Search

Background The COVID-19 pandemic has severely impacted older people. The disease and the measures to combat it have had a differential impact according to gender, with higher mortality rates in men and worse psychological and social consequences in women. The objective of this work is to analyze the changes in perceived health of older people in Europe during the first months of the pandemic and to assess the combined role of age and gender. Methods Wave 8 data of SHARE-corona (Survey of Health, Aging and Retirement in Europe) (n = 51,695, aged≥50) collected between Jun-Aug 2020 were used. Perceived health status was explored with a question on whether there has been a change compared with the health status before the COVID-19 outbreak (response options: worse, the same and better). Two-way ANOVA with interaction and Student's t-test with Bonferroni correction were used to compare the effects of gender and age group (50-59 years, 60-69 years, 70-79 years, and ≥80) in changes in perceived health. Results Differences in perceived health were observed by age, as well as by gender in participants aged ≥70 years (F = 91.94; p < 0.001). These differences were significant both by gender (F = 19.39; p < 0.001) and age (F = 191.79; p < 0.001). No interaction was detected between both factors (p = 0.170), which allowed their effect to be studied individually. Among the people who reported a worsening in their perceived health, women aged 70 to 79 years predominated (11.1%), followed by men aged 80 and over (15.3%) and women of the same age group (16.4%). Conclusions The results suggest an association between the change in perceived health during the pandemic and age. Women have a slightly worse health status than men in all age groups. Therefore, gender can be considered as an influential factor in perceived health in old age, which in turn can have a potential impact in the quality of life of older people. Funding Projects Ref. H2019/HUM-5698 and Ref. 202010E158. Key messages

BACKGROUND: The potential benefit of adding palbociclib to fulvestrant as first-line treatment in hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative endocrine-sensitive advanced breast cancer (ABC) patients remains uncharacterized. PATIENTS AND METHODS: In this randomized (1:1), double-blind, phase II study, postmenopausal women with HR-positive, HER2-negative ABC with de novo metastatic disease or those who relapsed after >12 months of adjuvant endocrine therapy received palbociclib/fulvestrant or placebo/fulvestrant. Stratification was based on recurrent versus de novo metastatic disease and visceral involvement. The primary objective was one-year progression-free survival (PFS-1y) rate. The sample size was 190 patients. The two-sided alpha of 0.2, 80% of power to detect a difference between the arms, assuming PFS rates of 0.695 and 0.545 for palbociclib/fulvestrant and placebo/fulvestrant, respectively. RESULTS: In total, 189 patients were randomized to palbociclib/fulvestrant ([n = 94] or placebo/fulvestrant [n = 95]). 45.5% and 60.3% of patients had de novo metastatic disease and visceral involvement, respectively. PFS-1y rates were 83.5% and 71.9% in the palbociclib/fulvestrant and placebo/fulvestrant arms, (HR 0.55, 80% CI 0.36-0.83, P = 0.064). The median PFS were 31.8 and 22.0 months for the palbociclib/fulvestrant and placebo/fulvestrant arms (aHR 0.48, 80% CI 0.37-0.64, P = 0.001). The most frequent grade 3-4 adverse events were neutropenia (68.1% vs. 0%), leucopenia (26.6% vs. 0%), anemia (3.2% vs. 0%), and lymphopenia (14.9% vs. 2.1%) for the palbociclib/fulvestrant and placebo/fulvestrant, respectively. The most frequent non-hematologic grade 3-4 adverse event was fatigue (4.3% vs. 0%). CONCLUSIONS: Palbociclib/fulvestrant demonstrated better PFS-1y rates and median PFS than placebo/fulvestrant in HR-positive/HER2-negative endocrine-sensitive ABC patients.

INTRODUCTION The surgical indication for ascending aortic aneurysms (AAA) is established when the maximum diameter > 50 mm; It responds to Laplace's Law (T wall = P × r / 2e). The aim of the study is to define wall stress in AAA. MATERIAL AND METHODS 218 ascending aortic walls have been studied: 96 from organ donors, and 122 from AAA: Marfán 58 (47.5%), bicuspid aortic valve 26 (21.4%), and atherosclerosis 38 (31.1%). The samples were studied "in vitro", according to the model Young's (relationship between stress and deformed area), by means of the mechanical traction test (Tension = Force / Area). The analysis was performed with the stress-elongation curve (d Tension / d Elongation). RESULTS The stress of the aortic wall, classified from highest to lowest according to pathology and age was: cystic necrosis of the middle layer, arteriosclerosis, age > 60 years, between 35 and 59, and < 34 years. The stress of “control aortas” wall increased directly in relation to the age of the donors. CONCLUSIONS The maximum diameter of the ascending aorta, the patient's type of pathology and age are factors that affect the maximum tension of the aortic wall and resistance, factors that allow differentiation and prediction of the risk of rupture of the AAA. The validation of the results obtained through numerical simulation was significant and the uniaxial analysis has modeled the response of the vessels to their internal pressure.

INTRODUCTION Temperature affects the mechanical behavior of the arteries, a fact that intervenes in their function, both in physiology and in pathological states. The aim of the study is to analyze the mechanical response in the arteries (aorta and carotids) to changes in temperature. MATERIAL AND METHODS The thermo-mechanical behavior of human arteries (26 primitive carotids and 26 thoracic aortas) from cadaveric organ donors has been studied. The tests were carried out in a passive state, without electrical or chemical activation of the vessels. Pressurization tests were carried out at 4 different temperatures (17, 27, 37 and 42ºC) correlating internal pressure-external diameter of the vessels. The thermo-mechanical analysis was evaluated using the pressure-diameter curves at different temperatures, for this the coefficient of thermal expansion (α = (ΔD / D) / ΔT) and the Hayashi stiffness (β), exponential equation (Pressure / Diameter ratio). RESULTS The effect of temperature on arterial behavior is maximum when the curves refer to the initial diameter of the vessel at 0 mmHg for each temperature. At low pressures, the coefficient of dilation is negative, while above a certain threshold pressure (different for each type of artery), the coefficient of dilation becomes positive. CONCLUSIONS The stiffness of the vessels is manifested in the slope of the pressure-diameter curves and decreases with increasing temperature. The coefficient of thermal expansion is a function of the internal pressure to which the arteries are subjected.

Resumen El linfoma anaplasico de celulas grandes asociado a implantes mamarios (BIA-ALCL segun sus siglas en ingles) es un tipo raro de linfoma no Hodgkin que se ha descrito en el contexto de la cirugia reconstructiva y estetica de mama mediante implantes. Este segundo articulo presenta la parte del consenso de la Sociedad Espanola de Senologia y Patologia Mamaria (SESPM) sobre el tratamiento quirurgico, medico, radioterapico, pronostico y seguimiento.

Resumen El linfoma anaplasico de celulas grandes asociado a implantes mamarios (BIA-ALCL segun sus siglas en ingles) es un tipo raro de linfoma no Hodgkin que se ha descrito en el contexto de la cirugia reconstructiva y estetica de mama mediante implantes. Estos articulos presentan un consenso de la Sociedad Espanola de Senologia y Patologia Mamaria (SESPM) con la idea de unificar, en esta primera parte, los criterios de diagnostico de esta enfermedad describiendo asimismo la epidemiologia y la etiopatogenia.

Germline/somatic BRCA-mutated ovarian carcinomas (OC) are associated to have better response with platinum-based chemotherapy and long-term prognosis than non-BRCA-associated OCs. In addition, these mutations are predictive factors to response to Poly(ADP-ribose) polymerase (PARP) inhibitors. Different positioning papers have addressed the clinical recommendations for BRCA testing in OC. This consensus guide represents a collection of technical recommendations to address the detection of BRCA1/2 mutations in the molecular diagnostic testing strategy for OC. Under the coordination of Spanish Society of Pathology (SEAP-IAP) and the Spanish Society of Human Genetics (AEGH), these recommendations have been developed by pathologists and geneticists taking into account previously published recommendations and their experience in the molecular characterization of these genes. Since the implementation of BRCA testing as a predictive factor can initiate the workflow by testing germline mutations in the blood or by testing both germline and somatic mutations in tumor tissue, distinctive features of both strategies are discussed. Additionally, the recommendations included in this paper provide some references, quality parameters, and genomic tools aimed to standardize and facilitate the clinical genomic diagnosis of OC.

The proportion of cancer patients with tumours that harbour a potentially targetable genomic alteration is growing considerably. The diagnosis of these genomic alterations can lead to tailored treatment at the onset of disease or on progression and to obtaining additional predictive information on immunotherapy efficacy. However, in up to 25% of cases, the initial tissue biopsy is inadequate for precision oncology and, in many cases, tumour genomic profiling at progression is not possible due to technical limitations of obtaining new tumour tissue specimens. Efficient diagnostic alternatives are therefore required for molecular stratification, which includes liquid biopsy. This technique enables the evaluation of the tumour genomic profile dynamically and captures intra-patient genomic heterogeneity as well. To date, there are several diagnostic techniques available for use in liquid biopsy, each one of them with different precision and performance levels. The objective of this consensus statement of the Spanish Society of Pathology and the Spanish Society of Medical Oncology is to evaluate the viability and effectiveness of the different methodological approaches in liquid biopsy in cancer patients and the potential application of this method to current clinical practice. The experts contributing to this consensus statement agree that, according to current evidence, liquid biopsy is an acceptable alternative to tumour tissue biopsy for the study of biomarkers in various clinical settings. It is therefore important to standardise pre-analytical and analytical procedures, to ensure reproducibility and generate structured and accessible clinical reports. It is essential to appoint multidisciplinary tumour molecular boards to oversee these processes and to enable the most suitable therapeutic decisions for each patient according to the genomic profile., SEAP and SEOM declare that there has not been any external financial support for this project.

The presence of both electronic-converter-based and rotating-machine-based energy sources in microgrids poses a challenge for its stable operation. Most of the stability studies in microgrids have been focused on the electronic converters interfacing a renewable energy source to an AC microgrid. However, the rotating machines are still a key component of many microgrids. This paper presents an induction machine model that uses dynamic phasors as an alternative to d-q modeling. The goal of this work is to obtain the small-signal impedances of the machine, which could be further used in stability studies. The results show that the machine model successfully reflects the actual impedance of the machine obtained by simulations. The process by which the practical machine impedance is obtained is also detailed in this paper.

Cancer immunology has gained renewed interest in the past few years due to emerging findings on mechanisms involved in tumoral immune evasion. Indisputably, immune edition is currently considered a critical hallmark of cancer. Basic research has revealed new targets which can be modulated in the clinical setting with new compounds and strategies. As recent evidence confirms, breast cancer (BC) is a complex and heterogeneous disease in which host immune responses play a substantial role. T-infiltrating lymphocytes measurement is suggested as a powerful new tool necessary to predict early BC evolution, especially in HER2-positive and triple negative subtypes. However, T-infiltrating lymphocytes, genomic platforms, and many other biomarkers in tissue and peripheral blood (e.g., regulatory T cells and myeloid-derived suppressor cells) are not the only factors being evaluated regarding their potential role as prognostic and/or predictive factors. Many ongoing clinical trials are exploring the activity of immune checkpoint modulators in BC treatment, both in the advanced and neoadjuvant setting. Although this field is expanding with exciting new discoveries and promising clinical results-and creating great expectations-there remain many uncertainties yet to be addressed satisfactorily before this long awaited therapeutic promise can come to fruition.

Polycyclic aromatic hydrocarbons present in rainwater were studied in two distinct areas in Mexico City Metropolitan Area throughout the rainy season. The results showed no significant difference between the two sites, thus suggesting a more regional phenomenon driving the dissolution of the PAHs in the rain. The PAHs concentration ranged from 1.7–30.2 ngL−1with the predominance of phenanthrene, fluoranthene, and pyrene. The PAH sources were traced predominantly to vehicular emission with signature PAHs, diagnostic ratios, and cluster statistical analyses. On the other hand, the temporal analysis of the PAHs showed that the fluxes of the Total PAH were slightly different for both sites. The urban-industrial site showed fluxes that ranged from 145–3263 ng m−2d−1, while the urban site ranged from 134–3139 ng m−2d−1, with the urban site having a moderate rate at which the total PAHs diminished throughout the rainy season while the urban-industrial showed no change throughout the rainy season. This study also...

Exposed probability in a classic ZINB model. Histogram of probabilities of being exposed for the data (a) and zoom of only the zero FEC (b) using only FEC data in the ZINB model. Animals with non-zero FEC will always have an “infected” status in the model (= 1) while animals with zero FEC can be exposed or unexposed. If only the FEC data is used, each animal with zero FEC will have a probability of being infected similar to one minus the zero-inflation parameter (b). (PDF 34 kb)

Exposed probability in a classic ZINB model. Histogram of probabilities of being exposed for the data (a) and zoom of only the zero FEC (b) using only FEC data in the ZINB model. Animals with non-zero FEC will always have an “infected” status in the model (= 1) while animals with zero FEC can be exposed or unexposed. If only the FEC data is used, each animal with zero FEC will have a probability of being infected similar to one minus the zero-inflation parameter (b). (PDF 34 kb)

Mean temperatures (ºC) and precipitation (mm) from December to June during the sampling period (highlighted in gray), and during the four previous years. (PDF 24 kb)

Annotated R code for the ZINB model. (PDF 20 kb)

Annotated R code for the ZINB model. (PDF 20 kb)

Global warming affects the carbon (C) pools in terrestrial ecosystems, accelerating biological processes that feed back into the phenomenon of climate change. Globally, grassland ecosystems accumulate large quantities of organic C into soils and are considered a corner stone for global warming mitigation. The aim of this study was to evaluate the temperature sensitivity of C decomposition in different soil aggregate fractions in grassland ecosystems across a north-south latitudinal gradient in Chile. Soil samples were collected from Mediterranean semi-arid (MSA; 32°31, to 34°19, south latitude), temperate semi-oceanic (TSO; 35°36, to 36°27, south latitude), temperate oceanic (TO; 40°36, to 43°03, south latitude) and subpolar semi-oceanic (SPSO; 43°57, to 47°40, south latitude) climate zones, and water-stable macroaggregates (250-2,000 µm) and free microaggregates (50-250 µm) were isolated. Two experiments were performed using short-term incubations (14 days). First, absolute soil respiration and specific soil respiration from isolated aggregates were assessed at 20 °C, and second, the isolated aggregates were incubated at different temperature levels (20-30 ºC for MSA and TSO; 10-20 ºC for TO and SPSO) to quantify the energy of activation (Ea) and temperature sensitivity (Q10). In general, the results do not provide evidence of differences between soil aggregate fractions in any of the evaluated parameters, but the soils differed across the latitudinal gradient. High absolute respiration rates and specific respiration, which were related to high grassland productivity, were observed in soils from TO and SPSO zones. The Q10 values demonstrated a strong positive correlation with annual precipitation, so C decomposition in soils from zones with high precipitation exhibits increased temperature sensitivity.

Phosphite is an alkaline salt of phosphorous acid. Its antifungal properties against some phytopathogenic fungi are increasingly valued in the context of a growing concern about the detrimental environmental effects of the standard biocides used to protect plants against pests and diseases. The purpose of this work was to analyze the in vitro and in vivo effect of phosphite in the development and evolution of Phytophthora parasitica on a tomato crop. The phosphite potential to limit and control the fungus growth was first established through an in vitro assay. In a second assay, in the greenhouse, tomato plants were transplanted into pots, in a substrate previously inoculated or not inoculated with the fungus mycelium. Inoculated and non-inoculated plants were sprayed with a range of phosphite concentrations (0, 0.9, 1.4, and 1.9 mg ml-1). The in vitro growth of the fungus mycelium was progressively restricted as phosphite concentration increased in the medium, and no fungus growth was detected with a phosphite concentration of 0.9 mg/ml. In the greenhouse assay, the development of the inoculated plants improved during the culture time when treated with phosphite, as was acknowledged by their higher chlorophyll content and by the values of stress indicators when compared with untreated plants. Moreover, the dry weight of the infected plants increased as the phosphite concentration was higher, and their maximum growth was obtained at 1.4 mg ml-1 phosphite. It is also noteworthy that, when compared to healthy plants, the infected plants increased their root to total weight ratio by 31.6% when treated with the highest phosphite concentration.

Between 1996 and 1998, 580 litres of milk in Mexico were surveyed for aflatoxin B(1) (AFB(1)) and its metabolite aflatoxicol (AFL), which are mutagenic and carcinogenic mycotoxins that interconvert AFB(1)-AFL-AFB(1). The seven most consumed brands from different regions of Mexico included pasteurized and ultrapasteurized milk with four different fat levels: whole fat (28-33 g l(-1)), half-skimmed (10-20 g l(-1)), light (1-4 g l(-1)) and with vegetable oil (33 g l(-1)). Aflatoxins in each sample were concentrated with total aflatoxin immunoaffinity columns and quantitated by high-performance liquid chromatography. A milk sample was considered contaminated if it contained >/=0.05 microg l(-1) AFL. Pasteurization and ultrapasteurization of milk did not control contamination with AFL, which was present in 13% of samples at >/=0.05 microg l(-1) and in 8% at >/=0.5 microg l(-1), with a range of AFL from 0 to 12.4 microg l(-1). AFB(1) was present mainly in traces (0-0.4 microg l(-1)). The safest milk in relation to AFL contamination was imported milk powder with vegetable oil. There was a significant correlation between contamination of milk with AFL and the autumn (p

A surficial clay aquitard extends through the urban area where Mexico City is located. It has been assumed to function as a protective layer to the underlying aquifer that provides 42 m3/s out of 63 m3/s of water used by 18 million inhabitants. To provide such protection, the aquitard must be impermeable to water flow and, ideally, have a significant capacity to sorb contaminants. The latter aspect was addressed, studying the vertical variability of sorption of perchloroethylene (PCE), a widely used organic compound considered to pose health risks in groundwater. Batch sorption tests were used and the clay-rich strata in the depth interval from 8 to 75 m were studied. The results suggest that sorption depends mainly on the fraction of organic carbon (foc) present in the clayey materials. The sorption data were fit to the linear and Freundlich models; many strata could be fit well by either model, while some strata were distinctly non-linear. The linear isotherms showed a mean value of 32.8 ml/g, and the Freundlich isotherm 96.6 ml/g, confirming that the clay-rich media have significant sorption capacity for PCE. From the environmental perspective the clay-rich materials are serving as protection to the groundwater system.

Our case report describes a patient with clear cell fallopian tube carcinoma (histological grade 3; stage (FIGO): III c.) associated with an endometrial cyst of the tube wall.

Background: This is the first study to analyze the psychometric properties of the International Wellbeing Index (IWI), which comprises the Personal Wellbeing Index (PWI) and National Wellbeing Index (NWI), among community-dwelling older adults.Methods: The IWI was applied to 1106 community-dwelling adults aged 60 years and over. The sample was additionally assessed using scales for comorbidity, disability, mood, general orientation to life, social support, health-related quality of life, and two questions assessing satisfaction with life as a whole and with life in Spain. The PWI and NWI were separately analyzed for acceptability, internal consistency, convergent and discriminative validity, and precision. Linear regression analyses of the PWI and the NWI were also conducted.Results: Mean scores were 71.0 ± 13.5 for the PWI and 49.5 ± 14.4 for the NWI. No floor or ceiling effects were detected. Cronbach's α was 0.88 for the PWI and 0.92 for the NWI. Factor analysis identified two factors in the IWI, and one factor in the PWI and NWI respectively. The PWI showed a correlation of 0.50 with the “satisfaction with life as a whole” item, and the NWI showed a correlation of 0.73 with the “satisfaction with life in Spain” item. There were significant differences in scores: in the PWI, according to gender, age, social support, education and depression; and in the NWI, according to education and depression. The regression model identified psychosocial, health and functional factors as determinants of the PWI (explained variance: 46.8%).Conclusions: The IWI displays good acceptability and is a consistent, valid and precise measure of global quality of life in older adults.

Trichoderma species has been suggested as potential biocontrol agent forFusarium verticillioides on maize. In this cereal,F. verticillioides and F. proliferatum contributed to fumonisin accumulation. In addition,F. proliferatum could produce beauvericin and fusaproliferin.The aim of this work was to evaluate the effect ofTrichoderma spp. on growth and fumonisin B(1) fusaproliferin and beauvericin production byF. proliferatum.Dual cultures of F.proliferatum andT. harzianum ITEM 3636 andT. longibrachiatum ITEM 3635 on maize meal agar at 0.995 aw were done. The effect ofTrichoderma spp. on the lineal growth ofF. proliferatum was determined. The effect ofTrichoderma species on fumonisin B(1), fusaproliferin and beauvericin production byF. proliferatum was determined on co-inoculated maize kernels by HPLC.T. harzianum suppressedF. proliferatum growth once contact between the colonies occurred.T. longibrachiatum showed a less antagonistic effect againstF. proliferatum. A reduction on fumonisin B(1) production of 98% and 88% was observed in the co-incubation ofF. proliferatum withT. harzianum andT. longibrachiatum, respectively. The decrease of FB(1) production was significant even in maize kernels on whichF. proliferatum had been growing 7 days prior to the addition ofTrichoderma spp. The concentration of beauvericin and fusaproliferin produced during 30 days coincubation ofF. proliferatum with bothTrichoderma spp. did not differ to those produced byF. proliferatum alone. These mycotoxins might enter the food chain causing so far unknown consequences to the health of domestic animals and humans. For this reason it is important, when a potential biocontrol agent is under study, to test the effect on the fungal growth and on the putative mycotoxin produced.

Vascular endothelial growth factor (VEGF) is an angiogenic factor that stimulates endothelial cell growth and enhances vascular permeability. VEGF exerts its action by binding to the specific cell surface receptors, fms-like tyrosine kinase 1 (Flt-1) and fetal liver kinase 1 (FLK/KDR). In tumor angiogenesis, Vascular endothelial growth factor stimulates endothelial cells to produce Basic fibroblastic growth factor (bFGF), which further enhances angiogenic activity. Very little information on the expression of VEGF, bFGF, and the receptors Flt-1 and FLK/KDR is available. Herein, we evaluate the expression of these angiogenic factors and receptors in normal prostate, high grade prostate intraepithelial neoplasia (HGPIN) and prostatic cancer (CaP).58 selected surgical specimens exhibiting areas of normal prostate, HGPIN, and CaP were evaluated for microvessel density, and for VEGF, bFGF, Flt-1 and FLK/KDR protein expression by immunohistochemistry. Results were correlated with pathological data.There was a statistically significant increase in the microvessel density and in the expression of the angiogenic factors VEGF, bFGF and the receptors FLK/KDR and Flt-1, in the premalignant and malignant tissues in comparison with normal prostatic glands. Microvessel density also correlated with higher Gleason grade, pathological stage and the expression of the receptors FLK/KDR and Flt-1.The "initiation switch" of angiogenesis was observed to be an early event consistent with the recruitment of new vasculature into high grade PIN lesions and it increased in the progression of prostatic cancer.

The increased sphinganine/sphingosine (SA/SO) ratio has previously been shown as a biomarker of fumonisin exposure in experimental animals and has been proposed as a tool to assess human exposure to fumonisin mainly occurring through the dietary consumption of fumonisin contaminated maize-based foods. Sphinganine and sphingosine were measured in urines of humans resident in two areas of North Argentina and South Brazil with high maize consumption and compared with urine samples collected in areas with very low or no maize consumption, such as Central Argentina and Southern Italy. The pattern of SA/SO values in the two groups with no maize consumption (assumed as controls) was similar, with all SA/SO values lower than one. Mean SA/SO ratio was 1.27 in urine of subjects with high maize consumption (n = 123) and 0.36 in controls (n = 66) and the difference was statistically significant (p

Cytokines produced in mesenteric lymph nodes of cirrhotic rats with bacterial translocation may participate in circulatory alterations of cirrhosis.To investigate whether cirrhotic patients present an increased local generation of cytokines in mesenteric lymph nodes.Mesenteric lymph nodes from 26 cirrhotic and 10 control patients were assessed for tumour necrosis factor alpha (TNF) and interleukin 6 mRNA and protein expression by competitive reverse transcription-polymerase chain reaction, and by enzyme immunoassay and immunohistochemistry, respectively.Interleukin 6 levels were not different between cirrhotics and controls. Protein and mRNA TNF levels in mesenteric lymph nodes from cirrhotics were higher than in controls (p0.05). Tissue expression of TNF by immunohistochemistry was more abundant in cirrhotics. Ascitic patients showed higher TNF levels (47 (34-54) pg/mg protein) than patients without ascites (18 (17-25) pg/mg protein) (p0.001). Elevated TNF levels (28 pg/mg protein) in cirrhotics were associated with a higher Child-Pugh score, the antecedent of ascites, a lower prothrombin rate, and higher bilirubin and blood TNF levels. The strongest association, confirmed by multivariate analysis, was with the presence of ascites (p0.001). Bacterial infections after transplantation, mainly by enteric bacteria, were only detected in patients with high TNF levels in mesenteric lymph nodes (33% of patients; p=0.05).Patients with advanced liver cirrhosis, and especially with ascites, have increased local production of TNF in mesenteric lymph nodes that, in common with experimental cirrhosis, may also be induced by bacterial translocation.