Articles: treatment.
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Multicenter Study
Clinical differentiation of inflammatory bowel disease (IBD) in Latin America and the Caribbean.
The aim of the present study was to describe the epidemiological and clinical characteristics of inflammatory bowel disease (IBD), including medical and surgical treatments, in several countries in Latin America and the Caribbean. IBD is recognized as a global health problem because its incidence and prevalence have increased significantly over the last few years. This multicenter retrospective cohort study included 4714 patients with IBD diagnosed from 9 countries in Latin America and the Caribbean: Colombia, Cuba, Dominican Republic, Ecuador, Mexico, Peru, Puerto Rico, Uruguay, and Venezuela. ⋯ The following clinical characteristics were more frequent in the Caribbean: penetrating behavior in CD, steroid dependence, steroid resistance, intolerance to thiopurines, extraintestinal manifestations, surgeries, hospitalizations due to IBD, and family history of IBD. The factors associated with the use of biological therapy were pancolitis in ulcerative colitis, penetrating behavior in CD, steroid resistance and dependence, presence of extraintestinal manifestations, and the need for surgery. This study from Latin America and the Caribbean demonstrated the different epidemiological and clinical characteristics of IBD.
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Randomized Controlled Trial Multicenter Study
SER-109, an Oral Microbiome Therapy for Recurrent Clostridioides difficile Infection.
Current therapies for recurrent Clostridioides difficile infection do not address the disrupted microbiome, which supports C. difficile spore germination into toxin-producing bacteria. SER-109 is an investigational microbiome therapeutic composed of purified Firmicutes spores for the treatment of recurrent C. difficile infection. ⋯ In patients with symptom resolution of C. difficile infection after treatment with standard-of-care antibiotics, oral administration of SER-109 was superior to placebo in reducing the risk of recurrent infection. The observed safety profile of SER-109 was similar to that of placebo. (Funded by Seres Therapeutics; ECOSPOR III ClinicalTrials.gov number, NCT03183128.).
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Multicenter Study
Surgical Factors and Treatment Severity for Perioperative Complications Predict Hospital Length of Stay in Adult Spinal Deformity Surgery.
Retrospective review of prospectively collected multicenter registry data. ⋯ Careful selection of surgical factors may help reduce hospital LOS following surgery for ASD. Classification of complications by treatment severity can help surgeons better understand and predict the implications of complications, in turn assisting with surgical planning and patient counseling.Level of Evidence: 4.
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Randomized Controlled Trial Multicenter Study
Trial of Three Rounds of Mass Azithromycin Administration for Yaws Eradication.
Treponema pallidum subspecies pertenue causes yaws. Strategies to better control, eliminate, and eradicate yaws are needed. ⋯ The reduction in the community prevalence of yaws was greater with three rounds of mass administration of azithromycin at 6-month intervals than with one round of mass administration of azithromycin followed by two rounds of targeted treatment. Monitoring for the emergence and spread of antimicrobial resistance is needed. (Funded by Fundació "la Caixa" and others; ClinicalTrials.gov number, NCT03490123.).
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Achieving glycemic control in type 2 diabetes(T2D) prevents or delays chronic complications and extends survival. ⋯ of 1329 DMT2 cases included, 60.2% achieved the goal. Regarding pharmacological treatment in diabetes: 5.1% were without medication, 47.5% with 1 drug, 34.5% with 2, 12.9% with 3 or more; in turn, with insulin (alone or combined) 38.1%. According to the questionnaire, 68.4% adhered to treatment and 72.6% reached A1C <7%. Among the non-adherents, 27.4% reached the goal. Achieving the glycemic goal was associated with age = 65 years (p < 0.0001), higher adherence score (p < 0.0001), private health insurance (p < 0.0001), and physical activity (p < 0.02). The worst metabolic control was associated with time of DMT2 diagnosis (p <0.0001), insulin therapy (p < 0.0001) and symptoms of depression (p < 0.002) Conclusions: The youngest and most vulnerable presented lower values for adherence; intervening and intensifying the treatment earlier in them would allow better results.