Efficacy of conduction hyperthermia in the treatment of non-muscle invasive bladder cancer: A systematic review.

INTRODUCTION: Intravesical treatment for non-muscle invasive bladder cancer (NMIBC) aims to reduce recurrences and stop progression. Hyperthermia-enhanced chemotherapy with devices like COMBAT BRS, Unithermia, and BR-TRG-I is a promising alternative to conventional Bacillus de Calmette Guerin (BCG) therapy. OBJECTIVE: To systematically review the efficacy of hyperthermia generated by conduction devices in the treatment of NMIBC. MATERIAL AND METHODS: The review followed the preferred reporting items for systematic reviews and meta-analyses guidelines. A search was performed in the PubMed, Cochrane Library, Scopus, and ClinicalTrials.gov databases. Two reviewers independently assessed the eligibility of candidate studies and abstracted data from studies that met the inclusion criteria. The primary endpoint was assessment of recurrence. Secondary objectives included evaluation of treatment progression and safety. RESULTS: Thirty studies meeting inclusion criteria underwent data extraction. In intermediate-risk NMIBC patients, COMBAT versus mitomycin C (MMC) in normothermia revealed no superiority in reducing recurrence or progression. High-risk NMIBC patients using COMBAT achieved similar or superior outcomes to BCG. BR-TRG-I demonstrated superior results over normothermia in intermediate- and high-risk NMIBC patients. Unithermia proved less effective than BCG in high-risk NMIBC. Progression outcomes were promising with COMBAT and BR-TRG-I, but comprehensive analysis was limited due to inconsistent assessment across studies. Adverse events were primarily mild-moderate, with some device-specific differences. CONCLUSIONS: Studies on conduction hyperthermia present great variability, which do not allow us to determine the superiority of 1 device over another in terms of recurrence, progression, and/or adverse effects. Further research with consistent administration protocols is crucial for definitive conclusions.

Epidemiología de la litiasis urinaria en el mundo y en España / Urinary stone epidemiology in Spain and worldwide

La litiasis urinaria es una patología cuya incidencia y prevalencia van en aumento tanto en países desarrollados como países subdesarrollados. De forma global, en Estados Unidos se ha visto incrementada su prevalencia del 3,2% en 1980 hasta el 10,1% en 2014. En España, este aumento también ha sido significativo, desde el 5% en 2005 hasta el 14,6% en 2016. En el resto del mundo sucede de forma similar, donde se observa un incremento medio en los últimos 15-20 años del 5-7% aproximadamente. La década de la vida entre los 40-60 años suele ser la de mayor incidencia de litiasis. En cuanto a sexo, en los últimos años ha existido una tendencia cada vez mayor en la mujer, asociada al cambio de dieta y la obesidad, fundamentalmente y actualmente no existen prácticamente diferencias entre sexos. Es una enfermedad más frecuente en el mundo occidental, aunque existen países del Oriente Medio como Arabia Saudí en donde la prevalencia es muy elevada, en torno al 20%. En cuanto a la composición litiásica, la de oxalato cálcico sigue siendo la más frecuente en torno al 70-80% con un incremento en los últimos años de la litiasis de ácido úrico y un descenso en la litiasis infectiva. En relación a la aparición de esta patología en los niños, es poco frecuente en los primeros años de vida, siendo más prevalente a partir de los 12-13 años e incrementándose en la adolescencia. Suele ser más frecuente en niñas que en niños y en la raza caucásica respecto a los afroamericanos. No existen diferencias en cuanto a la composición litiásica con respecto a los adultos, siendo el oxalato cálcico el compuesto más frecuente, pero con una prevalencia del 50-60%. Sin embargo, las causas y factores etiopatogénicos en los niños están peor estudiados y son menos conocidos que en los adultos

Urinary stones is a pathology whose incidence and prevalence are increasing in developed and underdeveloped countries. Overall, in the United States the prevalence has been increased from 3.2% in 1980 to 10.1% in 2014. In Spain, this increase has also been significant, from 5% in 2005 to 14.6% in 2016. In the rest of the world happens in a similar way, where an average increase is observed in the last 15-20 years of approximately 5-7%. The decade of life between 40-60 years is usually the highest incidence of stones. Regarding sex, in recent years there has been a growing in women, associated with a change in diet and obesity, and currently there are no differences between sex. It is a more frequent disease in the Western world, although there are countries in the Middle East such as Saudi Arabia where the prevalence is very high, around 20%. Respect the lithiasis composition, calcium oxalate continues to be the most frequent around 70-80%, with an increase in uric acid lithiasis in recent years and a decrease in infective lithiasis. In relation to the appearance of this pathology in children, it is rare in the first years of life, being more prevalent from 12-13 years of age and increasing in adolescence. It is usually more common in girls than in boys and in the Caucasian race compared to African Americans. There are no differences in lithiasic composition with respect to adults, calcium oxalate being the most frequent composition, but with a prevalence of 50-60%. However, the causes and etiopathogenic factors in children are less studied and well known than in adults

Maternal obesity is associated with gut microbial metabolic potential in offspring during infancy

Children born to obese mothers are at increased risk for obesity, but the mechanisms behind this association are not fully understood. Our study aimed to investigate differences in the functions encoded by the microbiome of infants at 18 months of age when the transition from early infant-feeding to solid family foods is established. To investigate the impact of maternal prepregnancy body mass index on infants' gut microbiome, faecal samples from infants born to normoweight (n = 21) and obese mothers (n = 18) were analysed by 16S rRNA gene sequencing and a functional-inference-based microbiome analysis. Our results indicated that Firmicutes was significantly enriched in infants born to normoweight mothers whereas Bacteroidetes was significantly enriched in infants born to obese women. In both microbiomes, the greatest number of genes (>50%) that were assigned a function encoded for proteins involved in "metabolism" among tier 1 KEGG Orthology (KO) categories. At lower KO functional categories, the microbiome of infants born to normoweight mothers was characterized by a significant enrichment in the abundances of "pentose phosphate pathway" (p = 0.037), "lysine biosynthesis" (p = 0.043), "glycerolipid metabolism" (p = 0.042), and "C5-branched dibasic acid metabolism" (p = 0.045). Notably, the microbiome of infants born to obese mothers was significantly enriched in "streptomycin biosynthesis" (p = 0.047), "sulphur metabolism" (p = 0.041), "taurine and hypotaurine metabolism" (p = 0.036), and "lipopolysaccharide biosynthesis" (p = 0.043). In summary, our study showed that maternal prepregnancy obesity may imprint a selective gut microbial composition during late infancy with distinct functional performances

Maternal, fetal and perinatal alterations associated with obesity, overweight and gestational diabetes: an observational cohort study (PREOBE).

BACKGROUND: Maternal overweight, obesity, and gestational diabetes (GD) have been negatively associated with offspring development. Further knowledge regarding metabolic and nutritional alterations in these mother and their offspring are warranted. METHODS: In an observational cohort study we included 331 pregnant women from Granada, Spain. The mothers were categorized into four groups according to BMI and their GD status; overweight (n:56), obese (n:64), GD (n:79), and healthy normal weight controls (n:132). We assessed maternal growth and nutritional biomarkers at 24 weeks (n = 269), 34 weeks (n = 310) and at delivery (n = 310) and the perinatal characteristics including cord blood biomarkers. RESULTS: Obese and GD mothers had significantly lower weight gain during pregnancy and infant birth weight, waist circumference, and placental weight were higher in the obese group, including a significantly increased prevalence of macrosomia. Except for differences in markers of glucose metabolism (glucose, HbA1c, insulin and uric acid) we found at some measures that overweight and/or obese mothers had lower levels of transferrin saturation, hemoglobin, Vitamin B12 and folate and higher levels of C-reactive protein, erythrocyte sedimentation rate, ferritin, and cortisol. GD mothers had similar differences in hemoglobin and C-reactive protein but higher levels of folate. The latter was seen also in cord blood. CONCLUSIONS: We identified several metabolic alterations in overweight, obese and GD mothers compared to controls. Together with the observed differences in infant anthropometrics, these may be important biomarkers in future research regarding the programming of health and disease in children. TRIAL REGISTRATION: The trial was registered at clinicaltrials.gov, identifier ( NCT01634464 ).