[CHRONIC KIDNEY DISEASE AND ITS RELATIONSHIP WITH INTAKE OF TURMERIC, CATECHINS, PROANTHOCYANIDINS AND OMEGA-3]. / ENFERMEDAD RENAL CRÓNICA Y SU RELACIÓN CON LA INGESTA DE CÚRCUMA, CATEQUINAS, PROANTOCIANIDINAS Y OMEGA-3.

Chronic renal disease is characterized by decreased glomerular filtration rate (GFR) < 60 ml/min/ 1.73m2 and/or the presence of kidney damage independent of the cause for a period of 3 months or more. The treatment of more advanced stages of chronic kidney disease is dialysis, and most common form of hemodialysis. This treatment is costly in our country reaching USD 900 per person. The main cause of admission to dialysis, diabetic nephropathy remains with 34% of all revenue. This alone makes any improvement in the treatment of CKD is highly desirable. There is evidence available about the fundamental role of turmeric, proanthocyanidins, catechins and omega-3 on how these compounds are related to the response to treatment of chronic kidney disease for various reasons.

La enfermedad renal crónica se caracteriza por disminución de la velocidad de filtración glomerular (VFG) < 60 ml/min/1,73m2 y/o la presencia de daño renal independiente de la causa durante un periodo superior a tres meses. El tratamiento de las etapas más avanzadas de la enfermedad renal crónica (ERC) es la diálisis, y su forma más frecuente la hemodiálisis. Este tratamiento tiene un coste elevado en nuestro país, correspondiendo a USD 900 mensuales por persona. La causa principal de ingreso a diálisis corresponde a la nefropatía diabética, con un 34% de todos los ingresos. Solo estos indicadores justifican los esfuerzos en investigación por mejorar el tratamiento de la ERC. Existe evidencia disponible acerca del rol fundamental de cúrcuma, prontocianidinas, catequinas y omega-3 sobre cómo estos compuestos se relacionan con una mejor respuesta al tratamiento de la enfermedad renal crónica por distintas causas1.

Enfermedad renal crónica y su relación con la ingesta de cúrcuma, catequinas, proantocianidinas y omega-3 / Chronic kidney disease and its relationship with intake of turmeric, catechins, proanthocyanidins and omega-3

La enfermedad renal crónica se caracteriza por disminución de la velocidad de filtración glomerular (VFG) < 60 ml/min/1,73m2 y/o la presencia de daño renal independiente de la causa durante un periodo superior a tres meses. El tratamiento de las etapas más avanzadas de la enfermedad renal crónica (ERC) es la diálisis, y su forma más frecuente la hemodiálisis. Este tratamiento tiene un coste elevado en nuestro país, correspondiendo a USD 900 mensuales por persona. La causa principal de ingreso a diálisis corresponde a la nefropatía diabética, con un 34% de todos los ingresos. Solo estos indicadores justifican los esfuerzos en investigación por mejorar el tratamiento de la ERC. Existe evidencia disponible acerca del rol fundamental de cúrcuma, prontocianidinas, catequinas y omega-3 sobre cómo estos compuestos se relacionan con una mejor respuesta al tratamiento de la enfermedad renal crónica por distintas causas (AU)

Chronic renal disease is characterized by decreased glomerular filtration rate (GFR) < 60 ml/min/ 1.73m2 and/or the presence of kidney damage independent of the cause for a period of 3 months or more. The treatment of more advanced stages of chronic kidney disease is dialysis, and most common form of hemodialysis. This treatment is costly in our country reaching USD 900 per person. The main cause of admission to dialysis, diabetic nephropathy remains with 34% of all revenue. This alone makes any improvement in the treatment of CKD is highly desirable. There is evidence available about the fundamental role of turmeric, proanthocyanidins, catechins and omega-3 on how these compounds are related to the response to treatment of chronic kidney disease for various reasons (AU)

Intensification of infliximab therapy in Crohn's disease: efficacy and safety.

INTRODUCTION: The response of Crohn's disease (CD) to infliximab is initially good, although a loss of efficacy is observed over time. Dose escalation has been recommended in such cases. AIMS: To study the response to an intensified infliximab regimen in patients with CD; and to evaluate the adverse effects associated with intensification of therapy and identify predictors of loss of response. METHODS: We performed a retrospective multicenter survey of all patients with CD who had been treated with at least the 3 induction doses of standard infliximab therapy, and for whom treatment had to be intensified due to loss of response. We analyzed the efficacy of the intensified regimen. RESULTS: Thirty-three patients were included. After the first intensification dose, 79% of patients had a clinical response (33.5% complete response, 45.5% partial response). In the long term, 83%, 69%, 47%, and 29% of patients who had an initial response to the intensification maintained the response at 6, 12, 18, and 36 months, respectively. The loss of efficacy after escalation was 43% per patient-year of follow-up. One patient had an infusion reaction after 36 doses. One patient developed a herpes zoster infection. CONCLUSIONS: A high proportion of patients whose dose of infliximab is increased due to loss of efficacy respond initially. However, nearly half lose the response after one year. The safety profile of an intensified infliximab regimen is good.

Adalimumab induction and maintenance therapy for patients with ulcerative colitis previously treated with infliximab.

BACKGROUND: The long-term efficacy of adalimumab in patients with ulcerative colitis is not well known. AIM: To evaluate the short- and long-term outcomes of adalimumab in ulcerative colitis patients previously treated with infliximab. METHODS: Patients with active ulcerative colitis were treated with adalimumab after failure of other therapies including infliximab. Short-term clinical response and remission were assessed at weeks 4 and 12. The proportion of patients who continued on adalimumab and the proportion of patients who remained colectomy free were assessed over the long term. RESULTS: Clinical response at weeks 4 and 12 was achieved in 16 (53%) and 18 (60%) patients, respectively, and clinical remission was obtained in 3 (10%) and 8 (27%) patients, respectively. After a mean 48 weeks' follow-up, 15 patients (50%) continued on adalimumab. Six patients (20%) required colectomy. All patients who achieved clinical response at week 12 were colectomy free at long term. CONCLUSIONS: Adalimumab was well tolerated and induced durable clinical response in many patients with otherwise medically refractory ulcerative colitis. Patients achieving clinical response at week 12 avoided colectomy over the long term.

Anisakiasis múltiple / No disponible

No disponible

[Limbic encephalitis with severe sleep disorder associated with voltage-gated potassium channels (VGKCs) antibodies]. / Encéphalite limbique avec anticorps anticanaux potassiques voltage dépendants et troubles sévères du sommeil.

INTRODUCTION: Voltage-gated potassium channels (VGKCs) antibodies are associated with neuromyotonia, limbic encephalitis and Morvan syndrome. CASE REPORT: We report the case of a patient who, after three weeks of fever, presented an anamnestic syndrome, associated with confusion and partial seizures. MRI showed left hyperintensity of mesial temporal structures on Flair images and right hippocampal atrophy on T1 weighted sequences. Laboratory tests only showed high level of anti-TPO antibodies. Thus, the patient was considered as having Hashimoto's encephalopathy. She was treated with intravenous methylprednisolone with no improvement of symptoms. On the contrary, the patient suffered from insomnia, deep diurnal drowsiness and complete disappearance of REM sleep. Episodes of hypothermia and severe hyponatremia were recorded. Serum VGKC antibodies were found at high level. After intravenous immunoglobulin treatment followed by methylprednisolone, we noted remarkable improvement of clinical status. Polysomnography showed reappearence of REM sleep. CONCLUSION: This case report broadens the spectrum of clinical manifestations associated with VGKC antibodies and suggests that VGKC are implicated in regulation of sleep. The potential pathophysiological mechanisms linking sleep disturbances and VGKC antibodies are discussed.

Granulocitoaféresis: viejos procedimientos, nuevas soluciones / Granulocytapheresis: old procedures, new solutions

No disponible

Enfermedad de Crohn fistulizante / Fistulizing Chron's disease

No disponible

A young woman with first-trimester metrorrhagia, fever and skin lesions.

Inflammatory bowel disease commonly affects women with child-bearing potential, and clinical activity extent is most relevant at the time of conception. Below, we report on the case of a 19-year-old woman who was admitted for first-trimester metrorrhagia and fever, with various extraintestinal manifestations, mainly including erythema nodosum and episcleritis during the course of disease. The differential diagnosis of these manifestations led to the diagnosis of Crohn's disease, which involved the whole colon.

Mujer joven con metrorragia del primer trimestre, fiebre y lesiones cutáneas / Clinicopathological Conference A young woman with first-trimester metrorrhagia, fever and skin lesions

La enfermedad inflamatoria intestinal afecta frecuentemente a mujeres en edad fértil, siendo fundamental el grado de actividad clínica en el momento de la concepción. A continuación se presenta el caso de una mujer de 19 años que ingresa por metrorragia del primer trimestre y fiebre; destacando durante su evolución la aparición de diferentes manifestaciones extraintestinales, fundamentalmente eritema nodoso y epiescleritis. A través del diagnóstico diferencial de estas manifestaciones se llegó al diagnóstico de una enfermedad de Crohn que afectaba a todo el colon

Metástasis hepáticas de melanoma uveal / Liver metastases from uveal melanoma

No disponible

Safe endoscopic resection of gangliocytic paraganglioma of the major duodenal papilla.

A case of gangliocytic paraganglioma of the papilla of Vater in a 76-year-old man with a history of recurrent obstructive jaundice is presented. This is the first case of gangliocytic paraganglioma of the major papilla successfully resected by endoscopic ampullectomy.

Soluble carbohydrates (trehalose in particular) and cryoprotection in polar biota.

Data are presented here on low molecular weight carbohydrates contents (assessed from samples collected in situ) of selected, representative terrestrial species from the maritime Antarctic. Significant seasonal variation for most species were observed. Increased levels overwinter in arthropods contrasted with cryptogams where levels were higher in spring and summer samples. The occurrence and seasonal variation of trehalose in particular is demonstrated for invertebrate and lichen species. The data are discussed in relation to published results from experimental manipulation of growth temperatures on Antarctic fungi and an Arctic springtail providing further evidence for the protective role of trehalose. The widespread presence of trehalose in polar biota is documented and discussed regarding acclimatisation to both low temperature and partial dehydration.

[Thyroid disorders associated with interferon treatment in patients with chronic viral hepatitis or multiple sclerosis]. / Alteraciones tiroideas asociadas al tratamiento con interferón en pacientes con hepatitis crónica viral o esclerosis múltiple.

BACKGROUND: Alpha and beta interferon (IFN-alpha and beta) treatment is associated with the synthesis of thyroid autoantibodies and the development of autoimmune thyroid diseases. METHODS AND RESULTS: We have retrospectively evaluated their effect in patients with chronic viral hepatitis (CH) (n = 118) and multiple esclerosis (ME) (n = 10). Thyroid dysfunction has been detected in 7.4% of patients, and seroconversion in 4.7%. CONCLUSIONS: Pre-treatment antithyroid antibodies do not predispose to altered thyroid function, after IFN therapy; their presence should not contraindicate IFN treatment.

Partial desiccation induced by sub-zero temperatures as a component of the survival strategy of the Arctic collembolan Onychiurus arcticus (Tullberg).

The mechanism by which the freeze susceptible Arctic collembolan Onychiurus arcticus survives winter temperatures of -25 degrees C in the field is not fully understood but exposure to sub-zero temperatures (e.g. -2.5 degrees C) is known to induce dehydration and lower the supercooling point (SCP). In this study, changes in the water status and certain biochemical parameters (measured in individual Collembola) during a 3-week exposure to decreasing temperatures from 0 to -5.5 degrees C were studied. Osmotically active and inactive body water contents were measured by differential scanning calorimetry (DSC), water soluble carbohydrates by high performances liquid chromatography (HPLC) and glycogen by enzymatic assays. The activity of trehalase and trehalose 6-phosphate synthase were also measured. During the experiment, total water content decreased from 70 to 40% of fresh weight, mostly by the loss of osmotically active water with only a small reduction in the osmotically inactive component. The SCP decreased from -7 to -17 degrees C. Analysis of the results shows that if O. arcticus is exposed to -7 degrees C in the presence of ice, all osmotically active water would be lost due to the vapour pressure gradient between the animals supercooled body fluids and the ice. Under these conditions the estimated SCP would reach a minimum of c. -27 degrees C, but the Collembola may never freeze as all the osmotically active water has been lost, the animal becoming almost anhydrobiotic. Trehalose concentration increased from 0.9 to 94.7&mgr;g mg(-1)fw while glycogen reserves declined from 160 to 7.7 nmol glucose equivalents mg(-1) protein. Trehalase activity declined as the temperature was reduced, while trehalose 6-phosphate activity peaked at 0 degrees C. By adopting a strategy of near anhydrobiosis induced by sub-zero temperatures, O. arcticus, which was previously thought to be poorly adapted to survive severe winter temperatures, is able to colonise high Arctic habitats.