Rectal neuroendocrine tumor - Case report / Tumor neuroendocrino rectal: un caso clínico

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Incidence, predictive factors and clinical significance of development of portal vein thrombosis in cirrhosis: A prospective study.

BACKGROUND AND AIMS: The role of portal vein thrombosis (PVT) in the natural history of cirrhosis is controversial. There are few prospective studies validating risk factors for development of PVT. We analysed the incidence, factors associated with PVT development and its influence on cirrhosis decompensations and orthotopic liver transplant (OLT)-free survival. METHODS: In this prospective observational study between January 2014 and March 2019, 445 consecutive patients with chronic liver disease were screened and finally 241 with cirrhosis included. Factors associated with PVT development and its influence on cirrhosis decompensations and OLT-free survival by time dependent covariate coding were analysed. RESULTS: Majority of patients belonged to Child-Pugh class A 184 (76.3%) and the average MELD score was 10 ± 5. Previous cirrhosis decompensations occurred in 125 (52.1%), 63 (26.1%) were on NSBB and 59 (27.2%) had undergone banding for bleeding prophylaxis. Median follow-up was 29 (1-58) months. Cumulative incidence of PVT was 3.7% and 7.6% at 1 and 3 years. Previous decompensation of cirrhosis and low platelet counts but not NSBB independently predicted the development of PVT. During follow-up, 82/236 (34.7%) patients developed cirrhosis decompensations. OLT-free survival was 100% and 82.8% at 3 years, with and without PVT respectively. MELD score, but not PVT, independently predicted cirrhosis decompensations (HR 1.14; 95%CI:1.09-1.19) and OLT-free survival (HR 1.16;95%CI:1.11-1.21). CONCLUSION: Previous decompensations of cirrhosis and thrombocytopenia predict PVT development in cirrhosis suggesting a pathophysiologic role for severity of portal hypertension. PVT development did not independently predict cirrhosis decompensations or lower OLT-free survival.

Anticoagulation in Cirrhosis and Portal Vein Thrombosis Is Safe and Improves Prognosis in Advanced Cirrhosis.

BACKGROUND: The role of portal vein thrombosis (PVT) in the natural history of cirrhosis is controversial. AIMS: We analyzed the safety and effect of anticoagulant therapy (AT) on PVT recanalization and orthotopic liver transplant (OLT)-free survival. METHODS: Eighty consecutive patients from a prospective registry of cirrhosis and non-tumoral PVT at a tertiary center were analyzed. AT effect on PVT recanalization and OLT-free survival was determined by time-dependent Cox regression analysis. RESULTS: Average MELD score was 15 ± 7. Portal hypertension-related complications at PVT diagnosis were present in 65 (81.3%) patients. Isolated portal vein trunk/branch thrombosis was present in 53 (66.3%) patients. AT was started in 37 patients. AT was stopped in 17 (45.9%) patients, in 4 (10.8%) due to bleeding events. No variceal bleeding occurred while on AT. Anticoagulation was restarted in 6/17 (35.2%) patients due to rethrombosis. In 67 patients with adequate follow-up imaging, AT significantly increased the rate of PVT recanalization compared with those who did not receive anticoagulation [51.4% (18/35) vs 6/32 (18.8%), p = 0.005]. OLT-free survival after a median follow-up of 25 (1-146) months was 32 (40%). Although there was no significant effect of AT on overall OLT-free survival, OLT-free survival was higher among patients with MELD ≥ 15 receiving AT compared to those who did not (p = 0.011). Baseline MELD at PVT detection independently predicted PVT recanalization (HR 1.11, 95% CI 1.01-1.21, p = 0.027) and mortality/OLT (HR 1.12, 95% CI 1.05-1.19, p < 0.001). CONCLUSIONS: Although AT did not improve overall OLT-free survival, it was associated with higher survival in advanced cirrhosis. Anticoagulation increased PVT recanalization and should be maintained after PVT recanalization to avoid rethrombosis.

Temporal variations of heavy metals levels in Perna viridis, on the Chacopata-Bocaripo lagoon axis, Sucre State, Venezuela.

Perna viridis was used as biomonitor to assess heavy metal levels in the Chacopata-Bocaripo lagoon axis, Venezuela, during rain and drought seasons. The mussels were weighed and measured. The metal concentrations were determined by atomic absorption spectrophotometry. For rain period, the order of bioavailability was: Cu>Ni>Mn>Co>Cd>Pb, and for drought: Cu>Mn>Ni>Co>Pb>Cd. The concentrations of Ni, Co, Cd and Pb showed significant differences (P<0.05) in both periods. There was higher metal accumulation during drought season, possibly related to upwelling, since it produces an increase in primary productivity, which translates more food into organisms, making metals bioavailable for mussels. Only Cu and Mn showed significant relationships between the size and metal concentration, during drought period, it may be because of the organisms need for these essential metals in different physiological processes.

Microbial activity in surface sediments of Chacopata-Bocaripo lagoon axis, Sucre State, Venezuela.

The aim of this work was to evaluate the microbial activity of the surface sediments (0-10 cm) of the Chacopata-Bocaripo lagoon axis (Ch-BLA) through microbiological parameters: microbial biomass (Cmic) dehydrogenase activity (DHS), fluorescein diacetate hydrolysis (HFDA), arginine ammonification (AA) and biochemical parameters: phosphatase (PHa) and urease (URa) activity. They were determined during transition (July 2010) and upwelling (March 2011) periods. Total organic carbon (TOC) did not vary significantly (p⩾0.05) between climatic periods. All the parameters studied were higher in upwelling season: Cmic (191.79 mg Cmic kg(-1)), DHS (228.70 µg TFF g(-1) 24 h(-1)), HFDA (204.09 µg fluorescein g(-1) 24 h(-1)), AA (13.09 µg NH4-N g(-1) h(-1)), PHa (132.31 µg pNF g(-1) h(-1)), URa (12.90 µg NH4-N g(-1) h(-1)). They appear to be controlled by the availability and quality of nutrients in each climatic period, and were useful tools for evaluating changes in microbial activity in marine sediments.

[Fenology and life cycle of Gracilariopsis tenuifions (Gracilariaceae) at Sucre, Venezuela]. / Fenologia y ciclo de vida del alga Gracilariopsis tenuifrons (Gracilariaceae) en Sucre, Venezuela.

The aim of this work was to determine the frequency of different reproductive phases and to induce the germination of spores from tetrasporic and cystocarpic Gracilariopsis tenuifrons from Chacopata and La Peña, Venezuela, under controlled laboratory conditions (temperature 22 +/- 1 degree C, 12L:12D photoperiod, salinity of 36 +/-1 PSU and irradiance of 269 microE m(-2) s(-1)). Tetrasporic individuals dominated numerically over gametophitic individuals. The proportion of vegetative algae was very low. Only cystocarpic algae were collected and the spermatangia were absent. Sporulation, germination and formation of algae suggest that they present a Polysiphonia-type life cycle. Algae with reproductive structures were not obtained in the laboratory,

Nuevas adiciones de algas marinas para el Parque Nacional Mochima, Sucre, Venezuela / New additions to the marine algae of Mochima National Park, Sucre, Venezuela

The marine algal flora from the eastern coast of Mochima National Park, Sucre, Venezuela was studied with a total of 51 taxa identified, including eight new additions of red algae which are Erythrotrichia carnea (Dillwyn) J. Agardh, Sahlingia subintegra (Rosenvinge) Kornmann, Liagora ceranoides Lamouroux, Asparagopsis taxiformis (Delile) Trevisan, Dasya corymbifera J. Agardh, Chondria dasyphylla (Woodward) C. Agardh, Herposiphonia secunda f. tenella (C. Agardh) M.J. Wynne and Polysiphonia subtilissima Montagne. Morphological and anatomical aspects of the specimens are described and illustrated.

[New additions to the marine algae of Mochima National Park, Sucre, Venezuela]. / Nuevas adiciones de algas marinas para el Parque Nacional Mochima, Sucre, Venezuela.

The marine algal flora from the eastern coast of Mochima National Park, Sucre, Venezuela was studied with a total of 51 taxa identified, including eight new additions of red algae which are Erythrotrichia carnea (Dillwyn) J. Agardh, Sahlingia subintegra (Rosenvinge) Kornmann, Liagora ceranoides Lamouroux, Asparagopsis taxiformis (Delile) Trevisan, Dasya corymbifera J. Agardh, Chondria dasyphylla (Woodward) C. Agardh, Herposiphonia secunda f. tenella (C. Agardh) M.J. Wynne and Polysiphonia subtilissima Montagne. Morphological and anatomical aspects of the specimens are described and illustrated.