Evaluation of factors associated with trust in telemedicine in patients with inflammatory bowel disease during COVID-19 pandemic: a multicenter cross-sectional survey.

OBJECTIVE: Telemedicine (TM) has had a powerful impact in recent years, particularly on managing chronic diseases such as inflammatory bowel disease (IBD). Knowing patients' expectations and concerns is essential to increase their confidence in this mode of medical care. PATIENTS AND METHODS: We interviewed a large cohort of IBD patients enrolled at two Italian tertiary referral centers to investigate their trust in TM. RESULTS: A total of 376 patients completed the survey and were included in the study: 293 (77.9%) considered TM valuable for managing their disease, and 307 (85%) wanted to have TM service at their center. However, only 99 patients (26.3%) believed that TM guarantees the same level of care as the in-person visit. Among the socio-demographic variables, those independently associated with trust in TM were the higher education qualification (p=0.02) and the level of competence in information and communication technologies (ICT) (p=0.03). CONCLUSIONS: Our findings highlighted the importance of equipping IBD patients with basic ICT skills to utilize TM services and increase their confidence in ICT with the help of caregivers. Additionally, to improve the perceived value of TM, it will be helpful to use additional tools such as telemonitoring of disease activity using patients' reported outcomes or remote measurement of fecal calprotectin.

Changes in admissions, and hospitalization outcomes of IBD patients in an Italian tertiary referral center over a 13-year period.

OBJECTIVE: The management of Inflammatory Bowel Disease (IBD) has changed significantly in recent years, mainly due to the introduction of biologic medications, however, other factors may also have a role. The aim of this study was to evaluate the evolution of IBD admissions, including trends, modality of admission and rates of surgical intervention, in a tertiary care center. PATIENTS AND METHODS: Hospitalization of patients with a diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) were identified between 2000 and 2013, using ICD-9-CM codes for IBD, from our hospital database. The following parameters were evaluated for each admission: type of admission (ordinary vs. day care service), mode of admission (elective vs. emergency care, for ordinary admissions only), admission code, surgical procedures and complication rates. Comparison between pre- and post-biologic therapy introduction years was also performed. RESULTS: Between 2000 and 2013 a total of 8834 IBD-related admissions were recorded. Hospitalizations increased linearly reaching a peak in 2006, with a downward trend in the following years. The downward trend was especially marked for patients younger than 40 years. No significant differences in hospitalization trends between CD and UC were recorded. Disease flare represented the cause of hospitalization in approximately 50% of cases. Overall, 10.8% of patients underwent surgery with no difference between the two conditions. Complications occurred in 28.7% of admissions. CONCLUSIONS: Hospitalizations for IBD patients have decreased in recent years, especially in younger patients. However, a significant proportion of patients are still admitted to complete diagnostic workup, indicating the need to better implement outpatient services. A clear reduction in surgery occurrence over time could not be observed in our study.

The educational role of IBD nurses in Italy in vaccinations: do not miss the moment for COVID-19.

OBJECTIVE: The role of nurses has great educational-scientific potential in COVID-19 vaccination. The aim of this work is to clarify whether the educational role of IBD nurses in vaccination is perceived by IBD patients. MATERIALS AND METHODS: A cross-sectional study was carried out, through a questionnaire, to evaluate how many IBD patients received health education about vaccinations from the dedicated nurses (IBD nurses). RESULTS: There were four hundred questionnaires, 310 patients (77.5%) answered all questions. The nurse does not appear to help educate patients on influenza vaccination (66.1%) or pneumococcal vaccination (81.6%). Disclosed patients have many doubts about the new COVID-19 vaccination (74.4%) and many seek information (74.8%) and think that the nurse can provide the necessary information (70%). CONCLUSIONS: IBD nurses do not seem very active in the vaccination education role, and they do not meet patients' expectations, which are conversely very high.

Effects of Bothrops moojeni venom on Leishmania amazonensis promastigote forms

In the present work, the effect of Bothrops moojeni venom fractions on Leishmania promastigotes was evaluated. The snake venom was fractionated into five protein fractions (E1 to E5), by ion exclusion chromatography, that were used to treat Leishmania amazonensis and Leishmania braziliensis promastigote forms whereas the viability and nitric oxide production were evaluated. It was observed that E5 venom fraction strongly inhibited Leishmania amazonensis nitric oxide production, while in Leishmania braziliensis the nitric oxide production was enhanced in all doses. Bothrops moojeni crude venom reduced the viability of both parasites in a dose-dependent manner and a peptide of 64 kDa was apparently degraded. Bothrops moojeni E5 venom fraction only reduced the viability and nitric oxide production of Leishmania amazonensis and no protein degradation was observed. Thus, these results suggest that Bothrops moojeni E5 venom fraction may offer components with a promising antileishmanial therapeutic application.

Measurement of problem behaviour during medication evaluations.

BACKGROUND: The focus of this review is on methods that are currently being used to evaluate the behavioural effects of medication for individuals with intellectual disabilities. First we describe what has been identified as the ideal criteria for conducting clinical trials and how these criteria may be adapted to do less controlled evaluations. The central theme is a review of the biological measures (e.g. labs, drug levels), behavioural rating scales and direct observation measures that are often used to evaluate medication effects. Issues related to how the side effects of medication can affect behaviour will also be discussed. CONCLUSION: The importance of encouraging communication and collaboration across all systems of care and the use of socially valid measures are discussed.

Identification and characterization of Mycobacterium tuberculosis antigens in urine of patients with active pulmonary tuberculosis: an innovative and alternative approach of antigen discovery of useful microbial molecules.

Despite the clear need to control tuberculosis, the diagnosis and prevention of this serious disease are poorly developed and have remained fundamentally unchanged for more than 50 years. Here, we introduce an innovative approach to directly identify Mycobacterium tuberculosis antigens produced in vivo in humans with tuberculosis. We combined reversed phase high performance liquid chromatography and mass spectrometry and categorize four distinct M. tuberculosis proteins produced presumably in lung lesions and excreted in the urine of patients with pulmonary tuberculosis. The genes (MT_1721, MT_1694, MT_2462 and MT_3444) coding for these proteins were cloned and the recombinant molecules were produced in Escherichia coli. The proteins were recognized by immunoglobulin G antibodies from tuberculosis patients but not from non-diseased subjects. In addition, the recombinant proteins were recognized strongly by peripheral blood mononuclear cells from healthy purified protein derivative of tuberculin-positive individuals and to a lesser extent from patients with tuberculosis. These molecules are the only proteins reported to date that are derived directly from bodily fluids of tuberculosis patients, therefore are interesting candidate antigens for the development of vaccine and/or antigen detection assay for accurate diagnosis of active tuberculosis.

The relationship between compulsive behaviour and academic achievement across the three genetic subtypes of Prader-Willi syndrome.

BACKGROUND: Prader-Willi syndrome (PWS) is a genetic syndrome associated with several physical, cognitive and behavioural characteristics. For many individuals with this syndrome, compulsive behaviour is often noted in both food and non-food situations. The focus of this paper is on the non-food-related compulsions in individuals with PWS and comparing differences across the three genetic subtypes of the syndrome. METHODS: Compulsive behaviours in 73 people with PWS were assessed using the Yale-Brown Obsessive Compulsive Scale and the Compulsive Behavior Checklist. Compulsive behaviour and its relation to IQ and academic achievement also were evaluated. Phenotypic differences were characterized for the three most common genetic subtypes of the disorder: 16 individuals with the long Type I (TI) 15q deletion, 26 individuals with the short Type II (TII) 15q deletion and 31 individuals with maternal disomy 15. RESULTS: There appeared to be important differences between the two deletion subtypes. Specifically, individuals with the TI deletion had more compulsions regarding personal cleanliness (i.e. excessive bathing/grooming), and their compulsions were more difficult to interrupt and interfered with social activities more than the other subtypes. Individuals with the TII deletion were more likely to have compulsions related to specific academic areas (i.e. rereading, erasing answers and counting objects or numbers). CONCLUSIONS: These findings may help clinicians and researchers identify possible intervention strategies and supports based on the behavioural phenotype associated with genetic subtype in individuals with PWS.

Down-modulation of nitric oxide production in murine macrophages treated with crude plant extracts from the Brazilian Cerrado.

Several plant species from the Cerrado biome in Brazil are popularly used as herbal medicines for its reputed analgesic, anti-acid, anti-microbial, anti-inflammatory and anti-tumoral properties, among others. It has been reported that some plant extracts interfere in the production of nitric oxide (NO), an important inflammatory mediator. In the present study, we investigated the effect of hexanic and ethanolic extracts from three plant species on NO production by LPS/IFN-gamma-activated J774 macrophages based on traditional use. The cytotoxic effect of the crude extracts was determined by the thiazolyl blue test (MTT) to measure cell viability. Serjania lethalis stem extracts and Cupania vernalis leaf extracts significantly inhibited NO production, while extracts from Casearia sylvestris var. lingua were inactive or showed low activity on NO production, or were very cytotoxic. The ethanolic stem bark and leaf extracts of Serjania lethalis and Cupania vernalis, respectively, almost completely inhibited the production of NO by J774 macrophages. It can be concluded that the selected extracts are potential sources of active compounds that might be used as anti-inflammatory agents.

Effects of heterozygosity of major histocompatibility complex haplotypes on performance of Leghorn hens sharing a common inbred background.

Four sets of diallele crosses between partially congenic lines of Leghorns differing in their MHC haplotypes (B blood group) were made in 4 successive yr. Hens heterozygous for B haplotypes resulting from the crosses were then compared with those representing the homozygous congenic parent lines. Heterozygotes superior in performance to the average of their parental homozygotes were found to occur predominantly for survivor egg production, egg weight, and viability to 40 wk of age. Body weight of adult hens showed least heterosis. Surprisingly few crosses produced heterozygous embryos with superior hatchability, although heterotic combinations did exist. Additive differences between parent homozygotes were of greater magnitude than dominance effects measured as average excess of heterozygotes over homozygote averages of parents. A control genotype heterozygous for the B2/BQ combination was included in all tests and proved heterotic in most cases. This same genotype also had been found to confer resistance to Marek's disease under experimental inoculation.

Reproductive performance of inbred congenic Leghorns carrying different haplotypes for the major histocompatibility complex.

Twelve congenic lines of White Leghorn chickens carrying distinct haplotypes of the MHC (B blood group) but sharing a common genetic background from a highly inbred line (UCD 003) were compared. Each of the lines had been bred back to Line UCD 003 for five generations before intercrossing its members to establish its distinct genetically homozygous MHC type. Seven generations of these congenic lines were compared between 1981 and 1987 for fertility, hatchability of fertile eggs, egg production, mortality to 40 wk of age, 40-wk egg weight, and 40-wk body weight. Statistically significant differences between MHC haplotypes were found for all traits except fertility.

Genetic correlations of abdominal fat with production traits of Leghorn hens based on inbred line averages.

Data from 16 inbred lines derived by three generations of full sib mating from a common outbred base population were used to estimate genetic correlations between body weight, abdominal fat content, follicle number, liver weight, egg weight and egg number using between-line variances and covariances. High genetic correlations were found between body weight, fat content and egg weight. Low genetic correlations were found between follicle number and all traits other than egg weights. Theoretical expectations and low correlations within lines led to the conclusion that environmental correlations among the traits considered were very low.

Differences in body fat of six inbred lines of white leghorns derived from a common base population.

Genetic differences in body fat, body weight, follicle number, and egg production were found among six inbred lines of White Leghorn hens derived from a common outbred base population. High positive genetic correlations of body fat with body weight were found between inbred lines as well as between inbred parents and line-cross progeny. Heterosis of fatness, body weight, egg production, egg weight, and liver weight were observed. Large follicles and liver weight were unaffected by inbreeding and crossing of lines.

A study of heterosis and recombination loss in crosses of inbred Leghorn lines derived from a common base population.

This study was designed to estimate heterosis and recombination loss of feed efficiency at peak egg production using six inbred White Leghorn lines and their crosses. Percent hen day egg production was highest in three-line crosses with 94.6%, 93.5% for two-line crosses and 91.0% for inbred lines, respectively. Feed efficiency of three-line crosses was superior to that of two-line crosses, primarily because of low feed consumption. Heterosis effects for body and egg weights were observed in all mating combinations. The value of heterosis for egg number and feed efficiency were dependent upon parental line. Egg number and egg weight showed small average recombination losses, depending on lines involved. Small but consistent recombination loss for body weight was observed. The recombination loss for feed efficiency was large and negative; the highest three-line cross value for this trait was about 16% above that of the mean of the corresponding two-line crosses.