Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the ...prognosis. A multicenter, observational, descriptive and cross-sectional study of consecutive patients diagnosed with RA-ILD. Demographic, analytical, respiratory functional and evolution characteristics were analyzed to evaluate the predictors of progression and mortality. 106 patients were included. The multivariate analysis showed that the diagnostic delay was an independent predictor of mortality (HR 1.11, CI 1.01-1.23, p = 0.035). Also, age (HR 1.33, 95% CI 1.09-1.62, p = 0.0045), DLCO (%) (HR 0.85, 95% CI 0.73-0.98, p = 0.0246), and final SatO2 (%) in the 6MWT (HR 0.62, 95% CI 0.39-0.99, p = 0.0465) were independent predictor variables of mortality, as well as GAP index (HR 4.65, 95% CI 1.59-13.54, p = 0.0051) and CPI index (HR 1.12, 95% CI 1.03-1.22, p = 0.0092). The withdrawal of MTX or LFN after ILD diagnosis was associated with disease progression in the COX analysis (HR 2.18, 95% CI 1.14-4.18, p = 0.019). This is the first study that highlights the diagnostic delay in RA-ILD is associated with an increased mortality just like happens in IPF.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Breast cancer ranks first in women, and is the second cause of death in this gender. In addition to genetics, the environment contributes to the development of the disease, although the factors ...involved are not well known. Among the latter is the influence of microorganisms and, therefore, attention is recently being paid to the mammary microbiota. We hypothesize that the risk of breast cancer could be associated with the composition and functionality of the mammary/gut microbiota, and that exposure to environmental contaminants (endocrine disruptors, EDCs) might contribute to alter these microbiota.
We describe a case-control clinical study that will be performed in women between 25 and 70 years of age. Cases will be women diagnosed and surgically intervened of breast cancer (stages I and II). Women with antecedents of cancer or advanced tumor stage (metastasis), or who have received antibiotic treatment within a period of 3 months prior to recruitment, or any neoadjuvant therapy, will be excluded. Controls will be women surgically intervened of breast augmentation or reduction. Women with oncological, gynecological or endocrine history, and those who have received antibiotic treatment within a period of 3 months prior to recruitment will also be excluded. Blood, urine, breast tissue and stool samples will be collected. Data regarding anthropometric, sociodemographic, reproductive history, tumor features and dietary habits will be gathered. Metabolomic studies will be carried out in stool and breast tissue samples. Metagenomic studies will also be performed in stool and breast tissue samples to ascertain the viral, fungal, bacterial and archaea populations of the microbiota. Quantitation of estrogens, estrogen metabolites and EDCs in samples of serum, urine and breast tissue will also be performed.
This is the first time that the contribution of bacteria, archaea, viruses and fungi together with their alteration by environmental contaminants to the risk of breast cancer will be evaluated in the same study. Results obtained could contribute to elucidate risk factors, improve the prognosis, as well as to propose novel intervention studies in this disease.
ClinicalTrials.gov NCT03885648 , 03/25/2019. Retrospectively registered.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
There is a possibility that excess body fat affects bone mass gain and may compromise skeletal health in obese children. The purpose of the study was to identify the relationship between bone mineral ...density (BMD) and body composition in normal weight, overweight and obese children.
This was a cross-sectional study of 6- to 11-year-old children who attended the hospital's outpatient clinic. They were apparently healthy and had no history of prematurity, low birth weight, or chronic diseases. Body mass index (BMI) was used to identify subjects as normal weight, overweight or obese. BMD and body composition were assessed by dual energy X-ray absorptiometry. The BMD values (total and lumbar spine) were compared between normal weight, overweight and obese children. Correlation coefficients were calculated, and multivariate models were performed.
Forty-nine children were included: 16 with normal weight, 15 that were overweight and 18 with obesity; the mean age was 8.4 ± 1.7 years. All the participants had a normal BMD (> - 2 SD). BMD was higher in obese children and had a positive correlation with total and trunk lean mass in the three study groups (p < 0.001). In obese children, an inverse correlation of lumbar spine BMD (Z score) with total and trunk fat mass (p < 0.05) was identified. In the multivariate models (with the whole group), the total lean mass was the only significant variable that explained BMD variability.
BMD in obese children was higher than that in normal weight children, which is explained by their greater lean mass and not by excess body fat. In obese children, a higher fat mass was related to a lower lumbar spine BMD. Lean mass had a direct correlation with BMD in the three study groups and was the most important predictor of BMD, reflecting the importance of strengthening the muscular system through performing physical activity and practicing a healthy lifestyle.
TiO₂-ZnO-MgO mixed oxide nanomaterials (MONs) were synthetized via the sol-gel method and characterized by scanning electron microscopy (SEM) coupled with energy dispersive spectroscopy (EDS), ...transmission electron microscopy (TEM), nitrogen physisorption analysis, X-ray diffraction (XRD), UV-Vis diffuse reflectance spectroscopy (UV-Vis DRS), Fourier transform infrared spectroscopy (FTIR), and color (Luminosity (
),
,
, Chrome, hue) parameters. Furthermore, the antimicrobial activity of the MONs was tested against
(EC),
(SP),
(SA), and
(LM). The MONs presented a semi globular-ovoid shape of ≤100 nm. Samples were classified as mesoporous materials and preserved in the TiO₂ anatase phase, with slight changes in the color parameters of the MONs in comparison with pure TiO₂. The MONs exhibited antimicrobial activity, and their effect on the tested bacteria was in the following order: EC > SP > SA > LM. Therefore, MONs could be used as antimicrobial agents for industrial applications.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
•There is an unmet need for rescue therapies in patients with progressive RA-ILD who do not respond to csDMARDs or immunosuppressants.•RTX rescue therapy was able to reverse the decline of lung ...function parameters in a not negligible proportion of patients that develop a progressive fibrosing course•The use of RTX was well tolerated in the majority of patients.•RTX was associated with a high retention rate (around 74%) at the end of follow-up.
To assess the real-world, long-term effectiveness of rituximab (RTX) as a rescue therapy in patients with progressive rheumatoid arthritis-related interstitial lung disease (RA-ILD) in whom more conventional therapy has failed.
Longitudinal retrospective observational study of a cohort of patients with RA-ILD that started treatment with RTX due to ongoing progressive ILD despite treatment with glucocorticoids and csDMARDs or immunosuppressants (IS). All patients were treated with two or more cycles of RTX and evaluated for at least 12 months. Ongoing therapy with csDMARDs or IS remained unchanged.
Thirty-one patients were analyzed. Before initiation of RTX the mean decline (delta) in %pFVC and %pDLCO from the ILD diagnosis (median 21 months) was -16.5% and -19.7%, respectively. After 1 year of treatment, RTX was able to reverse the decline of pulmonary function test (PFTs) parameters: ∆%pFVC +8.06% compared to baseline (95% CI: -10.9 to -5.2; p<0.001) and ∆%pDLCO +12.7% (95% CI: -16.3 to -9.1; p<0.001). In addition, there was a significant reduction in the median dose of prednisone, and it could be suspended in 26% of cases. Dividing the population into UIP and non-UIP patterns, we observed a significant increase in PFTs parameters in both groups. In the 25 patients (80.6%) that completed 2 years of treatment, the statistically significant amelioration in PFTs parameters observed at one year was maintained: ∆%pFVC +11.2% (95% CI: -15.6 to -6.8; p<0.001) and ∆%pDLCO +14.8% (95% CI: -19.3 to -10.3; p<0.001). At the end of the follow-up period (median 32 months; IQR 25th–75th 26–64), only 23 of the 31 patients (74.2%) were still undergoing treatment with RTX: in 3 cases (10%) it was stopped due to adverse events, in another 3 (10%) treatment failed ultimately requiring a lung transplant, and 2 patients (6%) died due to progression of the ILD and infectious complications. The frequency of adverse events reached 32% of cases.
Based on our results, RTX appears to be effective as rescue therapy in a considerable proportion of patients with progressive RA-ILD unresponsive to conventional treatment.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Dieulafoy's lesion of the small bowel is an uncommon cause of gastrointestinal (GI) bleeding that often recurs after endoscopic treatment.
we report an observational, descriptive, retrospective, ...single-center study in 15 patients with small bowel bleeding who were diagnosed with a Dieulafoy's lesion by capsule endoscopy or double-balloon enteroscopy.
all patients underwent combined endoscopic treatment. During a median follow-up of 33.5 months (range, 2-145), three of the 12 cases that stayed in follow-up (25 %) recurred, all within 48 hours after treatment. Two were successfully re-treated with a repeat endoscopic procedure.
Justificación: En Colombia, el comercio de especies de fauna silvestre sin la documentación necesaria es prohibido por ley, por lo que, en el contexto de una investigación penal sobre venta de ...reptiles a través de internet, como parte de una diligencia de allanamiento y registro, se realizó el procesamiento del lugar de los hechos. Objetivo: realizar la asignación taxonómica más probable utilizando análisis genético en muestras biológicas recolectadas del lugar de los hechos para establecer la presencia de reptiles, dada la ausencia de animales en el momento del allanamiento. Métodos: se recolectaron seis muestras biológicas que incluyeron un trozo de muda de piel, hisopados de superficies y materia fecal, para su posterior procesamiento siguiendo los protocolos de análisis establecidos. Se realizó extracción de ADN empleando sílice y se amplificó un marcador mitocondrial 12S-120pb; los fragmentos resultantes fueron secuenciados y las secuencias fueron comparadas con la información disponible en la base de datos Genbank mediante el algoritmo BLASTn. Resultados y discusión: a partir de los datos obtenidos de la comparación realizada, 100% de cobertura y 100% de identidad y tras analizar las características de cada grupo taxonómico y la información genética disponible se realizó la asignación taxonómica. En la muestra de muda de piel se encontró dificultad para la amplificación y secuenciación de todo el fragmento, lo que limitó el empleo de marcadores de mayor tamaño, sin embargo, a partir de la información obtenida se logró la identificación de la especie Boa constrictor (boa común); en el caso de la materia fecal y los hisopados se determinó la presencia de muestras provenientes de grupos taxonómicos comúnmente empleados para alimentación de algunas especies de reptiles, como Mus musculus (ratón común) y el género Rattus (especies de ratas). Conclusión: El marcador mitocondrial 12S-120pb empleado en este caso resultó exitoso para la obtención de secuencias a partir de muestras forenses, sin embargo, la utilización de cualquier marcador para la asignación taxonómica depende en gran medida de la información disponible y las características propias de cada grupo taxonómico.
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