Comparison Between Two Warm Ischemic Models in Experimental Liver Transplantation in Pigs

Experimental models of warm ischemia in liver transplantation have been employed to study the mechanisms and treatment of ischemia reperfusion injury. METHODS: We compared a control group without (group A, n = 10) versus two models of warm ischemia of liver transplants in pigs: namely, occlusion of the hepatic artery and portal vein for 30 minutes (group B, n = 23) and extraction of the liver 60 minutes after cardiac arrest (group C, n = 5). Liver function tests, coagulation studies, and liver biopsies were performed during the first 24 hours post-liver transplant. RESULTS: Clamping of the hepatic vasculature in group B produced a significant liver injury compared with the control group: elevation of the ALT and an abnormal 1-hour post-revascularization biopsy similar to that observed in the cardiac arrest group C. The transaminase levels were lower among group A animals (P <.05). But the hepatic synthetic functions as reflected in the protrombin time (PT) were not affected in group B versus group A. The alteration in PT with respect to the initial value was similar among group A and group B animals, which were significantly less than that in group C (P <.05). CONCLUSIONS: Occlusion of the hepatic artery and portal vein, a simple surgical maneuver, causes moderate damage to a liver graft but less alteration of hepatic synthetic function. Clamping of the hepatic vasculture obtains more long-term survivors after OLT than cardiac arrest

A system of three transiting super-Earths in a cool dwarf star

We present the detection of three super-Earths transiting the cool star LP415-17, monitored by K2 mission in its 13th campaign. High resolution spectra obtained with HARPS-N/TNG showed that the star is a mid-late K dwarf. Using spectral synthesis models we infer its effective temperature, surface gravity and metallicity and subse- quently determined from evolutionary models a stellar radius of 0.58 R Sun. The planets have radii of 1.8, 2.6 and 1.9 R Earth and orbital periods of 6.34, 13.85 and 40.72 days. High resolution images discard any significant contamination by an intervening star in the line of sight. The orbit of the furthest planet has radius of 0.18 AU, close to the inner edge of the habitable zone. The system is suitable to improve our understanding of formation and dynamical evolution of super-Earth systems in the rocky - gaseous threshold, their atmospheres, internal structure, composition and interactions with host stars.Comment: Accepted for publication in MNRAS Letter

Papel de la linfadenectomía ampliada tipo R2 en el tratamiento quirúrgico del cáncer gástrico resecable

The extended lymphadenectomy has been proposed as routine procedure in the surgical treatment of gastric cancer, although some controversies have been published. We present a retrospective analysis on the impact of extended lymph node dissection after total gastrectomy, in terms of post-operative course and histopathologic findings, in a group of 30 patients with R2 lymphadenectomy and in 16 patients with R1 lymphadenectomy. There were no significant differences in duration of operation, amount of blood trasfusion and length of hospital stay between the 2 groups. The only significant difference was found in the greater amount of drainage output after R2 lymphadenectomy as compared with R1. There were no mortalities in either group and morbidity rate was similar for both [43% in R1 and 40% in R2) mostly in the form of abdominal infections (18% in R1 and 16% in R2]). A significantly greater number of lymph nodes was identified after R2 gastrectomy. Fifty-three per cent of patients has positive lymph nodes, 12% of them being from the N2 echelon of nodes (including one case of early gastric cancer). Careful lymph node dissection in gastric cancer surgery allows a more precise staging of the tumor with no increase in postoperative morbidit

Solving patients with rare diseases through programmatic reanalysis of genome-phenome data

Reanalysis of inconclusive exome/genome sequencing data increases the diagnosis yield of patients with rare diseases. However, the cost and efforts required for reanalysis prevent its routine implementation in research and clinical environments. The Solve-RD project aims to reveal the molecular causes underlying undiagnosed rare diseases. One of the goals is to implement innovative approaches to reanalyse the exomes and genomes from thousands of well-studied undiagnosed cases. The raw genomic data is submitted to Solve-RD through the RD-Connect Genome-Phenome Analysis Platform (GPAP) together with standardised phenotypic and pedigree data. We have developed a programmatic workflow to reanalyse genome-phenome data. It uses the RD-Connect GPAP’s Application Programming Interface (API) and relies on the big-data technologies upon which the system is built. We have applied the workflow to prioritise rare known pathogenic variants from 4411 undiagnosed cases. The queries returned an average of 1.45 variants per case, which first were evaluated in bulk by a panel of disease experts and afterwards specifically by the submitter of each case. A total of 120 index cases (21.2% of prioritised cases, 2.7% of all exome/genome-negative samples) have already been solved, with others being under investigation. The implementation of solutions as the one described here provide the technical framework to enable periodic case-level data re-evaluation in clinical settings, as recommended by the American College of Medical Genetics

¿Es razonable el abordaje laparoscópico en patología maligna colo-rectal?

Desde que se efectuó la primera resección de colon por vía laparoscópica en 1990, han sido publicados numerosos artículos, manifestándose diferentes opiniones, algunas de ellas francamente contrapuestas, en cuanto a validez o no de esta vía de abordaje quirúrgico, para el tratamiento del cáncer colo-rectal. El presente estudio de revisión pretende poner en claro cuál es la situación actual de la resección de colon por vía laparoscópica. Se analizan las ventajas e inconvenientes de dicho tratamiento, haciendo especial hincapié en situar la realidad actual de la incidencia de metástasis en el orificio de entrada de los trócares, así como, analizar las posibles causas. Se estudia la importancia de la experiencia del equipo quirúrgico y de la curva de aprendizaje para obtener los mejores resultados. Así como la necesidad de mantener las normas establecidas para una correcta resección de intestino grueso desde el punto de vista oncológico y la importancia de efectuar este tipo de cirugía dentro de ensayos clínicos controlados