Assessing the impact of long-term inhaled corticosteroid therapy on patients with COVID-19 and coexisting chronic lung disease: A multicenter retrospective cohort study.

Background: Patients with chronic lung disease (CLD), such as asthma or chronic obstructive pulmonary disease, were expected to have an increased risk of clinical manifestations and severity of COVID-19. However, these comorbidities have been reported less frequently than expected. Chronic treatment with inhaled corticosteroids (ICS) may impact the clinical course of COVID-19. The main objective of this study is to know the influence of chronic treatment with ICS on the prognosis of COVID-19 hospitalized patients with CLD. Methods: A multicenter retrospective cohort study was designed, including patients hospitalized with COVID-19. Epidemiological and clinical data were collected at admission and at seven days, and clinical outcomes were collected. Patients with CLD with and without chronic treatment with ICS were compared. Results: Two thousand five hundred ninety-eight patients were included, of which 1,171 patients had a diagnosis of asthma and 1,427 of COPD (53.37% and 41.41% with ICS, respectively). No differences were found in mortality, transfer to ICU, or development of moderate-severe ARDS. Patients with chronic ICS had a longer hospital stay in both asthma and COPD patients (9 vs. 8 days, p = 0.031 in asthma patients), (11 vs. 9 days, p = 0.018 in COPD patients); although they also had more comorbidity burden. Conclusions: Patients with chronic inhaled corticosteroids had longer hospital stays and more chronic comorbidities, measured by the Charlson comorbidity index, but they did not have more severe disease at admission, evaluated with qSOFA and PSI scores. Chronic treatment with inhaled corticosteroids had no influence on the prognosis of patients with chronic lung disease and COVID-19.

The role of calcium and vitamin D dietary intake on risk of colorectal cancer: systematic review and meta-analysis of case-control studies.

PURPOSE: The aim of this study is to analyze the current evidence about the relationships between calcium/vitamin D and CRC based on case-control studies according to sex, tumor location and continental region to complement the information obtained in meta-analyses of other designs. METHODS: The articles were located in three databases (PUBMED, EMBASE and SCOPUS), they should be written in English language, with a case and control design and published between 1 January 1970 and 31 October 2019. RESULTS: There were 37 selected studies, 32 for intake of calcium, that involved 24,353 CRC cases and 30,650 controls, and 23 for that of VIT D, with a total of 19,076 cases and 36.746 controls included. For dietary calcium intake, the overall OR was 0.94 (95% CI 0.92-0.97), suggesting a reducing effect with a 6% decrease in CRC risk for every 300 mg of calcium ingested daily. Regarding vitamin D intake a global OR of 0.96 (95% CI 0.93-0.98) was observed, what means a 4% decrease in the risk of CRC per 100 IU/day of vitamin D. CONCLUSION: Higher dietary intakes of calcium and vitamin D are associated to a decreased risk of CRC.

[HCV and HIV infection, and coinfection in the León health area in the period 1993-2004]. / Infección por los virus de la hepatitis C y de la inmunodeficiencia humana y coinfección por ambos en el área de salud de León durante el período 1993-2004.

BACKGROUND: As few population studies exist, the study of positive serological tests detected in laboratory services may be an acceptable approximation for the assessment of HIV and Hepatitis C infection and coinfection by both. METHODS: A study was made of the database of positive serologies of the Laboratory Service of León General Hospital. Data were treated in accordance with the origin of the samples. To calculate rates, the municipal census of persons over 14 was used. For the prison population, the number of inmates on the last day of each year was considered. The period analysed was 1993-2004. The Chi-square test and Chi-square test for tendencies were used. RESULTS: The number of positive serologies for HCV, HIV and coinfection were 467, 112 and 78 in 1993; 217, 24 and 15 in 2002, and 294, 42 and 21 in 2004. According to the samples from the hospital, blood bank and health centres, the average annual rate per 100,000 inhabitants for the three-year periods 1993-95 and 2001-04 in men varied from 153.3 to 69.5 for HCV, from 26.2 to 10,0 for HIV and from 21.7 to 3.8 for coinfection. The figures for women were 56.6-37.7 for HCV, 9.2-2.3 for HIV and 6.3-0.4 for coinfection. In all cases, there was a significant downward trend (p<0.05). The positive serologies from the prison for the period 1993-2004 varied between 34.5% and 7.2% for HCV, 11.7%-1.1% for HIV and 9.55 and 1.0% for coinfection. Of those infected by HCV, 11.5% were HIV positive, and of those infected by HIV, 65.5% were also positive for HCV. CONCLUSIONS: A drop was observed in the number and rates of positive serological tests over the period studied.

Purple urine bag syndrome, a travel companion. / Síndrome de la orina morada en bolsa, un compañero de viaje.

OBJECTIVE: Purple urine bag syndrome is a rare entity that appears in elderly patients with long-term urinary catheters with chronic diseases. METHOD: We describe the cases of two patients admitted to our service, who serve as example to illustrate this pathology and which process should be followed in its diagnosis and treatment. CONCLUSION: Purple urine bag syndrome is a rare entity that occurs more frequently in elderly patients, women, with long-term urinary catheters, whose main factors are debilitating diseases, prolonged immobility and chronic constipation. It should be treated by avoiding the triggering factors, adequate hydration of the patient, antibiotics directly antibiogram therapy and the change of urinary catheter can be evaluated.

Colorectal cancer, sun exposure and dietary vitamin D and calcium intake in the MCC-Spain study.

OBJECTIVES: To explore the association of colorectal cancer with environmental solar radiation and sun exposure behavior, considering phenotypic variables (eye color, hair color and skin phenotype), dietary intake of vitamin D and calcium, and socio-demographic factors. STUDY DESIGN: Multicenter population-based frequency matched case-control study in Spain (MCC-Spain), with 2140 CRC cases and 3950 controls. METHODS: Data were obtained through personal interviews using a structured epidemiological questionnaire that included socio-demographic data, residential history, environmental exposures, behavior, phenotypic and dietary information. An environmental-lifetime sun exposure score was constructed combining residential history and average daily solar radiation, direct and diffuse. Logistic regression was used to explore the association between different variables. A structural equation model was used to verify the associations of the conceptual model. RESULTS: We found a lower risk of CRC in subjects frequently exposed to sunlight during the previous summer and skin burning due to sun exposure. No association was observed in relation to the residential solar radiation scores. Subjects with light eye or light hair colors had a lower risk of CRC that those with darker colors. Dietary calcium and vitamin D were also protective factors, but not in the multivariate model. The structural equation model analysis suggested that higher sun exposure was associated with a decreased risk of CRC, as well as dietary intake of calcium and vitamin D, and these factors are correlated among themselves and with environmental solar radiation and skin phenotypes. CONCLUSION: The results agree with previous observations that sun exposure, dietary vitamin D and calcium intake, and serum 25(OH)D concentration reduce the risk of CRC and indicate that these factors may be relevant for cancer prevention.

[Gastric tuberculosis. Review apropos of a case]. / Tuberculosis gástrica: revisión a propósito de un caso.

Abdominal tuberculosis (TB) is infrequent in the Western world. This disease occurs more commonly among at-risk populations, mainly among older patients and patients with HIV infection. Abdominal TB usually manifests as intestinal TB, peritoneal TB, and mediastinal lymphadenitis. Gastric TB is a rare manifestation of abdominal TB. We present the case of an 80-year-old man, who had been diagnosed with anemia 2 years previously without establishing the etiology. Treatment consisted of oral iron administration without improvement. Symptoms included epigastralgia, nausea and vomiting, as well as asthenia, anorexia and weight loss (approximately 20 kg in 2 years). A computed tomography scan showed mediastinal and mesenteric adenopathy, ascites, splenomegaly, and thickening of the gastric wall. Diagnosis was made by endoscopic biopsy of the affected areas in the antral region, the result being granulomatous chronic gastritis suggestive of tubercular origin.