Summary
Aims
To evaluate in a real‐world setting the effectiveness of two drugs, orlistat and liraglutide, in patients with overweight or obesity and insufficient weight loss (WL) after a lifestyle ...modification programme.
Methods
Retrospective, observational cohort study comparing clinical outcomes of orlistat 120 mg three times a day and liraglutide (up to 3 mg daily) in adult patients with BMI ≥30 kg/m2 or ≥27 kg/m2 with at least a weight‐related comorbidity who had failed to lose at least 5% of their weight after 6 months of lifestyle modification. The co‐primary end‐points, assessed at 3‐6 months and at the end of the follow‐up, were weight change from baseline, proportion of patients who lost at least 5% of their baseline weight and adjusted differences in WL between both drugs.
Results
Five hundred patients, 400 in the group of orlistat (age 47.0, weight 107.8 kg) and 100 in the group of liraglutide (age 51.9 years, weight 105.1 kg), were included. Treatment with both drugs significantly reduced weight, fasting plasma glucose, systolic BP, low‐density lipoprotein‐cholesterol and alanine transaminase over a median follow‐up period of 7 months. WL with liraglutide (−7.7 kg) was significantly greater than that observed with orlistat (−3.3 kg), and more individuals lost at least 5% of their baseline weight with liraglutide (64.7%) than with orlistat (27.4%). Rates of prediabetes significantly decreased with liraglutide in comparison to orlistat.
Conclusions
In this real‐world study, liraglutide showed a greater effectiveness in WL compared with orlistat and improved several obesity‐associated metabolic and cardiovascular risk factors.
Aim
The Rome IV criteria for the diagnosis of functional constipation are one month, compared with two months in the Rome III criteria. Our aim was to see whether this altered the prevalence in ...Ecuador by surveying school children and comparing the results to our previous study.
Methods
A cross‐sectional study was conducted in Quito, Ecuador, in 2013 two randomly selected schools: one private and one public. Children aged 8–15 completed the Spanish version of the Questionnaire of Paediatric Gastrointestinal Symptoms based on the Rome IV criteria. We compared our findings with our previous 2013 study based on the Rome III criteria.
Results
A total of 951 children (61% male) completed the Rome IV questionnaire from June to July 2017 at a mean age of 11.2 ± 1.8 years, and 417 children (52% male) completed the Rome III questionnaire in June 2013 at a mean age of 12.0 ± 1.8 years. We found that 14.4% met the Rome IV criteria for functional constipation compared with 11.8% for the Rome III criteria (p = 0.11).
Conclusion
Modifying the time required for a diagnosis functional constipation from two months to one month did not result in a significant difference in the prevalence.
Background
The diagnosis of functional constipation (FC) is based on the Rome criteria. The last edition of the criteria (Rome IV) for infants and toddlers modified the criteria to differentiate ...toilet‐trained (TT) and non‐toilet‐trained (NTT) children. These changes have not been validated. We aimed to understand the impact of adding toilet training to the diagnostic criteria and to assess the prevalence of FC.
Methods
Parents of infants and toddlers from six outpatient clinics (four public, two private) located in three geographically dispersed cities in Colombia completed validated questionnaires to diagnose functional gastrointestinal disorders according to Spanish version of Rome IV criteria (QPGS‐IV).
Results
A total of 1334 children (24.4 months ±15.0) participated: 482 (36%) TT and 852 (64%) NTT. The prevalence of FC was 21.1%. The prevalence increased with age, 0‐1 years 7.7%; 2 years 18.2%; 3 years 23.7%; and 4 years 37.2%. TT vs NTT for FC 41.9% vs 9.3%, respectively (OR 7.06, 95% CI 5.26‐9.47, P < .0001). TT more likely to report ≥ 3 criteria (OR = 2.43, 95% CI 1.41‐4.21, P = .0015). 18.3% of TT had episodes of fecal incontinence that met the frequency required by Rome for FC (≤1 episode/week). However, 87.1% had fecal incontinence less often. 7.4% of them characterized as large quantity.
Conclusion
We found no changes in the prevalence of FC using the Rome IV criteria vs Rome III. TT children are more likely to have FC. Study suggests that changes in Rome IV criteria were potentially clinically relevant and to have adequate face validity. Future studies should confirm our findings.
The diagnosis of functional constipation (FC) is based on the Rome criteria. The last edition of the criteria (Rome IV) for infants and toddlers modified the criteria to differentiate toilet‐trained (TT) and non‐toilet‐trained (NTT) children. We aimed to understand the impact of adding toilet training to the diagnostic criteria and to assess the prevalence of FC. We found that TT children are more likely to have FC, and there were no changes in the prevalence of FC using the Rome IV criteria vs Rome III.
Background
Multiple psychological factors influence disorders of gut–brain interaction (DGBIs). We aimed to evaluate psychological distress in Colombian schoolchildren with and without DGBIs.
Methods
...We included children ages 8–18 years without organic medical conditions from largest regional public schools in Colombia. Children completed Spanish versions of Rome III diagnostic questionnaire for DGBIs, State Trait Anxiety Inventory for Children (STAIC), Children's Somatization Inventory (CSI), and a measure of coping efficacy. These data, demographic and socioeconomic characteristics, were compared between children with DGBIs and healthy peers. Exploratory analyses investigated differences between youth with symptoms of functional abdominal pain disorders (FAPDs) compared with healthy peers.
Key Results
Of 1496 children, 281 (mean age 12.9 ± 2.2 years, 49.8% females) self‐reported criteria for DGBIs and 125 reported (44.5%) FAPDs. Children with DGBIs had higher trait anxiety, emotional sensitivity, somatization including GI, non‐GI, pain‐related, and non‐pain‐related subscales (p < 0.001 each) and lower coping efficacy (p = 0.02) compared to healthy peers. Females had higher trait anxiety and somatization (p = 0.04 and p = 0.005, respectively). State and trait anxiety and coping efficacy differed based on location in children with DGBIs (p = 0.02, p = 0.03, and p < 0.001, respectively). Children with FAPDs had higher trait anxiety (p = 0.02) and somatization (p < 0.001) compared to healthy youth.
Conclusions & Inferences
Children with DGBIs had higher anxiety, emotional sensitivity, and somatization, and lower coping efficacy compared with healthy youth. This highlights the importance of appraising psychological distress characteristics as well as incorporating conflict resolution, assertiveness training, and resilience building during the treatment of DGBIs.
School‐aged children with disorders of gut–brain interaction and more so Functional Abdominal Pain Disorders reported higher rates of trait anxiety, somatization, emotional sensitivity and lower coping efficacy compared with healthy peers. This emphasizes the role of psychological functioning in DGBIs and FAPDs and need for specialized screening and treatments for outcome optimization.
This book analyzes the genesis and evolution of the late Gothic painting in the Crown of Aragon and the Hispanic kingdoms, examining this phenomenon in relation to the whole context of Europe in the ...second half of the fifteenth century.
En el presente artículo se da a conocer un tríptico pseudoflamenco pintado hacia finales del siglo XIX o inicios del XX por Joseph Van der Veken (1872-1964), un restaurador, copista y falsificador de ...Amberes mundialmente conocido por su habilidad en la reproducción de pinturas flamencas. La realización de esta obra se inscribe en el contexto de revaloración de la pintura flamenca de los siglos XV y XVI, que generó una producción a gran escala de falsificaciones debido a la gran demanda existente en el mercado europeo. Estas obras espurias también se comercializaron en España, llegando a introducirse en colecciones importantes y pasando inadvertidas a ojos expertos. En el caso que nos ocupa, el tríptico de Van der Veken, entonces propiedad del coleccionista Francisco de Paula Arróspide Álvarez, XIII Conde de La Revilla, llegó a exhibirse como un original en la Exposición Internacional de Barcelona de 1929.
Objectives To determine prevalence for functional gastrointestinal disorders (FGIDs) in Colombian school children using the Questionnaire on Pediatric Gastrointestinal Symptoms–Rome III Version ...(QPGS-III) and to determine possible risk factors. Study design The QPGS-III was translated into Spanish then reverse translated by a team of bilingual physicians. Focus groups of Colombian children were conducted to assure understanding of the Spanish version. Children at 1 public school and 2 private schools in Pasto, Colombia were invited to participate in a prevalence study using the translated questionnaire. Results A total of 373 children (95 private school, 278 public school), with mean age 9.9 years completed the QPGS-III. Twenty-nine percent of children were diagnosed with FGIDs. FGIDs were more common in females (OR, 1.63; 95% CI, 1.04-2.56). Functional constipation (14%) was the most common FGID. Irritable bowel syndrome was the most common abdominal pain-related FGID (5.4%). Abdominal migraine (1%) and cyclic vomiting syndrome (0.3%) were the least common FGIDs. Conclusion FGIDs are common in Colombian school children.
Introduction: One of the main challenges in pediatric dentistry is to provide a favorable experience to the patient, and the success of the treatment depends on this to a large extent. For this ...reason, multiple methods have arisen, among which are virtual reality glasses, that try to facilitate the management of behavior in the dental office by reducing the dental anxiety of patients. Objectives: The effectiveness of the use of virtual reality glasses as a distraction in pediatric dentistry was studied. In addition, a bibliographic review was performed to determine whether the use of virtual reality reduces anxiety and improves the behavior of children during their dental consultations and dental treatments. Methodology: To obtain the information, we performed a bibliographic review using electronic bibliographic sources from scientific databases, high-impact journals and specialized search engines. Results and Discussion: It is relatively easy to obtain information on the level of dental anxiety of the child patient by means of different scales and the use of a digital pulse oximeter, which helps us to know the effectiveness of the use of virtual reality glasses at the time of the dental procedure. The greatest controversy is found in cases in which it is not possible to adjust them because of the age and size of the child or because of the personal use of glasses. Conclusions: There are multiple studies that confirm the effectiveness of the use of virtual reality glasses as a distraction in pediatric dentistry, and these studies support the effectiveness of virtual reality glasses in reducing dental anxiety and improving the behavior of patients during their consultations and dental treatments.
Belantamab-mafodotin (belamaf) is a novel antibody-drug conjugate targeting B-cell maturation antigen that showed anti-myeloma activity in patients with relapsed and refractory multiple myeloma ...(RRMM). We performed an observational, retrospective, and multicenter study aimed to assess the efficacy and safety of single-agent belamaf in 156 Spanish patients with RRMM. The median number of prior therapy lines was 5 (range, 1-10), and 88% of patients were triple-class refractory. Median follow-up was 10.9 months (range, 1-28.6). The overall response rate was 41.8% (≥CR 13.5%, VGPR 9%, PR 17.3%, MR 2%). The median progression-free survival was 3.61 months (95% CI, 2.1-5.1) and 14.47 months (95% CI, 7.91-21.04) in patients achieving at least MR (
< 0.001). Median overall survival in the entire cohort and in patients with MR or better was 11.05 months (95% CI, 8.7-13.3) and 23.35 (NA-NA) months, respectively (
< 0.001). Corneal events (87.9%; grade ≥ 3, 33.7%) were the most commonly adverse events, while thrombocytopenia and infections occurred in 15.4% and 15% of patients, respectively. Two (1.3%) patients discontinued treatment permanently due to ocular toxicity. Belamaf showed a noticeably anti-myeloma activity in this real-life series of patients, particularly among those achieving MR or better. The safety profile was manageable and consistent with prior studies.
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