Portal and arterial washout after hypothermic preservation of the pig liver: prevention of hyperkalaemia after revascularization.

In an orthotopic liver transplantation (OLT), portal revascularization may produce acidosis and hyperkalaemia due to loss of intracellular acid metabolites and K+ during hypothermic preservation. To verify the effectiveness of portal and arterial washout in preventing hypokalaemia after liver preservation, an OLT was done in 18 large-white pigs. The donor livers were perfused in situ via the portal vein with Hartmann's solution containing 1.000 IU of heparin at 4 degrees C. Afterwards, a cold Collins C2 solution was perfused either in vitro (group A) or in situ (group B). The cold ischemia time in both groups was less than 3 1/2 h. Before doing the portal revascularization of the donor livers, a washout via the portal vein and hepatic artery with saline serum was performed. The concentration of K+, glucose, GOT and LDH in effluents obtained through infrahepatic inferior vena cava were significantly lower in group B than in group A. Simple washout of the livers prior to revascularization prevented hyperkalaemia in both groups.

Protagonism of the arterial circulation in the preservation of the pig's liver by simple perfusion and hypothermic storage.

A modified technique to perform the successive perfusions of the liver that are necessary for its preservation by the simple perfusion method and hypothermic storage is presented. This technical variety has been tested on Large White pig's livers and consists in doing the successive perfusions of cooling, preservation and washout, first through the hepatic artery and there after through the portal vein. The macroscopic and biochemical characteristics of the effluents obtained through the infrahepatic inferior vena cava during the perfusion-washout of the livers at the end of the period cold ischemia shows its effectiveness. Likewise, the hepatic perfusion-washout begun via the arterial vein and finished via the portal one avoids post-revascularization hyperpotassemia in the receptor animals. It is hypothesized that the arterial protoganism of perfusions, when the simple perfusion and hypothermic storage method of hepatic preservation is used, could be a prophylaxis against complications of a post-transplant biliary origin.

[Determinants of poor mental health in people aged 16 to 64 residing in a large city]. / Factores que determinan la mala salud mental en las personas de 16 a 64 años residentes en una gran ciudad.

BACKGROUND: Know what factors determine the poor mental health in the city of Madrid. MATERIAL AND METHODS: Cross-sectional study Health Survey of the City of Madrid (ESCM'05), analyzed 5746, persons aged 16 to 64 years, in the years 2004-2005. Dependent variable was obtained from the General Health Questionnaire (GHQ-12), was considered score above 2. Independent variables included sociodemographic factors, lifestyle, health and environmental issues. The quality of life related to health (HRQOL) was measured with the questionnaire COOP / WONCA. RESULTS: The overall prevalence of poor mental health was 19.2%, p <0.05 for gender, age group 16 to 24 years and lower social classes. The predictors most strongly associated with poor mental health in the multiple regression are: women OR=1.48 (1.23-1.78), minors OR=3.21 (2.40-4.29), immigrant economic OR=1.33 (1.06-1.68), smoking or drinking alcohol OR=1.22 (1.02 -1.49) and 1.31 (1.09 -1.57), chronic disease OR=1.47 (1.21 -1.79), sleeping less 8 hours OR=1.41 (1.17 -1.68), having fair or poor health status perception OR=1.65 (1.22-2.22), self-perceived poor quality of life HRQOL OR=1.18 (1.15-1.22), and limited social activities OR=1.34 (1.07 -1.69) . CONCLUSIONS: The mental health problems are highly prevalent in this city. Being woman, young, economic migrant, worse lifestyles, poor quality of life refered or limited social activities are the factors that force to explain the association with poor mental health.

Self-perception of health status, mental health and quality of life among adults with diabetes residing in a metropolitan area.

AIM: The study aimed to compare the self-perception of health, physiological distress and health-related quality of life (HRQL) in subjects with and without diabetes residing in a large metropolitan area (the city of Madrid), and to identify the variables associated with the poorest HRQL among diabetes patients. METHODS: In this case-control epidemiological study, we selected 358 patients with diabetes from the Madrid City Health Survey. For every patient, two controls without diabetes were randomly selected from the same database and matched for age, gender and health district. The resultant study population comprised 1074 subjects, who were analyzed according to their self-rated health status, with mental health assessed by the 12-item General Health Questionnaire (GHQ-12) and HRQL by the COOP/WONCA questionnaire. Independent variables included sociodemographic characteristics, lifestyle variables, associated chronic diseases and consumption of medications. Multivariate analyses were conducted using ANCOVA tests. RESULTS: The prevalence of health perceived as fair or poor was 64.12% in those with diabetes vs 38.57% in those without diabetes (P<0.05). The GHQ-12 results showed that mental health was also significantly worse among diabetes sufferers, and the COOP/WONCA questionnaire results indicated significantly poorer HRQL in those with diabetes. The variables that determined a poorer perception of HRQL among diabetes sufferers were female gender, older age, obesity, lack of physical exercise, coexistence of depression, use of sleeping pills, and Alzheimer's and cerebrovascular diseases. CONCLUSION: Self-rated health and psychological well-being, and HRQL, are all considerably poorer among patients with diabetes vs those without diabetes. The poorest quality of life among those with diabetes associated with female gender, depression, lack of exercise and obesity.