First consensus document of waiting list prioritization for liver transplantation by the Spanish Society of Liver Transplantation (SETH).

Spain is worldwide leader in deceased donation rates per million habitants and count on a strong network of twenty-five liver transplant institutions. Although the access to liver transplantation is higher than in other countries, approximately 10% of patients qualifying for liver transplantation in Spain will die in the waiting list or would be excluded due to clinical deterioration. A robust waiting list prioritization system is paramount to grant the sickest patients with the first positions in the waiting list for an earlier access to transplant. In addition, the allocation policy may not create or perpetuate inequities, particularly in a public and universal healthcare system. Hitherto, Spain lacks a unique national allocation system for elective liver transplantation. Most institutions establish their own rules for liver allocation and only two autonomous regions, namely Andalucía and Cataluña, share part of their waiting list within their territory to provide regional priority to patients requiring more urgent transplantation. This heterogeneity is further aggravated by the recently described sex-based disparities for accessing liver transplantation in Spain, and by the expansion of liver transplant indications, mainly for oncological indications, in absence of clear guidance on the optimal prioritization policy. The present document contains the recommendations from the first consensus of waiting list prioritization for liver transplantation issued by the Spanish Society of Liver Transplantation (SETH). The document was supported by all liver transplant institutions in Spain and by the Organización Nacional de Trasplantes (ONT). Its implementation will allow to homogenize practices and to improve equity and outcomes among patients with end-stage liver disease.

Effects of cardiac rehabilitation in patients with ventricular assist devices: a scoping review.

INTRODUCTION: Ventricular assist devices represent a treatment option for patients with advanced heart failure, offering control over various haemodynamic variables. Similarly, the prescription of exercise within a cardiac rehabilitation programme for heart failure patients is recommended to reduce symptoms, and hospitalisations, improve cardiorespiratory fitness, and increase exercise tolerance. Therefore, exercise prescription can impact those with ventricular assist devices. Given the limited evidence on exercise-based cardiac rehabilitation programmes for this population, this review aims to describe the most commonly used strategies and their health benefits when physical exercise is included in a cardiac rehabilitation programme for patients with ventricular assist devices. MATERIALS AND METHODS: An exploratory review was conducted through searches in the databases: PubMed, SCOPUS, PeDro, and ScienceDirect. The search was limited to studies published between 2013 and 2023. Filters were applied independently by title, abstract, and full text. The included articles were analysed based on the description of the types of cardiac rehabilitation strategies used in patients with ventricular assist devices. RESULTS: Seven articles were included. Each programme employed a cardiopulmonary exercise test before prescribing physical exercise. The most commonly used strategy was aerobic exercise, predominantly high-intensity interval training (HIIT) with intensities close to 90% of peak VO2, followed by continuous moderate-intensity exercise. Limb strength exercises were included in three programmes. CONCLUSIONS: The analysed literature suggests that cardiac rehabilitation in patients with ventricular assist devices is safe and can provide benefits in cardiorespiratory fitness and exercise tolerance. High-intensity interval training is identified as an appropriate strategy for achieving results, offering short-term improvements.

Risk Factors for Multiple Violations of Protective Orders in Intimate Partner Violence Against Women.

This study examined 1,134 cases of violence against women in intimate partner relationships with violations of protective orders in a monitoring period of up to 15 months. The dynamics of time and violence were analyzed in the cases of multiple violation versus one-time violation, with the objective of identifying and thus neutralizing the risk factors for this type of recidivism. The results showed that early violation, serious physical violence, death threats, as well as jealousy, harassment, and control are related to multiple violation. This article discusses the results in comparison with other research and proposes measures to avoid revictimizations.

Joint movement patterns differ among male recreational runners with different running style.

The purpose of this study was to analyse the differences in joint kinematic patterns among runners with different spatiotemporal characteristics in the running cycle. Lower extremity kinematic data and spatiotemporal stride parameters were collected for ninety-two recreational runners during a treadmill run at a self-selected comfortable speed. A K-means clustering analysis was conducted on normalised stride cadence and Duty Factor to identify running style. Cluster 1 characterised by reduced stance times and low Duty Factor; Cluster 2, long stance times and low stride cadence; Cluster 3, high Duty Factor and stride cadence. Functional principal component analysis was used to identify patterns of variability between runners. Runners who used a combination of high cadence and Duty Factor showed differences in hip, knee and ankle sagittal kinematics compared to other runners. On the contrary, the joint kinematics was not altered when the Duty Factor was increased along with a decrease in the stride cadence. This study has demonstrated that the combination of several spatial-temporal parameters of the running cycle should be considered when analysing the movement pattern of the lower limb.

Diagnosis and management of Abernethy syndrome.

Abernethy syndrome (AS or extrahepatic portosystemic shunt) is an uncommon congenital malformation consisting of agenesis or hypoplasia of the portal vein (PV) in such a way that splanchnic venous blood drains directly into the systemic circulation through aberrant communications, resulting in a portosystemic shunt that bypasses the liver AS is an underdiagnosed condition with unknown incidence and complication rate given that symptoms are usually absent. AS identification is increasingly common because of improved imaging techniques, hence prognostic implications and clinical management need be understood. This editorial reviews the natural history of AS and its diagnostic-therapeutic implications, illustrating the process with a series of cases from our institution.

Medicina regenerativa de cartílago: efecto del tratamiento con ácido hialurónico reticulado bifásico en lesiones osteocondrales / Regenerative medicine: effect of treatment with biphasic cross-linked hyaluronic acid in osteochondral lesions

Objetivo: Evaluar si el tratamiento con ácido hialurónico reticulado bifásico de lesiones osteocondrales promovería la regeneración del tejido cartilaginoso, favoreciendo así la reparación de la lesión. Materiales y métodos: Quince conejos hembra adultos fueron divididos aleatoriamente en tres grupos: grupo 1, de control; grupo 2 y grupo 3, sometidos a una estrategia quirúrgica de lesión osteocondral en la rodilla derecha (4 mm de diámetro, 5 mm de profundidad), el grupo 3 recibió tratamiento con 0,2 ml de ácido hialurónico por vía intrarticular después de la cirugía. Se realizaron controles clínicos, bioquímicos, histopatológicos y estudios por imágenes. Resultados: Se detectaron menos casos de dolor a la palpación en el grupo 3 que en el grupo 2 a partir de los 45 días. En la resonancia magnética, casi todas las muestras del grupo 3 tenían signos de regeneración del tejido cartilaginoso en el sitio de la lesión, sin edema óseo, ni derrame articular significativo. Los estudios histopatológicos de las muestras del grupo 3 indicaron un aumento de la matriz extracelular propia de tejido cartilaginoso, comparada con la del grupo 2, con hipercelularidad, dada por condrocitos, los que formaban grupos isogénicos axiales y coronales. Conclusiones: Este estudio brinda evidencias de que el tratamiento con ácido hialurónico reticulado bifásico en unidades experimentales de conejos con lesión osteocondral no tuvieron dolor en etapas tempranas después de la lesión, a diferencia de las unidades intervenidas y sin dicho tratamiento. A su vez, los estudios por imágenes e histopatológico mostraron la reparación del tejido dañado.

Objective: To demonstrate whether treatment with biphasic cross-linked hyaluronic acid in osteochondral lesions promotes the regeneration of cartilage tissue. Materials and methods: Fifteen adult female rabbits were randomly assigned to three groups. G1 was the control group, whereas G2 and G3 underwent surgery to treat an osteochondral injury in the right knee (4mm diameter, 5mm depth). G3 received treatment with 0.2 ml of hyaluronic acid intrarticularly after surgery. Clinical, biochemical, histopathological controls and imaging studies were performed. Results:Clinically, G3 exhibited less pain on palpation than G2 after 45 days. In G3, almost all samples showed evidence of cartilage tissue regeneration at the injury site, with neither bone edema or considerable joint effusion detected on MRI. The histological tests of G3 samples revealed an increase in the extracellular matrix of cartilaginous tissue when compared to G2, with hypercellularity caused by chondrocytes that formed axial and coronal isogenic groups. Conclusions: This study provides evidence that treatment with biphasic cross-linked hyaluronic acid in experimental units of rabbits with osteochondral injuries did not cause pain in the early stages of the injury. In turn, imaging and histopathological studies revealed that the injured tissue had been repaired.

New electronic implementation of the timestamps method intended for high resolution comparison of laser wavelengths.

This article describes a new measurement system for the comparison of two electronic signals of different frequencies with application to high resolution comparison of laser wavelengths using a Michelson interferometer. It was built within the framework of research projects made by the University of Vigo and the Laboratorio Oficial de Metroloxía de Galicia (LOMG) in cooperation with Escolas Proval High School. The new hardware is based on a cheap high-speed module for the acquisition of data and a microcontroller module for processing, which can also be used for practical lessons in vocational training. The system has been tested with electronic signal generators. The novel measurement method reduces the uncertainty using multiple consecutive measurements and the fractional part of the fringes and could achieve precisions in the range 10-12 of the wavelength ratios.

Exploring the Risk of Resulting in Homicide and Suicide in Spanish Missing Person Cases.

The study explores in depth the relationship between missing persons' psychosocial and criminological characteristics/circumstances and violent-fatal outcomes (suicide and homicide). A relational analytical explicative study of 929 cases and controls was designed using a retrospective and stratified design. Data gathering was conducted through the content analysis of judicial and police information, as well as the development of psychological autopsy techniques and semi-structured interviews with the persons involved in the missing person cases including offenders in prison. Bivariate and multivariate statistical techniques were utilised for analyses. The findings showed that there are different risk and protective factors which can distinguish between good state of health, suicide, and homicide outcomes. This research entails implications for prevention and police risk assessment system.

Why Is It so Difficult to Investigate Violent Radicalization?

Imagine that you are a researcher interested in disentangling the underlying mechanisms that motivate certain individuals to self-sacrifice for a group or an ideology. Now, visualize that you are one of a few privileged that have the possibility of interviewing people who have been involved in some of the most dramatic terrorist attacks in history. What should you do? Most investigations focused on terrorism do not include empirical data and just a handful of fortunate have made face-to-face interviews with these individuals. Therefore, we might conclude that most experts in the field have not directly met the challenge of experiencing studying violent radicalization in person. As members of a research team who have talked with individuals under risk of radicalization, current, and former terrorists, our main goal with this manuscript is to synopsize a series of ten potential barriers that those interested in the subject might find when making fieldwork, and alternatives to solve them. If all the efforts made by investigators could save the life of a potential victim, prevent an individual from becoming radicalized, or make him/her decide to abandon the violence associated with terrorism, all our work will have been worthwhile.

Different Ventricular Fibrillation Types in Low-Dimensional Latent Spaces.

The causes of ventricular fibrillation (VF) are not yet elucidated, and it has been proposed that different mechanisms might exist. Moreover, conventional analysis methods do not seem to provide time or frequency domain features that allow for recognition of different VF patterns in electrode-recorded biopotentials. The present work aims to determine whether low-dimensional latent spaces could exhibit discriminative features for different mechanisms or conditions during VF episodes. For this purpose, manifold learning using autoencoder neural networks was analyzed based on surface ECG recordings. The recordings covered the onset of the VF episode as well as the next 6 min, and comprised an experimental database based on an animal model with five situations, including control, drug intervention (amiodarone, diltiazem, and flecainide), and autonomic nervous system blockade. The results show that latent spaces from unsupervised and supervised learning schemes yielded moderate though quite noticeable separability among the different types of VF according to their type or intervention. In particular, unsupervised schemes reached a multi-class classification accuracy of 66%, while supervised schemes improved the separability of the generated latent spaces, providing a classification accuracy of up to 74%. Thus, we conclude that manifold learning schemes can provide a valuable tool for studying different types of VF while working in low-dimensional latent spaces, as the machine-learning generated features exhibit separability among different VF types. This study confirms that latent variables are better VF descriptors than conventional time or domain features, making this technique useful in current VF research on elucidation of the underlying VF mechanisms.

Manifold analysis of the P-wave changes induced by pulmonary vein isolation during cryoballoon procedure.

BACKGROUND/AIM: In atrial fibrillation (AF) ablation procedures, it is desirable to know whether a proper disconnection of the pulmonary veins (PVs) was achieved. We hypothesize that information about their isolation could be provided by analyzing changes in P-wave after ablation. Thus, we present a method to detect PV disconnection using P-wave signal analysis. METHODS: Conventional P-wave feature extraction was compared to an automatic feature extraction procedure based on creating low-dimensional latent spaces for cardiac signals with the Uniform Manifold Approximation and Projection (UMAP) method. A database of patients (19 controls and 16 AF individuals who underwent a PV ablation procedure) was collected. Standard 12-lead ECG was recorded, and P-waves were segmented and averaged to extract conventional features (duration, amplitude, and area) and their manifold representations provided by UMAP on a 3-dimensional latent space. A virtual patient was used to validate these results further and study the spatial distribution of the extracted characteristics over the whole torso surface. RESULTS: Both methods showed differences between P-wave before and after ablation. Conventional methods were more prone to noise, P-wave delineation errors, and inter-patient variability. P-wave differences were observed in the standard leads recordings. However, higher differences appeared in the torso region over the precordial leads. Recordings near the left scapula also yielded noticeable differences. CONCLUSIONS: P-wave analysis based on UMAP parameters detects PV disconnection after ablation in AF patients and is more robust than heuristic parameterization. Moreover, additional leads different from the standard 12-lead ECG should be used to detect PV isolation and possible future reconnections better.

Detection of Mycobacterium tuberculosis Complex Using the Xpert MTB/RIF Ultra Assay on the Stool of Pediatric Patients in Dushanbe, Tajikistan.

We report the findings of a prospective laboratory diagnostic accuracy study to evaluate the sensitivity, specificity, and predictive values of the Xpert MTB/RIF Ultra assay for Mycobacterium tuberculosis detection in fresh stool specimens from children under 15 years of age with confirmed tuberculosis (TB) disease from Dushanbe, Tajikistan. Six hundred eighty-eight (688) participants were enrolled from April 2019 to October 2021. We identified 16 participants (2.3%) with confirmed TB disease, defined as ≥1 TB sign/symptom plus microbiologic confirmation. With the Xpert MTB/RIF Ultra assay for stool, we found a sensitivity of 68.8% (95% CI, 46.0 to 91.5) and a specificity of 98.7% (95% CI, 97.8 to 99.5) in confirmed TB disease. Our results are comparable to other published studies; however, our cohort was larger and our confirmed TB disease rate lower than most. We also demonstrated that this assay was feasible to implement in a centralized hospital laboratory in a low-middle-income Central Asian country. However, we encountered obstacles such as lack of staffing, material ruptures, outdated government protocols, and decreased case presentation due to COVID-19. We found eight patients whose only positive test was an Xpert Ultra stool assay. None needed treatment during the study; however, three were treated later, suggesting such cases require close observation. Our report is the first from Central Asia and one of a few from a low-middle-income country. We believe our study demonstrates the generalizability of the Xpert MTB/RIF Ultra assay on fresh stool specimens from children and provides further evidence supporting WHO's approval of this diagnostic strategy. IMPORTANCE The importance of this report is that it provides further support for WHO's recent recommendation that fresh stool is an acceptable sample for GeneXpert TB testing in children, especially small children who often cannot produce an adequate sputum sample. Diagnosing TB in this age group is difficult, and many cases are missed, leading to unacceptable rates of TB illness and death. In our large cohort of children from Dushanbe, Tajikistan, the GeneXpert stool test was positive in 69% of proven cases of TB, and there were very few false-positive tests. We also showed that this diagnostic strategy was feasible to implement in a low-middle-income country with an inefficient health care delivery system. We hope that many more programs will adopt this form of diagnosing TB in children.

Multiple-Perpetrator and Solo-Offender Sexual Assaults Between Strangers: Differences and Predictive Variables.

Multiple-perpetrator rape is an under-studied topic, but there has been a recent increase in studies on the differences between multiple-perpetrator sexual offenses and the ones perpetrated by solo offenders. This study aims to have a deeper understanding of the differences between multiple-perpetrator and solo-offender sexual assaults committed by strangers, from a sample of 400 sexual aggressions reported to the Spanish police in 2010. Differences were explored on variables related to characteristics of perpetrators, the assault (approach, control, maintenance, termination, and sexual behavior), and the victims. Data were obtained from police files on sexual assaults committed around the country. Significant differences found were similar to other studies conducted in other countries and proved that multiple perpetrator assaults committed by strangers are a different subtype. Additionally, four predictive variables of multiple-perpetrator rape were identified: older age (OR = 0.943, 95% CI = [0.92, 0.97]), alcohol or drug use (OR = 2.499, 95% CI = [1.50, 4.32]), non-Spanish nationals (OR = 1.980, 95% CI = [1.14, 3.45]), and use of violence to control the victim (OR = 2.465, 95% CI = [1.03, 5.90]). The cultural and leisure characteristics of Spanish society provide facilitating opportunities for multiple-perpetrator rapes and prevention strategies should be urgently addressed.

Transitions in an integrated model of renal replacement therapy in a regional health system.

INTRODUCTION AND OBJECTIVES: The choice of renal replacement therapy (RRT) is an important decision that determines the quality of life and survival. Most patients change from one RRT modality to another to adapt RRT to clinical and psychosocial needs. This has been called «integrated model of RRT¼ that implies new questions about the best sequence of techniques. MATERIAL AND METHODS: The study describes the impact of transitions between RRT modalities on survival using the Madrid Registry of Renal Patients (2008-2018). This study used the proportional hazards models and competitive risk models to perform an intention-to-treat (ITT), according to their 1st RRT modality and as-treated (AT) analysis, that consider also their 1st transition. RESULTS: A total of 8971 patients started RRT during this period in Madrid (6.6 Million population): 7207 (80.3%) on hemodialysis (HD), 1401 (15.6%) on peritoneal dialysis (PD) and 363 (4.2%) received a pre-emptive kidney transplantation (KT). Incident HD-patients were older (HD group 65.3 years (SD 15.3) vs PD group 58.1 years (SD 14.8) vs KTX group 52 years (SD 17.2); p < 0.001) and had more comorbidities. They presented higher mortality (HD group 40.9% vs PD group 22.8% vs KTX group 8.3%, p < 0.001) and less access to a transplant (HD group 30.4% vs PD group 51.6%; p < 0.001). Transitions between dialysis techniques define different groups of patients with different clinical outcomes. Those who change from HD to PD do it earlier (HD â†’ PD: 0.7 years (SD 1.1) vs PD â†’ HD: 1.5 years (SD 1.4) p < 0.001), are younger (HD â†’ PD: 53.5 years (SD 16.7) vs PD â†’ HD: 61.6 years (SD 14.6); p < 0.001), presented less mortality (HD â†’ PD: 24.5% vs PD â†’ HD: 32.0%; p < 0.001) and higher access to a transplant (HD â†’ PD: 49.4% vs PD â†’ HD: 31.7%; p < 0.001). Survival analysis by competitive risks is essential for integrated RRT models, especially in groups such as PD patients, where 51.6% of the patients were considered as lost follow-up (received a KTX after during the first 2.5 years on PD). In this analysis, survival of patients who change from one technique to another, is more similar to the destination modality than the origin one. CONCLUSION: Our data suggest that transitions between RRT-techniques describes different patients, who associate different risks, and could be analyzed in an integrated manner to define improvement actions. This approach should be incorporated into the analysis and reports of renal registries.

Prognosis patients with COVID-19 using deep learning.

BACKGROUND: The coronavirus (COVID-19) is a novel pandemic and recently we do not have enough knowledge about the virus behaviour and key performance indicators (KPIs) to assess the mortality risk forecast. However, using a lot of complex and expensive biomarkers could be impossible for many low budget hospitals. Timely identification of the risk of mortality of COVID-19 patients (RMCPs) is essential to improve hospitals' management systems and resource allocation standards. METHODS: For the mortality risk prediction, this research work proposes a COVID-19 mortality risk calculator based on a deep learning (DL) model and based on a dataset provided by the HM Hospitals Madrid, Spain. A pre-processing strategy for unbalanced classes and feature selection is proposed. To evaluate the proposed methods, an over-sampling Synthetic Minority TEchnique (SMOTE) and data imputation approaches are introduced which is based on the K-nearest neighbour. RESULTS: A total of 1,503 seriously ill COVID-19 patients having a median age of 70 years old are comprised in the research work, with 927 (61.7%) males and 576 (38.3%) females. A total of 48 features are considered to evaluate the proposed method, and the following results are achieved. It includes the following values i.e., area under the curve (AUC) 0.93, F2 score 0.93, recall 1.00, accuracy, 0.95, precision 0.91, specificity 0.9279 and maximum probability of correct decision (MPCD) 0.93. CONCLUSION: The results show that the proposed method is significantly best for the mortality risk prediction of patients with COVID-19 infection. The MPCD score shows that the proposed DL outperforms on every dataset when evaluating even with an over-sampling technique. The benefits of the data imputation algorithm for unavailable biomarker data are also evaluated. Based on the results, the proposed scheme could be an appropriate tool for critically ill Covid-19 patients to assess the risk of mortality and prognosis.

Psychopathic femicide: The influence of psychopathy on intimate partner homicide.

High scores in psychopathy were associated with acts of violence, and the prevalence of this condition is greater among the prison population than among the general population. In terms of its relation to femicide, two studies, one carried out in Sweden and another in Spain with a prison population, found that psychopathy is an uncommon condition among perpetrators of femicide. This study analyzes 97 cases of femicide in the whole of Spain, in which it was possible to evaluate the degree of psychopathy of the perpetrators using the Psychopathy Checklist-Revised (PCL-R). The scores are analyzed not only directly, but also in terms of Factors and Facets. The results show an average in the total score of the PCL-R of 14.4, with only 13 subjects (13.4%) presenting scores of 25 or more, and just 3 (3.1%) of these presenting scores of 30 or higher. It was found that, in general, high scores in psychopathy are associated with shorter relationships and less time between the first complaint, the breakup, and the femicide. What is more, characteristics of the victims, such as addiction to toxic substances or economic dependency, also demonstrated a relationship to the scores of the perpetrators of femicide in the PCL-R. Lastly, it was found that the scores in the different dimensions of psychopathy are associated with different types of violence, whereby there was a noteworthy difference between the most explicit violence and control exercised over the partner.

Generalization and Regularization for Inverse Cardiac Estimators.

Electrocardiographic Imaging (ECGI) aims to estimate the intracardiac potentials noninvasively, hence allowing the clinicians to better visualize and understand many arrhythmia mechanisms. Most of the estimators of epicardial potentials use a signal model based on an estimated spatial transfer matrix together with Tikhonov regularization techniques, which works well specially in simulations, but it can give limited accuracy in some real data. Based on the quasielectrostatic potential superposition principle, we propose a simple signal model that supports the implementation of principled out-of-sample algorithms for several of the most widely used regularization criteria in ECGI problems, hence improving the generalization capabilities of several of the current estimation methods. Experiments on simple cases (cylindrical and Gaussian shapes scrutinizing fast and slow changes, respectively) and on real data (examples of torso tank measurements available from Utah University, and an animal torso and epicardium measurements available from Maastricht University, both in the EDGAR public repository) show that the superposition-based out-of-sample tuning of regularization parameters promotes stabilized estimation errors of the unknown source potentials, while slightly increasing the re-estimation error on the measured data, as natural in non-overfitted solutions. The superposition signal model can be used for designing adequate out-of-sample tuning of Tikhonov regularization techniques, and it can be taken into account when using other regularization techniques in current commercial systems and research toolboxes on ECGI.

Willingness to sacrifice among convicted Islamist terrorists versus violent gang members and other criminals.

Is terrorism just another form of criminal activity, as many nations' justice systems assume? We offer an initial answer using face-to-face interviews and structured surveys in thirty-five Spanish prisons. Recent theories of extreme sacrifice inform this direct observational and comparative study. Islamist terrorists display levels of self-sacrifice for their primary reference group similar to that of Latino gangs, but greater willingness to sacrifice for primary values than other inmates (non-radical Muslims, Latino gangs, and delinquent bands). This disposition is motivated by stronger perceived injustice, discrimination, and a visceral commitment to such values (risk/radicalization factors). Nevertheless, state authorities, prison staff, and families are (protective/de-radicalization) factors apt to reduce willingness to sacrifice and keep foreign fighters, now being released in large numbers, from returning to terrorism.

Endoscopic findings unrelated to portal hypertension in patients with liver cirrhosis undergoing a varicose vein screening programme. / Hallazgos endoscópicos no relacionados con hipertensión portal en pacientes con cirrosis hepática sometidos a un programa de cribado de varices.

AIM: To determine the prevalence of endoscopic lesions unrelated with portal hypertension in patients with cirrhosis. PATIENTS AND METHODS: Cross-sectional study including a consecutive cohort of patients with liver cirrhosis enrolled in a screening program of oesophageal varices who underwent an upper gastrointestinal endoscopy from November, 2013, to November, 2018. Clinical predictors of endoscopic lesions unrelated to portal hypertension were analyzed by univariate and multivariate logistic regression. RESULTS: A total of 379 patients were included. The most frequent aetiology of liver disease was alcohol consumption (60.4%). The prevalence of endoscopic lesions unrelated with portal hypertension was 39.6% (n=150). Among 96 patients with peptic lesions, urease was obtained in 56.2% of patients (positive in 44.4% of them). The prevalence of endoscopic lesions unrelated to portal hypertension was not associated with age, gender, liver function or ultrasound findings of portal hypertension. The prevalence of endoscopic lesions unrelated to portal hypertension was not associated with age, gender, liver function or ultrasound findings of portal hypertension. Smokers had a trend to increased prevalence of endoscopic lesions unrelated to portal hypertension (43.2% vs. 34.6%; p=0.09), particularly peptic ulcer (6.4% vs. 0.6%; p=0.05) and peptic duodenitis (17.3% vs. 6.3%; p=0.002). Active smoking was the only independent predictor of peptic ulcer or duodenitis (OR=2.56; p=0.017). CONCLUSION: Active smoking is a risk factor for endoscopic lesions unrelated to portal hypertension. This finding should be further investigated to reassess endoscopic screening programs in cirrhotic smokers.

Proinflammatory Cytokine Profile Differences between Primary Open-Angle and Pseudoexfoliative Glaucoma.

INTRODUCTION: Few studies have investigated glaucoma biomarkers in aqueous humor and tear and have found elevations of proinflammatory cytokines in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PXG). In this study, we investigate differences in inflammatory cytokines between POAG and PXG patients to find specific disease biomarkers. METHODS: For this purpose, tear and aqueous humor samples of 14 eyes with POAG and 15 eyes with PXG undergoing cataract surgery were immunoassayed for 27 proinflammatory cytokines. The concentrations of cytokines in tear and aqueous humor and their association with clinical variables were analyzed, correlated, and compared between the groups. RESULTS: We found that the levels of three cytokines differed significantly in the aqueous humor of POAG and PXG patients: IL-12 and IL-13 were higher in the POAG group, while monocyte chemoattractant protein-1 (monocyte chemotactic and activating factor) was higher in the PXG group. The number of topical hypotensive medications was correlated with diminished levels of two cytokines (IL-7 and basic fibroblast growth factor) in aqueous humor in the POAG group and with diminished levels of IL-12 in tear in the PXG group. CONCLUSION: We conclude that both POAG and PXG show elevated concentrations of proinflammatory cytokines in tear and aqueous humor that could be used as biomarkers for these types of glaucoma and that the concentrations in aqueous humor of three cytokines, IL-12, IL-13, and monocyte chemoattractant protein-1 (monocyte chemotactic and activating factor), could be used to differentiate POAG and PXG.