Background: Recent trials suggested that the Crohn’s disease (CD) exclusion diet (CDED) plus partial enteral nutrition (PEN) is a safe and effective strategy in remission induction of paediatric-onset CD. However, real-world evidence regarding the safety and efficacy of the CDED plus PEN approach is still lacking. The present case-series study reported our experience with the outcomes of CDED plus PEN in the paediatric-onset CD at disease onset and after the loss of response to biologics. Methods: We conducted a retrospective chart review on children who were treated with CDED plus PEN through the period from July 2019 and December 2020. Clinical and laboratory data were retrieved and compared at baseline, 6, 12, and 24 weeks of treatment. The primary endpoint of the present study was the rate of clinical remission. Results: The present study retrieved the data from 15 patients. Of them, nine patients were treatment naïve at the time of initiation of CDED plus PEN (group A) and the remaining patients relapsed on biologics before treatment. All patients in groups A and B exhibited clinical remission in week six, which was sustained until week 12. At the end of the follow-up, the clinical remission rate was 87% and 60% in groups A and B, respectively. No side effects were observed in both groups. In group A, the faecal calprotectin (FC) and albumin improved at week six, week 12, and week 24 (p < 0.05). The erythrocyte sedimentation rate (ESR) improved significantly at week 12 (p = 0.021) and week 24 (p = 0.027). At the same time, the haemoglobin and iron levels showed significant improvement only at week 24. For group B, only FC showed numerical reductions over time that did not reach the level of statistical significance. Conclusion: Treatment with CDED plus PEN was well tolerated and achieved an excellent clinical remission rate in treatment-naive patients. However, the benefit of CDED plus PEN was less in patients who initiated the strategy after losing the response to biologics.

Glutathione-S transferases (GSTs) are part of a ubiquitous family of dimeric proteins that participate in detoxification reactions. It has been demonstrated that various GSTs induce allergic reactions in humans: those originating from house dust mites (HDM), cockroaches, and helminths being the best characterized. Evaluation of their allergenic activity suggests that they have a clinical impact. GST allergens belong to different classes: mu (Blo t 8, Der p 8, Der f 8, and Tyr p 8), sigma (Bla g 5 and Asc s 13), or delta (Per a 5). Also, IgE-binding molecules belonging to the pi-class have been discovered in helminths, but they are not officially recognized as allergens. In this review, we describe some aspects of the biology of GST, analyze their allergenic activity, and explore the structural aspects and clinical impact of their cross-reactivity.

Dupilumab is a treatment approved for uncontrolled moderate-to-severe atopic dermatitis (AD). Tropical and developing countries such as Colombia have characteristics that may impact the natural history of AD and access to medical treatments. In that sense, we aimed to describe the effectiveness and safety of dupilumab in adults with moderate to severe AD in a Colombian multicenter cohort. Multicenter descriptive study that included patients who started treatment between March 2018 and May 2020 in 6 centers. Disease severity was assessed using the following: Scoring Atopic Dermatitis (SCORAD), Eczema Area and Severity Index (EASI), Patient Oriented Eczema Measure (POEM), and Dermatology Life Quality Index (DLQI). These measurements were collected according to availability at baseline, 3–5 months, 6–12 months, and more than 12 months. Days of sick leave, hospitalizations, and AD flares before and after dupilumab treatment were reported. Adverse events (AEs) were recorded during follow-up. Ninety-three patients were included, with a median age of 32 years (IQR: 24.0; 40.0) and a disease evolution time of 21 years (IQR: 16.0; 29.5). 88.2% had at least 1 allergic disease other than AD. An improvement greater than or equal to 75% EASI was observed in 41.7% of patients at 3–5 months, in 73.7% of patients at 6–12 months, and in 75.0% of patients after 12 months. For those reporting SCORAD and POEM, the median percent change ([IQR], n) from baseline in SCORAD was −67.1 ([−79.2; −54.2], n = 16), −70.5 ([−85.8; −47.9], n = 36) and −66.7 ([−77.3; −51.0], n = 13); and POEM, −58.6 ([−66.4; −55.5], n = 4), −73.0 ([−86.5; −66.7], n = 16) and −87.3 ([−93.4; −69.6], n = 8), respectively. Before initiation of dupilumab treatment, 82 (88.2%) patients reported at least 1 flare of AD in the past 12 months. During the follow-up period, 30 (32.3%) patients reported at least 1 exacerbation or flare. Twelve patients (12.9%) presented an AE and 3 (3.2%) patients discontinued dupilumab for this cause. Dupilumab was effective and safe for the treatment of moderate to severe AD in point-of-care settings, with results similar to randomized controlled and other real-life studies. These positive results are still maintained even though a high number of patients had short interruptions in the use of dupilumab due to administrative problems.

Der p 23 induces a high-frequency sensitization in allergic individuals. However, its allergenic activity and clinical impact are scarce. We aimed to evaluate the ability of rDer p 23 to induce allergic inflammation in a mouse model and to test IgE reactivity in humans. Female Balb/c mice were sensitized and challenged with rDer p 23 and Dermatophagoides pteronyssinus extract. Specific antibodies were determined by ELISA, inflammatory cell infiltration and goblet cells hyperplasia were evaluated by lung histology, and bronchial hyperreactivity (BHR) was assessed by the FinePoint RC System^TM and whole-body plethysmography (WBP). IgE reactivity was evaluated by ELISA, the basophils activation test (BAT) and the skin pick test (SPT) in humans. rDer p 23, produced in Escherichia coli, adopts a random coil structure, predominantly exists in a monomeric state, and exhibits high stability. rDer p 23-treated mice showed a significant increase in lung resistance and bronchial hyperreactivity, as well as in eosinophils, neutrophils, and T cell count in bronchoalveolar lavage fluid (BALF). Cytokine and antibodies profiles were biased to a Type-2 response. No significant difference was observed in group 2 Innate Lymphoid Cells (ILC-2s) in lung and regulatory T cells (Treg) in the spleen. In asthmatic individuals sensitized to D. pteronyssinus, serum IgE reactivity to rDer p 23 was 67.5%. BAT and SPT results were significantly higher in allergic patients. Our findings support the pro-allergenic role of rDer p 23 in the development of the pathological features of asthma.

Resumo Objetivo: Estimar a carga econômica associada à covid-19 em Córdoba, Colômbia, entre 2020 e 2021. Métodos: Estudo de avaliação da carga econômica da covid-19. Os custos diretos foram analisados segundo terceiros pagadores, usando-se bases de dados administrativas e entrevistas. A agregação dos custos foi realizada usando-se o método bottom-up. Os custos indiretos foram estimados pela perda de produtividade. Testes de contraste ortogonais e modelos de regressão estatísticos foram estimados com 5% de significância. Resultados: Foram estudadas 1.800 pessoas com covid-19. O custo econômico médio da covid-19 por episódio foi estimado em US$ 2.519 (IC95% 1.980;3.047). O componente de custo médico direto representou 92,9% do total; as despesas diretas e custos indiretos representaram 2,0% e 5,1%, respectivamente. Conclusão: O custo econômico da covid-19 deveu-se principalmente aos custos médicos diretos. Este estudo forneceu avaliações da carga econômica enfrentada pelas famílias devido à covid-19; as mais vulneráveis tiveram grande parte da carga sobre os seus rendimentos.

Objetivos: Describir las características sociodemográficas y clínicas de adultos con diagnóstico de neoplasia maligna, atendidos en el Centro Radio Oncológico del Caribe (CROC) de Cartagena, Colombia, entre 2015-2020. Métodos: Estudio descriptivo que incluyó, primero, todos los pacientes de 18 años o más con neoplasias sólidas (CIE-10: C00-C75) atendidos en el CROC entre 2015-2020. En una segunda fase, se revisaron 907 historias clínicas seleccionadas mediante muestreo aleatorio simple para estimar proporciones de cáncer avanzado en cinco neoplasias priorizadas (estómago [C16], colon y recto [C18-C21], mama [C50] en mujeres, cuello uterino [C53] y próstata [C61]) y extraer información clínica relevante para cada tipo de cáncer. Resultados: Se incluyeron 11 855 pacientes, de los cuales el 68 % eran mujeres. Los cánceres de mama y de cuello uterino fueron los más frecuentes en mujeres, mientras que en hombres fueron los de próstata y colorrectal. Los porcentajes de pacientes en estadios avanzados (III-IV) al diagnóstico fueron: mama 33,6 % (IC95 % 27,2-40,1), estómago 66,7 % (IC95 % 58,0-75,3), colorrectal 51,8 % (IC95 % 44,5-59,0), cuello uterino 38,4 % (IC95 % 31,1-45,7) y próstata 31,8 % (IC95 % 24,9-38,6). Conclusiones: La epidemiología del cáncer de tumores sólidos en la población estudiada fue similar a la de otras regiones del país, excepto para el cáncer de mama, cuya proporción de diagnósticos en estadios avanzados fue más baja. Aunque un estudio hospitalario no es representativo de toda la región, los datos sugieren un diagnóstico tardío de estos tipos de cáncer y revelan oportunidades de mejora en Bolívar.