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Introduction: A condition of high short-term mortality in the cirrhotic patient is Acute-on-Chronic Liver Failure (ACLF), characterized by organ failure (s) and usually preceded by acute decompensation (AD)., Objective: To determine the frequency, clinical profile, and mortality in cirrhotic patients hospitalized with ACLF., Materials and Methods: This is an observational analytical study conducted from July 2016 to June 2017. We established the ACLF condition through the criteria of the CANONIC study., Results: The study population was 118 patients, of whom 34 (28.8%) presented ACLF, 14 (41%) were Grade 1, 16 (47%) Grade 2 and 4 (11.9%) Grade 3. The average age was 61.5 years old, alcoholism being the most frequent etiology with 18 patients (53%) and mostly without episodes of AD (64.7%). The most frequent precipitating factors were: Digestive hemorrhage (41%) and infections (29.4%). The groups with and without ACLF were statistically significant in the Child-Turcot-Pugh score (CTP) (11.4 ± 1.8 vs. 8.69 ± 2.04; p < 0.0001 ). MELD score (26.4 ± 8.1 vs. 14.4 ± 4.6; p < 0.0001), leukocytes (11,809.7 +/- 6,906.3 per mm3 vs. 8,434.01 ± 5,434.9 per mm3; p: 0.006) and 28-day mortality (76.5% vs. 21.4%, p < 0.0001), with a relative risk (RR) of 3.5., Conclusions: The frecuency of ACLF was 28.8%, similar to that of the CANONIC study (30.9%). The digestive hemorrhage being the main precipitating factor. The CTP, MELD and leukocyte scores were highest in this group. Mortality in patients with ACLF was 3.5 times more frequent than in patients without ACLF.

Objective: To determine whether erradication of Helicobacter pylori (HP) infection from gastric mucosae is associated with changes in symptoms severity and satisfaction degree in patients with non-ulcer dyspepsia (NUD)., Methods: Prospective cohort study in patients with NUD and HP infection that were evaluated for six months following treatment, made up of 70 HP Negative patients in whom HP infection was erradicated, and 28 HP Positive patients in whom infection was not eradicated following treatment. Dyspeptic symptoms were assessed using SODA scale., Results: There was significant differences on decrease of pain (RR= 0.6, IC 90%: 0.47 -0.78) and non-pain symptoms intensity (RR= 0.5, IC 90%: 0.39 - 0.67), as well as on increase on degree of satisfaction (RR= 3.28, IC 90%: 2.86 - 3.75) among HP Negative patients group with regards to HP Positive patients at sixth month., Conclusions: In patients with nonulcer dyspepsia, erradication of HP infection is associated with decrease in symptoms intensity and increase on degree of satisfaction six month after treatment.

Introduction: The present study intends to validate the Rockall Score in patients with upper gastrointestinal bleeding (UGB) in our current medical setting and to find the value that best discriminates between patients with high or low risk of mortality, rebleeding and the need of more than two units of packed red blood cells (PRBC)., Materials and Methods: A descriptive prospective study was made from patients who arrived to Cayetano Heredia Hospital's emergency department between February 2007 and January 2008 due to UGB symptoms (hematemesis, coffe ground remit melena or hematoquezia). The Rockall score was used to determine severity of UGB and to stratify patients with higher risk of mortality or rebleeding. All patients were interviewed and any additional information was gathered from medical history records and emergency and hospitalization endoscopic procedure reports. During the study all patients were evaluated for rebleeding, the number of units of PRBCs needed and mortality rate., Results: 163 patients were included in our study, 107 (65.64%) were male and 56 (34.36%) female, 8 were excluded due to lack of an endoscopic procedure. The remaining 155 patients were studied to evaluate the discriminative ability of the scoring system, and to determine which value best distinguishes high and low severity patients using Receiver Operating Characteristic curve (ROC) and calculated area under the curve. The data analysis showed patients with a Rockall Score e 5 had an increased mortality rate compared to lower score with an area under the curve of 0.807, meaning an accurate relationship between mortality and a score e 5. For rebleeding and the need of two packed red blood cells for transfusion, the area under the curve were 0.65 and 0.64 respectively showing a low predictive value., Conclusion: The Rockall scoring system is useful to identify patients with high mortality risk, but not to predict rebleeding or the need for blood transfusion in our hospital.