Clinical Presentation, Management, and Evolution of Lymphomas in Patients with Inflammatory Bowel Disease: An ENEIDA Registry Study

Simple Summary An increased risk of hematological malignancies, mainly lymphomas, has been described in patients with inflammatory bowel disease (IBD). Because there are scarce data about the management and evolution of lymphomas in patients with IBD, the aim of our study was to analyze these points in those patients with IBD and lymphoma diagnosis included in the prospectively maintained ENEIDA registry of GETECCU. We identified 52 patients (2.4 cases of lymphoma/1000 patients with IBD). We found that most IBD patients had been treated with thiopurines and/or anti-TNF agents before lymphoma diagnosis, and these patients were younger at diagnosis of lymphoma than those not treated with these drugs. Relapse and mortality of lymphoma were not related with these therapies. The five-year survival rate was 85% for non-Hodgkin lymphoma and 84% in patients with Hodgkin lymphoma. An increased risk of lymphoma has been described in patients with inflammatory bowel disease (IBD). The aims of our study were to determine the clinical presentation, the previous exposure to immunosuppressive and biologic therapies, and the evolution of lymphomas in patients with IBD. IBD patients with diagnosis of lymphoma from October 2006 to June 2021 were identified from the prospectively maintained ENEIDA registry of GETECCU. We identified 52 patients (2.4 cases of lymphoma/1000 patients with IBD; 95% CI 1.8-3.1). Thirty-five were men (67%), 52% had ulcerative colitis, 60% received thiopurines, and 38% an anti-TNF drug before lymphoma diagnosis. Age at lymphoma was lower in those patients treated with thiopurines (53 +/- 17 years old) and anti-TNF drugs (47 +/- 17) than in those patients not treated with these drugs (63 +/- 12; p < 0.05). Five cases had relapse of lymphoma (1.7 cases/100 patient-years). Nine patients (17%) died after 19 months (IQR 0-48 months). Relapse and mortality were not related with the type of IBD or lymphoma, nor with thiopurines or biologic therapies. In conclusion, most IBD patients had been treated with thiopurines and/or anti-TNF agents before lymphoma diagnosis, and these patients were younger at diagnosis of lymphoma than those not treated with these drugs. Relapse and mortality of lymphoma were not related with these therapies

Risk Factors for COVID-19 in Inflammatory Bowel Disease: A National, ENEIDA-Based Case–Control Study (COVID-19-EII)

(1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case-control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March-July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p < 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p < 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3-5.9), occupational risk (OR: 2.9; 95%CI: 1.8-4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2-2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09-0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution

Nationwide COVID-19-EII Study : Incidence, Environmental Risk Factors and Long-Term Follow-Up of Patients with Inflammatory Bowel Disease and COVID-19 of the ENEIDA Registry

We aim to describe the incidence and source of contagion of COVID-19 in patients with IBD, as well as the risk factors for a severe course and long-term sequelae. This is a prospective observational study of IBD and COVID-19 included in the ENEIDA registry (53,682 from 73 centres) between March-July 2020 followed-up for 12 months. Results were compared with data of the general population (National Centre of Epidemiology and Catalonia). A total of 482 patients with COVID-19 were identified. Twenty-eight percent were infected in the work environment, and 48% were infected by intrafamilial transmission, despite having good adherence to lockdown. Thirty-five percent required hospitalization, 7.9% had severe COVID-19 and 3.7% died. Similar data were reported in the general population (hospitalisation 19.5%, ICU 2.1% and mortality 4.6%). Factors related to death and severe COVID-19 were being aged ≥ 60 years (OR 7.1, 95% CI: 1.8-27 and 4.5, 95% CI: 1.3-15.9), while having ≥2 comorbidities increased mortality (OR 3.9, 95% CI: 1.3-11.6). None of the drugs for IBD were related to severe COVID-19. Immunosuppression was definitively stopped in 1% of patients at 12 months. The prognosis of COVID-19 in IBD, even in immunosuppressed patients, is similar to that in the general population. Thus, there is no need for more strict protection measures in IBD

Risk Factors for COVID-19 in Inflammatory Bowel Disease: A National, ENEIDA-Based Case&ndash;Control Study (COVID-19-EII)

(1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case&ndash;control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March&ndash;July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p &lt; 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p &lt; 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3&ndash;5.9), occupational risk (OR: 2.9; 95%CI: 1.8&ndash;4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2&ndash;2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09&ndash;0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution

La hora 31

Este proyecto se basa en la organización de actividades extraescolares que se desarrollan fuera del horario lectivo. Están orientadas a ser una alternativa de ocio para que los alumnos ocupen su tiempo libre y amplíen su cultura. Para la organización de muchas de estas actividades ha sido necesaria la colaboración con otras instituciones, sobre todo del entorno del centro. Se plantean objetivos generales como estrechar relaciones entre los diferentes sectores de la comunidad educativa y poder lograr un ambiente de trabajo y estudio favorable y así, generar un mejor rendimiento académico de los alumnos y la máxima implicación por parte de los profesores; que los alumnos desarrollen hábitos de vida saludables y provocar en estos una visión positiva del centro y no solo como centro de formación académica; y desarrollar y favorecer inquietudes culturales en los alumnos. La metodología se basa en el diseño de actividades que ofrecen una enseñanza multidisciplinar que complementa los contenidos curriculares. Las actividades realizadas se agrupan en torno a cuatro ámbitos, el sociolingüístico, el cientificotécnico, el artístico y el deportivo. Entre las actividades destacan talleres de matemáticas, de teatro, de creación de páginas web, de fotografía, la creación de una revista escolar y organización de viajes y clubes de tiempo libre. Se adjunta una relación de unas actividades descritas a través de fichas y algunos materiales creados durante su realización.Madrid (Comunidad Autónoma). Consejería de Educación. Dirección General de Ordenación AcadémicaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Mirando a África

Este proyecto pretende acercar a la comunidad educativa del centro una realidad tan próxima, compleja y dramática como la del continente africano, desde casi todas las materias. Y pretende hacerlo en coherencia con valores que identifican al centro. Los objetivos son fomentar la colaboración y participación de los alumnos intercambiando sus propias experiencias; potenciar una conciencia social y ecológica; formar integralmente a los alumnos para el mejor desarrollo de la sociedad; valorar la utilidad de la enseñanza activa y el aprendizaje cooperativo; diseñar actividades que permitan desarrollar una enseñanza interdisciplinar; posibilitar que los alumnos desarrollen estrategias globalizadoras de organización del conocimiento mediante el tratamiento de la información; favorecer el aprendizaje significativo; animar al profesorado a buscar estrategias que favorezcan la actividad didáctica; fomentar la lectura y el uso correcto de la expresión oral y escrita, además de mejorar la ortografía; extender el conocimiento y la utilización de las nuevas tecnologías de la información y la comunicación; estrechar las relaciones entre los diferentes sectores de la comunidad educativa; fomentar la participación activa en la vida social; mejorar la convivencia en el centro; desarrollar hábitos de vida saludables; provocar en los alumnos una visión positiva del centro como lugar de ocio y de enriquecimiento cultural; desarrollar y favorecer las inquietudes culturales de los alumnos; desarrollar las actitudes positivas hacia otras culturas; extender el conocimiento de lenguas extranjeras y mantener relaciones estables de colaboración con instituciones culturales y sociales. Las actividades desarrolladas se organizan en tres modalidades que son actividades globales que implican a toda la comunidad educativa como un concurso de lectura llamado África desde la biblioteca, el día del Libro, viaje de fin de curso a Túnez, apadrinar una escuela en Marruecos, una jornada cultural antes de las vacaciones de Semana Santa, talleres a cargo de la Fundación Yehudi Menuhin y Hora 31 con ciclos de charlas y conferencias; actividades durante el horario lectivo en los distintos departamentos didácticos como proyecciones de películas, composición de textos, debates y trabajos en equipo; y las actividades realizadas fuera del horario lectivo como son talleres, cineclub, coloquios, exposiciones, actividades de cooperación y asistir a diversos espectáculos. La metodología es diversa, en relación con la pluralidad de actividades que se llevan a cabo. Como indicadores del proceso de evaluación se toman para las actividades del currículo, la propia evaluación de profesores. Aunque es un indicador cuantitativo para el análisis final y junto a otros parámetros, se trabaja también la evaluación cualitativa, para que las conclusiones tengan un carácter más global de los resultados del proyecto. Por el contrario, las actividades que se realizan fuera del horario lectivo se miden con el grado de participación. Además como herramienta de evaluación individual se elaboran encuestas para alumnos y profesores para que reflejen sus opiniones personales sobre el proyecto. Se adjunta como anexo dos CD-ROM y cuestionarios..Madrid (Comunidad Autónoma). Consejería de Educación. Dirección General de Mejora de la Calidad de la EnseñanzaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES