This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. Conclusions: Anti-B13 antibodies were significantly higher in chronic Chagas disease stage III patients, suggesting that these antibodies may be involved in disease progression and that they might be a useful marker of poor prognosis in terms of heart compromise. Our results also reveal an important correlation between the level of anti-B13 autoantibodies and symptomatic heart failure and/or dilated cardiomyopathy. ß 2013 Sociedad Españ ola de Cardiología. Published by Elsevier Españ a, S.L. All rights reserved.Valoració n de anticuerpos con reactividad cruzada pató geno-hué sped en pacientes con diferentes estadios de cardiopatía chagá sica cró nicaPalabras clave: Enfermedad de Chagas Trypanosoma cruzi Insuficiencia cardiaca Autoanticuerpos anti-B13 R E S U M E N Introduccio´n y objetivos: La infecció n por Trypanosoma cruzi induce una respuesta autoinmunitaria humoral contra diferentes antígenos del hué sped. En especial, los anticuerpos que presentan reactividad cruzada con antígenos del miocardio tienen un papel importante en el desarrollo de las formas graves de la cardiopatía chagá sica cró nica. En este trabajo se analiza la asociació n del estadio clínico de la enfermedad con la presencia de autoanticuerpos en pacientes con cardiopatía chagá sica cró nica. Me´todos: Estudio transversal con pacientes con serología positiva para enfermedad de Chagas, categorizados en tres grupos segú n la clasificació n de cardiopatía chagá sica de Storino et al. Se realizó a todas las personas incluidas un examen clínico completo y se usaron las muestras de suero para cuantificar los autoanticuerpos. Resultados: Todos los pacientes presentaron cantidades detectables de anti-p2b y anti B13; el antiNa-K-ATPasa fue negativo en todos los casos. No se halló asociació n significativa entre las alteraciones electrocardiográ ficas y los valores de autoanticuerpos. Los pacientes con cardiopatía chagá sica en estadio III presentaron mayor concentració n de anti-B13 y riesgo de mortalidad alto, lo que muestra una clara asociació n entre el estadio de la enfermedad y la puntuació n de mortalidad. Conclusiones: La concentració n del autoanticuerpo anti-B13 fue significativamente mayor en los pacientes con cardiopatía chagá sica en estadio III, lo que indica que este anticuerpo puede estar involucrado en la progresió n de la enfermedad y podría usarse como marcador de mal pronó stico

Conflict of interest: noneIntroduction: ascites is one of the most common complications of cirrhosis associated with a high rate of mortality. Although several scores have been developed in order to assess the prognosis of the disease, they were designed for predicting liver transplantation requirements and mortality in the short term, but not while in hospital. The aim of this study was to weigh risk factors for in-hospital mortality in adult patients with ascites due to alcoholic cirrhosis. Material and methods: we performed a cross-sectional study in 180 adult patients with diagnosis of cirrhosis with portal hypertension associated with high alcohol intake. The diagnosis of cirrhosis was made by liver echography and portal hypertension was defined by clinical features plus serum-ascites albumin gradient. Sampled individuals were subjected to complete clinical examination. Child Pugh and the MELD scores were applied in all the patients. Results: nineteen patients died while in-hospital. Mortality was associated with increased levels of serum white blood cell, urea, creatinine, prolonged prothrombin time, aspartate aminotransferase and alanine aminotransferase. We conducted a multiple binary logistic to predict in-hospital mortality which yielded that serum urea, creatinine and prothrombin time made a significant contribution to prediction with an OR 14 (95% CI 12.8 -16.7 p = 0.03), 2 (95% CI 0.5 -3.47, p = 0.04), and 2 (95% CI 1.03 -2.31, p = 0.01) linearly-related. Conclusions: our results suggest that acute renal failure and prolonged prothrombin time are predictors of in-hospital mortality in patients with portal hypertension due to alcoholic cirrhosis.

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our findings suggest that a simple model that uses only 4 variables, which are easily accessible and interpretable, can identify seriously ill patients with CAP.

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