Stable quantum-correlated many-body states through engineered dissipation.

Engineered dissipative reservoirs have the potential to steer many-body quantum systems toward correlated steady states useful for quantum simulation of high-temperature superconductivity or quantum magnetism. Using up to 49 superconducting qubits, we prepared low-energy states of the transverse-field Ising model through coupling to dissipative auxiliary qubits. In one dimension, we observed long-range quantum correlations and a ground-state fidelity of 0.86 for 18 qubits at the critical point. In two dimensions, we found mutual information that extends beyond nearest neighbors. Lastly, by coupling the system to auxiliaries emulating reservoirs with different chemical potentials, we explored transport in the quantum Heisenberg model. Our results establish engineered dissipation as a scalable alternative to unitary evolution for preparing entangled many-body states on noisy quantum processors.

Gender differences in workplace violence against physicians and nurses in Latin America: a survey from the Interamerican Society of Cardiology.

OBJECTIVES: To evaluate gender differences in workplace violence (WPV) against physicians and nurses in Latin America. STUDY DESIGN: Cross-sectional study. METHODS: A cross-sectional electronic survey was conducted between January 11 and February 28, 2022. A prespecified gender analysis was performed. RESULTS: Among the 3056 responses to the electronic survey, 57% were women, 81.6% were physicians, and 18.4% were nurses. At least one act of violence was experienced by 59.2% of respondents, with verbal violence being the most common (97.5%). Women experienced more WPV than men (65.8% vs 50.4%; P < 0.001; odds ratio [OR]: 1.89; 95% confidence interval [CI]: 1.63-2.19). Women were more likely to report at least one episode of WPV per week (19.2% vs 11.9%, P < 0.001), to request for psychological help (14.5% vs 9%, P = 0.001) and to experience more psychosomatic symptoms. In addition, women were more likely to report having considered changing their job after an aggression (57.6% vs 51.3%, P = 0.011) and even leaving their job (33% vs 25.7%, P = 0.001). In a multivariate analysis, being a woman (OR: 1.76), working in emergency departments (OR: 1.99), and with COVID-19 patients (OR: 3.3) were independently associated with more aggressive interactions, while older age (OR: 0.95) and working in a private setting (OR: 0.62) implied lower risk. CONCLUSIONS: Women are more likely to experience WPV and to report more psychosomatic symptoms after the event. Preventive measures are urgently needed, with a special focus on high-risk groups such as women.

Endourological treatment of ectopic ureterocele. Our experience in the last 15 years. / Tratamiento endourológico del ureterocele ectópico. Experiencia en los últimos 15 años.

OBJECTIVE: To assess the efficacy of the endourological treatment of ectopic ureterocele in children in a large series and with a long-term follow-up. MATERIALS AND METHODS: A retrospective, descriptive study of patients with ectopic ureterocele who had undergone surgery in our institution in the last 15 years was carried out. All patients were treated using an endourological approach, both for ureterocele and postoperative vesicoureteral reflux (VUR). RESULTS: 40 patients were treated -55% with left involvement and 5% with bilateral involvement. Mean age at diagnosis was 4.97 months, with diagnosis being established prenatally in 54.1% of cases. In all patients but one, endourological puncture of the ureterocele was conducted. Mean age at surgery was 6.96 months (0-1.11). Surgery was performed on an outpatient basis in 94.9% of patients. No perioperative complications were recorded. In the last 30 patients, preoperative voiding cystourethrography was not carried out. 72.5% of patients had postoperative VUR (44.8% into the upper pyelon, 10.3% into the lower pyelon, 17.2% into both, 6.9% into the contralateral system, and 20.7% into the bilateral system), but it was resolved with a single endoscopic procedure in 48.1% of cases (65% of patients were healed with two procedures). VUR was not endoscopically resolved in 3 patients who required ureteral re-implantation. 6 patients required heminephrectomy (n=3) or nephrectomy (n=3) as a result of functional impairment and infections. CONCLUSION: The endourological treatment of ectopic ureterocele is a little aggressive and little invasive technique that allows the obstruction to be resolved on an outpatient basis, which means bladder surgery -if required- can be performed outside the neonatal period.

OBJETIVO: Evaluar la eficacia del tratamiento endourológico del ureterocele ectópico en niños en una serie amplia y con seguimiento a largo plazo. MATERIAL Y METODOS: Estudio retrospectivo descriptivo de los pacientes con ureterocele ectópico intervenidos en nuestro centro en los últimos 15 años. Todos los pacientes se tratan por vía endourológica, tanto el ureterocele como el reflujo vesicoureteral (RVU) postoperatorio. RESULTADOS: Se trataron 40 pacientes, 55% eran izquierdos y 5% bilaterales. La edad media al diagnóstico fue de 4,97 meses siendo de diagnóstico prenatal el 54,1%. En todos los pacientes menos uno se realizó una punción endourológica del ureterocele. La edad media en el momento de la cirugía era de 6,96 meses (0-1,11). La cirugía fue ambulante en un 94,9% de los pacientes. No se registraron complicaciones perioperatorias. En los últimos 30 pacientes no se realizó cistouretrografía miccional preoperatoria. Un 72,5% de los pacientes presentaron RVU postoperatorio (44,8% a pielón superior, 10,3% a pielón inferior, 17,2% a ambos, 6,9% al sistema contralateral y 20,7% bilateral), pero este se resolvió con un único procedimiento endoscópico en un 48,1% de los casos (curación del 65% de los pacientes con dos procedimientos). El RVU no se resolvió de forma endoscópica en 3 pacientes que requirieron un reimplante ureteral. Seis pacientes precisaron heminefrectomía (n= 3) o nefrectomía (n= 3) por anulación funcional e infecciones. CONCLUSION: El tratamiento endourológico del ureterocele ectópico es una técnica poco agresiva invasiva que consigue la resolución de la obstrucción de forma ambulante permitiendo diferir la cirugía vesical (si fuera necesaria) fuera del periodo neonatal.

Tratamiento endourológico del ureterocele ectópico. Experiencia en los últimos 15 años / Endourological treatment of ectopic ureterocele. Our experience in the last 15 years

Objetivo: Evaluar la eficacia del tratamiento endourológico delureterocele ectópico en niños en una serie amplia y con seguimientoa largo plazo. Material y métodos: Estudio retrospectivo descriptivo de los pacientes con ureterocele ectópico intervenidos en nuestro centro en losúltimos 15 años. Todos los pacientes se tratan por vía endourológica,tanto el ureterocele como el reflujo vesicoureteral (RVU) postoperatorio. Resultados: Se trataron 40 pacientes, 55% eran izquierdos y 5%bilaterales. La edad media al diagnóstico fue de 4,97 meses siendo dediagnóstico prenatal el 54,1%. En todos los pacientes menos uno serealizó una punción endourológica del ureterocele. La edad media enel momento de la cirugía era de 6,96 meses (0-1,11). La cirugía fue ambulante en un 94,9% de los pacientes. No se registraron complicacionesperioperatorias. En los últimos 30 pacientes no se realizó cistouretrografía miccional preoperatoria. Un 72,5% de los pacientes presentaron RVUpostoperatorio (44,8% a pielón superior, 10,3% a pielón inferior, 17,2%a ambos, 6,9% al sistema contralateral y 20,7% bilateral), pero este seresolvió con un único procedimiento endoscópico en un 48,1% de loscasos (curación del 65% de los pacientes con dos procedimientos). ElRVU no se resolvió de forma endoscópica en 3 pacientes que requirieronun reimplante ureteral. Seis pacientes precisaron heminefrectomía (n= 3)o nefrectomía (n= 3) por anulación funcional e infecciones. Conclusión: El tratamiento endourológico del ureterocele ectópicoes una técnica poco agresiva invasiva que consigue la resolución de laobstrucción de forma ambulante permitiendo diferir la cirugía vesical(si fuera necesaria) fuera del periodo neonatal.(AU)

Objective: To assess the efficacy of the endourological treatmentof ectopic ureterocele in children in a large series and with a long-termfollow-up. Materials and methods: A retrospective, descriptive study ofpatients with ectopic ureterocele who had undergone surgery in ourinstitution in the last 15 years was carried out. All patients were treatedusing an endourological approach, both for ureterocele and postoperativevesicoureteral reflux (VUR). Results: 40 patients were treated – 55% with left involvement and5% with bilateral involvement. Mean age at diagnosis was 4.97 months,with diagnosis being established prenatally in 54.1% of cases. In allpatients but one, endourological puncture of the ureterocele was conducted. Mean age at surgery was 6.96 months (0-1.11). Surgery wasperformed on an outpatient basis in 94.9% of patients. No perioperativecomplications were recorded. In the last 30 patients, preoperative voidingcystourethrography was not carried out. 72.5% of patients had postoper-ative VUR (44.8% into the upper pyelon, 10.3% into the lower pyelon,17.2% into both, 6.9% into the contralateral system, and 20.7% into thebilateral system), but it was resolved with a single endoscopic procedurein 48.1% of cases (65% of patients were healed with two procedures).VUR was not endoscopically resolved in 3 patients who required ureteral remplantation. 6 patients required heminephrectomy (n=3) ornephrectomy (n=3) as a result of functional impairment and infections. Conclusion: The endourological treatment of ectopic ureterocele isa little aggressive and little invasive technique that allows the obstructionto be resolved on an outpatient basis, which means bladder surgery – ifrequired – can be performed outside the neonatal period.(AU)

Formation of robust bound states of interacting microwave photons.

Systems of correlated particles appear in many fields of modern science and represent some of the most intractable computational problems in nature. The computational challenge in these systems arises when interactions become comparable to other energy scales, which makes the state of each particle depend on all other particles1. The lack of general solutions for the three-body problem and acceptable theory for strongly correlated electrons shows that our understanding of correlated systems fades when the particle number or the interaction strength increases. One of the hallmarks of interacting systems is the formation of multiparticle bound states2-9. Here we develop a high-fidelity parameterizable fSim gate and implement the periodic quantum circuit of the spin-½ XXZ model in a ring of 24 superconducting qubits. We study the propagation of these excitations and observe their bound nature for up to five photons. We devise a phase-sensitive method for constructing the few-body spectrum of the bound states and extract their pseudo-charge by introducing a synthetic flux. By introducing interactions between the ring and additional qubits, we observe an unexpected resilience of the bound states to integrability breaking. This finding goes against the idea that bound states in non-integrable systems are unstable when their energies overlap with the continuum spectrum. Our work provides experimental evidence for bound states of interacting photons and discovers their stability beyond the integrability limit.

Buried penis secondary to ectopic scrotum. / Pene oculto secundario a ectopia escrotal.

INTRODUCTION: Ectopic scrotum is a rare clinical entity, potentially associated with other congenital abnormalities. We present the case of a patient with buried penis secondary to ectopic scrotum. The surgical technique was described, and a literature review was carried out. CLINICAL CASE: 1-year-old patient with ectopic right hemiscrotum and the testes within the scrotal sac. A double Z-plasty was performed with two flaps - one above the penis, surrounding the ectopic scrotum, and the other one at the scrotum to modify the bifid scrotum. The upper flap was rotated downwards, which allowed ectopy to be repaired, and the lower flap was used to repair bifidity. No postoperative complications were recorded. Follow-time was 6 months, with good final cosmetic results. DISCUSSION: Ectopic scrotum is an infrequent congenital malformation. Cutaneous rotation flaps with Z-plasties are a valid treatment option, with good long-term cosmetic results.

INTRODUCCION: La ectopia escrotal constituye una entidad clínica rara, que puede asociar otras anomalías congénitas. Presentamos el caso de un paciente con un pene oculto secundario a una ectopia escrotal, con descripción de la técnica quirúrgica y revisión de la literatura. CASO CLINICO: Paciente de un año de vida que presentaba un hemiescroto derecho ectópico con testes en bolsa. Se diseñó una doble Z-plastia con realización de dos colgajos, uno suprapeneano rodeando el escroto ectópico y otro escrotal para modificar el escroto bífido. El colgajo superior se rotó hacia abajo corrigiendo la ectopia y el colgajo inferior corregió la bifidez. No se produjeron complicaciones posoperatorias. El tiempo de seguimiento fue de seis meses con buen aspecto estético final. COMENTARIOS: El escroto ectópico es una malformación congénita infrecuente. Los colgajos de rotación cutáneos con Z-plastias son una opción válida de tratamiento con buenos resultados estéticos a largo plazo.

Pene oculto secundario a ectopia escrotal / Buried penis secondary to ectopic scrotum

Introducción: La ectopia escrotal constituye una entidad clínicarara, que puede asociar otras anomalías congénitas.Presentamos el caso de un paciente con un pene oculto secundario auna ectopia escrotal, con descripción de la técnica quirúrgica y revisiónde la literatura. Caso clínico: Paciente de un año de vida que presentaba un he-miescroto derecho ectópico con testes en bolsa. Se diseñó una dobleZ-plastia con realización de dos colgajos, uno suprapeneano rodeandoel escroto ectópico y otro escrotal para modificar el escroto bífido.El colgajo superior se rotó hacia abajo corrigiendo la ectopia y elcolgajo inferior corregió la bifidez. No se produjeron complicacionesposoperatorias. El tiempo de seguimiento fue de seis meses con buenaspecto estético final.Comentarios: El escroto ectópico es una malformación congénitainfrecuente. Los colgajos de rotación cutáneos con Z-plastias son una op-ción válida de tratamiento con buenos resultados estéticos a largo plazo.(AU)

Introduction: Ectopic scrotum is a rare clinical entity, potentiallyassociated with other congenital abnormalities. We present the case ofa patient with buried penis secondary to ectopic scrotum. The surgicaltechnique was described, and a literature review was carried out. Clinical case: 1-year-old patient with ectopic right hemiscrotumand the testes within the scrotal sac. A double Z-plasty was performedwith two flaps – one above the penis, surrounding the ectopic scrotum,and the other one at the scrotum to modify the bifid scrotum. The up-per flap was rotated downwards, which allowed ectopy to be repaired,and the lower flap was used to repair bifidity. No postoperative com-plications were recorded. Follow-time was 6 months, with good finalcosmetic results. Discussion: Ectopic scrotum is an infrequent congenital malfor-mation. Cutaneous rotation flaps with Z-plasties are a valid treatmentoption, with good long-term cosmetic results.(AU)

Experience, prevalence, need for treatment and cost of care for caries: A multicenter study in a developing country.

OBJECTIVE: To assess the experience, prevalence, need for treatment and economic impact of caries among students 6-12 years old in four cities in Mexico. BASIC RESEARCH DESIGN: Cross-sectional clinical study. SETTING: Elementary public schools. PARTICIPANTS: 500 schoolchildren aged 6 to 12 years. METHOD: Oral clinical examinations using WHO criteria for caries in the primary (dmft) and permanent (DMFT) dentitions. MAIN OUTCOME MEASURES: Indicators of caries in the primary and permanent dentitions: experience, prevalence, severity and the Significant Caries Index. In addition, we calculated the treatment needs, dental care rate and cost of care. RESULTS: dmft in the primary dentition was 2.59±2.83, and DMFT was 0.82±1.44 in the permanent dentition. Caries prevalence reached 67.7% in the primary and 34.1% in permanent dentition. The treatment needs index was 85.9% and 91.3% in the primary and permanent dentitions, respectively; the dental care index was 13.9% and 8.5%, respectively. The cost of care for caries in the primary dentition was estimated at $22.087 millions of international dollars (PPP US$) when amalgam was the restorative material used, and PPP US$19.107 millions for glass ionomer. For the permanent dentition, the cost was PPP US$7.431 millions when amalgam was used and PPP US$7.985 millions when resin/composite was used as restorative material. CONCLUSIONS: The prevalence and experience of caries in the primary dentition were 50% greater than those of other studies carried out in Mexico. In the permanent dentition they were less. There is considerable need for the treatment of caries and minimal experience with restorative care. The cost of care for caries may be assumed to be high for a health system such as Mexico's.

Closing nutrient loops in a maize rotation. Catch crops to reduce nutrient leaching and increase biogas production by anaerobic co-digestion with dairy manure.

Three catch crop species, ryegrass, forage rape and black oat, were grown between successive rotations of maize to reduce nitrogen leaching due to maize fertilization with digested dairy manure. Catch crops showed a high nutrient uptake, but with a wide range, depending on the year and the specie. Ensiling was shown to be a feasible storing method increasing catch crop methane production per hectare between 14-36% compared with fresh catch crop. In semi-continuous co-digestion experiments, methane production was increased between 35-48%, in comparison with anaerobic digestion of dairy manure alone. Catch crops were shown to be a good co-substrate, being a sustainable option to prevent leaching of nutrients to the environment, thus closing the loops from production to utilization by optimal recycling measures.

Solar drying in the vineyard: a sustainable technology for the recovery of nutrients from winery organic waste.

The present study describes a pilot-scale experimental validation of a forced-convection greenhouse solar dryer, combined with a biofilter, for controlled atmospheric emissions. This set-up was applied to the dewatering of sewage sludge from a biological plant that treated process wastewater in a commercial Mediterranean winery. Experiments were performed after the harvest, from September onwards, during the peak generation of sludge. The average drying rate during the first 10 days of operation ranged from 1.17 to 2.24 kg m-2 d-1, depending on the measurement method, during which the water content of the sludge was reduced from 90% down to 67%. Biofiltration was quite inefficient against greenhouse gases (methane and dinitrous oxide), and direct emissions during the drying process were on average 57 g CO2-eq m-2 d-1. Ammonia and volatile organic compounds were removed with average efficiencies of 71% and 35%, but ammonia losses through volatilization represented less than 2% of the initial nitrogen content. The sludge was dried further during November, to the lowest possible water content of 14%. Both the intermediate and final sludge dried materials were characterized for their agronomical value as organic fertilizers.

Immunophenotypic Pattern of De Novo Malignancy After Liver Transplantation.

Long-term survival after liver transplantation is affected by de novo neoplasia. The incidence of this type of malignancy is increased in the setting of immunosuppressive therapy. The aim of this study was to characterize the immunologic pattern of liver transplant recipients with de novo malignancies. Fifty-one liver recipients were studied, 19 of whom had a history of de novo neoplasia. Immunophenotypic patterns among patients with/without tumors were compared. The subpopulations of CD4+ T lymphocytes and CD8+ T lymphocytes differed between the 2 types of patients studied. In patients with tumor, activation membrane markers in CD4+ T lymphocytes and CD8+ T-lymphocytes, such as CD56 or CD25, were expressed in a greater proportion, whereas activation markers CD314 and CD16 were reduced in CD56bright natural killer (NK) cells. We concluded that cytotoxic response seems to be more activated in de novo neoplasia patients, which highlights the still unknown malignancy risk effect on these immune cells.

Next generation flow for minimally-invasive blood characterization of MGUS and multiple myeloma at diagnosis based on circulating tumor plasma cells (CTPC).

Here, we investigated for the first time the frequency and number of circulating tumor plasma cells (CTPC) in peripheral blood (PB) of newly diagnosed patients with localized and systemic plasma cell neoplasms (PCN) using next-generation flow cytometry (NGF) and correlated our findings with the distinct diagnostic and prognostic categories of the disease. Overall, 508 samples from 264 newly diagnosed PCN patients, were studied. CTPC were detected in PB of all active multiple myeloma (MM; 100%), and smoldering MM (SMM) patients (100%), and in more than half (59%) monoclonal gammopathy of undetermined significance (MGUS) cases (p <0.0001); in contrast, CTPC were present in a small fraction of solitary plasmacytoma patients (18%). Higher numbers of CTPC in PB were associated with higher levels of BM infiltration and more adverse prognostic features, together with shorter time to progression from MGUS to MM (p <0.0001) and a shorter survival in MM patients with active disease requiring treatment (p ≤ 0.03). In summary, the presence of CTPC in PB as assessed by NGF at diagnosis, emerges as a hallmark of disseminated PCN, higher numbers of PB CTPC being strongly associated with a malignant disease behavior and a poorer outcome of both MGUS and MM.

Current applications of multiparameter flow cytometry in plasma cell disorders.

This corrects the article DOI: 10.1038/bcj.2017.90.

Evaluación del efecto de Aloe barbadensis sobre el peso en ratones normopesos y obesos / Evaluation of the effect of Aloe barbadensis on weight in normal and obese mice

La obesidad es el trastorno metabólico más frecuente, para el tratamiento es fundamental el cambio del tipo alimentación y mantener un estilo de vida saludable. La publicidad engañosa sobre productos denominados milagrosos conlleva a un consumo desmedido, no controlado y sin previa evaluación de los resultados sobre el peso y/o la posible toxicidad de los mismos. Se diseñó una investigación preliminar en ratones, para verificar el efecto del zumo de Aloe barbadensis y un producto comercial sobre el peso de ratones normopesos y obesos inducidos por glutamato monosódico (GMS), después de cuatro semanas de tratamiento. El grupo de ratones inducidos a obesidad con GMS, presentaron un porcentaje de cambio de peso de 160,5±37,5%, mientras que en el grupo de ratones normopesos fue de 59,4±12,1%, esta diferencia resultó significativa (p<0,001). En los ratones obesos que recibieron el zumo de A.barbadensis se logró un descenso no significativo de peso de 2,8% con respecto al peso al inicio de la intervención (p 0,05). En los ratones obesos tratados con el producto comercial se observó un aumento de peso, aunque en menor proporción que los obesos que recibieron agua (3,5% y 4,4%, respectivamente). Los resultados indican que el zumo de Aloe barbadensis induce un descenso de peso mayor en los animales obesos, comparado con el producto comercial, sin embargo, esto no es significativo en el periodo de observación. Palabras claves: Aloe barbadensis, peso corporal, obesidad, glutamato monosódico, ratón.

Obesity is the most frequent metabolic disorder, for the treatment is fundamental to change the type of food and maintain a healthy lifestyle. Misleading advertising of so-called miraculous products leads to excessive, uncontrolled consumption and without prior evaluation of the effect on weight or their possible toxicity. A preliminary investigation was designed in mice, to verify the effect of the juice of Aloe barbadensis and a commercial product on the weight of normal and obesemice induced by monosodium glutamate(MSG),after four weeks of treatment. The group of mice induced to obesity with MSG had a weight change percentage of 160.5 ± 37.5%, while in the group with normal body weight was of 59.4 ± 12.1%, this difference was significant (p<0,001). In the obese mice that received the juice of A. barbadensis, a non-significant weight decrease of 2.8% was achieved when compared with the weight at the beginning of the intervention (p0.05). In obese mice treated with the commercial product,an increase in weight was observed, although in a smaller proportion than the obese ones that received water (3.5% and 4.4%, respectively). The results indicated that Aloe barbadensis juice induced a greater weight loss in obese animals, compared to the commercial product, however, this is not significant in the period considered. Key words: Aloe barbadensis, body weight, obesity, monosodic glutamate, mice.

Automated database-guided expert-supervised orientation for immunophenotypic diagnosis and classification of acute leukemia.

Precise classification of acute leukemia (AL) is crucial for adequate treatment. EuroFlow has previously designed an AL orientation tube (ALOT) to guide towards the relevant classification panel (T-cell acute lymphoblastic leukemia (T-ALL), B-cell precursor (BCP)-ALL and/or acute myeloid leukemia (AML)) and final diagnosis. Now we built a reference database with 656 typical AL samples (145 T-ALL, 377 BCP-ALL, 134 AML), processed and analyzed via standardized protocols. Using principal component analysis (PCA)-based plots and automated classification algorithms for direct comparison of single-cells from individual patients against the database, another 783 cases were subsequently evaluated. Depending on the database-guided results, patients were categorized as: (i) typical T, B or Myeloid without or; (ii) with a transitional component to another lineage; (iii) atypical; or (iv) mixed-lineage. Using this automated algorithm, in 781/783 cases (99.7%) the right panel was selected, and data comparable to the final WHO-diagnosis was already provided in >93% of cases (85% T-ALL, 97% BCP-ALL, 95% AML and 87% mixed-phenotype AL patients), even without data on the full-characterization panels. Our results show that database-guided analysis facilitates standardized interpretation of ALOT results and allows accurate selection of the relevant classification panels, hence providing a solid basis for designing future WHO AL classifications.

Prognostic value of antigen expression in multiple myeloma: a PETHEMA/GEM study on 1265 patients enrolled in four consecutive clinical trials.

Persistence of minimal residual disease (MRD) after treatment for myeloma predicts inferior outcomes, but within MRD-positive patients there is great heterogeneity with both early and very late relapses. Among different MRD techniques, flow cytometry provides additional information about antigen expression on tumor cells, which could potentially contribute to stratify MRD-positive patients. We investigated the prognostic value of those antigens required to monitor MRD in 1265 newly diagnosed patients enrolled in the GEM2000, GEM2005MENOS65, GEM2005MAS65 and GEM2010MAS65 protocols. Overall, CD19pos, CD27neg, CD38lo, CD45pos, CD81pos, CD117neg and CD138lo expression predicted inferior outcomes. Through principal component analysis, we found that simultaneous CD38lowCD81posCD117neg expression emerged as the most powerful combination with independent prognostic value for progression-free survival (HR:1.69; P=0.002). This unique phenotypic profile retained prognostic value among MRD-positive patients. We then used next-generation flow to determine antigen stability throughout the course of the disease, and found that the expression of antigens required to monitor MRD is mostly stable from diagnosis to MRD stages, except for CD81 whose expression progressively increased from baseline to chemoresistant tumor cells (14 vs 28%). Altogether, we showed that the phenotypic profile of tumor cells provides additional prognostic information, and could be used to further predict risk of relapse among MRD-positive patients.

Diabetes or hypertension as risk indicators for missing teeth experience: An exploratory study in a sample of Mexican adults.

BACKGROUND: To determine an exploratory estimation of the strength of type 2 diabetes mellitus (T2DM) and hypertension diagnoses as risk indicators for missing teeth in a sample of Mexican adults. MATERIALS AND METHODS: A comparative cross-sectional study of sixty adult patients in a health center in Mexico included as dependent variable, the number of missing teeth (and having a functional dentition) and as independent variables, diagnoses for diabetes or hypertension, age, sex, maximum level of schooling, and tobacco use. Of the 60 participants, 20 were diagnosed with T2DM, 13 with hypertension, and 27 were otherwise diagnosed as healthy in their most recent medical checkup. A negative binomial regression (NBR) model was generated. RESULTS: Mean age was 50.7 ± 16.2 and 50.0% were women. Mean number of missing teeth was 4.98 ± 4.17. In the multivariate NBR model, we observed that individuals with T2DM had higher risk of more missing teeth (incidence rate ratios [IRRs] = 3.13; 95% confidence interval [CI] = 2.09-4.69), followed by those with hypertension (IRRs = 2.63; 95% CI = 1.77-3.90). In addition, participants with current tobacco use were significantly more likely to have suffered tooth loss (P < 0.05) than those who were never smokers or former smokers, just like older participants (P < 0.05). CONCLUSIONS: T2DM and hypertension are independently associated with higher experience of missing teeth in an open adult population in Mexico. Future studies with a more sophisticated epidemiological design and encompassing a more detailed landscape of chronic diseases, type and length of use of long-term medications, and patterns of dental care use are needed to better delineate these associations.

Current applications of multiparameter flow cytometry in plasma cell disorders.

Multiparameter flow cytometry (MFC) has become standard in the management of patients with plasma cell (PC) dyscrasias, and could be considered mandatory in specific areas of routine clinical practice. It plays a significant role during the differential diagnostic work-up because of its fast and conclusive readout of PC clonality, and simultaneously provides prognostic information in most monoclonal gammopathies. Recent advances in the treatment and outcomes of multiple myeloma led to the implementation of new response criteria, including minimal residual disease (MRD) status as one of the most relevant clinical endpoints with the potential to act as surrogate for survival. Recent technical progress led to the development of next-generation flow (NGF) cytometry that represents a validated, highly sensitive, cost-effective and widely available technique for standardized MRD evaluation, which also could be used for the detection of circulating tumor cells. Here we review current applications of MFC and NGF in most PC disorders including the less frequent solitary plasmocytoma, light-chain amyloidosis or Waldenström macroglobulinemia.

Posibilidades terapéuticas de las urolitiasis en la infancia / Therapeutic possibilities for urolithiasis in childhood

Objetivos: Presentamos nuestra casuística de urolitiasis infantiles, técnicas empleadas en su tratamiento y sus resultados. Material y métodos: Estudio retrospectivo de urolitiasis infantiles de tracto urinario superior (TUS) tratadas en nuestro centro entre 2003-2014. Recogimos datos demográficos, clínicos, diagnósticos, terapéuticos y complicaciones. El plan terapéutico fue recogido como procedimiento aislado (litotricia extracorpórea, ureterorrenoscopia, nefrolitotomía o cirugía) o terapia combinada. Resultados: Estudiamos 41 unidades renoureterales en 32 pacientes. La mediana de edad se situó en 5 años (rango 11 meses-14 años). El tamaño medio fue de 12,9 mm (± 7,3 mm). La localización: 23 (56%) en pelvis renal (coraliformes en 15 casos), 10 (24%) en cáliz inferior y 8 (20%) ureterales. Realizamos 80 procedimientos, sin diferencias en los grupos de edad, encontrando 12 complicaciones (15%), sin presencia de ningún cuadro séptico secundario a litotricia. Las litiasis en localización ureteral tuvieron un 100% de tasa de éxito con la ureterorrenoscopia. El porcentaje de curación global fue del 90%. Conclusión: El abordaje de la urolitiasis en la infancia ofrece múltiples alternativas, por lo que es importante individualizar en función del tamaño, localización y composición del cálculo. En nuestro centro la utilización de LEOC en niños es segura. La URS, semirrígida o flexible, obtiene excelentes resultados en el uréter. La NLP con mínimo acceso se puede realizar en niños pequeños y lactantes

Objectives: We present our case studies on paediatric urolithiasis, the techniques employed in its treatment and its results. Material and methods: A retrospective study of paediatric urolithiasis of the upper urinary tract (UUT) treated at our centre between 2003 and 2014. We recorded demographic, clinical, diagnostic and therapeutic data and the complications. The therapeutic plan was recorded as isolated (extracorporeal lithotripsy, ureterorenoscopy, nephrolithotomy or surgery) or combined therapy. Results: We examined 41 renal/urethral units in 32 patients. The median age was 5 years (range, 11 months-14 years). The mean size was 12.9 cm (± 7.3 mm). The locations were as follows: 23 (56%) in the renal pelvis (stag horn in 15 cases), 10 (24) in lower calyx and 8 (20%) in the urethra. We performed 80 procedures, with no differences in the age groups, which resulted in 12 complications (15%) but no septic condition secondary to lithotripsy. Stone removal from the urethra had a 100% success rate with the ureterorenoscopy. The overall cure rate was 90%. Conclusion: The paediatric urolithiasis approach offers multiple alternatives. It is therefore important to tailor the procedure according to the size, location and composition of the stone. In our centre, the use of paediatric extracorporeal shock wave lithotripsy is safer. Ureterorenoscopy, semirigid or flexible, provides excellent results in ureters. Percutaneous nephrolithotomy with minimal access can be performed on small children and nursing infants

Therapeutic possibilities for urolithiasis in childhood. / Posibilidades terapéuticas de las urolitiasis en la infancia.

OBJECTIVES: We present our case studies on paediatric urolithiasis, the techniques employed in its treatment and its results. MATERIAL AND METHODS: A retrospective study of paediatric urolithiasis of the upper urinary tract (UUT) treated at our centre between 2003 and 2014. We recorded demographic, clinical, diagnostic and therapeutic data and the complications. The therapeutic plan was recorded as isolated (extracorporeal lithotripsy, ureterorenoscopy, nephrolithotomy or surgery) or combined therapy. RESULTS: We examined 41 renal/urethral units in 32 patients. The median age was 5 years (range, 11 months-14 years). The mean size was 12.9cm (±7.3mm). The locations were as follows: 23 (56%) in the renal pelvis (staghorn in 15 cases), 10 (24) in lower calyx and 8 (20%) in the urethra. We performed 80 procedures, with no differences in the age groups, which resulted in 12 complications (15%) but no septic condition secondary to lithotripsy. Stone removal from the urethra had a 100% success rate with the ureterorenoscopy. The overall cure rate was 90%. CONCLUSION: The paediatric urolithiasis approach offers multiple alternatives. It is therefore important to tailor the procedure according to the size, location and composition of the stone. In our centre, the use of paediatric extracorporeal shock wave lithotripsy is safer. Ureterorenoscopy, semirigid or flexible, provides excellent results in ureters. Percutaneous nephrolithotomy with minimal access can be performed on small children and nursing infants.