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BACKGROUND: Acute-on-chronic liver failure (ACLF) is a common syndrome that occurs in patients with advanced chronic liver disease. It consists of the rapid failure of various organs and is associated with high short-term mortality. We aim to describe the main features and outcomes of inpatients who developed ACLF and to identify the factors associated with in-hospital and 28-day mortality. PATIENTS AND METHODS: All patients meeting ACLF criteria with advanced chronic liver disease admitted for decompensation from January 2014 to December 2016 were identified. Clinical and biological data were collected at the time of ACLF diagnosis and at 3-7 days thereafter, as well as in-hospital and 28-day mortality. RESULTS: Eighty nine out of 354 admission episodes (28%) developed ACLF, which was present at the time of admission in 72% of cases. A precipitating factor was identified in 83% of cases, the most frequent being infection (53%) and gastrointestinal bleeding (19%). In the multivariate regression analysis, the ACLF grade at 3-7 days after diagnosis was predictive of in-hospital mortality and 28-day mortality, and lower creatinine and bilirubin levels at the time of ACLF diagnosis and a precipitating factor other than bacterial infection were associated with ACLF reversion at 3-7 days. CONCLUSIONS: ACLF is a frequent complication among patients with chronic liver disease admitted for acute decompensations and is associated with a high mortality rate and is related to the number of organs involved. Bacterial infection is the most frequent precipitating factor of ACLF and probably entails a worse prognosis.

A characteristic shared by most frequent types of primary liver cancer, i.e., hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) in adults, and in a lesser extent hepatoblastoma (HB) mainly in children, is their high refractoriness to chemotherapy. This is the result of synergic interactions among complex and diverse mechanisms of chemoresistance (MOC) in which more than 100 genes are involved. Pharmacological treatment, although it can be initially effective, frequently stimulates the expression of MOC genes, which results in the relapse of the tumor, usually with a more aggressive and less chemosensitive phenotype. Identification of the MOC genetic signature accounting for the "resistome" present at each moment of tumor life would prevent the administration of chemotherapeutic regimens without chance of success but still with noxious side effects for the patient. Moreover, a better description of cancer cells strength is required to develop novel strategies based on pharmacological, cellular or gene therapy to overcome liver cancer chemoresistance. (C) 2018 Elsevier Masson SAS. All rights reserved.

Se presentan los resultados de la introducción de un CD interactivo sobre la dispensación de medicamentos y productos sanitarios en farmacias comunitarias para los estudiantes que terminan sus estudios de farmacia. Los alumnos valoran la aplicación práctica del “Live” CD, lo que se ha podido comprobar mediante una encuesta. El objetivo de la utilización de esta herramienta de trabajo es el facilitar que los alumnos se introduzcan en el ámbito de la regulación farmacéutica de una forma práctica y que valoren los conocimientos teóricos de la asignatura como una necesidad en una parte de la actividad profesional y que complementa al resto de conocimientos y habilidades impartidas en otras asignaturas de la carrera. La prueba piloto se ha llevado a cabo con los alumnos que han optado por la evaluación continuada con objeto de valorar si esta herramienta de trabajo facilita el aprendizaje y rendimiento de los resultados del alumnado. Se ha constatado que se han obtenido mejores resultados en los alumnos que han utilizado este medio., We present the results of the introduction of an interactive CD on dispensing drugs and medical devices in community pharmacies for students graduating in pharmacy. We have been able to demonstrate through a survey that students can see the practical application of the Live CD, which helps them to see the subject of Law and Ethics as practical and not so far away from the knowledge that they expect to acquire when they join the college. Moreover, the academic performance of students who opted for continuous assessment, which involved working with the CD, has been better than those who opted for the single assessment.

La reflexió sobre la pròpia professió ajuda els professionals i també l'organització on s'ubiquen a desenvolupar-se. Aquesta idea constitueix l'eix central dels seminaris CCUC. En el present article es dóna a conèixer una experiència continuada i no puntual de reflexió cooperativa del professorat de diverses universitats respecte al seu propi desenvolupament i el desenvolupament organitzatiu de la universitat. Es tracta d'una experiència no institucional que sorgeix a partir d'un grup d'investigació interessat en el canvi de cultura a les universitats, el core group, que dinamitza i convida diferents grups, experts i estudiosos dels temes de canvi de la nostra universitat. La fórmula escollida per fer aquesta reflexió és el seminari, que permet un tractament dels temes amb deteniment. Cada seminari té una temàtica que aglutina els diferents participants i dins d'aquesta temàtica cada grup aporta un aspecte que coneix en profunditat. S'hi expliquen aspectes i temàtiques tractades, així com les principals conclusions en l'àmbit de reflexions compartides pels participants. Reflection about one's profession contributes to the professionals' development and at the development of the institution at the same time. This idea is the central axis of the CCUC seminaries. In this article we explain an experience of cooperative reflection among teachers of diverse universities about their own development and about the university's organizational development. It is not an institutional experience, but it emerges from a research group interested in the change of culture at universities, the «core group» which invites and moderates different groups, experts and scholars of issues related to university change. The chosen formula for this reflection is the seminar which allows a thoroughly study of the different topics. Each seminar has a diverse subject matter and brings together different participants who bring expertise in one specific aspect. All the topics are extensively discussed, and conclusions are drawn from the shared reflections of the participants. La reflexión sobre la propia profesión ayuda a los profesionales y también a la organización donde se ubican a desarrollarse. Esta idea es el eje central de los seminarios CCUC. En el presente artículo se da a conocer una experiencia continuada y no puntual de reflexión cooperativa de profesorado de diversas universidades sobre su propio desarrollo y sobre el desarrollo organizativo de la universidad. Se trata de una experiencia no institucional que surge a partir de un grupo de investigación interesado en el cambio de cultura en las universidades, el core group, que dinamiza e invita a diferentes grupos, expertos y estudiosos de los temas de cambio de nuestra universidad. La fórmula elegida para esta reflexión es el seminario, que permite un tratamiento de los temas con detenimiento. Cada seminario tiene una temática que aglutina a los diferentes participantes y, dentro de ella, cada grupo aporta un aspecto que conoce en profundidad. Se explican esos aspectos y esas temáticas tratadas así como las principales conclusiones en el ámbito de reflexiones compartidas por los participantes.

Congress; 3rd, Spanish Society of Developmental Biology; 2001; Malaga, Spain., The cellular and molecular mechanisms underlying vasculogenesis and angiogenesis are still poorly understood. However, an increasing number of intercellular signaling molecules have been identified that play an essential role in this process. Prominent among these are transmembrane receptor tyrosine kinases and their ligands (angiopoietins, platelet-derived growth factors, vascular endothelial growth factors and ephrins). Moreover, it is known that repulsive signaling between arteries and veins is decisive for angiogenic remodeling during the functional maturation of the vascular system. Recently, ephrinB2 has been shown to be required for the remodeling of the embryonic blood vessels. Because of its exclusive expression on arteries and the complementary expression of one of its cognate receptors, EphB4, on veins, it was suggested that ephrinB2 acts both as a ligand and as a receptor for EphB4. However, it is not known the role of ephrinB2 during the tremendous vascular remodeling that occurs when an embryonic organ is functionally substituted by the definitive one. Avian mesonephros is an embryonic transitory organ with a complex, but well known, vascular system. Degeneration of the mesonephros leads to vessel disintegration. However, mesonephric vessels that communicate with metanephros, the definitive kidney, and gonads do not degenerate. The aim of this study is to analyze ephrinB2 mRNA expression throughout the development and degeneration of chick mesonephros, in order to understand the function of ephrinB2 during vascular mesonephric remodelation. In 24 HH embryos, ephrinB2 transcripts were observed in endothelial cells of dorsal aorta, vitelline, femoral, umbilical and intersomitic arteries. Mesonephric arteries with the ephrinB2 signal were only seen in the cranial part of the mesonephros. At stage 30, ephrinB2 mRNA was only observed in the dorsal aorta and the caudal mesonephric arteries. In 38 HH embryos, ephrinB2 expression was only present in the aorta and mesonephric arteries that will not degenerate. We found no ephrinB2 transcripts in glomerular capillaries or veins at any stage. In conclusion, the ephrinB2 temporal expression pattern matches the cranial-to-caudal morphogenetic gradient of mesonephros development. Totally differentiated mesonephric arteries do not express ephrinB2 and, when mesonephric degeneration occurs, only mesonephric arteries that remain expressed ephrinB2. Our results confirm the morphogenetic role of ephrinB2. Only arteries under remodelation expressed ephrinB2.