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Las técnicas de imagen desempeñan un papel fundamental en el diagnóstico inicial y seguimiento de la enfermedad inflamatoria intestinal. La ecografía intestinal tiene alta sensibilidad y especificidad en la sospecha de la enfermedad de Crohn, en la detección de actividad inflamatoria y permite el diagnóstico temprano de complicaciones intraabdominales, como estenosis, fístulas y abscesos; además, ha demostrado su utilidad en la monitorización del tratamiento y en la recurrencia posquirúrgica. El desarrollo técnico de los equipos de ecografía, la incorporación de avances tecnológicos como el contraste ecográfico o la elastografía y, sobre todo, una mayor experiencia, han impulsado su papel en la evaluación de la patología del tubo digestivo. La ecografía es particularmente atractiva gracias a su amplia disponibilidad, su inocuidad, bajo coste y buena reproducibilidad, ya que puede repetirse de forma fácil y bien tolerada por el paciente durante el seguimiento. Esta revisión resume el papel de la ecografía intestinal en la detección y seguimiento de pacientes con enfermedad inflamatoria intestinal.

Understanding the origin of cooperativity and the equilibrium temperature of transition (T1/2) displayed by the spin-crossover (SCO) compounds as well as controlling these parameters are of paramount importance for future applications. For this task, the occurrence of polymorphism, presented by a number of SCO complexes, may provide deep insight into the influence of the supramolecular organization on the SCO behavior. In this context, herein we present a novel family of mononuclear octahedral FeIIcomplexes with formula cis-[Fe(bqen)(NCX)2], where bqen is the chelating tetradentate ligand N,N′-bis(8-quinolyl)ethane-1,2-diamine and X = S, Se. Depending on the preparation method, these compounds crystallize in either the orthorhombic or the trigonal symmetry systems. While the orthorhombic phase is composed of a racemic mixture of mononuclear complexes (polymorph I), the trigonal phase contains only one of the two possible enantiomers (Λ or Δ), thereby generating a chiral crystal (polymorph II). The four derivatives undergo SCO behavior with well-differentiated T1/2values occurring in the interval 90–233 K. On one hand, T1/2is about 110 K (polymorph I) and 87 K (polymorph II) higher for the selenocyanate derivatives in comparison to those for their thiocyanate counterparts. These differences in T1/2are ascribed not only to the higher ligand field induced by the selenocyanate anion but also to a remarkable difference in the structural reorganization of the [FeN6] coordination core upon SCO. Likewise, the higher cooperativity observed for the thiocyanate derivatives seems to be related to their stronger intermolecular interactions within the crystal. On the other hand, T1/2is about 53 K (thiocyanate) and 29 K (selenocyanate) higher for the trigonal polymorph II in comparison to those for the orthorhombic polymorph I. These differences, and the small changes observed in cooperativity, stem from the slightly different hetero- and homochiral crystal packing generated by the cis-[Fe(bqen)(NCX)2] molecules, which determines subtle adaptations in the intermolecular contacts and the FeIIcoordination core.

Cow's milk and egg are the most frequent causes of food allergy in the first years of life. Treatments such as oral immunotherapy (OIT) have been investigated as an alternative to avoidance diets. No clinical practice guides on the management of OIT with milk and egg are currently available.

The design and performance of borate glass samples compositionally pre-designed to be femtosecond laser writable via laser-induced ion migration is reported in this Letter. It is demonstrated that borate glasses modified on purpose with small amounts of La_2O_3 and Na_2O can be straightforwardly used to produce high-index contrast (Δn) waveguides by femtosecond-laser-assisted ion migration. The positive Δn of the waveguides is caused by the local enrichment of La_2O_3 in the guiding region with a slope of 8·10^−3(mol.%)^−1. The value of this is consistent with numerical aperture measurements of the waveguides and local compositional measurements at the guiding region performed by energy-dispersive x-ray micro-analysis. The maximum achievable Δn values can be controlled through the initial La_2O_3 content of the glass. Maximum Δn values >10^−2 for samples with just 5.5 mol. % of La_2O_3 have been produced. This compositional design approach could be potentially used to produce highly efficient femtosecond laser writeable glasses in other glass families.

Conventional control strategies for holonomic Unmanned Aircraft Systems (UASs) require that, while executing a mission, the UAS attitude dynamics remains very close to zero in order to satisfy the assumption of small angles approximation. This requirement may be valid for hover flight, but not for translational flights or aggressive maneuvers. To overcome this issue, this paper presents the controllability analysis for a non-linear representation of a holonomic UAS. Under the proposed scheme, it is shown that it is possible to design control schemes for stabilizing the complete UAS state space without the necessity of separating the system in attitude and translation subsystems. A set of simulations are presented to evaluate the effectiveness of the proposed control laws. These results show that the proposed strategy enables the UAS to track a desired trajectory while keeping the attitude close to a desired value.

Objectives:To determine the efficacy and safety of cyclosporine (CyA) in a large national registry-based population of patients with steroid-refractory (SR) acute severe ulcerative colitis (ASUC) and to establish predictors of efficacy and adverse events.Methods:Multicenter study of SR-ASUC treated with CyA, based on data from the ENEIDA registry. SR-ASUC patients treated with infliximab (IFX) or sequential rescue therapy (CyA-IFX or IFX-CyA) were used as comparators.Results:Of 740 SR-ASUC patients, 377 received CyA, 131 IFX and 63 sequential rescue therapy. The cumulative colectomy rate was higher in the CyA (24.1%) and sequential therapy (32.7%) than in the IFX group (14.5%; P=0.01) at 3 months and 5 years. There were no differences in early and late colectomy between CyA and IFX in patients treated after 2005. 62% of patients receiving CyA remained colectomy-free in the long term (median 71 months). There were no differences in mortality between CyA (2.4%), IFX (1.5%) and sequential therapy (0%; P=0.771). The proportion of patients with serious adverse events (SAEs) was lower in CyA (15.4%) than in IFX treated patients (26.5%) or sequential therapy (33.4%; P<0.001). This difference in favor of CyA was maintained when only patients treated after 2005 were analyzed.Conclusions:Treatment with CyA showed a lower rate of SAE and a similar efficacy to that of IFX thereby supporting the use of either CyA or IFX in SR-ASUC. In addition, the risk-benefit of sequential CyA-IFX for CyA non-responders is acceptable.

Los pacientes con miastenia gravis (MG) suelen empezar con afectación de la musculatura ocular. Es relevante que el oftalmólogo disponga de información actualizada del estado de la investigación respecto a la relación de esta enfermedad con el consumo de fármacos, como las estatinas.

A pesar de la mejor optimización posible de los fármacos disponibles en la enfermedad inflamatoria intestinal (EII), un grupo importante de pacientes precisará de nuevas alternativas terapéuticas. Afortunadamente, existen ya incorporaciones recientes como el vedolizumab o próximas como el ustekinumab; sin embargo, son muchas más las que previsiblemente estarán disponibles en un futuro no muy lejano. En esta revisión repasamos las evidencias y posibles usos de las alternativas con más probabilidad de llegar a la práctica clínica. Entre ellas destacamos los fármacos que bloquean la adhesión leucocitaria, los inhibidores de las JAK quinasas, anticitocinas, con especial hincapié en el ustekinumab, y el mongersen.

Cow's milk and egg are the most frequent causes of food allergy in the first years of life. Treatments such as oral immunotherapy (OIT) have been investigated as an alternative to avoidance diets. No clinical practice guides on the management of OIT with milk and egg are currently available.

Cow's milk and egg are the most frequent causes of food allergy in the first years of life. Treatments such as oral immunotherapy (OIT) have been investigated as an alternative to avoidance diets. No clinical practice guides on the management of OIT with milk and egg are currently available.

OBJECTIVES:The aims of this study were to assess the risk of relapse after discontinuation of anti-tumor necrosis factor (anti-TNF) drugs in patients with inflammatory bowel disease (IBD), to identify the factors associated with relapse, and to evaluate the overcome after retreatment with the same anti-TNF in those who relapsed.METHODS:This was a retrospective, observational, multicenter study. IBD patients who had been treated with anti-TNFs and in whom these drugs were discontinued after clinical remission was achieved were included.RESULTS:A total of 1,055 patients were included. The incidence rate of relapse was 19% and 17% per patient-year in Crohn’s disease and ulcerative colitis patients, respectively. In both Crohn’s disease and ulcerative colitis patients in deep remission, the incidence rate of relapse was 19% per patient-year. The treatment with adalimumab vs. infliximab (hazard ratio (HR)=1.29; 95% confidence interval (CI)=1.01–1.66), elective discontinuation of anti-TNFs (HR=1.90; 95% CI=1.07–3.37) or discontinuation because of adverse events (HR=2.33; 95% CI=1.27–2.02) vs. a top-down strategy, colonic localization (HR=1.51; 95% CI=1.13–2.02) vs. ileal, and stricturing behavior (HR=1.5; 95% CI=1.09–2.05) vs. inflammatory were associated with a higher risk of relapse in Crohn’s disease patients, whereas treatment with immunomodulators after discontinuation (HR=0.67; 95% CI=0.51–0.87) and age (HR=0.98; 95% CI=0.97–0.99) were protective factors. None of the factors were predictive in ulcerative colitis patients. Retreatment of relapse with the same anti-TNF was effective (80% responded) and safe.CONCLUSIONS:The incidence rate of inflammatory bowel disease relapse after anti-TNF discontinuation is relevant. Some predictive factors of relapse after anti-TNF withdrawal have been identified. Retreatment with the same anti-TNF drug was effective and safe.

El desarrollo de dependencia a corticoides es frecuente en pacientes con colitis ulcerosa (CU). El objetivo de este estudio fue evaluar la eficacia clínica de ADA, entendida como mantenimiento de remisión sin corticoides, en pacientes con CU dependiente de corticoides.

En el presente trabajo hemos analizado, desde un enfoque bibliométrico, las publicaciones científicas de los investigadores españoles en el área de la Optometría, desde que se tienen datos de publicaciones (1974) hasta el año 2013.

La presencia de antecedentes familiares implica un riesgo aumentado de presentar colorrectal (CCR), lo que condiciona una estrategia de cribado diferente.

The presence of a family history implies an increased risk for developing colorectal cancer (CRC), and may require a different screening strategy.

Evaluar los factores de riesgo de luxación tras artroplastia total de cadera (ATC) primaria y su resultado funcional.

For theoretical and practical reasons, it is of great interest to understand how accurate and persistent episodic memories of enjoyable experiences are formed and maintained, for example, in the context of gastronomy and other instances of experience design. Here, we investigated factors that might affect the quality (a measure of coherence) of immediate and long-term emotional episodic memories of individual dishes of a long and complex dinner in a fine-dining restaurant. We also assessed long-term recognition memory for pictures of the dishes. Intra-class correlations revealed good immediate emotional episodic memory, which remained stable over three months. Contributing factors to these kinds of memory were assessed with path modelling. The quality of emotional episodic memory was enhanced by the hedonic intensity of the most valued dishes during the meal and was impaired with the hedonic intensity of the least valued dishes. Enjoying the final dish positively affects emotional memory after the experience. Interestingly, when diners reported to have been distracted from the meal, presumably by communicating with their meal companions about the food, it had a positive effect on the long-term emotional episodic memory. Personality traits of the diners had no substantial impact on either type of memory. Alcohol intake during the meal modestly affected recognition memory but – interestingly – had no statistically significant effect on emotional episodic memory. Altogether, this study provides novel information about the main determinants of the precision and temporal stability of emotional episodic memory and nonemotional recognition memory for a meal. These findings contribute to the psychological foundations of designing memorable experiences in gastronomy and other areas.

Incluso después de la promulgación del código de Nuremberg las investigaciones sobre sífilis continuaron alejándose en muchas ocasiones de los estándares éticos. En este artículo hemos revisado las investigaciones que sobre esta enfermedad tuvieron lugar después de la Segunda Guerra Mundial, centrándonos en los casos de Guatemala y de Tuskegee. En Guatemala durante los años 1946 a 1948 se inoculó deliberadamente a más de 1.000 adultos sífilis, chancroide y gonorrea, y se hicieron miles de serologías a poblaciones indígenas o a niños huérfanos. El experimento Tuskegee sobre sífilis fue realizado entre 1932 y 1972 por el Servicio Público de Salud de los Estados Unidos para estudiar la evolución natural de esta enfermedad en ausencia de tratamiento. Se realizó sobre un grupo de población rural de raza negra y no se interrumpió a pesar de la introducción de tratamientos eficaces para la resolución de la enfermedad durante estos años (1945).

Even after the Nuremberg code was published, research on syphilis often continued to fall far short of ethical standards. We review post-World War IIresearch on this disease, focusing on the work carried out in Guatemala and Tuskegee. Over a thousand adults were deliberately inoculated with infectious material for syphilis, chancroid, and gonorrhea between 1946 and 1948 in Guatemala, and thousands of serologies were performed in individuals belonging to indigenous populations or sheltered in orphanages. The Tuskegee syphilis study, conducted by the US Public Health Service, took place between 1932 and 1972 with the aim of following the natural history of the disease when left untreated. The subjects belonged to a rural black population and the study was not halted when effective treatment for syphilis became available in 1945.

Physicians have conducted research on syphilis for centuries, seeking to understand its etiology and the means of transmission as well as find ways to prevent and cure the disease. Their research practices often strayed from today's ethical standards. In this paper we review ethical aspects of the long history of research on syphilis with emphasis on the experiments performed in the 20th century. The description of research around the time of World War II covers medical experiments carried out in US prisons and in the experimentation centers established by Japanese doctors in occupied territory, as well as experiments in Nazi Germany and the treatment of syphilitics there.

Durante siglos la sífilis ha sido objeto de investigación por parte de los médicos, dado que la etiología, la forma de contagio, la profilaxis y el tratamiento eran desconocidos. En muchas ocasiones las investigaciones se han alejado de los estándares éticos actuales. En este artículo hemos revisado desde un punto de vista histórico y ético las investigaciones que sobre esta enfermedad se han ido realizando a lo largo de los siglos, centrándonos sobre todo en aquellos experimentos realizados en el siglo xx. Describimos con detalle los estudios realizados en los años que tuvieron lugar alrededor de la Segunda Guerra Mundial: experimentos realizados por los médicos norteamericanos en prisiones de Estados Unidos, la sífilis en la Alemania nazi o los ensayos realizados por los japoneses en centros de experimentación creados a tal fin en los territorios ocupados.

In this paper we describe the design, fabrication, and characterization of cylindrical gold micropillar array electrodes. Micropillar array electrodes bring about several advantages compared to planar electrodes and microelectrode arrays, as they provide a much larger surface area than the latter devices. Micropillar array electrodes are closely related to porous electrodes, as suggested by the recent literature and as our experimental results show. We fabricated a number of different gold micropillar array structures using standard microfabrication techniques, particularly DRIE plasma etching, thermal oxidations, and gold metallization by dc sputtering. Experimental results were compared with simulations, and very good agreement was found. This served both to validate the diffusion domain approximation for these particular devices and also to deepen our understanding on the modes of mass transport controlling the current response of these devices. We found that planar diffusion dominates the response of these devices and that thin layer diffusion effects play a crucial role and are responsible for both displacing the position of the peaks and narrowing the peak-to-peak separation in cyclic voltammograms. These effects arise only as a result of the surface topology and should not be mistaken by catalytic effects.

Copyright of Neurocirugía is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The design and construction of a prototype of a dividing‐wall distillation column was possible by integrating previous knowledge in process intensification, energy savings, theoretical control properties, and closed‐loop dynamics of thermally coupled distillation sequences. In order to achieve the predicted energy savings for this class of complex distillation column, a dividing wall and a side tank were implemented in order to manipulate the internal flows associated with energy consumption. The reaction between ethanol and acetic acid was conducted within the prototype, and the experimental results indicate that a heterogeneous mixture of ethyl acetate and water is obtained as the top product. The temperature profile measured during the experimental run can be used for controlling the batch distillation column in cyclic operation mode.

The bacterial PEP:sugar PTS consists of a cascade of several proteins involved in the uptake and phosphorylation of carbohydrates, and in signal transduction pathways. Its uniqueness in bacteria makes the PTS a target for new antibacterial drugs. These drugs can be obtained from peptides or protein fragments able to interfere with the first reaction of the protein cascade: the phosphorylation of the HPr by the first enzyme, the so-called enzyme EI. To that end, we designed a peptide, HPr9–30, spanning residues 9 to 30 of the intact HPr protein, containing the active site histidine (His-15) and the first α-helix of HPr of Streptomyces coelicolor, HPrsc. By using fluorescence and circular dichroism, we first determined qualitatively that HPrsc and HPr9–30 did bind to EIsc, the enzyme EI from S. coelicolor. Then, we determined quantitatively the binding affinities of HPr9–30 and HPrsc for EIsc by using ITC and STD-NMR. The STD-NMR experiments indicate that the epitope region of HPr9–30 was formed by residues Leu-14, His-15, Ile-21, and Val-23. The binding reaction between EIsc and HPrsc is enthalpy driven and in other species is entropy driven; further, the affinity of HPrsc for EIsc was smaller than in other species. However, the affinity of HPr9–30 for EIsc was only moderately lower than that of EIsc for HPrsc, suggesting that this peptide could be considered a promising hit compound for designing new inhibitors against the PTS.

Copyright of Neurocirugía is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)