Differences in peripheral and tissue immune cell populations following haematopoietic stem cell transplantation in Crohn's disease patients

Background and aims: recent studies have shown the efficacy of autologous haematopoietic stem cell transplantation [HSCT] in severely refractory Crohn's disease [CD] patients. HSCT is thought to eliminate auto-reactive cells; however, no specific studies of immune reconstitution in CD patients are available. Methods: we followed a group of CD patients [n = 18] receiving autologous HSCT, with 50% of them achieving endoscopic drug-free remission. To elucidate the mechanisms driving efficacy, we monitored changes after HSCT in blood and intestine immune-cell composition. CD patients [n = 22] receiving anti-tumour necrosis factor [TNF]-α were included for comparison. Results: severe immune ablation followed by HSCT induced dramatic changes in both peripheral blood T and B cells in all patients regardless of the efficacy of the treatment. Endoscopic remission at week 52 following HSCT was associated with significant intestinal transcriptional changes. A comparison of the remission signature with that of anti-TNFα identified both common and unique genes in the HSCT-induced response. Based on deconvolution analysis of intestinal biopsy transcriptome data, we show that response to HSCT, but not to anti-TNFα, is associated with an expansion of naïve B-cells, as seen in blood, and a decrease in the memory resting T-cell content. As expected, endoscopic remission, in response to both HSCT and anti-TNFα, led to a significant reduction in intestinal neutrophil and M1 macrophage content. Conclusions: peripheral blood immune remodelling after HSCT does not predict efficacy. In contrast, a profound intestinal T-cell depletion that is maintained long after transplant is associated with mucosal healing following HSCT, but not anti-TNFα

Model of teleconsultation pharmaceutical integrated in the electronic clinical history of the patient

OBJECTIVE: Describe the phases of implementation, scaling and integration of a pharmacy teleconsultation model in electronic history, to coordinate the care transition of patients. METHOD: Descriptive and retrospective study in a health area of 500,000 inhabitants (3 years). In the first phase, a working group was created, a communication platform was designed and a continuity program was piloted between a hospital pharmacist and the 13 primary care pharmacists. The objective was to solve problems related to medications (especially those of sanitary approval) in polymedicated patients hospitalized in the Short Stay Unit- Emergency. In a second phase, the program included all the patients in any unit and all the pharmacists in the hospital. In the third phase, the program was extended to the teleconsultation format within the corporate information systems of the Health Service. Quantitative descriptive variables were recorded (number, motives and resolution of the teleconsultations). RESULTS: In total, more than 470 consultations were registered (118 in the first phase, 158 in the second and 194 in the third), which were resolved in 90% of the cases. The main reasons were discrepancies in type approval drugs, prescribed in the care transition and nutritional assessment. CONCLUSIONS: Teleconsultation allows the coordination of pharmaceutical care between levels, quickly and easily. Increase the visibility and access of professionals. Problems are resolved without displacements or time delays for patients

Phylogenetic diversity of Amazonian tree communities

Aim: To examine variation in the phylogenetic diversity (PD) of tree communities across geographical and environmental gradients in Amazonia. Location: Two hundred and eighty-three c. 1 ha forest inventory plots from across Amazonia. Methods: We evaluated PD as the total phylogenetic branch length across species in each plot (PDss), the mean pairwise phylogenetic distance between species (MPD), the mean nearest taxon distance (MNTD) and their equivalents standardized for species richness (ses.PDss, ses.MPD, ses.MNTD). We compared PD of tree communities growing (1) on substrates of varying geological age; and (2) in environments with varying ecophysiological barriers to growth and survival. Results: PDss is strongly positively correlated with species richness (SR), whereas MNTD has a negative correlation. Communities on geologically young- and intermediate-aged substrates (western and central Amazonia respectively) have the highest SR, and therefore the highest PDss and the lowest MNTD. We find that the youngest and oldest substrates (the latter on the Brazilian and Guiana Shields) have the highest ses.PDss and ses.MNTD. MPD and ses.MPD are strongly correlated with how evenly taxa are distributed among the three principal angiosperm clades and are both highest in western Amazonia. Meanwhile, seasonally dry tropical forest (SDTF) and forests on white sands have low PD, as evaluated by any metric. Main conclusions: High ses.PDss and ses.MNTD reflect greater lineage diversity in communities. We suggest that high ses.PDss and ses.MNTD in western Amazonia results from its favourable, easy-to-colonize environment, whereas high values in the Brazilian and Guianan Shields may be due to accumulation of lineages over a longer period of time. White-sand forests and SDTF are dominated by close relatives from fewer lineages, perhaps reflecting ecophysiological barriers that are difficult to surmount evolutionarily. Because MPD and ses.MPD do not reflect lineage diversity per se, we suggest that PDss, ses.PDss and ses.MNTD may be the most useful diversity metrics for setting large-scale conservation priorities

Seafood Consumption, Omega-3 Fatty Acids Intake, and Life-Time Prevalence of Depression in the PREDIMED-Plus Trial

Background: The aim of this analysis was to ascertain the type of relationship between fish and seafood consumption, omega-3 polyunsaturated fatty acids (ω-3 PUFA) intake, and depression prevalence. Methods: Cross-sectional analyses of the PREDIMED-Plus trial. Fish and seafood consumption and ω-3 PUFA intake were assessed through a validated food-frequency questionnaire. Self-reported life-time medical diagnosis of depression or use of antidepressants was considered as outcome. Depressive symptoms were collected by the Beck Depression Inventory-II. Logistic regression models were used to estimate the association between seafood products and ω-3 PUFA consumption and depression. Multiple linear regression models were fitted to assess the association between fish and long-chain (LC) ω-3 PUFA intake and depressive symptoms. Results: Out of 6587 participants, there were 1367 cases of depression. Total seafood consumption was not associated with depression. The odds ratios (ORs) (95% confidence intervals (CIs)) for the 2nd, 3rd, and 4th quintiles of consumption of fatty fish were 0.77 (0.63–0.94), 0.71 (0.58–0.87), and 0.78 (0.64–0.96), respectively, and p for trend = 0.759. Moderate intake of total LC ω-3 PUFA (approximately 0.5–1 g/day) was significantly associated with a lower prevalence of depression. Conclusion: In our study, moderate fish and LC ω-3 PUFA intake, but not high intake, was associated with lower odds of depression suggesting a U-shaped relationship

Ciencia Odontológica 2.0

Libro que muestra avances de la Investigación Odontológica en MéxicoEs para los integrantes de la Red de Investigación en Estomatología (RIE) una enorme alegría presentar el segundo de una serie de 6 libros sobre casos clínicos, revisiones de la literatura e investigaciones. La RIE está integrada por cuerpos académicos de la UAEH, UAEM, UAC y UdeG

Generación de empleos mediante la Constitución de una cooperativa denominada The Urban Blue boutique

El presente trabajo se realiza con la finalidad de hacer frente al fenómeno socioeconómico, el cual sufre nuestro país, debido a las diversas crisis que han resultado de los diferentes sexenios presidenciales, los cuales se realizarán desde los años 80 para su mayor comprensión, esto para poder responder a muchas de las necesidades de la población marginada, entre las cuales están los bajos ingresos y el aumento de desempleo

Longitudinal Changes in Mitochondrial DNA Copy Number and Telomere Length in Patients with Parkinson’s Disease

Parkinson’s disease (PD) pathophysiology includes mitochondrial dysfunction, neuroinflammation, and aging as its biggest risk factors. Mitochondrial DNA copy number (mtDNA-CN) and telomere length (TL) are biological aging markers with inconclusive results regarding their association with PD. A case–control study was used to measure TL and mtDNA-CN using qPCR in PBMCs. PD patients were naive at baseline (T0) and followed-up at one (T1) and two (T2) years after the dopaminergic treatment (DRT). Plasmatic cytokines were determined by ELISA in all participants, along with clinical parameters of patients at T0. While TL was shorter in patients vs. controls at all time points evaluated (p p p p < 0.05). TL and mtDNA-CN could be useful markers for monitoring inflammation progression or treatment response in PD. DRT might modulate TL and mtDNA-CN, reflecting a compensatory mechanism to counteract mitochondrial dysfunction in PD, but this needs further investigation

Medication non- adherence as a cause of hospital admissions

Objectives: 1. To determine the profile of patients who are admitted to hospital as a result of non-adherence. 2. To obtain an estimate of the economic impact for the hospital. Methods: Observational and retrospective study that included patients who were admitted to hospital with a secondary diagnosis of «Personal history of non-compliance with chronic medication» according to International Classification of Diseases, during 2012. Data collected: demographics; socioeconomic and clinical data; data related to the treatment; readmissions; hospital days; degree of adherence: ≤75% or severe non-adherence and > 75% or moderate non-adherence; type of non-adherence: non-persistence and noncompliance; hospitalization costs. Statistical analysis was performed. Results: Eighty-seven patients were admitted. These patients caused 104 episodes (16.3% were readmissions). 71.2% were men, and 51.5 (SD 17.8) years old. All patients had a chronic disease, adherence ≤75% (76%) and non-persistence (63.5%). Polypharmacy (47.1%) was not associated with non-adherence. Total stay was 1,527 days (mean stay was 14.7 (SD 14.0) days/episode): psychiatry 827 days (54.2%); cardiology 174 days (11.4%); critical unit 48 days (3.1%). Patients with a degree of adherence ≤75% had a mean stay/episode higher than those with a degree of adherence > 75%, without significant differences (p > 0.05, t-Student). Overall cost of hospitalization was 594,230.8, with a mean cost/episode: 5,713.6 (SD 5,039.5). Mean cost/episode for adherence ≤75% was higher than > 75%, 6,275.8 (SD 5,526.2) vs 3,895.6 (SD 2,371.3), (p < 0.05, t-Student). Conclusions: The profile of this patient is fundamentally, a male psychiatric or chronic cardiac patient with a degree of adherence ≤75% due to abandoning domiciliary treatment. Admissions due to medication non-adherence are associated with an important depletion of economic resources in the hospital