150 research outputs found
A Phase 2a, Multicenter, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial of IBD98-M Delayed-Release Capsules to Induce Remission in Patients with Active and Mild to Moderate Ulcerative Colitis
No full textIBD98-M is a delayed-release formulation of mesalamine (mesalazine) and SH with a potential therapeutic role in ulcerative colitis (UC). A total of 51 patients with a modified Ulcerative Colitis Disease Activity Index (UCDAI) score of ≥4 and ≤10, and a modified UCDAI endoscopy subscore ≥1 were randomized for 6 weeks of double-blind treatment with IBD98 0.8 g/day or IBD 1.2 g/day or placebo. The efficacy and safety of IBD98-M in mild to moderate active UC were primarily evaluated. At week 6, 1 (5.9%), 2 (12.5%), and 2 (11.1%) patients receiving IBD98-M 0.8 g, IBD98-M 1.2 g, and placebo, respectively, (p > 0.999) achieved clinical remission. Higher clinical response was seen in IBD98-M 1.2 g (31.3%) versus placebo (16.7%) and endoscopic improvement in IBD98-M 0.8 g (29.4%) versus placebo (22.2%) was seen. Fecal calprotectin levels were reduced in IBD98-M groups versus placebo (p > 0.05). IBD98-M patients achieved significant improvement in physical health summary score component of the SF-36 (p = 0.01 and p = 0.03 respectively) compared to placebo. IBD98-M did not meet the primary end point but had higher clinical response (1.2 g/day) and endoscopic improvement (0.8 g/day) compared to placebo. The safety result shown that IBD98-M treatment was safe and well tolerated in this patient population. No new safety signals or unexpected safety findings were observed during the study. Further trials with different stratification and longer follow-up may be needed to evaluate the efficacy
Three Afro-Latin genres: deconstructing and arranging the danzón, the chôro, and the bossa nova
No full textThis thesis project delves exclusively into three Afro-Latin genres: the danzón (and a variant, the danzonete), the chôro, and the bossa nova. For each genre, the author provided a brief historical background and analysis of the genre, and two original arrangements. A public performance showcasing these six arrangements was given on June 9th, 2013 as part of a larger, more diverse set of music, although only these original arrangements were discussed here. This concert served as demonstration of the candidate's abilities in both arranging for ensemble of various sizes (and instrumentation) as well as keyboard performance within the Afro-Latin group setting. The inspiration for all six arrangements were drawn from various sources: the Cuban danzón from an Étude by Frédéric Chopin; the danzonete from a french popular song that became a jazz standard in English, then retranslated into Spanish; the two Brazilian chôros by Pixinguinha/Lacerda and Abreu; and two contrasting Brazilian bossa novas by Antonio Carlos Jobim. The author attempted to deconstruct, musically analyze, and reconstitute a piece in good representation of that particular genre, each with some of its particular vernacular and genre-specific norms. Although some rhythmic, textural, and harmonic choices within each arrangement were original, many aspects of form and style conventions were arranged in close proximation to notable recordings, in an effort to reconstitute a piece in good representation of that particular genre
Pattern-based Histologic Approach in Very Early Onset IBD: Main Features and Differential Diagnosis
No full textVery early onset inflammatory bowel disease (VEO-IBD) is a clinical umbrella classification composed of IBD-like diseases encompassing both classic IBD (Crohn's disease and ulcerative colitis) and monogenic disorder, both arising before 6 years of age. VEO-IBD patients present significant clinical differences from IBD occurring in older children and in adults, including more severe disease, often unresponsive to conventional IBD therapy and a greater proportion of cases featuring an underlying genetic alteration. Histologic findings of gastrointestinal biopsies can show an IBD-like pattern (both Crohn's disease-like and ulcerative colitis-like pattern), an apoptotic-like and enterocolitis-like pattern. Findings of specific morphologic alterations, such as villous blunting, apoptosis, dense eosinophilic infiltrates, lack of plasma cells and severe glandular atrophy, can suggest a monogenic disorder. Moreover, individuals with monogenic disorders may develop significant problems such as primary immunodeficiency, impacting treatment options. Finally, IBD histology in childhood can differ from that in older patients and adults. This complexity makes a differential diagnosis between IBD and other pediatric diseases involving the gastrointestinal tract difficult, especially considering that histologic features can be similar between different diseases. Without an appropriate diagnosis, the clinical course of VEO-IBD has greater potential for escalated treatment regimens involving extensive surgery and more intensive medical therapies rather than specific therapy directed toward the underlying defect. For these reasons, a pattern-based histologic approach correlated with clinical and laboratory findings with a multidisciplinary approach is fundamental to reach a correct diagnosis in an adequate clinical context
Three Afro-Latin genres: deconstructing and arranging the danz??n, the ch??ro, and the bossa nova
No full textThis thesis project delves exclusively into three Afro-Latin genres: the danz??n (and a variant, the danzonete), the ch??ro, and the bossa nova. For each genre, the author provided a brief historical background and analysis of the genre, and two original arrangements. A public performance showcasing these six arrangements was given on June 9th, 2013 as part of a larger, more diverse set of music, although only these original arrangements were discussed here. This concert served as demonstration of the candidate's abilities in both arranging for ensemble of various sizes (and instrumentation) as well as keyboard performance within the Afro-Latin group setting. The inspiration for all six arrangements were drawn from various sources: the Cuban danz??n from an ??tude by Fr??d??ric Chopin; the danzonete from a french popular song that became a jazz standard in English, then retranslated into Spanish; the two Brazilian ch??ros by Pixinguinha/Lacerda and Abreu; and two contrasting Brazilian bossa novas by Antonio Carlos Jobim. The author attempted to deconstruct, musically analyze, and reconstitute a piece in good representation of that particular genre, each with some of its particular vernacular and genre-specific norms. Although some rhythmic, textural, and harmonic choices within each arrangement were original, many aspects of form and style conventions were arranged in close proximation to notable recordings, in an effort to reconstitute a piece in good representation of that particular genre
Clinical and economic impact of infliximab one-hour infusion protocol in patients with inflammatory bowel diseases: A multicenter study
No full textAIM:
To assess the impact of short infliximab (IFX) infusion on hospital resource utilization and costs.
METHODS:
All inflammatory bowel diseases (IBD) patients who received IFX 1 h infusion from March 2007 to September 2014 in eight centers from Southern Italy were included in the analysis. Demographic, clinical and infusion related data were collected. The potential benefits related to the short infusion protocol were assessed both in terms of time saving and increased infusion unit capacity. In addition, indirect patient-related cost savings were evaluated.
RESULTS:
One hundred and twenty-five patients were recruited (64 with ulcerative colitis and 61 with Crohn's disease). Median duration of disease was of 53 mo and mean age of pts at diagnosis was of 34 years (SD: ± 13). Adverse infusion reactions were reported in less than 4% both before and after short infusion. The total number of infusions across the selected centers was of 2501 (30.5% short infusions). In the analyzed cohort, 1143 h were saved (762 in the infusion and 381 in observation phases) through the rapid IFX infusion protocol. This time saving (-15% compared to the standard protocol in infusion phase) represents, from the hospital perspective, an opportunity to optimize infusion unit capacity by allocating the saved time in alternative cost-effective treatments. This is the case of opportunity cost that represents the value of forgone benefit which could be obtained from a resource in its next-best alternative use. Hence, an extra hour of infusion in the case of standard 2-h IFX represents a loss in opportunity to provide other cost effective services. The analysis showed that the short infusion increased the infusion units capacity up to 50% on days when the IFX infusions were scheduled (infusion phase). Furthermore, the analysis showed that the short IFX infusion protocol leads to time savings also in the post-infusion phase (observation) leading to a time saving of 10% on average among the analyzed centers. Finally, the short infusion protocol has been demonstrated to lead to indirect cost savings of €138/patient (average -€17.300 on the whole cohort).
CONCLUSION:
A short IFX infusion protocol can be considered time and cost saving in comparison to the standard infusion protocol both from the hospital's perspective, as it contributes to increase infusion units capacity, and the patients' perspective, as it reduces indirect costs and the impact of treatment on everyday life and work productivity
Vita
No full textThe work consists of six contemporary pop songs, containing arrangements based on bossa nova harmonies, however without the bossa nova rythms. The pieces of music are partly bossa nova classics and partly originals.
Bossa nova harmonies have always inspired the author and he wondered whether these could be applied to contemporary music. The research part focused on dissecting the harmonies that form an integral part of bossa nova of the late 1950s and 1960s. This knowledge is then applied to rearranging songs from that era into contemporary music pieces deleting all bossa nova rhythms, as well as to newly written songs. Arrangements of lead and backing vocals play a key part, applying bossa nova harmonic progressions. The latter was more of a challenge for pop chord progressions. The author believes the “Waters of March/Joy” song is a fine example of how the concept works in practice.
The music will be released as an EP in the fall of 2023 by the artist Vita with some additional live recordings.https://remix.berklee.edu/graduate-studies-production-technology/1323/thumbnail.jp
Deciphering Microbial Composition in Patients with Inflammatory Bowel Disease: Implications for Therapeutic Response to Biologic Agents
No full textGrowing evidence suggests that alterations in the gut microbiome impact the development of inflammatory bowel diseases (IBDs), including Crohn’s disease (CD) and ulcerative colitis (UC). Although IBD often requires the use of immunosuppressant drugs and biologic therapies to facilitate clinical remission and mucosal healing, some patients do not benefit from these drugs, and the reasons for this remain poorly understood. Despite advancements, there is still a need to develop biomarkers to help predict prognosis and guide treatment decisions. The aim of this study was to investigate the gut microbiome of IBD patients using biologics to identify microbial signatures associated with responses, following standard accepted criteria. Microbiomes in 66 stool samples from 39 IBD patients, comprising 20 CD and 19 UC patients starting biologic therapies, and 29 samples from healthy controls (HCs) were prospectively analyzed via NGS and an ensemble of metagenomics analysis tools. At baseline, differences were observed in alpha and beta metrics among patients with CD, UC and HC, as well as between the CD and UC groups. The degree of dysbiosis was more pronounced in CD patients, and those with dysbiosis exhibited a limited response to biological drugs. Pairwise differential abundance analyses revealed an increasing trend in the abundance of an unannotated genus from the Clostridiales order, Gemmiger genus and an unannotated genus from the Rikenellaceae family, which were consistently identified in greater abundance in HC. The Clostridium genus was more abundant in CD patients. At baseline, a greater abundance of the Odoribacter and Ruminococcus genera was found in IBD patients who responded to biologics at 14 weeks, whereas a genus identified as SMB53 was more enriched at 52 weeks. The Collinsella genus showed a higher prevalence among non-responder IBD patients. Additionally, a greater abundance of an unclassified genus from the Barnesiellaceae family and one from Lachnospiraceae was observed in IBD patients responding to Vedolizumab at 14 weeks. Our analyses showed global microbial diversity, mainly in CD. This indicated the absence or depletion of key taxa responsible for producing short-chain fatty acids (SCFAs). We also identified an abundance of pathobiont microbes in IBD patients at baseline, particularly in non-responders to biologic therapies. Furthermore, specific bacteria-producing SCFAs were abundant in patients responding to biologics and in those responding to Vedolizumab
Samba-Jazz beneath and beyond Bossa Nova : three arrangements for Céu e Mar by Johnny Alf
No full textOrientadores: Antonio Rafael Carvalho dos Santos, José Roberto ZanTese (doutorado) - Universidade Estadual de Campinas, Instituto de ArtesResumo: Este trabalho consiste da criação, realização, análise e reflexão de três arranjos para a peça "Céu e Mar", de Johnny Alf (1929-2010). Inicialmente, faz-se uma revisão do Samba-Jazz e de suas relações com a Bossa Nova, por meio de critérios harmônicos, melódicos, rítmicos e outras características particulares desses conteúdos sonoros. Em seguida, verifica-se de que maneira certo grupo de músicos brasileiros, no período de 1952 a 1967, reinventa o samba instrumental, na medida em que se encontra exposto à presença marcante do jazz e da produção cultural norte-americana da época. A partir daí, o autor inicia um diálogo criativo com os resultados obtidos até então, e assim são concebidos três arranjos para "Céu e Mar", distintos nas técnicas empregadas e em seu grau de intervenção nos modos de execução. Finalmente, as gravações são analisadas, considerando suas inserções num plano cartesiano especificamente criado para tal, e cuja proposta é matizar, em cada um dos arranjos e nas relações que estabelecem entre si, articulações entre concepção e performanceAbstract: This work consists of the creation, implementation, analysis and discussion about three arrangements of the song "Céu e Mar", Johnny Alf (1929-2010). Initially, it is a review of Samba-Jazz and its relations with bossa nova, using harmonic, melodic, rhythmic as criteria, besides other particular characteristics of these sound contents. Just following that, this work shows how certain group of Brazilian musicians, from 1952 to 1967, reinvents instrumental samba, as it is exposed to the strong presence of jazz and American cultural production of the time. From there, the author starts a creative dialogue with the results obtained so far, and then he conceives three arrangements for "Céu e Mar", using different techniques and intervention in the ways of musical playing. Finally, the recordings are analyzed, considering their insertions in a Cartesian plane specifically created for that, and whose purpose is to measure how intense are the articulations between concepts and performances in each of the arrangements, and in the relations established among theirselvsDoutoradoMusicaDoutor em Músic
Ultrasound Features of Helicobacter pylori-Related Gastritis
No full textBackground Abdominal ultrasound (US) is a reliable method for visualizing gastric wall layers and measuring their thickness. The objective of this study is to characterize the ultrasound features of H. pylori-induced gastritis and assess its predictive potential role for this condition. Methods A cohort of 119 patients underwent gastroscopy with biopsy and abdominal US to evaluate antral wall thickness (AWT), submucosal wall thickness (SLT), mucosal wall thickness (MLT), gastric motility, and the presence of ingested material. They were divided into three groups: group A (normal mucosa without H. pylori infection), group B (gastritis H. pylori negative) and group C (gastritis H. pylori positive). Results: SLT and reduced gastric motility were significantly increased in the H. pylori gastritis group (p < 0.001). Multivariate analysis identified SLT as the only significant independent predictor of H. pylori gastritis (p < 0.001). An SLT threshold of 1.55 mm was determined as optimal for differentiating H. pylori-positive patients from -negative, yielding a sensitivity of 77% and a specificity of 72%. Conclusions These findings suggest that H. pylori gastritis is characterized by submucosal layer thickening and impaired gastric motility
New biologics in the management of Crohn&rsquo;s disease: focus on certolizumab pegol
No full textElisabetta Colombo1, Fabrizio Bossa1, Anna Latiano2, Orazio Palmieri2, Angelo Andriulli1,2, Vito Annese2,31Unit of Gastroenterology, 2Laboratory of Genetic Research, 3Unit of Endoscopy, Department of Medical Sciences, IRCCS-CSS Hospital, San Giovanni Rotondo, ItalyAbstract: Crohn&rsquo;s disease (CD) is a chronic inflammatory condition involving the gastrointestinal tract characterized by recurrent exacerbations and remission. The disease frequently occurs in the lower part of the small bowel, but can affect any part of the digestive tract, from the mouth to the anus. The traditional goals of treatment of Crohn&rsquo;s disease were to induce and maintain clinical remission. More recently targets such as mucosal healing, reduced hospitalization and surgery, and improved quality of life are becoming increasingly achievable. The general principles for treatment should consider clinical activity, site and behavior of disease; however, the appropriate choice of medication depends on many factors that are the best tailored to the individual patient. This review focuses on certolizumab pegol, the first Fc-free PEGylated Fab&#39; fragment of humanized monoclonal antibody that binds and neutralizes human tumor necrosis factor alpha. Data on indication, pharmacokinetics, efficacy, safety, and influence on quality of life are reviewed.Keywords: Crohn&rsquo;s disease, certolizumab (CDP870), antiTNF-&alpha; agent
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