Over the last several decades, there has been a tendency towards a predominance of less symptomatic forms of coeliac disease (CD) and an increase in the patient age at diagnosis. This study aimed to ...assess the clinical presentation and diagnostic process of paediatric CD in Spain.
A nationwide prospective, observational, multicentre registry of new paediatric CD cases was conducted from January 2011 to June 2017. The data regarding demographic variables, type of birth, breastfeeding history, family history of CD, symptoms, height and weight, associated conditions, serological markers, human leukocyte antigen (HLA) phenotype, and histopathological findings were collected.
In total, 4,838 cases (61.0% female) from 73 centres were registered. The median age at diagnosis was 4.0 years. Gastrointestinal symptoms were detected in 71.4% of the patients, and diarrhoea was the most frequent symptom (45.9%). The most common clinical presentation was the classical form (65.1%), whereas 9.8% of the patients were asymptomatic. There was a trend towards an increase in the age at diagnosis, proportion of asymptomatic CD cases, and usage of anti-deamidated gliadin peptide antibodies and HLA typing for CD diagnosis. However, there was a decreasing trend in the proportion of patients undergoing biopsies. Some of these significant trend changes may reflect the effects of the 2012 ESPGHAN diagnosis guidelines.
Paediatric CD in Spain is evolving in the same direction as in the rest of Europe, although classical CD remains the most common presentation form, and the age at diagnosis remains relatively low.
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Our study sought to know the current implementation of video-assisted thoracoscopic surgery (VATS) for anatomical lung resections in Spain. We present our initial results and describe ...the auditing systems developed by the Spanish VATS Group (GEVATS).
We conducted a prospective multicentre cohort study that included patients receiving anatomical lung resections between 12/20/2016 and 03/20/2018. The main quality controls consisted of determining the recruitment rate of each centre and the accuracy of the perioperative data collected based on six key variables. The implications of a low recruitment rate were analysed for “90-day mortality” and “Grade IIIb-V complications”.
The series was composed of 3533 cases (1917 VATS; 54.3%) across 33 departments. The centres’ median recruitment rate was 99% (25–75th:76–100%), with an overall recruitment rate of 83% and a data accuracy of 98%. We were unable to demonstrate a significant association between the recruitment rate and the risk of morbidity/mortality, but a trend was found in the unadjusted analysis for those centres with recruitment rates lower than 80% (centres with 95–100% rates as reference): grade IIIb-V OR=0.61 (p=0.081), 90-day mortality OR=0.46 (p=0.051).
More than half of the anatomical lung resections in Spain are performed via VATS. According to our results, the centre's recruitment rate and its potential implications due to selection bias, should deserve further attention by the main voluntary multicentre studies of our speciality. The high representativeness as well as the reliability of the GEVATS data constitute a fundamental point of departure for this nationwide cohort.
Nuestro estudio buscó conocer el grado de implementación actual de la cirugía toracoscópica asistida por video (VATS, por sus siglas en inglés) para las resecciones pulmonares anatómicas en España. Presentamos nuestros resultados iniciales y describimos los sistemas de auditoría desarrollados por el grupo español de VATS (GEVATS).
Realizamos un estudio de cohortes prospectivo multicéntrico que incluyó pacientes que fueron tratados con resecciones pulmonares anatómicas entre el 20/12/2016 y el 20/03/2018. Los controles de calidad principales consistieron en determinar la tasa de reclutamiento de cada centro y la precisión de los datos perioperatorios recolectados en base a seis variables clave. Se analizaron las implicaciones de una baja tasa de reclutamiento para “mortalidad a los 90 días” y “complicaciones de grado IIIb-V”.
La serie estaba compuesta por 3533 casos (1917 VATS; 54,3%) en 33 servicios. La mediana de la tasa de reclutamiento de los centros fue del 99% (p25-p75: 76-100%), con una tasa de reclutamiento global del 83% y una precisión de los datos del 98%. No pudimos demostrar una asociación significativa entre la tasa de reclutamiento y el riesgo de morbi-mortalidad, pero se encontró una tendencia en el análisis no ajustado para aquellos centros con tasas de reclutamiento inferiores al 80% (usando los centros con tasas de 95-100% como referencia): OR=0,61 para el grado IIIb-V (p=0,081), OR=0,46 para la mortalidad a los 90 días (p=0,051).
Más de la mitad de las resecciones pulmonares anatómicas en España se realizan a través de VATS. Según nuestros resultados, la tasa de reclutamiento del centro y sus posibles implicaciones debido al sesgo de selección, deberían recibir más atención por parte de los principales estudios multicéntricos voluntarios de nuestra especialidad. La alta representatividad y la confiabilidad de los datos de GEVATS constituyen un punto de partida fundamental para esta cohorte nacional.
Thermogenesis and heat generating tissues in inflorescences of the giant taro (
Alocasia macrorrhizos
(L.) G. Don) were studied from December 2005 to February 2006, on the Island of Espiritu Santo, ...Vanuatu. Temperatures were recorded in the ambient air, in the peduncle tissue, and on 12 positions within spadices during periods of maximum thermogenic activity, in the early morning hours of the female and male phases. The study showed that there were three thermogenic tissues: the sterile appendix, the fertile male part, and the differentiated sterile area below the fertile male part. During the female phase, heat was generated by the sterile appendix and the differentiated sterile area below the fertile male part, the smallest region of the spadix (mean ± SD = 0.86 ± 0.24 cm, 3.17% of the spadix length), and most probably by the fertile male part. Within the spadix, average temperatures gradually increased from the base of the female part and reached the first peak at the midpoint of the differentiated sterile area below the fertile male part (36.11 ± 1.54 °C). After that, they gradually decreased towards the midpoint of the fertile male part and increased again, reaching a second (main) peak at 1/4 of the sterile appendix height (44.83 ± 1.87 °C). From 1/4 to 1/2 of the appendix height they remained at more or less the same level, and then they decreased towards the tip of the spadix. During the male phase, heat was generated only within the fertile male part.
Celotno besedilo
Dostopno za:
BF, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The thermogenesis and flowering biology of Colocasia gigantea (Blume) Hook. f. were studied from December 2005 to February 2006 on Espiritu Santo, Vanuatu (South Pacific). Endogenous thermogenesis ...was measured in two ways: (1) continuously over 5-day periods, and (2) over 3 h during maximum heating. The study showed that heat was generated by the male part of the spadix and probably the lower zone of the sterile region. The temperatures of the male part peaked twice: (1) between 0625 and 0640 (during the female phase) and (2) 24 h later (during the male phase). The average maximum temperature was 42.25+-0.14degC during the female phase (16.63degC above the ambient temperature) and 35.14+-0.22degC during the male phase (10.61degC above the ambient temperature). In the lower zone of the sterile region, thermogenesis was documented only during the female phase. The average maximum temperature was 35.44+-0.41degC (9.82degC above the ambient temperature). Thermogenic heating appeared to be closely associated with the activities of pollinating insects.
Spanish National Registry of Paediatric Coeliac Disease Pérez Solís, David; Cilleruelo Pascual, Ma Luz; Ochoa Sangrador, Carlos ...
Journal of pediatric gastroenterology and nutrition,
June 2022, Letnik:
74, Številka:
6
Journal Article
Recenzirano
ABSTRACT
Objectives:
Over the last several decades, there has been a tendency towards a predominance of less symptomatic forms of coeliac disease (CD) and an increase in the patient age at diagnosis. ...This study aimed to assess the clinical presentation and diagnostic process of paediatric CD in Spain.
Methods:
A nationwide prospective, observational, multicentre registry of new paediatric CD cases was conducted from January 2011 to June 2017. The data regarding demographic variables, type of birth, breast‐feeding history, family history of CD, symptoms, height and weight, associated conditions, serological markers, human leukocyte antigen (HLA) phenotype, and histopathological findings were collected.
Results:
In total, 4838 cases (61% girls) from 73 centres were registered. The median age at diagnosis was 4 years. Gastrointestinal symptoms were detected in 71.4% of the patients, and diarrhoea was the most frequent symptom (45.9%). The most common clinical presentation was the classical form (65.1%) whereas 9.8% ofthe patients were asymptomatic. There was a trend towards an increase in the age at diagnosis, proportion of asymptomatic CD cases, and usage of anti‐deamidated gliadin peptide antibodies and HLA typing for CD diagnosis. There was, however, a decreasing trend in the proportion of patients undergoing biopsies. Some of these significant trend changes may reflect the effects of the 2012 ESPGHAN diagnosis guidelines.
Conclusions:
Paediatric CD in Spain is evolving in the same direction as in the rest of Europe, although classical CD remains the most common presentation form, and the age at diagnosis remains relatively low.
African trypanosomiasis is a deadly neglected disease caused by the extracellular parasite Trypanosoma brucei. Current therapies are characterized by high drug toxicity and increasing drug resistance ...mainly associated with loss-of-function mutations in the transporters involved in drug import. The introduction of new antiparasitic drugs into therapeutic use is a slow and expensive process. In contrast, specific targeting of existing drugs could represent a more rapid and cost-effective approach for neglected disease treatment, impacting through reduced systemic toxicity and circumventing resistance acquired through impaired compound uptake. We have generated nanoparticles of chitosan loaded with the trypanocidal drug pentamidine and coated by a single domain nanobody that specifically targets the surface of African trypanosomes. Once loaded into this nanocarrier, pentamidine enters trypanosomes through endocytosis instead of via classical cell surface transporters. The curative dose of pentamidine-loaded nanobody-chitosan nanoparticles was 100-fold lower than pentamidine alone in a murine model of acute African trypanosomiasis. Crucially, this new formulation displayed undiminished in vitro and in vivo activity against a trypanosome cell line resistant to pentamidine as a result of mutations in the surface transporter aquaglyceroporin 2. We conclude that this new drug delivery system increases drug efficacy and has the ability to overcome resistance to some anti-protozoal drugs.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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El objetivo es obtener un modelo predictor de riesgo quirúrgico en pacientes sometidos a resecciones pulmonares anatómicas a partir del registro del Grupo Español de Cirugía Torácica ...Videoasistida.
Se recogen datos de 3.533 pacientes sometidos a resección pulmonar anatómica por cualquier diagnóstico entre el 20 de diciembre de 2016 y el 20 de marzo de 2018.
Definimos una variable resultado combinada: mortalidad o complicación Clavien Dindo IV a 90 días tras intervención quirúrgica. Se realizó análisis univariable y multivariable por regresión logística. La validación interna del modelo se llevó a cabo por técnicas de remuestreo.
La incidencia de la variable resultado fue del 4,29% (IC 95%: 3,6-4,9). Las variables que permanecen en el modelo logístico final fueron: edad, sexo, resección pulmonar oncológica previa, disnea (mMRC), neumonectomía derecha y DLCOppo. Los parámetros de rendimiento del modelo, ajustados por remuestreo, fueron: C-statistic 0,712 (IC 95%: 0,648-0,750), Brier score 0,042 y Booststrap shrinkage 0,854.
El modelo predictivo de riesgo obtenido a partir de la base de datos Grupo Español de Cirugía Torácica Videoasistida es un modelo sencillo, válido y fiable, y constituye una herramienta muy útil a la hora de establecer el riesgo de un paciente que se va a someter a una resección pulmonar anatómica.
The aim of this study was to develop a surgical risk prediction model in patients undergoing anatomic lung resections from the registry of the Spanish Video-Assisted Thoracic Surgery Group (GEVATS).
Data were collected from 3,533 patients undergoing anatomic lung resection for any diagnosis between December 20, 2016 and March 20, 2018.
We defined a combined outcome variable: death or Clavien Dindo grade IV complication at 90 days after surgery. Univariate and multivariate analyses were performed by logistic regression. Internal validation of the model was performed using resampling techniques.
The incidence of the outcome variable was 4.29% (95% CI 3.6-4.9). The variables remaining in the final logistic model were: age, sex, previous lung cancer resection, dyspnea (mMRC), right pneumonectomy, and ppo DLCO. The performance parameters of the model adjusted by resampling were: C-statistic 0.712 (95% CI 0.648-0.750), Brier score 0.042 and bootstrap shrinkage 0.854.
The risk prediction model obtained from the GEVATS database is a simple, valid, and reliable model that is a useful tool for establishing the risk of a patient undergoing anatomic lung resection.
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