Effectiveness and safety of Ustekinumab in ulcerative colitis: real-world evidence from the ENEIDA registry

Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si lo hubiere, y los autores pertenecientes a la UAMThe development programm UNIFI has shown promising results of ustekinumab in ulcerative colitis [UC] treatment which should be confirmed in clinical practice. We aimed to evaluate the durability, effectiveness, and safety of ustekinumab in UC in real life. Methods: Patients included in the prospectively maintained ENEIDA registry, who received at least one intravenous dose of ustekinumab due to active UC [Partial Mayo Score [PMS]>2], were included. Clinical activity and effectiveness were defined based on PMS. Short-term response was assessed at Week 16. Results: A total of 95 patients were included. At Week 16, 53% of patients had response [including 35% of patients in remission]. In the multivariate analysis, elevated serum C-reactive protein was the only variable significantly associated with lower likelihood of achieving remission. Remission was achieved in 39% and 33% of patients at Weeks 24 and 52, respectively; 36% of patients discontinued the treatment with ustekinumab during a median follow-up of 31 weeks. The probability of maintaining ustekinumab treatment was 87% at Week 16, 63% at Week 56, and 59% at Week 72; primary failure was the main reason for ustekinumab discontinuation. No variable was associated with risk of discontinuation. Three patients reported adverse events; one of them had a fatal severe SARS-CoV-2 infection. Conclusions: Ustekinumab is effective in both the short and the long term in real life, even in a highly refractory cohort. Higher inflammatory burden at baseline correlated with lower probability of achieving remission. Safety was consistent with the known profile of ustekinuma

Long-term safety of in utero exposure to anti-TNFα drugs for the treatment of inflammatory bowel disease: Results from the multicenter European TEDDY study

Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si le hubiere, y los autores pertenecientes a la UAMThe long-term safety of exposure to anti-tumor necrosis factor (anti-TNF alpha) drugs during pregnancy has received little attention. We aimed to compare the relative risk of severe infections in children of mothers with inflammatory bowel disease (IBD) who were exposed to anti-TNF alpha drugs in utero with that of children who were not exposed to the drugs. METHODS: Retrospective multicenter cohort study. Exposed cohort: children from mothers with IBD receiving anti-TNF alpha medication (with or without thiopurines) at any time during pregnancy or during the 3 months before conception. Non-exposed cohort: children from mothers with IBD not treated with anti-TNF alpha agents or thiopurines at any time during pregnancy or the 3 months before conception. The cumulative incidence of severe infections after birth was estimated using Kaplan-Meier curves, which were compared using the log-rank test. Cox-regression analysis was performed to identify potential predictive factors for severe infections in the offspring. RESULTS: The study population comprised 841 children, of whom 388 (46%) had been exposed to anti-TNF alpha agents. Median follow-up after delivery was 47 months in the exposed group and 68 months in the non-exposed group. Both univariate and multivariate analysis showed the incidence rate of severe infections to be similar in non-exposed and exposed children (1.6% vs. 2.8% per person-year, hazard ratio 1.2 (95% confidence interval 0.8-1.8)). In the multivariate analysis, preterm delivery was the only variable associated with a higher risk of severe infection (2.5% (1.5-4.3)). CONCLUSIONS: In utero exposure to anti-TNF alpha drugs does not seem to be associated with increased short-term or long-term risk of severe infections in childrenTh is research has been funded by grant from the Instituto de Salud Carlos III (PI13/00041

Tofacitinib in ulcerative colitis: real-world evidence from the ENEIDA registry

Artículo escrito por un elevado número de autores, solo se referencian el que aparece en primer lugar, el nombre del grupo de colaboración, si lo hubiere, y los autores pertenecientes a la UAMTo evaluate the effectiveness and safety of tofacitinib in ulcerative colitis [UC] in real life. Methods Patients from the prospectively maintained ENEIDA registry and treated with tofacitinib due to active UC were included. Clinical activity and effectiveness were defined based on Partial Mayo Score [PMS]. Short-term response/remission was assessed at Weeks 4, 8, and 16. Results, A total of 113 patients were included. They were exposed to tofacitinib for a median time of 44 weeks. Response and remission at Week 8 were 60% and 31%, respectively. In multivariate analysis, higher PMS at Week 4 (odds ratio [OR] = 0].2; 95% confidence interval [CI] = 0].1–0.4) was the only variable associated with lower likelihood of achieving remission at Week 8. Higher PMS at Week 4 [OR = 0.5; 95% CI = 0.3–0.7] and higher PMS at Week 8 [OR = 0.2; 95% CI = 0.1–0.5] were associated with lower probability of achieving remission at Week 16. A total of 45 patients [40%] discontinued tofacitinib over time. Higher PMS at Week 8 was the only factor associated with higher tofacitinib discontinuation [hazard ratio = 1.5; 95% CI = 1.3–1.6]. A total of 34 patients had remission at Week 8; of these, 65% had relapsed 52 weeks after achieving remission; the dose was increased to 10 mg/12 h in nine patients, and five of them reached remission again. Seventeen patients had adverse events. Conclusions: Tofacitinib is effective and safe in UC patients in real practice, even in a highly refractory cohort. A relevant proportion of patients discontinue the drug over time, mainly due to primary failur

Identificación, análisis y evaluación de los riesgos para la estructuración del proyecto : construcción de la doble calzada en el tramo Calarcá (Quindío) - La Paila (Valle) con una longitud de 62 km en el corredor vial Bogotá - Buenaventura

El presente estudio se identificaron los riesgos presentes en la intervención para la construcción vial del tramo Calarcá-La Paila, como complemento del corredor vial Bogotá-Buenaventura, además se analizaron las amenazas con mayor probabilidad de ocurrencia e impacto para el desarrollo del proyecto, para así plantear las acciones preventivas que pueden ser implementadas durante el proceso constructivo. Para la identificación y su efecto, como el análisis cualitativo y descriptivo de cada riesgo, fue necesario revisar fuentes documentadas en gestión de riesgos, normatividad, y políticas de gestión, documentos contractuales del contrato de concesión, información referente a amenazas, vulnerabilidades y riesgos de tipo ambiental, social y predial dentro del área de influencia por donde se proyecta ejecutar las obras de infraestructura vial, lo que permite comprender mejor el estado de las condiciones de infraestructura vial que se presentan en Colombia. Este estudio se desarrolló a partir de una metodología de tipo mixto, ya que en el método de recopilación y análisis de la información fue combinado con la investigación documental y la de campo junto con las experiencias encontradas en proyectos similares, con el fin de profundizar en el tema de estudio y poder cubrir los diferentes ángulos de la investigación la cual facilitó el desarrollo de los objetivos propuestos

Análisis sobre la ausencia de ediciones en torno a la criminalidad en Colombia : una propuesta de publicación

"El gran potencial que tiene el contenido de la historia de Colombia en términos de violencia, y la necesidad de contribuir socialmente con un proyecto enfocado a condensar esta historia mediante el uso de dos disciplinas fundamentales en el estudio del crimen, desembocan en la propuesta de una publicación trimestral que recoja la historia de un personaje famoso y la analice desde todos los campos necesarios para formar los 360 grados que le corresponden: ""Rastros. Del crimen mundial"". La reseña histórica de la criminalística y la criminología, en el mundo y específicamente en Colombia, es el primer acercamiento al campo y la base teórica de esta propuesta. Contenido que posteriormente se complementa con un análisis de las publicaciones que han surgido en torno a este tema y la oferta y demanda evidenciadas en los contenidos digitales y en las nuevas propuestas educativas que hoy en día se ofrecen a los amantes del conocimiento. Este panorama, que nos muestra el campo a trabajar y las necesidades editoriales presentes en nuestro país, es la parte que termina de reforzar la necesidad latente de los colombianos por tener un producto propio que les permita contar su historia y además dejar una visión propia del mundo que les rodea. Los contenidos detallados en el presente trabajo muestran el potencial histórico y mediático necesario para desarrollar una propuesta editorial que llene el vacío encontrado, refiriéndonos al tipo de publicaciones existentes,esto quiere decir que poseemos las historias necesarias y bien documentadas para trabajar sobre ellas, y además contamos con recursos que apenas están siendo explorados, para adaptarlos a nuestros contenidos y ofrecer a los lectores interesados un producto que ha intentado surgir muchas veces pero que lamentablemente no ha contado con los medios y recursos necesarios para mantenerse en el campo. Por esto, aparte de la publicación planteada, también contamos con un estudio del mercado y público al que le estamos apuntando y posibles soluciones a los inconvenientes que se presentaran en el transcurso del camino.""The great potential that has the content of the history of Colombia in terms of violence, and it need of contribute socially with a project focused to condense this history through the use of two disciplines fundamental in the study of the crime, lead in it proposed of a publication quarterly that collect the history of a character famous and it analyze from all them fields necessary to form them 360 degrees that you correspond: ""Traces."" Global crime"". The brief history of the Criminalistics and Criminology, in the world and specifically in Colombia, is the first approach to the field and the theoretical basis of this proposal. Content that it subsequently complemented by an analysis of publications that have sprung up around this issue and offer and demand evidenced in digital content and new educational proposals that today are the lovers of knowledge. This panorama, that us shows the field to work and them needs publishing present in our country, is the part that ends of reinforce the need latent of them Colombian by have a product own that them allow count its history and also leave a vision own of the world that the surrounds. Them contained detailed in the present work shows the potential historical and media necessary to develop a proposed publishing that fill the vacuum found, referring us to the type of publications existing,This wants to say that possess them stories necessary and well documented for work on them, and also have with resources that just are being explored, to adapt them to our content and offer to them readers interested a product that has tried arise many times but that unfortunately not has counted with them media and resources necessary for keep is in the field. For this reason, apart from the proposed publication, we also have a study of market and public that we are pointing, and possible Solutions to the problems that arose in the course of the road. Without more ADO, here is a new proposal from the communication to contribute socially with the history of our country."Comunicador (a) SocialPregrad

Integral Waste Management Generated by Solar Photovoltaic Panels in Colombia

La energía fotovoltaica al ser una fuente de energía renovable y de baja emisión de GEI, se ha establecido como una de las fuente de mayor crecimiento e importancia a nivel mundial para la sustitución enérgica generada por los combustibles fósiles, y Colombia no ha sido la excepción a esta tendencia pues le ha abierto un espacio degeneración en la matriz de generación enérgica del país partir de año 2014, sin embargo en los últimos años se ha encontrado que los elementos básicos para la obtención de esta energía “los paneles solares” generan en la parte final de su ciclo de vida una gran cantidad residuos sólidos que dado sus características y componentes se pueden llegar considerar como residuos peligrosos o de gran potencial de eco toxicidad, y que al dárseles un mal manejo y disposición a éstos se pueda convertir en una problemática de gran escala generando problemas a la salud humana y a los ecosistemas. Es por eso que en este artículo se planteó una investigación de tipo documental y monográfica con base en escritos científicos e informes de entidades gubernamentales sobre los principales componentes de fabricación de los paneles solares más utilizados a nivel mundial, así como los residuos que generarían y el grado de toxicidad que puedan llegar presentar por una mala disposición: encontrándose como resultado principal que si bien el mayor porcentaje de residuos es aprovechable hay una pequeña porción conformada por compuestos tóxicos que pueden llegarse a diluir con agentes externos y generar algún tipo lixiviados.Photovoltaic energy, as a source of renewable energy and low GHG emissions, has established itself as one of the most important sources of growth and importance worldwide for the energetic substitution generated by fossil fuels, and Colombia has not been the exception. This trend has opened up a space for degeneration in the generation matrix of the country since 2014, however in recent years it has been found that the basic elements for obtaining this energy "solar panels" generate in the final part of its life cycle a large amount of solid waste that given its characteristics and components can be considered as hazardous waste or of great potential for ecotoxicity, and that being given a bad management and disposal to these can become a problem of large scale generating problems to human health and ecosystems. That is why in this article a documentary and monographic research based on scientific writings and reports from government entities on the main manufacturing components of the most used solar panels worldwide, as well as the waste they would generate and the degree of toxicity that may come from a bad disposition: finding as a main result that although the highest percentage of waste is usable there is a small portion formed by toxic compounds that can be diluted with external agents and generate some type of leachate

Study of student satisfaction with the Educational Services to Universities of the Toluca Valley

Uno de los aspectos de mayor importancia al evaluar la calidad organizacional es evaluar la satisfacción de los usuarios. Los estudiantes al ser los principales usuarios de las Universidades, serán quienes mejor puedan evaluar la calidad de los servicios educativos. Se diseñó y aplicó un instrumento a estudiantes del Valle de Toluca, de Universidades públicas y privadas. En base a escala Likert los estudiantes calificaron aspectos como Plan de estudios, Habilidad para enseñanza docente, Métodos de enseñanza-evaluación, Nivel de autorrealización del estudiante, Servicios de apoyo, Servicios administrativos, Ambiente propicio e Infraestructura. Como resultado se concluye que las variables donde se encuentran mayormente satisfechos son: Habilidad para la enseñanza de los Docentes y nivel de Autorrealización de Estudiantes. En cambio, las variables Infraestructura y Servicios Administrativos obtuvieron niveles de satisfacción inferior. La prueba Chi-cuadrado confirma diferencias significativas entre Universidades públicas y privadas las cuales serán presentadas en este reporte de investigaciónOne of the most important aspects for qualify the quality of the organizations is evaluate the users satisfaction. Students are the main users of the Universities, for this reason they will be able to better assess the quality of educational services. It was designed and tested an instrument measuring student satisfaction was applied to various university institutions of higher Toluca Valley both public and private sources Education. Based on a Likert scale students rated aspects concerning curriculum, teaching skills of teachers, teaching methods and evaluation, student self level, Support Services, Administrative Services, Enabling Environment and Infrastructure. As a result we conclude that the variables, which are the most satisfied by the students, are: Skill Teaching and Teachers' level of self-realization of Students. Instead variables, and Administrative Services Infrastructure were the most inferior satisfaction. The chi-square test confirms significant differences between public and private universities, all of the differences will present in this research repor

Benefits of paediatric to adult transition programme in onflammatory bowel disease: The BUTTERFLY study of GETECCU and SEGHNP

Transition is a planned movement of paediatric patients to adult healthcare systems, and its implementation is not yet established in all inflammatory bowel disease (IBD) units. The aim of the study was to evaluate the impact of transition on IBD outcomes. (2) Methods: Multicentre, retrospective and observational study of IBD paediatric patients transferred to an adult IBD unit between 2017–2020. Two groups were compared: transition (≥1 joint visit involving the gastroenterologist, the paediatrician, a programme coordinator, the parents and the patient) and no-transition. Outcomes within one year after transfer were analysed. The main variable was poor clinical outcome (IBD flare, hospitalisation, surgery or any change in the treatment because of a flare). Predictive factors of poor clinical outcome were identified with multivariable analysis. (3) Results: A total of 278 patients from 34 Spanish hospitals were included. One hundred eighty-five patients (67%) from twenty-two hospitals (65%) performed a structured transition. Eighty-nine patients had poor clinical outcome at one year after transfer: 27% in the transition and 43% in the no-transition group (p = 0.005). One year after transfer, no-transition patients were more likely to have a flare (36% vs. 22%; p = 0.018) and reported more hospitalisations (10% vs. 3%; p = 0.025). The lack of transition, as well as parameters at transfer, including IBD activity, body mass index < 18.5 and corticosteroid treatment, were associated with poor clinical outcome. One patient in the transition group (0.4%) was lost to follow-up. (4) Conclusion: Transition care programmes improve patients’ outcomes after the transfer from paediatric to adult IBD units. Active IBD at transfer impairs outcome