Nontuberculous mycobacteria in cystic fibrosis patients on the Island of Gran Canaria. A population study.

OBJECTIVE: To determine the prevalence of nontuberculous mycobacteria (NTM) colonization and disease in cystic fibrosis (CF) patients. PATIENTS AND METHODS: All the CF patients followed-up from 2002 to 2012 with three acid-fast bacilli (AFB) cultures were included. The American Thoracic Society (ATS) criteria for NTM lung disease were applied. RESULTS: Forty-four of the 53 patients being followed-up were included. The mean time of follow-up was 7.0 years. A total of 18 patients (40.9%) were NTM positive. The NTN mean annual prevalence was 14.1%. The risk of Mycobacterium abscessus complex was higher in the group of 10-14 years-old (p < 0.001). Ten patients (22.7% of the entire cohort) met the ATS microbiological criteria. The mean annual prevalence of NTM disease was 10.4%. Seven patients (four with Mycobacterium simiae and three with M. abscessus complex) with multiple positive cultures, positive AFB smears and clinical worsening were treated. Three patients with M. simiae and none of those with M. abscessus were cured. CONCLUSIONS: Overall NTM prevalence of colonization and disease were high in our CF patients. Patients <15 years old had a higher risk of M. abscessus complex colonization. Multiple positive cultures or positive AFB smears were associated with disease.

[Cochlear implant in hypoacusis with alteration of connexin 26]. / Implante coclear en hipoacusias con alteración de la conexina 26.

OBJECTIVE: The objective of this paper is to assess the benefits of cochlear implantation in a population of profound prelingual congenital deaf children with mutation of Connexin 26 (DFNB1 phenotype), compared with a population of profound congenital deaf children without mutation of this gene. PATIENTS AND METHOD: This retrospective study was carried out in 36 children with cochlear implants under the age of 6. All had profound congenital bilateral sensorineural hearing impairment, without cochlear malformation. Fifteen children were diagnosed as having DFNB1 and homozygous 30-35delG mutation, and 21 had no mutation of Connexin 26 (Cx26). All of them used Nucleus 24K or ST cochlear implants, with complete non-traumatic insertion of the electrodes, and follow-up was 12 months. RESULTS: There is no significant difference in pure tone audiometry and logoaudiometric tests between the 2 groups, children diagnosed as having DFNB1 (homozygous 30-35delG mutation) and children without mutation of Cx26. However, the population with DFNB1 shows a tendency to achieve better results more quickly in vowels and bisyllabic word tests 12 months after implantation. CONCLUSIONS: The cochlear implant is an effective therapy for children with profound prelingual congenital hearing loss with mutation of Cx26.

Adjuvant Ozonetherapy in Advanced Head and Neck Tumors: A Comparative Study.

Advanced head and neck (H&N) tumors have a poor prognosis, and this is worsened by the occurrence of hypoxia and ischemia in the tumors. Ozonetherapy has proved useful in the treatment of ischemic syndromes, and several studies have described a potential increase of oxygenation in tissues and tumors. The aim of this prospective study was to evaluate the clinical effect of ozonetherapy in patients with advanced H&N cancer in the course of their scheduled radiotherapy. Over a period of 3 years, 19 patients with advanced H&N tumors who were undergoing treatment in our department with non-standard fractionated radiotherapy plus oral tegafur. A group of 12 patients was additionally treated with intravenous chemotherapy before and/or during radiotherapy. In the other group of seven patients, systemic ozonetherapy was administered twice weekly during radiotherapy. The ozonetherapy group was older (64 versus 54 years old, P = 0.006), with a higher percentage of lymph node involvement (71% versus 8%, P = 0.019) and with a trend to more unfavorable tumor stage (57% versus 8% IVb + IVc stages, P = 0.073). However, there was no significant difference in overall survival between the chemotherapy (median 6 months) and ozonetherapy (8 months) groups. Although these results have to be viewed with caution because of the limited number of patients, they suggest that ozonetherapy could have had some positive effect during the treatment of our patients with advanced H&N tumors. The adjuvant administration of ozonetherapy during the chemo-radiotherapy for these tumors merits further research.