Effect of Mucuna pruriens seed extract on depression-like behavior derived from mild traumatic brain injury in rats.

Background: Traumatic brain injury (TBI) is a severe health problem for which there is no specific treatment, leading to neurological or neuropsychological consequences. One of the most described disorders, even after mild TBI (mTBI), is depression, related to mechanisms involving reactive oxygen species (ROS). The Mucuna pruriens (M. pruriens) plant has various antioxidant, neuroprotective, and anti-inflammatory properties. Purpose: There is insufficient evidence of M. pruriens use for the treatment of neurobehavioral and depressive impairments induced by TBI and of the mechanisms underlying this effect, so we aimed to evaluate the ability of shortterm administration of M. pruriens extract to prevent neurobehavioral impairment and depression-like behaviors in a murine model of mTBI as well as evaluate the role of oxidative stress. Methods: Male Wistar rats underwent mTBI or sham surgery. Immediately after, they were treated with vehicle or M. pruriens extract (50 mg/kg ip/day for five days). We evaluated neurobehavioral recovery using the Neurobehavioral Severity Scale-Revised (NSS-R) and the immobility time in the forced swimming test 3, 7, 15, 30, and 60 days after mTBI. In addition, lipid peroxidation (LP) and GSH concentrations were determined in some brain areas (motor cortex, striatum, midbrain, and nucleus accumbens). Results: M. pruriens extract did not decrease neurobehavioral impairment caused by mTBI. Nevertheless, it prevented depression-like behaviors starting three days after mTBI, reduced LP, and increased GSH in some brain areas. Conclusions: M. pruriens may prevent depression-like behaviors and reduce oxidative stress by decreasing LP and increasing concentrations of antioxidant compounds.

Characterization of copper speciation on waste biomass of phytofiltration systems using energy dispersive Inelastic X-ray scattering.

BACKGROUND: Remediation of heavy metal-contaminated water using phytoremediation with accumulator aquatic plants is a promising low-cost emerging technology that adapts very well to the surrounding ecosystem. For the system to work efficiently, metal-saturated plants must be replaced, producing a potentially toxic amount of biomass that is usually stored dry to reduce its volume. The speciation of the high metal content in this biomass is crucial to define its final destination. This work explores the application of synchrotron-based EDIXS (Energy Dispersive Inelastic X-ray Scattering) to monitor the speciation of copper in regional aquatic plants from a laboratory-scale phytoremediation system. RESULTS: The phytofiltration system utilized Lemna minor L. and Salvinia biloba Raddi species grown under controlled conditions of light and nutrient availability. Both species are known hyperaccumulators of copper and are prevalent in lakes and rivers across South America. The validation of EDIXS was previously carried out by comparing the results of copper standard samples with those obtained by XANES. The findings revealed that both plant species retained copper in chemical complexes exhibiting octahedral coordination with a Cu valence of 2. Notably, differences emerged between the leaves and roots of Lemna minor L., suggesting a more pronounced adsorption of copper in its leaves, a trend that intensified with exposure. In opposite, for Salvinia the differences between leaves and roots suggests the presence of specific protective mechanisms to cope the copper exposure. Surprisingly, no significant dependence on copper concentration of the aqueous media was observed for either species. SIGNIFICANCE AND NOVELTY: These promising results endorse the viability of the proposed methodology in identifying the most effective fate of biomass generated in phytoremediation systems. EDIXS provides a valid tool for performing local copper speciation in aquatic plants with sufficient selectivity to identify subtle differences in various biological tissues. The simplicity of this methodology renders it a valuable tool for advancing our comprehension of metal speciation within waste biomass, thereby holding significant implications for the development of environmental remediation strategies.

Hereditary Renal Tumor Syndromes and the Use of mTOR Inhibitors.

The Case A 47-year-old woman with a history of drug-resistant epilepsy during childhood presented to the emergency department with sudden dyspnea and chest pain. Upon admission, her oxygen saturation was 88%. A chest CT scan revealed pulmonary cystic lesions consistent with lymphangioleiomyomatosis and a right spontaneous pneumothorax, which resolved with the placement of a chest tube. Physical examination revealed a hypopigmented macule on the skin of the lumbar region, facial angiofibromas, and periungual fibromas. An abdominal MRI documented multiple bilateral renal tumors that were hypointense on T2-weighted imaging and showed a black boundary artifact, suggestive of fat-poor angiomyolipomas (AMLs). Subsequent percutaneous biopsy of the largest renal tumor confirmed the diagnosis of angiomyolipoma (positive for HMB-45 on immunohistochemistry). The brain MRI revealed subependymal nodules. The pulmonary function tests showed a mild obstructive pattern. Germline genetic testing confirmed the suspected diagnosis, and the patient started oral systemic treatment with everolimus (Afinitor) 10 mg once daily, along with dexamethasone rinses for prophylaxis.

Tuning and Matching Error-Compensated, Quantitative Solid-State Nuclear Magnetic Resonance.

NMR spectroscopy has long been recognized as a powerful quantitative analytical tool. Quantification is commonly done against internal and external standards. A third approach is to quantify against an electronic reference, which combines the advantages of the two methods. The implementation of this approach in solid-state NMR is more challenging due to the single-coil design of double resonance probes. In this study, a novel approach for implementing the electronic referencing method in solid-state NMR by injecting the reference signal using a broadband antenna installed near the NMR receiver coil is presented. This method demonstrates excellent accuracy and precision, as it remains robust to changes in the electronic conditions of the probe, including tuning and matching errors.

Quantitative analysis of the effect of the magnetic field generated by a PET/MR scanner on positron range.

OBJECTIVE: Image quality in positron emission tomography (PET) is influenced by positron range. In this work, the effect of the magnetic field of a PET/MR Siemens Biograph mMR 3T on the quality of PET images was studied. APPROACH: Experimental measurements were conducted using18F and68Ga-filled phantoms to quantify image uniformity, recovery coefficients (RCs), spill-over ratios and percent contrast for spherical lesions. Tissue-equivalent phantoms (lung inhale and exhale, adipose, water, trabecular and cortical bone) were used together with a line source to quantify the impact of the magnetic field on the reconstructed PET images. A comparative analysis was made with images obtained with a PET/CT Biograph Vision 600, using the same radionuclides and phantoms. MAIN RESULTS: Higher RCs values were obtained when the image quality phantom was filled with68Ga and scanned with the PET/MR system compared to those obtained with the PET/CT scanner. Hot spheres in the lesion detectability phantom, appear contracted in the transverse direction in the PET/MR system, an effect more evident for68Ga compared to18F, but no elongation in the direction parallel to the magnetic field was observed. In the PET/CT scanner, radial profiles taken from axial slices of line sources, show longer distribution tails extending beyond 20 mm when filled with68Ga and placed inside lung-inhale tissue. In the PET/MR scanner the radial profiles of all materials collapsed into a single distribution with tails extending no more than 10 mm in the direction perpendicular to the magnetic field. SIGNIFICANCE: Positron range depends on positron energy and material density in which they traverse. The results show an evident improvement in image quality in the transaxial direction only, particularly in phantoms filled with68Ga when using a PET/MR system as opposed to images acquired in the PET/CT system due to the presence of the magnetic field.

Enablers and Inhibitors to Implementing Tobacco Cessation Interventions within Homeless-Serving Agencies: A Qualitative Analysis of Program Partners' Experiences.

Despite the high tobacco use rates (~80%) and tobacco-related cancers being the second leading cause of death among people experiencing homelessness within the United States, these individuals rarely receive tobacco use treatment from homeless-serving agencies (HSAs). This qualitative study explored the enablers and inhibitors of implementing an evidence-based tobacco-free workplace (TFW) program offering TFW policy adoption, specialized provider training to treat tobacco use, and nicotine replacement therapy (NRT) within HSAs. Pre- and post-implementation interviews with providers and managers (n = 13) pursued adapting interventions to specific HSAs and assessed the program success, respectively. The organizational readiness for change theory framed the data content analysis, yielding three categories: change commitment, change efficacy and contextual factors. Pre- to post-implementation, increasing challenges impacted the organizational capacity and providers' attitudes, wherein previously enabling factors were reframed as inhibiting, resulting in limited implementation despite resource provision. These findings indicate that low-resourced HSAs require additional support and guidance to overcome infrastructure challenges and build the capacity needed to implement a TFW program. This study's findings can guide future TFW program interventions, enable identification of agencies that are well-positioned to adopt such programs, and facilitate capacity-building efforts to ensure their successful participation.

A Dorsal Skinfold Window Chamber Tumor Mouse Model for Combined Intravital Microscopy and Magnetic Resonance Imaging in Translational Cancer Research.

Preclinical intravital imaging such as microscopy and optical coherence tomography have proven to be valuable tools in cancer research for visualizing the tumor microenvironment and its response to therapy. These imaging modalities have micron-scale resolution but have limited use in the clinic due to their shallow penetration depth into tissue. More clinically applicable imaging modalities such as CT, MRI, and PET have much greater penetration depth but have comparatively lower spatial resolution (mm scale). To translate preclinical intravital imaging findings into the clinic, new methods must be developed to bridge this micro-to-macro resolution gap. Here we describe a dorsal skinfold window chamber tumor mouse model designed to enable preclinical intravital and clinically applicable (CT and MR) imaging in the same animal, and the image analysis platform that links these two disparate visualization methods. Importantly, the described window chamber approach enables the different imaging modalities to be co-registered in 3D using fiducial markers on the window chamber for direct spatial concordance. This model can be used for validation of existing clinical imaging methods, as well as for the development of new ones through direct correlation with "ground truth" high-resolution intravital findings. Finally, the tumor response to various treatments-chemotherapy, radiotherapy, photodynamic therapy-can be monitored longitudinally with this methodology using preclinical and clinically applicable imaging modalities. The dorsal skinfold window chamber tumor mouse model and imaging platforms described here can thus be used in a variety of cancer research studies, for example, in translating preclinical intravital microscopy findings to more clinically applicable imaging modalities such as CT or MRI.

Crystal scatter effects in a large-area dual-panel Positron Emission Mammography system.

Positron Emission Mammography (PEM) is a valuable molecular imaging technique for breast studies using pharmaceuticals labeled with positron emitters and dual-panel detectors. PEM scanners normally use large scintillation crystals coupled to sensitive photodetectors. Multiple interactions of the 511 keV annihilation photons in the crystals can result in event mispositioning leading to a negative impact in radiopharmaceutical uptake quantification. In this work, we report the study of crystal scatter effects of a large-area dual-panel PEM system designed with either monolithic or pixelated lutetium yttrium orthosilicate (LYSO) crystals using the Monte Carlo simulation platform GATE. The results show that only a relatively small fraction of coincidences (~20%) arise from events where both coincidence photons undergo single interactions (mostly through photoelectric absorption) in the crystals. Most of the coincidences are events where at least one of the annihilation photons undergoes a chain of Compton scatterings: approximately 79% end up in photoelectric absorption while the rest (<1%) escape the detector. Mean positioning errors, calculated as the distance between first hit and energy weighted (assigned) positions of interaction, were 1.70 mm and 1.92 mm for the monolithic and pixelated crystals, respectively. Reconstructed spatial resolution quantification with a miniDerenzo phantom and a list mode iterative reconstruction algorithm shows that, for both crystal types, 2 mm diameter hot rods were resolved, indicating a relatively small effect in spatial resolution. A drastic reduction in peak-to-valley ratios for the same hot-rod diameters was observed, up to a factor of 14 for the monolithic crystals and 7.5 for the pixelated ones.

Association Between Interleukin 6 and C-Reactive Protein Serum Levels and Body Composition Compartments and Components in Breast Cancer Survivors.

Obesity is highly prevalent in breast cancer (BC) survivors. Adipose tissue promotes inflammation, affecting recurrence, morbidity, and quality of life. This study aimed to determine the relationship of body composition parameters with the levels of C-reactive protein (CRP) and interleukin 6 (IL-6) in female BC survivors. Additionally, we evaluated the association of log-transformed serum concentrations of CRP and IL-6 with the appendicular skeletal lean mass index (ASMI). The results showed that CRP was positively associated with body fat percentage (BFP; ß adjusted = .08, 95% CI: .02-.14) in all participants, and with fat mass index (FMI; ß = .24, 95% CI: .08-.40) only in premenopausal women. IL-6 was positively associated with FMI (ß adjusted = .16, 95% CI: .03-.29), while ASMI decreased as CRP levels increased (ß adjusted = -.30, 95% CI: -.53 to -.06). Interventions to improve body composition in BC survivors should also consider the role of inflammatory markers in changes in body composition to avoid sarcopenic obesity (SO) and the risk of BC recurrence.

[Complex management of intramural hematoma of the descending aorta: about a case]. / Manejo complejo del hematoma intramural de aorta descendente: a propósito de un caso.

Acute aortic syndromes (AAS) include a variety of overlapping anatomical and clinical conditions. Intramural hematoma (IMH), penetrating aortic ulcer, and aortic dissection occur in isolation or may coexist in the same patient. IMH represents 5-30% of all AAS and 60-70% of cases are located in the descending aorta. The diagnosis relies on a high index of clinical suspicion and on the use of complementary images. Management is conservative, but patients with some high-risk characteristics have a higher risk of mortality in the acute phase, so initial endovascular management should be considered. We present the case of a 69-year-old patient, in whom IMH was diagnosed in the course of a hypertensive emergency and who required hybrid management due to high-risk anatomical characteristics for endovascular management only.

Assessment of the Glycan-Binding Profile of Pseudomonas aeruginosa PAO1.

Pseudomonas aeruginosa is an opportunistic pathogen that can establish acute and chronic infections in individuals who lack fully functional innate immunity. In particular, phagocytosis by neutrophils and macrophages is a key mechanism that modulates host control and clearance of P. aeruginosa. Individuals with neutropenia or cystic fibrosis are highly susceptible to P. aeruginosa infection, thus underscoring the importance of the host innate immune response. Cell-to-cell contact between host innate immune cells and the pathogen, a first step in phagocytic uptake, is facilitated by simple and complex glycan structures present at the host cell surface. We have previously shown that endogenous polyanionic N-linked glycans localized to the cell surface of phagocytes mediate the binding and subsequent phagocytosis of P. aeruginosa cells. However, the suite of glycans that P. aeruginosa cells bind to on host phagocytic cells remains poorly characterized. Here, we demonstrate, with the use of exogenous N-linked glycans and a glycan array, that P. aeruginosa PAO1 cells preferentially attach to a subset of glycans, including a bias toward monosaccharide versus more complex glycan structures. Consistent with these findings, we were able to competitively inhibit bacterial adherence and uptake by the addition of exogenous N-linked mono- and disaccharide glycans. We discuss our findings in the context of previous reports of P. aeruginosa glycan binding. IMPORTANCE P. aeruginosa cells bind to a variety of glycans as part of their interaction with host cells, and a number of P. aeruginosa-encoded receptors and target ligands have been described that allow this microbe to bind to such glycans. Here, we extend this work by studying the glycans used by P. aeruginosa PAO1 cells to bind to phagocytic cells and by using a glycan array to characterize the suite of such molecules that can facilitate host cell binding by this microbe. This study provides an increased understanding of the glycans bound by P. aeruginosa and furthermore provides a useful data set for future studies of P. aeruginosa-glycan interactions.

Assessment of the Glycan-Binding Profile of Pseudomonas aeruginosa PAO1.

Pseudomonas aeruginosa is an opportunistic pathogen that can establish acute and chronic infections in individuals that lack fully functional innate immunity. In particular, phagocytosis by neutrophils and macrophages is a key mechanism that modulates host control and clearance of P. aeruginosa . Individuals with neutropenia or cystic fibrosis are highly susceptible to P. aeruginosa infection thus underscoring the importance of the host innate immune response. Cell-to-cell contact between host innate immune cells and the pathogen, a first step in phagocytic uptake, is facilitated by simple and complex glycan structures present at the host cell surface. We have previously shown that endogenous polyanionic N-linked glycans localized to the cell surface of phagocytes mediate binding and subsequent phagocytosis of P. aeruginosa . However, the suite of glycans that P. aeruginosa binds to on host phagocytic cells remains poorly characterized. Here we demonstrate, with the use of exogenous N-linked glycans and a glycan array, that P. aeruginosa PAO1 preferentially attaches to a subset of glycans, including a bias towards monosaccharide versus more complex glycan structures. Consistent with these findings, we were able to competitively inhibit bacterial adherence and uptake by the addition of exogenous N-linked mono- and di-saccharide glycans. We discuss of findings in the context of previous reports of P. aeruginosa glycan binding. IMPORTANCE: P. aeruginosa binds to a variety of glycans as part of its interaction with host cells, and a number of P. aeruginosa- encoded receptors and target ligands have been described that allow this microbe to bind to such glycans. Here we extend this work by studying the glycans used by P. aeruginosa PAO1 to bind to phagocytic cells and by using a glycan array to characterize the suite of such molecules that could facilitate host cell-binding by this microbe. This study provides an increased understanding of the glycans bound by P. aeruginosa , and furthermore, provides a useful dataset for future studies of P. aeruginosa- glycan interactions.

Echo pulses for background suppression by optimal control.

Materials used to construct magic-angle-spinning NMR probes can contain NMR active nuclei that produce a significant amount of background signal. Because these materials are located outside the sample coil, the use of spatially selective pulses to remove the background is a popular approach for background suppression. However, previously suggested spatially selective pulses suffer from limited excitation bandwidths, which may make them unsuitable for the acquisition of nuclei with a large chemical shift range. Here, a pulse (OC-BACK) is presented, which has been developed by optimal control, which has a flat profile of ~120 kHz with respect to off-resonance effects and extended pass and suppression bands with respect to the nominal nutation frequency. The presented solution is large enough to be effective for background suppression schemes in 19 F magic-angle-spinning NMR at medium and low magnetic fields.

Telephonic Follow-up and the Risk of Death in Ambulatory Patients with COVID-19.

BACKGROUND: Primary care level close monitoring of mild COVID-19 patients has shown to provide a risk reduction in hospitalization and death. We aimed to compare the risk of all-cause death among COVID-19 ambulatory patients who received and did not receive telephonic follow-up in primary health care settings. METHODS: A secondary database analysis, 2-group comparative study, was conducted with data from the medical information systems of the Mexican Institute of Social Security. A total of 1,498,808 ambulatory patients aged 20 years old and over and with laboratory confirmed SARS-CoV-2 by PCR or rapid antigen test were analyzed. Of them, 535,898 (35.8%) where followed by telephonic calls. The cases were attended from October 14, 2020, to April 10, 2022. Death incidence was evaluated. To assess the association between death and telephonic follow-up we calculated risk ratio using a multivariate logistic model. RESULTS: Case fatality rate was 1.29% in the patients who received telephonic follow-up and 2.95% in the cases who did not receive phone calls. Medical history of chronic kidney disease, COPD, cardiovascular disease, tobacco consumption and diabetes were associated with increased risk of death. In the multivariate model, telephonic follow-up was associated with lower risk of all-cause death, with an adjusted risk ratio of 0.61 (95% confidence interval from 0.59, 0.64). CONCLUSION: Our data suggest that telephonic follow-up is associated with a risk of death reduction in adult outpatients with mild COVID-19, in the context of a multimodal strategy in the primary health care settings.

Conjugated linoleic acid modifies transcriptional cytokine profile and induces early specific secretory IgA response in Giardia lamblia infected mice.

Objectives: Adaptive immunity is crucial in controlling Giardia lamblia infection in the intestinal mucosa, and some dietary lipids may improve mucosal immune function. The aim of this study was to evaluate conjugated linoleic acid (CLA) on the Th17/Treg response and secretory IgA production in a model of giardiasis infection. Materials and Methods: C3H/HeN male mice were infected with 5×106 G. lamblia trophozoites (GS/M-83-H7, ATCC collection). Mice were assigned randomly to experimental and control groups. CLA was administered to the experimental group and phosphate-buffered saline (PBS) was given to the control group. Parasite load kinetics was determined. Enzyme-linked immunosorbent assay (ELISA) was performed to evaluate IgA and cytokines. Nuclear transcription factors and cytokines were measured by RT-qPCR, and histology of small bowel cells was evaluated. Results: CLA administration reduced the parasite load (P<0.05) and increased early Giardia-specific secretory IgA production. CLA also increased the expression of interleukin-10, transforming growth factor (TGF)-ß, and inducible nitric oxide synthase (iNOS) (P<0.05), while infection elevated the expression of Foxp3, with a peak at 40 days post-infection (P<0.05). There were no pathological changes in the colonic mucosa due to infection or treatment. Thus, CLA stimulated mucosal immunity and enhanced the humoral response against G. lamblia, not only for early infection control but also to promote regulatory cytokine production at 40 dpi, restoring the intestinal balance after parasite elimination. Conclusion: Our findings reveal novel anti-parasitic effects through the immune-modulatory activity of CLA against the intestinal parasite G. lamblia.

Localization in Two-Dimensional Quasicrystalline Lattices.

We investigate the emergence of localization in a weakly interacting Bose gas confined in quasicrystalline lattices with three different rotational symmetries: five, eight, and twelve. The analysis, performed at a mean field level and from which localization is detected, relies on the study of two observables: the inverse participation ratio (IPR) and the Shannon entropy in the coordinate space. Those physical quantities were determined from a robust statistical study for the stationary density profiles of the interacting condensate. Localization was identified for each lattice type as a function of the potential depth. Our analysis revealed a range of the potential depths for which the condensate density becomes localized, from partially at random lattice sites to fully in a single site. We found that localization in the case of five-fold rotational symmetry appears for (6ER,9ER), while it occurs in the interval (12ER,15ER) for octagonal and dodecagonal symmetries.

Trace elements concentration in blood of nesting Kemp's Ridley turtles (Lepidochelys kempii) at Rancho Nuevo sanctuary, Tamaulipas, Mexico.

The concentrations of trace elements including As, Zn, Cu, Se, Pb, Hg and Cd, were determined in the blood of nesting Kemp's ridley turtles (Lepidochelys kempii) at Rancho Nuevo sanctuary, Tamaulipas, Mexico during 2018-2020. The sequential concentrations analyzed were Zn> Se> Cu> As> Pb; while Cd and Hg concentrations were below the limits of detection (0.01 µg g-1). No significant differences were observed between the concentrations of trace elements (p> 0.05) by year, except Se levels, possibly resulting from recorded seasonal differences in turtle size. No relationships among turtle size vs elements concentration were observed. In conclusion, essential and toxic trace elements concentrations in the blood of nesting Kemp's ridley turtles may be a reflex of the ecosystem in which the turtles develop, that is, with low bioavailability of elements observed in the trophic webs in the Gulf of Mexico.

An empirical data analysis of "price runs" in daily financial indices: Dynamically assessing market geometric distributional behavior.

In financial time series there are time periods in which market indices values or assets prices increase or decrease monotonically. We call those events "price runs", "elementary uninterrupted trends" or just "uninterrupted trends". In this paper we study the distribution of the duration of uninterrupted trends for the daily indices DJIA, NASDAQ, IPC and Nikkei 225 during the period of time from 10/30/1978 to 08/07/2020 and we compare the simple geometric statistical model with [Formula: see text] consistent with the EMH to the empirical data. By a fitting procedure, it is found that the geometric distribution with parameter [Formula: see text] provides a good model for uninterrupted trends of short and medium duration for the more mature markets; however, longest duration events still need to be statistically characterized. Estimated values of the parameter p were also obtained and confirmed by calculating the mean value of p fluctuations from empirical data. Additionally, the observed trend duration distributions for the different studied markets are compared over time by means of the Anderson-Darling (AD) test, to the expected geometric distribution with parameter [Formula: see text] and to a geometric distribution with a free parameter p, making possible to assess and compare different market geometric behavior for different dates as well as to measure the fraction of time runs duration from studied markets are consistent with the geometric distribution with [Formula: see text] and in parametric free way.

Clinical characteristics and treatment of perianal fistulising Crohn's disease in Colombia: Results of a multicentric registry. / Características clínicas y tratamiento de la enfermedad de Crohn perianal fistulizante en Colombia: resultados de un registro multicéntrico.

INTRODUCTION: Perianal fistulizing Crohn's disease (CD) is a phenotype with a poor prognosis. There are no studies in our country. Our objective is to determine the clinical, sociodemographic and treatment characteristics of perianal fistulizing CD in a Colombian multicenter registry. MATERIALS AND METHODS: A retrospective, multicenter observational study was carried out, with prospective data collection, in the main reference centers for inflammatory Bowel disease (IBD) in the country. Continuous variables were expressed as medians and interquartile ranges. The categorical outcome variables were compared by the Chi-square test. RESULTS: Sixty-five patients with perianal fistulizing CD were documented, with a median age of appearance of perianal fistula of 31.0 years (range: 24-42), predominantly in men (61.5%; H:M ratio: 1.4:1). Complex perianal fistulas were more frequent than simple ones (75.35 vs. 24.6%). Regarding medical treatment, 66.2% of the patients received antibiotics, 64.6% steroids, 78.5% biological therapy, 47.7% non-cutting setons, and 46.2% required surgical management, other than seton placement. Only 29.2% achieved complete remission of the fistula, and 9.2% of the patients ended up in a definitive colostomy. CD patients with complex fistulas received more biological therapy, compared to CD patients with simple fistulas (84.8 vs. 56.3%; P: 0.038). CONCLUSIONS: Perianal fistulizing CD has a poor prognosis in our setting, only 3 out of 10 patients achieve complete remission despite treatment. A multidisciplinary management is essential for the comprehensive management of this difficult pathology.