated with the BVDV, a questionnaire epidemiologic was applied and followed by statistical analysis of logistic regression, with the serological test considered as the dependent variable (reagent or non-reagent). A prevalence of 51.1% (163/319; C.I. 45.5% -56.7%) was found in the present study. Of the 24 herds sampled, 100.0% contained at least one reagent animal. The prevalence in the counties ranged from 23.1% to 70.0%. The following risk factors were identified in the present study: not providing colostrum (OR 3.85; p=0.018); disease unknown (OR 2.54; p=0.001) and consortium breeding (OR 1.76; p=0.013). Based on these results, it was clear that BVDV infection is widespread in herds on family farms in the microregion studied herein. Health education policies must be implemented for producers and professionals who provide technical assistance. In addition, based on the risk factors identified in the present study, hygiene-sanitary measures should be implemented in order to reduce the prevalence of the BVDV. Key words: BVDV. Cattle. Diagnosis. Risk factors. ResumoObjetivou-se com este estudo determinar a soroprevalência e estudar os fatores de risco associados à infecção pelo vírus da diarreia viral bovina (BVDV) nas unidades produtivas de agricultura familiar. Foram coletadas 319 amostras de soro sanguíneo, de bovinos em idade reprodutiva (>24 meses), procedentes de 24 rebanhos bovinos em 11 municípios da microrregião brejo pernambucano. As amostras foram submetidas ao teste de soroneutralização para detecção de anticorpos anti-BVDV. Para a identificação dos fatores de risco associados ao BVDV, foi aplicado um questionário epidemiológico e foi realizada uma análise estatística de regressão logística, considerando como variável dependente o exame sorológico (reagente ou não reagente). Observou-se com este estudo uma prevalência de 51,1% (163/319; I.C. 45,5% -56,7%). Dos 24 rebanhos amostrados, 100% apresentaram pelo menos um animal reagente. A prevalência nos municípios variou de 23,1% a 70,0%. Os fatores de risco identificados neste estudo foram: não fornecer colostro (OR 3,85; p=0,018); não conhecer a enfermidade (OR 2,54; p=0,001) e criação consorciada (OR 1,76; p=0,013). Diante dos resultados obtidos, constatou-se que a infecção pelo BVDV está disseminada nos rebanhos de agricultura familiar na microrregião estudada e que políticas de educação em saúde devem ser implementadas tanto para os produtores como para os profissionais que prestam assistência técnica. Além disso, medidas higiênico-sanitárias com base n...