Are we ready for telemonitoring inflammatory bowel disease?A review of advances,enablers,and barriers

This review summarizes the evidence about telemonitoring in patients with inflammatory bowel disease(IBD). To give an overview of the advances performed, as well as the enablers and barriers which favoured/hindered telemonitoring implementation. We performed a literature search in Pub Med, EMBASE, MEDLINE, Cochrane Database, Web of Science and Conference Proceedings. Titles and abstracts published up to September 2022 were screened for a set of inclusion criteria: telemonitoring intervention, IBD as the main disease, and a primary study performed. Ninety-seven reports were selected for full review. Finally, 20 were included for data extraction and critical appraisal. Most studies used telemonitoring combined with tele-education, and programs evolved from home telemanagement systems towards web portals through m Health applications. Web systems demonstrated patients’ acceptance, improvement in quality of life, disease activity and knowledge, with a good cost-effectiveness profile in the short-term. Initially, telemonitoring was almost restricted to ulcerative colitis, but new patient reported outcome measures, home-based tests and mobile devices favoured its expansion to different patients’ categories. However, technological and knowledge advances led to legal, ethical, economical and logistic issues. Standardization of remote healthcare is necessary, to improve the interoperability of systems as well as to address liability concerns and users’ preferences. Telemonitoring IBD is well accepted and improves clinical outcomes at a lower cost in the short-term. Funders, policymakers, providers, and patients need to align their interests to overcome the emerging barriers for its full implementation.

Cellular targets in diabetic retinopathy therapy

Despite the existence of treatment for diabetes,inadequate metabolic control triggers the appearance of chronic complications such as diabetic retinopathy.Diabetic retinopathy is considered a multifactorial disease of complex etiology in which oxidative stress and low chronic inflammation play essential roles.Chronic exposure to hyperglycemia triggers a loss of redox balance that is critical for the appearance of neuronal and vascular damage during the development and progression of the disease.Current therapies for the treatment of diabetic retinopathy are used in advanced stages of the disease and are unable to reverse the retinal damage induced by hyperglycemia.The lack of effective therapies without side effects means there is an urgent need to identify an early action capable of preventing the development of the disease and its pathophysiological consequences in order to avoid loss of vision associated with diabetic retinopathy.Therefore,in this review we propose different therapeutic targets related to the modulation of the redox and inflammatory status that,potentially,can prevent the development and progression of the disease.

Metabolic dysregulation in term infants from SARS-CoV-2-infected mothers

Severe acute respiratory syndrome coronavirus 2(SARSCoV-2)is a novel beta coronavirus that causes coronavirus disease 2019(COVID-19),a severe infectious respiratory disease.In January 2020,the World Health Organization(WHO)declared the outbreak a public health emergency of international concern,and in March 2020.

How to avoid overtreatment of benign colorectal lesions:Rationale for an evidence-based management

Implementing population-based screening programs for colorectal cancer has led to an increase in the detection of large but benign histological lesions.Currently,endoscopic mucosal resection can be considered the standard technique for the removal of benign lesions of the colon due to its excellent safety profile and good clinical results.However,several studies from different geographic areas agree that many benign colon lesions are still referred for surgery.Moreover,the referral rate to surgery is not decreasing over the years,despite the theoretical improvement of endoscopic resection techniques.This article will review the leading causes for benign colorectal lesions to be referred for surgery and the influence of the endoscopist experience on the referral rate.It will also describe how to categorize a polyp as complex for resection and consider an endoscopist as an expert in endoscopic resection.And finally,we will propose a framework for the accurate and evidence-based treatment of complex benign colorectal lesions.