Treatment with hyperbaric oxygen in a Crohn`s disease patient

Despite advances in the treatment of inflammatory bowel disease, particularly with biological therapies and new small molecules, a significant gap still exists in achieving persistent remission from a symptomatic, biomarker, and endoscopic perspective. In this context, hyperbaric oxygen therapy (HBOT) is considered as a therapeutic strategy. This approach has also been suggested for managing ischemic ulcers located at anastomotic sites. In this clinical case, we describe the clinical and endoscopic evolution of a challenging-to-manage Crohn's disease (CD) patient with an ischemic ulcer at the ileo-rectal anastomosis who underwent HBOT.

Personalized therapy in inflammatory bowel disease

Inflammatory bowel diseases (IBD), with ulcerative colitis and Crohn's disease being their most common presentations, comprise a spectrum of diverse disease phenotypes, exhibiting variable behaviors ranging from an indolent course to aggressive phenotypes that impact quality of life of these patients. The last two decades have been marked by the development of new medications (biological therapy and novel small molecules) with diverse mechanisms of action, which have revolutionized the management of IBD, thereby enhancing the quality of life for these patients. This landscape of multiple therapeutic options underscores the need to define which medication will benefit each patient the most and at what speed it should be started. The objective of this review is to present personalized approaches for patients with IBD, thus contributing to therapeutic management.

Vancomycin in the treatment of inflammatory bowel disease: there is a role beyond Clostridioides difficile infection

The development of new biological agents and small molecules has revolutionized the treatment of Inflammatory Bowel Disease (IBD). However, many patients do not respond or gradually lose their response, necessitating the search for other therapeutic strategies (1). In this clinical case, we describe the evolution of a patient with difficult-to-manage Crohn's Disease (CD) who was treated with oral vancomycin.

The putative phosphate transporter PitB (PP1373) is involved in tellurite uptake in Pseudomonas putida KT2440

Tellurium oxyanions are chemical species of great toxicity and their presence in the environment has increased because of mining industries and photovoltaic and electronic waste. Recovery strategies for this metalloid that are based on micro-organisms are of interest, but further studies of the transport systems and enzymes responsible for implementing tellurium transformations are required because many mechanisms remain unknown. Here, we investigated the involvement in tellurite uptake of the putative phosphate transporter PitB (PP1373) in soil bacterium Pseudomonas putida KT2440. For this purpose, through a method based on the CRISPR/Cas9 system, we generated a strain deficient in the pitB gene and characterized its phenotype on exposing it to varied concentrations of tellurite. Growth curves and transmission electronic microscopy experiments for the wild-type and ΔpitB strains showed that both were able to internalize tellurite into the cytoplasm and reduce the oxyanion to black nano-sized and rod-shaped tellurium particles, although the ΔpitB strain showed an increased resistance to the tellurite toxic effects. At a concentration of 100 μM tellurite, where the biomass formation of the wild-type strain decreased by half, we observed a greater ability of ΔpitB to reduce this oxyanion with respect to the wild-type strain (~38 vs ~16 %), which is related to the greater biomass production of ΔpitB and not to a greater consumption of tellurite per cell. The phenotype of the mutant was restored on over-expressing pitB in trans. In summary, our results indicate that PitB is one of several transporters responsible for tellurite uptake in P. putida KT2440.

[Valve replacement in severe aortic regurgitation following valve sparing operation with David's technique]

The aortic valve sparing operation is of great interest in the treatment of severe aortic insufficiency caused by annulus enlargement in aortic annuloectasia. If valve leaflets are normal, and we want to prevent complications derived from valve prosthesis and chronic anticoagulation, techniques like David s for valve preserving surgery will be performed. Although long-term results of these techniques are usually good, in some cases, like in the one we are dealing with here fibrosis is produced in the native valve, which evolves into a severe aortic insufficiency needing reoperation. We hereby describe the time related events of aortic valve deterioration, when the reintervention was indicated, and how the surgery was performed.

[Cholestatic hepatitis associated with piroxicam use. Case report]

Most nonsteroidal antiinflammatory drugs can produce hepatotoxicity. We report a 22 years old female who presented with an acute cholestatic hepatitis after a prolonged period of piroxicam use. Hepatitis was attributed to this drug since all markers for hepatitis virus (A, B, C, E, Epstein Barr, Cytomegalovirus and Herpex Simplex) were negative, autoimmune markers were negative, serum iron and ceruloplasmin were normal, there was a temporal relationship between the administration of piroxicam and the hepatitis, the histological picture was compatible with this etiology and the patient had a favorable evolution after the discontinuance of the drug. This type of hepatotoxicity is not common but it must be born in mind when patients must receive nonsteroidal antiinflammatory drugs for prolonged periods.

Electrophoretic analysis of serum and urinary proteins in rats with aminonucleoside-induced nephrotic syndrome

Albumin; and alpha 1-, alpha 2-, beta-, and gamma-globulins were estimated by cellulose acetate electrophoresis in the serum and urine from rats with nephrotic syndrome (NS), 2, 4, 6, 8, 10, 12, 16, 20, and 30 days after a single injection of puromycin aminonucleoside (PAN). It was found that: (a) total serum protein level decreased on days 4-16, and total urine protein excretion rose on days 6-16; (b) serum albumin level fell on days 4-16, and urine albumin excretion increased on days 6-16; (c) serum alpha 1-globulin level rose on days 8-30, and urine alpha 1-globulin excretion increased on days 8-16; (d) serum alpha 2-globulin level remained essentially unchanged, and urine alpha 2-globulin excretion rose on days 4-10; (e) serum beta-globulin level decreased on days 4-20, and urine beta-globulin excretion increased on days 6-16, (f) serum gamma-globulin level diminished on days 6, 8, and 12, and urine gamma-globulin excretion rose on days 6-10. All serum protein fractions were excreted in the urine of nephrotic rats; these findings suggest that proteinuria is nonselective. The differences observed in the serum protein profiles, even when all protein fractions were lost in the urine, suggest an independent regulation of each protein fraction in PAN-nephrotic rats. In addition, the electrophoretic profile of serum proteins in PAN-nephrotic rats is different from previously reported patterns in human nephrosis and in rats with an acute-phase response.

[Female physicians: work and family]

One hundred female physicians were surveyed to describe features of their family, social and academic lives and obstetric history. Most outstanding findings were that 8% of women were divorced or separated, a trend to have few children and a mean day's work of 9.2 hour. Sixteen percent of women had a history of premature delivery and 22% premature labour symptoms (higher than the frequency found in the general population). Mean age at first childbirth was 26 years, significantly higher than the average of the general population (22.8 years). Prenatal leave was partially or not used by 50% of women, while postnatal leave was not benefitted by 12%. Breast feeding had a mean lapse of 3.8 months (shorter than advised). Sixty seven percent of women found scarce the length of time devoted to their children and 67% felt satisfied with their mate relationship. Fifty three percent performed 4 or more spare time activities a month and 55% declared to be satisfied with their professional performance. A mean of 0.89 scientific papers/year/woman were published or presented to meeting. Thirty percent believed that their professional work had a negative impact on their family life.

[High incidence of ampicillin resistance in Salmonella spp non typhi]

Salmonella spp non typhi is a common cause of gastroenteritis and, more rarely, extraintestinal infections in humans. The type of syndrome determines the choice and duration of antibiotic therapy. Extraintestinal infections by this organism require correct antibiotic therapy. In the present study, the susceptibility to antibiotics of 59 strains of Salmonella spp non typhi from clinical sources, isolated during a period of three and a half months, were evaluated. Fifty one of them were S. enteritidis, 7 S. typhimurium and 1 S. schwarzengrund. A high frequency (45.8%) of resistance to ampicillin (MIC greater than 256 micrograms/ml) was found. Other antibiotics had good or excellent in vitro activity: 90% of strains were sensitive to tetracyclines, 93% to chloramphenicol, 97% to co-trimoxazole, and 100% to cefotaxime and ciprofloxacine. It was concluded that the high frequency of ampicillin resistance to ampicillin precludes its use as first choice antibiotic in our area for suspected extraintestinal infections caused by Salmonella spp non typhi.

[Unwanted children: incidence and characteristics among puerperal women in a hospital of Santiago]

A scoring instrument to detect unwanted newborns was applied to 556 living-in women at a Santiago urban hospital in december 1987. Based upon previous research a scoring instrument including 10 items was designed and applied within 24 hours following delivery. According to the total score each newborn was classified as wanted (W), unwanted (U) or doubtful situation: 37.6% of children were born to unwed mothers. In a total of 556 children 4.5% (n = 25) were classified as U, 91.4% as W (n = 508) and 4.1% as doubtful (n = 23). Comparing U and W children the former had mothers with poorer education, higher frequency of bad relationships with their partners as well as higher proportion of three or more previous deliveries and late beginning of prenatal care (significant). On the other hand no significant differences were detected in age distribution of the mothers or their socio-economic level. The applicability of this scoring system and the magnitude and importance of the problem are analyzed and discussed. The need for further research on the natural history of the sequence unwanted pregnancy-unwanted child is stressed.