Pharmacologic therapy for inflammatory bowel disease refractory to steroids.

Although corticosteroids are an effective treatment for induction of remission in inflammatory bowel disease (IBD), many patients are dependent on or refractory to corticosteroids. This review is based on scrutinizing current literature with emphasis on randomized controlled trials, meta-analyses, and Cochrane reviews on the management of IBD refractory to corticosteroids. Based on this evidence, we propose algorithms and optimization strategies for use of immunomodulator and biologic therapy in IBD refractory to corticosteroids.

[Lung cancer projections for Aragon (Spain)]. / Proyecciones del cáncer de pulmón en Aragón (España).

INTRODUCTION AND OBJECTIVE: Lung cancer has a high incidence in Aragon (Spain). Current measures, such as stopping smoking, may lead to a change in lung cancer trends. The objective of the study is to track the trends during the period of 15 years from 2008 to 2022. PARTICIPANTS AND METHODS: The mortality from all causes and that specific to lung cancer in Aragon between 1998 and 2007 was analysed using the statistical program MIAMOD/PIAMOD to estimate incidence rates, prevalence, and mortality until 2022. RESULTS: Projections between 2008 and 2022 in men: adjusted incidence rates per 100,000 will decline from 64.62 to 58.49. The mortality will decline from 57.41 to 51.95, and the prevalence of 94.13 cases per 100,000 inhabitants to 88.45. In women, the adjusted incidence rate will increase from 8.3 to 10.58, with a mortality of 7.21 to 9.18 and a prevalence from 14.78 to 18.75. CONCLUSIONS: These projections indicate that lung cancer incidence and mortality will remain a serious problem in the Aragon (Spain), and that a more intense primary prevention program is needed.

Predictions and estimations of colorectal cancer mortality, prevalence and incidence in Aragon, Spain, for the period 1998-2022.

OBJECTIVE: estimate colorectal cancer incidence and prevalence in, based on mortality and survival data from the period 1998-2007, and provide projections of incidence, prevalence and mortality until the year 2022. METHODS: general and colorectal cancer mortality rates were obtained from the National Statistics Institute and survival data was obtained from the EUROCARE study. Estimations were carried out through the program MIAMOD. The joinpoint program was used to quantify the annual change expected in the projections. RESULTS: in men, an increase in prevalence is expected, from 237.2 (Crude Rate - CR = 303.5) to 237.7 (CR = 412.7) per 100.000 inhabitants/year in 2022. Incidence rates would increase from 48.2 (CR = 61.6) in 2007 to 55.2 (CR = 83.1), and mortality would increase from 22.7 (CR = 29.4) to 26.0 (CR = 39.6) when comparing 2007 and women, a reduction in prevalence is expected from 181.5 (CR = 268.3) to 167.9 (CR = 286.2) cases per 100,000 inhabitants/year. Incidence would change from 25.0 (CR = 38.0) in 2007 to 22.7 (CR = 39.2), and for mortality there is also an expected decrease, from 11.3 (CR =18.0) to 10.3 (CR = 18.5). CONCLUSION: the projections indicate that colorectal cancer in follows an increasing trend in incidence, mortality and prevalencein men, in opposition to corresponding decreasing trends in women.These projections must be considered in order to plan more effective prevention and treatment measures.

Riesgo de segundas neoplasias primarias / Risk of second primary cancers

Introducción: Múltiples neoplasias primarias se ven frecuentemente, considerándose habitual en un porcentaje de 3,5% de los casos de cáncer. El objetivo de este estudio es calcular en que localizaciones son más frecuentes estas neoplasias en relación a la primera detectada y calcular el excesivo riesgo de incidencia (SIR) para ellas. Material y Métodos: Se estudiaron 325 casos de pacientes con neoplasias múltiples, 215 en hombre y 110 en mujeres, todas ellas pertenecientes al Registro de Cáncer del Hospital Clínico Univeristario Lozano Blesa de Zaragoza, en el que se recogen alrededor de 1.500 casos anuales de cáncer. Resultados: La más frecuente localización para un Segundo tumor primario fue en piel (45.2) seguida de vejiga (8.3%), próstata (7.1%), laringe (4.9%), colon (4.3%), labio (piel del labio 4%), pulmón (3.1%), cuerpo de útero (2.5%) y melanoma (2.2%). Hemos encontrado un exceso de incidencia (SIR) en segundos tumores, en pulmón 1,6 (95% CI 1,2-2,6), faringe SIR 1,2 (95% IC 0,8-1,8), melanoma SIR 2,1 (95% IC1,7-2,3), glándulas salivales. SIR=2,1 (CI 95% 1,9-2,8) y vejiga SIR=1,7 (95% 1,2-3). Conclusión: Hemos visto un significativo incremento de la incidencia en segundos tumores primarios en nuestro medio por lo que se hace necesario controlar a aquellas personas que han tenido un cáncer previo para prevenir o detectar precozmente la posibilidad de un segundo tumor

Introduction: Multiple primary malignant neoplasias are found relatively frequently. The presence of two malignant tumours in the same patient is found in 3.5% of the cases. The objective of this study was to determine in which parts of the body we can find these second tumours calculating the excessive incidence (SIR). Material and methods: 325 cases of tumours of second primary tumors were studied, 215 in men (66.2%) and 110 in womwn (33.8%). All the cases were taken from Zaragoza (Spain) hospital cancer registry, of about 1500 cases annually, dating from 1989. Results: the most frequent location for second primary tumors found was taken the skin (45,2) followed by bladder (8.3%), prostate (7.1%), larynx (4.9%), colon (4.3%) lips (skin iof the lips 4%) lungs (3.1%) main body of the uterus (2.5%) and melanome (2.2%). We found a standardized incidence ratio (SIR) in second tumours, in lung cancer of 1,6 (95% CI 1,2-2,6), pharynx SIR 1,2 (95% CI 0,8-1,8), melanoma SIR 2,1 (95% IC 1,7-2,3), salivary gland. SIR=2,1 (CI 95% 1,9-2,8) and blader RR=1,7 (95% 1,2-3). Conclusion: there is a significant increase of incidence for second primary cancers and it would be necessary to display procedures that could allow to detect these cases in advance and prevent those patients in risk to reproduce a new tumour

Cambios recientes en la incidencia y mortalidad del cáncer en España / Recent changes in the incidence and mortality of cancer in Spain

Introducción: Las estimaciones nacionales del riesgo de enfermedad por cáncer pueden permitirestimar variaciones del riesgo de esta enfermedad.Métodos: Realizamos un estudio epidemiológico observacional analítico de cohortes estratificadasrealizado a partir de datos previos publicados en Globocan 2000 y en otras ediciones de tasas deincidencia. Los datos para la Mortalidad fueron tomados de las estadísticas de mortalidad publicadasen Zaragoza.Resultados: Ha variado el riesgo de padecer cáncer en España respecto a las diferentes localizaciones,siendo menor en mujeres que en hombres.Conclusión: Los datos de cáncer podrían ser una guía para prevención de las actividades en España.La diferencia temporal del riesgo en cáncer manifiesta una urgencia en medidas de control decáncer

Purpose: To study the different rates of cancer incidence and mortality risk observed in theSpanish national estimates.Methods: The authors make an observational-analytical cohort study of cancer mortality usingdeath records and incidence rates published in Globocan 2000, and in the 1985 Saragossa mortalityrecords. The 95% confidence intervals (95% CI) were calculated.Results: Cancer localization has changed in Spain as time passes. The overall cancer mortalityand incidence risk is lower in women than in men.Conclusions: Regional data should guide cancer prevention and control activities in the differentparts of Spain. The disparity of regional risk of mortality, incidence and localization makes urgent toimprove regional cancer control measures

Response latencies and event-related potentials during the gap paradigm using saccadic responses in human subjects.

An experiment was conducted in naive human subjects to measure the time benefits of the latencies of saccadic eye movements to peripheral targets when the offset of a central fixation point precedes the switching on of the peripheral target by 200 ms. Naive subjects produced a shift advancement of the eye movement latencies to the targets with respect to when there is no such temporal gap. Simultaneously, the event-related potentials produced by visual stimuli and saccadic eye movements were recorded. The switching on of the central fixation point induced a negative component that could be considered a contingent negative variation. Subsequently, in the control non-gap condition visual evoked potentials and P300 appear. The temporal gap paradigm induced offset visual-evoked potentials and a frontal negativity; it also induced a higher P300 than the non-gap condition. The saccadic ERPs also showed a frontal negativity preceding the saccade during the gap condition. The results suggest that fast regular saccades during the gap paradigm occur by a priming of premotor and motor frontal circuits indexed by the recorded negativity during the gap paradigm.

Cortical potentials during gap and non-gap paradigms using manual responses in humans.

An experiment was conducted on naive human subjects to measure the time benefits on finger reaction times produced by the offset of a central fixation point 200 ms before the appearance of a target stimulus in the periphery. Subjects produced a shift advancement of manual reaction times. Simultaneously, the event-related potentials were recorded. The gap paradigm induced offset visual evoked potentials and a frontal negativity, it also induced a higher P300 than the non-gap condition. The results suggest that the gap promotes the speeding of the response by a cortical priming.

Some studies on the experimental infection of golden hamsters with Taenia solium.

Golden hamsters were infected orally with viable cysticerci of Taenia solium obtained from infected pigs. After two weeks of infection implanted scolices of about 4 mm were found in exactly the same number as the number of ingested cysticerci. At six weeks 66% of the ingested cysticerci were found as implanted tapeworms (average size: 5.7 cm). At ten weeks 16% of the ingested cysticerci were found as implanted tapeworms (average size: 5.8 cm). At 14 weeks no tapeworms were found. Skin tests with taenia extracts were positive after 9 weeks of infection peaked at 12 and 14 weeks and declined afterwards becoming negative after 27 weeks. Skin test with cysticercus extracts were weaker, peaked at 8 and 10 weeks, were very low after 12 weeks and became negative after 16 weeks. Histological studies in the attachment site at the small intestine showed at 2 weeks a cellular infiltrate formed by macrophages, epithelioid cells and some plasma cells, there was very little alteration of epithelium. At 6 and 8 weeks the epithelium was damaged and necrotized. At 17 and 19 weeks the lesion started to resolve. We conclude that the golden hamster can be used to reproduce in the laboratory at least part of the life cycle of Taenia solium.

Efectos de la temperatura e inactivantes sobre cepas de virus aftoso en Colombia. / Effects of temperature and inactivating agents on Colombian foot-and-mouth virus strains

Se realizaron estudios sobre la susceptibilidad de cepas de virus aftoso en Colombia a la accion de la temperatura (26o C y 37o C) y de agentes inactivantes acetiletilenimina (AEI) y etileniminabinaria.(BEI) aplicando procesos corrientes de in activacion o mediante la tecnica de estabilidad termica a 47.5oC durante 5 minutos. Las observaciones sobre la concentracion de particulas 146S de cada virus fueron efectuadas aplicando analisis lineares de gradientes de densidad de sucrosa. En nuestros resultados se obtuvo una mayor susceptilizada a la degradacion del virus Tipo O Subtipo 1 (Cepa 9489) respecto a la observada con el virus O1 (Cepa Campos).Las Cepas de Tipo A Subtipo 24 (Cruzeiro)y A27 (8046) fueron mas resistentes a la accion de la temperatura y de los inactivantes utilizados en estos ensayos que los virus O1