4 research outputs found
Infecciones más comunes en el paciente trasplantado
Organ transplantation has become one of the
most important areas of medical research and, at present,
is still the only therapeutical tool for several
diseases. However, there are a number of factors
related to transplantation, like immunosuppression
and prolonged neutropenia that affect the incidence
of infection. These infections are somehow peculiar
to trasplant recipients. In fact, there are infectious
diseases that only occur in immunodepression situations
and, moreover, clinical expression of these
infectious diseases can be quite different from that in
immunocompetent patients. Besides these aspects,
some infections, due to the high prevalence
described, must be considered for prevention strategies
because they continue to be a principal cause of
morbidity and mortality, either due to direct effects
or to their implication in the pathogenesis of rejection.
These strategies commence before trasplantation
by active immunization through vaccine administration
to the patient and to people in the milieu
and continue after trasplantation with prophylaxis or
pre-emptive therapy. The importance of infectious
diseases in the evolution and prognosis of trasplant
recipients gives a special meaning to the understanding
of associated infections, their clinical expression
and ways of prevention and treatment
Update on pathogenesis and predictors of response of therapeutic strategies used in inflammatory bowel disease
The search for biomarkers that characterize specific aspects of inflammatory bowel disease (IBD), has received substantial interest in the past years and is moving forward rapidly with the help of modern technologies. Nevertheless, there is a direct demand to identify adequate biomarkers for predicting and evaluating therapeutic response to different therapies. In this subset, pharmacogenetics deserves more attention as part of the endeavor to provide personalized medicine. The ultimate goal in this area is the adjustment of medication for a patient’s specific genetic background and thereby to improve drug efficacy and safety rates. The aim of the following review is to utilize the latest knowledge on immunopathogenesis of IBD and update the findings on the field of Immunology and Genetics, to evaluate the response to the different therapies. In the present article, more than 400 publications were reviewed but finally 287 included based on design, reproducibility (or expectancy to be reproducible and translationable into humans) or already measured in humans. A few tests have shown clinical applicability. Other, i.e., genetic associations for the different therapies in IBD have not yet shown consistent or robust results. In the close future it is anticipated that this, cellular and genetic material, as well as the determination of biomarkers will be implemented in an integrated molecular diagnostic and prognostic approach to manage IBD patients
Development, content validity and cross-cultural adaptation of a Patient-Reported Outcome Measure for Real-time Symptom Assessment in Irritable Bowel Syndrome
BACKGROUND: End-of-day questionnaires, which are considered the gold standard for assessing abdominal pain and other gastrointestinal (GI) symptoms in irritable bowel syndrome (IBS), are influenced by recall and ecological bias. The Experience Sampling Method (ESM) is characterized by random and repeated assessments in the natural state and environment of a subject, and herewith overcomes these limitations. This report describes the development of a patient-reported outcome measure (PROM) based on the ESM-principle, taking into account content validity and cross-cultural adaptation.
METHODS: Focus group interviews with IBS patients and expert meetings with international experts in the fields of neurogastroenterology & motility and pain were performed in order to select the items for the PROM. Forward-and-back translation and cognitive interviews were performed to adapt the instrument for the use in different countries and to assure on patients’ understanding with the final items.
KEY RESULTS: Focus group interviews revealed 42 items, categorized into five domains: physical status, defecation, mood and psychological factors, context and environment, and nutrition and drug use. Experts reduced the number of items to 32 and cognitive interviewing after translation resulted in a few slight adjustments regarding linguistic issues, but not regarding content of the items.
CONCLUSIONS AND INFERENCES: An ESM-based PROM, suitable for momentary assessment of IBS symptom patterns was developed, taking into account content validity as well as cross-cultural adaptation. This PROM will be implemented in a specifically designed smartphone application and further validation in a multicenter setting will follow