Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Measurement of colonic transit time in children

Transit times through the whole colon and its segments were measured in 10 healthy children and 14 children suffering constipation secondary to myelomenin-gocele. The subjects ingested radio-opaque markers on three successive days, and on the fourth a plain abdominal roentgenogram was taken using fast film. In the healthy children, total colonic transit time (mean ± SD) was 37.8 ± 6.2 h, with segmental times of 10.8 ± 3.5 h for the right colon, 12.2 ± 2.7 h for the left, and 14.7 ± 2.1 h for the rectosigmoid; upper normal limits of 17.8 h for the right colon, 17.6 h for the left, 19.1 h for the rectosigmoid, and 50.2 h for the total colonic transit time were established. In the constipated children, the total transit time was 59.9 ± 5.4 h, with segmental times of 15.9 ± 2.3 h for the right colon, 18.9 ± 2.3 h for the left, and 25.0 ± 2.6 h for the rectosigmoid. The technique described is simple, is easy to use in clinical practice, and involves a lower radiation dose than other methods. It may prove useful for measurement of colonic transit time in suitable patients. © 1991 Raven Press, Ltd. New York.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

A retrospective analysis of ingestion of caustic substances by children. Ten-year statistics in Galicia

We reviewed the case histories of 743 children seen at our hospital from 1981 to 1990 for suspected ingestion of caustic substances. Mean patient age was 27 months; 85% of patients were less than 3 years old. The male-to-female ratio was about 2:1. About 53% of patients were from urban environments. All ingestions appear to have been accidental. Of the 743 children, 20% presented oesophageal burns (11.8% first-degree, 3.1% second-degree and 2.7% third-degree). Alkaline products were ingested about 11 times more frequently than acid products. The substance ingested was bleach in 73% of cases. The most dangerous substances were dishwasher liquids/powders (59% of ingestions led to oesophageal burn), caustic soda (55%) and drain cleaners (55%). The caustic product was not in its original container in 75% of cases. Most accidents (58%) took place in the home. We did not detect any reliable predictive relationship between the presence of symptoms and signs and of oesophageal burns. Of the 743 patients, 5% developed oesophageal stricture and 3% required oesophageal dilatation. Conclusion: The incidence of accidents caused by the ingestion of caustic substances can only be reduced by broad-based preventive strategies, including enforcement of safe manufacturing practices and public education programmes. Most importantly, the containers for caustic household products should be cheap, small and childproof.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Relevance of herniography for accurate diagnosis of patent processus vaginalis in cryptorchidism

OBJECTIVE: To clarify the role of peritoneography in assessing the patency of processus vaginalis (PV) in pediatric patients diagnosed with cryptorchidism. MATERIALS AND METHODS: We designed a prospective clinical trial to evaluate the patency of PV in boys presenting cryptorchidism. Herniography was performed in 310 prepubertal boys. Data about the morphology of PV was compared with operative findings in those surgically treated patients. Retractile and ectopic testes were excluded from the study. RESULTS: Of the 376 undescended testes (310 patients), 281 cases were associated with an obliterated PV. Herniography revealed 95 cases of open PV in cryptorchid boys. The 244 normally descended testes had associated patent processus vaginalis in only 31 cases. CONCLUSIONS: Herniography is the most relevant procedure for accurate diagnosis of persistent PV. The persistence of PV was significantly more frequent when the position of the testes is more cranial. The incidence of an open PV decreases with age