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Evaluar el grado de seguimiento de las recomendaciones de las versiones de la Guía española para el manejo del asma(GEMA 2009 y 2015) y su repercusión en el control de la enfermedad.

Introduction:Intestinal fibrosis, characterized by excessive deposition of extracellular matrix proteins, is a common and severe clinical complication of inflammatory bowel disease (IBD). However, the mechanisms underlying fibrosis remain elusive, and currently, there are limited effective pharmacologic treatments that target the development of fibrosis. Hypoxia is one of the key microenvironmental factors influencing intestinal inflammation and has been linked to fibrosis. Objective:In the present study, we sought to elucidate the impact of hypoxia on fibrotic gene expression in the intestinal mucosa. Methods:Human volunteers, IBD patients, and dextran sulphate sodium-treated mice were exposed to hypoxia, and colonic biopsies were collected. The human intestinal epithelial cell line Caco-2, human THP-1 macrophages, and primary human gut fibroblasts were subjected to hypoxia, and changes in fibrotic gene expression were assessed. Results:Human volunteers subjected to hypoxia presented reduced transcriptional levels of fibrotic and epithelial-mesenchymal transition markers in the intestinal mucosa. IBD patients showed a trend towards a decrease in tissue inhibitor of metalloproteinase 1 protein expression. In mice, hypoxic conditions reduced the colonic expression of several collagens and matrix metalloproteinases. Hypoxic Caco-2 cells, THP-1 cells, and primary gut fibroblasts showed a significant downregulation in the expression of fibrotic and tissue remodelling factors. Conclusions:Stabilization of hypoxia-inducible factors might represent a novel therapeutic approach for the treatment of IBD-associated fibrosis.

En los últimos meses se han realizado grandes esfuerzos para evaluar las terapias más eficaces en el manejo de pacientes con COVID-19. Actualmente ninguna combinación ha demostrado de manera consistente una relación clara con la mortalidad. Nuestro objetivo fue valorar el patrón de asociaciones observado entre los distintos tratamientos intrahospitalarios administrados a 238 pacientes ingresados por COVID-19 y la mortalidad.

Sexual dysfunction (SD) is one of the least studied non-motor symptoms in Parkinson’s disease (PD). To assess sexual function in a cohort of patients with early-onset PD (EOPD) and compare it to a group of healthy controls. In this cross-sectional multicenter study, SD was assessed with gender-specific multi-dimensional self-reported questionnaires: The Brief Male Sexual Function Inventory (BSFI-M) and the Female Sexual Function Index (FSFI). Scores between patients and controls were compared and associations between SD and demographical and clinical variables were studied. One hundred and five patients (mean age 47.35±7.8, disease duration 6 (3–11) years, UPDRS part III 17 (10–23) and 90 controls were recruited. The BSFI-M total score was lower in EOPD men than in controls, and specific items were also significantly lower, such as drive, erections, ejaculation, and satisfaction. EOPD women had lower scores than controls in total FSFI, and certain domains such as lubrication and pain. SD was present in 70.2% of patients and 52.5% of controls. Sexual satisfaction in 35.2% of patients and 81.2% of controls. By gender, male and female patients had more SD than controls but only male patients had more dissatisfaction than controls. Gender, higher depression scores and urinary dysfunction were associated with SD in multivariate analysis; and gender, UPDRS and urinary dysfunction with sexual satisfaction In this Spanish cohort, SD and sexual dissatisfaction was more prevalent in EOPD patients than in the general population. Gender and urinary disfunction were associated with SD and sexual dissatisfaction.

Four years after the beginning of the COVID-19 pandemic, it is important to reflect on the events that have occurred during that time and the knowledge that has been gained. The response to the pandemic was rapid and highly resourced; it was also built upon a foundation of decades of federally funded basic and applied research. Laboratories in government, pharmaceutical, academic, and non-profit institutions all played roles in advancing pre-2020 discoveries to produce clinical treatments. This perspective provides a summary of how the development of high-throughput screening methods in a biosafety level 3 (BSL-3) environment at Southern Research Institute (SR) contributed to pandemic response efforts. The challenges encountered are described, including those of a technical nature as well as those of working under the pressures of an unpredictable virus and pandemic.

The present work deals with an experimental and modeling analysis of the oxidation of ammonia–methane mixtures at high pressure (up to 40 bar) in the 550–1250 K temperature range using a quartz tubular reactor and argon as a diluent. The impact of temperature, pressure, oxygen stoichiometry, and CH4/NH3ratio has been analyzed on the concentrations of NH3, NO2, N2O, NO, N2, HCN, CH4, CO, and CO2obtained as main products of the ammonia–methane mixture oxidation. The main results obtained indicate that increasing either the pressure, CH4/NH3ratio, or stoichiometry results in a shift of NH3and CH4conversion to lower temperatures. The effect of pressure is particularly significant in the low range of pressures studied. The main products of ammonia oxidation are N2, NO, and N2O while NO2concentrations are below the detection limit for all of the conditions considered. The N2O formation is favored by increasing the CH4/NH3ratio and stoichiometry. The experimental results are simulated and interpreted in terms of an updated detailed chemical kinetic mechanism, which, in general, is able to describe well the conversion of both NH3and CH4under almost all of the studied conditions. Nevertheless, some discrepancies are found between the experimental results and model calculations.

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In the last 3 years the numbers of forcibly displaced people around the world has reached a record high. Experiences of war, persecution, violence, torture, participating in the killing of others, disruptions of attachments, and emotional losses increase the risk for psychological distress and may contribute to the risk of developing psychiatric and substance abuse disorders. The authors review the existing psychiatric literature on refugees, discuss the sociological reasons that explain the recent crisis, describe the psychiatric consequences, the risk factors and protective factors of the refugee experience, narrate the current conditions in refugee camps located in Greece and discuss the most up-to-date treatment modalities and preventive interventions to treat this patient population.

With the objective of assessing the periodontal health status, treatment needs, and oral hygiene habits of the population of Mérida, in Mexico, a descriptive cross-sectional study was performed. Four hundred forty individuals individually completed a questionnaire on oral health, oral hygiene habits, and quality of life. Additionally, a complete clinical dental examination was performed for each. For the statistical analysis, continuous variables (means and standard deviation) and categorical variables (frequencies) were studied. The associations were made using the analysis of variance test for continuous variables and the Chi-square test for categorical variables. The critical value to identify statistically significant differences was P < .05. The main concern of the population was the possible untreated caries they thought they had, with 36.21% followed by pain with 14.62%. Possible periodontal issues were the main discomfort for only 9%. The percentage of the sample that required periodontal intervention by a specialist was 21.14%. Statistically significant differences were found between age, place of residence, socioeconomic level, and schooling. There are great deficiencies in oral health in the studied group, which is accompanied by a great need for periodontal treatment. Periodontal health is closely related to oral hygiene, so the related sociocultural level should also be taken into account for the study of oral health in the most vulnerable populations. It is crucial to establish strategies to promote oral health.

ObjectiveWestern lifestyle and diet are major environmental factors playing a role in the development of IBD. Titanium dioxide (TiO2) nanoparticles are widely used as food additives or in pharmaceutical formulations and are consumed by millions of people on a daily basis. We investigated the effects of TiO2in the development of colitis and the role of the nucleotide-binding oligomerisation domain receptor, pyrin domain containing (NLRP)3 inflammasome.DesignWild-type and NLRP3-deficient mice with dextran sodium sulfate-induced colitis were orally administered with TiO2nanoparticles. The proinflammatory effects of TiO2particles in cultured human intestinal epithelial cells (IECs) and macrophages were also studied, as well as the ability of TiO2crystals to traverse IEC monolayers and accumulate in the blood of patients with IBD using inductively coupled plasma mass spectrometry.ResultsOral administration of TiO2nanoparticles worsened acute colitis through a mechanism involving the NLRP3 inflammasome. Importantly, crystals were found to accumulate in spleen of TiO2-administered mice. In vitro, TiO2particles were taken up by IECs and macrophages and triggered NLRP3-ASC-caspase-1 assembly, caspase-1 cleavage and the release of NLRP3-associated interleukin (IL)-1β and IL-18. TiO2also induced reactive oxygen species generation and increased epithelial permeability in IEC monolayers. Increased levels of titanium were found in blood of patients with UC having active disease.ConclusionThese findings indicate that individuals with a defective intestinal barrier function and pre-existing inflammatory condition, such as IBD, might be negatively impacted by the use of TiO2nanoparticles.

A rapid drug discovery response to influenza outbreaks with the potential to reach pandemic status could help minimize the virus's impact by reducing the time to identify anti-influenza drugs. Although several anti-influenza strategies have been considered in the search for new drugs, only a few therapeutic agents are approved for clinical use. The cytopathic effect induced by the influenza virus in Madin Darby canine kidney (MDCK) cells has been widely used for high-throughput anti-influenza drug screening, but the fact that the MDCK cells are not human cells constitutes a disadvantage when searching for new therapeutic agents for human use. We have developed a highly sensitive cell-based imaging assay for the identification of inhibitors of influenza A and B virus that is high-throughput compatible using the A549 human cell line. The assay has also been optimized for the assessment of the neutralizing effect of anti-influenza antibodies in the absence of trypsin, which allows testing of purified antibodies and serum samples. This assay platform can be applied to full high-throughput screening campaigns or later stages requiring quantitative potency determinations for structure-activity relationships.

Despite advances in therapies, disparities in outcomes have been documented for rheumatoid arthritis (RA) patients for both ethnicity and English language proficiency. The goals of these analyses were to compare differences in RA patient‐reported outcomes, by both self‐identification of ethnicity and English language proficiency, and to identify factors that might explain differences among groups. Data were collected through structured telephone interviews of a longitudinal cohort with physician‐diagnosed RA (n = 438); only women were included (n = 335). Three groups were defined based on self‐reported ethnicity and English proficiency: white/English (n = 219), Hispanic/English (n = 39), and Hispanic/Spanish (n = 77). Outcomes examined were patient‐reported physical functioning, pain, and presence of moderate or severe fatigue. Multivariate regression analyses compared outcomes among groups, adjusting for sociodemographic characteristics, health and disease factors, and depression. Hispanic/Spanish women had worse function, pain, and fatigue than either English‐proficient group. Depression was associated with all outcomes (P< 0.0001), and accounted for greater differentials in scores than ethnicity/language proficiency. In interaction analyses, differences between women who were and were not depressed were greater for Hispanic/English than for Hispanic/Spanish. Nondepressed Hispanic/Spanish scores were significantly worse than nondepressed Hispanic/English, i.e., the impact of depression was less for Hispanic/Spanish women because both depressed and nondepressed women in this group reported worse outcomes. After adjustment for sociodemographic factors and depression, language remained significantly associated with outcomes. Disparities in patient‐reported outcomes may be driven less by ethnicity than by sociodemographic or psychological factors. Measurement instruments that are not culturally appropriate and equivalent may also hamper meaningful analyses of disparities.

La estimulacion cerebral profunda (ECP) es un tratamiento eficaz para pacientes con enfermedad de Parkinson con complicaciones motoras. El elemento más importante que predice la respuesta a la ECP es la respuesta a la levodopa. Mostramos dos casos de pacientes con enfermedad de Parkinson de comienzo precoz con intolerancia severa a la levodopa y excelente respuesta a ECP. La ECP puede ser una alternativa en pacientes parkinsonianos con intolerancia a la levodopa siempre que la respuesta a apomorfina sea positiva.

Resumen La estimulacion cerebral profunda (ECP) es un tratamiento eficaz para pacientes con enfermedad de Parkinson con complicaciones motoras. El elemento más importante que predice la respuesta a la ECP es la respuesta a la levodopa. Mostramos dos casos de pacientes con enfermedad de Parkinson de comienzo precoz con intolerancia severa a la levodopa y excelente respuesta a ECP. La ECP puede ser una alternativa en pacientes parkinsonianos con intolerancia a la levodopa siempre que la respuesta a apomorfina sea positiva. Deep brain stimulation (DBS) is at present, a useful treatment for patients with advanced Parkinson's disease and motor complications. The crucial step toward consistent DBS outcomes remains careful patient selection; several conditions must be fulfilled including excellent levo dopa response. We report two cases of early onset Parkinson's disease with severe intolerance to levo dopa but excellent and sustained response to DBS. DBS can be a useful alternative for parkinsonian patients with severe intolerance to levo dopa, provided a positive acute response to levo dopa or apomorphine is obtained. [ABSTRACT FROM AUTHOR]

Resumen Introducción La terapia electroconvulsiva de continuación/mantenimiento ha demostrado su eficacia en la prevención de recaídas tanto en cuadros afectivos como psicóticos. Sin embargo, existen pocos estudios sobre variables de gestión clínica, costes asociados y calidad percibida. Material y métodos Se presenta una serie de 8 casos incluidos en el Programa de terapia electroconvulsiva de Continuación/Mantenimiento del Servicio de Psiquiatría del Hospital Universitario 12 de Octubre durante los primeros 18 meses de su funcionamiento. Para cada paciente se compararon variables clínicas (Escala de Impresión Clínica Global-Mejoría Global, días de ingreso, visitas a Urgencias, ingresos urgentes) antes y después de su inclusión en el programa, así como costes asociados y calidad percibida. Resultados Tras su inclusión en el programa, el 50,0% de los pacientes refirió encontrarse «mucho mejor», y el 37,5% «moderadamente mejor» en la Escala de Impresión Clínica Global-Mejoría Global. Además, una vez incluidos en el programa de terapia electroconvulsiva de continuación/mantenimiento, los pacientes tuvieron un total de 349 días de ingreso, 3 visitas a Urgencias y 2 ingresos urgentes, frente a los 690 días de ingreso (p = 0,012), 26 visitas a Urgencias (p = 0,011) y 22 ingresos urgentes (p = 0,010) en el mismo periodo, antes de su inclusión en el programa. Los costes directos asociados por estancia/día tras su inclusión en el programa se redujeron al 50,6% del coste previo, y los costes asociados a visitas a Urgencias disminuyeron al 11,5% del coste previo. Respecto a la calidad percibida, un 87,5% de los pacientes evaluaron la atención y tratamiento recibido como «muy satisfactorio», y un 12,5% como «satisfactorio». Conclusiones El programa de terapia electroconvulsiva de continuación/mantenimiento estudiado ha demostrado utilidad clínica, repercusión económica favorable, así como una elevada calidad percibida. Introduction Continuation/maintenance electroconvulsive therapy has been shown to be effective for prevention of relapse in affective and psychotic disorders. However, there is a limited nubber of studies that investigate clinical management, associated costs, and perceived quality variables. Material and methods A series of 8 cases included during the first 18 months of the Continuation/Maintenance Electroconvulsive Therapy Program of the Psychiatry Department at 12 de Octubre University Hospital is presented. Clinical variables (Clinical Global Impression-Improvement Scale, length of hospitalization, number of Emergency Department visits, number of urgent admissions) before and after inclusion in the continuation/maintenance electroconvulsive therapy program were compared for each patient, as well as associated costs and perceived quality. Results After inclusion in the program, 50.0% of patients reported feeling «much better» and 37.5% «moderately better» in the Clinical Global Impression-Improvement Scale. In addition, after inclusion in the continuation/maintenance electroconvulsive therapy program, patients were hospitalized for a total of 349 days, visited the Emergency Department on 3 occasions, and had 2 urgent admissions, compared to 690 days of hospitalization ( P = .012), 26 Emergency Department visits ( P = .011) and 22 urgent admissions ( P = .010) during the same period before inclusion in the program. Associated direct costs per day of admission were reduced to 50.6% of the previous costs, and costs associated with Emergency Department visits were reduced to 11.5% of the previous costs. As regards perceived quality, 87.5% of patients assessed the care and treatment received as being «very satisfactory», and 12.5% as «satisfactory». Conclusions This continuation/maintenance electroconvulsive therapy program has shown to be clinically useful and to have a favourable economic impact, as well as high perceived quality. [ABSTRACT FROM AUTHOR]