Marina Alonso

The use of laminar inorganic salts to make organic molecules display new properties at the supramolecular level in the solid state

The design of porous solids of controlled molecular geometry for umpteen applications is a challenge of enormous technological and scientific importance. The placing of organic molecules between the layers of certain inorganic salts leads to enduring solid materials where the confinement makes the organic molecules change their properties or even display new ones at the supramolecular level. Past and ongoing results of our research group concerning the chemistry of metal phosphates/phosphonates are reviewed in relation with recognition, chemically-driven porosity changes, chiral memory and supramolecular chirality, luminescence signaling, photoinduced electron-transfer, gas storage and drug confinement.

Liver Transplantation for Hepatocellular Carcinoma: Results of a Multicenter Study With Common Priorization Criteria

OBJECTIVE To evaluate the results of liver transplantation (OLT) performed for hepatocellular carcinoma (HCC) among a multicenter cohort of patients with predefined common inclusion and priorization criteria. PATIENTS AND METHODS Over a 5-year period (January 2002-December 2006), 199 HCC patients underwent OLT in four centers in Andalusia. The morphological (Milan) inclusion criteria were priorized in two consecutive periods, according to the Model for End-stage Liver Disease score: group I, 53 patients (HCC < 2 cm = 24 points; > or = 2 cm or multinodular = 29 points) and group II, 146 cases (HCC < 3 cm without priorization; HCC > or = 3 cm or multinodular = 18 points). RESULTS Among the 199 HCCs, 186 (93.5%) subjects were transplanted and 13 (6.5%) were excluded. There were 18 cases (9.7%) where the diagnosis was incidental and 168 were known HCC cases; 144 (85.7%) complied with the Milan criteria (Milan+); 24 (14.3%) exceeded there criteria (Milan-). According to preoperative imaging, the number of nodules and tumor mean sizes among the excluded-Milan+ and Milan- groups-were 1.8/5.3 cm, 1.4/3.5 cm, and 2.3/6.7 cm, respectively (P < .001). Percutaneous treatment during listing was delivered to 55% of the excluded cases: 49% of Milan+ and 96% of Milan-. The median time on the list was 88 days for known HCC (53 days for group I, and 97 days for group II), and 172 days for the incidental HCCs. Staging (pTNM) was correct in 64% of cases: 23% were understaged and 13% were overstaged. Overall mortality within the first 90 days was 9%, and transplant patient survival at 5 years was 61%. No differences were observed in survival rates between both study periods, although there were differences between the Milan+ (65%) and Milan- (23%) groups (P < .04). In addition, the difference in the recurrence rates was also significant between the Milan+ (7%), Milan- (24%), and the incidental (25%) groups (P < .02). CONCLUSIONS A common priorization policy of HCC for OLT based on morphological criteria results in a low exclusion rate on the waiting lists (6.5%). The Milan criteria are still a good cutoff to stratify the risk of recurrence, despite preoperative tumor staging being correct in only two-thirds of cases.

Asymmetric Synthesis of Cyclopropanes from Sulfinylpyrazolines Mediated by Acids

Abstract

Trasplante hepático en pacientes con infección VIH

: During the few last years, after the introduction of high activity antiretroviral therapy (HAART), liver diseases, particularly those related to HCV infection, have emerged as one of the most important causes of mortality in patients with HIV infection. Consequently, liver transplantation is increasingly indicated in this population. Post-transplantation survival in HIV-positive patients with non-hepatitis C virus (HCV) liver diseases is adequate and similar to that in HIV-negative patients. In contrast, survival in patients coinfected with HIV and HCV is only moderate (around 50% at 5 years after transplantation). The main cause of mortality in these patients is HCV recurrence. In almost all patients, HIV infection remains controlled with HAART after liver transplantation. Other issues of interest in this setting are the selection of liver transplantation candidates and the frequent interactions between HAART and immunosuppressive drugs.

THU0068 Clinical Risk Factors Associated with the Development of Systemic Disease in Patients with Isolated HLA-B27 Uveitis

Background HLA-B27 uveitis has been defined as a unilateral acute syndrome without associated systemic disease [1]. However, in some patients the ocular disease precedes the occurrence of systemic diseases as ankylosing spondylitis (AS), reactive arthritis (ReA), spondyloarthritis (SpA), undifferentiated spondyloarthritis (UspA), SpA associated with psoriasis and SpA associated with inflammatory bowel disease (SpA-IBD) Objectives To determine how many patients with isolated HLA-B27 uveitis will develop systemic disease and to identify the clinical risk factors associated with their occurrence Methods Patients with HLA-B27 and at least 1 episode of uveitis diagnosed by an ophthalmologist were identified among all adult patients (>14 years) consecutively typed for HLA-B27 in our hospital from January 1, 2006 to December 31, 2011. These patients were seen in our Unit to perform a complete rheumatologic examination to look for prior or concurrent systemic disease associated with HLA-B27. Also, a comprehensive clinical, radiological and analytical evaluation to exclude autoimmune and infectious diseases that may cause uveitis was carried out. Follow-up was defined as the period of time from the first episode of uveitis confirmed by an ophthalmologist to the latest medical evaluation. Values are shown as average and standard deviation (SD) and percentage for quantitative and qualitative variables respectively. The T test and chi squared are used for comparisons Results During the 6 years of study period 1803 patients were typed for HLA-B27, of which 293 tested positive (16%). Of these patients, 42 (14%) had at least 1 episode of uveitis. 14 of these patients (33%) were excluded from the study because prior or concurrent systemic disease related with HLA-B27 positivity (8 AS, 4 UspA, 1 ReA, 1 SpA-IBD). So, a cohort of 28 patients with isolated HLA-B27 uveitis, 15 males (54%), 36.9years ± 14.19 (15-60), was follow-up during a mean of 7.7 years ±5.89 (1-20). 9 patients (33%) developed systemic disease: 5 AS, 3 UspA and 1 SpA-IBD. The diagnosis of the systemic disease was made 3.7 years ±4 (0.5-12) after the onset of uveitis. Bilateral uveitis (including alternating uveitis) was identified as the only significant risk factor for the development of systemic disease, OR 8.3 (95% confidence interval 1.25-55.35, p=0.03), so a multivariate analysis was not performed.The risk for systemic disease was 1.8 times greater for patients with bilateral HLA-B27 uveitis than for patients with unilateral involvement. Significant differences with age, gender, location of the uveitis, chronicity, response to treatment and ophthalmic complications were not found between patients with isolated uveitis and those who developed systemic diseases Conclusions A third of patients who present with isolated HLA-B27 uveitis will develop associated systemic disease. Bilateral ocular involvement was identified as the only significant risk factor for the occurrence of systemic disease in the present cohort References Jakob E, Reuland MS, Mackensen F, Harsch N, Fleckenstein M, Lorenz HM, et al. Uveitis Subtypes in a German Interdisciplinary Uveitis Center- Analysis of 1916 Patients. J Rheumatol 2009; 36:127-36 Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.5872