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  • SAGE Publications  (4)
  • 1
    Online Resource
    Online Resource
    Rapid subacute myelopathy following kidney transplantation from HTLV-1 donors: role of immunosuppresors and failure of antiretrovirals
    SAGE Publications ; 2019
    In:  Therapeutic Advances in Infectious Disease Vol. 6 ( 2019-01), p. 204993611986802-
    Details
    In: Therapeutic Advances in Infectious Disease, SAGE Publications, Vol. 6 ( 2019-01), p. 204993611986802-
    Abstract: Two kidney transplant recipients from a single donor became infected with HTLV-1 (human T-lymphotropic virus type 1) in Spain. One developed myelopathy 8 months following surgery despite early prescription of antiretroviral therapy. The allograft was removed from the second recipient at month 8 due to rejection and immunosuppressors discontinued. To date, 3 years later, this patient remains infected but asymptomatic. HTLV-1 infection was recognized retrospectively in the donor, a native Spaniard who had sex partners from endemic regions. Our findings call for a reappraisal of screening policies on donor–recipient organ transplantation. Based on the high risk of disease development and the large flux of persons from HTLV-1 endemic regions, pre-transplant HTLV-1 testing should be mandatory in Spain.
    Type of Medium: Online Resource
    ISSN: 2049-9361 , 2049-937X
    URL: Article
    DOI: 10.1177/2049936119868028
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2728410-4
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    Online Resource
  • 2
    Online Resource
    Online Resource
    EpidemIBD: rationale and design of a large-scale epidemiological study of inflammatory bowel disease in Spain
    SAGE Publications ; 2019
    In:  Therapeutic Advances in Gastroenterology Vol. 12 ( 2019-01), p. 175628481984703-
    Details
    In: Therapeutic Advances in Gastroenterology, SAGE Publications, Vol. 12 ( 2019-01), p. 175628481984703-
    Abstract: Inflammatory bowel disease (IBD) is associated with a considerable burden to the patient and society. However, current data on IBD incidence and burden are limited because of the paucity of nationwide epidemiological studies, heterogeneous designs, and a low number of participating centers and sample size. The EpidemIBD study is a large-scale investigation to provide an accurate assessment of the incidence of IBD in Spain, as well as treatment patterns and outcomes. Methods: This multicenter, population-based incidence cohort study included patients aged 〉 18 years with IBD (Crohn’s disease, ulcerative colitis, or unclassified IBD) diagnosed during 2017 in 108 hospitals in Spain, covering 50% of the Spanish population. Each participating patient will attend 10 clinic visits during 5 years of follow up. Demographic data, IBD characteristics and family history, complications, treatments, surgeries, and hospital admissions will be recorded. Results: The EpidemIBD study is the first large-scale nationwide study to investigate the incidence of IBD in Spain. Enrollment is now completed and 3627 patients are currently being followed up. Conclusions: The study has been designed to overcome many of the limitations of previous European studies into IBD incidence by prospectively recruiting a large number of patients from all regions of Spain. In addition to epidemiological information about the burden of IBD, the 5-year follow-up period will also provide information on treatment patterns, and the natural history and financial burden of IBD.
    Type of Medium: Online Resource
    ISSN: 1756-2848 , 1756-2848
    URL: Article
    DOI: 10.1177/1756284819847034
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2440710-0
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Anti-tumour necrosis factor discontinuation in inflammatory bowel disease patients in remission: study protocol of a prospective, multicentre, randomized clinical trial
    SAGE Publications ; 2019
    In:  Therapeutic Advances in Gastroenterology Vol. 12 ( 2019-01), p. 175628481987420-
    Details
    In: Therapeutic Advances in Gastroenterology, SAGE Publications, Vol. 12 ( 2019-01), p. 175628481987420-
    Abstract: Patients with inflammatory bowel disease who achieve remission with anti-tumour necrosis factor (anti-TNF) drugs may have treatment withdrawn due to safety concerns and cost considerations, but there is a lack of prospective, controlled data investigating this strategy. The primary study aim is to compare the rates of clinical remission at 1 year in patients who discontinue anti-TNF treatment versus those who continue treatment. Methods: This is an ongoing, prospective, double-blind, multicentre, randomized, placebo-controlled study in patients with Crohn’s disease or ulcerative colitis who have achieved clinical remission for ⩾6 months with an anti-TNF treatment and an immunosuppressant. Patients are being randomized 1:1 to discontinue anti-TNF therapy or continue therapy. Randomization stratifies patients by the type of inflammatory bowel disease and drug (infliximab versus adalimumab) at study inclusion. The primary endpoint of the study is sustained clinical remission at 1 year. Other endpoints include endoscopic and radiological activity, patient-reported outcomes (quality of life, work productivity), safety and predictive factors for relapse. The required sample size is 194 patients. In addition to the main analysis (discontinuation versus continuation), subanalyses will include stratification by type of inflammatory bowel disease, phenotype and previous treatment. Biological samples will be obtained to identify factors predictive of relapse after treatment withdrawal. Results: Enrolment began in 2016, and the study is expected to end in 2020. Conclusions: This study will contribute prospective, controlled data on outcomes and predictors of relapse in patients with inflammatory bowel disease after withdrawal of anti-TNF agents following achievement of clinical remission. Clinical trial reference number: EudraCT 2015-001410-10
    Type of Medium: Online Resource
    ISSN: 1756-2848 , 1756-2848
    URL: Article
    DOI: 10.1177/1756284819874202
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2440710-0
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  • 4
    Online Resource
    Online Resource
    Hypothalamic-pituitary-adrenal axis function and prolactin secretion in systemic lupus erythematosus
    SAGE Publications ; 1998
    In:  Lupus Vol. 7, No. 6 ( 1998-07), p. 404-408
    Details
    In: Lupus, SAGE Publications, Vol. 7, No. 6 ( 1998-07), p. 404-408
    Abstract: The objective was to study the response of cortisol and of prolactin (PRL) to specific stimuli in systemic lupus erythematosus (SLE). We measured the response of cortisol to insulin-induced hypoglycemia and of PRL to thyrotropin releasing hormone (TRH) in seven patients with active untreated SLE and in ten paired control subjects. All were women with regular menstrual cycles. With the exception of two patients, they had never received corticosteroids before the study. The basal serum levels of cortisol (12.5 2.4 μg/dl) and PRL (10.7 1.0 ng/ml) in the SLE group were not significantly different from those of the control group (12.3 1.1 mg/dl and 13.7 2.4 ng =ml, respectively). The cortisol response after hypoglycemia was significantly lower in SLE patients compared to the control group at 45 min (P = 0.01), at 60 min (P = 0.009), and at 90 min (P = 0.001). The integrated cortisol response to hypoglycemia expressed as area under the response curve (AUC) did not differ significantly in either group (1447 187 vs 1828 84, P = 0.06). Although the peak of PRL after TRH did not differ significantly in both groups (68.0 7.4 ng =ml in SLE vs 66.3 77 ng/ml in controls) and the AUC of PRL response after TRH was comparable in both groups (4672 537 vs 4128 541, P = 0.32), the interval-specific ‘delta’ response was significantly higher in SLE than the control group at 0–60 min (P = 0.02) and 0–90 min (P = 0.01) after TRH injection. These findings suggest that active SLE is associated with some degree of dysfunction of the hypothalamic-pituitary-glucocorticoid axis and PRL secretion.
    Type of Medium: Online Resource
    ISSN: 0961-2033 , 1477-0962
    URL: Article
    DOI: 10.1191/096120398678920343
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1998
    detail.hit.zdb_id: 2008035-9
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