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Aims: Reports regarding the effects of antioxidants in obesity have been contradictory. AntioxidantN-acetylcysteine is usually considered a nutritional supplement. Our aim is to evaluate bioactivity ofN-acetylcysteine (NAC) on mature adipocytes, which is a close model to in vivo condition.Study Design: In vitro study.Place and Duration of Study: Department of Basic Science (Universidad Nacional de Lujan),Department of Chemical Biology (Universidad de Buenos Aires), CONICET ? INEDES andCONICET ? IQUIBICEN, between March 2017 and June 2019.Methodology: We evaluated the bioactivity of different concentrations of NAC for 5 days (0.01 mMto 5 mM) on fully differentiated 3T3-L1 cells (mature adipocytes).Results: We demonstrated that NAC treatment was not toxic to mature adipocytes. Only 5mM NACinhibited reactive oxygen species production. 5 mM NAC treatment resulted in a 60% decrease incellular triglycerides content and inhibited 70% cholesterol accumulation. We also determined themRNA and protein expression levels of Peroxisome Proliferator-Activated Receptor  as well as,mRNA levels of lipid protein Perilipin in NAC treated adipocytes; we observed that 5mM NACtreatment caused nearly 30% decrease in the expression of these parameters.Conclusion: These results suggest that NAC could avoid lipid accumulation in mature adipocytes;the antioxidant NAC could be beneficial in obesity treatment. Fil: Soto, Daniela. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina Fil: Martini, Claudia Noemí. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina Fil: Frontera, Evelyn Micaela. Universidad Nacional de Luján. Departamento de Ciencias Básicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Montaldo, Laura Andrea. Universidad Nacional de Luján. Departamento de Ciencias Básicas; Argentina Fil: Vila, Maria del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentina Fil: Calvo, Juan Carlos. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Guerra, Liliana Noemi. Universidad Nacional de Luján. Instituto de Ecología y Desarrollo Sustentable. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Ecología y Desarrollo Sustentable; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina

En esta entrevista, la filologa y artista grafica Marika Vila analiza la presencia femenina en el discurso del comic espanol, contrastandola con su representacion en el discurso misogino y homofobo que ha dominado el medio desde sus origenes. Su trabajo de investigacion resalta las transformaciones de la narrativa grafica espanola desde los anos de la Transicion – cuando, con el advenimiento de la democracia, se asiste al nacimiento del comic de autor y al Boom del comic para adultos – hasta la epoca actual en la que se aprecia un gran surgimiento de obras de autoria femenina. Asimismo, gracias a un trabajo de investigacion de largo recorrido, Vila recupera la visibilidad y resistencia de las autoras pioneras. A partir de las preguntas de Marina Bettaglio, Trujillo revisa el pasado del comic espanol desde una perspectiva de genero para destacar la necesidad de rescatar el trabajo de las creadoras y entender su aporte a lo largo de su historia.

espanolAntecedentes: el balon intragastrico Elipse® consiste en una capsula ingerible que se rellena bajo control radiologico. Pasadas 16 semanas, su valvula se degrada, el balon se vacia y se elimina por via natural, sin endoscopia. El objetivo del estudio es valorar su viabilidad, eficacia, duracion, seguridad y requerimientos endoscopicos. Metodos: estudio prospectivo y descriptivo, no aleatorizado, de los primeros pacientes remitidos para Elipse®. Tras colocacion, se realizaba sistematicamente una radiografia para confirmar su correcto rellenado. Se determinaba la duracion del balon en funcion de su visualizacion excretado o por radiografia/ecografia. Se recogieron datos de eficacia, tolerancia, efectos adversos y su resolucion (requerimientos endoscopicos), asi como el grado final de satisfaccion a las 16 semanas. Resultados: participaron en el estudio 30 pacientes con peso e indice de masa corporal (IMC) medios basales de 83,3 ± 10,7 kg y 30,6 ± 2,7 kg/m². Todos pudieron ingerir la capsula con correcto control radiologico. A los cuatro meses presentaban una perdida media de 11,2 ± 5,5 kg (12,1 ± 5,8% de perdida total de peso [PTP], 64,7 ± 25% de perdida del exceso de peso [PEP]), con perdida de peso > 10% en el 80% de pacientes (p EnglishBackground: the Elipse® intragastric balloon (EIGB) is a swallowable capsule that is filled under x-ray control. After 16 weeks, its self-releasing valve is degraded and the balloon is deflated and excreted naturally, without endoscopy. The aim of this study was to assess the feasibility of EIGB and its efficacy, duration, safety and endoscopic requirements. Methods: this is a prospective, descriptive, non-randomized study of the first patients enrolled for EIGB. An x-ray was systematically performed after placement to ensure the correct filling of the balloon. The balloon duration was determined according to its excreted visualization or by x-ray/ultrasound. The efficacy, tolerance, adverse events and their resolution outcome (endoscopic requirements), as well as the final satisfaction degree at 16 weeks, were analyzed. Results: the study included 30 patients with a basal mean weight and body mass index (BMI) of 83.3 ± 10.7 kg and 30.6 ± 2.7 kg/m². All subjects swallowed the capsule with correct x-ray control. The mean weight loss was 11.2 ± 5.5 kg (12.1 ± 5.8% of total weight loss [TWL], 64.7 ± 25% of excess weight loss [EWL]), with a weight loss > 10% in 80% of patients (p

Introduccion: la enfermedad hepatica grasa no alcoholica (EHGNA) es la causa mas frecuente de hepatopatia cronica en nuestro medio. Los beneficios de la endoscopia bariatrica en esta enfermedad estan escasamente documentados. Objetivo: evaluar los cambios de EHGNA, mediante metodos no invasivos, en pacientes obesos sometidos a endoscopia bariatrica restrictiva. Secundariamente, analizamos los cambios ponderales y metabolicos y el grado de seguridad tecnica. Metodos: treinta pacientes con EHGNA y obesidad (indice de masa corporal [IMC] medio de 38,22 ± 6,55 kg/m²) sometidos a endoscopia bariatrica restrictiva: 15 balones de un ano y 15 gastroplastias mediante suturas (ESG-Apollo®). Se realiza un analisis prospectivo no invasivo mediante parametros analiticos (funcion hepatica, insulinorresistencia, scores de esteatosis y fibrosis hepatica) y ecograficos. Ademas, se evalua la evolucion antropometrica y de las principales comorbilidades mayores asociadas, todo ello con seguimiento a un ano. Resultados: treinta pacientes (63% mujeres, edad media 46 ± 13,8 anos). A los 12 meses presentaron disminucion en FLI, HSI, NAFLD-Fibrosis Score, esteatosis hepatica ecografica y grasa subcutanea (p 25% en 27/30 pacientes (PP > 10% en 25/30 pacientes) (p < 0,001). Se objetivo resolucion en 17/30 (57%) de las comorbilidades asociadas: 5/8 (62,5%) hipertension arterial (HTA), 5/12 (41,7%) dislipemia (DLP), 2/4 (50%) diabetes mellitus tipo 2 (DM2), 2/3 (66,7%) sindrome de apnea obstructiva del sueno (SAOS) y 3/3 (100%) artropatia. Comparando ambos procedimientos, la mejoria en HbA1c en el grupo de ESG-Apollo (p = 0,017) fue la unica diferencia. Un balon migrado y expulsado espontaneamente fue la unica incidencia tecnica. Conclusiones: la endoscopia bariatrica puede postularse, en un seguimiento a corto plazo, como una alternativa eficaz y segura en aquellos pacientes obesos con EHGNA. Favorece la perdida de peso y mejora los biomarcadores analiticos y ecograficos de grasa hepatica, la insulinorresistencia, la hipertrigliceridemia y las comorbilidades mayores asociadas.

We investigated for the first time the expression of melanoma cell adhesion molecule (MCAM) and its involvement in the differentiation of 3T3-L1 fibroblasts to adipocytes. We found that MCAM mRNA increased subsequent to the activation of the master regulator of adipogenesis, PPARγ, and this increase was maintained in the mature adipocytes. On the other hand, MCAM knockdown impaired differentiation and induction of PPARγ as well as expression of genes activated by PPARγ. However, events that precede and are necessary for early PPARγ activation, such as C/EBPβ induction, β-catenin downregulation, and ERK activation, were not affected in the MCAM knockdown cells. In keeping with this, the increase in PPARγ mRNA that precedes MCAM induction was not altered in the knockdown cells. In conclusion, our findings suggest that MCAM is a gene upregulated and involved in maintaining PPARγ induction in the late but not in the early stages of 3T3-L1 fibroblasts adipogenesis. Fil: Gabrielli, Matias. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina Fil: Romero, Damián Gastón. University of Mississippi; Estados Unidos Fil: Martini, Claudia Noemí. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina Fil: Raiger Iustman, Laura Judith. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentina Fil: Vila, Maria del Carmen. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentina

Postnatal overfeeding increases the risk of chronic diseases later in life, including obesity, insulin resistance, hepatic steatosis, and type 2 diabetes. Epigenetic mechanisms might underlie the long-lasting effects associated with early nutrition. Here we aimed to explore the molecular pathways involved in early development of insulin resistance and hepatic steatosis, and we examined the potential contribution of DNA methylation and histone modifications to long-term programming of metabolic disease. We used a well-characterized mouse model of neonatal overfeeding and early adiposity by litter size reduction. Neonatal overfeeding led to hepatic insulin resistance very early in life that persisted throughout adulthood despite normalizing food intake. Up-regulation of monoacylglycerol O-acyltransferase ( Mogat) 1 conceivably mediates hepatic steatosis and insulin resistance through increasing intracellular diacylglycerol content. Early and sustained deregulation of Mogat1 was associated with a combination of histone modifications that might favor Mogat1 expression. In sum, postnatal overfeeding causes extremely rapid derangements of hepatic insulin sensitivity that remain relatively stable until adulthood. Epigenetic mechanisms, particularly histone modifications, could contribute to such long-lasting effects. Our data suggest that targeting hepatic monoacylglycerol acyltransferase activity during early life might provide a novel strategy to improve hepatic insulin sensitivity and prevent late-onset insulin resistance and fatty liver disease.-Ramon-Krauel, M., Pentinat, T., Bloks, V. W., Cebrià, J., Ribo, S., Pérez-Wienese, R., Vilà, M., Palacios-Marin, I., Fernández-Pérez, A., Vallejo, M., Téllez, N., Rodríguez, M. À., Yanes, O., Lerin, C., Díaz, R., Plosch, T., Tietge, U. J. F., Jimenez-Chillaron, J. C. Epigenetic programming at the Mogat1 locus may link neonatal overnutrition with long-term hepatic steatosis and insulin resistance., This work was supported by Instituto de Salud Carlos III (PI14/00035, CP11/00312 to J.J.C.), Ministerio de Economía y Competitividad (BFU2011-29739 to J.J.C.), the Netherlands Organization for Health Research and Development (ZonMW, Grant 91211053 to T.P.), and the Spanish Ministry of Economy and Competitiveness (BFU2014-52149-R to M.V.). I.P.-M. is supported by a National Council for Science and Technology in Mexico (CONACyT) Ph.D. Scholarship. M.R.-K. and T.P. share senior authorship.

RESUMEN Introducción: muchos de los pacientes sometidos a cirugía bariátrica (bypass gástrico en Y-de-Roux [RYGB]), con el tiempo, pueden recuperar parte del peso perdido. La reducción transoral del vaciamiento gástrico (TORe) con sutura endoscópica podría ser una alternativa válida en estos pacientes. Métodos: serie inicial retrospectiva que incluye a 13 pacientes consecutivos remitidos por reganancia ponderal tras RYGB y con anastomosis gastroyeyunal dilatada (> 15 mm). El TORe fue realizado mediante un dispositivo endoscópico de suturas transmurales (OverStitch-Apollo(r)), reduciendo el diámetro de la anastomosis y del reservorio gástrico. Se describen los datos iniciales de viabilidad técnica, seguridad y eficacia, con un seguimiento limitado a seis meses. Resultados: tras el RYGB, existía una pérdida media máxima de 37,69 kg y una posterior reganancia media de 21,62 kg. Se redujo el diámetro medio de la anastomosis de 36 mm (rango 20-45) a 9 mm (rango 5-12) (reducción del 75%) con una media de 2,5 suturas y el del reservorio de 7,2 cm (rango 2-10) a 4,7 cm (rango 4-5) (reducción del 34,72%) con una media de 2,7 suturas. La pérdida media de peso a los seis meses tras el TORe fue de 12,29 kg (pérdida del 56,85% del peso reganado tras RYGB). No se registraron complicaciones relacionadas con el procedimiento. Conclusiones: la reducción mediante sutura endoscópica de la anastomosis gastroyeyunal dilatada y del reservorio gástrico parece una opción viable y segura según nuestra limitada experiencia inicial. Dentro de un abordaje multidisciplinar y en un seguimiento a corto plazo, se presenta como una opción mínimamente invasiva y eficaz para controlar la reganancia ponderal tras RYGB. ABSTRACT Introduction: many patients that undergo bariatric surgery (Roux-en-Y gastric bypass [RYGB]) may regain some of their weight lost over time. A transoral outlet reduction (TORe) with endoscopic suture could be a valid alternative in these patients. Methods: this was a retrospective initial series of 13 consecutive patients with weight regain after RYGB and a dilated gastro-jejunal anastomosis (> 15 mm). TORe was performed using an endoscopic transmural suture device (OverStitch-Apollo(r)), which was used to reduce the anastomosis aperture and also to treat the gastric pouch. The initial data of feasibility, safety and weight loss are described with a limited follow-up of six months. Results: there was a mean maximum weight loss of 37.69 kg after RYGB and a subsequent average regain of 21.62 kg. The mean anastomosis diameter was 36 mm (range 20-45) which was reduced to 9 mm (range 5-12) (75% reduction), with an average of 2.5 sutures. The mean pouch size was 7.2 cm (range 2-10), which decreased to 4.7 cm (range 4-5) (34.72% reduction), with an average of 2.7 sutures. The mean weight loss six months after TORe was 12.29 kg, a weight loss of 56.85% of the weight regained after RYGB. No complications related to the procedure were recorded. Conclusions: endoscopic suture reduction of the dilated gastro-jejunal anastomosis and the gastric pouch seems a feasible and safe option in our limited initial experience. With a multidisciplinary approach and a short term follow-up, this seems to be a minimally invasive and effective option to control weight regain after RYGB.

Adipogenesis is stimulated in 3T3-L1 fibroblasts by a combination of insulin, dexamethasone and isobutylmethylxanthine, IBMX, (I+D+M). Two transcription factors are important for the acquisition of the adipocyte phenotype, C/EBP beta (CCAT enhancer-binding protein beta) and PPAR gamma (peroxisome proliferator-activated receptor gamma). IBMX increases cAMP content, which can activate protein kinase A (PKA) and/or EPAC (exchange protein activated by cAMP). To investigate the importance of IBMX in the differentiation mixture, we first evaluated the effect of the addition of IBMX on the increase of C/EBP beta and PPAR gamma and found an enhancement of the amount of both proteins. IBMX addition (I+D+M) or its replacement with a cAMP analogue, dibutyryl-cAMP or 8-(4-chlorophenylthio)-2-O′-methyl-cAMP (8CPT-2-Me-cAMP), the latter activates EPAC and not PKA, remarkably increased PPAR gamma mRNA. However, neither I+D nor any of the inducers alone, increased PPAR gamma mRNA to a similar extent, suggesting the importance of the presence of both IBMX and I+D. It was also found that the addition of IBMX or 8CPT-2-Me-cAMP was able to increase the content of C/EBP beta with respect to I+D. In agreement with these findings, a microarray analysis showed that the presence of either 8CPT-2-Me-cAMP or IBMX in the differentiation mixture was able to upregulate PPAR gamma and PPAR gamma-activated genes as well as other genes involved in lipid metabolism. Our results prove the involvement of IBMX-cAMP-EPAC in the regulation of adipogenic genes during differentiation of 3T3-L1 fibroblasts and therfore contributes to elucidate the role of cyclic AMP in this process. Fil: Gabrielli, Matias. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Martini, Claudia Noemí. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina Fil: Brandani, Javier Nahuel. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Raiger Iustman, Laura Judith. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Romero, Damián Gastón. University Of Mississippi; Estados Unidos Fil: Vila, Maria del Carmen. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

Background: in recent years new endoscopic strategies and techniques for the treatment of obesity have emerged and develop ed. Aim of the study: in this article we will review and analyze the current state of the following techniques and the basic differential characteristics between each of them: balloons and prosthesis, injection of substances, systems of sutures, malabsorptives techniques and others currently in research. Methods: we will evaluate the endoscopic technique and their main indications, results, tolerances, complications and adverse effects observed, reporting our personal experience and in relation with an extensive literature review. Results: comparatively with the most widespread technique of the Bioenterics balloon, the Spatz balloon can provide greater weight loss but with worse tolerance and more complications and the Heliosphere Bag gets a similar weight loss but with greater technical difficulty. Other balloons and prosthesis (Ullorex, Semistationary, Silimed, Endogast) still require technical improvements and higher studies. The injection of botulinum toxin, although secure, seems to offer a smaller and more transient efficacy. Suture systems (TOGa, endoluminal vertical gastroplasty and POSE) appear to be effective but are technically more laborious. Malabsorptives procedures (Endobarrier, ValenTX) are somewhat laborious but effective, particularly indicated in obese patients with type 2 diabetes mellitus. Conclusions: the development of new endoscopic techniques and improvement in existing designs, suggest an increasingly important role of the endoscopist in the treatment of obesity. We consider it important to individually select and use the endoscopic technique, depending on the desirable outcomes (efficacy, tolerance, safety, adverse effects and risks) and the experience of each hospital. We believe that these techniques should be applied by specifically trained endoscopists in specialized hospitals.

OBJECTIVES: Protein intake impacts on nutritional status and may determine the recurrence of hepatic encephalopathy (HE). A low-protein diet has been considered the standard treatment after an episode of HE, while branched-chain amino acids (BCAA) have been shown to improve minimal HE. We performed a study to investigate the long-term effects of supplementing a protein-controlled diet with BCAA. METHODS: A randomized, double-blind, multicenter study that included 116 patients with cirrhosis and a previous episode of HE was conducted in four tertiary care hospitals. All patients received a standard diet of 35 kcal/kg per day and 0.7 g of proteins/kg per day and a supplement of 30 g of BCAA (BCAA group) or maltodextrin (MDX group) during 56 weeks. RESULTS: The actuarial risk of remaining free of HE did not differ between groups (BCAA = 47%, MDX = 34%, P = 0.274), but patients in the BCAA group exhibited a better outcome on two neuropsychological tests and an increase in the mid-arm muscle circumference. Recurrence was associated with low plasma albumin at baseline and a decrease in sodium and an increase in creatinine during follow-up. Patients with recurrence of HE exhibited a lack of improvement in global cognitive function. CONCLUSIONS: Diet supplementation with BCAA after an episode of HE does not decrease recurrence of HE. However, supplementation with BCAA improves minimal HE and muscle mass. Identification of risk factors for recurrence of HE may allow the development of new preventive therapies that could decrease the neuropsychological sequelae of repeated episodes of HE.

Norfloxacin is highly effective in preventing spontaneous bacterial peritonitis recurrence in cirrhosis, but its role in the primary prevention of this complication is uncertain.Patients with cirrhosis and low protein ascitic levels (15 g/L) with advanced liver failure (Child-Pugh scoreor = 9 points with serum bilirubin levelor = 3 mg/dL) or impaired renal function (serum creatinine levelor = 1.2 mg/dL, blood urea nitrogen levelor = 25 mg/dL, or serum sodium levelor = 130 mEq/L) were included in a randomized controlled trial aimed at comparing norfloxacin (35 patients) vs placebo (33 patients) in the primary prophylaxis of spontaneous bacterial peritonitis. The main end points of the trial were 3-month and 1-year probability of survival. Secondary end points were 1-year probability of development of spontaneous bacterial peritonitis and hepatorenal syndrome.Norfloxacin administration reduced the 1-year probability of developing spontaneous bacterial peritonitis (7% vs 61%, P.001) and hepatorenal syndrome (28% vs 41%, P = .02), and improved the 3-month (94% vs 62%, P = .003) and the 1-year (60% vs 48%, P = .05) probability of survival compared with placebo.Primary prophylaxis with norfloxacin has a great impact in the clinical course of patients with advanced cirrhosis. It reduces the incidence of spontaneous bacterial peritonitis, delays the development of hepatorenal syndrome, and improves survival.

Background: Prophylaxis with recombinant factor VIII (rFVIII) is considered the optimal treatment for severe or moderate haemophilia A (HA). Bleeding into joints determines a proportional chronic joint damage to its frequency and severity. Knowledge of the individual's pharmacokinetics (PK) using Bayesian analysis helps to individualize prophylaxis therapy with recombinant factor VIII (rFVIII) in severe or moderate haemophilia A (HA) and minimize the risk of bleeding, extracting only 2-3 samples. Methods Retrospective study in HA patients with rFVIII (Advate®) prophylaxis from January 2014 to May of 2016. Bayesian model (myPKFit®) was employed to perform an individual PK profile using the retrospective data of rFVIII levels. PK parameters analyzed were: clearance (Cl); steady state volume (Vss); plasma half-life (t1/2); and time to reach rFVIII levels Results Nineteen patients were analyzed, with a mean age of 32 years (SD: 11.3; range 11-46) and 86 PK monitoring (4.5 per patient). Two patients with p75 14.4 h), with average age of 19.5; 39.4 & 35.8 years, respectively. We detected significant differences between t1/2 and median values of joint state, but not in ABR and AJBR. The mean values of joint scores were: PS (5.5, 22.1; 17; p=0.028), GS (1, 25.9, 17.6; p= 0,008) and NMR (1.2, 2.6, 2.0; p=0.042) for short, normal and long t1/2, respectively. The limited number of patients only allows observe significant differences in patients with short t1/2, patients that also have significantly lower age (p=0.007). The younger age of these patients also justifies the lower joint damage observed. After excluding two patients Conclusion PK monitoring showed a low intraindividual variability in t1/2, but significant interindividual CV. Age could modify PK parameters, so it should be assessed in an integrated manner with other clinical variables. Bayesian estimate with MyPKFit® allows know the PK profile of each patient and could be a useful tool to individualize prophylaxis adjusting by the physical activity and the bleeding pattern. We are performing a personalized one-year program to identify and treat the specific causes of poor bleeding control in prophylaxis therapy, and these are our preliminary results. Acknowledgments: This study will be supported by Baxalta grant "H15-29403". Disclosures Cid: Baxalta Innovations GmbH, now part of Shire: Other: Investigator Clinical Studies.

Long-term primary antibiotic prophylaxis of spontaneous bacterial peritonitis has been suggested to be useful in cirrhotic patients with low ascitic fluid protein levels. However, it is unlikely that all such patients need prophylactic treatment. The aim of this study was to identify the group of cirrhotic patients with low ascitic fluid protein levels at high risk of developing a first episode of spontaneous bacterial peritonitis during outpatient follow-up.One hundred nine cirrhotic patients with low ascitic fluid protein levels and without previous episodes of spontaneous bacterial peritonitis were followed up in an outpatient clinic.Twenty-eight patients developed a first spontaneous bacterial peritonitis episode. In the multivariate analysis, serum bilirubin level (3.2 mg /dL) and platelet count (98.000/mm(3)) independently correlated with the risk of developing the first spontaneous bacterial peritonitis (P0.01 and P0.05, respectively). According to the median relative risk coefficient, a low-risk group (relative risk1.09) and a high-risk group (relative risk1.09) were established. The probability of developing a first spontaneous bacterial peritonitis episode at 1-year follow-up was significantly higher in the high risk-group (low-risk group, 23.6%; high-risk group, 55%; P0.01) as a consequence of a higher probability of the first community-acquired episode (13.7% vs. 47.6%, respectively, P0.01). One-year probability of survival was significantly lower in the high-risk group (low-risk group, 57.6%; high-risk group, 38%, P0.05).Cirrhotic patients with low ascitic fluid protein levels (/=1 g /dL) and high bilirubin level and/or low platelet count are at high risk of developing a first episode of spontaneous bacterial peritonitis during long-term follow-up.

Submitted by Joana Lopes Dias (jdias@ubi.pt) on 2014-06-06T18:45:12Z No. of bitstreams: 1 Dissertação de Mestrado em Estudos Ibéricos - O Bilinguismo na Comunidade Autónoma da Catalunha.pdf: 5940589 bytes, checksum: 44c460277a943c2a947740153c1b368b (MD5) Made available in DSpace on 2014-06-06T18:45:12Z (GMT). No. of bitstreams: 1 Dissertação de Mestrado em Estudos Ibéricos - O Bilinguismo na Comunidade Autónoma da Catalunha.pdf: 5940589 bytes, checksum: 44c460277a943c2a947740153c1b368b (MD5) Previous issue date: 2010

We tested the hypothesis that the presence of bacterial DNA (bactDNA) in ascitic fluid and serum is associated with decreased survival in patients with cirrhosis. In a prospective, multicenter study, we analyzed the clinical evolution of 156 patients with cirrhosis and ascites (first or recurrence) with lower than 250 polymorphonuclear cells (PMN)/L, negative ascites bacteriological culture, and absence of other bacterial infections being admitted for evaluation of largevolume paracentesis, according to the presence of bactDNA at admission. Survival, causes of death, and successive hospital admissions were determined during a 12-month follow-up period. BactDNA was detected in 48 patients. The most prevalent identified bactDNA corresponded to Escherichia coli (n 32/48 patients, 66.6%). Patients were followed for 12 months after inclusion and in this period 34 patients died: 16 of 108 (15%) bactDNA negative versus 18 of 48 (38%) bactDNA positive (P 0.003). The most frequent cause of death was acute-on-chronic liver failure in both groups (7/16 and 9/18 in patients without or with bactDNA, respectively), although more prevalent in the first month of follow-up in patients with presence of bactDNA (0 versus 4/7). When considering patients with model for end-stage liver disease (MELD) score less than 15, mortality was significantly higher in those with presence of bactDNA. Spontaneous bacterial peritonitis developed similarly in patients with or without bactDNA at admission. Conclusion: The presence of bactDNA in a patient with cirrhosis during an ascitic episode is an indicator of poor prognosis. This fact may be related to the development of acute-on-chronic liver failure at short term and does not predict the development of spontaneous bacterial peritonitis. (HEPATOLOGY 2008;48:1924-1931.)

Esta investigación quiere facilitar la aplicación de la metodología enfermera utilizando las taxonomías NANDA, NOC y NIC a una población inmigrante y se plantea los siguientes. Objetivos: - Identificar los diagnósticos NANDA más prevalentes, vinculados al proceso migratorio de la población inmigrante y sus familias. - Confeccionar e implementar planes de cuidados de enfermería adecuados a la población inmigrante y sus familias, utilizando las taxonomías NANDA, NOC y NIC - Evaluar la idoneidad y validez de los planes estandarizados confeccionados. Metodología: El proyecto se lleva a cabo en diversos Centros de Atención Primaria del Institut Català de la Salut (ICS) de Cataluña escogidas aleatoriamente. El estudio multicéntrico consta de cuatro fases: a) Primera fase descriptiva: detección de necesidades de la población inmigrante realizada por 60 enfermeras responsables de la recogida de datos. b) Segunda fase: elaboración de planes de cuidados estandarizados según los problemas detectados ,utilizando los lenguajes enfermeros. c) Tercera fase: Implementación de planes de cuidados estandarizados d) Cuarta fase: Medición y evaluación de resultados. Conclusiones: Presentamos elementos innovadores (triangulación metodológica) para abordar con poca evidencia científica enfermera. Hemos identificado 47 etiquetas diagnósticas que están siendo asociadas con los factores relacionados y características definitorias correspondientes. The present research study tries to apply the nursing methodology of NANDA, NOC and NIC taxonomy to an immigrant population and presents the following Aims: - To identify the most prevalent NANDA diagnoses linked to the migratory process of immigrant population and their families. - To elaborate and implement nursing care schemes adequate to the immigrant population and their families, using NANDA, NOC and NIC taxonomy. - To evaluate suitability and validity of the already made standard schemes. Methodology: The project is being dealt with in several Primary Health Centres of the Institut Català de la Salut (ICS) in Catalonia previously selected. The multi-centre study has four stages: a) A descriptive stage: Detection of needs in the immigrant population by 60 nurses responsible for the data collection. b) Preparing some standard care plans according to the detected problems using the appropriate nursing language. c) Implementing those standard care plans. d) Outcomes measure and assessment. Conclusions: Innovative elements as methodological triangulation are here presented in order to show the small scientific nursing evidence. 47 diagnoses associated to those factors and definite characteristics have been identified.

Insulin (10 and 100 nM) and phorbol esters increased the phosphorylation of several proteins, including 40, 47 and 80 kDa proteins, which are markers for protein kinase C activation. Insulin effects were evident at 2 min and increased over 20 min. These findings suggest that insulin activates protein kinase C in BC3H-1 myocytes.