Cytokine profiling and transcriptomics in mononuclear cells define immune variants in Meniere Disease.

Meniere Disease (MD) is a chronic inner ear disorder characterized by vertigo attacks, sensorineural hearing loss, tinnitus, and aural fullness. Extensive evidence supporting the inflammatory etiology of MD has been found, therefore, by using transcriptome analysis, we aim to describe the inflammatory variants of MD. We performed Bulk RNAseq on 45 patients with definite MD and 15 healthy controls. MD patients were classified according to their basal levels of IL-1ß into 2 groups: high and low. Differentially expression analysis was performed using the ExpHunter Suite, and cell type proportion was evaluated using the estimation algorithms xCell, ABIS, and CIBERSORTx. MD patients showed 15 differentially expressed genes (DEG) compared to controls. The top DEGs include IGHG1 (p = 1.64 × 10-6) and IGLV3-21 (p = 6.28 × 10-3), supporting a role in the adaptative immune response. Cytokine profiling defines a subgroup of patients with high levels of IL-1ß with up-regulation of IL6 (p = 7.65 × 10-8) and INHBA (p = 3.39 × 10-7) genes. Transcriptomic data from peripheral blood mononuclear cells support a proinflammatory subgroup of MD patients with high levels of IL6 and an increase in naïve B-cells, and memory CD8+ T cells.

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.

A Predictive Model of Bilateral Sensorineural Hearing Loss in Meniere Disease Using Clinical Data.

OBJECTIVES: Meniere disease (MD) is defined by a clinical syndrome of recurrent attacks of spontaneous vertigo associated with tinnitus, aural fullness, and sensorineural hearing loss (SNHL). Most patients have unilateral SNHL, but some of them will develop contralateral SNHL during the course of the disease. Several studies have reported a frequency of 2 to 73% SNHL in the second ear, according to the duration of disease and the period of follow-up. We hypothesize that unilateral and bilateral MD are different conditions, the first would initially involve the apical turn of the cochlea, while bilateral MD would affect the entire length of the cochlea. The aim of the study is to search for clinical predictors of bilateral SNHL in MD to build a predictive model of bilateral involvement. DESIGN: A retrospective, longitudinal study including two cohorts with a total of 400 patients with definite MD was carried out. The inception cohort consisted of 150 patients with MD and the validation cohort included 250 cases. All of the cases were diagnosed of unilateral MD according to their hearing loss thresholds. The following variables were assessed as predictors of bilateral SNHL for the two cohorts: sex, age of onset, familiar history of MD, migraine and high-frequency hearing loss (HFHL, defined if hearing threshold >20 dB in two or more consecutive frequencies from 2 to 8 KHz). A descriptive analysis was carried out according to the presence of HFHL in the first audiogram for the main variables. By using multiple logistic regression, we built-up several predictive models for the inception cohort and validated it with the replication cohort and merged dataset. RESULTS: Twenty-three (19.3%) and 78 (41%) of patients with HFHL developed contralateral SNHL during the follow-up, in the inception and validation cohorts, respectively. In the inception cohort, the best predictive model included HFHL in the first audiogram (OR = 6.985, p = 0.063) and the absence of migraine (OR = 0.215, p = 0.144) as clinical predictors for bilateral SNHL [area under the curve (AUC) = 0.641, p = 0.002]. The model was validated in the second cohort (AUC = 0.621, p < 0.001). Finally, we merged both datasets to improve the precision of the model including HFHL in the first audiogram (OR = 3.168, p = 0.001), migraine (OR = 0.482, p = 0.036) and age of onset >35 years old (OR = 2.422, p = 0.006) as clinical predictors (AUC = 0.639, p < 0.001). CONCLUSIONS: A predictive model including the age of onset, HFHL in the first audiogram and migraine can help to assess the risk of bilateral SNHL in MD. This model may have significant implications for clinical management of patients with MD.

Rare coding variants involving MYO7A and other genes encoding stereocilia link proteins in familial meniere disease.

The MYO7A gene encodes a motor protein with a key role in the organization of stereocilia in auditory and vestibular hair cells. Rare variants in the MYO7A (myosin VIIA) gene may cause autosomal dominant (AD) or autosomal recessive (AR) sensorineural hearing loss (SNHL) accompanied by vestibular dysfunction or retinitis pigmentosa (Usher syndrome type 1B). Familial Meniere's disease (MD) is a rare inner ear syndrome mainly characterized by low-frequency sensorineural hearing loss and episodic vertigo associated with tinnitus. Familial aggregation has been found in 6-8% of sporadic cases, and most of the reported genes were involved in single families. Thus, this study aimed to search for relevant genes not previously linked to familial MD. Through exome sequencing and segregation analysis in 62 MD families, we have found a total of 1 novel and 8 rare heterozygous variants in the MYO7A gene in 9 non-related families. Carriers of rare variants in MYO7A showed autosomal dominant or autosomal recessive SNHL in familial MD. Additionally, some novel and rare variants in other genes involved in the organization of the stereocilia links such as CDH23, PCDH15 or ADGRV1 co-segregated in the same patients. Our findings reveal a co-segregation of rare variants in the MYO7A gene and other structural myosin VIIA binding proteins involved in the tip and ankle links of the hair cell stereocilia. We suggest that recessive digenic inheritance involving these genes could affect the ultrastructure of the stereocilia links in familial MD.

Management of sewage sludge by composting using fermented water hyacinth.

The goal of the present research work was to assess the management of sewage sludge (SS) by composting using fermented water hyacinth (WHferm) as an amendment. The water hyacinth was fermented, and a higher production of volatile fatty acids (VFAs) (782.67 mg L(-1)) and soluble organic carbon (CSOL) (4788.34 mg L(-1)) was obtained using a particle size of 7 mm compared to 50 mm. For composting, four treatments (10 kg fresh weight each) were evaluated: treatment A (100 % SS + 0 % WHferm), treatment B (75 % SS + 25 % WHferm), treatment C (50 % SS + 50 % WHferm), and treatment D (25 % SS + 75 % WHferm). The WHferm added to SS, especially in treatments C (50 %) and D (75 %), increased the initial contents of organic matter (OM), organic carbon (CORG), CSOL, the C/N ratio, and the germination index (GI). The heavy metal content (HMC) (As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn) at the beginning was below the maximum allowed by USEPA regulations. All of the samples were free of Salmonella sp. from the beginning. The reduction of the CORG, CSOL, total Kjeldahl nitrogen (TKN), and C/N ratio indicated the degradation of the OM by day 198. The treatments with WHferm (B, C, and D) yielded higher values of electrical conductivity, cation exchange capacity, and GI than SS at day 198. No significant differences were observed in GI among the treatments with WHferm. The fecal coliforms were eliminated (<3 MPN g(-1)) and the helminths were reduced to ≤5 eggs/2 g during the process. The competition for nutrients and the presence of suppressive fungi of the genera Penicillium, Rhizopus, Paecilomyces (penicillin producers), and Fusariella isolated from the compost may have promoted the elimination of pathogens since no thermophile temperatures were obtained. WHferm as an amendment in the composting of SS improved the characteristics of the final product, especially when it was used in proportions of 25 and 50 %. An excellent product was obtained in terms of HMC, and the product was B class in terms of pathogens.

Estatura final de una población de prematuros con muy bajo peso al nacer / Final height in a population of preterm infants with very low birth weight

Los niños nacidos prematuros de muy bajo peso, tienen una mayor frecuencia de baja talla a la edad adulta. En la Argentina no contamos con reportes de estatura final de estos niños. Se evaluaron el peso y estatura de 46 jóvenes de la ciudad de Buenos Aires con antecedentes de prematurez y muy bajo peso al nacer egresados de 7 unidades neonatales de la ciudad de Buenos Aires y conurbano bonaerense, entre los años 1990 y 1995. Los 46 jóvenes (27 mujeres) tenían una edad promedio de 18.97 años (16.04 - 22.93). La estatura media de las mujeres fue de -0,71 sDS (0.20) y -0.75 sDS (0.22) en varones. Se detectó baja estatura en 2 mujeres (7.4%) y 1 varón (5.3%). La incidencia global de baja estatura es de 6.5% (AU)

Infants born prematurely with a very low birth weight more often have short stature in adulthood. In Argentina there are no reports on final height in these children. We evaluated weight and height of 46 adolescents and young adults from the city of Buenos Aires with a history of prematurity and very low birth weight who were discharged from seven Departments of Neonatology in the city of Buenos Aires and Greater Buenos Aires between 1990 y 1995. The 46 youth (27 females) had a mean age of 18.97 years (16.04 ­ 22.93). Mean height of the women was -0.71 SDS (0.20) and mean height of the men was -0.75 SDS (0.22). Low stature was observed in two women (7.4%) and one man (5.3%). Overall incidence of short stature was 6.5%. (AU)

Waterborne diseases in the state of Mexico, Mexico (2000-2005).

This paper reports a spatial-temporal examination of waterborne disease data from the State of Mexico, 2000 to 2005, by county as the spatial unit. It was found that the incidence of waterborne disease did not decrease during the period under study. Inequality between metropolitan areas and rural zones was observed. People living in population centres had lower incidence of water-related diseases, possibly due to better access to services. In all cases, children under five years old suffered a much higher relative morbidity than the population in general. Improvement of the water distribution network between 2000 and 2005 could explain the decrease in morbidity from 30% to 15%, for the total population, and from 34% to 18.5%, for children under five years old. Coverage of sewer services over the period was not substantially improved; as a result the coefficient of determination remained nearly constant: 16.5% for the total population and 25% for children under five. Maintenance and operation deficiencies in the water distribution and wastewater sanitation systems play an important role in the incidence of this type of disease. It was found that the institutional division of the territory does not correspond to the actual distribution of the risk areas.

[Effect of pamidronate infusion time on renal function in patients with multiple myeloma]. / Influencia del tiempo de perfusión de pamidronato en la función renal de pacientes con mieloma múltiple.

INTRODUCTION: Administration of biphosphonates in patients with renal failure requires a dosage adjustment. OBJECTIVES: Analyse renal function evolution in multiple myeloma patients after reducing infusion time for 90 mg pamidronate by 2 h. METHODS: In 2007, a retrospective study was carried out on all patients who presented multiple myeloma and bone metastasis treated with pamidronate administered every 4 h. Following a review of the literature, a protocol for administering pamidronate every 2 h was created in partnership with Haematology, and a specific dose reduction framework was established for patients with baseline renal failure. Additionally, a prospective follow-up study of those patients' renal function was completed to analyse its evolution after the change in infusion time. RESULTS: A total of six patients received 90 mg pamidronate every 4 h. 33.32% of the patients (2/6) presented baseline renal insufficiency, and therefore needed to have the pamidronate dose adjusted according to the new protocol. Subsequently, all of them received the treatment every 2 h, and one patient (16.6%) experienced altered renal function after two treatment cycles. DISCUSSION: Reducing administration time for pamidronate from four to 2 h did not lead to significant variations in patients' renal function. This therapeutic practice can improve patients' quality of life by shortening their hospital stay without aggravating their renal function.

Influencia del tiempo de perfusión de pamidronato en la función renal de pacientes con mieloma múltiple / Effect of pamidronate infusion time on renal function in patients with multiple myeloma

Introducción La administración de bifosfonatos requiere un ajuste de dosis en pacientes con insuficiencia renal. Objetivos Analizar la evolución de la función renal tras reducir 2h el tiempo de infusión de pamidronato en pacientes con mieloma múltiple. Métodos Estudio descriptivo retrospectivo de los pacientes que presentaban mieloma múltiple y metástasis óseas tratados con pamidronato administrado en 4h. Se elaboró un protocolo conjunto con Hematología para administrar pamidronato en 2h, realizándose un seguimiento prospectivo de la función renal de dichos pacientes. Resultados Un total de 6 pacientes recibieron pamidronato en 4h. Posteriormente, todos recibieron la administración en 2h, y uno de ellos (16,6%) evidenció alteración de la función renal. Discusión La reducción en el tiempo de administración de pamidronato no mostró variaciones significativas en la función renal de los pacientes. Esta práctica terapéutica podría mejorar la calidad de vida de los pacientes, al disminuir el tiempo de estancia hospitalaria, sin empeorar su función renal (AU)

Introduction Administration of biphosphonates in patients with renal failure requires a dosage adjustment. Objectives Analyse renal function evolution in multiple myeloma patients after reducing infusion time for 90mg pamidronate by 2h.MethodsIn 2007, a retrospective study was carried out on all patients who presented multiple myeloma and bone metastasis treated with pamidronate administered every 4h. Following a review of the literature, a protocol for administering pamidronate every 2h was created in partnership with Haematology, and a specific dose reduction framework was established for patients with baseline renal failure. Additionally, a prospective follow-up study of those patients’ renal function was completed to analyse its evolution after the change in infusion time. Results A total of six patients received 90mg pamidronate every 4h. 33.32% of the patients (2/6) presented baseline renal insufficiency, and therefore needed to have the pamidronate dose adjusted according to the new protocol. Subsequently, all of them received the treatment every 2h, and one patient (16.6%) experienced altered renal function after two treatment cycles (AU)

Mid-term results in total hip arthroplasty with the basic noncemented hip prosthesis.

The Basic (IQL-Biomet, Valencia, Spain) hip prosthesis was used in 430 implant procedures, of which 417 had mean follow-up of 6 years. Radiographic follow-up was performed at 1, 3, 6, and 12 months postoperatively, and annually thereafter. The average Harris hip score improved from 35.7 preoperatively to 90.9 postoperatively. Clinical results after 2 years of follow-up showed 6% thigh pain, which decreased to 2% at 6 years. Radiographic evaluation demonstrated 22 cases of calcar resorption, 14% of which had distal pedestal formation. Heterotopic ossification was noted radiographically in 36%. These mid-term results obtained with the Basic prosthesis are similar to the findings of other series and warrant its use.

[Cost-benefit analysis of fluoridating the public water supply of the city of Málaga]. / Análisis coste-beneficio de la fluoración de las aguas de abastecimiento público de la ciudad de Málaga.

The aim of the present study was to assess the cost-benefit of the program of fluoridation of the public water supply in the city of Málaga. Marginal benefits and the rate cost/benefit were the two parameters used to evaluate the cost-benefit. We have considered all the information available about similar experiences performed in other countries and about the particular aspects of the city in which this program was going to be set up. The cost of fluoridation per inhabitant per year and the effects of the cost of fluoridation on the price of the water supplied were also estimated. The program for the fluoridation of the public water supply in Málaga is profitable from the first year, as for each peseta spent we will benefit 2.10 pesetas. After 20 years of public water fluoridation the net benefit of this program will reach between 519 and 5,300 millions pesetas.