Endoscopic treatment (endoscopic balloon dilation/self-expandable metal stent) vs surgical resection for the treatment of de novo stenosis in Crohn's disease (ENDOCIR study): an open-label, multicentre, randomized trial.

Background: Stenosis is one of the most common complications in patients with Crohn's disease (CD). Endoscopic balloon dilation (EBD) is the treatment of choice for a short stenosis adjacent to the anastomosis from previous surgery. Self-expandable metal stents (SEMS) may be a suitable treatment option for longer stenoses. To date, however, there is no scientific evidence as to whether endoscopic (EBD/SEMS) or surgical treatment is the best approach for de novo or primary stenoses that are less than 10 cm in length. Methods/design: Exploratory study as "proof-of-concept", multicentre, open-label, randomized trial of the treatment of de novo stenosis in the CD; endoscopic treatment (EBD/SEMS) vs surgical resection (SR). The type of endoscopic treatment will initially be with EDB; if a therapeutic failure occurs, then a SEMS will be placed. We estimate 2 years of recruitment and 1 year of follow-up for the assessment of quality of life, costs, complications, and clinical recurrence. After the end of the study, patients will be followed up for 3 years to re-evaluate the variables over the long term. Forty patients with de novo stenosis in CD will be recruited from 15 hospitals in Spain and will be randomly assigned to the endoscopic or surgical treatment groups. The primary aim will be the evaluation of the patient quality of life at 1 year follow-up (% of patients with an increase of 30 points in the 32-item Inflammatory Bowel Disease Questionnaire (IBDQ-32). The secondary aim will be evaluation of the clinical recurrence rate, complications, and costs of both treatments at 1-year follow-up. Discussion: The ENDOCIR trial has been designed to determine whether an endoscopic or surgical approach is therapeutically superior in the treatment of de novo stenosis in CD

Efecto de la melatonina y el celecoxib sobre el estrés oxidativo en la carcinogénesis colónica experimental

El cáncer colorrectal (CCR) constituye un problema sanitario mundial. Celecoxib (CEL) inhibe la incidencia de adenocarcinomas colónicos, mientras que melatonina (MEL) modula el estrés oxidativo e inhibe la COX-2. EL objetivo del estudio fue investigar el efecto de la administración de ambos sobre el estrés oxidativo y la producción de lesiones en un modelo de carcinogénesis colónica experimental. CCR fue inducido con azoximetano (AOM) en ratas Wistar. MEL y/o CEL fue administrado durante inducción, postinducción o ambas. La presencia de tumores colónicos fue observada macro y microscópicamente, y se midieron niveles de lipoperoxidasas (LPO), superoxido dismutasa (SOD), catalasa (CAT) y glutation peroxidasa (GPx) en tejido colónico. La combinación intervino de forma significativa en el aumento de LPO y en la modulación de las enzimas antioxidantes produciendo menor número de tumores. La combinación MEL-CEL produce un efecto beneficioso respecto a su administración por separado en la profilaxis del CCR.El càncer colorectal (CCR) constitueix un problema de salut mundial. Celecoxib (CEL) inhibeix la Incidència dels adenocarcinomes colònics, mentre que melatonina (MEL) modula l'estrès oxidatiu i inhibeix la COX-2. L'objectiu de l'estudi va ser investigar l'efecte de l'administració de tots dos sobre l'estrès oxidatiu i la producció de lesions en un model de carcinogènesi colorectal experimental. CCR va ser induït amb azoximetá (AOM) en rates Wistar. MEL i / o CEL van ser administrats durant la inducció, postinducció o ambdues. La presència de tumors colònics va ser observada macro i microscòpicament, i es van mesurar ells nivells de lipoperoxidasas (LPO), superòxid dismutasa (SOD), catalasa (CAT) i glutatió peroxidasa (GPx) en teixit colónic. La combinació va influir de forma significativa en l'augment de LPO i en la modulació dels enzims antioxidants produint menor nombre de tumors. MEL-CEL produeix un efecte beneficiós respecte a la seva administració per separat en la profilaxi del CCR.Colorectal cancer (CRC) is a global health problem. Celecoxib (CEL) inhibits the incidence of colonics adenocarcinomas, whereas melatonin (MEL) modulates the oxidative stress and inhibits COX-2. The aim of the study was to investigate the effect of the administration of both on oxidative stress and the production of lesions in an experimental model of colon carcinogenesis. CCR was inducted by azoxymethane (AOM) in Wistar rats. MEL and / or CEL were administered during induction, post induction or both. The presence of colonic tumors were observed macroscopically and microscopically, and levels of lipoperoxidasas (LPO), superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were measured in colonic tissue. The combination intervened in significantly in the increased of LPO and in the modulation of antioxidant enzymes and a less amount of tumors were produced. The MEL-CEL combination produces a beneficial effect with respect to its separate administration in the prophylaxis of colorectal cancer

DMARDs–Gut Microbiota Feedback: Implications in the Response to Therapy

Due to its immunomodulatory effects and the limitation in the radiological damage progression, disease-modifying antirheumatic drugs (DMARDs) work as first-line rheumatoid arthritis (RA) treatment. In recent years, numerous research projects have suggested that the metabolism of DMARDs could have a role in gut dysbiosis, which indicates that the microbiota variability could modify the employment of direct and indirect mechanisms in the response to treatment. The main objective of this review was to understand the gut microbiota bacterial variability in patients with RA, pre and post-treatment with DMARDs, and to identify the possible mechanisms through which microbiota can regulate the response to pharmacological therapy

Los derechos de la infancia y de la adolescencia

Bibliografí

Serum Levels of IFABP2 and Differences in Lactobacillus and Porphyromonas gingivalis Abundance on Gut Microbiota Are Associated with Poor Therapeutic Response in Rheumatoid Arthritis: A Pilot Study

Intestinal dysbiosis is related to the physiopathology and clinical manifestation of rheumatoid arthritis (RA) and the response to pharmacologic treatment. The objectives of this study were (1) to analyze the effect of conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the abundance of gut microbiota’s bacteria; (2) to evaluate the relationship between the differences in microbial abundance with the serum levels of intestinal fatty-acid binding protein 2 (IFABP2), cytokines, and the response phenotype to csDMARDs therapy in RA. A cross-sectional study was conducted on 23 women diagnosed with RA. The abundance of bacteria in gut microbiota was determined with qPCR. The ELISA technique determined serum levels of IFABP2, TNF-α, IL-10, and IL-17A. We found that the accumulated dose of methotrexate or prednisone is negatively associated with the abundance of Lactobacillus but positively associated with the abundance of Bacteroides fragilis. The Lactobacillus/Porphyromonas gingivalis ratio was associated with the Disease Activity Score-28 for RA with Erythrocyte Sedimentation Rate (DAS28-ESR) (r = 0.778, p = 0.030) and with the levels of IL-17A (r = 0.785, p = 0.027) in the group treated with csDMARD. Moreover, a relation between the serum levels of IFABP2 and TNF-α (r = 0.593, p = 0.035) was observed in the group treated with csDMARD. The serum levels of IFABP2 were higher in patients with secondary non-response to csDMARDs therapy. In conclusion, our results suggest that the ratios of gut microbiota’s bacteria and intestinal permeability seems to establish the preamble for therapeutic secondary non-response in RA

Serum Levels of IFABP2 and Differences in <i>Lactobacillus</i> and <i>Porphyromonas gingivalis</i> Abundance on Gut Microbiota Are Associated with Poor Therapeutic Response in Rheumatoid Arthritis: A Pilot Study

Intestinal dysbiosis is related to the physiopathology and clinical manifestation of rheumatoid arthritis (RA) and the response to pharmacologic treatment. The objectives of this study were (1) to analyze the effect of conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the abundance of gut microbiota’s bacteria; (2) to evaluate the relationship between the differences in microbial abundance with the serum levels of intestinal fatty-acid binding protein 2 (IFABP2), cytokines, and the response phenotype to csDMARDs therapy in RA. A cross-sectional study was conducted on 23 women diagnosed with RA. The abundance of bacteria in gut microbiota was determined with qPCR. The ELISA technique determined serum levels of IFABP2, TNF-α, IL-10, and IL-17A. We found that the accumulated dose of methotrexate or prednisone is negatively associated with the abundance of Lactobacillus but positively associated with the abundance of Bacteroides fragilis. The Lactobacillus/Porphyromonas gingivalis ratio was associated with the Disease Activity Score-28 for RA with Erythrocyte Sedimentation Rate (DAS28-ESR) (r = 0.778, p = 0.030) and with the levels of IL-17A (r = 0.785, p = 0.027) in the group treated with csDMARD. Moreover, a relation between the serum levels of IFABP2 and TNF-α (r = 0.593, p = 0.035) was observed in the group treated with csDMARD. The serum levels of IFABP2 were higher in patients with secondary non-response to csDMARDs therapy. In conclusion, our results suggest that the ratios of gut microbiota’s bacteria and intestinal permeability seems to establish the preamble for therapeutic secondary non-response in RA

¿Puedo cerrar la ventana?

Convocatoria proyectos de innovación de Extremadura 2020/2021Se presenta un proyecto que intentaba dar soluciones a la transmisión del virus SARS-CoV-2 en el IES Santiago Apostol de Almendralejo. Ante las evidencias científicas que sostenían su transmisión por el aire se plantea la medición de CO2 y distintas estrategias de ventilación posibles que minimicen el contagio del virus y sean viables económicamente. Además, se pretende concienciar a la comunidad educativa de la importancia de la ventilación en la salud. Otros objetivos del proyecto eran: promover que el alumno sea capaz de aprender por sí mismo; trabajar utilizando las etapas del método científico que se trabajan desde todas las áreas del conocimiento: Microbiología, Química Analítica, Matemáticas, Física y Química, Plástica, Informática, etc.; fomentar y promocionar la investigación; promover el trabajo colaborativo; potenciar las metodologías activas; generar reflexión social con la que poder dar respuestas a los problemas sociales de cada momento, etc.ExtremaduraES