Inclusive Development in Latin America and Smallholders’ Interactive Learning Spaces

Inclusive development appears as a challenge in Latin America countries after the rupture of the social inclusion as a trickle-down effect of the economic growth. Searching development with inclusion several public policies were implemented in Latin American focusing in the agri-food production. In order to assess the progress to reach such objectives, two cases are studied. Smallholder milk producers at the Loma Blanca community (Mexico) and smallholders olive producers at Aimogasta (Argentina) were considered. Interactive learning spaces were clearly identified as consequence of the linking between product, producers and territory. Despite these results, several queries are still opened.Fil: Bastida Mercado, Claudia. Universidad Autónoma del Estado de México; MéxicoFil: García Martínez, Anastacio. Universidad Autónoma del Estado de México; MéxicoFil: Sanchez, Guillermo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro de Estudios Urbanos y Regionales; Argentina. Universidad de Morón; Argentina. Instituto Nacional de Tecnología Agropecuaria; Argentin

A chemosensor for dihydrogenphosphate based on an oxoazamacrocycle possessing three thiourea arms

We report a new H-bond macrocyclic chromogenic chemosensor in organic media, H3L, which displayed drastic changes in its UV–vis spectra revealing selectivity for dihydrogenphosphate over other inorganic anions, such as acetate or fluoride. The X-ray crystal structures of the [H4L⋯NO3]·(CH3CN)4 and [H4L⋯CF3CO2]·(CH3CN)2 salt complexes are also reportedR. B. thanks the Xunta de Galicia (Spain), Projects PGIDI10PXIB209028PR and INCITE09E1R209058ES. M. V. L. thanks the Directorate-General for Research and Development of the Xunta of Galicia (INCITE09 209 084 PR) and the Ministry for Science and Innovation of Spain (CTQ2009-14431/BQU) for financial supportS

Cholinesterase Inhibition Activity, Alkaloid Profiling and Molecular Docking of Chilean Rhodophiala (Amaryllidaceae)

Amaryllidaceae plants are the commercial source of galanthamine, an alkaloid approved for the clinical treatment of Alzheimer's disease. The chemistry and bioactivity of Chilean representatives of Rhodophiala genus from the family of Amaryllidaceae have not been widely studied so far. Ten collections of five different Chilean Rhodophiala were analyzed in vitro for activity against enzymes such as acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) as well as for their alkaloid composition by GC-MS. To obtain an insight into the potential AChE and BuChE inhibitory activity of the alkaloids identified in the most active samples, docking experiments were carried out. Although galanthamine was found neither in aerial parts nor in bulbs of R. splendens, these plant materials were the most active inhibitors of AChE (IC50: 5.78 and 3.62 μg/mL, respectively) and BuChE (IC50: 16.26 and 14.37 μg/mL, respectively). Some 37 known alkaloids and 40 still unidentified compounds were detected in the samples, suggesting high potential in the Chilean Amaryllidaceae plants as sources of both novel bioactive agents and new alkaloids. Keywords: AChE; BuChE; GC-MS; Rhodophiala; alkaloids; molecular docking

Sucrosomial Iron Supplementation for the Treatment of Iron Deficiency Anemia in Inflammatory Bowel Disease Patients Refractory to Oral Iron Treatment

Malaltia inflamatòria intestinal; Deficiència de ferro; Suplementació de ferroEnfermedad inflamatoria intestinal; Deficiencia de hierro; Suplementación con hierroInflammatory bowel disease; Iron deficiency; Iron supplementationIron deficiency anemia (IDA) is a common manifestation of Inflammatory Bowel Disease (IBD). Oral iron supplements are the treatment of choice, but are not always well tolerated. Sucrosomial® iron (SI) may represent an alternative. This prospective study assessed the tolerability and effectiveness of SI, and quality of life (QoL) of IDA-IBD patients who were intolerant to oral iron salts. The study included 52 individuals treated with 1 capsule/day for 12 weeks. Tolerability was assessed through a gastrointestinal symptom severity questionnaire. Hemoglobin (Hb) levels and clinical symptoms of IDA were analyzed. QoL was assessed using IBDQ-9 and EuroQoL questionnaires. The percentage of patients with excellent/good health increased from 42.9% to 94.3%. Mean Hb concentration significantly increased at all follow-up visits (p < 0.05). Almost all participants (96.9%) were adherent to the study medication. Patients’ QoL improved (IBDQ-9: from 60.9 to 65.5). Patients also improved in mobility (71.8% to 78.1%), usual activities (51.3% to 68.7%), pain/discomfort (41.0% to 53.1%), and extreme depression/anxiety problems (7.7% to 3.2%); they worsened in self-care (100% to 90.6%), but perceived an enhancement in their global health [EQ-VAS score: 61.9 (±26.1) to 66.9 (±20.3)]. SI was well tolerated and improved IDA symptoms, IBD activity, and patients’ QoL. In conclusion, SI should be considered in IDA–IBD patients.The authors of this manuscript received financial support from ZAMBON S.A.U. for the writing of the manuscript. The sponsor had no role in the design or conduct of the study, data collection and analysis, or preparation of the manuscript

Historia natural y calidad de vida de los pacientes con enfermedad inflamatoria intestinal tratados con inmunosupresores tiopurínicos

La enfermedad inflamatoria intestinal (EII) es una patología crónica que afecta fundamentalmente el tubo digestivo. Los pacientes con EII, Enfermedad de Crohn (EC) o Colitis Ulcerosa (CU), tienen una percepción alterada de su calidad de vida (CV). La actividad inflamatoria es la variable que más influye en su mala CV. La tiopurinas, azatioprina (AZA) o 6-mercaptopurina (6MP), son utilizadas en múltiples escenarios, sobre todo para mantener al paciente en remisión. El efecto de las tiopurinas sobre la CV ha sido controvertido. El objetivo principal de esta tesis es conocer el impacto del tratamiento con tiopurinas sobre la CV relacionada con la salud en los pacientes con EII, su perfil evolutivo temporal y su relación con la cuantificación objetiva de la inflamación intestinal. Se incluyeron prospectiva y consecutivamente 92 pacientes con EII. Fueron valorados a los 0, 2 y 6 meses mediante cuestionarios de CV (IBDQ y SF-36) e índices clínicos (Crohn's disease activity index -CDAI- en EC e Índice Mayo en CU). Se consideró curación mucosa (CM) la ausencia de úlceras en pacientes con EC y un subescore endoscópico del índice de Mayo de 0-1 en pacientes con CU. En caso pacientes tratados para la prevención de la recurrencia (PR) se consideró CM un índice de Rutgeerts de 0. Cincuenta y ocho (63%) pacientes tuvieron un efecto adverso. La toxicidad gastrointestinal fue el efecto adverso más frecuente, sobre todo en mujeres, y obligó a la retirada del fármaco en 15 (50%) de ellos. Catorce pacientes intolerantes a AZA fueron tratados con 6MP, de ellos 5 (36%) la toleraron. Cincuenta pacientes fueron incluidos con EC (los pacientes con PR se presentan de forma separada). Tanto el IBDQ como el SF-36 mostraron valores inferiores a la población de referencia. El uso de esteroides se asoció con peor CV. Treinta (60%) y 23 (54%) pacientes estaban en remisión por protocolo a los 6 y 12 meses respectivamente. Todas las dimensiones del SF-36 y del IBDQ mejoraron a lo largo del seguimiento y las hizo comparables a la población general española. Nueve de 20 pacientes (45%) a los seis meses y 11/20 (55%) a los 12 meses alcanzaron CM. Los pacientes con CM obtuvieron mejores puntuaciones de CV. Veinticuatro pacientes fueron incluidos con CU. Las puntuaciones basales del IBDQ y del SF-36 fueron inferiores que la población de referencia. Ocho (33%) y 12/17 (54%) pacientes estaban en remisión a los 6 y 12 meses respectivamente. La mejoría de la CV fue escasa, no alcanzó significación estadística ni se igualó a la población de referencia. Tres de 13 (23%) a los 6 meses y 6/12 (50%) a los 12 meses alcanzaron CM. La CV fue mejor en los pacientes con CM. Dieciocho pacientes comenzaron para PR. El IBDQ y el SF-36 mostraron una afectación de la CV. Los valores de PCR y de CDAI se correlacionaron con mayor alteración de la CV. Diecisiete (94%) pacientes a los 6 meses y 10/12 (83%) a los 12 meses estaban en remisión. Todas las dimensiones de CV mejoraron a los 6 y a los 12 meses. Los valores basales de PCR predijeron una mayor ganancia de CV. Seis de 11 (55%) y 4/7 (57%) alcanzaron la CM por protocolo a los 6 y 12 meses respectivamente. La CV no tuvo relación con la CM. Conclusiones: La toxicidad gastrointestinal fue el efecto secundario más frecuente, sobre todo en mujeres. La 6MP es útil aproximadamente en el 40% de los intolerantes a AZA. Las tiopurinas tienen un impacto positivo y duradero sobre la CV en la EII. La CM se asocia con mejores resultados de CV excepto en la PR.Inflammatory bowel disease (IBD) is chronic disorder that causes inflammation of the digestive tract. IBD patients, both ulcerative colitis (UC) and Crohn's disease (CD), have an impaired perception of their health-related quality of life (HRQoL). Disease activity is the main factor associated with impaired HRQoL. Thiopurines, azathioprine (AZA) or 6-mercaptopurine (6MP), are used in multiple scenarios in IBD, mainly to maintain the patient in remission. The effect of thiopurines on HRQoL in patients with IBD has been controversial. The aims of this thesis were to evaluate the HRQoL in patients with IBD treated with thiopurines and assess the short- and long-term impacts of the treatment on HRQoL and to know the influence of objective variables (mucosal healing) on the HRQoL. Ninety-two consecutive patients who started treatment with thiopurines were prospectively included. Evaluation of HRQoL was performed at months 0, 6, and 12 using two questionnaires, the Short-Form Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ). Clinical activity was assessed with the CDAI (Crohn's disease activity index) in CD-patients and with the Mayo Clinic score in UC-patients. Mucosal healing (MH) was considered in the absence of ulcers in CD-patients. In patients with UC, MH was considered in case of Mayo endoscopy subscore of 0-1. In those patients treated to prevent the postoperative recurrence of CD a Rutgeerts score of 0 was considered mucosal healing. Fifty eight (63%) patients had an adverse effect, the most frequent was gastrointestinal toxicity in 30 (33%) patients, leading to treatment withdrawal in 15 (50%). Gastrointestinal toxicity was more frequent in female gender. Fourteen patients intolerant to AZA were treated with 6MP, of them, 5 (36%), tolerated 6MP. Fifty patients were included with CD (patients treated to prevent the postoperative recurrence (POR) are reported separately). At baseline HRQoL, both assessed with IBDQ and SF-36, were impaired compared with a background population. The use of steroids was associated with worse HRQoL. Thirty (60%) and 23 (54%) patients were in remission per protocol at 6 and 12 months respectively. All dimensions of IBDQ and SF-36 scored better at 6 and 12 months and were comparable to Spanish general population. Nine of 20 (45%) at six months and 11/20 (55%) at 12 months achieved MH. HRQoL was better in those patients with MH. Twenty four patients were included with UC. At baseline IBDQ and SF-36 scored worse if compared with reference population. Eight (33%) and 12/17 (54%) patients were in remission per protocol at 6 and 12 months respectively. Most of domains of IBDQ and SF-36 experienced a slightly improvement but they did not reach statistical difference and were worse than Spanish general population. Three of 13 (23%) at six months and 6/12 (50%) at 12 months achieved MH. HRQoL was better in those patients with MH. Eighteen patients were treated to prevent POR. At baseline IBDQ and SF-36 scored worse if compared with reference population. C reactive protein (CRP) and CDAI correlated with worse HRQoL. Seventeen (94%) and 10/12 (83%) were in remission per protocol at 6 and 12 months respectively. All dimensions of IBDQ and SF-36 scored better at 6 and 12 months and were comparable to Spanish general population. Baseline CRP correlated with higher improvement in HRQoL. Six of 11(55%) at six months and 4/7 (57%) at 12 months achieved MH per protocol. HRQoL was independent of the MH. Conclusions: Gastrointestinal toxicity was the most frequent side effect, mainly in women; 6MP is effective in near 40% of AZA-intolerant patients. Thiopurines have a positive and long lasting impact on HRQoL of IBD patients. Patients with MH had better HRQoL except during the prevention of POR

Role of oxidative stress and antioxidant enzymes in Crohn’s disease,”

Abstract There is increasing interest in oxidative stress being a potential aetiological factor and/or a triggering factor in Crohn&apos;s disease, rather than a concomitant occurrence during the pathogenesis of the disease. Recent research has shown that the immune mononuclear cells of Crohn&apos;s disease patients are induced to produce hydrogen peroxide (H 2 O 2 ). Similarly, the regulation of antioxidant enzymes during disease in these cells has been unravelled, showing that SOD (superoxide dismutase) activity and GPx (glutathione peroxidase) activity is increased during active disease and returns to normal in remission phases. However, catalase remains constantly inhibited which supports the idea that catalase is not a redox-sensitive enzyme, but a regulator of cellular processes. ROS (reactive oxygen species) can be produced under the stimulus of different cytokines such as TNFα (tumour necrosis factor α). It has been shown in different experimental models that they are also able to regulate apoptosis and other cellular processes. The status of oxidative stress elements in Crohn&apos;s disease and their possible implications in regulating cellular processes are reviewed in the present paper

Recomendaciones del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) sobre el tratamiento de pacientes con enfermedad inflamatoria intestinal asociada a espondiloartritis

Las manifestaciones extraintestinales en general, y entre ellas las articulares en particular, suponen un problema frecuente en los pacientes con enfermedad inflamatoria intestinal. De hecho, la relación entre ambas entidades parece estrecha y cada vez hay más datos que sugieren que el intestino desempeña un importante papel en la patogenia de las espondiloartritis. La asociación de la enfermedad inflamatoria intestinal con algún tipo de espondiloartritis supone un escenario clínico complejo. Es necesario, por tanto, que gastroenterólogos y reumatólogos puedan trabajar juntos y establecer una comunicación fluida que permita a cada paciente recibir el tratamiento más adecuado para cada situación concreta. El objetivo de esta revisión es el de establecer unas recomendaciones sobre el tratamiento de los pacientes con enfermedad inflamatoria intestinal y espondiloartritis asociada, en cada uno de los distintos escenarios clínicos

Treatment patterns and intensification within 5 year of follow-up of the first-line anti-TNFα used for the treatment of IBD : Results from the VERNE study

Altres ajuts: Takeda Farmacéutica España S.A.Background: Anti-TNFα represent one of the main treatment approaches for the management of inflammatory bowel diseases (IBD). Therefore,the evaluation of their treatment patterns over time provides valuable insights about the clinical value of therapies and associated costs. Aims: To assess the treatment patterns with the first anti-TNFα in IBD. Methods: Retrospective, observational study. Results: 310 IBD patients were analyzed along a 5-year follow-up period. 56.2% of Crohn's disease (CD) patients started with adalimumab (ADA), while 43.8% started with infliximab (IFX). 12.9% of ulcerative colitis (UC) patients initiated with ADA, while 87.1% initiated with IFX. Treatment intensification was required in 28.9% of CD and 37.1% of UC patients. Median time to treatment intensification was shorter in UC than in CD (5.3 vs. 14.3 months; p = 0.028). Treatment discontinuation due to reasons other than remission were observed in 40.7% of CD and 40.5% of UC patients, although, in UC patients there was a trend to lower discontinuation rates with IFX (36.6%) than with ADA (66.7%). Loss of response accounted for approximately one-third of discontinuations, in both CD and UC. Conclusions: Around one-third of IBD biologic-naive patients treated with an anti-TNFα required treatment intensification (earlier in UC) and around 40% discontinued the anti-TNFα due to inappropriate disease control

Impact of comorbidities on anti-TNF alpha response and relapse in patients with inflammatory bowel disease: the VERNE study

Objective: To evaluate the impact of comorbidities and extraintestinal manifestations of inflammatory bowel disease on the response of patients with inflammatory bowel disease to antitumour necrosis factor alpha (anti-TNFalpha) therapy. Design: Data from 310 patients (194 with Crohn's disease and 116 with ulcerative colitis) treated consecutively with the first anti-TNFalpha in 24 Spanish hospitals were retrospectively analysed. Univariate and multivariate logistic regression analyses were performed to assess the associations between inflammatory bowel disease comorbidities and extraintestinal manifestations with anti-TNFalpha treatment outcomes. Key clinical features, such as type of inflammatory bowel disease and concomitant treatments, were included as fixed factors in the model. Results: Multivariate logistic regression analyses (OR, 95% CI) showed that chronic obstructive pulmonary disease (2.67, 1.33 to 5.35) and hepato-pancreato-biliary diseases (1.87, 1.48 to 2.36) were significantly associated with primary non-response to anti-TNFalpha, as was the use of corticosteroids and the type of inflammatory bowel disease (ulcerative colitis vs Crohn's disease). It was also found that myocardial infarction (3.30, 1.48 to 7.35) and skin disease (2.73, 1.42 to 5.25) were significantly associated with loss of response, along with the use of corticosteroids and the type of inflammatory bowel disease (ulcerative colitis vs Crohn's disease). Conclusions: Our results suggest that the presence of some comorbidities in patients with inflammatory bowel disease, such as chronic obstructive pulmonary disease and myocardial infarction, and of certain extraintestinal manifestations of inflammatory bowel disease, such as hepato-pancreato-biliary conditions and skin diseases, appear to be related to failure to anti-TNFalpha treatment. Therefore, their presence should be considered when choosing a treatment. Trial registration number: NCT02861118