Heterotopic Auxiliary Liver Transplantation With Portal Flow

One of the causes of auxiliary liver transplantation failure is the inter-liver competition between the host liver and the graft for the hepatotrophic factors of the portal blood. We have developed an experimental model of heterotopic partial (30%) liver isotransplant using Wistar rats so as to study this competition

Atopic Dermatitis and Erythrodermia Associated With Systemic Lupus Erythematosus: A Case Report

La eritrodermia es una dermatosis inflamatoria que involucra capas parciales o totales de la piel. La mortalidad es del 16%. Los síntomas sistémicos incluyen fiebre, taquicardia, hinchazón de las extremidades, adenomegalia y hepatomegalia. Las causas infecciosas son las más frecuentes, estando presentes hasta en un 40%, seguidas de ictiosis y dermatitis en el 15% de los casos

Immunological and senescence biomarker profiles in patients after spontaneous clearance of hepatitis C virus: gender implications for long-term health risk

Background: About 25% of patients with acute hepatitis C virus (HCV) infection show spontaneous clearance within the first six months of infection but may remain at risk of inflammaging, aging, and liver and non-liver disease complications. This study evaluated the differences in the plasma levels of immune checkpoints (ICs) and senescence-associated secretory phenotype (SASP) biomarkers between patients who had spontaneously eliminated HCV infection (SC group) and individuals without evidence of HCV infection (C group). Methods: We performed a multicenter retrospective study of 56 individuals: 32 in the SC and 24 in the C groups. ICs and SASP proteins were analyzed using a Luminex 200TM analyzer. The statistical analysis used Generalized Linear Models with gamma distribution (log-link) adjusted by significant variables and sex. Results: 13 ICs (BTLA, CD137(4-1BB), CD27, CD28, CD80, GITR, HVEM, IDO, LAG-3, PD-1, PD-L1, PD-L2, and TIM-3) and 13 SASP proteins (EGF, Eotaxin, IL-1alpha, IL-1RA, IL-8, IL-13, IL-18, IP-10, SDF-1alpha, HGF, beta-NGF, PLGF-1, and SCF) were significantly higher in SC group after approximately more than two years of HCV clearance. After stratifying by sex, differences remained significant for males, which showed higher levels for 13 ICs and 4 SASP proteins in SC. While only PD-L2 was significantly higher in SC women, and no differences in SASP were found. Conclusions: Higher plasma levels of different IC and SASP proteins were found in individuals after more than two years of HCV clearance, mainly in men. Alterations in these molecules might be associated with an increased risk of developing liver and non-hepatic diseases.This study was supported by grants from Instituto de Salud Carlos III (ISCIII; grant number CP14/0010) to AFR), Fundación Universidad Alfonso X el Sabio (FUAX) – Santander (grant number 1.010.932 to AFR) and by PID2021–126781OB-I00 funded by MCIN/AEI/10.13039/501100011033 and by “ERDF A way of making Europe”. The study was also funded by the CIBER -Consorcio Centro de Investigación Biomédica en Red- (CB 2021), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea–Next‑GenerationEU (CB21/13/00044, CB21/13/00118, and GVC16/EHD/4). M.A.J.-S. is Miguel Servet researcher supported and funded by ISCIII (grant numbers CP17CIII/00007). RME is Juan de la Cierva researcher supported and fnanced by MICINN of Spain (FJC2020-042865-I).S

Influence of Sex on Stroke Prognosis: A Demographic, Clinical, and Molecular Analysis

Identifying the complexities of the effect of sex on stroke risk, etiology, and lesion progression may lead to advances in the treatment and care of ischemic stroke (IS) and non-traumatic intracerebral hemorrhage patients (ICH). We studied the sex-related discrepancies on the clinical course of patients with IS and ICH, and we also evaluated possible molecular mechanisms involved. The study's main variable was the patient's functional outcome at 3-months. Logistic regression models were used in order to study the influence of sex on different inflammatory, endothelial and atrial dysfunction markers. We recruited 5,021 patients; 4,060 IS (54.8% male, 45.2% female) and 961 ICH (57.1% male, 42.9% female). Women were on average 5.7 years older than men (6.4 years in IS, 5.1 years in ICH), and more likely to have previous poor functional status, to suffer atrial fibrillation and to be on anticoagulants. IS patients showed sex-related differences at 3-months regarding poorer outcome (55.6% women, 43.6% men, p < 0.0001), but this relationship was not found in ICH (56.8% vs. 61.9%, p = 0.127). In IS, women had higher levels of NT-proBNP and 3-months worse outcome in both cardioembolic and non-cardioembolic stroke patients. Stroke patients showed sex-related differences in pre-hospital data, clinical variables and molecular markers, but only IS patients presented independent sex-related differences in 3-months poor outcome and mortality. There was a relationship between the molecular marker of atrial dysfunction NT-proBNP and worse functional outcome in women, resulting in a possible indicator of increased dysfunction

Dynamics and determinants of household consumption in Colombia during the Covid-19 post pandemic

En este documento se analiza el comportamiento del consumo de los hogares en Colombia durante la postpandemia del COVID-19. Inicialmente se presenta una comparación regional destacando la severidad de los confinamientos y las respuestas fiscales de los gobiernos. Luego, se describe la dinámica de las principales canastas de consumo y los ítems de gasto. El documento se concentra en identificar y evaluar los principales determinantes macroeconómicos del consumo, destacándose el ingreso disponible de las familias, su ahorro y riqueza, la tasa de interés real y el crédito, las remesas y las transferencias monetarias del gobierno. También se provee información de los días sin IVA. Entre los resultados se resalta el rebote excepcional que registró el consumo en 2021 y 2022, beneficiado por todos estos factores. Para 2023 se prevé una desaceleración del consumo explicado, entre otros, por la reversión de sus principales determinantes.This paper analyses the behavior of household consumption in Colombia during Covid-19 post pandemic. Initially, it introduces a regional comparison emphasizing in the severity of lockdown and the government fiscal responses. Then, it describes the dynamics of the main consumption baskets and expenditure items. The paper focuses on the main macroeconomic determinants of consumption, emphasizing in the available income of households, their savings and wealth, the real interest rate and credit, the remittances and monetary transfer from government. The paper also provide evidence about days without VAT. Among the results is highlighted the exceptional rebound in consumption between 2021 and 2022, benefited by all these factors. Finally, a slowdown in consumption is projected for 2023, driven in part by the reversal of its main determinants among other factors.Dinámica y determinantes del consumo de los hogares en Colombia durante la postpandemia del Covid-19 Enfoque Luego de presentar una fuerte caída durante el confinamiento ocasionado por el COVID-19, el consumo de los hogares en Colombia registró tasas de crecimiento excepcionales, convirtiéndose en el principal impulsor de la actividad económica durante 2021 y 2022. Entre los factores que explican este repunte está la recuperación del empleo con la reactivación de la economía, el incremento sin precedentes de las transferencias monetarias del gobierno, el aumento de las remesas enviadas por los trabajadores en el exterior, los incentivos tributarios a las compras, como los días sin IVA, y las bajas tasas reales de interés de consumo. La combinación de algunos de estos factores incrementó el ingreso disponible de los hogares y favoreció su acumulación de riqueza, impulsando los gastos de las familias. Contribución El documento describe la dinámica del consumo privado en Colombia y de las principales economías de la región desde la crisis sanitaria del Covid-19, identificando los factores que explican el rebote del gasto de los hogares durante la reapertura económica y las canastas de bienes y servicios que lideraron ese proceso. La caída abrupta y el posterior rebote del consumo fueron comunes en la región, siendo Perú, Chile y México los países que presentaron los efectos más adversos, mientras que Colombia y Brasil salieron relativamente mejor librados. El grado de rigurosidad en las medidas de aislamiento para enfrentar el virus al comienzo de la pandemia y la rapidez en la reapertura, así como los programas de ayuda de los gobiernos, jugaron un papel importante. Resultados El consumo de los hogares en Colombia registró una caída cercana al 20% en los trimestres más críticos de la pandemia del COVID-19. Sin embargo, un año después del choque, el nivel de consumo ya excedía con los niveles observados previamente. Utilizando la técnica de mínimos cuadrados totalmente modificados, FMOLS, se estima la relación de largo plazo entre el consumo privado en Colombia y sus principales determinantes macroeconómicos. Los resultados encontrados confirman los efectos esperados. El ingreso disponible y la riqueza de los hogares son determinantes fundamentales que lo estimulan al tiempo que la tasa de interés real lo contrae. Con los resultados de la estimación se evalúa la capacidad de pronósticos del modelo. En 2023 el consumo ha mostrado signos de desaceleración, explicado por la reversión de los determinantes que en su momento incentivaron su expansión. Frase destacada: El consumo de los hogares registró tasas de crecimiento excepcionales, luego de una fuerte caída durante el confinamiento. La recuperación del empleo, las transferencias monetarias del gobierno, las remesas desde el exterior, los días sin IVA, y las bajas tasas de interés de consumo, jugaron un papel destacado en esa dinámica

Intra- and extra-hospital improvement in ischemic stroke patients: influence of reperfusion therapy and molecular mechanisms

Neuroprotective treatments in ischemic stroke are focused to reduce the pernicious effect of excitotoxicity, oxidative stress and inflammation. However, those cellular and molecular mechanisms may also have beneficial effects, especially during the late stages of the ischemic stroke. The objective of this study was to investigate the relationship between the clinical improvement of ischemic stroke patients and the time-dependent excitotoxicity and inflammation. We included 4295 ischemic stroke patients in a retrospective study. The main outcomes were intra and extra-hospital improvement. High glutamate and IL-6 levels at 24 hours were associated with a worse intra-hospital improvement (OR:0.993, 95%CI: 0.990-0.996 and OR:0.990, 95%CI: 0.985-0.995). High glutamate and IL-6 levels at 24 hours were associated with better extra-hospital improvement (OR:1.13 95%CI, 1.07-1.12 and OR:1.14, 95%CI, 1.09-1.18). Effective reperfusion after recanalization showed the best clinical outcome. However, the long term recovery is less marked in patients with an effective reperfusion. The variations of glutamate and IL6 levels in the first 24 hours clearly showed a relationship between the molecular components of the ischemic cascade and the clinical outcome of patients. Our findings suggest that the rapid reperfusion after recanalization treatment blocks the molecular response to ischemia that is associated with restorative processes

Investment in machinery and equipment in Colombia: long-run determinants and its dynamic during the COVID-19

El choque ocasionado por el COVID-19 generó un desplome de la inversión en Colombia que se tradujo en una brecha negativa de -2,8% del PIB en el segundo trimestre de 2020. A nivel regional, este episodio afectó en mayor grado a Perú, mientras que países como México, Chile y Brasil sufrieron menores detrimentos. La reactivación de la inversión en Colombia fue relativamente más lenta frente a sus pares y ha sido impulsada por el buen desempeño de las compras de maquinaria y equipo. En este documento se analizan los factores macro que determinan este tipo de inversión y su comportamiento durante la pandemia. Los resultados confirman los efectos esperados: las compras de maquinaria y equipo se reducen con los aumentos del costo de uso del capital y de la tasa de cambio real, y aumentan con el crecimiento de la actividad económica y la confianza de los empresarios. Estos últimos generan impactos más duraderos. Otras variables que podrían influir las decisiones de inversión, como el acceso al crédito y el grado de apertura, son usadas como variables de control.Colombia saw a drop in investment as a result of the COVID-19 shock, which resulted in a negative gap in the second quarter of 2020 of -2.8% of the GDP. In the context of the region, Peru was hardest hit, while countries such as Mexico, Chile, and Brazil suffered minor setbacks. The recovery of investment in Colombia has been relatively slow, although strengthened by sustained and growing dynamics in machinery and equipment purchases. This paper analyzes the macroeconomic factors that explain this type of investment and its behavior during the pandemic. The results confirm the expected effects: purchases of machinery and equipment fall when the cost of capital use and the real exchange rate rise, while increase in response to rise in economic activity and industrial confidence, which have longer-lasting effects. Control variables include additional factors that may affect investment decisions, such as loan availability and degree of openness.Inversión en maquinaria y equipo en Colombia: determinantes de largo plazo y efecto del COVID 19 sobre su dinámica Enfoque La tendencia creciente de la inversión real en maquinaria y equipo observada en Colombia, y en algunos países de la región, se vio impactada dramáticamente por la pandemia del COVID-19. Experimentó una caída promedio trimestral de 14,25% en 2020 frente al 3,54% de crecimiento entre 2016 y 2019. En 2021 se expandió al 22,12% correspondiendo a la recuperación más baja de la región, cuando se compara, por ejemplo, con Brasil, Chile y Perú. En este trabajo se cuantifica los principales factores que explican dicha caída y recuperación en Colombia, a partir de la estimación de las semi elasticidades instantáneas de sus determinantes de largo plazo. Además, analiza su dinámica a través de la contribución porcentual estimada de cada determinante a su crecimiento trimestral mediante un modelo VEC y sus funciones impulso-respuesta. Contribución La literatura para en el caso colombiano, desde la década de 1980 se ha destacado como determinantes de la inversión la actividad económica, a través del modelo del acelerador y el costo de uso del capital. Dada la expansión reciente de las compras de maquinaria y equipo y la escasez relativa de estudios recientes sobre su dinámica, en este trabajo se analizan las principales fuentes de variación reciente, que explican la caída generada ante la pandemia del Covid-19 y su recuperación posterior. Resultados El modelo confirma los impactos esperados de los principales determinantes de la inversión en maquinaria y equipo; entre otros, de la actividad económica, del costo de uso del capital, de la tasa de cambio real y la confianza de los industriales. El modelo también predice una caída de la inversión inferior a la observada durante la pandemia y una recuperación superior a la que muestran los datos, que se explica al parecer porque sus principales determinantes fueron mayormente afectados con este choque. Frase destacada: Los aumentos del costo de uso del capital y de la tasa de cambio real reducen las compras de maquinaria y equipo, en tanto que la actividad económica y la confianza de los industriales la aumentan, así como el acceso al crédito y el grado de apertura cuando se incluyen como variables de control

Regulatory T cells participate in the recovery of ischemic stroke patients

BACKGROUND: Recent preclinical studies have shown that regulatory T cells (Treg) play a key role in the immune response after ischemic stroke (IS). However, the role of Treg in human acute IS has been poorly investigated. Our aim was to study the relationship between circulating Treg and outcome in human IS patients. METHODS: A total of 204 IS patients and 22 control subjects were recruited. The main study variable was good functional outcome at 3 months (modified Rankin scale </=2) considering infarct volume, Early Neurological Deterioration (END) and risk of infections as secondary variables. The percentage of circulating Treg was measured at admission, 48, 72 h and at day 7 after stroke onset. RESULTS: Circulating Treg levels were higher in IS patients compared to control subjects. Treg at 48 h were independently associated with good functional outcome (OR, 3.5; CI: 1.9-7.8) after adjusting by confounding factors. Patients with lower Treg at 48 h showed higher frequency of END and risk of infections. In addition, a negative correlation was found between circulating Treg at 48 h (r = - 0.414) and 72 h (r = - 0.418) and infarct volume. CONCLUSIONS: These findings suggest that Treg may participate in the recovery of IS patients. Therefore, Treg may be considered a potential therapeutic target in acute ischemic stroke

Healthcare experience among patients with type 2 diabetes: A cross-sectional survey using the IEXPAC tool

Aim: To assess the experience with health care among patients with type 2 diabetes (T2DM) and to evaluate patients’ demographic variables and healthcare-related char- acteristics which may affect their experience. Methods: A cross-sectional survey was delivered to T2DM adults. Patient experi- ences were assessed with the ‘Instrument for Evaluation of the Experience of Chronic Patients’ (IEXPAC) questionnaire, a validated 12-item survey, which describes patient experience within the last 6 months (items 1–11) and hospitalization in the last 3 years (item 12), with possible scores ranging from 0 (worst) to 10 (best experience). Results: A total of 451 T2DM patients responded to the survey (response rate 72.3%; mean age 69.5 ± 10.1 years, 67.8% men). The mean overall IEXPAC score was 5.92 ± 1.80. Mean scores were higher for productive interactions (7.92 ± 2.15) and self-management (7.08 ± 2.27) than for new relational model (1.72 ± 2.01). Only 32.8% of patients who had been hospitalized in the past 3 years reported having received a follow-up call or visit after discharge. Multivariate analyses identified that regular follow-up by the same physician and follow-up by a nurse were associated with a better patient experience. Continuity of healthcare score was higher only in those patients requiring help from others. Conclusions: The areas of T2DM care which may need to be addressed to ensure bet- ter patient experience are use of the Internet, new technologies and social resources for patient information and interaction with healthcare professionals, closer follow- up after hospitalization, and a comprehensive multidisciplinary approach with regular follow-up by the same physician and a nurse