Liver transplant with controlled donors after circulatory death with normothermic regional perfusion and brain dead donors: A multicenter cohort study of transfusion, one-year graft survival and mortality.

BACKGROUND: Controlled donation after circulatory death (cDCD) has expanded the donor pool for liver transplantation (LT). However, transfusion requirements and perioperative outcomes should be elucidated. The aim of this multicenter study was to assess red blood cell (RBC) transfusions, one-year graft and patient survival after LT after cDCD with normothermic regional perfusion (NRP) compared with donors after brain death (DBD). METHODS: 591 LT carried out in ten centers during 2019 were reviewed. Thromboelastometry was used to manage coagulation and blood product transfusion in all centers. Normothermic regional perfusion was the standard technique for organ recovery. RESULTS: 447 patients received DBD and 144 cDCD with NRP. Baseline MCF Extem was lower in the cDCD group There were no differences in the percentage of patients (63% vs. 61% p = 0.69), nor in the number of RBC units transfused (4.7 (0.2) vs 5.5 (0.4) in DBD vs cDCD, p = 0.11. Twenty-six patients (6%) died during admission for LT in the DBD group compared with 3 patients (2%) in the cDCD group (p = 0.15). To overcome the bias due to a worse coagulation profile in cDCD recipients, matched samples were compared. No differences in baseline laboratory data, or in intraoperative use of RBC or one-year outcome data were observed between DBD and cDCD recipients. CONCLUSIONS: cDCD with NRP is not associated with increased RBC transfusion. No differences in graft and patient survival between cDCD and DBD were found. Donors after controlled circulatory death with NRP can increasingly be utilized with safety, improving the imbalance between organ donors and the ever-growing demand.

Depresión, ansiedad y fibromialgia / Depression, anxiety and fibromyalgia

Objetivo. El objetivo del presente artículo es reflejar la asociación existente entre la fibromialgia y los trastornos psicológicos y psiquiátricos. La fibromialgia es una enfermedad que cursa con dolor crónico, de difícil tratamiento, que está estrechamente relacionada con trastornos psicológicos y psiquiátricos, siendo los más frecuentes la ansiedad y la depresión. Los mecanismos fisiopatogénicos de dicha asociación no son bien conocidos, pero se han realizado numerosos estudios en los que se intenta explicar dicha asociación. Material, métodos y resultados. Se realiza una revisión bibliográfica de los estudios realizados que intentan explicar dicha asociación, así como una revisión de los mecanismos etiopatogénicos comunes a dichas patologías. Conclusiones. La fibromialgia es una patología que cursa con dolor crónico y que está asociada a patología psiquiátrica. Dicha asociación puede ser causal, comorbilidad o secundaria a dicho proceso. Asimismo, influye negativamente en el proceso retrasando la mejoría del paciente (AU)

Objective. The aim of the present article is to examine the existing relationship between fibromyalgia and psychological and psychiatric disorders. Fibromyalgia is a disease that involves difficult to treat chronic pain that is closely related to psychological and psychiatric disorders, of which anxiety and depression are the most common. The pathophysiological mechanisms of this relationship are not well known, but a number of studies have been conducted in an attempt to explain this relationship. Material, methods and results. A literature review has been made on all the studies carried out that attempt to explain this relationship, as well as a review of the aetio-pathogenic mechanisms common to these pathologies. Conclusions. Fibromyalgia is a disease that involves chronic pain and is associated with psychiatric illness. This association may be causal, a comorbidity or secondary to this condition. It also has a negative influence on the disease, delaying the improvement of the patient (AU)

[Multicenter comparative study of synthetic salmon calcitonin administered nasally in the treatment of established postmenopausal osteoporosis]. / Estudio comparativo multicéntrico de la calcitonina sintética de salmón, administrada por vía nasal en el tratamiento de la osteoporosis postmenopáusica establecida.

We study the effectivity and tolerance of synthetic salmon calcitonin nasally administered (Miacalcic) in the treatment of established postmenopausic osteoporosis. During one year, two randomized groups of postmenopausic women diagnosed of osteoporosis were treated in an outpatient service either with 1 gr of calcium element per day during the whole study or with 100 daily I.U. of salmon synthetic calcitonin nasally administered in patterns of 14 days and the same period of rest, plus a supplement of 500 mgr of calcium element per day. Globally, 43 patients were assessed at the end of the study in the calcitonin plus calcium group and 45 in the group receiving only calcium. The main evaluation parameters were pain and presence of new fractures. At the beginning and at the end of the study, complementary tests of blood biochemistry were conducted, including alkalin phosphatase, calcium, phosphorus and uric acid, as well as calcium, hydroxiprolin and creatinini in the urine. The results showed a significant improvement of pain (p < 0.001) in the group treated with calcitonin, supported by a lower consumption of analgesics. The rate of vertebral fractures determined according to the Meunier's index, was also significantly lower (p < 0.001) in the group treated with calcitonin at the end of the study period. These results suggest that, compared to only calcium, nasally administered calcitonin precludes the formation of new vertebral fractures during one year of treatment and it is effective in terms of pain reduction.(ABSTRACT TRUNCATED AT 250 WORDS)

[Colorectal cancer: are diagnostic delay, degree of spread and survival related? Clinical analysis of 307 cases followed up for more than 4 years]. / Cáncer colorrectal: existe relación entre el retraso diagnóstico, su grado de extensión y la supervivencia? Análisis clínico en 307 casos seguidos más de cuatro años.

It seems logical to think that the longer the interval between the patient's first symptom of colorrectal cancer and operation, the greater the tumoral extension found by the surgeon will be, and the lower the postoperative survival. Nevertheless, there is much evidence to indicate that this may not always be true. We've analyzed the problem in 307 patients operated of colorectal cancer in our service from January 1979 to December 1984 and followed-up until now. We investigated the time interval from the first clinical symptom until operation, and survival. These variables were related to the Duke grade. As regards the preoperative interval, the average (in months) for Duke's grade A was 7.41 (sigma = 16.88), for D it was 7.41 (sigma = 9.47) and for C, 5.13 (sigma = 8.41). There were no statistically significant differences. As for survival, after four years all the grade A patients, 64% of the grade B patients and 35% of the grade C patients followed-up survived. We've found no relation between diagnostic delay and postoperative survival. These results suggest that it is not true that the longer the symptomatic period, the greater the tumoral spread. As such, diagnostic delay is not a good prognostic indicator for predecting tumoral spread or survival.