Persistent pulmonary abnormalities after 18 months of SARS-CoV-2 pneumonia.

OBJECTIVE: To describe persistent pulmonary abnormalities detected on HRCT after 18 months of SARS-CoV-2 pneumonia, and to determine their extension and correlation with pulmonary function. PATIENTS AND METHODS: A prospective cross-sectional study with an initial cohort of 90 patients in follow-up due to persisting lung abnormalities on imaging, functional respiratory impairment and/or respiratory symptoms. Of these, 31 (34%) were selected for analysis due to the persistence of their lung abnormalities on HRCT at 18 months after infection. A double reading was performed for each HRCT (62 observations). RESULTS: Of the 31 patients included: 20 (65%) were men; mean age was 67 years; 17 (55%) were smokers/ex-smokers. The mean hospitalisation time was 38 days. Eighteen (58%) patients were admitted to intensive care units. Five patients (16%) suffered an acute pulmonary thromboembolism and three (9.7%) had a pneumothorax. The mean time between the onset of pneumonia and the follow-up HRCT was 20.34 months. Nineteen percent of patients suffered from total lung function abnormalities; and ground-glass opacities and reticulation were present in 12% and 4.5% respectively. The findings of the 62 readings were: ground-glass opacities (100%), reticulation (83%), subpleural curvilinear lines (62%), parenchymal bands (34%), traction bronchiectasis (69%), displacement of vessels/fissures (46%) and honeycombing (4.9%). Pulmonary function 18 months after the acute episode revealed a mean FVC of 92% of predicted value, with an FVC < 80% of predicted value in 11 patients (35.4%). Mean DLCO was 71% of predicted value, with a DLCO < 80% in 22 patients (70%). We observed a statistically significant relationship between total lung function abnormalities on HRCT and FVC (P < 0.05), and a trend towards statistical significance with DLCO (P = 0.051); there was a statistically significant relationship between the presence of ground-glass opacities and FEV1/FVC (P < 0.01). The relationships between reticulation and FVC, FVC%, FEV1, FEV1% and DLCO% were also considered statistically significant (P < 0.05). CONCLUSION: Persistent interstitial lung abnormalities are seen on HRCT for a subset of patients infected with SARS-CoV-2 pneumonia. Seventy percent of these patients suffered a slight decrease in DLCO.

Antibiotic prescribing patterns in the placement of dental implants in Europe: A systematic review of survey-based studies.

BACKGROUND: The present systematic review aims to investigate the guidelines for prescribing Preventive Antibiotic Therapy (PAT) in the placement of dental implants (DIs) without anatomical constraints in healthy patients by clinicians in Europe and to compare them with current recommendations. MATERIAL AND METHODS: A search was performed in 4 databases: Medline (via PubMed), Web of Science, Scopus, and LILACS. The criteria employed were those described in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) declaration (PROSPERO Registration number: CRD42022382278). RESULTS: The electronic search identified 10 studies published between 2010 and 2023 that met the established criteria. Overall, 60.8% ± 24.1% of European professionals routinely prescribe PAT, with the most frequent regimen being perioperative (mean= 46.7% ± 24.3%), followed by postoperative PAT only (mean= 20.3% ± 9.7%). CONCLUSIONS: The most commonly prescribed antibiotic both pre- and postoperatively is amoxicillin and, in allergic patients, clindamycin. In Europe, more doses of PAT are being prescribed than suggested by current recommendations. For this reason, more PAT education is needed in educational curricula to promote a more rational use of antibiotics to reduce the occurrence of antimicrobial resistance.

Characterization and treatment of enuresis in overactive bladder patients. / Caracterización y tratamiento de la enuresis en pacientes con vejiga hiperactiva.

OBJECTIVE: To define the types of overactive bladder (OAB) patient enuresis and study daytime bladder treatment response. MATERIALS AND METHODS: A prospective, multi-center study of OAB patients with enuresis treated with anticholinergics or neuromodulation over 3 months from 2019 to 2021 was carried out. Variables achieved from the voiding calendar and PLUTSS (Pediatric Lower Urinary Tract Score System), as well as enuresis-related variables, were collected. Two study groups were created -primary enuresis (PE) and secondary enuresis (SE). Partial enuretic response (PER) was defined as a > 50% reduction in baseline enuresis, and complete enuretic response (CER) as a 100% reduction. A multivariate analysis was eventually conducted to detect CER independent predictive factors. RESULTS: 152 OAB patients were included. 109 of them (71.7%) had enuresis -29 (26.7%) SE and 80 (73.3%) PE. PLUTSS score was higher in PE patients than in SE patients (20.8 vs. 17.2; p= 0.001). PER and CER were significantly higher in the SE group (55.2% vs. 15%; p= 0.000 in PER, and 48.3% vs. 5%; p= 0.000 in CER). In the multivariate analysis, SE patients demonstrated to have a 50-fold increased probability of responding to daytime bladder treatment than PE patients (OR: 49.79; 95%CI: 6.73-36.8). CONCLUSIONS: Most OAB children have PE and not SE, which explains why enuresis does not typically respond to daytime bladder treatment. Characterizing the type of enuresis in OAB children is important to adequately approach treatment.

OBJETIVOS: Definir los tipos de enuresis de los pacientes con vejiga hiperactiva (VH) y estudiar su respuesta al tratamiento vesical diurno. MATERIAL Y METODOS: Estudio prospectivo y multicéntrico: pacientes con VH y enuresis, tratados con anticolinérgicos o neuromodulación durante 3 meses (2019-2021). Recogimos variables obtenidas del calendario miccional, cuestionario PLUTSS (Pediatric Lower Urinary Tract Score System), y relacionadas con la enuresis. Generamos 2 grupos de estudio: enuresis primaria (EP) y enuresis secundaria (ES). Consideramos respuesta parcial enurética (RPE) a la reducción del valor de enuresis inicial en más de un 50% y respuesta completa (RCE) el 100%. Finalmente realizamos un análisis multivariante para detectar factores predictivos independientes de RCE. RESULTADOS: Incluimos 152 pacientes con VH, 109 de los cuales presentaban enuresis (71,7%): 29 ES (26,7%) y 80 EP (73,3%). El valor PLUTSS fue mayor en pacientes con EP que en ES (20,8 vs. 17,2, p= 0,001.) La RPE y la RCE fueron significativamente mayores en el grupo de ES (55,2% vs. 15%, p= 0,000 en RPE y 48,3% vs. 5%, p= 0,000 en RCE). En el análisis multivariante se identificó que los pacientes con ES tienen una probabilidad de responder al tratamiento vesical diurno 50 veces superior que los pacientes con EP (OR 49,79, IC95% 6,73-36,8). CONCLUSIONES: La mayoría de niños con VH tienen una EP y no secundaria, por lo que generalmente la enuresis de estos pacientes no responde al tratamiento vesical diurno. Es importante caracterizar el tipo de enuresis de los niños con VH para plantear su tratamiento de forma adecuada.

Caracterización y tratamiento de la enuresis en pacientes con vejiga hiperactiva / Characterization and treatment of enuresis in overactive bladder patients

Objetivos: Definir los tipos de enuresis de los pacientes con vejiga hiperactiva (VH) y estudiar su respuesta al tratamiento vesical diurno. Material y métodos. Estudio prospectivo y multicéntrico: pacientes con VH y enuresis, tratados con anticolinérgicos o neuromodulación durante 3 meses (2019-2021). Recogimos variables obtenidas del calendario miccional, cuestionario PLUTSS (Pediatric Lower Urinary Tract Score System), y relacionadas con la enuresis. Generamos 2 grupos de estudio: enuresis primaria (EP) y enuresis secundaria (ES). Consideramos respuesta parcial enurética (RPE) a la reducción del valor de enuresis inicial en más de un 50% y respuesta completa (RCE) el 100%. Finalmente realizamos un análisis multivariante para detectar factores predictivos independientes de RCE. Resultados. Incluimos 152 pacientes con VH, 109 de los cuales presentaban enuresis (71,7%): 29 ES (26,7%) y 80 EP (73,3%). El valor PLUTSS fue mayor en pacientes con EP que en ES (20,8 vs. 17,2, p= 0,001.) La RPE y la RCE fueron significativamente mayores en el grupo de ES (55,2% vs. 15%, p= 0,000 en RPE y 48,3% vs. 5%, p= 0,000 en RCE). En el análisis multivariante se identificó que los pacientes con ES tienen una probabilidad de responder al tratamiento vesical diurno 50 veces superior que los pacientes con EP (OR 49,79, IC95% 6,73-36,8). Conclusiones. La mayoría de niños con VH tienen una EP y no secundaria, por lo que generalmente la enuresis de estos pacientes no responde al tratamiento vesical diurno. Es importante caracterizar el tipo de enuresis de los niños con VH para plantear su tratamiento de forma adecuada.(AU)

Objective: To define the types of overactive bladder (OAB) patient enuresis and study daytime bladder treatment response. Materials and methods. A prospective, multi-center study of OAB patients with enuresis treated with anticholinergics or neuromodulation over 3 months from 2019 to 2021 was carried out. Variables achieved from the voiding calendar and PLUTSS (Pediatric Lower Urinary Tract Score System), as well as enuresis-related variables, were collected. Two study groups were created – primary enuresis (PE) and secondary enuresis (SE). Partial enuretic response (PER) was defined as a >50% reduction in baseline enuresis, and complete enuretic response (CER) as a 100% reduction. A multivariate analysis was eventually conducted to detect CER independent predictive factors. Results. 152 OAB patients were included. 109 of them (71.7%) had enuresis – 29 (26.7%) SE and 80 (73.3%) PE. PLUTSS score was higher in PE patients than in SE patients (20.8 vs. 17.2; p= 0.001). PER and CER were significantly higher in the SE group (55.2% vs. 15%; p= 0.000 in PER, and 48.3% vs. 5%; p= 0.000 in CER). In the multivariate analysis, SE patients demonstrated to have a 50-fold increased probability of responding to daytime bladder treatment than PE patients (OR: 49.79; 95%CI: 6.73-36.8). Conclusions. Most OAB children have PE and not SE, which explains why enuresis does not typically respond to daytime bladder treatment. Characterizing the type of enuresis in OAB children is important to adequately approach treatment.(AU)

Efficacy of sacral transcutaneous electrical nerve stimulation in patients with overactive bladder refractory to anticholinergic treatment: a prospective multi-center study. / Eficacia de la electroestimulación transcutánea sacra en pacientes con vejiga hiperactiva refractarios a fármacos anticolinérgicos. Estudio prospectivo y multicéntrico.

OBJECTIVE: To determine whether sacral transcutaneous electrical nerve stimulation (S-TENS) is an effective treatment in patients refractory to anticholinergic drugs (Achs). MATERIALS AND METHODS: A prospective multi-center study of patients with overactive bladder (OB) refractory to Achs treated with S-TENS from 2018 to 2021 was carried out. S-TENS was applied over 3 months. Symptom progression was assessed using the voiding calendar and the Pediatric Lower Urinary Tract Symptoms Score (PLUTSS), excluding questions 3 and 4 -referring to enuresis- so that progression of daytime symptoms only (LUTS variable) was analyzed. RESULTS: 66 patients -50% of whom were female- were included, with a mean age of 9.5 years (range: 5-15). S-TENS significantly lowered PLUTSS (19.1 baseline vs. 9.5 final, p< 0.001) and LUTS (13.1 baseline vs. 4.8 final, p< 0.001). It also reduced the number of mictions (8.5 baseline vs. 6.4 final, p< 0.001), while increasing urine volume in the voiding records (214 ml baseline vs. 258 ml final, p< 0.001). Enuresis was the only variable refractory to S-TENS. Complication rate was 3% (2 patients with dermatitis in the S-TENS application area). CONCLUSIONS: S-TENS is effective and safe in the short-term in patients with OB refractory to Achs. Further studies assessing long-term efficacy and potential relapses are required.

OBJETIVOS: Determinar si la electroterapia nerviosa transcutánea a nivel sacro (TENS-S) es un tratamiento efectivo en pacientes refractarios a fármacos anticolinérgicos (Ach). MATERIAL Y METODOS: Estudio prospectivo y multicéntrico: pacientes con VH refractaria a Ach tratados con TENS-S entre 2018-2021. El TENS-S se aplicó durante 3 meses. La evolución sintomática fue evaluada utilizando el calendario miccional y el cuestionario PLUTSS (Pediatric Lower Urinary Tract Symptoms Score), pero excluyendo sus preguntas 3 y 4 (referidas a la enuresis) para analizar solamente la evolución de la sintomatología diurna (variable LUTS). RESULTADOS: Fueron incluidos 66 pacientes (50% niñas), con una edad media de 9,5 años (rango: 5-15). El TENS-S disminuyó significativamente el PLUTSS (19,1 inicial vs 9,5 final, p< 0,001) y el LUTS (13,1 inicial vs 4,8 final, p< 0,001). Además, redujo el número de micciones (8,5 inicial vs 6,4 final, p< 0,001) y aumentó el volumen de orina en los registros miccionales (214 ml inicial vs 258 ml final, p< 0,001). La enuresis fue la única variable refractaria al TENS-S. La tasa de complicaciones fue del 3% (2 pacientes, dermatitis en el área de aplicación del TENS-S). CONCLUSIONES: El TENS-S es efectivo y seguro a corto plazo en pacientes con VH refractarios a los Ach. Deben realizarse estudios para evaluar la eficacia a largo plazo y posibles recaídas.

Eficacia de la electroestimulación transcutánea sacra en pacientes con vejiga hiperactiva refractarios a fármacos anticolinérgicos. Estudio prospectivo y multicéntrico / Efficacy of sacral transcutaneous electrical nerve stimulation in patients with overactive bladder refractory to anticholinergic treatment: a prospective multi-center study

Objetivos: Determinar si la electroterapia nerviosa transcutánea anivel sacro (TENS-S) es un tratamiento efectivo en pacientes refractariosa fármacos anticolinérgicos (Ach).Material y métodos: Estudio prospectivo y multicéntrico: pacientes con VH refractaria a Ach tratados con TENS-S entre 2018-2021. El TENS-S se aplicó durante 3 meses. La evolución sintomática fueevaluada utilizando el calendario miccional y el cuestionario PLUTSS(Pediatric Lower Urinary Tract Symptoms Score), pero excluyendo suspreguntas 3 y 4 (referidas a la enuresis) para analizar solamente laevolución de la sintomatología diurna (variable LUTS).Resultados: Fueron incluidos 66 pacientes (50% niñas), con unaedad media de 9,5 años (rango: 5-15). El TENS-S disminuyó significativamente el PLUTSS (19,1 inicial vs 9,5 final, p< 0,001) y el LUTS (13,1inicial vs 4,8 final, p< 0,001). Además, redujo el número de micciones(8,5 inicial vs 6,4 final, p< 0,001) y aumentó el volumen de orina enlos registros miccionales (214 ml inicial vs 258 ml final, p< 0,001). Laenuresis fue la única variable refractaria al TENS-S. La tasa de complicaciones fue del 3% (2 pacientes, dermatitis en el área de aplicacióndel TENS-S). Conclusiones: El TENS-S es efectivo y seguro a corto plazo enpacientes con VH refractarios a los Ach. Deben realizarse estudios paraevaluar la eficacia a largo plazo y posibles recaídas.(AU)

Objective: To determine whether sacral transcutaneous electricalnerve stimulation (S-TENS) is an effective treatment in patients refractory to anticholinergic drugs (Achs).Materials and methods. A prospective multi-center study of patients with overactive bladder (OB) refractory to Achs treated with S-TENS from 2018 to 2021 was carried out. S-TENS was applied over 3months. Symptom progression was assessed using the voiding calendarand the Pediatric Lower Urinary Tract Symptoms Score (PLUTSS),excluding questions 3 and 4 –referring to enuresis– so that progressionof daytime symptoms only (LUTS variable) was analyzed. Results: 66 patients –50% of whom were female– were included,with a mean age of 9.5 years (range: 5-15). S-TENS significantly lowered PLUTSS (19.1 baseline vs. 9.5 final, p< 0.001) and LUTS (13.1baseline vs. 4.8 final, p< 0.001). It also reduced the number of mictions(8.5 baseline vs. 6.4 final, p< 0.001), while increasing urine volume inthe voiding records (214 ml baseline vs. 258 ml final, p< 0.001). Enuresiswas the only variable refractory to S-TENS. Complication rate was 3%(2 patients with dermatitis in the S-TENS application area).Conclusions: S-TENS is effective and safe in the short-term inpatients with OB refractory to Achs. Further studies assessing long-termefficacy and potential relapses are required.(AU)

Two Xylella fastidiosa subsp. multiplex Strains Isolated from Almond in Spain Differ in Plasmid Content and Virulence Traits.

The plant-pathogenic bacterium Xylella fastidiosa is a major threat to agriculture and the environment worldwide. Recent devastating outbreaks in Europe highlight the potential of this pathogen to cause emergent diseases. X. fastidiosa subsp. multiplex ESVL and IVIA5901 strains that belong to sequence type 6 were isolated from almond orchards within the outbreak area in Alicante province (Spain). Both strains share more than 99% of the chromosomal sequences (average nucleotide identity), but the ESVL strain harbors two plasmids (pXF64-Hb_ESVL and pUCLA-ESVL). Here, virulence phenotypes and genome content were compared between both strains, using three strains from the United States as a reference for the phenotypic analyses. Experiments in microfluidic chambers, used as a simulation of xylem vessels, showed that twitching motility was absent in the IVIA5901 strain, whereas the ESVL strain had reduced twitching motility. In general, both Spanish strains had less biofilm formation, less cell aggregation, and lower virulence in tobacco compared with U.S. reference strains. Genome analysis of the two plasmids from ESVL revealed 51 unique coding sequences that were absent in the chromosome of IVIA5901. Comparison of the chromosomes of both strains showed some unique coding sequences and single-nucleotide polymorphisms in each strain, with potential deleterious mutations. Genomic differences found in genes previously associated with adhesion and motility might explain the differences in the phenotypic traits studied. Although additional studies are necessary to infer the potential role of X. fastidiosa plasmids, our results indicate that the presence of plasmids should be considered in the study of the mechanisms of pathogenicity and adaptation in X. fastidiosa to new environments. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

Tendencias en la mortalidad por neumonía en adultos en Chile, 2000-2016 / Trends in adult pneumonia mortality in Chile, 2000-2016

Objetivo: Analizar y modelar los cambios en la tendencia de la mortalidad por neumonía en la población mayor de 15 años de Chile, entre los años 2000 y 2016. Métodos: Estudio epidemiológico basado en información de bases de datos públicas de estadísticas vitales del Departamento de Estadística e Información en Salud (DEIS) y del Instituto Nacional de Estadística (INE) del Ministerio de Salud (MINSAL) de Chile. Los casos fueron identificados por los códigos CIE-10 J12-J18. Se calculó la tasa de mortalidad estandarizada por edad, según sexo y grupo etario. Se utilizó el análisis de regresión Joinpoint para modelar la mortalidad y estimar el porcentaje de cambio anual (CPA) en las tasas e identificar cambios significativos en las tendencias. Se utilizó el cambio del CPA como medida de resumen. Resultados: Durante el período de estudio, la tasa de mortalidad por neumonía en Chile disminuyó significativamente en un 61,9%, desde 56,3 muertes por 100.000 habitantes el año 2000 a 21,7 muertes por 100.000 habitantes en el año 2016, con un CPA de −4,2%, (p < 0,05). El 90% de los fallecidos tenían más de 65 años. Conclusiones: Las tasas de mortalidad por neumonía en Chile en mayores de 15 años muestran una tendencia a la disminución sostenida significativa en el período comprendido entre los años 2000 y 2016.

Objective: To analyze and model changes in the pneumonia mortality trend in the population over 15 years old of Chile, between 2000 and 2016. Methods: Epidemiological study based on information from public databases of vital statistics of the Department of Health Statistics and Information (DEIS) and the National Institute of Statistics (INE) of the Ministry of Health (MINSAL) of Chile. The cases were identified by the codes ICD-10 J12-J18. We calculated age-standardized overall mortality, according to sex and age group. Joinpoint regression analysis was used to model mortality and estimate the annual percentage of change (APC) in rates and identify significant changes in trends. APC was used as a summary measure. Results: During the period studied, the pneumonia mortality rate in Chile decreased significantly by 61.9%. Mortality rate diminished from 56.3 deaths per 100,000 inhabitants in 2000 to 21.7 deaths per 100,000 inhabitants in 2016 with an APC of −4.2%, (p < 0.05). Almost 90% of the deceased were over 65 years old. Conclusions: Mortality rates for pneumonia in Chile in people over 15 years of age show a significant sustained decreasing trend in the period between 2000 and 2016.

Use of magnetic double J stents in pediatric patients. / Uso de los catéteres doble J magnéticos en pacientes pediátricos.

OBJECTIVE: Traditionally, double J stent removal in pediatric patients has required cystoscopy under general anesthesia. Magnetic stents allow for double J stent removal without the need for anesthesia. This work describes our initial experience with these stents. MATERIAL AND METHODS: A prospective cohort study of patients under 14 years of age carrying magnetic double J stents from 2018 to 2021 was performed. Variables assessed included baseline diagnosis, surgical procedure, placement success rate, complications associated with use, and need for general anesthesia at removal. RESULTS: 23 stents (4.8 Fr, 15 cm-20 cm) were placed in 21 patients, 62% of whom were male. Mean age was 5.01 years (3 months-13 years). Indications for placement included Anderson-Hynes dismembered pyeloplasty (34.8%), endoscopic dilatation of the ureteropelvic junction (UPJ) (21.8%), cystoscopic dilatation of the ureterovesical junction (UVJ) (17.4%), endoscopic lithotripsy (13.1%), renal trauma (4.3%), suspected retroiliac ureter (4.3%), and cystoscopic drainage of pyonephrosis (4.3%). Mean time of stent use was 4.2 weeks. 3 complications (13%) associated with the double J stent - 1 urinary tract infection (UTI), 1 stent obstruction, and 1 distal stent migration - were recorded. 95.5% of magnetic stents were successfully removed without anesthesia. CONCLUSIONS: Magnetic double J stents can be regarded as an effective alternative to conventional double J stents, since they avoid an additional surgical procedure with general anesthesia in pediatric patients.

OBJETIVOS: Tradicionalmente los catéteres doble J precisan de cistoscopia bajo anestesia general para su retirada en pacientes pediátricos. Los catéteres imantados permiten la retirada del doble J sin necesidad de anestesia. Mediante este trabajo describimos nuestra experiencia inicial con dichos catéteres. MATERIAL Y METODOS: Se ha realizado un estudio de cohorte prospectivo, de pacientes menores de 14 años portadores de doble J imantado desde 2018 a 2021. Las variables estudiadas han sido el diagnóstico inicial, el procedimiento quirúrgico realizado, la tasa de éxito en la colocación, las complicaciones derivadas de su uso y la necesidad de anestesia general en la retirada. RESULTADOS: Se han colocado 23 catéteres (4,8 Fr, 15-20 cm) en 21 pacientes, media de edad de 5,01 años (3 meses-13 años), el 62% varones. Las indicaciones para la colocación han sido: 34,8% tras pieloplastia desmembrada Anderson-Hynes, 21,8% tras dilataciones endoscópicas de la unión pielo-ureteral (UPU), 17,4% tras dilataciones cistoscópicas de la unión uretero-vesical (UUV), 13,1% tras litotricia endoscópica, 4,3% tras traumatismo renal, 4,3% sospecha de uréter retroilíaco y 4,3% tras drenaje cistoscópico de pionefrosis. La media de tiempo de uso de los catéteres ha sido de 4,2 semanas. Registramos tres complicaciones (13%) relacionadas con el doble J: una infección del tracto urinario (ITU), una obstrucción del catéter y una migración distal del catéter. El 95,5% de los imantados se retiraron con éxito sin anestesia. CONCLUSIONES: El doble J magnético puede considerarse una alternativa eficaz a los doble J clásicos, que puede evitar un procedimiento extra con anestesia general en los pacientes pediátricos.

Uso de los catéteres doble J magnéticos en pacientes pediátricos / Use of magnetic double J stents in pediatric patients

Objetivos: Tradicionalmente los catéteres doble J precisan de cistoscopia bajo anestesia general para su retirada en pacientes pediátricos.Los catéteres imantados permiten la retirada del doble J sin necesidadde anestesia. Mediante este trabajo describimos nuestra experienciainicial con dichos catéteres.Material y métodos: Se ha realizado un estudio de cohorte prospectivo, de pacientes < 14 años portadores de doble J imantado desde 2018 a 2021. Las variables estudiadas han sido el diagnóstico inicial, el procedimiento quirúrgico realizado, la tasa de éxito en la colocación, las complicaciones derivadas de su uso y la necesidad de anestesia general en la retirada.Resultados: Se han colocado 23 catéteres (4,8 Fr, 15-20 cm) en 21pacientes, media de edad de 5,01 años (3 meses-13 años), el 62% varo-nes. Las indicaciones para la colocación han sido: 34,8% tras pieloplastiadesmembrada Anderson-Hynes, 21,8% tras dilataciones endoscópicas dela unión pielo-ureteral (UPU), 17,4% tras dilataciones cistoscópicas dela unión uretero-vesical (UUV), 13,1% tras litotricia endoscópica, 4,3%tras traumatismo renal, 4,3% sospecha de uréter retroilíaco y 4,3% trasdrenaje cistoscópico de pionefrosis. La media de tiempo de uso de loscatéteres ha sido de 4,2 semanas. Registramos tres complicaciones (13%)relacionadas con el doble J: una infección del tracto urinario (ITU), unaobstrucción del catéter y una migración distal del catéter. El 95,5% delos imantados se retiraron con éxito sin anestesia.Conclusiones: El doble J magnético puede considerarse una alternativa eficaz a los doble J clásicos, que puede evitar un procedimientoextra con anestesia general en los pacientes pediátricos.

Objective: Traditionally, double J stent removal in pediatric patients has required cystoscopy under general anesthesia. Magnetic stents allowfor double J stent removal without the need for anesthesia. This workdescribes our initial experience with these stents.Materials and methods: A prospective cohort study of patientsunder 14 years of age carry-ing magnetic double J stents from 2018 to2021 was performed. Variables assessed included baseline diagnosis,surgical procedure, placement success rate, complications associatedwith use, and need for general anesthesia at removal.Results: 23 stents (4.8 Fr, 15 cm-20 cm) were placed in 21 patients,62% of whom were male. Mean age was 5.01 years (3 months-13 years).Indications for placement included An-derson-Hynes dismembered py-eloplasty (34.8%), endoscopic dilatation of the ureteropelvic junction(UPJ) (21.8%), cystoscopic dilatation of the ureterovesical junction(UVJ) (17.4%), endoscopic lithotripsy (13.1%), renal trauma (4.3%),suspected retroiliac ureter (4.3%), and cystoscopic drainage of pyone-phrosis (4.3%). Mean time of stent use was 4.2 weeks. 3 com-plications(13%) associated with the double J stent – 1 urinary tract infection (UTI),1 stent obstruction, and 1 distal stent migration – were recorded. 95.5%of magnetic stents were suc-cessfully removed without anesthesia.Conclusions: Magnetic double J stents can be regarded as an effec-tive alternative to conven-tional double J stents, since they avoid an ad-ditional surgical procedure with general anesthe-sia in pediatric patients.

Serum microRNAs Catalog Asthma Patients by Phenotype.

BACKGROUND AND OBJECTIVES: Asthma is a chronic inflammatory condition of the airways with a complex pathophysiology. Stratification of asthma subtypes into phenotypes and endotypes should move the field forward, making treatment more effective and personalized. Eosinophils are the key inflammatory cells involved in severe eosinophilic asthma. Given the health threat posed by eosinophilic asthma, there is a need for reliable biomarkers to identify affected patients and treat them properly with novel biologics. microRNAs (miRNAs) are a promising diagnostic tool. The aim of this study was to identify serum miRNAs that can phenotype asthma patients. METHODS: Serum miRNAs of patients with eosinophilic asthma (N=40) and patients with noneosinophilic asthma (N=36) were evaluated using next-generation sequencing, specifically miRNAs-seq, and selected miRNAs were validated using RT-qPCR. Pathway enrichment analysis of deregulated miRNAs was performed. RESULTS: Next-generation sequencing revealed 15 miRNAs that were expressed differentially between eosinophilic and noneosinophilic asthma patients, although no differences were observed in the miRNome between atopic and nonatopic asthma patients. Of the 15 miRNAs expressed differentially between eosinophilic and noneosinophilic asthma patients, hsa-miR-26a-1-3p and hsa-miR-376a-3p were validated by RT-qPCR. Expression levels of these 2 miRNAs were higher in eosinophilic than in noneosinophilic asthma patients. Furthermore, expression values of hsa-miR-26a-1-3p correlated inversely with peripheral blood eosinophil count, and hsa-miR-376a-3p expression values correlated with FeNO values and the number of exacerbations. Additionally, in silico pathway enrichment analysis revealed that these 2 miRNAs regulate signaling pathways associated with the pathogenesis of asthma. CONCLUSIONS: hsa-miR-26a-1-3p and hsa-miR-376a-3p could be used to differentiate between eosinophilic and noneosinophilic asthma.

Serum microRNAs Catalog Asthma Patients by Phenotype

Background: Asthma is a chronic inflammatory condition of the airways with a complex pathophysiology. Stratification of asthma subtypes into phenotypes and endotypes should move the field forward, making treatment more effective and personalized. Eosinophils are the key inflammatory cells involved in severe eosinophilic asthma. Given the health threat posed by eosinophilic asthma, there is a need for reliable biomarkers to identify affected patients and treat them properly with novel biologics. microRNAs (miRNAs) are a promising diagnostic tool. Objective: The aim of this study was to identify serum miRNAs that can phenotype asthma patients. Methods: Serum miRNAs of patients with eosinophilic asthma (N=40) and patients with noneosinophilic asthma (N=36) were evaluated using next-generation sequencing, specifically miRNAs-seq, and selected miRNAs were validated using RT-qPCR. Pathway enrichment analysis of deregulated miRNAs was performed. Results: Next-generation sequencing revealed 15 miRNAs that were expressed differentially between eosinophilic and noneosinophilic asthma patients, although no differences were observed in the miRNome between atopic and nonatopic asthma patients. Of the 15 miRNAs expressed differentially between eosinophilic and noneosinophilic asthma patients, hsa-miR-26a-1-3p and hsa-miR-376a-3p were validated by RT-qPCR. Expression levels of these 2 miRNAs were higher in eosinophilic than in noneosinophilic asthma patients. Furthermore, expression values of hsa-miR-26a-1-3p correlated inversely with peripheral blood eosinophil count, and hsa-miR-376a-3p expression values correlated with FeNO values and the number of exacerbations. Additionally, in silico pathway enrichment analysis revealed that these 2 miRNAs regulate signaling pathways associated with the pathogenesis of asthma. Conclusion: hsa-miR-26a-1-3p and hsa-miR-376a-3p could be used to differentiate between eosinophilic and noneosinophilic asthma (AU)

The incorporation of HIV self-testing as an exclusive option among men who have sex with men in Spain: results of an online cross-sectional study.

BACKGROUND: We assessed to what extent HIV self-testing would be incorporated by men who have sex with men (MSM) with previous testing history as their exclusive testing option and describe what actions they would take in the case of obtaining a reactive self-test. METHODS: We conducted an online survey among Spanish resident MSM recruited mainly in gay dating apps and analyze 6171 ever tested individuals. We used Poisson regression to estimate factors associated with the incorporation of self-testing as the exclusive testing option. Among those who would incorporate self-testing as their exclusive option, we described actions taken if obtaining a reactive self-test by number of tests in the past. RESULTS: Nearly half of the participants (48.3%) were > =35 years old, 84.6% were born in Spain, 57.9% had attained a university degree, 55.1% lived in a municipality of ≤500.000 and 86.4% self-identified as homosexual. For 37.2%, self-testing would become their exclusive testing option. The incorporation of self-testing as the exclusive option increased with age 25-34 (PR:1.1, 95%CI:1.0-1.3), 35-44 (PR:1.3, 95%CI:1.2-1.5), 45-49 (PR:1.5, 95%CI:1.3-1.7) and > 50 (PR:1.5, 95%CI:1.3-1.8) and in those who reported unprotected anal intercourse (PR:1.1, 95%CI:1.0-1.2) or having paid for sex (PR:1.2, 95%CI:1.0-1.3) in the last 12 months. It was also associated with having had < 10 HIV test in the past (2-9 tests (PR:1.3, 95%CI:1.1-1.4); 1 test (PR:1.5, 95%CI:1.3-1.7)), and having been tested ≥2 years (PR:1.4, 95%CI:1.3-1.5) or between 1 and 2 years ago (PR:1.1, 95%CI:1.0-1.2). Of participants who would use self-testing exclusively 76.6% would confirm their result in case of obtaining a reactive self-test and only 6.1% wouldn't know how to react. Only one individual expressed that he would do nothing at all. CONCLUSION: HIV self-testing could become the exclusive testing option for more than a third of our participants. It was chosen as the exclusive option especially by older, at risk and under-tested MSM. Self-testing strategies need to especially consider the linkage to care process. In this sense, only a small fraction would not know how to react and virtually nobody reported taking no action if obtaining a reactive result.

Crisis epiléptica y cefalea tras infiltración epidural lumbar con corticoides / Epileptic crisis and headache after a lumbar epidural steroid injection

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