Clinical and endoscopic outcomes of patients with colonic Crohn's disease treated with 5-aminosalicylates as monotherapy.

BACKGROUND: In spite of the lack of evidence regarding the clinical benefits of oral 5-aminosalicylic acid (5-ASA) compounds in Crohn's disease (CD), these drugs are frequently used in daily clinical practice, particularly for colonic CD. Our aim is to assess the use and clinical outcomes of 5-ASA of those patients with colonic CD treated with 5-ASA as monotherapy. METHODS: Patients diagnosed with isolated colonic CD and treated with 5-ASA but never exposed to immunosuppressants or biologicals were identified from the local databases of five referral centres. A retrospective review of clinical and endoscopic outcomes was performed. RESULTS: Out of 545 patients with isolated colonic CD, 106 (19%) were treated with oral 5-ASA in monotherapy as maintenance therapy. The median follow-up was 144 months (interquartile range [IQR], 48-234). Almost all of the patients (92%) presented an inflammatory pattern and 11% developed perianal disease. Half of the patients had already received 5-ASA at diagnosis, and the median duration of 5-ASA treatment was 107 months (IQR 22.5-187). Endoscopic remission, as defined by the absence of ulcers at the last complete colonoscopy, was observed in 65% of those patients undergoing at least one colonoscopy during follow-up. Male gender and extraintestinal manifestations were associated with a lower likelihood of achieving endoscopic remission. Nine patients required colectomy, but mostly soon after CD diagnosis. CONCLUSIONS: 5-ASA seems to be of benefit in the long-term in one fifth of patients with colonic CD as the only maintenance therapy and should be considered in fragile patients with Crohn's colitis.

Impact of neuropsychological disorders on clinical aspects of smoking. / Impacto de las alteraciones neuropsicológicas sobre aspectos clínicos en tabaquismo.

Studies examining associations between cognitive measures and clinical aspects of smoking are scarce and generally limited to predicting risk profiles or relapses. However, it is essential to understand the influence of several measures of executive function in nicotine addiction in order to investigate factors associated with smoking maintenance. This study examined the ability of working memory and delay discount to predict years of smoking. The sample consisted of 180 smokers who were assessed at baseline with measures of cognitive impulsivity (Delay Discounting Task) and working memory [Visual Search and Attention Test (VSAT) and Letter-Number Sequencing (WAIS III)] while the outcome measure was years of smoking. Consistent with predictions, working memory evaluated with Visual Search and Attention Test was a statistically significant factor in predicting years of nicotine addiction. These findings suggest that working memory is clinically relevant in nicotine dependence and proposes a pattern of executive functioning associated with smoking.

Los estudios que examinan las asociaciones entre las medidas cognitivas y los aspectos clínicos del tabaquismo son limitados y, en general, se limitan a predecir perfiles de riesgo o recaídas. Sin embargo, es esencial comprender la influencia de varias medidas de la función ejecutiva en la adicción a la nicotina a fin indagar factores asociados al mantenimiento del tabaquismo. En el presente estudio se examinó la capacidad de la memoria de trabajo y el descuento por retraso para predecir los años de tabaquismo. La muestra consistió en 180 fumadores que fueron evaluados en la línea de base con medidas de impulsividad cognitiva (Tarea de Descuento de Retraso) y memoria de trabajo [Prueba de Búsqueda y Atención Visual (VSAT) y Secuenciación de Números de Letras (WAIS III)] mientras que la medida de resultado fue los años de adicción. De acuerdo con las predicciones, la memoria de trabajo evaluada con la Prueba de Búsqueda y Atención Visual fue un factor estadísticamente significativo para predecir los años de adicción a la nicotina. Estos hallazgos sugieren que la memoria de trabajo es clínicamente relevante en la dependencia de la nicotina y plantea un patrón de funcionamiento ejecutivo asociado al tabaquismo.

Methods for epidemiological studies in competitive cycling: an extension of the IOC consensus statement on methods for recording and reporting of epidemiological data on injury and illness in sport 2020.

In 2020, the IOC released a consensus statement that provides overall guidelines for the recording and reporting of epidemiological data on injury and illness in sport. Some aspects of this statement need to be further specified on a sport-by-sport basis. To extend the IOC consensus statement on methods for recording and reporting of epidemiological data on injury and illness in sports and to meet the sport-specific requirements of all cycling disciplines regulated by the Union Cycliste Internationale (UCI). A panel of 20 experts, all with experience in cycling or cycling medicine, participated in the drafting of this cycling-specific extension of the IOC consensus statement. In preparation, panel members were sent the IOC consensus statement, the first draft of this manuscript and a list of topics to be discussed. The expert panel met in July 2020 for a 1-day video conference to discuss the manuscript and specific topics. The final manuscript was developed in an iterative process involving all panel members. This paper extends the IOC consensus statement to provide cycling-specific recommendations on health problem definitions, mode of onset, injury mechanisms and circumstances, diagnosis classifications, exposure, study population characteristics and data collection methods. Recommendations apply to all UCI cycling disciplines, for both able-bodied cyclists and para-cyclists. The recommendations presented in this consensus statement will improve the consistency and accuracy of future epidemiological studies of injury and illness in cycling.

Analysis of two autoimmunity genes, IRAK1 and MECP2, in giant cell arteritis.

OBJECTIVES: The Xq28 region, containing IRAK and MECP2, represent a common susceptibility locus for a high number of autoimmune diseases. Our aim in the present study was to evaluate the influence of the IRAK1 and MECP2 autoimmunity-associated genetic variants in the giant cell arteritis (GCA) susceptibility and its clinical subphenotypes. METHODS: We analysed a total of 627 female biopsy-proven GCA patients and 1,520 female healthy controls of Spanish Caucasian origin. Two polymorphisms, rs1059702 and rs17345, located at IRAK1 and MECP2, respectively, were genotyped using TaqMan® allelic discrimination assays. RESULTS: No association with any of the analysed polymorphisms was evident when genotype and allele frequencies were compared between GCA patients and controls (rs1059702: allelic p-value=0.699, OR=0.96, CI 95% 0.80-1.17; rs17435: allelic p-value=0.994, OR=1.00, CI 95% 0.84-1.19). Likewise, the subphenotype analysis yield similar negative results. CONCLUSIONS: We have assessed for the first time the possible role of IRAK1 and MECP2 autoimmune disease-associated polymorphisms in GCA. Our data suggest that IRAK1 rs1059702 and MECP2 rs17435 genetic variants do not play a significant role in GCA susceptibility or severity.

Typology of reasons why a person kills in a war context: The case of rebel/nationalist army combatants in the Spanish Civil War.

European historiography on wars has embarked on a study of a matter of crucial significance: the involvement of ordinary individuals as perpetrators of mass casualties. This article aims to provide insights and hypotheses concerning the underlying motives behind such actions, focusing on the unique context of the Spanish Civil War. The data utilized for this study are drawn from a sample of 112 oral interviews conducted with former combatants of the Spanish Civil War, all born between 1905 and 1920. During these interviews, 112 men participated a semi structured discussion. Individual perceptions and variables of interest relevant to acts of violence were subjected to qualitative analysis. Our analysis suggests that instances of aggression often arise because of emotional triggers, alignment with fascist ideological convictions, societal pressures and a sense of duty-driven obedience. Our results refute the notion that ideological factors alone suffice as explanations.

Dynamics of Gut Microbiota and Short-Chain Fatty Acids during a Cycling Grand Tour Are Related to Exercise Performance and Modulated by Dietary Intake.

BACKGROUND: Regular exercise has been described to modify both the diversity and the relative abundance of certain bacterial taxa. To our knowledge, the effect of a cycling stage race, which entails extreme physiological and metabolic demands, on the gut microbiota composition and its metabolic activity has not been analysed. OBJECTIVE: The aim of this cohort study was to analyse the dynamics of faecal microbiota composition and short-chain fatty acids (SCFAs) content of professional cyclists over a Grand Tour and their relationship with performance and dietary intake. METHODS: 16 professional cyclists competing in La Vuelta 2019 were recruited. Faecal samples were collected at four time points: the day before the first stage (A); after 9 stages (B); after 15 stages (C); and on the last stage (D). Faecal microbiota populations and SCFA content were analysed using 16S rRNA sequencing and gas chromatography, respectively. A principal component analysis (PCA) followed by Generalised Estimating Equation (GEE) models were carried out to explore the dynamics of microbiota and SCFAs and their relationship with performance. RESULTS: Bifidobacteriaceae, Coriobacteriaceae, Erysipelotrichaceae, and Sutterellaceae dynamics showed a strong final performance predictive value (r = 0.83, ranking, and r = 0.81, accumulated time). Positive correlations were observed between Coriobacteriaceae with acetate (r = 0.530) and isovalerate (r = 0.664) and between Bifidobacteriaceae with isobutyrate (r = 0.682). No relationship was observed between SCFAs and performance. The abundance of Erysipelotrichaceae at the beginning of La Vuelta was directly related to the previous intake of complex-carbohydrate-rich foods (r = 0.956), while during the competition, the abundance of Bifidobacteriaceae was negatively affected by the intake of simple carbohydrates from supplements (r = -0.650). CONCLUSIONS: An ecological perspective represents more realistically the relationship between gut microbiota composition and performance compared to single-taxon approaches. The composition and periodisation of diet and supplementation during a Grand Tour, particularly carbohydrates, could be designed to modulate gut microbiota composition to allow better performance.

One Season in Professional Cycling Is Enough to Negatively Affect Bone Health.

Cycling is a very popular sport worldwide, and several studies have already indicated that cycling at various levels has a negative impact on bone health. This is of concern to both performance and health managers of many cycling teams at different levels because of its economic and social impact. Based on the scientific literature, we hypothesize that a single season at the professional level can negatively affect bone health status. The aim of this study was to assess how professional cycling affects bone health markers after one season. Densitometry was used to measure the bone mineral density (BMD), bone mineral content (BMC), bone area (BA), fat mass (FM), fat-free mass (FFM), T-score and Z-score in professional cyclists after one season. After one season at the professional level, cyclists' BMD decreased significantly in the legs, trunk, ribs and pelvis (p ≤ 0.05). BMC decreased in the arms and spine (p ≤ 0.05). BA decreased significantly in the arms and spine (p ≤ 0.05). In addition, a significant decrease in Z-score (p ≤ 0.05) and a decreasing trend in T-score and total BMD (p = 0.06) were observed. One season of professional cycling is enough to negatively affect bone health status.

Executive Functions in Tobacco Use Disorder: New Challenges and Opportunities.

There is increasing evidence that executive functions have significative effects on nicotine abuse. An unresolved challenge for smoking cessation interventions is the detection of factors associated with nicotine use. In order to understand how cognition is affected by nicotine abuse, this study was designed to determine the relationship between years of smoking addiction and several variables of executive functions. The sample was composed of 174 smokers, whose age ranged between 27 and 69 years old (M = 47.44; SD = 8.48). Smokers were assessed at baseline with measures of cognitive inhibition [Go/No Go Task and Five Digit Test (FDT)], updating [Visual Search and Attention Test (VSAT) and Letter-Number Sequencing (WAIS IV)] and shifting [Delay Discounting Task (DDT) and Iowa Gambling Task (IGT)] while the outcome measure was years of smoking. The linear regression and correlation analysis highlighting that the variable which has the strongest association with years of smoking is updating. Multivariate analysis of variance (MANCOVA) followed by Tukey post-hoc tests revealed significant differences such that heavy smoking indicated worse performance than light smoking on updating tasks. These findings report the ability of working memory to predict years of smoking and suggest that cigarette packaging warning may experience a loss of effectiveness in heavy smokers.

Professional cyclists have lower levels of bone markers than amateurs. Is there a risk of osteoporosis in cyclist?

Currently, there is a greater number of amateurs that practice cycling. However, there is no clear evidence regarding bone health in amateur cyclists compared to professional cyclists, as the latter has shown to have lower bone mineral content and density. Therefore, the aim of this study was to identify the differences in bone variables between professional (PRO) and amateur (AMA) road cyclists, and to see if these differences were related to differences in cycling performance. A parallel trial was carried out with 15 AMA and 10 PRO cyclists. All cyclists visited the laboratory twice: 1) in a fasted state, body composition measured by dual-energy X-ray absorptiometry (DXA) and 2) physiological variables measured using an incremental test until exhaustion. Significantly lower values were found in bone mineral density, bone mineral content and fat free mass in PRO compared to AMA (p < 0.05). In addition, significantly higher power was produced in ventilatory thresholds 1 and 2 (VT1 and VT2) and VO2MAX in PRO compared to AMA (p < 0.05). Overall, PRO cyclists had lower values in bone health and muscle mass but better results in performance compared to AMA.

Differences between Professional and Amateur Cyclists in Endogenous Antioxidant System Profile.

Currently, no studies have examined the differences in endogenous antioxidant enzymes in professional and amateur cyclists and how these can influence sports performance. The aim of this study was to identify differences in endogenous antioxidants enzymes and hemogram between competitive levels of cycling and to see if differences found in these parameters could explain differences in performance. A comparative trial was carried out with 11 professional (PRO) and 15 amateur (AMA) cyclists. All cyclists performed an endogenous antioxidants analysis in the fasted state (visit 1) and an incremental test until exhaustion (visit 2). Higher values in catalase (CAT), oxidized glutathione (GSSG) and GSSG/GSH ratio and lower values in superoxide dismutase (SOD) were found in PRO compared to AMA (p < 0.05). Furthermore, an inverse correlation was found between power produced at ventilation thresholds 1 and 2 and GSSG/GSH (r = -0.657 and r = -0.635; p < 0.05, respectively) in PRO. Therefore, there is no well-defined endogenous antioxidant enzyme profile between the two competitive levels of cyclists. However, there was a relationship between GSSG/GSH ratio levels and moderate and submaximal exercise performance in the PRO cohort.

Incidental occurrence of an unusually large mastoid foramen on cone-beam computed tomography and review of the literature.

The incidental finding of an enlarged mastoid foramen on the right posterior mastoid region of temporal bone is reported, together with a discussion of its clinical significance. A 67-year-old female underwent the pre-implant assessment of a maxillary left edentulous region. A cone-beam computed tomographic (CBCT) image was acquired and referred for consultation. Axial CBCT slices revealed a unilateral, well-defined, noncorticated, low-attenuation, transosseous defect posterior to the mastoid air cells in the right temporal bone. The borders of the osseous defect were smooth and continuous. No other radiographic signs suggestive of erosion or sclerosis were noted in the vicinity. The density within the defect was homogenous and consistent with a foramen and/or soft tissue. The patient's history and physical examination revealed no significant medical issues, and she was referred to a neuroradiologist for a second opinion. The diagnosis of an enlarged mastoid foramen was made and the patient was reassured.

Potencialidades da succinil quitosana como emulsificante e substituto de fração lipídica em massa de bolo / Potentialities of succinyl chitosan as emulsifier and lipid fraction substitute on cake batter

A necessidade da criação de produtos inovadores com características funcionais está relacionada com a demanda de consumidores que priorizam o bem-estar vinculado a uma alimentação saudável e equilibrado. Nesse sentido, o objetivo deste estudo foi avaliar os efeitos da adição de succinil quitosana (SQ) como um substituto da fração lipídica e agente emulsificante sobre a qualidade de bolos. Para tanto, no capítulo 1 foi realizado um levantamento conciso da literatura para a compreensão dos temas abordados. No capítulo 2, o estudo da SQ se baseou na sua obtenção e caracterização para aplicaçãoem bolos. A análise de infravermelho e difração de raio X validaram as reações de desacetilação e succinilação, sendo que os estudos térmicos demonstraram estabilidade térmica (acima de 300 °C) viabilizando a utilização da SQ em produtos de panificação. A aplicação da suspensão de SQ (2,0 g/100 g) em massas de bolos com níveis reduzidos de gordura (0 % (controle), 25 %, 50 %, 75 % e 100 % (ausência total de gordura)) com ajustes na quantidade de água, para adaptação das consistências das massas, resultou em massas de bolos com parâmetros de viscosidade semelhantes. A redução de gordura até um nível de 50 % e presença de SQ contribuiu para o aumento da área 2D (de 13, 83 para 19,05 mm2) e razão largura/altura, além da umidade e atividade de água. A SQ influenciou significativamente (p < 0,05) na vida de prateleira, visto que a taxa de endurecimento foi de 27,8 (N/dia) para os bolos controle, e em bolos com nível de 25 % apresentou o valor de 26,1 (N/dia) e 49,2 (N/dia) para àqueles com presença total de SQ. Os teores de lipídeos diminuíram significativamente (p < 0,05), embora o conteúdo total de minerais e proteínas tenham apresentado ligeiras variações. Em relação à análise sensorial, foram atribuídas aos bolos com redução de até 50 % de gordura notas entre 6 e 7, e àqueles com 75 % de redução, nota inferior para os atributos de textura, sabor e aspecto geral. Dos provadores, 35 % "provavelmente comprariam" os bolos com 50 % de gordura. Nesse sentido, a SQ pode ser considerada um potencial substituto de gordura em bolos, podendo-se reduzir à metade a quantidade deste ingrediente em sua formulação original, agregando qualidades tecnológicas, sensoriais e nutricionais a esses produtos

The need to create innovative products with functional characteristics is related to the demand of consumers which prioritize the well-being combined to a healthy and balanced diet. In this sense, the objective of this study was to evaluate the effects of the addition of succinyl chitosan (SQ) as an emulsifying agent and lipid fraction substitute on the qualities of cakes. Therefore, in chapter 1 a concise survey of the literature was carried out to understand the themes covered. In chapter 2, the SQ study was based on its obtaining and characterization for application in cakes. Infrared analysis and X-ray diffraction validated the deacetylation and succinylation reactions, and the thermal studies demonstrated thermal stability (above 300 °C), allowing the use of SQ in bakery products. The application of SQ suspension (2.0 g / 100 g) with reduced levels of fat (0 % (control), 25 %, 50 %, 75 % and 100 %) adjusting the amount of water, to adapt the batter's consistencies, resulted in cakes with similar viscosity parameters. The reduction of fat up to 50 % and presence of SQ contributed to the increase of the 2D area (from 13,83 to 19,05 mm2) and width / height ratio, as well as moisture and water activity. SQ significantly influenced (p <0.05) shelf life, since the hardening rate was 27,8 (N / day) for control cakes, and in cakes with a 25% level the value was 26,1 (N / day) and 49.2 (N / day) for those with total presence of SQ. The lipid contents decreased significantly (p <0.05), although the total content of minerals and proteins showed slight variations. Regarding sensory analysis, scores between 6 and 7 were attributed to cakes with a fat reduction of up to 50%, and those with a 75% reduction were attributed a lower score, according to the attributes of texture, taste and overall appearance. From consumers, 35% "I would probably purchase" the cakes with 50% fat. In this sense, SQ may be considered a potential substitute for fat in cakes, and it can reduce the amount of this ingredient by half in its original formulation, adding technological, sensorial and nutritional qualities to these products

[Results of defunctionalized jejunal loop after pancreaticoduodenectomy]. / Resultados de la derivación con 2 asas tras duodenopancreatectomía cefálica.

INTRODUCTION: Anastomotic leak continues to be a common cause of complications after pancreaticoduodenectomy. Numerous surgical techniques have been described to avoid this complication. OBJECTIVE: We evaluated the use of a defunctionalized jejunal loop for the pancreas after pancreaticoduodenectomy. MATERIAL AND METHODS: Between 1991 and 2005, the findings in 80 patients were analyzed in this prospective study of the use of a defunctionalized jejunal loop for the pancreas as a reconstructive procedure following pancreaticoduodenectomy. All the patients were operated on by two surgeons. The following clinical variables were recorded: age, sex, diameter of the main pancreatic duct, pancreas texture, operating time, intraoperative blood transfusion, mean length of hospital stay, and operative mortality. Seven complications were defined: anastomotic leakage (biliary and duodenal), pancreatic fistula, abscess, sepsis, bleeding, delayed gastric emptying, and postoperative pancreatitis. Four different definitions were used for pancreatic fistula. RESULTS: Of the 80 patients, 16 (20%) developed pancreatic fistula according to at least one of the criteria used. Pancreatic fistula was more frequent in patients with a small duct (33.3%), and soft pancreatic texture (29%), and was the cause of 100% of intraabdominal hemorrhages, 80% of abdominal abscesses, and 60% of mortality. The mean length of hospital stay was 20.6 days and the mortality rate was 6.6% (5/80). During follow-up two patients developed pancreatitis. CONCLUSION: After pancreaticoduodenectomy, reconstruction with a defunctionalized jejunal loop for the pancreas is a safe and effective technique.

The role of thrombopoietin in the thrombocytopenia of patients with liver cirrhosis.

OBJECTIVES: Thrombocytopenia is a common disorder among cirrhotics that has been traditionally explained by splenic platelet pooling and destruction. Thrombopoietin (TPO), the main stimuli for thrombopoiesis is produced primarily in the liver and degraded by circulating platelets, but its role in the thrombocytopenia of liver cirrhosis is not well understood. The main goal of this study is to clarify the role of TPO in the pathogenesis of thrombocytopenia in cirrhosis. METHODS: The relation among TPO, platelet count, spleen size, portal hypertension, and liver function was studied in 33 cirrhotic patients before and after either partial splenic embolization or liver transplantation. RESULTS: Cirrhotics with thrombocytopenia had lower serum TPO levels than healthy controls (median values (interquartile range: ICR) were 120.7 (42.0-191.6) vs 756.4 (527.0-965.1) pg/mL, respectively; p<0.001). Among cirrhotics with thrombocytopenia, serum TPO was related to spleen size (rho=-0.387, p=0.046), but not to platelet count as occurs physiologically. After partial splenic embolization, TPO and platelet count increased significantly and the physiological relation between TPO and platelet count was restored (rho=-0.665, p=0.026). Similar results were observed after liver transplantation. CONCLUSIONS: Our results suggest that besides impaired production in the failing liver, an increased TPO degradation by platelets sequestered in the congested spleen may contribute to thrombocytopenia in cirrhotic patients.

[Evaluation of the transcription of locus rfb for the biosynthesis of LPS in Leptospira interrogans subtype hardjoprajitno]. / Evaluacion de la transcripción del locus rfb para la biosíntesis de LPS en Leptospira interrogans subtipo hardjoprajitno.

Plasmid pGL4W15-96 was constructed from the pGL4W74 vector without promoter for kanamycin and a sequence of 480pb containing the supposed J15 promoter with the objective of confirming the role of J15 sequence as a promoter for Leptospira, which restored the transcription of the gene of resistance to kanamycin in Escherichia coli and Leptospira biflexa, corroborating this way the function of the insertion as a promoter for both organisms.

Efficacy and toxicity of intra-arterial cisplatin and etoposide for advanced hepatocellular carcinoma.

OBJECTIVE: To analyze the results of an intra-arterially delivered combination chemotherapy in a group of patients with regionally advanced hepatocellular carcinoma (HCC). METHODS: 26 patients with proven locally advanced HCC treated with hepatic artery infusion of cisplatin (20 mg/m(2), days 1-5) and etoposide (75 mg/m(2), days 1-5) every 4 weeks were retrospectively studied. RESULTS: In an intention-to-treat analysis, overall and complete response rates were 38 and 7%, respectively. Median duration of response was 5 months. Median survival time was 10 months and survival rates at 6, 12 and 24 months were 53, 33 and 24%, respectively. Survival was significantly longer for responders than for non-responders (median: 13 and 3 months, respectively). There were 4 treatment-related deaths among cirrhotics. CONCLUSIONS: Intra-arterial chemotherapy using cisplatin and etoposide seems to have some anti-tumor effect against advanced HCC, although a high rate of life- threatening complications precludes the indication of this regimen at least for patients with non-compensated cirrhosis.