Portal vein arterialization in 25 liver transplant recipients: A Latin American single-center experience.

BACKGROUND: Portal vein arterialization (PVA) has been used in liver transplantation (LT) to maximize oxygen delivery when arterial circulation is compromised or has been used as an alternative reperfusion technique for complex portal vein thrombosis (PVT). The effect of PVA on portal perfusion and primary graft dysfunction (PGD) has not been assessed. AIM: To examine the outcomes of patients who required PVA in correlation with their LT procedure. METHODS: All patients receiving PVA and LT at the Fundacion Santa Fe de Bogota between 2011 and 2022 were analyzed. To account for the time-sensitive effects of graft perfusion, patients were classified into two groups: prereperfusion (pre-PVA), if the arterioportal anastomosis was performed before graft revascularization, and postreperfusion (post-PVA), if PVA was performed afterward. The pre-PVA rationale contemplated poor portal hemodynamics, severe vascular steal, or PVT. Post-PVA was considered if graft hypoperfusion became evident. Conservative interventions were attempted before PVA. RESULTS: A total of 25 cases were identified: 15 before and 10 after graft reperfusion. Pre-PVA patients were more affected by diabetes, decompensated cirrhosis, impaired portal vein (PV) hemodynamics, and PVT. PGD was less common after pre-PVA (20.0% vs 60.0%) (P = 0.041). Those who developed PGD had a smaller increase in PV velocity (25.00 cm/s vs 73.42 cm/s) (P = 0.036) and flow (1.31 L/min vs 3.34 L/min) (P = 0.136) after arterialization. Nine patients required PVA closure (median time: 62 d). Pre-PVA and non-PGD cases had better survival rates than their counterparts (56.09 months vs 22.77 months and 54.15 months vs 31.91 months, respectively). CONCLUSION: This is the largest report presenting PVA in LT. Results suggest that pre-PVA provides better graft perfusion than post-PVA. Graft hyperperfusion could play a protective role against PGD.

Variation in the response to antibiotics and life-history across the major Pseudomonas aeruginosa clone type (mPact) panel.

Pseudomonas aeruginosa is a ubiquitous, opportunistic human pathogen. Since it often expresses multidrug resistance, new treatment options are urgently required. Such new treatments are usually assessed with one of the canonical laboratory strains, PAO1 or PA14. However, these two strains are unlikely representative of the strains infecting patients, because they have adapted to laboratory conditions and do not capture the enormous genomic diversity of the species. Here, we characterized the major P. aeruginosa clone type (mPact) panel. This panel consists of 20 strains, which reflect the species' genomic diversity, cover all major clone types, and have both patient and environmental origins. We found significant strain variation in distinct responses toward antibiotics and general growth characteristics. Only few of the measured traits are related, suggesting independent trait optimization across strains. High resistance levels were only identified for clinical mPact isolates and could be linked to known antimicrobial resistance (AMR) genes. One strain, H01, produced highly unstable AMR combined with reduced growth under drug-free conditions, indicating an evolutionary cost to resistance. The expression of microcolonies was common among strains, especially for strain H15, which also showed reduced growth, possibly indicating another type of evolutionary trade-off. By linking isolation source, growth, and virulence to life history traits, we further identified specific adaptive strategies for individual mPact strains toward either host processes or degradation pathways. Overall, the mPact panel provides a reasonably sized set of distinct strains, enabling in-depth analysis of new treatment designs or evolutionary dynamics in consideration of the species' genomic diversity. IMPORTANCE: New treatment strategies are urgently needed for high-risk pathogens such as the opportunistic and often multidrug-resistant pathogen Pseudomonas aeruginosa. Here, we characterize the major P. aeruginosa clone type (mPact) panel. It consists of 20 strains with different origins that cover the major clone types of the species as well as its genomic diversity. This mPact panel shows significant variation in (i) resistance against distinct antibiotics, including several last resort antibiotics; (ii) related traits associated with the response to antibiotics; and (iii) general growth characteristics. We further developed a novel approach that integrates information on resistance, growth, virulence, and life-history characteristics, allowing us to demonstrate the presence of distinct adaptive strategies of the strains that focus either on host interaction or resource processing. In conclusion, the mPact panel provides a manageable number of representative strains for this important pathogen for further in-depth analyses of treatment options and evolutionary dynamics.

Feasibility, acceptability and preliminary effectiveness of a community-based group psychosocial support model for conflict survivors in Colombia: An assessment of in-person and remote intervention modalities during the COVID-19 pandemic.

Background: Community-based psychosocial support (CB-PSS) interventions utilizing task sharing and varied (in-person, remote) modalities are essential strategies to meet mental health needs, including during the COVID-19 pandemic. However, knowledge gaps remain regarding feasibility and effectiveness. Methods: This study assesses feasibility, acceptability and preliminary effectiveness of a CB-PSS intervention for conflict-affected adults in Colombia through parallel randomized controlled trials, one delivered in-person (n = 165) and the other remotely (n = 103), implemented during the COVID-19 pandemic and national protests. Interventions were facilitated by nonspecialist community members and consisted of eight problem-solving and expressive group sessions. Findings: Attendance was moderate and fidelity was high in both modalities. Participants in both modalities reported high levels of satisfaction, with in-person participants reporting increased comfort expressing emotions and more positive experiences with research protocols. Symptoms of depression, anxiety and posttraumatic stress disorder improved among in-person participants, but there were no significant changes for remote participants in comparison to waitlist controls. Implications: This CB-PSS intervention appears feasible and acceptable in both in-person and remote modalities and associated with reduction in some forms of distress when conducted in-person but not when conducted remotely. Methodological limitations and potential explanations and areas for future research are discussed, drawing from related studies.

Case Report: Duodenal Papillary Stenosis Secondary to Strongyloides stercoralis Infection in a Non-Immunocompromised Host.

Strongyloides stercoralis infection is a common infection in tropical and subtropical regions and is considered one of the "neglected tropical diseases." Owing to its life cycle, this infection can remain undetectable for years, preventing an early diagnosis and prompt treatment. We report the case of a 65-year-old woman who presented to us with a history of nausea, abdominal pain, bloating, and weight loss and, after initial radiologic and laboratory workup, was diagnosed with a periampullary mass with no secondary spread. She underwent an uneventful pylorus-preserving pancreatoduodenectomy, and on histopathological study of the lesion, a diagnosis of S. stercoralis infection was confirmed. This case stands out because of the importance of keeping S. stercoralis infections as a differential diagnosis of periampullary masses, particularly when the patient comes from regions where S. stercoralis is prevalent.

Los postulados de la pedagogía franciscana en relación con la formación ética en contexto de la Universidad de San Buenaventura / The Postulates of Franciscan Pedagogy in Relation to Ethical Training in the Context of Saint Bonaventure University

Resumen Es importante recordar que los resultados de los saberes superiores en la Universidad de San Buenaventura, buscan el bien común de toda vida, de la biota en general, incluyendo la sostenibilidad de los ecosistemas. Este bien común se ha venido ejecutando con ayuda de un valor socio-humanístico denominado fraternidad, concretado en los proyectos de equipo interdisciplinario. He ahí dos grandes fortalezas que subraya la Universidad de San Buenaventura al tener en cuenta el ejercicio de una pedagogía franciscana.

Abstract It is important to remember that the results of higher knowledge at the Saint Bonaventure University seek the common good of all life, of the biota in general, which includes the sustainability of ecosystems. This common good has been implemented with the help of a socio-humanistic value called fraternity, which is concreted in interdisciplinary team projects. There are two great strengths underlined by the Saint Bonaventure University in considering the exercise of Franciscan pedagogy.

La Paideia Franciscana como experiencia y aporte epistemológico a una pedagogía crítica emancipadora / The Franciscan Paideia as experience and epistemological contribution to an emancipating critical pedagogy

Resumen La Universidad, con impronta franciscana, antes de ser un lugar donde se imparten conocimientos, es un estado existencial y un acto experiencial donde el sujeto social entra en contacto con una pedagogía que le exige pensar crítica y rigurosamente su episteme, teniendo en cuenta su contexto histórico-social.

Abstract The University, with a Franciscan imprint, before being a place where knowledge can be imparted, is an existential state and an experiential event where the social subject comes into contact with a pedagogy that requires them to think their episteme critically and rigorously, taking into account their socio-historical context.

Actividad de la aspartato aminotransferasa y la creatinkinasa y su relación con la actividad de la glutatión peroxidasa en caballos Pura Sangre Inglés, antes y después de una carrera de 1100 metros / Aspartate aminotrasnferase and creatinkinase activity and their relationship with glutathione peroxidase blood activity in Thoroughbred racehorses before and after a race of 1100 meters

Para describir los cambios en la actividad de la aspartato aminotrasferasa (AST; EC 2.6.1.1), la creatinkinasa (CK; EC 2.7.3.2) y su relación con glutatión peroxidasa (GSH-Px; EC 1.15.1.1) en caballos Pura Sangre Inglés (PSI) que corrieran 1100 metros en pista de arena, se seleccionaron 29 caballos entre 3 y 5 años de edad del Hipódromo "Los Comuneros" en el municipio de Guarne (6º17'LN-75º24'LO), Antioquia. Se tomaron 10 mL de sangre heparinizada e igual cantidad sin anticoagulante 12 horas antes de la carrera, al momento de terminarlay 12 horas después. Se determinó concentración de hemoglobina, actividad de AST, CK y GSH-Px. Los datos se analizaron mediante estadística descriptiva y las comparaciones entre grupos se realizaron mediante un ANOVA, se obtuvo la frecuencia de valores alterados para cada variable. La actividad de AST fue similar entre el reposo yposterior a la carrera (p>0.05). La actividad promedio de CK previa a la carrera fue 320±193 U/L aumentando hasta alcanzar valores de 705±528 U/L (p<0.05). La GSH-Px se encontró dentro de valores compatibles con un balance de selenio adecuado, su actividad fue similar entre el término de la carrera y el reposo posterior (p>0.05). La actividad de las enzimas AST y CK siguen siendo una herramienta diagnóstica útil para evaluar lesiones musculares en equinos. La actividad antioxidante y su relación con la actividad de las enzimas AST y CK no arrojó resultados concluyentes, ya que no hubo asociación entre dichas variables, lo que señalaría que la defensa antioxidante del músculo puede depender de otras sustancias diferentes a la GSH-Px.