BackgroundPosterior reversible encephalopathy syndrome (PRES) is a well-known but rare complication in patients (<1%) with systemic lupus erythematosus (SLE). However, current epidemiological data ...are quite scant. The aim of the present study was to describe potentially unrecognised risk factors.Patients and methodsWe performed a multicentre, retrospective case–control study in Mexico between 1999 and 2014. We included a total of 168 patients who accounted for 77 episodes of PRES, as follows: SLE/PRES, 43 patients with 48 episodes; SLE without PRES, 96 patients; and PRES without SLE, 29 patients. SLE diagnosis was considered when patients fulfilled ≥4 American College of Rheumatology criteria. PRES was defined by reversible neurological manifestations and MRI changes.ResultsPatients with SLE/PRES were younger, presented with seizures as the most common manifestation (81%) and 18% had the typical occipital MRI finding. Hypertension (OR=16.3, 95% CI 4.03 to 65.8), renal dysfunction (OR=6.65, 95% CI 1.24 to 35.6), lymphopenia (OR=5.76, 95% CI 1.36 to 24.4), Systemic Lupus Erythematosus Activity Index ≥ 6 points (OR=1.11, 95% CI 1.01 to 1.22) and younger age (OR=0.86, 95% CI 0.81 to 0.91, p<0.001) were independent risk factors for development of PRES in SLE. Furthermore, dyslipidemia also characterised the association between PRES and SLE (OR=10.6, 95% CI 1.17 to 96.4).ConclusionsThis is the largest reported series of patients with SLE and PRES. We were able to corroborate the known risk factors for of PRES, and found two previously undescribed factors (lymphopenia and dyslipidemia), which suggests that endothelial dysfunction is a key element in PRES pathogenesis in lupus patients.
Knowledge on the specific variation in the phenolic composition of wheat defined by germination conditions and its relationship with antioxidant and anti-inflammatory properties of sprouts would be ...useful to improve the functional value of wheat-derived products. Variation in soluble phenolic composition, antioxidant and anti-inflammatory potential of wheat was examined in a range of germination temperature (12-21 °C) and time (1-7 d). Response surface methodology was applied for building lineal and quadratic models to find optimal germination conditions to improve nutraceutical value of wheat sprouts using the desirability (
) function. Phenolics were determined by HPLC-DAD-ESI-MS.
biochemical methods and lipopolysaccharide stimulated RAW264.7 macrophages were used to determine antiradical and anti-inflammatory activities of wheat sprouts. Accumulation of soluble phenolic acids, flavone
-glycosides and lignans in sprouts was positively influenced by germination temperature and time. Increased concentration of individual polyphenols was directly associated with improved ability of sprouts for radical scavenging and reduction of tumor necrosis factor α and interleukin 6 in macrophages. Optimal desirability (
= 0.89) for improved nutraceutical value of wheat sprouts was achieved at 21 °C for 7 d. This information would be useful for food industry aiming at producing wheat-based products with better nutritional and healthy properties.
Purpose
Ewe’s milk yogurt is richer in proteins, minerals and short- and medium-chain fatty acids compared to cow’s milk yogurt. We aimed to evaluate the effects of cow’s milk yogurt (CW, 3.0% fat), ...semi-skimmed (ES, 2.8% fat) and whole ewe’s milk yogurts (EW, 5.8% fat) on inflammatory markers and gut microbiota in subjects with borderline-high plasma cholesterol.
Methodology
30 adults (16 women) were randomized into a crossover study to consume 250 g/yogurt/day during three 5-week periods (4-week washouts). Plasma insulin, leptin, adhesion molecules, cytokines and gut microbiota composition (qPCR) were analysed. Rates of change were used to assess treatment effects both in the whole group and in subgroups of subjects with different cholesterol/HDL-c ratio (Cho-I group A: the top 6 women and 4 men values; Cho-I group B: remaining subjects).
Results
The yogurts showed no different effects on the inflammatory biomarkers or the microbiota of the whole group. However, ICAM-1 and P-selectin rates of change were lower after EW compared to CW and ES, respectively, in subjects of the Cho-I group A (
P
= 0.047 and
P
= 0.020). Women of this group showed lower MCP-1 rates of change after EW compared to ES and CW (
P
= 0.028, both).
Blautia coccoides–Eubacterium rectale
decreased in women of the Cho-I group A during EW vs. ES (
P
= 0.028).
Conclusion
Ewe’s yogurt effects on inflammatory markers and microbiota were not different from those after cow’s yogurt, but the attenuation of some inflammatory biomarkers with ewe’s whole-milk yogurt in subjects with the highest TC/HDL-c deserves further study.
Background
Colchicine is an available, safe, and effective anti-inflammatory drug and has been suggested as a COVID-19 treatment, but its usefulness in hospitalized severe COVID-19 patients has not ...been thoroughly demonstrated.
Objective
To address the safety and efficacy of colchicine in hospitalized patients with severe COVID-19.
Design
We conducted a triple-blind parallel non-stratified placebo-controlled clinical trial.
Participants
We recruited 116 hospitalized patients with severe COVID-19 in Mexico.
Interventions
Patients were randomized to receive 1.5 mg of colchicine or placebo at the time of the recruitment in the study (baseline) and 0.5 mg BID PO to complete 10 days of treatment.
Main Measures
The primary composite outcome was the progression to critical disease or death. Besides, we evaluated immunological features at baseline and after recovery or disease progression in 20 patients.
Key Results
Fifty-six patients were allocated to colchicine and 60 patients received placebo. The study was suspended after the second interim analysis demonstrated colchicine had no effect on the primary outcome (OR 0.83, 95%CI 0.35–1.93,
P
= 0.67), nor in the days of ICU and hospital stays. Adverse events were similar between groups (OR 1.63, 95% CI 0.66–3.88,
P
= 0.37). After colchicine treatment, patients had higher BUN and lower serum levels of IL-8, IL-12p70, and IL-17A.
Conclusions
Colchicine is safe but not effective in the treatment of severe COVID-19.
Trial Registration
ClinicalTrials.gov Identifier: NCT04367168.
Up to 30% of patients with celiac disease (CD) suffer from concurrent autoimmune disease, compared to 3% of the general population. The association between CD and the current clinical phenotypes of ...inflammatory myopathies (IIM) patients has not been thoroughly addressed. Assess the CD features among patients with IIM and their relationship with the clinical phenotype and the myositis specific (MSA) and associated antibodies (MAA). For this cross-sectional study, we recruited 99 adult patients classified as IIM from a tertiary center in Mexico. We assessed serum MSA, MAA, and CD-associated autoantibodies (IgA anti-tissue transglutaminase (tTG) and both IgA and IgG anti-deaminated gliadin peptide (DGP)). Patients with highly suggestive serology for CD were then tested for IgG anti-endomysium antibodies, and a duodenal biopsy was performed. 70.7% of patients were positive for at least one antibody. Nine duodenal biopsies were taken, revealing findings compatible with celiac disease in two cases. Subjects with anti-MDA5 antibodies were more likely to have positive anti-tTG IgA antibodies (OR 6.76, 95% CI 1.85–24.62,
P
= 0.013) and suggestive CD serology (OR 6.41, 95% CI 1.62–25.29,
P
= 0.009). Patients with anti-Mi2 antibodies were more likely to have positive anti-DGP IgG antibodies (OR 3.35, 95% CI 1.12–9.96,
P
= 0.039), while positivity for these autoantibodies was less frequent in patients with anti-NXP2 antibodies (OR 0.22, 95% CI 0.06–0.80,
P
= 0.035). There is a higher prevalence of serologic and definite CD in patients with IIM compared to the general population. Identifying this subgroup of patients may have prognostic and therapeutic implications.
Key points
• The study estimated a serological celiac disease
(
CD
)
prevalence of 70.7% in patients with idiopathic inflammatory myopathies
(
IIM
)
and a biopsy-confirmed prevalence of 2%, suggesting that IIM patients should be considered a high-risk population for CD.
• We identified a significant association between serological CD and the presence of anti-MDA5 and anti-Mi2 antibodies, suggesting a potential justification for celiac disease screening in this specific subgroup of patients.
• The impact of gluten-free diets on IIM patients with serological markers of CD remains untested and warrants further investigation through prospective, randomized studies.
Associative classification is a pattern recognition approach that integrates classification and association rule discovery to build accurate classification models. These models are formed by a ...collection of contrast patterns that fulfill some restrictions. In this paper, we introduce an experimental comparison of the impact of using different restrictions in the classification accuracy. To the best of our knowledge, this is the first time that such analysis is performed, deriving some interesting findings about how restrictions impact on the classification results. Contrasting these results with previously published papers, we found that their conclusions could be unintentionally biased by the restrictions they used. We found, for example, that the jumping restriction could severely damage the pattern quality in the presence of dataset noise. We also found that the minimal support restriction has a different effect in the accuracy of two associative classifiers, therefore deciding which one is the best depends on the support value. This paper opens some interesting lines of research, mainly in the creation of new restrictions and new pattern types by joining different restrictions.
Objective
To describe the first pediatric case in the literature of neuropathic inguinal pain secondary to iatrogenic nerve injury that occurred during a laparoscopic appendectomy, detailing clinical ...and morphological findings before and after surgery. The literature on adult patients is reviewed and pathophysiological, therapeutic, and prognostic factors are discussed.
Clinical presentation
A 14-year-old female patient presented with a history of a laparoscopic appendectomy 3 years previously. Three months post-operatively, she developed progressively worsening neuropathic inguinal pain refractory to neuromodulators and several nerve blocks. Given her deterioration, poor response to conservative therapy, and clearly meeting the criteria for chronic post-operative inguinal pain (CPIP), surgical management was undertaken.
Results
Open surgery was performed through the previous incision, during which injury to a branch of the iliohypogastric nerve (IH) was confirmed. Neurolysis of the affected branch was performed, after which the patient experienced significant pain relief, resolution of allodynia, and reversal of skin hyperpigmentation. After discharge, analgesic therapy was gradually withdrawn and, ultimately, discontinued altogether.
Conclusions
Understanding the neuroanatomy of the inguinal region is an indispensable requirement for all surgeons operating in this region, to avoid complications including CPIP and optimize patient outcomes. Surgical management of CPIP can be effective for controlling severe pain in patients in whom conservative management has failed. Studies are needed in the pediatric population to identify specific characteristics of this entity in youth.
Recently, neutrophil extracellular traps (NETs), three-dimensional structures formed of neutrophil enzymes such as neutrophil elastase (NE) and nuclear components (DNA), have been associated with ...progression in different types of cancer. However, data remain scarce in breast cancer. Thus, the aim of this study was to associate NETs with clinical stages of breast cancer. A prospective analysis was performed in 45 plasma samples of female patients with newly diagnosed breast cancer. NE-DNA complexes were evaluated by ELISA. Optical density was dichotomized at the median for comparisons (low and high levels of NE-DNA). The most frequent clinical stage was localized (
n
= 28, 62%) followed by regional (
n
= 13, 29%) and distant (
n
= 4, 9%). Higher levels of NE-DNA complexes were observed in regional and distant stages compared to localized disease (68% vs 32%,
p
= 0.034). No differences were observed when comparing other clinical characteristics between both groups. We demonstrated that the levels of NETs increase in proportion to the stage of the disease, observing higher levels of NE-DNA complexes in regional and metastatic disease, which coincides with the proposed mechanism by which cancer progression and metastasis might result from the formation of NETs.
Oficialmente terminado el conflicto armado -pero todavía presente en muchas comunidades del país- la sociedad colombiana busca ahora la manera de garantizar una cohesión social plural para alcanzar ...la paz. Tal cohesión no puede realizarse sin la inclusión de los otros que se han considerado enemigos durante la guerra. Mediante el análisis de cuatro obras pertenecientes a géneros distintos de la literatura colombiana -drama (Donde se descomponen las colas de los burros, de Carolina Vivas), novela (Los ejércitos, de Evelio Rosero y Los informantes de Juan Gabriel Vásquez) y periodismo poético (Los escogidos, de Patricia Nieto)- exploro las estrategias éticas y estéticas que ofrecen para cuestionar la dicotomía entre víctima y victimario, propia del cosmopolitismo universalizante, y para apelar a la participación activa de los lectores tanto en el acto de la lectura como en el proceso de paz. Este análisis propone el ejercicio de la memoria agonista y la perspectiva decolonial como recursos ético-políticos eficaces para la autocrítica y la inclusión social de los otros conflictivos en Colombia. Keywords: lector, Colombia, conflicto, memoria agonísta, paz, discurso decolonial
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