Oral lichen planus. An evolutive clinical and histological study of 45 patients followed up on for five years

A study is made of 45 patients clinically and histologically diagnosed of oral lichen planus, and followed up on for 5 years. The course of the disease was monitored after three months and one, two and five years. The patients were classified in terms of lesion evolution (healed, improved, stationary or worse). Two evolutive groups were established for statistical purposes: (a) favorable (healed or improved lesions) and unfavorable cases (stationary or worsened oral lesions); and (b) healed and non-healed cases. Statistical correlations were established between these evolutive groups and different clinical and histological parameters, in an attempt to identify parameters of predictive value in the course of the disease. No statistically significant results were obtained, with the exception of inflammatory infiltrate. Thus, the depth of this infiltrate was found to be greater in patients with an unfavorable evolution (p = 0.02) than in those with a favorable course. Likewise, the inflammatory infiltrate was greater in non-healed than in healed cases.Dans ce travail, nous présentons une série de 45 patients, suivis pendant 5 ans, diagnostiqués cliniquement et histologiquement de lichen plan oral. Des contrôles évolutifs réalisés au bout de 3 mois, un an, deux ans et au bout de cinq ans ont classé les patients en fonction de l’évolution qu’ils présentaient en cas qui avaient guéri de leurs lésions, qui s’étaient améliorés, qui continuaient pareil et finalement ceux qui avaient empiré. Vis-à-vis des statistiques 2 groupes évolutifs se sont faits: 1) cas favorables (les guéris et ceux qui s’étaient améliorés), cas défavorables (ceux qui ne présentaient aucun changement ou ceux qui avaient empiré de leurs lésions intraorales) et 2) cas guéris, cas non-guéris. Diverses corrélations statistiques se sont établies entre ces groupes évolutifs et une série de variables cliniques et histologiques pour trouver un paramètre ayant une valeur de prédiction dans l’évolution de la maladie. Nous n’avons trouvé aucune donnée significativement statistique si l’on excepte une infiltration inflammatoire. Ainsi, nous démontrons une plus grande profondité moyenne de celle-ci dans les cas qui présentent une évolution défavorable (p = 0.02) que dans les cas favorables. De la même façon, nous trouvons une plus grande infiltration dans les cas non-guéris que dans les guéris

An adaptation of meaning-centered psychotherapy integrating "essential care": A pilot study

Introduction There is a growing interest in the emotional state of cancer patients. The main objective of this pilot study is to assess the feasibility, acceptability, and preliminary efficacy of Meaning-Centered Psychotherapy and Essential Care (MCP-EC) in patients with advanced cancer compared with usual psychological support. We define "Essential Care"as the promotion of patient care and self-care through the recall of good care experiences and discussion of the concepts: responsibility, self-compassion, kindness, and attitude. Method Pilot, single-center, and prospective study of 30 patients with advanced cancer and emotional distress. Our adaptation consisted in three session Meaning-Centered Psychotherapy-Palliative Care, plus a fourth session named "Essential Care". The study was carried out in two phases. First, 20 patients were randomized to one of the two arms: individual MCP-EC (experimental, n = 10) or usual psychological supportive (control, n = 10). In a second phase, 10 patients were assigned consecutively to Group MCP-EC (n = 10). All patients were evaluated at baseline (pre-) and post-intervention with questionnaires for sociodemographic data and clinical scales. Results Nineteen patients completed the 4 sessions of MCP-EC, 9 individual format and 10 group format. Usual supportive intervention was delivered to 10 control patients. Total 28 patients completed pre- and post-treatment evaluations. There were no pre- vs. post-differences in the evaluations of the control group. In the experimental group, significant pre- vs. post-differences were found in EQ-5D-3L, HADS, FACIT, DM, HAI, SCS-SF, and TD questionnaires. These results indicated that MCP-EC reduced anxiety and depression symptoms, hopelessness, demoralization, as well as increased spiritual well-being and sense of meaning. Participants were satisfied and found the MCP-EC intervention positively. Conclusions This pilot study suggests that the MCP-EC has feasibility, acceptability, and preliminary efficacy reducing the emotional distress in advanced cancer patients. Larger studies are warranted to clarify the strengths and limitations of this psychotherapy. © The Author(s), 2021. Published by Cambridge University Press

Evaluation of the efficiency of a conventional PCR protocol for the diagnosis of bacterial spot disease caused by Xanthomonas arboricola pv. pruni in stone fruits and almond

Xanthomonas arboricola pv. pruni (Xap), the causal agent of bacterial spot disease of stone fruits and almond, has a quarantine status for the European Union and the European and Mediterranean Plant Protection Organization. The symptoms in the diverse hosts show some differences and, although being quite typical, could be confused with those of some fungal diseases or other biotic or abiotic causes. Consequently, an accurate molecular diagnosis method is required for a rapid identification of the pathogen in samples of imported plants, from nurseries, orchards, etc. A protocol for conventional PCR designed by Pagani (2004) has been the only molecular analytic tool available for several years. It has been optimised for improving its specificity and sensitivity, and the results of its evaluation in 316 bacterial spot-like symptomatic samples of almond, apricot, cherry, Japanese plum and peach, compared with those of isolation and real-time PCR, are reported. The optimised PCR protocol showed specificity for a collection of Xap strains tested. Few non-desired reactions were obtained with some other xanthomonads which have not been reported from Prunus species. Sensitivity thresholds ranged from 102 to 105 CFU ml-1, depending on the hosts and type of plant material. This conventional PCR assay proved to be an excellent candidate for a rapid screening and presumptive diagnosis in cases where real-time PCR equipment is not available

The Mexican consensus on the diagnosis, treatment, and prevention of NSAID-induced gastropathy and enteropathy

Más de 30 millones de personas consumen diariamente antiinflamatorios noesteroideos (AINE) en el mundo, y este consumo se ve incrementado anualmente. Aunque losAINE poseen propiedades analgésicas y antiinflamatorias, sus eventos adversos gastrointesti-nales son bien reconocidos. En nuestro país no existía un consenso respecto al diagnóstico,tratamiento y prevención de la gastropatía y la enteropatía por AINE, por lo que la AsociaciónMexicana de Gastroenterología reunió a un grupo de expertos para establecer recomendacionesde utilidad para la comunidad médica. En este consenso se emitieron 33 recomendaciones. Elconsenso destaca que el riesgo de toxicidad gastrointestinal de los AINE varía según el fármacoempleado y su farmacocinética, lo cual debe ser considerado al momento de su prescripción. Losfactores de riesgo de complicación gastroduodenal por AINE son: antecedente de úlcera pép-tica, edad mayor a 65 a˜nos, dosis altas del AINE, infección por Helicobacter pylori (H.pylori), ypresencia de comorbilidades graves. Los síntomas y el da˜no gastroduodenal inducido por AINEson variables ya que puede cursar asintomático o manifestarse como anemia por deficiencia dehierro, hemorragia, estenosis y perforación. La cápsula endoscópica y la enteroscopia son méto-dos diagnósticos directos en la enteropatía por AINE. Respecto a la prevención, se recomiendaprescribir la dosis mínima necesaria de un AINE para obtener el efecto deseado y durante elmenor tiempo. Finalmente, los inhibidores de la bomba de protones (IBP) representan el están-dar de oro para la profilaxis y tratamiento de los efectos gastroduodenales, mas no son útilesen la enteropatía

Consenso Mexicano de Hepatitis Alcohólica

La hepatitis alcohólica es una condición frecuente en la población mexicana, se caracteriza por insuficiencia hepática aguda sobre crónica, importante reacción inflamatoria sistémica y fallo multiorgánico, que en la variante grave de la enfermedad implica una elevada mortalidad. Por lo anterior, la Asociación Mexicana de Gastroenterología y la Asociación Mexicana de Hepatología conjuntaron un equipo multidisciplinario de profesionales de la salud para elaborar el primer consenso mexicano de hepatitis alcohólica. El consenso fue elaborado con la metodología Delphi, emitiendo 37 recomendaciones. La enfermedad hepática relacionada con el consumo de alcohol comprende un amplio espectro, que incluye esteatosis, esteatohepatitis, fibrosis en diferentes grados, cirrosis y sus complicaciones. La hepatitis alcohólica grave se define por una función modificada de Maddrey ≥ 32 o por un puntaje de MELD (Model for End- Stage Liver Disease) igual o mayor a 21. Actualmente no existe un biomarcador específico para el diagnóstico. La presencia de leucocitosis con neutrofilia, hiperbilirrubinemia (> 3 mg/dL),AST > 50 U/L ( 1.5-2 pueden orientar al diagnóstico. La piedraangular del tratamiento es la abstiencia junto con el soporte nutricional. Los esteroides estanindicados en la forma grave, en donde han resultado efectivos para reducir la mortalidad a28 días. El trasplante hepático es en la actualidad la única opción con que se cuenta parasalvar la vida de pacientes que no responden a los esteroides. Ciertos fármacos, como la N-acetilcisteína, el factor estimulante de colonias de granulocitos y la metadoxina, pueden seruna terapia adyuvante que puede mejorar la supervivencia de los pacientes

The Mexican consensus on alcoholic hepatitis

Alcoholic hepatitis is a frequent condition in the Mexican population. It is characterized by acute-on-chronic liver failure, important systemic inflammatory response, and multiple organ failure. The severe variant of the disease implies elevated mortality. Therefore, the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Hepatología brought together a multidisciplinary team of health professionals to formulate the first Mexican consensus on alcoholic hepatitis, carried out utilizing the Delphi method and resultingin 37 recommendations. Alcohol-related liver disease covers a broad spectrum of patholo-gies that includes steatosis, steatohepatitis, different grades of fibrosis, and cirrhosis and itscomplications. Severe alcoholic hepatitis is defined by a modified Maddrey’s discriminant func-tion score ≥ 32 or by a Model for End-Stage Liver Disease (MELD) score equal to or above 21.There is currently no specific biomarker for its diagnosis. Leukocytosis with neutrophilia, hyper-bilirubinemia (>3 mg/dl), AST > 50 U/l ( 1.5-2 can guide thediagnosis. Abstinence from alcohol, together with nutritional support, is the cornerstone oftreatment. Steroids are indicated for severe disease and have been effective in reducing the28-day mortality rate. At present, liver transplantation is the only life-saving option for patientsthat are nonresponders to steroids. Certain drugs, such as N-acetylcysteine, granulocyte-colonystimulating factor, and metadoxine, can be adjuvant therapies with a positive impact on patientsurvival

J-PLUS: The javalambre photometric local universe survey

ABSTRACT: TheJavalambrePhotometric Local UniverseSurvey (J-PLUS )isanongoing 12-band photometricopticalsurvey, observingthousands of squaredegrees of theNorthernHemispherefromthededicated JAST/T80 telescope at the Observatorio Astrofísico de Javalambre (OAJ). The T80Cam is a camera with a field of view of 2 deg2 mountedon a telescopewith a diameter of 83 cm, and isequippedwith a uniquesystem of filtersspanningtheentireopticalrange (3500–10 000 Å). Thisfiltersystemis a combination of broad-, medium-, and narrow-band filters, optimallydesigned to extracttherest-framespectralfeatures (the 3700–4000 Å Balmer break region, Hδ, Ca H+K, the G band, and the Mg b and Ca triplets) that are key to characterizingstellartypes and delivering a low-resolutionphotospectrumforeach pixel of theobservedsky. With a typicaldepth of AB ∼21.25 mag per band, thisfilter set thusallowsforanunbiased and accuratecharacterization of thestellarpopulation in our Galaxy, itprovidesanunprecedented 2D photospectralinformationforall resolved galaxies in the local Universe, as well as accuratephoto-z estimates (at the δ z/(1 + z)∼0.005–0.03 precisionlevel) formoderatelybright (up to r ∼ 20 mag) extragalacticsources. Whilesomenarrow-band filters are designedforthestudy of particular emissionfeatures ([O II]/λ3727, Hα/λ6563) up to z < 0.017, theyalsoprovidewell-definedwindowsfortheanalysis of otheremissionlines at higherredshifts. As a result, J-PLUS has thepotential to contribute to a widerange of fields in Astrophysics, both in thenearbyUniverse (MilkyWaystructure, globular clusters, 2D IFU-likestudies, stellarpopulations of nearby and moderate-redshiftgalaxies, clusters of galaxies) and at highredshifts (emission-line galaxies at z ≈ 0.77, 2.2, and 4.4, quasi-stellarobjects, etc.). Withthispaper, wereleasethefirst∼1000 deg2 of J-PLUS data, containingabout 4.3 millionstars and 3.0 milliongalaxies at r <  21mag. With a goal of 8500 deg2 forthe total J-PLUS footprint, thesenumbers are expected to rise to about 35 millionstars and 24 milliongalaxiesbytheend of thesurvey.Funding for the J-PLUS Project has been provided by the Governments of Spain and Aragón through the Fondo de Inversiones de Teruel, the Spanish Ministry of Economy and Competitiveness (MINECO; under grants AYA2017-86274-P, AYA2016-77846-P, AYA2016-77237-C3-1-P, AYA2015-66211-C2-1-P, AYA2015-66211-C2-2, AYA2012-30789, AGAUR grant SGR-661/2017, and ICTS-2009-14), and European FEDER funding (FCDD10-4E-867, FCDD13-4E-2685

Consenso mexicano sobre diagnóstico, prevención y tratamiento de la gastropatía y enteropatía por antiinflamatorios no esteroideos

Más de 30 millones de personas consumen diariamente antiinflamatorios no este-roideos (AINE) en el mundo y este consumo se ve incrementado a˜no tras a˜no. Aunque los AINEposeen propiedades analgésicas y antiinflamatorias, sus eventos adversos gastrointestinales sonbien reconocidos. En nuestro país no existía un consenso respecto al diagnóstico, tratamientoy prevención de la gastropatía y la enteropatía por AINE, por lo que la Asociación Mexicana deGastroenterología reunió a un grupo de expertos para establecer recomendaciones de utilidadpara la comunidad médica. En este consenso se emitieron 33 recomendaciones. El consensodestaca que el riesgo de toxicidad gastrointestinal de los AINE varía según el fármaco empleadoy su farmacocinética, lo cual debe ser considerado al momento de su prescripción. Los factoresde riesgo de complicación gastroduodenal por AINE son: antecedente de úlcera péptica, edadmayor de 65 a˜nos, dosis altas del AINE, infección por Helicobacter pylori y presencia de comor-bilidades graves. Los síntomas y el da˜no gastroduodenal inducido por AINE son variables, ya quepuede cursar asintomático o manifestarse como anemia por deficiencia de hierro, hemorragia,estenosis y perforación. La cápsula endoscópica y la enteroscopia son métodos diagnósticosdirectos en la enteropatía por AINE. Respecto a la prevención, se recomienda prescribir la dosismínima necesaria de un AINE para obtener el efecto deseado y durante el menor tiempo. Porúltimo, los inhibidores de la bomba de protones representan el estándar de oro para la profilaxisy tratamiento de los efectos gastroduodenales, mas no son útiles en la enteropatí

IV consenso mexicano sobre Helicobacter pylori

Desde el último consenso mexicano para el diagnóstico y tratamiento de la infección por Helicobacter pylori (H. pylori) en el 2007, han existido avances importantes al respecto. Por tal motivo, la Asociación Mexicana de Gastroenterología convocó a 20 expertos para la realización del «IV consenso mexicano sobre H. pylori». Durante febrero y junio del 2017 se organizaron 4 mesas de trabajo, una revisión de la literatura y 3 rondas de votaciones donde se establecieron 32 enunciados para discusión y consenso. Dentro de las recomendaciones se destaca el reconocer a México como un país con riesgo de cáncer gástrico bajo a intermedio a pesar de la alta prevalencia de infección por H. pylori. Se corrobora que enfermedad ulcerosa péptica, presencia de lesiones premalignas, antecedentes de cáncer gástrico y linfoma asociado a la mucosa deben considerarse indicaciones claras para erradicación. La relación del H. pylori con los síntomas dispépticos sigue siendo controversial. La triple terapia de erradicación con amoxicilina, claritromicina y un inhibidor de la bomba de protones ya no debe ser considerada la primera línea de tratamiento. En su lugar, se proponen 2 opciones: la terapia cuádruple con bismuto (inhibidor de la bomba de protones, subcitrato de bismuto, tetraciclina y metronidazol) y la terapia cuádruple sin bismuto (inhibidor de la bomba de protones, amoxicilina, claritromicina y metronidazol). Se establece la necesidad de la realización de sensibilidad antimicrobiana ante la falla a 2 tratamientos de erradicación. Finalmente, se proponen campañas de educación respecto al diagnóstico y tratamiento del H. pylori para médicos de primer contacto y población general. Abstract Important advances have been made since the last Mexican consensus on the diagnosis and treatment of Helicobacter pylori (H. pylori) infection was published in 2007. Therefore, the Asociación Mexicana de Gastroenterología summoned 20 experts to produce ‘‘The Fourth Mexican Consensus on Helicobacter pylori’’. From February to June 2017, 4 working groups were organized, a literature review was performed, and 3 voting rounds were carried out, resulting in the formulation of 32 statements for discussion and consensus. From the ensuing recommendations, it was striking that Mexico is a country with an intermediate-to-low risk for gastric cancer, despite having a high prevalence of H. pylori infection. It was also corroborated that peptic ulcer disease, premalignant lesions, and histories of gastric cancer and mucosaassociated lymphoid tissue lymphoma should be considered clear indications for eradication. The relation of H. pylori to dyspeptic symptoms continues to be controversial. Eradication triple therapy with amoxicillin, clarithromycin, and a proton pump inhibitor should no longer be considered first-line treatment, with the following 2 options proposed to take its place: quadruple therapy with bismuth (proton pump inhibitor, bismuth subcitrate, tetracycline, and metronidazole) and quadruple therapy without bismuth (proton pump inhibitor, amoxicillin, clarithromycin, and metronidazole). The need for antimicrobial sensitivity testing when 2 eradication treatments have failed was also established. Finally, the promotion of educational campaigns on the diagnosis and treatment of H. pylori for both primary care physicians and the general population were proposed