Prolonged Q-T interval predicts severe arrhythmias and sudden death, and has been shown to occur in alcoholic liver disease and cirrhotic patients who are candidates for liver transplantation. This study first evaluated the prevalence of prolonged Q-T interval in a large population of unselected patients with cirrhosis, and assessed the relationship between abnormal Q-T, etiology, and severity of liver disease and mortality of patients. Possible causes of Q-T abnormality were also explored. Ninety-four patients with cirrhosis without overt heart disease and 37 control subjects with mild chronic active hepatitis were enrolled. Rate-corrected Q-T interval (Q-T c ) was assessed along with routine liver tests, Child-Pugh score, serum bile salts, electrolytes and creatinine, plasma renin activity, aldosterone, norepinephrine, atrial natriuretic factor and, gonadal hormones. Q-T c was longer in patients with cirrhosis than in controls (440.3 ؎ 3.2 vs. 393.6 ؎ 3.7 ms; P F .001) and prolonged (G440 ms) in 44 patients (46.8%) and 2 controls (5.4%; P F .001). Q-T c length was not influenced by the etiology of cirrhosis and correlated with Child-Pugh score (r ‫؍‬ .53; P F .001), liver tests such as prothrombin activity, and serum concentrations of albumin and bilirubin, plasma bile salts, and plasma norepinephrine. Multivariate analysis showed that only Child-Pugh score and plasma norepinephrine were independently correlated with Q-T c duration. Over a median follow-up period of 19 months (range, 2-33 months), patients with Q-T c longer than 440 ms had a significantly lower survival rate than those with normal Q-T c . Q-T interval is frequently prolonged in patients with cirrhosis, regardless the etiology of the disease, worsens in parallel with the severity of the disease, and may have an important prognostic meaning. In addition to other undefined factors related to the severity of cirrhosis, sympathoadrenergic hyperactivity may play a pathogenetic role. (HEPA-TOLOGY 1998;27:28-34.)

Late hepatic artery thrombosis (HAT) is a rare complication after orthotopic liver transplantation (OLT), conventionally described as occurring more than 30 days after surgery. Only a few reports document its course. In a consecutive series of 634 OLTs (704 grafts), 11 patients (1.7%) had late HAT, diagnosed a median of 6 months (range, 1.8 to 79 months) after OLT. Clinical variables were compared with those of 415 patients without HAT who had a complete database and follow-up, including cytomegalovirus (CMV) surveillance. At presentation, 11 patients had fever, 4 patients had jaundice. Hepatic abscesses were present in 6 patients (3 patients with biliary leak), 4 patients had biliary tree necrosis (2 patients with biliary leak), and 1 patient had no biliary complications. Five patients (45%) underwent accessory hepatic artery anastomosis versus 73 patients (17%) without HAT (P < .05). Five patients (45%) with late HAT had CMV infection versus 14% without HAT (P < .05). Two episodes of late HAT (11 and 79 months) occurred in patients who underwent re-OLT for early HAT (3.9%). Re-OLT was performed in 8 patients a median of 11 days (range, 3 to 37 days) after diagnosis (preceded by intravenous antibiotics and percutaneous drainage). The other 3 patients underwent partial hepatectomy (1 patient), external percutaneous drainage as unfit for surgery (1 patient), and antibiotic therapy only (1 patient). Death occurred in 4 patients who underwent re-OLT (50%) because of septicemia at 11, 23, and 60 days after re-OLT and 17 days after a third OLT. There was one late death (30 months) after partial hepatectomy (hepatitis C recurrence) and one death 6 months after long-term biliary drainage because of sepsis. The 5 survivors have good health with normal liver function test results at a median 52 months (range, 6 to 57 months). In conclusion, late HAT presents with fever caused by hepatic abscesses or biliary leak associated with biliary ischemia and necrosis. CMV infection and accessory hepatic artery anastomosis are risk factors for late HAT in our cohort. Early intervention followed by re-OLT can salvage patients. (Liver Transpl 2003;9: 605-611.) H epatic artery thrombosis (HAT) after orthotopic liver transplantation (OLT) is a potentially lifethreatening complication that occurs in 1.6% to 10.5% of adult liver transplant recipients and 10% to 25% of pediatric cadaver recipients. 1-3 HAT carries a mortality rate of 27% to 58%. 1,4,5 When re-OLT is not performed, the mortality rate increases to 73%. 5 HAT occurring early after OLT is associated with acute fulminant hepatic failure, biliary tract necrosis and leaks, or relapsing bacteremia and results in a high rate of graft loss and patient mortality. Late HAT generally is associated with a milder clinical course than acute HAT. [6][7][8] The time that divides early and late HAT has not been agreed on. Because technical aspects and surgical complications are associated with HAT development in the first 30 days after OLT, it is common practice to use 1 month from OLT to d...

The current study investigates the willingness of Millennial consumers towards several corporate social responsibility initiatives carried out by food companies. More specifically, it explores four cause related marketing campaigns implemented by food companies to spread corporate social responsibility. The analysis was carried out in Italy by administering a structured questionnaire to 308 consumers. The willingness of participants to switch a chocolate snack of their favourite brand to another with similar characteristics but produced by a company supporting different social and environmental causes was assessed in four different scenarios. The study uncovered the effects of both loyalty towards the brand and trust in cause related marketing on consumers’ willingness to support different corporate social responsibility initiatives. The findings unveiled the willingness of Millennials to support companies’ social and environmental initiatives. Both trust and loyalty played a key role in affecting consumers’ willingness to support corporate social responsibility initiatives of food companies. Social and environmental concerns as well as socio-demographics aspects are also significant in supporting cause related marketing campaigns. The study has shed light on the preference of consumers towards corporate social responsibility and cause related marketing. Specifically, it provides marketing insights on the initiatives most preferred by consumers to which companies should address their efforts.

Our cohort with prolonged follow-up showed significant improvement in renal function with both MMF monotherapy and in combination with low-dose CNI with minimal rejection (five of six steroid responsive) and no graft loss. MMF substitution is a therapeutic strategy that deserves more extensive use in liver transplantation.

Coronavirus disease COVID-19 has deeply modified national health services with a profound impact on hospitals, and in particular emergency and intensive care unit (ICU) activities. As recently reported in