Volatilome Analysis of Soursop Fruits for the Determination of Kairomone Components That Attract the Annonaceae Fruit Weevil (Optatus palmaris Pascoe).

Soursop possesses the largest fruit size of the Annona genus. However, this species is threatened by the Annonaceae fruit weevil (Optatus palmaris), which can cause the destruction of whole soursop fruits. Recently, the potential of semiochemicals for the management of this insect is highlighted, and its aggregation pheromone has been elucidated. This pheromone works well only when mixed with soursop volatiles. Thus, the aim of this research was to determine specific kairomone components to potentiate the aggregation pheromone of this Annonaceae fruit weevil. This task was carried out via volatilome analysis of soursop fruits, which was correlated with the biological activity of the identified volatiles. The GC-MS analysis of aroma collections of mature soursop fruits and flowers, determined using multivariate data analysis, confirmed a volatile differentiation between these organs. The volatile variation between fruits and flowers was reflected in weevils' preference for mature fruits instead of flowers. Moreover, weevils' response to soursop fruits increased with more mature fruits. This was correlated with volatile changes throughout the phenological stages of soursop fruits. The two volatiles most correlated with weevils' attraction were benzothiazole and (E)-ß-caryophyllene. These volatiles only evoked a response when mixed and potentiated the attraction of the aggregation pheromone. Thus, these two volatiles are active kairomone components with the potential for being used in combination with the aggregation pheromone of Annonaceae fruit weevils in field trials.

A Qualitative Study Exploring Parental Perceptions of Telehealth in Early Intervention.

Using telehealth as a mode of service delivery has the potential to address some long-standing challenges in early intervention (EI) services such as waiting lists to access services. Yet, little is known about parent perceptions of telehealth in EI based on their lived experiences partnering with EI practitioners. The purpose of this study was to explore parent perceptions on using telehealth, especially on family-professional partnerships and coaching. Interviews were conducted with 15 parents of children receiving EI services via telehealth from June to August of 2021. Almost half of the participants reflected under-represented racial and ethnic backgrounds. Constant comparative analysis and emergent coding were used for data analysis. The findings showed that the advantages outnumbered the disadvantages regarding telehealth. Participants reported that telehealth provided a safe and flexible option and eliminated the wait to access EI services. However, participants identified some disadvantages to telehealth including telehealth precluded substantive interactions with therapists and limited access to technology. The findings also indicated that telehealth enhanced family-professional partnerships. Nearly all participants valued coaching during telehealth. Participants suggested initial supports to facilitate EI via telehealth, including stable internet access, telehealth training, and an initial in-person visit. Implications for research and practice are discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s10882-022-09853-w.

Air pollution and health prevention: A document of reflection.

Ambient air quality, pollution and its implication on health is a topic of enormous importance that is normally dealt with by major specialists in their particular areas of interest. In general, it is not discussed from multidisciplinary approaches or with a language that can reach everyone. For this reason, the Health Sciences Foundation, from its prevention area, has formulated a series of questions to people with very varied competences in the area of ambient air quality in order to obtain a global panorama of the problem and its elements of measurement and control. The answers have been produced by specialists in each subject and have been subjected to a general discussion that has allowed conclusions to be reached on each point. The subject was divided into three main blocks: external ambient air, internal ambient air, mainly in the workplace, and hospital ambient air and the consequences of its poor control. Along with the definitions of each area and the indicators of good and bad quality, some necessary solutions have been pointed out. We have tried to know the current legislation on this problem and the competences of the different administrations on it. Despite its enormous importance, ambient air quality and health is not usually a topic of frequent presence in the general media and we have asked about the causes of this. Finally, the paper addresses a series of reflections from the perspective of ethics and very particularly in the light of the events that the present pandemic raises. This work aims to provide objective data and opinions that will enable non-specialists in the field to gain a better understanding of this worrying reality.

Overview of virus and cancer relationships. Position paper.

The role of certain viruses in the etiology of some tumors is today indisputable, but there is a lack, however, of annoverview of the relationship between viruses and cancer with amultidisciplinary approach. For this reason, the Health Sciences Foundation has convened a group of professionals from different areas of knowledge to discuss the relationship between viruses and cancer, and the present document is the result of these deliberations. Although viruses cause only 10-15% of cancers, advances in oncology research are largely due to the work done during the last century on tumor viruses. The clearest cancer-inducing viruses are: HPV, HBV, HCV, EBV and, depending on the geographical area, HHV-8, HTLV-1 and HIV. HPVs, for example, are considered to be the causative agents of cervical carcinomas and, more recently, of a proportion of other cancers. Among the Herpes viruses, the association with the development of neoplasms is well established for EBV and HHV-8. Viruses can also be therapeutic agents in certain neoplasms and, thus, some oncolytic viruses with selective tropism for tumor cells have been approved for clinical use in humans. It is estimated that the prophylaxis or treatment of viral infections could prevent at least 1.5 million cancer deaths per year.

Implementation of an Enhanced Recovery After Surgery (ERAS) protocol for acute complicated and uncomplicated appendicitis.

BACKGROUND: Enhanced Recovery After Surgery (ERAS) protocols are well-documented logistic programs in elective surgery but it is still uncertain whether ERAS can benefit emergency patients, because of significant challenges facing its application to emergency surgery. The aim of this study was to evaluate the implementation of an ERAS protocol for patients with acute appendicitis (AA), both complicated and uncomplicated. METHODS: A prospective observational study was performed at two university hospitals in Spain, between January 2012 and December 2019. Inclusion criteria were patients with diagnosis of AA, undergoing appendectomy following an ERAS protocol of perioperative care. The different items of the ERAS protocol were recorded and their implementation was separately evaluated. Analyzed variables also included postoperative complications, hospital stay and readmission rate. Levels of acute phase reactants were assessed as predictors of implementation for the ERAS protocol. RESULTS: Eight hundred fifty patients were included; 498 males (58.5%) and 302 females (41.5%), with a mean age of 34.95 ± 17 years. The implementation of all the items of the protocol was achieved in 770 patients (90.6%), 86.8% of patients with complicated AA and 93.1% of patients with uncomplicated AA (p = 0.02). Higher preoperative C-reactive protein (CRP) levels were significantly associated with the impossibility of implementing all the items of the ERAS protocol (p < 0.001), establishing a cut-off point at CRP = 13.5 mg/dl. CONCLUSIONS: The implementation of ERAS protocols is safe and feasible in patients with AA. Although the implementation rate of all the items is lower in patients with complicated AA, it can be completed in 86.8% of these patients. CRP levels over 13.5 mg/dl are predictors of difficulties in the implementation of all the items of ERAS protocols.

Preoperative management of obese patients undergoing bariatric surgery: Role of endoscopy and Helicobacter eradication.

BACKGROUND: Obesity is a pandemic disease associated to severe health problems. Management is usually multimodal, but many patients eventually need surgery to reduce weight. Many guidelines recommend endoscopy prior to surgery. This study reviews a series of patients undergoing sleeve gastrectomy to see whether endoscopy performance and histopathological findings influence surgery outcome. MATERIAL AND METHODS: Retrospective series of patients undergoing sleeve gastrectomy as bariatric procedure at a single institution. We have reviewed the demographic data, the associated pathologies, endoscopic findings prior to surgery, histopathological findings in the surgical resection specimen and postoperative complication rate. RESULTS: 259 patients fulfilled criteria for the study. Over 70% were women and the mean age was 46.9 (SD 9.8). Preoperative endoscopy was performed in 28.9% of the patients and biopsy only in 19.3%. Helicobacter pylori was detected in 28% of the patients undergoing endoscopy (either in the biopsy or the urease test) and eradicated before surgery in all the patients. Helicobacter pylori was present in 9.7% of the surgical resection specimens and its presence was significantly associated with the development of postoperative complications, mostly staple line leaks (p = 0.01). CONCLUSION: Our study confirms that Helicobacter infection is significantly associated with postoperative complications after sleeve gastrectomy. It is therefore important to detect its presence and eradicate it before surgery.

Impacto económico de emicizumab en pacientes con hemofilia a con inhibidor en un hospital de tercer nivel / Economic impact of emicizumab in patients with haemophilia a with inhibitor in a third level hospital

Objetivo: Estimar el impacto económico del emicizumab en pacientes con hemofilia A (HA) e inhibidor en un hospital de tercer nivel, comparándolo con las alternativas terapéuticas. Métodos: Se estimó el coste anual del tratamiento de la HA e inhibidor con complejo protrombínico activado (aPCC), factor VII recombinante (rFVIIa) y emicizumab, y varias estrategias terapéuticas: profiláctica, a demanda e inmunotolerancia (ITI). Las dosis utilizadas, localización, frecuencia y gravedad de los sangrados se obtuvieron de la literatura. Resultados: El coste medio anual de la estrategia a demanda con aPCC/rFVIIa y de la estrategia profiláctica fueron 309.523 € y 354.866 €, en un paciente pediátrico y 808.928 € y 926.574 € en un adulto, respectivamente. El coste de la ITI fue 619.644 € y 1.029.399 € en el paciente pediátrico y adulto, respectivamente. Respecto a la estrategia profiláctica, el coste del tratamiento con emicizumab fue un 27,7% menor en el paciente pediátrico (240.255 €) y un 50,8% menor en el adulto (427.266 €).Conclusiones: Emicizumab, además de aportar mejoras clínicas y de calidad de vida a los pacientes con HA, ofrece ventajas económicas frente a los agentes “bypass”. (AU)

Purpose: Estimate the economic impact of the use of emicizumab in patients with hemophilia A (HA) and inhibitor in a third level hospital, comparing it with the different therapeutic alternatives.Methods: HA and inhibitor annual cost treatment with activated prothrombin complex (aPCC), recombinant factor VII (rFVIIa) and emicizumab was estimated. The patients were stratified in pediatrics (<14 years) and adults (>14 years). Several strategies were considered: prophylactic, on demand and immune tolerance induced (ITI). The dose used and the bleeding location, frequency and severity were obtained from the literature.Results: The average annual cost of on demand strategy with aPCC and rFVIIa and prophylactic strategy in a pediatric patient was 309,523 € and 354,866 € respectively, and 808,928 € and 926,574 € in an adult patient, respectively. ITI cost was 619,644 € and 1,029,399 € in pediatric and adult patient respectively. Regard prophylactic strategy, the treatment cost with emicizumab was 27.7% lower in pediatric patients (240,255 €) and 50.8% lower in adult patients (427,266 €). (AU)

Effects of a High-Intensity Exercise Program on Weight Regain and Cardio-metabolic Profile after 3 Years of Bariatric Surgery: A Randomized Trial.

Weight regain is one of the most common problems in the long-term after bariatric surgery. It is unknown if high-intensity exercise programs applied in late phases of post-surgical follow-up could counteract this trend. After a 3-year follow-up, 21 patients underwent sleeve gastrectomy were randomized into an exercise group (EG, n = 11), that performed a 5-month supervised exercise program, and a control group (CG, n = 10), that followed the usual care. Body composition, cardiorespiratory fitness, glycaemia and blood cholesterol were evaluated before and after the intervention. Finally, the EG repeated the evaluations 2 months after the end of the exercise program. Both groups reached their maximum weight loss at the first year after surgery and showed significant weight regain by the end of the follow-up. After the exercise program, the EG showed reductions in fat mass (-2.5 ± 2.6 kg, P < 0.05), glycaemia (-13.4 ± 8.7 mg·dL-1, P < 0.01) and blood cholesterol (-24.6 ± 29.1 mg·dL-1, P < 0.05), whereas the CG during the same period showed increases in weight (1.5 ± 1.3 kg, P < 0.05) and fat mass (1.8 ± 0.9, P < 0.01). Two months after the end of the program, EG had increases in weight (1.1 ± 1.2 kg, P < 0.05), fat mass (2.6 ± 2.2 kg, P < 0.01), glycaemia (8.2 ± 11.6 mg·dL-1, P < 0.05) and blood cholesterol (20.0 ± 22.1 mg·dL-1, P < 0.05), when compared with the values after the exercise program. Therefore, in the medium-term after sleeve gastrectomy exercise may contribute to prevent weight regain and to reduce fat mass, glycaemia, and blood cholesterol.

Impact of Exercise on Body Composition and Cardiometabolic Risk Factors in Patients Awaiting Bariatric Surgery.

BACKGROUND: The role of exercise to achieve weight reductions in patients awaiting bariatric surgery has been little studied. The aim of this study was to describe the effects of an exercise program on body composition and cardiometabolic risk factors in patients awaiting bariatric surgery. METHODS: Twenty-three patients awaiting bariatric surgery were divided into two groups: (a) an exercise group (EG, n = 12) and (b) a control group (CG, n = 11). Both groups received the usual care prior to surgery, but the EG also performed a 12-week exercise program which combined endurance and resistance training. Body composition, cardiometabolic risk factors, physical fitness, basal metabolic rate, and quality of life were assessed at baseline and at the end of the study. RESULTS: After the exercise program, the EG achieved significant reductions in total weight (- 7.3 ± 4.1 kg, P < 0.01), fat mass (- 7.1 ± 4.7 kg, P < 0.01), and waist circumference (- 5.3 ± 2.1 cm, P < 0.01), while they maintained their fat-free mass and basal metabolic rate levels. Only the EG showed reductions in HbA1c (- 0.4 ± 0.45%, P < 0.05), systolic (- 10.5 ± 12.7 mmHg), and diastolic blood pressure (- 3.9 ± 5.2 mmHg, P < 0.05), as well as a decrease in waist-to-height ratio (- 0.032 ± 0.12, P < 0.01) and an improvement in quality of life. CONCLUSIONS: The implementation of an exercise program prior to bariatric surgery reduces fat mass and central obesity and improves cardiometabolic risk factors and quality of life, especially in the physical scales. TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (NCT03613766).

Intraocular pressure fluctuations in patients implanted with an implantable collamer lens (ICL V4c). Three-month follow-up. / Fluctuaciones de presión intraocular en pacientes operados con implante de implantable collamer lens (ICL V4c). Seguimiento a 3 meses.

INTRODUCTION: Fluctuating elevated intraocular pressure (IOP) is one of the complications of an implantable collamer lens (ICL), and its alteration is a predictive factor for the development of glaucoma. MATERIAL AND METHODS: A prospective, cross-sectional analytic study was conducted on patients suitable for ICL implantation. Complete clinical and biometric work-ups were performed, as well as night-time IOP curve, in supine position, with 4 determinations, in order to assess fluctuation, considering abnormal with a value higher than 5 mmHg. Patients underwent surgery with conventional technique and three months after the work-ups were repeated, including a night-time IOP curve to assess any changes in IOP fluctuations. RESULTS: A total of 31 eyes of 16 patients were studied. Mean IOP fluctuation in the preoperative assessment was 3.35 ± 2 mmHg, whereas the postoperative mean was 3.0 ± 2.2 mmHg, with the difference not being statistically significant. Visual acuity and capacity, as well as spheric equivalent did show a statistically significant improvement. There were 6 cases of complications, which were related to a higher vault and a greater ICL size. There was no relationship between these findings and the angle grade, pigment, and the level of training of the surgeon. CONCLUSIONS: The effect of an ICL on IOP fluctuations, has been studied for the first time, which was found to be not statistically significant. As in previous publications, the procedure was safe and reproducible, adding the fact that the level of training of the surgeon is not a determining factor in these findings.

Effects of the application of vitamin E and silicone dressings vs conventional dressings on incisional surgical site infection in elective laparoscopic colorectal surgery: a prospective randomized clinical trial.

AIM: To compare the effect of conventional wound dressings (CD) with vitamin E and silicone (E-Sil) dressings on incisional surgical site infection (SSI) in patients undergoing elective colorectal laparoscopic surgery. PATIENTS AND METHODS: A prospective, randomized study was performed. Patients were assigned at random into two groups: an E-Sil group and a CD group. Incisional SSI, postoperative pain and acute phase reactants were investigated. RESULTS: In total, 120 patients were included in this study (60 in each group). The incisional SSI rate was 3.4% in the E-Sil group and 17.2% in the CD group (P = 0.013). Bacteroides fragilis alone grew in the cultures of infected wounds in the E-Sil group, while cultures for infected wounds in the CD group were polymicrobial. Mean postoperative pain 48 h after surgery was 27.1 [standard deviation (SD) 10.7] mm in the E-Sil group and 41.6 (SD 16.9) mm in the CD group (P < 0.001). White blood cell (WBC) count and C-reactive protein (CRP) level were lower in the E-Sil group, even after the exclusion of patients presenting with postoperative complications. CONCLUSION: Use of an E-sil dressing to cover the Pfannestiel wound after elective laparoscopic colorectal surgery leads to a reduction in the incisional SSI rate, lower postoperative pain, and a decrease in CRP level and WBC count.

Lessons Learned from Data Collection as Health Screening in Underserved Farmworker Communities.

BACKGROUND: Girasoles is an academic-community partnership investigating heat-related illness (HRI) among farm-workers. An unexpected outcome is health screening and intervention for participants without access to health care. OBJECTIVES: We present a case of renal failure in a farmworker, detected during data collection, to illustrate how academic-community collaboration can result in clinical benefits for study participants. METHODS: Girasoles is examining physiologic responses to heat stress, associated vulnerability factors, and HRI symptoms. Data include blood pressure, fasting and non-fasting blood glucose, blood creatinine, blood urea nitrogen, and urine dipsticks. Participants with out-of-range findings are referred to local health care providers. RESULTS: During two summers, health screenings of 192 workers resulted in 71 referrals (37%) for conditions to be rechecked and treated. One of these referrals involved chronic renal failure requiring extensive follow-up by research team members. CONCLUSIONS: The case of renal failure illustrates the value of collaborative research as a health intervention with vulnerable populations.

Composting of the invasive species Arundo donax with sewage and agri-food sludge: Agronomic, economic and environmental aspects.

This work evaluates several co-composting scenarios based on the use of Arundo donax biomass (AD) as bulking agent for the co-composting of sewage sludge (MS) and agri-food sludge (AS), to manage these organic wastes and to produce balanced organic fertilizers by optimizing the process. For this, six piles were prepared in commercial composting conditions, using AD in a range of 40%-80% (on a dry weight basis). Physico-chemical and chemical parameters and the thermal behaviour were evaluated during the process, as were the physical and chemical parameters of the final composts. The proportion of AD in the mixtures has a significant effect on the development of the thermophilic stage of composting, showing the piles with higher proportion of AD a quicker organic matter degradation. In addition, the evolution of the thermal indices R1 and R2 was different depending on the origin of the sludge used, indicating an increase in the relative concentration of more recalcitrant materials in the piles prepared with AS. The estimation of the global warming potential showed that the use of higher proportion of AD in the composting mixture may be a strategy to mitigate the emission of greenhouse gases during the composting process. Moreover, the end-products obtained had an additional marketable value, with a balanced nutrient content and a good degree of maturity, which indicates the viability of the composting process as a method for the stabilization of these organic wastes.

Anti-oxidants correct disturbance of redox enzymes in the hearts of rat fetuses with congenital diaphragmatic hernia.

AIM: To evaluate if the redox system is unbalanced in the hearts of nitrofen-induced congenital diaphragmatic hernia  (CDH) animals and to study the possible preventive effects of two anti-oxidant treatments, apocynin and epigallocatechin-3-gallate (EGCG). METHODS: Adult rats were divided into four groups. Group 1: rats received only vehicle on day E9.5. Group 2: rats received 100 mg nitrofen on day E9.5. Group 3: 1 month before mating rats received apocynin 1.5 mM and, when pregnant, 100 mg nitrofen on day E9.5. Group 4: same than group 3 but with EGCG 30 mg/kg. All fetuses were recovered at term and the hearts were processed. Nox activity and mRNA levels of Nox1, Nox2, Nox4, SOD1, SOD2, SOD3, catalase, and GPX1 were analyzed. Nox, SOD, and Catalase activity and H2O2 production were also evaluated. RESULTS: Nox activity, H2O2 production and Nox1, Nox2, and Nox4 mRNA levels were increased in the hearts of fetuses with CDH. There were no changes in SOD1 levels, whereas those of SOD2, SOD3, catalase, and GPX1 mRNA were decreased. Apocynin and EGCG treatments attenuated the increment of Nox and SOD activities and H2O2 production was only decreased by apocynin. CONCLUSION: These findings suggest a possible preventive effect on the abnormal redox metabolism of anti-oxidant treatments in the hearts from rat fetuses with CDH. If the same occurs in humans, it could represent a potential tool in future prenatal treatment.

Assessment of enlarged perivascular spaces and their relation to target organ damage and mild cognitive impairment in patients with hypertension.

BACKGROUND AND PURPOSE: Enlarged perivascular spaces (EPVS) have been recently considered a feature of cerebral small vessel disease. They have been related to aging, hypertension and dementia but their relationship with hypertension related variables (i.e. target organ damage, treatment compliance) and mild cognitive impairment (MCI) is not fully elucidated. Our aims were to investigate the relation between basal ganglia (BG) and centrum semiovale (CSO) EPVS with vascular risk factors, hypertension related variables and MCI. METHODS: In all, 733 hypertensive individuals free of stroke and dementia from the Investigating Silent Strokes in Hypertensives, a magnetic resonance imaging Study (ISSYS) underwent brain magnetic resonance imaging and cognitive testing to diagnose MCI or normal cognitive aging. RESULTS: The numbers of participants presenting high grade (>10) EPVS at the BG and CSO were 23.3% and 40.0%, respectively. After controlling for vascular risk factors, high grade BG EPVS were associated with age (odds ratio 1.68; 95% confidence interval 1.37, 2.06), poor antihypertensive compliance (1.49; 1.03, 2.14) and the presence of microalbuminuria (1.95; 1.16, 3.28), whereas in the CSO only age (1.38; 1.18, 1.63) and male sex were associated with EPVS (1.73; 1. 24, 2.42). MCI was diagnosed in 9.3% of the participants and it was predicted by EPVS in the BG (1.87; 1.03, 3.39) but not in the CSO. This last association was greatly attenuated after correction for lacunes and white matter hyperintensities. CONCLUSIONS: Basal ganglia EPVS are associated with the presence of microalbuminuria and poor adherence to antihypertensive drugs. The BG EPVS relation with MCI is not independent of the presence of other cerebral small vessel disease markers.

Possible role of increased oxidative stress in pulmonary hypertension in experimental diaphragmatic hernia.

PURPOSE: Congenital diaphragmatic hernia (CDH) is one of the causes of respiratory failure in newborns due to lung hypoplasia and pulmonary abnormalities leading to pulmonary hypertension (PH). NAD(P)H oxidase (Nox) is a family of isoenzymes that generate reactive oxygen species (ROS) which can contribute to PH-induced vascular dysfunction. On the other hand, superoxide dismutase (SOD) 1-2 and catalase are the antioxidant enzymes that eliminate the excess of ROS in pulmonary vascular cells. Our aim is to examine whether PH-associated with CDH is due to a dysregulation of ROS production in lungs from CDH fetuses. METHODS: Pregnant rats received either 100 mg nitrofen or vehicle on E9.5. Fetuses were recovered on E21. (1) Nox activity, (2) H2O2 production and (3) mRNA levels of Nox1, Nox2, Nox4, SOD1, SOD2 and catalase were analyzed in fetal lungs. RESULTS: Nox activity and Nox1 and Nox2 mRNA levels were increased in the lungs of fetuses with CDH. However, there were no changes in H2O2 production and Nox4 mRNA levels. SOD1, SOD2 and catalase were decreased. CONCLUSIONS: The raised oxidative stress due to increase in ROS generation by Nox isoenzymes and dysfunction of antioxidant enzymes seems to be a potential mechanism responsible on PH-associated with CDH.

Ulcerative ileitis after proctocolectomy in children: a complication of ulcerative colitis or a disease in itself after ileoanal pullthrough?

Ulcerative ileitis (UI) after restorative proctocolectomy (RPC) and ileoanal pullthrough procedure (IAPP) is a rare condition described as inflammation of the terminal ileum proximal to the anastomosis. It is mostly observed in ulcerative colitis (UC) and is designated as prepouch ileitis; sometimes with pouchitis, but not necessarily all the time. Its incidence in adults is less than 5%, but the information in children is limited. Pathogenesis is unknown, it has been considered as a disease by itself, independently on the underlying disease. It involves additional morbidity and impacts negatively on quality of life because there is no effective treatment so far. This study aims to review the cases of UI in our institution and to summarize their clinical features and management. A descriptive retrospective study of UI patients between 1990 and 2013 was conducted. Children with RPC and IAPP with clinical and pathological diagnosis of UI were included. Sociodemographic and clinical data, diagnostic, and therapeutic procedures were collected through medical records. UI was diagnosed in eight patients (six males) after RCP; four had UC, two had total colonic aganglionosis (TCA), and two had complex anorectal malformations (one cloacal exstrophy and one omphalopagus twin with bladder exstrophy). Different surgical techniques were used in each case: UC patients underwent IAPP, 50% with J-reservoir and 50% without it; posterior sagittal pullthrough was performed in those with anorectal malformations; one Soave and one Swenson procedure in those with TCA. In summary, three patients had reservoir and five did not. The median age at the IAPP and ostomy closure was 6 years (range 2 months-8 years) and 7 years (range 6 months-9 years), respectively. UI was found after a median of 23 months (range 1-48 months), all of them after digestive tract continuity was reestablished. The leading symptom was lower GI or gastrointestinal, both of them bleeding with abdominal pain, followed by abdominopelvic abscesses and malabsorption with weight loss. Pathology showed nonspecific inflammatory changes. Treatment included antibiotics, corticosteroids and/or immunosuppressive agents with variable response, requiring a new ileostomy in five cases. Ileitis disappeared after diversion. In our experience, UI after colectomy is not an exclusive feature of UC as has been previously described. Although it appears with pouchitis, the presence of a reservoir is not a must, suggesting that this is a different entity. No medical treatment has been really effective in our patients and diversion above this level stopped the process. Further studies on its pathogenesis and treatment strategies are necessary.