Withdrawal of infliximab therapy in ankylosing spondylitis in persistent clinical remission, results from the REMINEA study

Altres ajuts: This work is conducted under the umbrella of the Rheumatology Society of Catalonia and supported by Merck Research Laboratories.Background: Recent data suggest that anti-TNF doses can be reduced in ankylosing spondylitis (AS) patients. Some authors even propose withdrawing treatment in patients in clinical remission; however, at present there is no evidence to support this. Objective: To assess how long AS patients with persistent clinical remission remained free of flares after anti-TNF withdrawal and to evaluate the effects of treatment reintroduction. We also analyze the characteristics of patients who did not present clinical relapse. Methods: Multicenter, prospective, observational study of a cohort of patients with active AS who had received infliximab as a first anti-TNF treatment and who presented persistent remission (more than 6 months). We recorded at baseline and every 6-8 weeks over the 12-month period the age, gender, disease duration, peripheral arthritis or enthesitis, HLA-B27 status, BASDAI, CRP, ESR, BASFI, and three visual analogue scales, spine global pain, spinal night time pain, and patient's global assessment. Results: Thirty-six out of 107 patients (34%) presented persistent remission and were included in our study. After treatment withdrawal, 21 of these 36 patients (58%) presented clinical relapse during follow-up. Infliximab therapy was reintroduced and only 52% achieved clinical remission, as they had before the discontinuation of infliximab; in an additional 10%, reintroduction of infliximab was ineffective, obliging us to change the anti-TNF therapy. No clinical or biological factors were associated with the occurrence of relapse during the follow-up. Conclusions: Two thirds of patients in clinical remission presented clinical relapse shortly after infliximab withdrawal. Although the reintroduction of infliximab treatment was safe, half of the patients did not present the same clinical response that they had achieved prior to treatment withdrawal

Diseños urbanos modelan vidas y cuerpos

La modernidad ha propiciado nuevas formas de convivencia social y desarrollo económico entre las sociedades. Ser moderno, urbano, citadino, consumista, capitalista, ha costado el detrimento del espíritu y el cuerpo, en pocas palabras, hemos dejado de ser movimiento sentido y pensado para actuar como masas hipoactivas. El costo de crecer urbanamente buscando el funcionamiento óptimo de la dinámica económica consideró la construcción de ciudades funcionales pero inmovilizantes, se construyeron centros deportivos y se abandono la calle; la vida perdió aprecio por la contemplación y lo importante del SER; los satisfactores devenidos del consumismo se apoderaron del cuerpo en la búsqueda del confort. El cuerpo en tanto modificó su estructura, forma y utilización, dejo de ser herramienta de trabajo y convertirse en masas ideológicas. La presente ponencia reflexiona en la transformación que propicio la modernidad y tecnología al cuerpo. Precisamente en Colima, el diseño urbano está diseñado para no moverno

Diseños urbanos modelan vidas y cuerpos

La modernidad ha propiciado nuevas formas de convivencia social y desarrollo económico entre las sociedades. Ser moderno, urbano, citadino, consumista, capitalista, ha costado el detrimento del espíritu y el cuerpo, en pocas palabras, hemos dejado de ser movimiento sentido y pensado para actuar como masas hipoactivas. El costo de crecer urbanamente buscando el funcionamiento óptimo de la dinámica económica consideró la construcción de ciudades funcionales pero inmovilizantes, se construyeron centros deportivos y se abandono la calle; la vida perdió aprecio por la contemplación y lo importante del SER; los satisfactores devenidos del consumismo se apoderaron del cuerpo en la búsqueda del confort. El cuerpo en tanto modificó su estructura, forma y utilización, dejo de ser herramienta de trabajo y convertirse en masas ideológicas. La presente ponencia reflexiona en la transformación que propicio la modernidad y tecnología al cuerpo. Precisamente en Colima, el diseño urbano está diseñado para no moverno

Diseños urbanos modelan vidas y cuerpos

La modernidad ha propiciado nuevas formas de convivencia social y desarrollo económico entre las sociedades. Ser moderno, urbano, citadino, consumista, capitalista, ha costado el detrimento del espíritu y el cuerpo, en pocas palabras, hemos dejado de ser movimiento sentido y pensado para actuar como masas hipoactivas. El costo de crecer urbanamente buscando el funcionamiento óptimo de la dinámica económica consideró la construcción de ciudades funcionales pero inmovilizantes, se construyeron centros deportivos y se abandono la calle; la vida perdió aprecio por la contemplación y lo importante del SER; los satisfactores devenidos del consumismo se apoderaron del cuerpo en la búsqueda del confort. El cuerpo en tanto modificó su estructura, forma y utilización, dejo de ser herramienta de trabajo y convertirse en masas ideológicas. La presente ponencia reflexiona en la transformación que propicio la modernidad y tecnología al cuerpo. Precisamente en Colima, el diseño urbano está diseñado para no moverno

Percepción del beneficio de los deportes y actividades recreativas en habilidades para la vida en niños y adolescentes de Ciudad Juárez, México

The present exploratory research aims to describe the perceptions of the benefit encouraged by sports practice in physical-motor, cognitive, social and interpersonal skills in Juarenses children and young people from 6 to 16 years who participated in the summer school. The population consisted of 46 subjects, divided into two groups: infants and preteens participants of a summer sports teaching experience designed and controlled by the Autonomous University of Ciudad Juarez. For the information-collecting the Natural Semantic Networks technique and questionnaire was used, at the same time, for the analysis, the theory of social representations and HJ-Biplot for the data´s representation and interpretation was used. Among the most outstanding findings is evidenced at a perceptive level on the physical-motor skills development  with the practice of the following sports disciplines: swimming (59%), aerial dance (58%), indoor soccer (55%) and basketball (54% ), in turn, tennis (30%), flag football (26%) and recreation (24%) activities promoted the improvement of cognitive skills; likewise, social skills were encouraged with recreation (33%), flag football (24%) and handball (15%) and interpersonal skills were encouraged with sports such as swimming (31%), karate (28%) and dance (14%). In conclusion, the aforementioned learning space called summer school offers participants a perceived benefit of sport beyond the enjoyment by practice, recreation and health. And enables to observe the relationships that our mind and body have with other everyday learning.El objetivo del presente trabajo consistió en describir la percepción que tienen los niños, niñas y jóvenes juarenses de 6 a 16 años, participantes en el Campamento de Verano promovido por la Universidad Autónoma de Ciudad Juárez (UACJ), respecto de los beneficios que estimulan las actividades deportivas y recreativas en las habilidades físico-motoras, cognitivas, sociales e interpersonales. La investigación se asume de carácter exploratoria, tipo mixta. La técnica utilizada para recuperación de la información fue Redes Semánticas Naturales (RSN); y el cuestionario, a su vez —para el análisis, representación e interpretación de los datos— se usó la teoría de la percepción y el HJ-Biplot. Entre los hallazgos más sobresalientes se evidencia, a nivel perceptivo, que el desarrollo de habilidades físico-motoras se potencia con la práctica de las siguientes disciplinas deportivas: natación (59%), danza aérea (58%), fútbol rápido (55%) y basquetbol (54%); a su vez, las actividades de tenis (30%), tochito (26%) y recreación (24%) promovieron la mejora de habilidades cognitivas. De igual forma, las habilidades sociales se vieron estimuladas con recreación (33%), tochito (24%) y handball (15%) y en las habilidades interpersonales influyeron deportes como la natación (31%), karate (28%) y baile (14%). En conclusión, el Campamento de Verano con orientación deportiva y recreativa estimula y condiciona, en los participantes, una percepción de beneficio del deporte más allá del gusto por la práctica, el esparcimiento y la salud. Y posibilita la observación de las relaciones que la mente y cuerpo tienen con otros aprendizajes cotidianos

El Modelo Educativo Integral y Flexible en la Formación del Profesional de Educación Física

Hablar de educación es hablar de hechos, situaciones variadas y cambios sociales, de este modo, si el mundo cambia, la educación cambia. Los fenómenos globales, en los que entran la mayoría de los países y el surgimiento de nuevas tecnologías a pasos agigantados, obligan a los sistemas educativos a ser igualmente competitivos entre instituciones y a la constante actualizació

Influencia del estilo de vida y la funcionalidad sobre la calidad de vida relacionada con la salud en población mexicana con salud comprometida.

 This study aims to examine the influence of lifestyle factors and functionality on health-related quality of life (HRQOL) in people with compromised health. Method: 139 subjects were part of this study divided into four groups of co-morbid diseases (overweight-obesity, diabetes, hypertension and hyperlipidemia). The lifestyle was determined by the FANTASTIC questionnaire, health-related quality of life using the Short-Form-36 (SF-36) and functionality with Chair-Stand (CS) and Up and Go (UG). The results show us that a great lifestyle affects positively the Health-Physical Component and Health-Mental Component (p <0.05) versus relative lower lifestyle (good, average and low) and does not affect the functional capacity (TSL and TIV). In addition, different conditions of co-morbid conditions (SO vs SOD vs SODT vs ODTH) may not affect HRQOL, and it does affect the functional capacity (p <0.05). Conclusions: excellent levels of lifestyle influence positively on HRQOL specifically on the physical and mental aspects. Functional testing of CS and UG differences appear to be useful for functional levels in people with compromised health or people with co-morbid diseasesEste estudio tiene como objetivo estudiar la influencia de los factores del estilo de vida y funcionalidad sobre la calidad de vida relacionada con la salud (CVRS) en población con salud comprometida. Método: 139 sujetos formaron parte de este estudio divididos en cuatro grupos de enfermedades co-morbidas (sobrepeso-obesidad, diabetes, hipertensión e hiperlipidemias). El estilo de vida se determinó mediante la encuesta FANTASTIC, calidad de vida relacionada con la salud mediante el SF-36 y la funcionalidad con los Test Sentar y Lenvantar (TSL) e Ir y Venir (TIV). Los resultados nos muestras un estilo de vida excelente influye positivamente sobre la Compuesta Salud Fí­sica y Compuesta Salud Mental (p < 0.05) en relación estilo de vida inferiores (bueno, regular y bajos) y no influye sobre la capacidad funcional (TSL y TIV). Además, diferentes condiciones de enfermedades co-morbidas (SO vs SOD vs SODT vs ODTH) parecen no afectar la CVRS, y si la capacidad funcional (p < 0.05). Conclusiones: niveles excelentes de estilo de vida influyen positivamente sobre la CVRS especí­ficamente sobre los aspectos fí­sicos y mentales. Las pruebas funcionales de TSL y TIV parecen ser útiles para diferencias los niveles funcionales en población con salud comprometida o población con enfermedades co-morbida

Novel clinical and molecular findings in Spanish patients with naevoid basal cell carcinoma syndrome

[Background]: Naevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder characterized by developmental alterations and multiple basal cell carcinomas. Mutations in PTCH1, which encodes a membrane receptor for Sonic Hedgehog, are associated with the development of the disease. Most of them produce a truncated protein, which is unable to suppress Smoothened protein and continuously activates the downstream pathway. [Objectives]: We aimed to characterize 22 unrelated Spanish patients with NBCCS, the largest cohort with Gorlin syndrome reported to date in Spain. [Methods]: Genomic analysis of PTCH1 was performed in patients with NBCCS and controls, and mutations were analysed using bioinformatics tools. [Results]: We report for the first time two young patients, one each with uterus didelphys and ganglioneuroma, within the context of NBCCS. One patient showing a severe phenotype of the disease had developed basal cell carcinomas since childhood. Sanger sequencing of PTCH1 in this cohort identified 17 novel truncating mutations (11 frameshift, five nonsense and one mutation affecting an exon–intron splice site) and two novel missense mutations that were predicted to be pathogenic. The patients showed great clinical variability and inconsistent genotype–phenotype correlation, as seen in relatives carrying similar mutations. [Conclusions]: This study contributes to increase the pool of clinical manifestations of NBCCS, as well as increasing the number of pathogenic mutations identified in PTCH1 predisposing to the condition. The inconsistencies found between phenotype and genotype suggest the involvement of other modifying factors, genetic, epigenetic or environmental.This project was funded by Fundación Rodríguez Pascual, Consejería de Sanidad de la Junta de Castilla y León‐FEDER (GRS165/A/07) and ISCIII‐FEDER (PI10/00219 and PI13/01741). The research at the Melanoma Unit in Barcelona was partially funded by grants 12/00840 from Fondo de Investigaciones Sanitarias, Spain; by the CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain; by the AGAUR 2014_SGR_603 of the Catalan Government, Spain; by a grant from ‘Fundació La Marató de TV3, 201331‐30’, Catalonia, Spain; and by the European Commission under the 6th Framework Programme, contract no. LSHC‐CT‐2006‐018702 (GenoMEL), under the 7th Framework Programme (Diagnoptics). J.C. is partially supported by grant GRS 1342/A/16 (Gerencia Regional de Salud de Castilla y León) and by the program INT/M/16/17 from the Gerencia Regional de Salud de Castilla y León.Peer Reviewe

Withdrawal of infliximab therapy in ankylosing spondylitis in persistent clinical remission, results from the REMINEA study

Altres ajuts: This work is conducted under the umbrella of the Rheumatology Society of Catalonia and supported by Merck Research Laboratories.Background: Recent data suggest that anti-TNF doses can be reduced in ankylosing spondylitis (AS) patients. Some authors even propose withdrawing treatment in patients in clinical remission; however, at present there is no evidence to support this. Objective: To assess how long AS patients with persistent clinical remission remained free of flares after anti-TNF withdrawal and to evaluate the effects of treatment reintroduction. We also analyze the characteristics of patients who did not present clinical relapse. Methods: Multicenter, prospective, observational study of a cohort of patients with active AS who had received infliximab as a first anti-TNF treatment and who presented persistent remission (more than 6 months). We recorded at baseline and every 6-8 weeks over the 12-month period the age, gender, disease duration, peripheral arthritis or enthesitis, HLA-B27 status, BASDAI, CRP, ESR, BASFI, and three visual analogue scales, spine global pain, spinal night time pain, and patient's global assessment. Results: Thirty-six out of 107 patients (34%) presented persistent remission and were included in our study. After treatment withdrawal, 21 of these 36 patients (58%) presented clinical relapse during follow-up. Infliximab therapy was reintroduced and only 52% achieved clinical remission, as they had before the discontinuation of infliximab; in an additional 10%, reintroduction of infliximab was ineffective, obliging us to change the anti-TNF therapy. No clinical or biological factors were associated with the occurrence of relapse during the follow-up. Conclusions: Two thirds of patients in clinical remission presented clinical relapse shortly after infliximab withdrawal. Although the reintroduction of infliximab treatment was safe, half of the patients did not present the same clinical response that they had achieved prior to treatment withdrawal