Evaluation of AIF-1 (Allograft Inflammatory Factor-1) as a Biomarker of Crohn’s Disease Severity

Background: Recently, increased tissue levels of AIF-1 have been shown in experimental colitis, supporting its role in intestinal inflammation. Therefore, we studied the levels of AIF-1 in Crohn’s disease (CD). Methods: This study included 33 patients with CD (14 men and 19 women) who participated in the PREDICROHN project, a prospective multicenter study of the Spanish Group of Inflammatory bowel disease (GETECCU). Results: This article demonstrates declines with respect to baseline levels of serum AIF-1 in Crohn’s disease (CD) patients after 14 weeks of treatment with anti-TNFs. Furthermore, in patients with active CD (HB ≥ 5), serum AIF-1 levels were significantly higher than those in patients without activity (HB ≤ 4). The study of serum AIF-1 in the same cohort, revealed an area under the ROC curve (AUC) value of AUC = 0.66 (p = 0.014), while for the CRP (C-reactive protein), (AUC) value of 0.69 (p = 0.0066), indicating a similar ability to classify CD patients by their severity. However, the combination of data on serum levels of AIF-1 and CRP improves the predictive ability of these analyses for classifying CD patients as active (HB ≥ 5) or inactive (HB ≤ 4). When we used the odds ratio (OR) formula, we observed that patients with CRP > 5 mg/L or AIF-1 > 200 pg/mL or both conditions were 13 times more likely to show HB ≥ 5 (active CD) than were those with both markers below these thresholds. Conclusion: The development of an algorithm that includes serum levels of AIF-1 and CRP could be useful for assessing Crohn’s disease severityThis research has been funded by grants from: Asociación Española de Gastroenterología (AEG), Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU), Instituto de Salud Carlos III (FIS12/02557 and PI13/00041) and Universidad de Alcalá (32/2013, 22/2014, 26/2015) and B2017/BMD-3804 MITIC-CM (Comunidad de Madrid) and Halekulani S.

Contaminación atmosférica y aerobiología del casco urbano de Calceta-Manabí

Biostabilization of poultry excreta through efficient microorganisms for the control of environmental contamination En la ciudad de Calceta (Manabí, Ecuador) se han identificado tres granjas avícolas destinadas a la producción de huevos, las cuales no realizan tratamiento alguno de las excretas de las aves ponedoras, lo que conlleva la generación de gases y malos olores que afectan a la población. El presente trabajo analiza la eficiencia en la reducción de la contaminación del aire al tratar las excretas avícolas con diferentes dosis de microorganismos eficientes (EMs). Se diseñó el experimento de manera unifactorial con cuatro tratamientos, tomando como base 5 Kg de excretas de avícolas. Se agregaron dosis volumétricas de 0,5; 1,0; y 1,5 litros de EMs; mientras que, se agregó 1 litro de agua como control. Se evaluó la variación de parámetros como el pH, humedad, amonio y el desarrollo de colonias de Bacillus spp., Lactobacillus spp. y levaduras. El proceso de bioestabilización fue evaluado con dos mediciones, la primera a los 10 días y la segunda a los 20 días de aplicación de los EMs. Los resultados demuestran que a los 20 días los valores del pH alcanzaron rangos entre 8,3 y 7,6; disminución de concentraciones de amonio desde 3,14 mg/L hasta 0,60 mg/ L; en el caso de la humedad, existió una disminución de aproximadamente 50%, lo cual afectó en la disminución de la población microbiana de levaduras, Bacillus spp., y Lactobacillus spp. en más de un 90%. Se concluye que los microorganismos eficientes empleados permiten la reducción de más del 70% de malos olores representados por el amoniaco, generados por la acumulación de excretas avícolas. Palabras clave: microorganismos eficientes; aves; desechos; contaminación del aire; aerobiología; patógenos. Abstract In the city of Calceta (Manabí, Ecuador) three poultry farms have been identified for the production of eggs, which do not perform any treatment of the excreta of the laying birds, which leads to the generation of gases and bad odors that affect the population. The present work analyzes the efficiency in the reduction of air pollution when treating poultry excreta with different doses of efficient microorganisms (EMs). The experiment was designed in a unifactorial way with four treatments, based on 5 Kg of poultry excreta. Volumetric doses were added in the following order: 0,5; 1,0; and 1,5 liters of EMs; while, 1 liter of water was added as control. The variation of parameters such as pH, humidity, ammonium and the development of colonies of Bacillus spp., Lactobacillus spp. and yeasts. The biostabilization process was evaluated with two measurements, the first at 10 days and the second at 20 days of application of the EMs. The results show that at 20 days the pH values ​​reached ranges between 8,3 and 7,6; a decrease in ammonium concentrations from 3,14 mg/L to 0,60 mg/L was achieved; in the case of humidity, there was a decrease of approximately 50%, which affected the decrease of the microbial population of yeasts, Bacillus spp., and Lactobacillus spp. in more than 90%. In conclusion, the efficient microorganisms allow the reduction of more than 70% of bad odors represented by ammonia, generated by the accumulation of poultry excreta. Keywords: efficient microorganisms; poultry; wastes; air contamination; aerobiology; pathogens

Contaminación atmosférica y aerobiología del casco urbano de Calceta-Manabí

Biostabilization of poultry excreta through efficient microorganisms for the control of environmental contamination En la ciudad de Calceta (Manabí, Ecuador) se han identificado tres granjas avícolas destinadas a la producción de huevos, las cuales no realizan tratamiento alguno de las excretas de las aves ponedoras, lo que conlleva la generación de gases y malos olores que afectan a la población. El presente trabajo analiza la eficiencia en la reducción de la contaminación del aire al tratar las excretas avícolas con diferentes dosis de microorganismos eficientes (EMs). Se diseñó el experimento de manera unifactorial con cuatro tratamientos, tomando como base 5 Kg de excretas de avícolas. Se agregaron dosis volumétricas de 0,5; 1,0; y 1,5 litros de EMs; mientras que, se agregó 1 litro de agua como control. Se evaluó la variación de parámetros como el pH, humedad, amonio y el desarrollo de colonias de Bacillus spp., Lactobacillus spp. y levaduras. El proceso de bioestabilización fue evaluado con dos mediciones, la primera a los 10 días y la segunda a los 20 días de aplicación de los EMs. Los resultados demuestran que a los 20 días los valores del pH alcanzaron rangos entre 8,3 y 7,6; disminución de concentraciones de amonio desde 3,14 mg/L hasta 0,60 mg/ L; en el caso de la humedad, existió una disminución de aproximadamente 50%, lo cual afectó en la disminución de la población microbiana de levaduras, Bacillus spp., y Lactobacillus spp. en más de un 90%. Se concluye que los microorganismos eficientes empleados permiten la reducción de más del 70% de malos olores representados por el amoniaco, generados por la acumulación de excretas avícolas. Palabras clave: microorganismos eficientes; aves; desechos; contaminación del aire; aerobiología; patógenos. Abstract In the city of Calceta (Manabí, Ecuador) three poultry farms have been identified for the production of eggs, which do not perform any treatment of the excreta of the laying birds, which leads to the generation of gases and bad odors that affect the population. The present work analyzes the efficiency in the reduction of air pollution when treating poultry excreta with different doses of efficient microorganisms (EMs). The experiment was designed in a unifactorial way with four treatments, based on 5 Kg of poultry excreta. Volumetric doses were added in the following order: 0,5; 1,0; and 1,5 liters of EMs; while, 1 liter of water was added as control. The variation of parameters such as pH, humidity, ammonium and the development of colonies of Bacillus spp., Lactobacillus spp. and yeasts. The biostabilization process was evaluated with two measurements, the first at 10 days and the second at 20 days of application of the EMs. The results show that at 20 days the pH values ​​reached ranges between 8,3 and 7,6; a decrease in ammonium concentrations from 3,14 mg/L to 0,60 mg/L was achieved; in the case of humidity, there was a decrease of approximately 50%, which affected the decrease of the microbial population of yeasts, Bacillus spp., and Lactobacillus spp. in more than 90%. In conclusion, the efficient microorganisms allow the reduction of more than 70% of bad odors represented by ammonia, generated by the accumulation of poultry excreta. Keywords: efficient microorganisms; poultry; wastes; air contamination; aerobiology; pathogens

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

Monitorización y seguimiento del esfuerzo realizado por los estudiantes y de su asistencia a actividades presenciales

Este artículo documenta el planteamiento, la metodología y los primeros resultados de un plan de monitorización detallada del esfuerzo y de asistencia a actividades presenciales por parte de los estudiantes de las titulaciones ofertadas por la Escuela Técnica Superior de Ingenieros Navales de la Universidad Politécnica de Madrid durante el segundo cuatrimestre del curso 2011-2012. Se ha establecido un sistema mecánico de recogida de datos de esfuerzo por parte de los estudiantes utilizando una hoja tipo test especialmente configurada al efecto. Se pasa una hoja en todas y cada una de las actividades presenciales realizadas y en la hoja se solicita información sobre el trabajo "fuera de clase". Se documenta en este artículo cómo se ha estructurado esa hoja, qué tipo de datos se recogen, cómo se tratan mediante una base de datos creada al efecto, qué tipo de análisis se puede realizar y qué resultados preliminares obtenemos de dichos análisis

Guía Mexicana para el Diagnóstico y el Tratamiento de la Urticaria

La urticaria es una enfermedad que padece una quinta parte de la población en algún momento de su vida. Las guías inter- nacionales recientes han propuesto unos cambios de fondo en su diagnóstico y tratamiento, por lo que había la necesidad de crear una guía nacional y multidisciplinaria, con base amplia en los gremios de especialistas y médicos de primer contacto en México. ABSTRACT Urticaria is a disease that a fifth of the population shall suffer once in a lifetime. Recent clinical guidelines have proposed some fundamental changes in the diagnosis and treatment of urticaria, making the development of a national, multidisciplinary guideline, with wide acceptability among different professional groups –both specialists and primary health care workers–, necessary in Mexico

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life