Publications by authors named "Pilar Varela Trastoy"

Background And Purpose Of The Study: Ustekinumab is a monoclonal antibody approved for the treatment of moderate to severe Crohn's disease (CD) and ulcerative colitis (UC). In spite of being an effective treatment, patients may have suboptimal response, or lose it over time. In these cases, ustekinumab intravenous (IV) maintenance therapy has been explored as a rescue option.

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Background: Ulcerative proctitis (UP) can have a milder, less aggressive course than left-sided colitis or extensive colitis. Therefore, immunosuppressants tend to be used less in patients with this condition. Evidence, however, is scarce because these patients are excluded from randomised controlled clinical trials.

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Article Synopsis
  • A study was conducted to evaluate the effectiveness and safety of ustekinumab and vedolizumab in treating complex perianal fistula in patients with Crohn's disease.
  • Out of 155 patients analyzed, ustekinumab achieved a remission rate of 54%, while vedolizumab had a remission rate of 46%, with some patients relapsing during the follow-up period.
  • Both medications exhibited mild adverse events and showed favorable safety profiles, indicating their potential effectiveness in managing this condition.
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Crohn's disease is a chronic inflammatory disorder which involves mainly the gut. It poses a continuous challenge for health care due to the lack of effective medical therapies. Given the situation of this refractory disease, surgery is indicated.

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Background: Both vedolizumab and ustekinumab are approved for the management of Crohn's disease [CD]. Data on which one would be the most beneficial option when anti-tumour necrosis factor [anti-TNF] agents fail are limited.

Aims: To compare the durability, effectiveness, and safety of vedolizumab and ustekinumab after anti-TNF failure or intolerance in CD.

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Crohn's disease is a chronic multifactorial disease for which therapeutic options have expanded in the last decades. However there are still patients who lack or lose response to current standard treatment strategies. A unicentric, retrospective, study was performed in order to evaluate the clinical and biochemical response to intravenous ustekinumab manteinance therapy (IVUMT) in patients with refractory CD.

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Objectives: This multicenter cross-sectional study was conducted to assess the psychosocial impact of COVID-19 on patients with inflammatory bowel disease (IBD) in Spain during lockdown and the first wave of the pandemic.

Patients And Methods: A self-report questionnaire that integrated the Spanish version of the Depression, Anxiety and Stress Scale-21 items (DASS-21) and the Perceived Stress Questionnaire (PSS) was designed to gather sociodemographic data and information related to the effects of lockdown on the lives of IBD patients. Twelve IBD units invited their patients to answer the anonymous online survey between the 1st July and the 25th August 2020.

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(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year.

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It has been demonstrated that ustekinumab (UST) is effective as an induction and maintenance therapy in patients with Crohn's disease (CD). However, a significant number of patients experience an insufficient response or a secondary non-response. We report six cases from our center that underwent a rescue treatment by changing maintenance treatment to weight-adjusted intravenous UST, obtaining a subsequent clinical improvement.

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Lymphomatoid granulomatosis is a rare lymphoproliferative disorder associated with immunosuppressive therapy in inflammatory bowel disease. We present the case of a patient with Crohn's disease and treated azathioprine that develops lymphomatoid granulomatosis, as well as its diagnostic process and the chosen treatment. Lymphomatoid granulomatosis is a serious disease barely described and whose suspicion is essential for its prognosis.

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Clostridium difficile (CD) infection is currently the most frequent etiology of nosocomial diarrhea. Besides, its incidence is progressively increasing in ambulatory patients. Inflammatory bowel disease (IBD) is a risk factor of CD infection itself, but also due to the regular immunosuppressive treatment used in these patients.

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Aims: Analyzing the readmission of patients with acute biliary edematous pancreatitis (ABEP) without cholecystectomy despite a previous episode of mild acute gallstone pancreatitis or lithiasic cholecystitis. Calculating the health costs associated with the non-performance of cholecystectomy.

Material And Methods: Prospective observational study conducted at a tertiary hospital from July to November 2014.

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