Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease : A Multicentre Study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered "exposed". The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2-2.0), urgent surgery (OR: 1.6; 95% CI: 1.2-2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1-1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3-2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97-1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03-2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

Hacia una práctica de aprendizaje-servicio a través de la literatura y el cine en el Grado de Estudios Ingleses: herramientas pedagógicas y educativas para desmantelar discursos colectivos de miedo

Memoria ID-096. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2019-2020.[ES]El objetivo del proyecto es fomentar el aprendizaje-servicio en el Grado de Estudios Ingleses, en temáticas consideradas no canónicas (literaturas y cines postcoloniales de diversidad racial, de género y sexual) para estudiar y promover análisis e intervenciones sobre cómo constructos culturales y performativos vertebran discursos de miedo, y establecer dinámicas de intervención, ordenación y, en la mayoría de los casos, subalternida

Using Interpretable Machine Learning to Identify Baseline Predictive Factors of Remission and Drug Durability in Crohn’s Disease Patients on Ustekinumab

Ustekinumab has shown efficacy in Crohn's Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients' data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index <= 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission

Long-Term Real-World Effectiveness and Safety of Ustekinumab in Crohn’s Disease Patients: The SUSTAIN Study

Background Large real-world-evidence studies are required to confirm the durability of response, effectiveness, and safety of ustekinumab in Crohn’s disease (CD) patients in real-world clinical practice. Methods A retrospective, multicentre study was conducted in Spain in patients with active CD who had received ≥1 intravenous dose of ustekinumab for ≥6 months. Primary outcome was ustekinumab retention rate; secondary outcomes were to identify predictive factors for drug retention, short-term remission (week 16), loss of response and predictive factors for short-term efficacy and loss of response, and ustekinumab safety. Results A total of 463 patients were included. Mean baseline Harvey-Bradshaw Index was 8.4. A total of 447 (96.5%) patients had received prior biologic therapy, 141 (30.5%) of whom had received ≥3 agents. In addition, 35.2% received concomitant immunosuppressants, and 47.1% had ≥1 abdominal surgery. At week 16, 56% had remission, 70% had response, and 26.1% required dose escalation or intensification; of these, 24.8% did not subsequently reduce dose. After a median follow-up of 15 months, 356 (77%) patients continued treatment. The incidence rate of ustekinumab discontinuation was 18% per patient-year of follow-up. Previous intestinal surgery and concomitant steroid treatment were associated with higher risk of ustekinumab discontinuation, while a maintenance schedule every 12 weeks had a lower risk; neither concomitant immunosuppressants nor the number of previous biologics were associated with ustekinumab discontinuation risk. Fifty adverse events were reported in 39 (8.4%) patients; 4 of them were severe (2 infections, 1 malignancy, and 1 fever). Conclusions Ustekinumab is effective and safe as short- and long-term treatment in a refractory cohort of CD patients in real-world clinical practice

El reto de la inclusión de los Objetivos de Desarrollo Sostenible en la formación inicial de profesores de secundaria: creación del MOOC curso cero sobre educación y ODS, inclusión en asignaturas y en trabajos fin de máster

Memoria ID-041. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2021-2022

Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885

The authors wish to make the following corrections to this paper [...]

Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery

POR UNA CULTURA DE PAZ: UNA MIRADA DESDE LAS CIENCIAS DE LA CONDUCTA

En
 virtud
 de
 lo
 anterior,
 los
 estudiosos
 de
 las
 ciencias
 de
 la
 conducta
 
de
 la
 Universidad
Autónoma 
del
 Estado 
de 
México,

ante 
la
persistencia
 y 
proliferación
 de
 estos 
hechos
 en
 diversas
 partes
 del
Mundo
 y
 de
 nuestro 
país 
en 
particular, se
 convocó
 a
 los
 estudiosos
 interesados
 y
 a
 la
 sociedad
 en
 general
 a
 presentar
 trabajos
 para
 analizar,
 debatir
 y
 proponer
 estrategias
 de
 acción
 y
 dirección,
 que
 fortalezcan
 una
 convivencia y bienestar con sentido humanista para una cultura de paz. El
 presente
 texto
 es
 producto
 de 
esta convocatoria 
que
 recoge 
los
trabajos 
de 

los
 interesados 
en 
la
 temática,

 de
 diferentes 
países
(España,
Argentina,
Cuba,
Brasil,
Costa
 Rica
 y
 México)
 retomando
 con
 ello
 sus
 experiencias
 relativas
 al
 estudio,
 análisis,
 comprensión
 e
 instrumentación
 de
 la
 cultura
 de
 paz
 en
 los
 distintos
 ámbitos
 institucionales
 en
 los
 que
 participan:
 educativo,
 salud,
 penitenciario,
 social,
laboral,
familia,
alimentario,
psicológico,
por 
mencionar 
algunos.
 El
 presente
 libro,
 propicia
 un
 espacio
 de
 reflexión,
 diálogo
 y
 posicionamiento
 de
 las 
ciencias 
de 
la 
conducta
 para 
la 
apropiación,
análisis,
debate
 y 
propuestas 
que
 fortalezcan 
una
 cultura
 de 
paz
 a
través
 de 
la
 convivencia 
y
 el 
bienestar
 social 
con
 sentido 
humanista.
El
 sistema 
económico
 neoliberal
 y 
el 
proceso
 de 
globalización 
han
 contribuido
al
 logro
 de
 avances
 significativos
 en
 la
 ciencia
 y
 la
 tecnología,
 pero
 también
 han
 propiciado
 la
 polarización
 de
 las
 sociedades
 lo
 que
 ha
 impactado
 de
 manera
 negativa
 a
 la
 sociedad
 en
 su
 conjunto,
 pero
 en
 mayor
 medida
 a
 los grupos
 vulnerables. Dicha
 polarización
 ha
 traído
 consigo
 un
 desarrollo
 desigual
 del
 mundo
 que
 se
 expresa
 de
 diferentes
 maneras
 tanto
 en
 países
 desarrollados
 como
 en
 los
 llamados
 del
 tercer
 mundo,
 en
 donde
 no
 están
 satisfechas
 las
 necesidades
 humanas 
elementales
 de
 todos 
los
sectores 
de 
la 
población,
siempre 
falta 
algo. 
Si 
a
 esto 
le
 sumamos 
los
conflictos
 internacionales por
 diferentes
 motivos
 que
 enfrentan
 algunas
 naciones,
 una
 insuficiente
 cobertura
 educativa
 y
 de
 salud,

 desempleo
 y
 pobreza 
extrema,
 entre 
otras
 cosas; 
estamos
 frente
 a
retos 
de
 gran
 envergadura
 para
 los
 gobiernos,
 para
 los
 estudiosos
 y
 para
 la
 sociedad
 civil
 en
 general. Uno 
de 
los
 intentos
 para
 frenar 
y prevenir 
la
 agudización
 de 
estas 
problemáticas
 es
 la
 cultura 
de 
paz,
cuyo
 estudio
y propuestas 
han 
ido 
avanzando 
en 
diferentes
 sentidos 
y 
de 
manera 
favorable,
el 
tema 
está 
presente 
en 
diferentes 
Organismos
 Internacionales
 como
 la
 ONU,
 la
 UNESCO,
 la
 OCDE,
 El
 Banco
 Mundial,
 entre
 otros.
 Pero
 falta 
mucho 
por 
hacer.Universidad Autónoma del Estado de Méxic

Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered “exposed”. The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2–2.0), urgent surgery (OR: 1.6; 95% CI: 1.2–2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1–1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3–2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97–1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03–2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections