Fungal microbiota in newborn infants with and without respiratory distress syndrome.

BACKGROUND: Pneumocytis jirovecii infection in preterm newborns has recently been associated with neonatal respiratory distress syndrome and bronchopulmonary dysplasia. Changes in the bacterial microbiota of the airways have also been described in infants with bronchopulmonary dysplasia. However, until now there has been no information on the airway mycobiota in newborns. The purpose of this study was to describe the airway mycobiota in term and preterm newborns and its possible association with respiratory distress syndrome. METHODS: Twenty-six matched preterm newborns with and without respiratory distress syndrome were studied, as well as 13 term babies. The identification of the fungal microbiota was carried out using molecular procedures in aspirated nasal samples at birth. RESULTS: The ascomycota phylum was identified in 89.7% of newborns, while the basidiomycota phylum was found in 33.3%. Cladosporium was the predominant genus in both term and preterm infants 38.4% vs. 73% without statistical differences. Candida sake and Pneumocystis jirovecii were only found in preterm infants, suggesting a potential relationship with the risk of prematurity. CONCLUSIONS: This is the first report to describe the fungal microbiota of the airways in term and preterm infants with and without respiratory distress syndrome. Although no differences have been observed, the number of cases analyzed could be small to obtain conclusive results, and more studies are needed to understand the role of the fungal microbiota of the airways in neonatal respiratory pathology.

Racial disparity in the genomics of precision oncology of prostate cancer.

BACKGROUND: Significant racial disparities in prostate cancer incidence and mortality have been reported between African American Men (AAM), who are at increased risk for prostate cancer, and European American Men (EAM). In most of the studies carried out on prostate cancer, this population is underrepresented. With the advancement of genome-wide association studies, several genetic predictor models of prostate cancer risk have been elaborated, as well as numerous studies that identify both germline and somatic mutations with clinical utility. RECENT FINDINGS: Despite significant advances, the AAM population continues to be underrepresented in genomic studies, which can limit generalizability and potentially widen disparities. Here we outline racial disparities in currently available genomic applications that are used to estimate the risk of individuals developing prostate cancer and to identify personalized oncology treatment strategies. While the incidence and mortality of prostate cancer are different between AAM and EAM, samples from AAM remain to be unrepresented in different studies. CONCLUSION: This disparity impacts the available genomic data on prostate cancer. As a result, the disparity can limit the predictive utility of the genomic applications and may lead to the widening of the existing disparities. More studies with substantially higher recruitment and engagement of African American patients are necessary to overcome this disparity.

Therapeutic impact and routine application of next-generation sequencing: A single institute study.

Genomic sequencing of tumor tissues provides information on actionable gene aberrations that have diagnostic and therapeutic significance and may guide clinical management through the use of targeted therapies. The indications for these techniques and their possible limitations for application in daily practice should be established as a priority. In the present study, a group of patients with few suitable therapeutic options who were eligible for a next-generation sequencing (NGS) analysis were analyzed, and the molecular targets identified and their therapeutic impact are described. A series of 26 patients treated at the Virgen Macarena Hospital for whom an NGS study was requested between January 2017 and December 2019 were reviewed. Actionable molecular alterations were identified in 20 of the cases, and 4 patients received NGS-guided treatment. NGS techniques represent a novel opportunity for guiding treatment in cancer patients. Patients with few therapeutic alternatives, either due to diagnosis, atypical evolution or resistance to standard therapy, may be suitable candidates.

Bilateral superior oblique palsy: etiology and therapeutic options.

PURPOSE: To study the causes of bilateral superior oblique palsy (BSOP), treatment with botulinum toxin and/or surgery, and outcome of treatment. METHODS: This was an 11-year retrospective study of patients with BSOP treated with injections of botulinum toxin (Botox), surgery, or both. Treatment was considered successful when anomalous head turn and diplopia in primary gaze position and downgaze resolved. RESULTS: Bilateral superior oblique palsy was diagnosed in 12 patients (8 male; mean age, 29.5 years). Palsy was secondary to a neoplasm in 3 cases and to head trauma in 2. In 2 cases, it was ischemic, in 2 it was congenital; the remaining cases were iatrogenic (hydrocephalus secondary to meningitis, 1), hemorrhagic (1), and idiopathic (1). The clinical manifestations recorded were diplopia (10), anomalous head posture (9), V pattern (12), subjective excyclotorsion (8), and objective excyclotorsion (6). Recovery was spontaneous in 1 case with neoplastic disease. Botox was injected in 8 cases (inferior oblique and/or inferior rectus muscles [successful in 2]), and subsequent surgery was required in 6. Two patients underwent surgery without prior injection of Botox. The most common surgical technique was recession of the inferior oblique muscle (6 patients), either as the only operation or associated with other procedures. The final result was good in 72.72% (8/11). Mean follow-up was 62.6 months (range 9-99 months). CONCLUSIONS: Causes of BSOP were varied (most frequently neoplastic). Botox was effective as the only treatment in 25% (2/8). Outcome was good in a high percentage of cases with Botox, surgery, or both.

Factores de riesgo para infección respiratoria aguda en los barrios Ciudad Jardín y Pinos de Oriente, Tunja, Colombia / Risk factors for acute respiratory infection in the neighborhoods Ciudad Jardín and Pinos de Oriente, Tunja, Colombia

La infección respiratoria aguda es la principal causa de muerte en niños menores de cinco años. Diversos factores de riesgo se relacionan con su desarrollo, como el tabaquismo, las condiciones de la vivienda y la lactancia materna. Objetivo. Identificar los factores de riesgo asociados con la infección respiratoria aguda en un grupo de niños menores de 12 años de Ciudad Jardín y Pinos de Oriente, Tunja, en 2013. Materiales y métodos. Se trata de un estudio observacional de tipo descriptivo, transver-sal y prospectivo. La población estudiada fueron 200 niños menores de 12 años. Mediante muestreo aleatorio simple, se obtuvo una muestra de 136 niños, se encuestó a los acudientes de los niños y se registraron los datos en el instrumento diseñado para tal fin. Resultados. En la población estudiada existen factores de riesgo para la infección respira-toria aguda, principalmente: tiempo de lactancia (OR=1,11; IC95% 0,19-6,21), número de ventanas de la vivienda (OR=2,43; IC95% 0,52-11,20), tipo de piso de la vivienda (OR=6,21; IC95% 0,0-1,3) y tabaquismo en la madre (OR=4,08; IC95% 0,0-1,8). Conclusiones. Como factores de riesgo de infección respiratoria aguda, se encontraron el hecho que la vivienda cuente con piso de tierra y el que la madre sea fumadora.

Acute respiratory infection is the leading cause of death in children under age 5. Several risk factors are associated with its development, such as smoking, housing conditions, and breastfeeding. Objective: To identify risk factors associated with acute respiratory infection in a group of children under age 12 inhabiting Ciudad Jardín or Pinos de Oriente neighborhoods, Tunja, in 2013. Materials and Methods: An observational study of type descriptive, transversal and pro-spective was carried out; the studied population was 200 children under age 12; a sample of 136 children was obtained through simple random sampling. The people in charge of the children were surveyed and the data registration was recorded in the instrument designed for this purpose. Results: The studied population revealed risk factors associated mainly with breastfeeding time (OR=1.11, IC 95% 0.19-6.21), number of windows in the house (OR=2.43, IC 95% 0.52-11.20), flooring materials in the house (OR=6.21, IC 95% 0.0-1.3), and smoking in the mother (OR=4.08, IC 95% 0.0-1.8) Conclusions: AsRisk factors of acute respiratory infection were found fact that the house floor is made of dust and the mother was a smoker.