IDIBELL Seminars. 15 juny 2012. En la confer\u00e8ncia del Dr Jos\u00e9 Such, de la Unitat Hep\u00e0tica de l’Hospital General i Universitari d’Alacant i del CIBERehd, especialitzat en translocaci\u00f3 bacteri en pacients amb cirrosi i va parlar de translocaci\u00f3 i efectes cl\u00ednics. “La cirrosi provoca hipertensi\u00f3 portal, la qual cosa pot derivar en vasodilataci\u00f3 espl\u00e0nica, i tot aix\u00f2 ocasionar la s\u00edndrome hiperdin\u00e0mica. Pretenem veure la relaci\u00f3 entre translocaci\u00f3 bacteriana, \u00e9s a dir pas dels bacteris a trav\u00e9s de la paret intestinal, amb la cirrosi”, va comentar el Dr Such. Quan la paret intestinal deixa de ser prou eficient per mantenir els bacteris i aquests la traspassen, poden donar lloc a infeccions. Les defici\u00e8ncies immunes poden permetre que els bacteris accedeixin i actu\u00efn en diversos territoris.<\/p>\n
La detecci\u00f3 de fragments gen\u00f2mics bacterians pot correspondre a bacteris viables o no, provocant infeccions o resposta inflamat\u00f2ria respectivament. Per\u00f2, quina \u00e9s la incid\u00e8ncia de la translocaci\u00f3 bacteriana en pacients amb cirrosi? El 42 per cent dels pacients amb ascites mostraven un increment de la prote\u00efna transportadora de lipopolisac\u00e0rid (LBP), mol\u00e8cula proposta com a marcador de la translocaci\u00f3 bacteriana, respecte als controls. El 34 per cent dels pacients van mostrar signes evidents de translocaci\u00f3. Els bacteris, en entrar en contacte amb l’ADN, que ha desenvolupat receptors espec\u00edfics, alliberen citosines, mostrant una resposta inflamat\u00f2ria.<\/p>\n
En menjar hi ha un augment de la vasodilataci\u00f3, per\u00f2 la pressi\u00f3 portal s’iguala. No passa aix\u00ed en els pacients cirr\u00f2tics, \u00e9s a dir, aquests presenten una disfunci\u00f3 endotelial. Hi ha una alteraci\u00f3 hemodin\u00e0mica com a resposta a la inflamaci\u00f3.<\/p>\n
Translocaci\u00f3 bacteriana i insufici\u00e8ncia renal<\/strong><\/p>\n “Estudiem pacients de risc: pacients amb cirrosi amb ascites. Aquells pacients que van rebre norfloxacina (Nflx), milloraven la superviv\u00e8ncia. La translocaci\u00f3 bacteriana pot arribar a causar la mort del pacient, independentment de la funcionalitat hep\u00e0tica del mateix”, va explicar el Dr Such.<\/p>\n En aplicar norfloxacina es va detenir la translocaci\u00f3, per tant la inflamaci\u00f3 i la mortalitat. Cal detectar el bacteri i, posteriorment, identificar-lo, per a aix\u00f2 \u00e9s necessari tres o quatre dies.<\/p>\n La vasodilataci\u00f3 en diferents parts de l’organisme juga un paper fonamental en la patog\u00e8nia. El bloqueig de translocaci\u00f3, mitjan\u00e7ant Nflx disminueix la resposta inflamat\u00f2ria. La translocaci\u00f3 bacteriana pot considerar-se com una diana terap\u00e8utica.<\/p>\n “Si identifiquem els pacients de risc, llavors s’ha d’aplicar la profilaxi prim\u00e0ria, encara que \u00e9s el principal problema dels potencials casos de resist\u00e8ncia”, va concloure el Dr Such.<\/p>\n","protected":false},"excerpt":{"rendered":" IDIBELL Seminars. 15 juny 2012. En la confer\u00e8ncia del Dr Jos\u00e9 Such, de la Unitat Hep\u00e0tica de l’Hospital General i Universitari d’Alacant i del CIBERehd, especialitzat en translocaci\u00f3 bacteri en pacients amb cirrosi i va parlar de translocaci\u00f3 i efectes cl\u00ednics. “La cirrosi provoca hipertensi\u00f3 portal, la qual cosa pot derivar en vasodilataci\u00f3 espl\u00e0nica, i […]<\/p>\n","protected":false},"author":6,"featured_media":21629,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[1],"tags":[],"publishpress_future_action":{"enabled":false,"date":"2024-05-13 21:01:06","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"_links":{"self":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/9496"}],"collection":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/comments?post=9496"}],"version-history":[{"count":2,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/9496\/revisions"}],"predecessor-version":[{"id":21630,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/9496\/revisions\/21630"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media\/21629"}],"wp:attachment":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media?parent=9496"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/categories?post=9496"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/tags?post=9496"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}