Influence of stress and depression on the immune system in patients evaluated in an anti-aging unit

Background: There is compelling evidence pointing out that stress and depression produce a dramatic impact on human well-being mainly through impairing the regular function of the immune system and producing a low-chronic inflammation status that favors the occurrence of infections, metabolic diseases, and even cancer. The present work aims to evaluate the stress/depression levels of some patients treated in an antiaging unit and detect any potential relationship with their immune system status prior of the implementation of a physical/psychological program designed to prevent health deterioration. Methods: We evaluated 48 patients (16 men and 32 women with a mean age of 55.11 ± 10.71 years) from middle-upper class from psychological and immunological points of view. In particular, we analyzed neutrophil chemotaxis and phagocytosis; lymphocyte chemotaxis and proliferation, and natural killer (NK) cell activity. Results: Women showed more depressive symptoms than men. Chemotaxis levels of lymphocytes and neutrophils in women showed a significant reduction compared with those in men. We also found a strong negative correlation between depression and NK cell function. This correlation was also significant independently of gender. Conclusion: We conclude that NK activity is affected at least by depression state, and we propose that a combined treatment consisting of cognitive behavioral therapy and physical activity programs might improve patient health deterioration

Characterization of the rat Na+/nucleoside cotransporter 2 and transport of nucleoside-derived drugs using electrophysiological methods.

The Na(+)-dependent nucleoside transporter 2 (CNT2) mediates active transport of purine nucleosides and uridine as well as therapeutic nucleoside analogs. We used the two-electrode voltage-clamp technique to investigate rat CNT2 (rCNT2) transport mechanism and study the interaction of nucleoside-derived drugs with the transporter expressed in Xenopus laevis oocytes. The kinetic parameters for sodium, natural nucleosides, and nucleoside derivatives were obtained as a function of membrane potential. For natural substrates, apparent affinity (K(0.5)) was in the low micromolar range (12-34) and was voltage independent for hyperpolarizing membrane potentials, whereas maximal current (I(max)) was voltage dependent. Uridine and 2'-deoxyuridine analogs modified at the 5-position were substrates of rCNT2. Lack of the 2'-hydroxyl group decreased affinity but increased I(max). Increase in the size and decrease in the electronegativity of the residue at the 5-position affected the interaction with the transporter by decreasing both affinity and I(max). Fludarabine and formycin B were also transported with higher I(max) than uridine and moderate affinity (102 +/- 10 and 66 +/- 6 microM, respectively). Analysis of the pre-steady-state currents revealed a half-maximal activation voltage of about -39 mV and a valence of about -0.8. K(0.5) for Na(+) was 2.3 mM at -50 mV and decreased at hyperpolarizing membrane potentials. The Hill coefficient was 1 at all voltages. Direct measurements of radiolabeled nucleoside fluxes with the charge associated showed a ratio of two positive inward charges per nucleoside, suggesting a stoichiometry of two Na(+) per nucleoside. This discrepancy in the number of Na(+) molecules that bind rCNT2 may indicate a low degree of cooperativity between the Na(+) binding sites

Evaluation of Natural Language Processing for the Identification of Crohn Disease-Related Variables in Spanish Electronic Health Records:A Validation Study for the PREMONITION-CD Project

Background: The exploration of clinically relevant information in the free text of electronic health records (EHRs) holds the potential to positively impact clinical practice as well as knowledge regarding Crohn disease (CD), an inflammatory bowel disease that may affect any segment of the gastrointestinal tract. The EHRead technology, a clinical natural language processing (cNLP) system, was designed to detect and extract clinical information from narratives in the clinical notes contained in EHRs. Objective: The aim of this study is to validate the performance of the EHRead technology in identifying information of patients with CD. Methods: We used the EHRead technology to explore and extract CD-related clinical information from EHRs. To validate this tool, we compared the output of the EHRead technology with a manually curated gold standard to assess the quality of our cNLP system in detecting records containing any reference to CD and its related variables. Results: The validation metrics for the main variable (CD) were a precision of 0.88, a recall of 0.98, and an F1 score of 0.93. Regarding the secondary variables, we obtained a precision of 0.91, a recall of 0.71, and an F1 score of 0.80 for CD flare, while for the variable vedolizumab (treatment), a precision, recall, and F1 score of 0.86, 0.94, and 0.90 were obtained, respectively. Conclusions: This evaluation demonstrates the ability of the EHRead technology to identify patients with CD and their related variables from the free text of EHRs. To the best of our knowledge, this study is the first to use a cNLP system for the identification of CD in EHRs written in Spanish. © 2022 JMIR Medical Informatics. All rights reserved

Influence of stress and depression on the immune system in patients evaluated in an anti-aging unit

Background: There is compelling evidence pointing out that stress and depression produce a dramatic impact on human well-being mainly through impairing the regular function of the immune system and producing a low-chronic inflammation status that favors the occurrence of infections, metabolic diseases, and even cancer. The present work aims to evaluate the stress/depression levels of some patients treated in an antiaging unit and detect any potential relationship with their immune system status prior of the implementation of a physical/psychological program designed to prevent health deterioration. Methods: We evaluated 48 patients (16 men and 32 women with a mean age of 55.11 ± 10.71 years) from middle-upper class from psychological and immunological points of view. In particular, we analyzed neutrophil chemotaxis and phagocytosis; lymphocyte chemotaxis and proliferation, and natural killer (NK) cell activity. Results: Women showed more depressive symptoms than men. Chemotaxis levels of lymphocytes and neutrophils in women showed a significant reduction compared with those in men. We also found a strong negative correlation between depression and NK cell function. This correlation was also significant independently of gender. Conclusion: We conclude that NK activity is affected at least by depression state, and we propose that a combined treatment consisting of cognitive behavioral therapy and physical activity programs might improve patient health deterioration

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

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

Perianal lesions in Crohn's disease: analysis of Epimad registry from 2007 to 2012

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Translational blogging: a bidirectional communication between the class and society.

Higher Education Students (HES) may find the lectures as something far away from their everyday life. Professors feel a big gap between themselves and their pupils. Furthermore, some students can find that subjects are not connected in between them and make close boxes of knowledge. To show them the great net of knowledge they can build, we have redesigned an old strategy, the use of blogs in education, to break that gap and increase student interest in the lectures. After the introduction of the Bologna Process in the European Higher Education Area, annual subjects have almost disappeared in behalf of shorter ones. This reduction might help the students pass their courses, but it brings up the problem of compartments in knowledge. Because of this, our project has been focused on the students of the Pharmacy Faculty which have 4 subjects associated to infectious diseases (ID) from 3rd to 6th semester (Microbiology, Parasitology, Immunology, and Biological Analysis) of a curriculum of 5 years (10 semesters). Technological gap is a reality in between students and teachers because the internet and technology are used in a different way. HES have grown in a world where social media is a part of them, sharing their daily life with pictures, videos or comments. We have therefore thought to use this enthusiasm to create a blog to share and associate the knowledge they acquire in our classes, with news they find related to ID. The blog is edited by teachers, but written by students named the “Infectious Gazzete”. Students have looked for information related to ID in different media. Once they have found attractive news, students have to practice their critical thinking and write a small blog entry containing a review of the subject using their lectures notes or books. By means of this activity, students can link the knowledge acquired in the lectures to the latest news in the field of ID. Before the entry is published in the blog, teachers play an editor role where the entry is sent back to students for improvement. Finally, the text is uploaded to the blog. As the blog entries are published in an open blog, their peers are able to read and discuss the news. Because this activity is carried out during 4 semesters, students are also able to have a global and up to date view of every aspect related to ID. Furthermore, students from other Universities (The Montfort University, UK) have joined our initiative contributing to the blog. A survey was carried to analyze students’ opinion on this initiative. Ninety-five students answer the survey with a mean age of 19,11 (± 2,11) years old. After statistically analyzing the results, the medians that favorably scored for the activity were for the statements: In general, I liked this activity. The realization of this activity is interesting and I consider that this project favors my Personal development. None negative impression was observed for any question. Overall our project has improved students’ interest in the different subjects that could be used to interconnect the different topics addressed in the lectures. Moreover, the use of the blog as an open platform, make students feel the responsibility of being well informed and read about a topic before open publishing. The exposure of students to this experience creates a platform where we introduce our subjects into an open discussion in students’ families and friends, increasing the attention and interest of infectious diseases in their everyday life