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Stress is one of the primary triggers of serious pathologies (e.g., depression, obesity, heart attack). Prolonged exposure to it can lead to addictive substance consumption and even suicide, without ignoring other adverse side effects in the economic, work and family spheres. Early detection of stress would relax the pressure of medical practice exercised by the population affected and result in a healthier society with a more satisfying quality of life. In this work, a convolutional-neural-network (CNN) model is proposed to detect an individual’s stress state by analyzing the diffusive dynamics of the photoplethysmographic (PPG) signal. The characteristic (p,q)-planes of the 0–1 test serve as a framework to preprocess the PPG signals and feed the CNN with the dynamic information they supply to typify an individual’s stress level. The methodology follows CRISP-DM (Cross Industry Standard Process for Data Mining), which provides the typical steps in developing data-mining models. An adaptation of CRIPS-DM is applied, adding specific transitions between the usual stages of deep-learning models. The result is a CNN model whose performance amounts to 97% accuracy in diagnosing the stress level; it compares with other published results.

The aim of this study was to determine the presence of SARS-CoV-2 on food surfaces and surfaces in public spaces in 3 districts of Lima, Peru. A cross-sectional descriptive study was carried out in three districts of the Lima metropolitan area. Surfaces that were most exposed to users were selected. Samples were swabbed for 4 weeks and transported to the laboratory to determine the presence of the virus. One thousand ninety-five inert surface samples and 960 food surface samples were evaluated for the identification of SARS-CoV-2 by the real time-PCR molecular test, whereby only one sample from an automated teller machine was positive. Most of the inert and food surfaces evaluated did not show the presence of SARS-CoV-2 during the time of sample collection. Despite the negative results, the frequency of disinfection and hygiene measures on high-contact surfaces should be maintained and increased to prevent other highly contagious infectious diseases.

Maslinic acid (MA), a pentacyclic triterpenoid obtained from olives that is characterized by its antiproliferative activity in tumor cells, has become a promising molecule that could be modified to improve cancer treatment. In this work we have synthesized in good yields several new MA conjugates, including glycerin, oligo(ethylene glycol), and amino acid derivatives (compounds 3a-f). The synthesis offers the possibility of recovering unreacted MA, and thus the scaling up of the process. For the tyramine-MA conjugate, compound 3f or TMA, the preparation has been optimized to a one-pot reaction. Solubility of conjugates in polar solvents has been measured, showing a marked increase of solubility with respect to MA. Moreover, we selected the tyramidyl maslinic acid conjugate (3f or TMA) to determine antitumor capacity over a wide range of cancer cell lines, including glioblastoma, melanoma, breast, lung, colorectal and pancreatic cancer. Our results clearly demonstrated that TMA induced higher cytotoxicity in all cancer cell types compared to MA. TMA was more effective than MA, especially in breast cancer cells (MCF-7) and melanoma cells (B16–F10) where IC50 reductions of 4.12 and 4.72, respectively, was detected. Interestingly, TMA showed a remarkable antitumor ability against the resistant HCT-15 colon cancer cell line. Furthermore, we demonstrated for the first time a relevant effect of a MA derivative against glioblastoma cells (A172 and SF-268). These results suggest that TMA is able to improve the antitumor characteristics of MA in a wide range of cancers and that it may be a promising compound for various tumor types, including resistant cancer.

Convective transport is an important phenomenon for nanomedicine delivery. We present an imaging-based approach to recover tissue properties that are significant in the accumulation of nanoparticles delivered via systemic methods. The classical pharmacokinetic analysis develops governing equations for the particle transport from a first principle mass balance. Fundamentally, the governing equations for compartmental mass balance represent a spatially invariant mass transport between compartments and do not capture spatially variant convection phenomena. Further, the parameters recovered from this approach do not necessarily have direct meaning with respect to the governing equations for convective transport. In our approach, a framework is presented for directly measuring permeability in the sense of Darcy flow through porous tissue. Measurements from our approach are compared to an extended Tofts model as a control. We demonstrate that a pixel-wise iterative clustering algorithm may be applied to reduce the parameter space of the measurements. We show that measurements obtained from our approach are correlated with measurements obtained from the extended Tofts model control. These correlations demonstrate that the proposed approach contains similar information to an established compartmental model and may be useful in providing an alternative theoretical framework for parameterizing mathematical models for treatment planning and diagnostic studies involving nanomedicine where convection dominated effects are important.

Resumen: Introducción y objetivos: El síndrome de Peutz-Jeghers (SPJ) es una enfermedad hereditaria, autosómica dominante caracterizada por la presencia de pólipos hamartomatosos en el tubo digestivo de predominio en el intestino delgado y que se acompañan de lesiones mucocutáneas pigmentadas. Algunas guías proponen la realización de polipectomía con enteroscopio asistido por balones (EAB) cuando los pólipos sean mayores de 10 mm. Las complicaciones en población adulta puede ser tan altas como 6.8%, sin embargo, en población pediátrica hay poca información. Nuestro objetivo es describir la seguridad y eficacia de la polipectomía en un grupo de pacientes pediátricos con SPJ tratados con EAB. Material y métodos: Es un estudio retrospectivo realizado en el Hospital de Especialidades del Centro Médico Nacional Siglo XXI entre enero del 2010 y diciembre del 2015. Se incluyó a todos los pacientes pediátricos con SPJ que requirieron EAB y polipectomía. Se excluyeron las polipectomías realizadas con enteroscopia de empuje. Resultados: Se realizaron un total de 35 polipectomías en 4 pacientes (femenino/masculino: 3/1). La edad media de los pacientes fue 13.7 (11-16) años. Se llevaron a cabo 12 enteroscopias, 8 de ellas anterógradas. El enteroscopio monobalón se utilizó en 7 procedimientos y el doble-balón en 5. El tamaño promedio de los pólipos fue de 1.6 cm (1-4 cm). Se presentó una complicación mayor (pancreatitis aguda) en un solo caso (8.3%). No se observaron otras complicaciones mayores. Conclusión: El uso de EAB con polipectomía en niños es un procedimiento seguro y efectivo con complicaciones similares a las reportadas en adultos. Abstract: Introduction and aims: Peutz-Jeghers syndrome is an autosomal dominant inherited pathology characterized by gastrointestinal hamartomatous polyps, predominantly in the small bowel, and pigmented mucocutaneous lesions. Guidelines suggest polypectomy with a balloon-assisted enteroscope when polyps are larger than 10 mm. Complications in adults can be as high as 6.8%, but there is little information on pediatric populations. Our aim was to describe the safety and efficacy of polypectomy in a group of pediatric patients with Peutz-Jeghers syndrome using balloon-assisted enteroscopy. Materials and methods: A retrospective study was conducted at the Hospital de Especialidades del Centro Médico Nacional Siglo XXI on pediatric patients with Peutz-Jeghers syndrome that required balloon-assisted enteroscopy and polypectomy within the time frame of January 2010 and December 2015. Patients that underwent polypectomy with a push enteroscope were excluded from the study. Results: A total of 35 polypectomies were performed on 4 patients (female/male: 3/1). The mean age of the patients was 13.7 years (range:11-16). Twelve enteroscopies were carried out, 8 of which were anterograde. A single-balloon enteroscope was used in 7 procedures and a double-balloon enteroscope in 5. The mean size of the polyps was 1.6 cm (range: 1-4 cm). A major complication (acute pancreatitis) presented in only one case (8.3%). No other major complications associated with the procedures were observed. Conclusion: Balloon-assisted enteroscopy with polypectomy in children is a safe and effective procedure, with complications similar to those reported in adults. Palabras clave: Peutz-Jeghers, Enteroscopia, Polipectomía, Niños, Keywords: Peutz-Jeghers, Enteroscopy, Polypectomy, Children

Studies for the prevention and mitigation of floods require information on discharge and extent of inundation, commonly unavailable or uncertain, especially during extreme events. This study was initiated by the devastating flood in Tegucigalpa, the capital of Honduras, when Hurricane Mitch struck the city. In this study we hypothesized that it is possible to estimate, in a trustworthy way considering large data uncertainties, this extreme 1998 flood discharge and the extent of the inundations that followed from a combination of models and post-event measured data. Post-event data collected in 2000 and 2001 were used to estimate discharge peaks, times of peak, and high-water marks. These data were used in combination with rain data from two gauges to drive and constrain a combination of well-known modelling tools: TOPMODEL, Muskingum–Cunge–Todini routing, and the LISFLOOD-FP hydraulic model. Simulations were performed within the generalized likelihood uncertainty estimation (GLUE) uncertainty-analysis framework. The model combination predicted peak discharge, times of peaks, and more than 90 % of the observed high-water marks within the uncertainty bounds of the evaluation data. This allowed an inundation likelihood map to be produced. Observed high-water marks could not be reproduced at a few locations on the floodplain. Identifications of these locations are useful to improve model set-up, model structure, or post-event data-estimation methods. Rainfall data were of central importance in simulating the times of peak and results would be improved by a better spatial assessment of rainfall, e.g. from radar data or a denser rain-gauge network. Our study demonstrated that it was possible, considering the uncertainty in the post-event data, to reasonably reproduce the extreme Mitch flood in Tegucigalpa in spite of no hydrometric gauging during the event. The method proposed here can be part of a Bayesian framework in which more events can be added into the analysis as they become available.

3D computer vision techniques are now required for the virtual reconstruction of ancient buildings and monuments in urban environments. In this paper, we include a new subfield within the broad field of Urban Heritage that we denominate as Rural Heritage (RH), and which is focused on recovering 3D models of small buildings and facilities of significance in rural environments. We, therefore, present a multi-sensory approach whose objective is to create complete architectural documentation of the dovecotes in an extended region of central Spain. This kind of aviary construction was very common in Spanish rural environments during the 19th century and the first half of the 20th century and is representative of an RH building. Sensory fusion was developed using color cameras, 3D terrestrial laser scanners, and photogrammetric techniques with Unmanned Aerial Vehicles (UAV) and achieves precise indoor and outdoor 3D models. The sensory fusion here also refers to the fact that the information coming from different sensors is integrated into a common documentation framework. A total of 80 dovecotes have been referenced and made available to the public in open access resources. The successful results and applicability of our method lead us to believe that the current documentation and the safeguard technologies in the RH field should evolve towards the use of these 3D computer vision techniques.

En el presente trabajo se analizan las ayudas paliativas de primera hora destinadas a compensar la disminución de rentas derivada de la inactividad provocada por la marea negra del Prestige en el sector pesquero y marisquero gallego. En particular se analiza el diseño uniforme de dichas ayudas y sus efectos distributivos entre los subsectores de actividad afectados. Asimismo se estima el coste total soportado por las administraciones públicas y se muestra cómo una sencilla re-evaluación de las ayudas hubiese permitido ajustar las compensaciones a la realidad económica de cada subsector de actividad afectado, corrigiendo de este modo la notable distorsión en la asignación de los recursos públicos.

Introduction: celiac disease (CD) is a common autoimmune condition (involves 1-2% of the general population) that develops at any age in life but manifests differently in children and adults. Objectives: to analyze clinical differences in disease expression between both groups, as well as findings at the time of diagnosis. Methods: a retrospective study of a series of patients diagnosed with CD during childhood (< 14 years) versus a series of adult patients (> 14 years). Results: a total of 187 patients were included, of which 43 were children and 144 were adults. Among clinical manifestations in children classic presentation forms predominated -34 patients (79%) versus 20 adult patients (14%) (p < 0.001) (OR = 23.4; 95% CI: 9.8-56.1). In contrast, atypical forms were predominant in the latter, and anemia was the most common finding in 61 patients (42%) versus 8 pediatric patients (19%) (p < 0.01). Adults had a greater diagnostic delay with a mean 10 ± 9 years versus 1 ± 2 years in children (p < 0.001). In adults, we found a higher frequency of associated autoimmune diseases (24.3 versus 9.3% in children) (p < 0.05). Regarding serum markers, TGt-2 was more commonly positive among children (88%) as compared to adults (31%) (p < 0.001); (OR = 21.4: 95% CI: 7.2-63.6). We found similar results with regard to the presence of villous atrophy, which was more common in children (95%) than in adults (33%) (p < 0.001) (OR = 41.0; 95% CI: 9.5-76.7). As regards genetic markers, DQ2 was somewhat more common in children (97.7%) than in adults (90.3%) whereas DQ8 was less common in children (2.3%) than in adults (9.7%), with no significant differences between groups. Patients negative for both markers were not included. Conclusions: pediatric CD has clear differences when compared to adult CD, with classic forms predominating in the former, who also display a higher occurrence of positive serology and villous atrophy, and less diagnostic delay. In contrast, atypical forms predominate in the adult, with a lower occurrence of positive serology and milder histological forms. In these patients associated autoimmune conditions are more common and diagnostic delay is longer.Introducción: la enfermedad celiaca (EC) es un proceso frecuente (afecta al 1-2% en población general), de naturaleza autoimmune, que aparece a cualquier edad de la vida, pero que se presenta de forma diferente en el niño que en el adulto. Objetivos: analizar las diferencias clínicas en las formas de expresión de la enfermedad entre ambos grupos, así como los hallazgos al momento del diagnóstico. Métodos: estudio retrospectivo de una serie de pacientes diagnosticados, en la infancia (< 14 años), frente a una serie de adultos (> 14 años). Resultados: se incluyeron un total de 187 pacientes, de los cuales 43 eran niños y 144 adultos. En las manifestaciones clínicas de los niños, predominaron las formas de presentación clásicas, 34 casos (79%) frente a los adultos 20 casos (14%) (p < 0,001) (OR = 23,4; IC-95%: 9,8-56,1). Por el contrario, en estos predominaron las formas atípicas, siendo la anemia el hallazgo más frecuente en 61 casos (42%) frente a 8 casos (19%) en los niños (p < 0,01). En los adultos existía un mayor retraso diagnóstico con una media de 10 ± 9 años, frente a los niños, que es de 1 ± 2 años (p < 0,001). Encontramos en los adultos una mayor frecuencia de enfermedades autoinmunes asociadas (24,3%), frente al 9,3% en niños (p < 0,05). Respecto a los marcadores serológicos, la TGt-2 fue más frecuentemente positiva en los niños (88%), que en los adultos (31%) (p < 0,001); (OR = 21,4: IC-95%: 7,2-63,6). Resultados similares encontramos en relación con la presencia de atrofia vellositaria, que estuvo presente más frecuentemente en los niños (95%) que en los adultos (33%) (p < 0,001) (OR = 41,0; IC-95%: 9,5-76,7). Respecto a los marcadores genéticos, el DQ2 fue algo más frecuente en niños (97,7%) que en adultos 90,3%, y el DQ8 ocurrió al contrario, siendo menos frecuente en niños (2,3%) que en adultos (9,7%), no encontrando diferencias entre ambos grupos. No se incluyeron pacientes negativos para ambos marcadores. Conclusiones: la EC en el niño presenta claras diferencias con el adulto predominando en aquel las formas clásicas, con mayor positividad de la serología y atrofia vellositaria, con menor retraso diagnóstico. Por el contrario, en el adulto predominan las formas atípicas, con menor positividad de la serología y formas histológicas más leves. En ellos son más frecuentes las enfermedades autoinmunes asociadas y existe un mayor retraso diagnóstico.

Introducción: la enfermedad celiaca (EC) es un proceso autoinmune, desencadenado por la ingesta del gluten contenido en la mayor parte de los cereales, que afecta a individuos genéticamente predispuestos. Por todo ello, muestra una clara tendencia familiar, centrada fundamentalmente en marcadores del sistema HLA de clase II. Objetivos: nos propusimos en el presente trabajo analizar la prevalencia de EC en una familia extensa, a partir de un caso índice fallecido hacía unos años, como consecuencia de padecer la misma enfermedad, complicada además con el desarrollo de un tumor maligno del intestino delgado, del tipo del adenocarcinoma. Métodos: se estudiaron un total de 19 miembros. Se les realizó un protocolo diagnóstico que incluía un historia clínica detallada, junto con una hemograma y estudio de coagulación, una bioquímica amplia incluyendo pruebas de función hepática, estudio sérico del metabolismo del hierro, niveles circulantes de ácido fólico y vitamina B12, pruebas de función tiroidea, determinación de la transglutaminasa tisular y marcadores genéticos (DQ2 y DQ8). En los casos sospechosos y para su confirmación se realizó gastroscopia completada con toma de biopsias duodenales múltiples. Resultados: encontramos una prevalencia global de EC en 9/19 de los familiares estudiados, lo que representa un 47,4%, distribuidos de la siguiente manera en función del parentesco con el caso índice: cuatro de siete hermanos (57%); uno de tres hijos (33,3%); tres de ocho sobrinos (37,5%); y el único sobrino-nieto estudiado de nueve años de edad, también estaba afecto. Conclusiones: de todo ello se deduce la necesidad de hacer estudios amplios familiares, cada vez que se diagnostica un paciente de enfermedad celiaca, incluyendo familiares de primero y segundo grado, dada la relativa facilidad actual para llevarlos a cabo y la elevada prevalencia encontrada.Introduction: celiac disease (CD) is an autoimmune condition that is triggered by the ingestion of gluten, a substance present in most cereals, and that affects genetically predisposed individuals. As a result, this condition is clearly familial, and mainly associated with HLA class II markers. Objectives: in this work we set out to analyze the prevalence of CD in an extensive family based on an index subject who had already died from this disease a few years ago, where CD had been complicated by the development of a small-bowel malignancy, namely an adenocarcinoma. Methods: nineteen members were studied. They all were subjected to a diagnostic protocol including a detailed medical history, hemogram, coagulation tests, and blood biochemistry (including liver function tests, serum iron metabolism, circulating folic acid and vitamin B12 levels, thyroid function tests, tissue transglutaminase measurement, and genetic markers (DQ2 and DQ8). Suspect cases underwent gastroscopy plus multiple duodenal biopsy for confirmation. Results: overall we encountered CD in 9/19 studied members, which represents 47.4% with the following distribution according to degree of kinship -four of seven siblings (57%); one of three children (33.3%); three of eight nephews and nieces (37.5%), and the only grandnephew, who was 9 years old. Conclusions: from all this it may be seen that family studies are needed every time a patient is diagnosed with celiac disease; these studies should include both first- and second-degree relatives, given the high prevalence encountered and the fact that these tests are relatively straighforward to perform.

We discuss the case of a 17-year-old male who at the age of 7 was diagnosed with celiac disease (CD) together with ulcerative colitis (UC) and primary sclerosing cholangitis (PSC). The patient was treated with gluten-free diet and immunosuppressive drugs (azathioprine), and currently remains asymptomatic. The patient's younger, 12-year-old sister was diagnosed with CD when she was 1.5 years old, and at 7 years she developed type-I diabetes mellitus, which was difficult to control. A family study was made, and both parents were found to be affected with silent CD. All were DQ2 (+). In relation to the case and family study, we provide a series of comments related to CD and its complications.Presentamos el caso de un varón de 17 años, que a la edad de 7 años fue diagnosticado de enfermedad celiaca (EC) junto con una colitis ulcerosa (CU) y una colangitis esclerosante primaria (CEP) asociadas. Fue tratado con DSG e inmuno-supresores tipo azatioprina y se encuentra asintomático en la actualidad. Su hermana menor de 12 años, fue diagnosticada de EC cuando tenía 1,5 años y a los 7 años desarrolló una DM tipo 1 de difícil control. Se realizó un estudio familiar y ambos padres están afectos de una EC silente. Todos ellos son DQ2 (+). A propósito del caso y estudio familiar, se hacen una serie de consideraciones sobre la enfermedad celiaca y el desarrollo de complicaciones.

We performed a family study to evaluate a total of 34 extended family members (8 siblings, 23 children and nephews, and 3 grandchildren) of an adult patient with celiac disease (CD), a 58- year-old male with severe neurologic involvement manifested as myoclonias. We found 3 other members affected with CD (a 44-year old sister, a 39-year old niece, and a 26-year old nephew). Two of them were completely asymptomatic and all had hypertransaminasemia. All exhibited a villous atrophy pattern of the duodenal mucosa (1 mild, 1 moderate, 1 severe). Overall family involvement was 11.8% (4/14). We wish to emphasize the need to perform extended family studies when diagnosing a case of CD, since risk is not restricted to only first-degree relatives.Presentamos un estudio familiar de enfermedad celiaca, en el que se estudiaron un total de 34 miembros (8 hermanos, 23 hijos y sobrinos y 3 nietos) de un paciente adulto varón de 58 años con enfermedad celiaca (EC) complicada con afectación neurológica manifestada como mioclonías. Encontramos 3 miembros más afectos de EC (1 hermana de 44, 1 sobrina de 39 y un sobrino de 26 años). Dos de ellos se encontraban completamente asintomáticos y todos presentaban hipertransaminasemia. Todos tenían atrofia de la mucosa duodenal (1 leve, 1 moderada y 1 importante). La afectación global familiar fue del 11,8% (4/14). Resaltamos la importancia de realizar estudios familiares extensos ante todo nuevo diagnóstico de EC, por la elevada incidencia de agregación familiar y predominio de formas asintomáticas y señalar que el riesgo no está limitado únicamente a familiares de primer grado.

Objectives: infliximab has clearly demonstrated its efficacy in the short-term treatment of fistulizing Crohn' disease. We present here the results of retreatment and long-term maintenance therapy. Patients and methods: eighty one consecutive patients with active fistulizing Crohn' disease, in whom previous treatments had failed, were treated with infliximab. All patients received as the initial treatment of 5 mg/kg i.v. infusions (weeks 0, 2, and 6). Those patients who failed to respond after the initial cycle (group 1, n= 25), or those who relapsed after having responded (group 2, n=13), received retreatment with three similar doses (weeks 0,2, and 6). Those who responded to retreatment were included in a long-term maintenance programme (n=44), with repeated doses (5 mg/kg i.v. infusions) every eight weeks for 1-2 years. Results: in the initial treatment 56% of the patients responded partially; this response being complete in 44%. In the retreatment, 28% of group 1 (non-responders) presented a complete response, compared to 77% in group 2 (relapsers) (p< 0.0001). In the maintenance treatment, the global response was 88% (39/44). The mean number of doses per patient was 4.4 ± 2 (range 1-9) with a duration of 36 ± 12 weeks (range 8-72). Adverse effects were not significantly increased in either treatment. Conclusions: both retreatment and long-term maintenance therapy with infliximab, are highly effective and well tolerated in fistulizing Crohn' disease patients.Objetivos: el infliximab ha demostrado su eficacia en el tratamiento a corto plazo de la enfermedad de Crohn (EC) fistulosa. En este trabajo presentamos los resultados del retratamiento y del tratamiento de mantenimiento a largo plazo. Pacientes y métodos: se trataron con infliximab un total de 81 pacientes consecutivos con EC fistulosa activa, en los cuales, habían fallado tratamientos previos. Todos los pacientes recibieron como tratamiento inicial infusiones a dosis de 5 mg/kg i.v. en las semanas 0, 2 y 6. Aquellos pacientes que no respondieron después del ciclo inicial (grupo 1, n=25), o los que recayeron después de haber respondido (grupo 2, n=13), recibieron retratamiento con 3 dosis similares (semanas 0, 2 y 6). Aquellos que respondieron a la terapia de retratamiento fueron incluidos en un programa de mantenimiento a largo plazo (n=44), con dosis repetidas (infusiones con 5 mg/kg i.v.) cada 8 semanas, durante 1-2 años. Resultados: en el tratamiento inicial el 56% de los pacientes respondieron parcialmente, siendo la respuesta completa del 44%. En la modalidad del retratamiento, el 28% de los pacientes del grupo 1 (no respondedores) presentaron respuesta completa frente al 77% del grupo 2 (recidivantes) (p< 0,0001). En el grupo de tratamiento de mantenimiento, la respuesta global fue del 88%. La media de dosis por paciente fue de 4,4 ± 2 (rango 1-9) con una duración media del tratamiento de 36 ± 12 semanas (rango 8-72). Los efectos adversos no aumentaron significativamente en los grupos de retratamiento y mantenimiento, comparados con el tratamiento inicial. Conclusiones: ambas modalidades de administración del infliximab, a saber el retratamiento y el tratamiento de mantenimiento a largo plazo, son muy efectivas y bien toleradas en pacientes con enfermedad de Crohn fistulosa.

Objectives: to assess the effect of infliximab on quality of life in a series of patients with fistulizing Crohn's disease. Patients and methods: a prospective observational study was made. A total of 25 patients with single or multiple draining abdominal or perianal fistulas were selected for the study. All received an intravenous infusion of infliximab at a dose of 5 mg per kilogram of body weight in weeks 0, 2, and 6. The clinical activity was calculated every two weeks over a 10-week follow-up. HRQOL (SF-36 and IBDQ scores ) were compared at baseline and at weeks 4 and 10. Results: sixty-four percent of patients had a clinical response to treatment with infliximab, with complete closure of fistulas. The mean values of CDAI decreased during follow-up, with a significant difference between weeks 0 and 10 (p < 0.01). Health-related quality of life (HRQOL), as measured by means of SF-36, showed an overall improvement in the physical domain (PCS) after 4 and 10 weeks (p < 0.05). An increase was also observed in IBDQ overall score on comparing the results obtained at week 0 and week 4 (p < 0.01). The social functioning domain of IBDQ was not significantly changed with treatment. Conclusions: treatment with infliximab in active fistulizing Crohn's disease results in a significant increase in the quality of life of patients at short-term.Objetivos: evaluar el efecto del infliximab sobre la calidad de vida en pacientes con enfermedad de Crohn fistulosa. Pacientes y métodos: se realizó un estudio prospectivo observacional encuadrado en la práctica clínica. Se seleccionaron un total de 25 pacientes con enfermedad de Crohn todos ellos con fístulas asociadas. Fueron tratados con tres infusiones intravenosas de infliximab a la dosis de 5 mg por kilogramo de peso en cada una de ellas, administradas a las semanas 0, 2, y 6. Todos los pacientes fueron seguidos durante 10 semanas. La actividad clínica medida con el CDAI, se determinó cada dos semanas. La calidad de vida relacionada con la salud (CVRS) se evaluó mediante un cuestionario general (SF-36) y otro específico (IBDQ), a las semanas 0, 4 y 10. Resultados: sesenta y cuatro por ciento de los pacientes presentaron respuesta clínica completa con infliximab, consistente en el cierre total de las fístulas, al final del tratamiento. Los valores medios del CDAI disminuyeron durante el seguimiento, con diferencias significativas entre las semanas 0 y 10 (p

Objective: to assess the incidence of inflammatory bowel disease in Oviedo (Northern Spain), and to describe the clinical features of new patients. Patients and methods: a prospective population-based study was made at the Health Area IV, Principality of Asturias (Oviedo, 312,324 inhabitants). All new diagnosed patients with inflammatory bowel disease were registered over a 2-year period. Results: a total of 85 patients were included, 47 of these with ulcerative colitis (UC), 37 with Crohn's disease (CD), and 1 with undetermined colitis. The overall adjusted incidence rate of UC and CD per 10(5) inhabitants between 15-64 years was 9.1 (95% CI: 5-13.1) and 7.5 (95% CI: 3.8-11.2), respectively. The global male/female ratio was 0.9, without significant differences between both diseases. CD patients were younger than those with UC (33 ± 15 years vs 45 ± 20 years; p < 0.05). Mostly, CD patients were diagnosed at an age younger than 35 years (65%), while UC patients were diagnosed at an age between 25 and 64 years (81%). Disease extension in UC was proctitis in 11%, left-side colitis in 53% and extensive colitis in 36%. With respect to CD, the ileo-colonic form predominated (49%), followed by the ileal (40%) and colonic (11%) forms; an inflammatory, stenotic and fistulous pattern was seen in 54, 22 and 24% of patients, respectively. Conclusions: in our area, the incidence of CD is similar to that in other Northern European countries, while UC has a lower incidence. CD mainly affects young people, while UC predominates in middle-aged patients. At diagnosis, UC is predominantly localized, the ileo-colonic form and an inflammatory pattern being most frequent in CD patients.Objetivo: conocer la incidencia de enfermedad inflamatoria intestinal en el área de Oviedo y describir las características clínicas de los nuevos pacientes. Pacientes y métodos: estudio prospectivo poblacional en el Área Sanitaria IV del Principado de Asturias (Oviedo, 312.324 habitantes). Fueron registrados todos los pacientes nuevos diagnosticados de enfermedad inflamatoria intestinal en un periodo de 2 años consecutivos. Resultados: se incluyeron un total de 85 pacientes, 47 con colitis ulcerosa (CU), 37 con enfermedad de Crohn (EC) y 1 con colitis indeterminada (CI). La tasa de incidencia ajustada por 10(5) habitantes entre 15 y 64 años, de CU y EC, fue de 9,1 para CU (IC95%: 5-13,1) y 7,5 para la EC (IC95%: 3,8-11,2). La proporción hombre/mujer fue de 0,9, sin diferencias significativas entre ambas enfermedades. Los pacientes con EC eran más jóvenes que los que tenían CU (33 ± 15 años vs 45 ± 20 años; p

La estabilización de la inmunidad de las cerdas madres ha sido adoptada recientemente como medida eficaz para el control del Síndrome Respiratorio y Reproductivo Porcino. En la presente investigacion, la aplicación de este concepto para el control de la pleuroneumonía porcina, fue evaluada mediante la realización de ensayos de campo en diez granjas porcinas ubicadas en cuatro entidades federales de Venezuela. Los resultados de este estudio mostraron que el nivel de anticuerpos en la población de madres, antes de la estabilización de la inmunidad frente a Actinobacillus pleuropneumoniae, fué altamente variable. El rango de madres seropositivas antes de la aplicación del plan de estabilización de la inmunidad estuvo entre 12 y 80%. El promedio de inmunidad calostral humoral contra dicho microorganismo, detectada mediante una prueba de neutralización de actividad hemolítica en agar sangre, fue significativamente más baja (P > 0,05) en granjas con una alta proporción de hembras seronegativas. Después de la vacunación del rebaño de reproductoras se observó, una menor variación en la duración de la inmunidad maternal (promedio de 7semanas +/- 1) y un incremento de 4 semanas en la duración de la inmunidad maternal con relación a la observada antes de la inmunización de las madres. La tasa de mortalidad por pleuroneumonía porcina fue significativamente reducida (P > 0,05) en las diez granjas en donde la inmunización de todas las hembras reproductorasfue llevada a cabo. Por otra parte, no se observó efecto favorable del plan de vacunación de madres en el 30% de las granjas.