0000000000400552
AUTHOR
Julio Ponce
Seguridad de la utilización de los inhibidores de la bomba de protones
La importante capacidad inhibitoria de la secrecion acida gastrica de los inhibidores de la bomba de protones (IBP) los convierte en los farmacos de eleccion en las enfermedades relacionadas con el acido. La elevada prevalencia de esas enfermedades y la necesidad de mantener la administracion del farmaco durante periodos muy prolongados determinan que este grupo terapeutico sea uno de los de mayor volumen de gasto para el sistema sanitario. Sin embargo, con la enorme generalizacion de su uso, aun siguen aflorando periodicamente reservas sobre su potencial toxicidad, una opinion basada en una cierta desconfianza sobre la especificidad de su mecanismo de accion y en la sensacion consiguiente …
Mitochondrial dysfunction, persistent oxidative damage, and catalase inhibition in immune cells of naïve and treated Crohnʼs disease
Background: Oxidative stress is considered a potential etiological factor for Crohn's disease (CD). We characterized the reactive oxygen species (ROS) generated in immune peripheral cells of CD patients, as well as their antioxidant enzyme status and the presence of oxidative damage. In addition, mitochondrial function (ΔΨm) was analyzed to detect the possible origin of ROS. Methods: Cells were obtained from patients at the onset of disease, prior to any treatment. Experiments were repeated when patients were in clinical remission. A set of experiments was carried out in a group of CD patients in persistent morphological remission. Controls were healthy volunteers who were not receiving any…
Decreased Esophageal Sensitivity to Acid in Morbidly Obese Patients: A Cause for Concern?
Background/Aims: To evaluate esophageal sensitivity to acid between morbidly obese (MO) patients and non-MO controls with abnormal esophageal acid exposure. Methods: We conducted a cross-sectional study of 58 patients: 30 MO (cases) and 28 non-MO (controls). Esophageal symptoms and esophageal sensitivity to 0.1 M hydrochloric acid solution (Bernstein test) were compared between MO and non- MO patients with a prior diagnosis of abnormal esophageal acid exposure. Results: MO patients were less symptomatic than non-MO controls (14% vs 96%; odds ratio [OR], 0.006; 95% confidence interval [CI], 0.001 to 0.075; p=0.000). MO patients were more likely to present with decreased esophageal sensitivit…
Structural alterations of faecal and mucosa-associated bacterial communities in irritable bowel syndrome
Summary Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder in western coun- tries. Previous studies on IBS, mostly based on faecal samples, suggest alterations in the intestinal micro- biota. However, no consensus has been reached regarding the association between specific bacteria and IBS. We explore the alterations of intestinal bac- terial communities in IBS using massive sequencing of amplified 16S rRNA genes. Mucosal biopsies of the ascending and descending colon and faeces from 16 IBS patients and 9 healthy controls were analysed. Strong inter-individual variation was observed in the composition of the bacterial communities in both patients and cont…
Instability of the faecal microbiota in diarrhoea-predominant irritable bowel syndrome
The irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with a largely unknown aetiology and a wide range of symptoms. Most cross-sectional studies carried out so far suggest subtle alterations in the structure of the intestinal microbiota that are barely reproduced, partly because of the high inter-subject variation in the community composition and disorder-specific features. We performed a longitudinal study to explore the within-subject variation in the faecal microbiota in two patients with IBS classified into the diarrhoea subtype and the healthy spouse of one of them. Faecal communities were monitored over 6-8 weeks and analysed through metagenomic and metatranscr…
The appropriateness of colonoscopies at a teaching hospital: magnitude, associated factors, and comparison of EPAGE and EPAGE-II criteria.
Background The growing demand for colonoscopies and inappropriate colonoscopies have become a significant problem for health care. Objectives To assess the appropriateness of colonoscopies and to analyze the association with some clinical and organizational factors. To compare the results of the European Panel of Appropriateness of Gastrointestinal Endoscopy (EPAGE) and the EPAGE-II criteria. Design Cross-sectional study. Setting Endoscopy unit of a teaching hospital in Spain. Patients Patients referred for colonoscopy, excluding urgent, therapeutic indications, and poor cleansing. Main Outcome Measurements Appropriateness of colonoscopies according to the EPAGE criteria. Results From 749 c…