Campylobacter infection of young children in Colombia and its impact on the gastrointestinal environment.

Campylobacter infections are a leading cause of bacterial-derived gastroenteritis worldwide with particularly profound impacts on pediatric patients in low- and middle-income countries. It remains unclear how Campylobacter impacts these hosts, though it is becoming increasingly evident that it is a multifactorial process that depends on the host immune response, the gastrointestinal microbiota, various bacterial factors, and host nutritional status. Since these factors likely vary between adult and pediatric patients in different regions of the world, it is important that studies define these attributes in well-characterized clinical cohorts in diverse settings. In this study, we analyzed the fecal microbiota and the metabolomic and micronutrient profiles of asymptomatic and symptomatic pediatric patients in Colombia who were either infected or uninfected with Campylobacter during a case-controlled study on acute diarrheal disease. Here, we report that the microbiome of Campylobacter-infected children only changed in their abundance of Campylobacter spp. despite the inclusion of children with or without diarrhea. In addition to increased Campylobacter, computational models were used to identify fecal metabolites that were associated with Campylobacter infection and found that glucose-6-phosphate and homovanillic acid were the strongest predictors of infection in these pediatric patients, which suggests that colonocyte metabolism is impacted during infection. Despite changes to the fecal metabolome, the concentrations of intestinal minerals and trace elements were not significantly impacted by Campylobacter infection but were elevated in uninfected children with diarrhea.IMPORTANCEGastrointestinal infection with pathogenic Campylobacter species has long been recognized as a significant cause of human morbidity. Recently, it has been observed that pediatric populations in low- and middle-income countries are uniquely impacted by these organisms in that infected children can be persistently colonized, develop enteric dysfunction, and exhibit reduced development and growth. While the association of Campylobacter species with these long-term effects continues to emerge, the impact of infection on the gastrointestinal environment of these children remains uncharacterized. To address this knowledge gap, our group leveraged clinical samples collected during a previous study on gastrointestinal infections in pediatric patients to examine the fecal microbiota, metabolome, and micronutrient profiles of those infected with Campylobacter species and found that the metabolome was impacted in a way that suggests gastrointestinal cell metabolism is affected during infection, which is some of the first data indicating how gastrointestinal health in these patients may be affected.

Campylobacter infection of young children in Colombia and its impact on the gastrointestinal environment.

Campylobacter infections are a leading cause of bacterial-derived gastroenteritis worldwide with particularly profound impacts on pediatric patients in low-and-middle income countries. It remains unclear how Campylobacter impacts these hosts, though it is becoming increasingly evident that it is a multifactorial process that depends on the host immune response, the gastrointestinal microbiota, various bacterial factors, and host nutritional status. Since these factors likely vary between adult and pediatric patients in different regions of the world, it is important that studies define these attributes in well characterized clinical cohorts in diverse settings. In this study, we analyzed the fecal microbiota and the metabolomic and micronutrient profiles of asymptomatic and symptomatic pediatric patients in Colombia that were either infected or uninfected with Campylobacter during a case-controlled study on acute diarrheal disease. Here, we report that the microbiome of Campylobacter- infected children only changed in their abundance of Campylobacter spp. despite the inclusion of children with or without diarrhea. In addition to increased Campylobacter, computational models were used to identify fecal metabolites that were associated with Campylobacter infection and found that glucose-6-phosphate and homovanillic acid were the strongest predictors of infection in these pediatric patients, which suggest that colonocyte metabolism are impacted during infection. Despite changes to the fecal metabolome, the concentrations of intestinal minerals and trace elements were not significantly impacted by Campylobacter infection, but were elevated in uninfected children with diarrhea. Importance: Gastrointestinal infection with pathogenic Campylobacter species has long been recognized as a significant cause of human morbidity. Recently, it has been observed that pediatric populations in low-and-middle income countries are uniquely impacted by these organisms in that infected children can be persistently colonized, develop enteric dysfunction, and exhibit reduced development and growth. While the association of Campylobacter species with these long-term effects continues to emerge, the impact of infection on the gastrointestinal environment of these children remains uncharacterized. To address this knowledge gap, our group leveraged clinical samples collected during a previous study on gastrointestinal infections in pediatric patients to examine the fecal microbiota, metabolome, and micronutrient profiles of those infected with Campylobacter species, and found that the metabolome was impacted in a way that suggests gastrointestinal cell metabolism is affected during infection, which is some of the first data indicating how gastrointestinal health in these patients may be affected.

Evaluation of sulfate rhizofiltration by Carpobrotus chilensis for treating mining waters.

Chile, the world's leading copper producer, generates significant volumes of mining waters, some of which cannot be recirculated into the production process. These mining waters are characterized by elevated sulfate (SO42-) concentrations, requiring sustainable management strategies for potential reuse. This study aims to evaluate the rhizofiltration technique using Carpobrotus chilensis for treating mining waters with a high SO42- concentration. Initially, the mining waters exhibited a pH of 7.97 ± 0.16 and a SO42- concentration of 2,743 ± 137 mg L-1, while the control water had a pH of 7.88 ± 0.08 and a SO42- concentration of 775 ± 19.0 mg L-1. The plants were hydroponically cultivated in 40 L containers with mining waters and drinking water as a control. Over an 8-week period, the pH of the mining water decreased to 3.12 ± 0.01, and the SO42- concentration declined to 2,200 ± 110 mg L-1. Notably, the fresh weight of roots was significantly higher in plants grown in mining water (22.2 ± 6.66 g) compared to those in the control treatment (14.3 ± 4.28 g). However, an undesirable increase in the acidity was observed in the mining waters after rhizofiltration, which was attributed to hydrogen sulfate (HSO4-) and/or root exudates. Despite the unexpected increase in acidity, C. chilensis effectively reduced the concentration of SO42- in mining waters by 20%. Additionally, the C. chilensis roots accumulated 4.84 ± 1.40% of sulfur (S), a level comparable to thiophore plants. This study provides evidence that this non-aquatic plant can be used in sulfate rhizofiltration.

Caprobrotus chilensis is a good candidate for sulfate rhizolfiltration in mining waters.The accumulation of sulfur by the roots of Carpobrotus chilensis reached 4.84%Mining waters with a high concentration of sulfates require control of the redox potential.

Follistatin-like 1 (FSTL1) levels as potential early biomarker of cardiovascular disease in a Mexican population.

Cardiovascular diseases (CVD) are the leading cause of death globally. In recent years, follistatin-like protein 1 (FSTL1) has been proposed as an emerging potential clinical biomarker of CVD, since its concentration is upregulated in heart failure. The aim of the present study was to evaluate the association of FSTL1 levels and classic biomarkers with the risk of CVD in Mexican population. A case-control study was carried out in patients with cardiovascular diseases (CVD), arterial hypertension, but not CVD (cardiovascular risk factor-CRF), and healthy controls (control group) from the Mexican Institute of Social Security. Lipid profile, homocysteine (Hcys), serum amyloid A (SAA), FSTL1 concentration, PON1 concentration and activities [Arylesterase (ARE), and Lactonase (LAC)] were evaluated. High levels of FSTL1 were found in the CRF group and a positive association of FSTL1 (OR = 4.55; 95% CI 1.29-16.04, p = 0.02) with the presence of arterial hypertension, as well as Hcys (OR, 3.09; 95% CI 1.23-7.76, p = 0.02) and SAA (OR, 1.03; 95% CI 1.01-1.05, p < 0.01) with the presence of CVD. LAC activity (OR, 0.26; 95% CI 0.07-0.94, p = 0.04) and PON1 concentration (OR, 0.17; 95% CI 0.05-0.62, p = 0.01) were associated with a decrease in OR belonging to the group with CVD. Our results suggest that FSTL1 may be a useful biomarker for monitoring cardiovascular risk in clinical settings. However, longitudinal studies are needed to evaluate how FSTL1 could influence the association of PON1 activity and Hcys with CVD.

Morphometry and morphology of fish otoliths on the coast of the state of Maranhão, Brazil.

The main objective of this study was to evaluate the biometric relationships between the species Bagre bagre, Lutjanus synagris and Nebris microps and their otoliths. The relationship between the size of the otolith (length and weight) and the size of the fish (standard length and total weight) was determined using the linear regression model (y = a + bx). For the morphological description, the otoliths of three specimens were selected by standard length class (10mm). The morphological characters analyzed were chosen according to traditional literature. Three hundred eight specimens of B. bagre, 200 of L. synagris and 237 of N. microps were analyzed. Throughout the collection period, the source of the capture of individuals was the municipality of Raposa. The linear correlations for fish and otolith length for B. bagre were 0.9129 and 0.9652, respectively. For L. synagris, the coefficients were 0.8634 and 0.8672, while for N. microps, 0.9597 and 0.8636, respectively. The morphological classification of L. synagris and N. microps is of the Saggita type, and the B. bagre species is of the Lapillus type. From the data presented here, it is possible to observe that otolith morphometric and morphological data can serve as a parameter to estimate the relationship between the fish and the otolith in terms of its biomass and the length of an individual and a population.

Structural analysis of potato starch transformation during high-energy ball-milling: Oxygen and humidity content effects.

High Energy Ball-Milling (HEBM) modifies starchs' granule morphology, physicochemical properties, and chemical structure. However, understanding how the HEBM changes the starch chemical structure is necessary to control these modifications. Therefore, this study aimed to investigate the changes in potato starch's long- and short-range molecular order during HEBM at different environmental conditions such as oxygen (Air) and humidity content. Due to the correlation between the starch modification and the energy supplied (Esupp) by the HEBM, Burgio's equation was used to calculate this energy. The starch transformation was followed by X-ray diffraction, Fourier Transform-Infrared Spectroscopy, and Raman spectroscopy. A Principal Component Analysis (PCA) was conducted to reduce the HEBM variables. PAC analysis demonstrated that the different oxygen-humidity conditions do not affect the HEBM of potato starch. Based on the starch chemical structure transformation correlated with Esupp during HEBM, four stages were observed: orientation, modification, mechanolysis, and over-destruction. It was identified for the first time that at low milling energy (<1.5 kJ/g, orientation stage), the glycosidic rings change their orientation, and starch-water interaction increases while the starch's organization reduces. Ergo, the potato starch could be more susceptible to chemical modifications during the first two stages.

[Caso clínico: síndrome de DRESS por hidroxicloroquina].

Background: DRESS syndrome (Drug reaction with eosinophilia and systemic symptoms) is an idiosyncratic reaction characterized by peripheral eosinophilia and systemic symptoms: fever, exanthema, lymphadenopathy, hepatitis, atypical lymphocytes and elevated liver enzymes. The incidence is 1 per 10,000 exposures, mortality 10-20%. Treatment is based on suspension of the suspected drug and steroids. Case report: A 42-year-old male with the following important antecedents. AHF: mother and father with Diabetes Mellitus type 2. APP: Arterial Hypertension, Diabetes Mellitus type 2, and bee sting allergy. Current Condition: He started 8 days after ingestion of hydroxychloroquine for probable SARS-COV-2 infection, with headache, facial and neck edema, desquamative dermatosis on trunk and upper extremities, went to private clinic with torpid evolution sent to third level for increased facial and neck edema, which merited orotracheal intubation, management with intravenous steroids and antihistamines. Labs on admission: Leukocytes 20090, platelets 322 thousand, eosinophilia (5%), elevated liver enzymes and acute kidney injury, fulfilling J-SCAR criteria. The patient was discharged due to adequate evolution with follow-up by Allergy and Clinical Immunology, the patient persists with desquamative lesions after 4 weeks and normalization of laboratory parameters. Conclusions: DRESS is a delayed adverse reaction. It is important the diagnostic presumption and the causal relationship with the drugs due to the high mortality rate.

Antecedentes: El síndrome DRESS (Drug reaction with eosinophilia and systemic symptoms) es una reacción idiosincrática, se caracteriza por eosinofilia perifé- rica y síntomas sistémicos: fiebre, exantema, linfadenopatía, hepatitis, linfocitos atípicos y elevación de enzimas hepáticas. La incidencia es de 1 por cada 10,000 exposiciones, mortalidad de 10 a 20%. El tratamiento se basa en la suspensión del fármaco sospechoso y en la aplicación de esteroides. Reporte de caso: Masculino de 42 años con los siguientes antecedentes de importancia. AHF: madre y padre con Diabetes Mellitus tipo 2. APP: Hipertensión Arterial, Diabetes Mellitus tipo 2, y alergia a picadura de abeja. Padecimiento Actual: Lo inicia posterior a 8 días tras la ingesta de hidroxicloroquina por probable infección por SARS-COV-2, con cefalea, edema facial y de cuello, dermatosis descamativa en tronco y extremidades superiores, acude a clínica particular con evolución tórpida enviado a tercer nivel por aumento de edema facial y cuello, que amerito intubación orotraqueal, manejo con esteroides intravenosos y anti- histamínicos. Laboratorios a su ingreso: Leucocitos 20090, plaquetas 322 mil, eosinofilia (5%), elevación de enzimas hepáticas y lesión renal aguda, cumpliendo criterios J-SCAR. Se egresa por adecuada evolución con seguimiento por Alergia e Inmunología Clínica, el paciente persiste con lesiones descamativas posterior a 4 semanas y normalización de parámetros de laboratorios. Conclusión: DRESS es una reacción adversa retardada. Es importante la presunción diagnóstica y la relación causal con los fármacos por la alta tasa de morta- lidad.

Sphingolipid Long-Chain Base Signaling in Compatible and Non-Compatible Plant-Pathogen Interactions in Arabidopsis.

The chemical diversity of sphingolipids in plants allows the assignment of specific roles to special molecular species. These roles include NaCl receptors for glycosylinositolphosphoceramides or second messengers for long-chain bases (LCBs), free or in their acylated forms. Such signaling function has been associated with plant immunity, with an apparent connection to mitogen-activated protein kinase 6 (MPK6) and reactive oxygen species (ROS). This work used in planta assays with mutants and fumonisin B1 (FB1) to generate varying levels of endogenous sphingolipids. This was complemented with in planta pathogenicity tests using virulent and avirulent Pseudomonas syringae strains. Our results indicate that the surge of specific free LCBs and ceramides induced by FB1 or an avirulent strain trigger a biphasic ROS production. The first transient phase is partially produced by NADPH oxidase, and the second is sustained and is related to programmed cell death. MPK6 acts downstream of LCB buildup and upstream of late ROS and is required to selectively inhibit the growth of the avirulent but not the virulent strain. Altogether, these results provide evidence that a LCB- MPK6- ROS signaling pathway contributes differentially to the two forms of immunity described in plants, upregulating the defense scheme of a non-compatible interaction.

Virulence Factors of the Gut Microbiome Are Associated with BMI and Metabolic Blood Parameters in Children with Obesity.

The development of metabolic diseases is linked to the gut microbiota. A cross-sectional study involving 45 children (6 to 12 years old) was conducted to investigate the relationship between gut microbiota and childhood obesity. Anthropometric and metabolic measurements, food-frequency questionnaires (FFQs), and feces samples were obtained. Using the body mass index (BMI) z-score, we categorized each participant as normal weight (NW), or overweight and obese (OWOB). We determined 2 dietary profiles: one with complex carbohydrates and proteins (pattern 1), and the other with saturated fat and simple carbohydrates (pattern 2). The microbial taxonomic diversity and metabolic capacity were determined using shotgun metagenomics. We found differences between both BMI groups diversity. Taxa contributing to this difference, included Eubacterium sp., Faecalibacterium prausnitzii, Dialister, Monoglobus pectinilyticus, Bifidobacterium pseudocatenulatum, Intestinibacter bartlettii, Bacteroides intestinalis, Bacteroides uniformis, and Methanobrevibacter smithii. Metabolic capacity differences found between NW and OWOB, included the amino acid biosynthesis pathway, the cofactor, carrier, and vitamin biosynthesis pathway, the nucleoside and nucleotide biosynthesis and degradation pathways, the carbohydrate-sugar degradation pathway, and the amine and polyamine biosynthesis pathway. We found significant associations between taxa such as Ruminococcus, Mitsuokella multacida, Klebsiella variicola, and Citrobacter spp., metabolic pathways with the anthropometric, metabolic, and dietary data. We also found the microbiome's lipooligosaccharide (LOS) category as differentially abundant between BMI groups. Metabolic variations emerge during childhood as a result of complex nutritional and microbial interactions, which should be explained in order to prevent metabolic illnesses in adolescence and maturity. IMPORTANCE The alteration of gut microbiome composition has been commonly observed in diseases involving inflammation, such as obesity and metabolic impairment. Inflammatory host response in the gut can be a consequence of dietary driven dysbiosis. This response is conducive to blooms of particular bacterial species, adequate to survive in an inflammatory environment by means of genetical capability of utilizing alternative nutrients. Understanding the genomic and metabolic contribution of microbiota to inflammation, including virulence factor prevalence and functional potential, will contribute to identifying modifiable early life exposures and preventive strategies associated with obesity risk in childhood.

Estado de ansiedad y comportamientos relacionados con la alimentación de los deportistas del departamento de Antioquia durante la medida de aislamiento obligatorio por covid-19 / State of anxiety and behaviors related to the diet of athletes in the department of Antioquia during the mandatory isolation measure due to covid-19 / Estado de ansiedade e comportamentos relacionadoscom a alimentação de atletas do departamento de Antioquia durante a medida de isolamento obrigatório devido à covid-19

Objetivo: identificar el impacto de la medida de confinamiento social, decretada por el gobierno colombiano ante el covid-19, sobre los niveles de ansiedad y los comporta­mientos alimentarios de los deportistas adscritos a selecciones Antioquia. Metodología: estudio observacional descriptivo de corte transversal en deportistas de altos logros deportivos de Indeportes Antioquia que fueron atendidos en el área de medicina, entre enero y agosto 2020. Se indagó sobre aspectos de ansiedad y compor­tamientos alimentarios, ocasionados durante la medida de aislamiento social derivada de la pandemia por covid-19. Resultados: la encuesta fue respondida por 150 deportistas. En hombres, la ansiedad aumenta a medida que se incrementa el grupo de edad. En las mujeres, el fenómeno es opuesto. Para la misma calificación de ansiedad alta, el porcentaje va disminuyendo con la edad. Con referencia a los comportamientos relacionados con la alimentación, analizados bajo una circunstancia tan compleja, como es la pandemia por covid-19, permitió a los profesionales del deporte y la salud direccionar recomendaciones efectivas para los deportistas que asesoran, frente al manejo de la ansiedad y el control de ciertos comportamientos negativos que pueden afectar la salud y el rendimiento deportivo. Conclusiones: los resultados con respecto a la ansiedad coinciden con estudios actua­les, en los que, en términos generales, las poblaciones evaluadas muestran niveles de ansiedad baja y esto se relaciona con una escasa tendencia a alteraciones en la conducta alimentaria en la población estudiada.

Objective: to identify the impact of the social confinement measure decreed by the Colombian government in the face of Covid-19 on anxiety levels and eating behaviors in athletes attached to different teams in the department of Antioquia. Methodology: cross-sectional descriptive observational study in athletes with high sports achievements from Indeportes Antioquia, who were treated in the medical area between January and August 2020. Aspects of anxiety and eating behaviors, caused during the social isolation measure derived of the Covid-19 pandemic were studied. Results: the survey was answered by 150 athletes. In men, anxiety increases as the age group increases. In women, the phenomenon is opposite. For the same high anxiety rating, the percentage decreases with age. With reference to behaviors related to eating, analyzed under such a complex circumstance, such as the Covid-19 pandemic, allowed sports and health professionals to direct effective recommendations for the athletes they advise, regarding anxiety management and the control of certain negative behaviors that can affect their health and their performance. Conclusions: the results regarding anxiety coincide with current studies, in which, in general terms, the assessed populations show low levels of anxiety; this is related to a low tendency to alterations in eating behavior in the studied population.

Objetivo: identificar o impacto da medida de confinamento social, decretada pelo governo colombiano diante da covid-19, nos níveis de ansiedade e comportamentos alimentares de atletas lotados nas equipes de Antioquia. Metodologia:estudo observacional descritivo transversal em atletas com altas conquistas esportivas do Indeportes Antioquia que foram atendidos na área médica, entre janeiro e agosto de 2020. Aspectos de ansiedade e comportamentos alimentares, causados durante a medida de isolamento social derivada do covid-19 pandemia. Resultados: a pesquisa foi respondida por 150 atletas. Nos homens, a ansiedade aumenta à medida que a faixa etária aumenta. Nas mulheres, o fenômeno é oposto. Para a mesma alta taxa de ansiedade, a porcentagem diminui com a idade. No que se refere aos comportamentos relacionados com a alimentação, analisados numa circunstância tão complexa, como é a pandemia de covid-19, permitiu aos profissionais do desporto e da saúde direcionar recomendações eficazes aos atletas que aconselham, no que diz respeito à gestão da ansiedade e ao controlo de determinados comportamentos negativos. que podem afetar a saúde e o desempenho esportivo.Conclusões:os resultados relativos à ansiedade coincidem com os estudos atuais, nos quais, em termos gerais, as populações avaliadas apresentam baixos níveis de ansiedade e isto está relacionado com uma baixa propensão a alterações do comportamento alimentar na população estudada.

Proteínas oxidadas de origen animal y su impacto sobre la salud intestinal / Oxidized proteins of animal origin and their impact on intestinal health / Proteínas oxidadas de origem animal e seu impacto na saúde intestinal

Los alimentos de origen animal como la carne de pollo, res, pescado y cerdo poseen una amplia demanda en todo el mundo debido, entre otros aspectos, a su valor nutricional, asociado al alto contenido proteico. No obstante, este tipo de proteínas son susceptibles de sufrir reacciones de oxidación, las cuales pueden mediar procesos de fragmentación, agregación, pérdida de solubilidad, funcionalidad y digestibilidad proteica; eventos implicados en la pérdida de su valor nutricional. En este sentido, las proteínas agrega­das tienden a no ser digeridas en el tracto gastrointestinal y acumularse en el intestino (colon), donde la microbiota colónica las degrada a productos mutagénicos como fenol y p-cresol, lo que incrementa el riesgo de cáncer colorrectal. Por otra parte, los ami­noácidos o péptidos oxidados liberados en la digestión podrían incorporarse en las vías de señalización celular intestinal y favorecer o exacerbar procesos intestinales crónicos como colon irritable o enfermedad de Crohn. Debido al gran interés de esta temática en los últimos años, el objetivo de esta revisión es realizar una descripción general del impacto de proteínas oxidadas de origen animal sobre la salud intestinal.

Animal foods such as chicken, beef, fish and pork are in wide demand throughout the world due, among other things, to their nutritional value, associated with their high protein content. However, this type of protein is susceptible to oxidation reactions, which can mediate processes of fragmentation, aggregation, loss of solubility, functionality, and protein digestibility, which are events involved in the loss of their nutritional value. In this sense, aggregated proteins tend not to be digested in the gastrointestinal tract and accumulate in the intestine (colon), where the colonic microbiota degrades them into mutagenic products such as phenol and p-cresol, which increases the risk of colorectal cancer. On the other hand, the oxidized amino acids or peptides released in digestion could be incorporated into intestinal cell signaling pathways and favor or exacerbate chronic intestinal processes such as irritable bowel syndrome or Crohn's disease. Due to the great interest in this topic in recent years, the objective of this review is to provide a general overview of the impact of oxidized proteins of animal origin on intestinal health.

Alimentos de origem animal como frango, carne bovina, peixe e carne suína são muito procurados em todo o mundo devido, entre outros fatores, ao seu valor nutricional, associado ao seu alto teor de proteínas. No entanto, esse tipo de proteína é suscetível a reações de oxidação, que podem mediar processos de fragmentação, agregação, perda de solubilidade, funcionalidade e digestibilidade da proteína; eventos envolvidos na perda de seu valor nutritivo. Nesse sentido, as proteínas agregadas tendem a não ser digeridas no trato gastrointestinal e se acumulam no intestino (cólon), onde a microbiota colônica as degrada em produtos mutagênicos como fenol e p - cresol, aumentando o risco de câncer colorretal. Por outro lado, os aminoácidos ou peptídeos oxidados liberados na digestão poderiam ser incorporados às vias de sinalização das células intestinais e favorecer ou exacerbar processos intestinais crônicos, como a síndrome do intestino irritável ou a doença de Crohn. Devido ao grande interesse neste tema nos últimos anos, o objetivo desta revisão é fornecer uma descrição geral do impacto das proteínas oxidadas de origem animal na saúde intestinal.

Quality assessment of Clinical Practice Guidelines (CPG) for the diagnosis and treatment of inflammatory bowel disease using the AGREE II instrument: a systematic review.

BACKGROUND: The incidence and diagnosis of inflammatory bowel disease (IBD) has increased considerably in recent years. Many clinical practice guidelines (CPG) have been developed for the management of this disease across different clinical contexts, however, little evidence exists on their methodological quality. Therefore, we aimed to systematically evaluate the quality of CPGs for the diagnosis and treatment of IBD using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. METHODS: We identified CPGs by searching databases (MEDLINE - PubMed, EMBASE, CINAHL, LILACS) and other sources of gray literature on January 2022. We included guidelines with specific recommendations for the diagnosis and treatment of IBD and evaluated them with the AGREE II instrument to assess their methodological quality. Six independent reviewers assessed the quality of the guidelines and resolved conflicts by consensus. We assessed the degree of agreement using the intraclass correlation coefficient (ICC) and change in quality over time was appraised in two periods: from 2012 to 2017 and from 2018 to 2022. RESULTS: We analyzed and evaluated 26 CPGs that met the inclusion criteria. The overall agreement among reviewers was moderate (ICC: 0.74; 95% CI 0.36 - 0.89). The mean scores of the AGREE II domains were: "Scope and purpose" 84.51%, "Stakeholder involvement" 60.90%, "Rigor of development" 69.95%, "Clarity of presentation" 85.58%, "Applicability" 26.60%, and "Editorial independence" 62.02%. No changes in quality were found over time. CONCLUSIONS: The quality of the CPGs evaluated was generally good, with a large majority of the assessed guidelines being "recommended" and "recommended with modifications"; despite this, there is still room for improvement, especially in terms of stakeholder involvement and applicability. Efforts to develop high quality CPGs for IBD need to be further optimized.

Clinical profile of patients with lupus psychosis in a Colombian cohort.

The objective of this study is to describe the frequency and the clinical, paraclinical, and treatment profile of patients with lupus psychosis in a Colombian cohort of patients with systemic lupus erythematosus (SLE). This retrospective cohort study evaluated epidemiological and clinical characteristics, results of neuroimaging, analysis of the cerebrospinal fluid, treatment, and disease evolution in patients with lupus psychosis. Among 2,479 patients with SLE, six female patients aged between 20 and 50 years with a diagnosis of lupus psychosis were identified. In two patients, psychosis was present at disease onset and in the other four, SLE was already present, although the majority of them were diagnosed less than two years prior to the onset of psychosis. The entire cohort had high disease activity as measured by SLEDAI-2K. We found concomitant cutaneous, joint, and hematological alterations. Cerebrospinal fluid data were obtained in half of the patients and were normal. We performed brain tomography on most of our patients, which was almost always described as normal. In 5 out of 6 patients, the induction therapy to treat psychosis was based on steroids, and in the majority of them, a resolution of psychiatric symptoms was observed after initiating treatment. Lupus psychosis is a rare event that usually occurs early in the course of the disease and is associated with other manifestations of SLE. This investigation mainly found concomitant cutaneous, joint, and hematological manifestations, with a favorable outcome after treatment, as described in the literature.

Nivel de dependencia funcional de los adultos mayores de la comunidad de Tula de Allende / Level of functional dependence of older adults in the community of Tula de Allende

Introducción: El estado funcional se mide mediante la autonomía que tienen las personas para desarrollar las actividades de la vida diaria, cuando no se pueden realizar de manera autónoma es necesario un cuidador. Esta medida se sustenta en el modelo de adaptación de Sor Callista Roy, ya que se identifica el proceso de envejecimiento como el estímulo focal que produce una respuesta inmediata en el adulto mayor de acuerdo con el modo de interdependencia. Objetivo: Conocer el nivel de dependencia funcional de los adultos mayores de la comunidad de Tula de Allende, Hidalgo. Material y métodos: Estudio de aplicabilidad básica, cuantitativo, descriptivo y trasversal. Participaron 366 adultos mayores de Tula de Allende, y se les dio a conocer los términos de confidencialidad conforme a lo establecido en la Ley General de Salud y Declaración de Helsinki mediante el consentimiento informado. Se aplicó el cuestionario de Índice de Barthel (IB), para medir la dependencia funcional en las actividades instrumentales de la vida diaria. Resultados: Predomina el género femenino con el 52.7% representado por 193 participantes, la mayoría son casadas y amas de casa. De acuerdo con el IB la mayoría de los participantes tiene una dependencia leve, con una frecuencia de 206 y un porcentaje de 56.3%, y el cruce de variables arroja como resultado una relación significativa. Conclusión: Los adultos mayores de la comunidad de Tula de Allende presentan un nivel de dependencia funcional leve.

Introduction: Functional status assesses people's ability to carry out daily activities; when these cannot be performed autonomously, a caregiver is necessary. This measure is based on the Roy Adaptation Model, which identifies the aging process as the focal stimulus that generates an effect according to the interdependence mode. Objective: To evaluate the level of functional dependence of the elderly in the community of Tula de Allende, Hidalgo. Material and methods: Quantitative, descriptive, and cross-sectional study of basic applicability. 366 older adults from Tula de Allende participated and were informed about confidentiality terms in accordance with the General Health Law and the Declaration of Helsinki through informed consent. The Barthel Index (BI) questionnaire was applied to measure functional dependence on daily instrumental activities. Results: The female gender predominates with 52.7% represented by 193 participants, the majority are married housewives. According to the BI, most of the participants have a slight dependency, with a frequency of 206 and a percentage of 56.3%; the correlation of variables showed statistical significance. Conclusion: Older adults in the community of Tula de Allende present a mild functional dependence level.