Clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in patients with ulcerative colitis treated with two consecutive anti-TNF agents: data from the ENEIDA registry.

Background: Infliximab seems to be the most efficacious of the three available anti-TNF agents for ulcerative colitis (UC) but little is known when it is used as the second anti-TNF. Objectives: To compare the clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in UC patients. Design: Retrospective observational study. Methods: Patients from the ENEIDA registry treated consecutively with infliximab and a subcutaneous anti-TNF (or vice versa), naïve to other biological agents, were identified and grouped according to the administration route of the first anti-TNF into IVi (intravenous initially) or SCi (subcutaneous initially). Results: Overall, 473 UC patients were included (330 IVi and 143 SCi). Clinical response at week 14 was 42.7% and 48.3% in the IVi and SCi groups (non-statistically significant), respectively. Clinical remission rates at week 52 were 32.8% and 31.4% in the IVi and SCi groups (nonsignificant differences), respectively. A propensity-matched score analysis showed a higher clinical response rate at week 14 in the SCi group and higher treatment persistence in the IVi group. Regarding long-term outcomes, dose escalation and discontinuation due to the primary failure of the first anti-TNF and more severe disease activity at the beginning of the second anti-TNF were inversely associated with clinical remission. Conclusion: The use of a second anti-TNF for UC seems to be reasonable in terms of efficacy, although it is particularly reduced in the case of the primary failure of the first anti-TNF. Whether the second anti-TNF is infliximab or subcutaneous does not seem to affect efficacy.

OBJECTIVES: To compare the clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in UC patients. DESIGN: Retrospective observational study. METHODS: Patients from the ENEIDA registry treated consecutively with infliximab and a subcutaneous anti-TNF (or vice versa), naïve to other biological agents, were identified and grouped according to the administration route of the first anti-TNF into IVi (intravenous initially) or SCi (subcutaneous initially). RESULTS: Overall, 473 UC patients were included (330 IVi, 143 SCi). Clinical response at week 14 was 42.7% and 48.3% in the IVi and SCi groups (non-statistically significant), respectively. Clinical remission rates at week 52 were 32.8% and 31.4%, in the IVi and SCi groups (nonsignificant differences), respectively. A propensity-matched score analysis showed a higher clinical response rate at week 14 in the SCi group and higher treatment persistence in the IVi group. Regarding long-term outcomes, dose escalation and discontinuation due to the primary failure of the first anti-TNF and more severe disease activity at the beginning of the second anti-TNF were inversely associated with clinical remission. CONCLUSION: The use of a second anti-TNF for UC seems to be reasonable in terms of efficacy, although it is particularly reduced in the case of the primary failure of the first anti-TNF. Whether the second anti-TNF is infliximab or subcutaneous does not seem to affect efficacy.

Clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in patients with ulcerative colitis treated with two consecutive anti-TNF agents. Data from the ENEIDA registry Background: Infliximab seems to be the most efficacious of the three available anti-TNF agents for ulcerative colitis (UC), but little is known when it is used as the second anti-TNF.

Cystic pancreatic neuroendocrine tumors: a multidisciplinary diagnostic challenge.

Cystic pancreatic neuroendocrine tumours (cPNETs) are an uncommon diagnosis, representing less than 10% of all cystic neoplasms. They tend to affect patients aged between 30 and 60 years, with no differences between the sexes. Herein we present the case of a woman aged 75 years with a history of AHT, DM2 and CKF. Given symptoms of abdominal pain, toxic syndrome and altered hepatic analyses, the patient underwent an abdominal CT, which showed a solid mass with neoproliferative appearance in the pancreatic tail, along with a small, non-specific portacaval adenopathy. Consequently, an echo-endoscopy (USE) was performed to complete the study.

Efecto genotóxico de la glibenclamida, metformina y terapia combinada en la línea celular de ovario de hámster chino Cricetulus griseus CHO-K-1 / Genotoxic effect of glibenclamide, metformin and combinated therapy on chinese hamster's ovary cell line cricetulus griseus cho

INTRODUCCIÓN: Actualmente, el efecto genotóxico de los antidiabéticos orales es desconocido, motivo por el cual es necesario investigar el tema. MATERIAL Y MÉTODOS: Modelo experimental, para evaluar el efecto genotóxico de los antidiabéticos orales mediante el Test de Intercambio de Cromátides Hermanas (ICH) y el Test de Micronúcleos (MN). Se empleó como material células de la línea celular de ovario de hámster chino (CHO-Kl) Cricetulus griseus y tabletas de glibenclamida y metformina. Las células de la línea celular fueron cultivadas en Ham's F10 suplementado con 2 % estreptomicina-penicilina, 0,5 % L-glutamina y 10% suero bovino fetal (PBS) 20. Las células fueron agrupadas y tratadas con Glibenclamida 5 mg, Metformina 850 mg, Glibenclamida + Metformina 5/850 mg y el grupo control. Los resultados se valoraron en base al Test de Evaluación Genotóxica. RESULTADOS: Se observó un incremento significativo de ICH (p< 0.05) en el grupo de la terapia combinada (8.03 ± 0.17) con respecto al grupo control y a la metformina (6.91 ± 0.19; 6.94 ± 0.45) respectivamente; además se observó un incremento significativo de MN en el grupo de la terapia combinada de glibenclamida con metformina (14.44 ± 0.93), glibenclamida sola (10.18 ± 0.93) Ymetformina sola (7.10 ± 1.04) con respecto al grupo control (3.93 ± 0.46). CONCLUSIÓN: La glibenclamida más metformina produce efecto genotóxico evidenciado por medio de las pruebas ICH y el Test de MN.

INTRODUCTION: Actually, the genotoxic effect of the oral anti-diabetics is unknown, so its important to investigate about it. MATERIAL AND METHODS: We used the experimental design, in order to evaluate the existence of genotoxic effect of the oral antidiabetics by using Sister Chromatid Exchanges (SCE) and Micronucleus assays (MN) techniques. The material was chinese hamster's ovaryan cell line Cricetulus griseus and pills of glibenclamide and metformin. The chinese hamster's ovaryan cellline was grown in Ham's F10 supplemented with streptomycin penicillin 2%, L glutamina 0.5 % and bovine fetal serum 10 % (PBS) 20. Cells were grouped and treated with Glibenclamide 5 mg, Metformin 850 mg, Glibenclamide + Metformine 5/850 mg and the group control. The results were evaluated with the test of Genotoxic assessment. RESULTS: We observed a significant in crease (8,03 ± 0,17) in the treatment with the combined therapy regarding the group control and to the metformin respectively (6.91 ± 0.19; 6.94 ± 0.45), also there were a significant increase of micronucleas in the therapy combined of glibenclamide with metformin (14.44 ± 0.93), glibenclamide alone (10.18 ± 0.93) and metformin alone (7.10 ± 1.04) regarding to the group control (3.93 ± 0.46). CONCLUSION: There is genotoxic effect in the group of combinated therapy (Glibenclamide + Metformine) demonstrated using the of Sister Chromatid Exchanges (SCE) and Micronucleus assays (MN) techniques.

Variación post absortiva de la concentración serica de vitamina C en adultos de la tercera edad / Post absorptive variation of the serum concentration of vitamin C in elderly people

Con el objetivo de determinar la variación de la concentración sérica de vitamina C en personas de la tercera edad, hicimos un estudio comparativo con adultos jóvenes de ambos sexos distribuidos en dos grupos de 14 sujetos cada uno a los que previo dosaje basal en ayuno se les administró un gramo de vitamina C y se midió a los 30, 90, 180 y 300 minutos la concentración sérica de dicha vitamina según el método de Roe y Kuther; luego se aplicó la T de Student y ANOVA, obteniendo los siguientes resultados: 1.- La concentración sérica basal de vitamina C en adultos jóvenes es de 1.16mg/dt. 2.- La concentración sérica basal de vitamina C en adultos de la tercera edad es de 0,82mg/dt. 3.- La concentración sérica postabsortiva de vitamina C en adultos jóvenes aumentó significativamente a los 90 minutos. 4.- La concentración sérica postabsortiva de vitamina C en adultos de la tercera edad aumenta significativamente en todos los tiempos en relacion al basal, alcanzando el máximo a los 300 minutos. 5.- La concentración sérica poostabsortiva de vitamina C es más lenta y sostenida en adultos de la tercera edad que en adultos jóvenes.

With the objective to determine the post absortive variation of the serum concentration séric of vitamin C in elderly people, we did a comparative study with young people of both sexes distributed in two groups of 14 people in each to them to whom previous basal dosage in fast were given a gram of vitamin C and it was measured at 30, 90, 180, and 300 minutes the serum concentration of this vitamin according to the Roe and Kutcher method; after that the student t and the Anova was applied getting the ollowing results: 1.- The serum basal concentration of vitamin C in young people is of e1.16mg/dt. 2.- The serum basal concentration in ederly peple is of 0,82mg/dt. 3.- The serum post-absortiva concentration of vitamin C in young people has greatly been increased at 90 minutes. 4.- The serum post-absortiva concentrationof vitamin C in elderly people gratly increase any time in connection with basal, getting the maximum at 300 minutes. 5.- The serum post-absortiva concentration of vitamin C is slower and shrp in elderly people than in young people.