Transmural Remission Improves Clinical Outcomes Up to 5 years in Crohn's Disease

Introduction: Evidence supporting transmural remission (TR) as a long-term treatment target in Crohn's disease (CD) is still unavailable. Less stringent but more reachable targets such as isolated endoscopic (IER) or radiologic remission (IRR) may also be acceptable options in the long-term. Methods: Multicenter retrospective study including 404 CD patients evaluated by magnetic resonance enterography and colonoscopy. Five-year rates of hospitalization, surgery, use of steroids, and treatment escalation were compared between patients with TR, IER, IRR, and no remission (NR). Results: 20.8% of CD patients presented TR, 23.3% IER, 13.6% IRR and 42.3% NR. TR was associated with lower risk of hospitalization (odds-ratio [OR] 0.244 [0.111-0.538], p < 0.001), surgery (OR 0.132 [0.030-0.585], p = 0.008), steroid use (OR 0.283 [0.159-0.505], p < 0.001), and treatment escalation (OR 0.088 [0.044-0.176], p < 0.001) compared to no NR. IRR resulted in lower risk of hospitalization (OR 0.333 [0.143-0.777], p = 0.011) and treatment escalation (OR 0.260 [0.125-0.540], p < 0.001), while IER reduced the risk of steroid use (OR 0.442 [0.262-0.745], p = 0.002) and treatment escalation (OR 0.490 [0.259-0.925], p = 0.028) compared to NR. Conclusions: TR improved clinical outcomes over 5 years of follow-up in CD patients. Distinct but significant benefits were seen with IER and IRR. This suggests that both endoscopic and radiologic remission should be part of the treatment targets of CD.info:eu-repo/semantics/publishedVersio

Atorvastatin Improves Survival in Septic Rats: Effect on Tissue Inflammatory Pathway and on Insulin Signaling

The aim of the present study was to investigate whether the survival-improving effect of atorvastatin in sepsis is accompanied by a reduction in tissue activation of inflammatory pathways and, in parallel, an improvement in tissue insulin signaling in rats. Diffuse sepsis was induced by cecal ligation and puncture surgery (CLP) in male Wistar rats. Serum glucose and inflammatory cytokines levels were assessed 24 h after CLP. The effect of atorvastatin on survival of septic animals was investigated in parallel with insulin signaling and its modulators in liver, muscle and adipose tissue. Atorvastatin improves survival in septic rats and this improvement is accompanied by a marked improvement in insulin sensitivity, characterized by an increase in glucose disappearance rate during the insulin tolerance test. Sepsis induced an increase in the expression/activation of TLR4 and its downstream signaling JNK and IKK/NF-κB activation, and blunted insulin-induced insulin signaling in liver, muscle and adipose tissue; atorvastatin reversed all these alterations in parallel with a decrease in circulating levels of TNF-α and IL-6. In summary, this study demonstrates that atorvastatin treatment increased survival, with a significant effect upon insulin sensitivity, improving insulin signaling in peripheral tissues of rats during peritoneal-induced sepsis. The effect of atorvastatin on the suppression of the TLR-dependent inflammatory pathway may play a central role in regulation of insulin signaling and survival in sepsis insult

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Confiabilidade e validade das Declarações de Óbito por câncer de boca no Município de Teresina, Piauí, Brasil, no período de 2004 e 2005 Reliability and validity of death certificates specifying oral cancer as cause of death in Teresina, Piauí State, Brazil, 2004-2005

A política de saúde brasileira depende da precisão dos dados contidos no sistema de informação em saúde. Com objetivo de avaliar a confiabilidade e validade da causa básica de morte por uma neoplasia específica, no Município de Teresina, Piauí, Brasil, foram utilizadas todas as Declarações de Óbito (DO) que possuíam como causa básica de morte o câncer de boca nos anos de 2004 e 2005, contabilizando um total de 23 DO. Elas foram submetidas à nova codificação da causa básica mediante utilização de formulário direcionado à coleta de dados clínicos e de exames complementares para a confirmação do diagnóstico nos prontuários médicos. O diagnóstico foi confirmado pelo exame histopatológico e história clínica. Observou-se uma concordância simples de 91,3% e coeficiente kappa de 0,84. O valor preditivo positivo correspondeu a 90,9%. Assim, pode-se afirmar que as referidas estatísticas de mortalidade são válidas e confiáveis. Este estudo teve como limitação possíveis sub-registros de casos que tiveram como causa básica de morte a referida patologia, visto que tais dados não constam no sistema de informação em mortalidade de Teresina.<br>Brazilian health policy depends on the accuracy of data in the health information system. This study aimed to assess the reliability and validity of data on underlying cause of death due to a specific neoplasm in the Municipality of Teresina, Piauí State, Brazil, based on all the death certificates from 2004 and 2005 that reported oral cancer as the underlying cause of death (total of 23 death certificates). The death certificates were recoded for underlying cause of death by using a form targeted at collecting clinical and laboratory data to confirm the medical diagnosis on patient charts. Diagnosis was confirmed by histopathologic examination and clinical history. Simple agreement was 91.3%, kappa coefficient 0.84, and positive predictive value 90.9%. Based on the findings, the mortality statistics were valid and reliable. One limitation to this study was the possible underreporting of cases with oral cancer as the underlying cause of death, given that such data are not included in the mortality information system in Teresina

Novel Ocellatin Peptides Mitigate LPS-induced ROS Formation and NF-kB Activation in Microglia and Hippocampal Neurons

Cutaneous secretions of amphibians have bioactive compounds, such as peptides, with potential for biotechnological applications. Therefore, this study aimed to determine the primary structure and investigate peptides obtained from the cutaneous secretions of the amphibian, Leptodactylus vastus, as a source of bioactive molecules. The peptides obtained possessed the amino acid sequences, GVVDILKGAAKDLAGH and GVVDILKGAAKDLAGHLASKV, with monoisotopic masses of [M + H]± = 1563.8 Da and [M + H]± = 2062.4 Da, respectively. The molecules were characterized as peptides of the class of ocellatins and were named as Ocellatin-K1(1–16) and Ocellatin-K1(1–21). Functional analysis revealed that Ocellatin-K1(1–16) and Ocellatin-K1(1–21) showed weak antibacterial activity. However, treatment of mice with these ocellatins reduced the nitrite and malondialdehyde content. Moreover, superoxide dismutase enzymatic activity and glutathione concentration were increased in the hippocampus of mice. In addition, Ocellatin-K1(1–16) and Ocellatin-K1(1–21) were effective in impairing lipopolysaccharide (LPS)-induced reactive oxygen species (ROS) formation and NF-kB activation in living microglia. We incubated hippocampal neurons with microglial conditioned media treated with LPS and LPS in the presence of Ocellatin-K1(1–16) and Ocellatin-K1(1–21) and observed that both peptides reduced the oxidative stress in hippocampal neurons. Furthermore, these ocellatins demonstrated low cytotoxicity towards erythrocytes. These functional properties suggest possible to neuromodulatory therapeutic applications.This work was funded through project UID/QUI/50006/2013-POCI/01/0145/FEDER/007265 (LAQV/REQUIMTE) with financial support from FCT/MEC through national funds and co-financed by FEDER, under the Partnership Agreement PT 2020

Mucinose Folicular: revisão da literatura e relato de um caso Follicular mucinosis: literature review and case report

A mucinose follicular (MuF), também chamada de alopecia mucinosa, é mucinose cutânea caracterizada pelo acúmulo de mucina no folículo pilossebáceo. As mucinoses têm duas formas de apresentação: uma idiopática ou primária, e outra sintomática ou associada a diversos processos benignos e malignos. Os autores apresentam um caso de mucinose folicular primária e fazem breve revisão do assunto. Trata-se de uma paciente de 26 anos de idade, com placa eritematosa recoberta por fina descamação, alopécica e localizada no supercílio direito. Após seis meses, sem qualquer tratamento, houve resolução espontânea da lesão. A paciente permaneceu durante 12 meses em controle ambulatorial sem que se evidenciasse qualquer sinal de recidiva.<br>Follicular mucinosis, also known as alopecia mucinosa, is a cutaneous mucinosis characterized by mucin accumulation predominantly in the pilosebaceous follicle. Two forms are distinguished: an idiopathic, or primary form, which is benign and without associated disease, and a symptomatic form associated with lymphoproliferative disorder, most commonly the cutaneous T-cell lymphoma mycosis fungoides. The authors present a new case of the disease and a brief review of the literature. The patient was a 26-year-old female with an asymptomatic plaque of erythema and scaling with alopecia on her right eyebrow. The lesion resolved spontaneously six months later. We have followed the patient over twelve months without relapse