Age-standardized incidence, mortality rate, and trend changes of thyroid cancer in the Balearic Islands during the 2000-2020 period: a population-based study.

Objective: Global thyroid cancer (TC) incidence is growing worldwide, but great heterogenicity exists among published studies, and thus, population-specific epidemiological studies are needed to adequate health resources and evaluate the impact of overdiagnosis. Methods: We conducted a Public Health System database retrospective review of TC incident cases from 2000 to 2020 in the Balearic Islands region and evaluated age-standardized incidence rate (ASIR), age at diagnosis, gender distribution, tumor size and histological subtype, mortality rate (MR), and cause of death. Estimated annual percent changes (EAPCs) were also evaluated and data from the 2000-2009 period were compared to the 2010-2020 period when neck ultrasound (US) was routinely performed by clinicians at Endocrinology Departments. Results: A total of 1387 incident cases of TC were detected. Overall, ASIR (×105) was 5.01 with a 7.82% increment in EAPC. A significant increase in the 2010-2020 period was seen for ASIR (6.99 vs 2.82, P < 0.001) and age at diagnosis (52.11 vs 47.32, P < 0.001) compared to the 2000-2009 period. A reduction in tumor size (2.00 vs 2.78 cm, P < 0.001) and a 6.31% increase in micropapillary TC (P < 0.05) were also seen. Disease-specific MR remained stable at 0.21 (×105). The mean age at diagnosis for all mortality groups was older than survivors (P < 0.001). Conclusion: The incidence of TC has grown in the 2000-2020 period in the Balearic Islands, but MR has not changed. Beyond other factors, a significant contribution of overdiagnosis to this increased incidence is likely due to changes in the routine management of thyroid nodular disease and increased availability of neck US.

In vitro grafting of hepatic spheroids and organoids on a microfluidic vascular bed.

With recent progress in modeling liver organogenesis and regeneration, the lack of vasculature is becoming the bottleneck in progressing our ability to model human hepatic tissues in vitro. Here, we introduce a platform for routine grafting of liver and other tissues on an in vitro grown microvascular bed. The platform consists of 64 microfluidic chips patterned underneath a 384-well microtiter plate. Each chip allows the formation of a microvascular bed between two main lateral vessels by inducing angiogenesis. Chips consist of an open-top microfluidic chamber, which enables addition of a target tissue by manual or robotic pipetting. Upon grafting a liver microtissue, the microvascular bed undergoes anastomosis, resulting in a stable, perfusable vascular network. Interactions with vasculature were found in spheroids and organoids upon 7 days of co-culture with space of Disse-like architecture in between hepatocytes and endothelium. Veno-occlusive disease was induced by azathioprine exposure, leading to impeded perfusion of the vascularized spheroid. The platform holds the potential to replace animals with an in vitro alternative for routine grafting of spheroids, organoids, or (patient-derived) explants.

Early invasion of the bladder wall by solitary bacteria protects UPEC from antibiotics and neutrophil swarms in an organoid model.

Recurrence of uropathogenic Escherichia coli (UPEC) infections has been attributed to reactivation of quiescent intracellular reservoirs (QIRs) in deep layers of the bladder wall. QIRs are thought to arise late during infection following dispersal of bacteria from intracellular bacterial communities (IBCs) in superficial umbrella cells. Here, we track the formation of QIR-like bacteria in a bladder organoid model that recapitulates the stratified uroepithelium within a volume suitable for high-resolution live-cell imaging. Bacteria injected into the organoid lumen enter umbrella-like cells and proliferate to form IBC-like bodies. In parallel, single bacteria penetrate deeper layers of the organoid wall, where they localize within or between uroepithelial cells. These "solitary" bacteria evade killing by antibiotics and neutrophils and are morphologically distinct from bacteria in IBCs. We conclude that bacteria with QIR-like properties may arise at early stages of infection, independent of IBC formation and rupture.

Hypocalcemia due to 22q11.2 deletion syndrome diagnosed in adulthood.

Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a genetic syndrome that may present with hypocalcemia due to primary hypoparathyroidism (PH) at any age. We report a new diagnosis of 22q11.2DS in a 57-year-old man who presented with symptomatic hypocalcemia. It is important to consider genetic causes of hypocalcemia due to PH regardless of age. LEARNING POINTS: It is important to discard genetic cause of primary hypoparathyroidism in a patient without autoimmune disease or prior neck surgery.A new diagnosis of a hereditary disease has familial implications and needs genetic counselling.It is also important to discard other syndrome's comorbidities.

Situación clínica de una cohorte de pacientes con diabetes tipo 1 más de 2 décadas después del inicio. Resultados de un programa específico de seguimiento en una unidad de referencia / Clinical status of a cohort of patients with type 1 diabetes diagnosed more than 2 decades before. Results of a specific clinical follow-up program

Antecedentes y objetivo: El curso clínico de la diabetes tipo 1 (DT1) ha cambiado en las últimas décadas. Nos propusimos describir las características de una población con DT1 de más de 20 años de evolución bajo el mismo programa de seguimiento desde el inicio. Pacientes y método: Estudio observacional de corte transversal en el que incluimos los pacientes del registro de inicios de DT1 entre 1986 y 1994 de nuestra Unidad de Diabetes. Desde 1986 todos siguen el mismo protocolo de seguimiento y tratamiento. Recogimos la presencia de complicaciones micro- y macrovasculares, factores de riesgo cardiovascular, control metabólico y tratamiento. Los datos se obtuvieron de la historia clínica informatizada. La comparación entre variables cuantitativas y cualitativas se realizó con el test apropiado en cada caso. Se consideró estadísticamente significativa una p<0,05. Resultados: De 279 pacientes del registro, 153 continuaban en nuestro centro (edad media±desviación estándar: 46,6±8,6 años) con una duración media de la DT1 de 23,3±2,6 años. De estos, un 53,6% eran mujeres. El 24,8% estaba en tratamiento con infusión subcutánea continua de insulina (ISCI). La media de HbA1c en el último año fue de 7,7±1,1% (7,3±1,5% en el grupo de ISCI) y de 7,8±0,9% en los últimos 5 años. Un 19,6% fumaban, 15,7% tenían hipertensión arterial y 37,9% dislipidemia. Un 20,4% presentaban retinopatía diabética y el 11,3% nefropatía. Únicamente un 1,3% presentaba antecedentes de enfermedad cardiovascular. Conclusiones: Tras más de 2 décadas de evolución de la DT1, consideramos que la prevalencia de complicaciones micro- y macrovasculares en nuestros pacientes con DT1 en un programa específico de seguimiento desde el inicio de la enfermedad es baja o, en algún caso, sustancialmente inferior a la esperada (AU)

Background and objective: The clinical course of type 1 diabetes mellitus (T1DM) has changed in recent decades. The aim of our study was to assess the long-term (> 20 years) clinical status of a patient cohort with T1DM under a specific treatment and follow-up program. Patients and methods: A single center, observational, cross-sectional study was conducted of a patient cohort diagnosed with T1DM in the 1986-1994 period at our tertiary university hospital. Clinical characteristics, metabolic parameters, and occurrence of chronic complications and comorbidities after > 20 years of follow-up were collected. All subjects entered our specific program for patients with newly-diagnosed T1D and were followed up using the same clinical protocol. Data are shown as mean (standard deviation) or as number of patients and percentage. The appropriate test was used to compare quantitative and qualitative data. A Pvalue <0.05 was considered statistically significant. Results: A total of 279 patients were recorded, of whom 153 (53.6% women; mean age 46.6±8.6 years; age at onset 23.3±8.8 years; disease duration, 23.3±2.6 years) continued to attend our diabetes unit at the time of the analysis. Of these patients, 24.8% were administered continuous subcutaneous insulin infusion (CSII). Mean HbA1c in the past 5 years and in the last year were7.8±0.9% and 7.7±1.1% respectively (7.3±1.5% in those given CSII). Smoking was reported by 19.6% of patients, while 15.7% had high blood pressure and 37.9% dyslipidemia. Diabetic retinopathy was diagnosed in 20.4%, and 11.3% of the total cohort had nephropathy. Only 1.3% of our patients had a history of CVD. Conclusions: Data collected from a cohort of patients with T1DM for more than 2 decades regularly followed up with a specific program in a tertiary university hospital suggest a remarkably low prevalence of diabetic complications (AU)

Clinical status of a cohort of patients with type 1 diabetes diagnosed more than 2 decades before. Results of a specific clinical follow-up program. / Situación clínica de una cohorte de pacientes con diabetes tipo 1 más de 2 décadas después del inicio. Resultados de un programa específico de seguimiento en una unidad de referencia.

BACKGROUND AND OBJECTIVE: The clinical course of type 1 diabetes mellitus (T1DM) has changed in recent decades. The aim of our study was to assess the long-term (> 20 years) clinical status of a patient cohort with T1DM under a specific treatment and follow-up program. PATIENTS AND METHODS: A single center, observational, cross-sectional study was conducted of a patient cohort diagnosed with T1DM in the 1986-1994 period at our tertiary university hospital. Clinical characteristics, metabolic parameters, and occurrence of chronic complications and comorbidities after > 20 years of follow-up were collected. All subjects entered our specific program for patients with newly-diagnosed T1D and were followed up using the same clinical protocol. Data are shown as mean (standard deviation) or as number of patients and percentage. The appropriate test was used to compare quantitative and qualitative data. A P value <0.05 was considered statistically significant. RESULTS: A total of 279 patients were recorded, of whom 153 (53.6% women; mean age 46.6±8.6 years; age at onset 23.3±8.8 years; disease duration, 23.3±2.6 years) continued to attend our diabetes unit at the time of the analysis. Of these patients, 24.8% were administered continuous subcutaneous insulin infusion (CSII). Mean HbA1c in the past 5 years and in the last year were7.8±0.9% and 7.7±1.1% respectively (7.3±1.5% in those given CSII). Smoking was reported by 19.6% of patients, while 15.7% had high blood pressure and 37.9% dyslipidemia. Diabetic retinopathy was diagnosed in 20.4%, and 11.3% of the total cohort had nephropathy. Only 1.3% of our patients had a history of CVD. CONCLUSIONS: Data collected from a cohort of patients with T1DM for more than 2 decades regularly followed up with a specific program in a tertiary university hospital suggest a remarkably low prevalence of diabetic complications.