Morphology of Roots and Canals of Maxillary First Premolars: A CBCT Study in a Peruvian Sample.

Introduction: It is important to take into account variations in structures related to dental pulp for planning the most adequate endodontic treatment management. The objective of this study was to determine the morphology of roots and canals of maxillary first premolars (MFPs) using cone-beam computed tomography (CBCT). Materials and Methods: This retrospective study included a sample of 392 CBCTs of Peruvian adults proportionally selected by sex, age, and quadrant. One MFP per individual was selected for evaluation by a calibrated evaluator based on the number of roots and canal configuration according to the Vertucci classification (VC; Cohen's κ ≥ 0.834). Pearson's χ 2 and Kruskal-Wallis tests were used with a significance level of P < 0.05. Results: Most MFP presented double roots (59.9%) and were VC type IV (52%). Morphology showed a nonsignificant difference by quadrants (P=0.994). A significant positive association was found between the presence of double roots and type IV in men and with older age, while single roots and type I and II were associated with women and younger age (P < 0.05). Double roots were associated with VC type IV (86%) and single roots with types III (34%), II (32%), and I (26%; P < 0.001). Conclusions: MFPs in a Peruvian sample presented a higher frequency of double roots with two separate canals. The morphology of root and canals was associated with age and sex.

Serum Glial Fibrillary Acidic Protein and Neurofilament Light Chain Levels Reflect Different Mechanisms of Disease Progression under B-Cell Depleting Treatment in Multiple Sclerosis.

OBJECTIVE: To investigate the longitudinal dynamics of serum glial fibrillary acidic protein (sGFAP) and serum neurofilament light chain (sNfL) levels in people with multiple sclerosis (pwMS) under B-cell depleting therapy (BCDT) and their capacity to prognosticate future progression independent of relapse activity (PIRA) events. METHODS: A total of 362 pwMS (1,480 samples) starting BCDT in the Swiss Multiple Sclerosis (MS) Cohort were included. sGFAP levels in 2,861 control persons (4,943 samples) provided normative data to calculate adjusted Z scores. RESULTS: Elevated sGFAP levels (Z score >1) at 1 year were associated with a higher hazard for PIRA (hazard ratio [HR]: 1.80 [95% CI: 1.17-2.78]; p = 0.0079) than elevated sNfL levels (HR, 1.45 [0.95-2.24], p = 0.0886) in a combined model. Independent of PIRA events, sGFAP levels longitudinally increased by 0.49 Z score units per 10 years follow-up (estimate, 0.49 [0.29, 0.69], p < 0.0001). In patients experiencing PIRA, sGFAP Z scores were 0.52 Z score units higher versus stable patients (0.52 [0.22, 0.83], p = 0.0009). Different sNfL Z score trajectories were found in pwMS with versus without PIRA (interaction p = 0.0028), with an average decrease of 0.92 Z score units per 10 years observed without PIRA (-0.92 [-1.23, -0.60], p < 0.0001), whereas levels in patients with PIRA remained high. INTERPRETATION: Elevated sGFAP and lack of drop in sNfL after BCDT start are associated with increased risk of future PIRA. These findings provide a rationale for combined monitoring of sNfL and sGFAP in pwMS starting BCDT to predict the risk of PIRA, and to use sGFAP as an outcome in clinical trials aiming to impact on MS progressive disease biology. ANN NEUROL 2024.

Evaluating CD1a Immunohistochemistry for Tegumentary Leishmaniasis Diagnosis in the New World: A Focus on Colombia.

INTRODUCTION: Leishmaniasis, a chronic vector-borne disease caused by parasites of the genus Leishmania, presents diagnostic challenges. Conventional diagnostic methods struggle with accurate visualization of these parasites. Immunostaining with CD1a has demonstrated effectiveness in visualizing Leishmania parasites, particularly in the Old World. However, the application of CD1a immunostaining in Colombian leishmaniasis remains unexplored. OBJECTIVE: To determine the utility of CD1a as an immunomarker in detecting chronic forms of tegumentary leishmaniasis. MATERIALS AND METHODS: This proof-of-concept study involved 48 paraffin-embedded samples categorized into 3 groups: moderate-to-high parasite load (n = 15), low load (n = 15), and chronic granulomatous inflammation (n = 13); 5 samples diagnosed with cutaneous histoplasmosis. These samples were stained with the immunomarker CD1a clone EP3622 for comparative analysis. In addition, CD1a immunohistochemistry was compared with 18S rDNA qPCR and hematoxylin-eosin staining to evaluate its performance in relation to these established methods. RESULTS: CD1a immunohistochemistry was positive in 46.51% of the samples evaluated. This immunomarker showed lower sensitivity and negative predictive value than 18S rDNA qPCR and hematoxylin-eosin staining; specificity and negative predictive value were consistent. ROC indicated inferior discrimination for leishmaniasis compared with 18 s rDNA qPCR and hematoxylin-eosin staining. CONCLUSIONS: Immunohistochemistry for CD1a could be a diagnostic support in the detection of chronic forms of tegumentary leishmaniasis.

Effectiveness of a Motivational Interviewing-Based Intervention in Decreasing Risky Alcohol Use in Primary Care Patients in Spain: A Controlled Clinical Trial.

OBJECTIVE: Our study aimed to evaluate the effectiveness of an intervention based on Motivational Interviewing (MI) performed by healthcare professionals in Primary Care (PC) patients with risky alcohol use through a multicenter, two-arm parallel, cluster-randomized, open-label controlled clinical trial. METHODS: PC professionals were randomized into two groups: an Experimental Group (EG) and a Control Group (CG). The study was carried out in PC centers of the Andalusian Health Service, located in Cordoba, Spain. An MI-based approach was implemented with patients recruited in the EG, while health advice was provided to those included in the CG. The follow-up period was 12 months, with five visits scheduled. The consumption of standard drinking units per week was quantified, and risky alcohol use was estimated using the Alcohol Use Disorders Identification Test (AUDIT). An intention-to-treat statistical analysis was performed. Relative risk (RR), absolute risk reduction (ARR) and the number of subjects needed to treat (NNT) were used to estimate the intervention effect size. RESULTS: A total of 268 patients were included, 148 in the EG and 120 in the CG. Considering the quantification of risky alcohol use, the ARR at 12 months after baseline visit was 16.46% (95% CI: 5.37-27.99), with an NNT of 6 (95% CI: 4-19). According to the AUDIT, the ARR at 12 months was 13.15% (95% CI: 2.73-24.24%), and the NNT was 8 (95% CI: 4-37). CONCLUSIONS: We concluded that MI is more effective than the usual health advice in decreasing risky alcohol use in patients treated in PC.

Inflammatory response to SARS-CoV 2 and other respiratory viruses.

INTRODUCTION: Lower respiratory tract infections (LRTI) remain a significant global cause of mortality and disability. Viruses constitute a substantial proportion of LRTI cases, with their pandemic potential posing a latent threat. After the SARS-CoV-2 pandemic, the resurgence of other respiratory viruses, including Influenza and Respiratory Syncytial Virus responsible for LRTI has been observed especially in susceptible populations. AREAS COVERED: This review details the inflammatory mechanisms associated with three primary respiratory viruses: SARS-CoV-2, Influenza, and Respiratory Syncytial Virus (RSV). The focus will be on elucidating the activation of inflammatory pathways, understanding cellular contributions to inflammation, exploring the role of interferon and induced cell death in the response to these pathogens and detailing viral evasion mechanisms. Furthermore, the distinctive characteristics of each virus will be explained. EXPERT OPINION: The study of viral pneumonia, notably concerning SARS-CoV-2, Influenza, and RSV, offers critical insights into infectious and inflammatory mechanisms with wide-ranging implications. Addressing current limitations, such as diagnostic accuracy and understanding host-virus interactions, requires collaborative efforts and investment in technology. Future research holds promise for uncovering novel therapeutic targets, exploring host microbiome roles, and addressing long-term sequelae. Integrating advances in molecular biology and technology will shape the evolving landscape of viral pneumonia research, potentially enhancing global public health outcomes.

Prison vaccination programmes: the impact of the SARS-CoV-2 virus and future challenges.

Vaccination has traditionally been one of the primary prevention activities to which most effort has been devoted in Spanish penitentiary institutions. Once again, the type 2 coronavirus pandemic causing severe acute respiratory syndrome (SARS-CoV-2) pandemic has highlighted the importance of vaccination in the control of immunopreventable diseases. After overcoming the health emergency caused by the coronavirus disease 2019 (COVID-19), we face the challenge of recovering the vaccination coverage we had before the pandemic, in addition to increasing the coverage of other vaccines with lesser implantation in our environment. Among the improvement strategies to be implemented would be the optimization of the transmission of health information between penitentiary centers dependent on different administrations. It would also be desirable to be able to access the vaccine information systems of the different autonomous communities, both to know the vaccination status of patients and to report the doses administered during the period of internment, as well as to improve the vaccine statistics available in prison.

Identification of host endotypes using peripheral blood transcriptomics in a prospective cohort of patients with endocarditis.

OBJECTIVES: Host responses to infection are a major determinant of outcome. However, the existence of different response profiles in patients with endocarditis has not been addressed. Our objective was to apply transcriptomics to identify endotypes in patients with infective endocarditis. METHODS: A total of 32 patients with infective endocarditis were studied. Clinical data and blood samples were collected at diagnosis and RNA sequenced. Gene expression was used to identify two clusters (endocarditis endotype 1 [EE1] and endocarditis endotype 2 [EE2]). RNA sequencing was repeated after surgery. Transcriptionally active cell populations were identified by deconvolution. Differences between endotypes in clinical data, survival, gene expression, and molecular pathways involved were assessed. The identified endotypes were recapitulated in a cohort of COVID-19 patients. RESULTS: A total of 18 and 14 patients were assigned to EE1 and EE2, respectively, with no differences in clinical data. Patients assigned to EE2 showed an enrichment in genes related to T-cell maturation and a decrease in the activation of the signal transducer and activator of transcription protein family pathway, with higher counts of active T cells and lower counts of neutrophils. A total of 14 patients (nine in EE1 and five in EE2) were submitted to surgery. Surgery in EE2 patients shifted gene expression toward a EE1-like profile. In-hospital mortality was higher in EE1 (56% vs 14%, P = 0.027), with an adjusted hazard ratio of 12.987 (95% confidence interval 3.356-50). Translation of these endotypes to COVID-19 and non-COVID-19 septic patients yielded similar results in cell populations and outcome. CONCLUSIONS: Gene expression reveals two endotypes in patients with acute endocarditis, with different underlying pathogenetic mechanisms, responses to surgery, and outcomes.

Differential regulation of the proteome and phosphoproteome along the dorso-ventral axis of the early Drosophila embryo.

The initially homogeneous epithelium of the early Drosophila embryo differentiates into regional subpopulations with different behaviours and physical properties that are needed for morphogenesis. The factors at top of the genetic hierarchy that control these behaviours are known, but many of their targets are not. To understand how proteins work together to mediate differential cellular activities, we studied in an unbiased manner the proteomes and phosphoproteomes of the three main cell populations along the dorso-ventral axis during gastrulation using mutant embryos that represent the different populations. We detected 6111 protein groups and 6259 phosphosites of which 3398 and 3433 were differentially regulated, respectively. The changes in phosphosite abundance did not correlate with changes in host protein abundance, showing phosphorylation to be a regulatory step during gastrulation. Hierarchical clustering of protein groups and phosphosites identified clusters that contain known fate determinants such as Doc1, Sog, Snail, and Twist. The recovery of the appropriate known marker proteins in each of the different mutants we used validated the approach, but also revealed that two mutations that both interfere with the dorsal fate pathway, Toll10B and serpin27aex do this in very different manners. Diffused network analyses within each cluster point to microtubule components as one of the main groups of regulated proteins. Functional studies on the role of microtubules provide the proof of principle that microtubules have different functions in different domains along the DV axis of the embryo.

Weight-adjusted waist index predicts metabolic syndrome in Caucasian patients with obesity.

BACKGROUND AND AIMS: the usefulness of the weight-adjusted waist index (WWI) among persons with metabolic syndrome (MS) has not been previously evaluated. The objective of this study was to evaluate the ability of WWI to predict MS in a Caucasian population with obesity. METHODS: we conducted a cross sectional study in 2162 Caucasian patients with obesity. Anthropometric data (weight, height, body mass index [BMI], waist circumference, [WWI]), bioimpedanciometer parameters (total fat mass [FM], skeletal muscle mass [SMM] and skeletal muscle mass index [SMMi]), blood pressure, presence of MS and biochemical parameters were recorded and compared by tertiles of WWI. RESULTS: a total of 1,176 subjects had MS (54.4 %) and 986 did not show MS (45.6 %). Compared with the lowest WWI category Q1 (< 11.24 cm/√kg), the prevalence of MS increased in the logistic regression model adjusted by sex and age in the Q3 group (OR = 2.53, 95 % CI = 1.71-3.23; p = 0.001). In addition, the prevalence of MS was higher in the Q3 group than in Q2 (OR = 1.65, 95 % CI = 1.25-2.17; p = 0.005). Finally, the prevalence of MS in Q2 was higher than in the Q1 group (OR = 1.21, 95 % CI = 1.06-3.11; p = 0.01). The area under the curve (AUC) to assess the ability of WWI to identify MS showed values of 0.811 (0.687-0.871; p = 0.001). The cut-off point according to the Youden index was 11.59, with sensitivity and specificity of 70 % and 93.4 %, respectively. CONCLUSION: we described a good accuracy of WWI to identify MS an independent association between WWI in Caucasian patients with obesity.

Corrigendum: Real-world experience with secukinumab in the entire axial spondyloarthritis spectrum.

[This corrects the article DOI: 10.3389/fmed.2023.1156557.].

Effectiveness of High-Protein Energy-Dense Oral Supplements on Patients with Malnutrition Using Morphofunctional Assessment with AI-Assisted Muscle Ultrasonography: A Real-World One-Arm Study.

Background: User-friendly tools for assessing nutrition status and interventions in malnourished patients are crucial. This study evaluated the effectiveness of a personalised nutrition intervention using a novel oral nutritional supplement and AI-supported morphofunctional assessment to monitor clinical outcomes in patients with disease-related malnutrition (DRM). Methods: This prospective observational study involved patients receiving concentrated high-protein, high-calorie ONS (cHPHC-ONS), per usual clinical practice. Comprehensive assessments were performed at baseline (B0) and three months (M3) post-intervention. Results: 65 patients participated in the study. Significant decreases were observed in the percentage weight loss from B0 (-6.75 ± 7.5%) to M3 (0.5 ± 3.48%) (p < 0.01), in the prevalence of malnutrition (B0: 93.4%; M3: 78.9%; p < 0.01), severe malnutrition (B0: 60.7%; M3: 40.3%; p < 0.01), and sarcopenia (B0: 19.4%; M3: 15.5%; p < 0.04). Muscle area increased (p = 0.03), and there were changes in the echogenicity of the rectus femoris muscle (p = 0.03) from B0 to M3. In patients aged ≥60, an increase in muscle thickness (p = 0.04), pennation angle (p = 0.02), and handgrip strength (p = 0.04) was observed. There was a significant reduction in the prevalence of malnutrition (B0: 93.4%; M3: 78.9%; p < 0.01) and severe malnutrition (B0: 60.7%; M3: 40.3%; p < 0.01). Conclusions: In patients with DRM, a personalised intervention with cHPHC-ONS significantly reduces the prevalence of malnutrition, severe malnutrition, and sarcopenia and improves muscle mass and function.

Spanish catheter ablation registry. 23rd official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2023).

INTRODUCTION AND OBJECTIVES: We report the results of the 2023 Spanish catheter ablation registry. METHODS: Procedural data were collected and incorporated into the REDCap platform by all participating centers through a specific form. RESULTS: There were 104 participating centers in 2023 compared with 103 in 2022. In 2023, the total number of ablation procedures was 26 207, indicating a stabilization of the increase observed in 2022 following the pandemic. The increase was mainly due to procedures for atrial fibrillation (AF), with a total of 9942 ablations, representing 38% of all substrates. Notably, pulse-field ablation represented 10.3% of all AF ablation procedures, leading single-shot ablation strategies to outnumber point-by-point AF ablation for the first time in the history of the registry. Cavotricuspid isthmus ablation remained the second most targeted substrate (19% of all substrates, n=5067). The overall acute success rate remained high (97%), with a downward trend in the complication rate (1.6% vs 1.8% in 2022) and mortality rate (0.03%; n=7). Compared with 2022, there was a significant increase in procedures performed using electro-anatomical mapping and zero-fluoroscopy techniques for cavotricuspid isthmus ablation (52% vs 26%), AV node re-entrant tachycardia (48% vs 34%), and accessory pathways (62% vs 22%). We registered 466 ablations in pediatric patients. CONCLUSIONS: The data indicate a stabilization in the post-pandemic increase in ablation procedures, with an absolute and relative increase in AF as the predominant substrate. Success rates remained stable with a modest reduction in complication and mortality rates.

Evaluation of Muscle Mass and Malnutrition in Patients with Colorectal Cancer Using the Global Leadership Initiative on Malnutrition Criteria and Comparing Bioelectrical Impedance Analysis and Computed Tomography Measurements.

OBJECTIVES: The aim of this investigation was to evaluate the discrepancies between bioelectrical impedance analysis (BIA) and computed tomography (CT) in assessing skeletal muscle mass and identifying low muscle mass in patients with colorectal cancer. METHODS: This study recruited 137 patients with colorectal cancer from February 2028 to December 2023. CT scans were analyzed at the Lumbar 3 vertebral level to determine the area of skeletal muscle, which was then utilized to estimate whole-body skeletal muscle mass. [BIA] was also employed to measure skeletal muscle. Both skeletal muscle mass values [kg] were divided by height2 [m2] to calculate the skeletal muscle index [SMI, kg/m2], denoted as SMI-CT and SMI-BIA, respectively. RESULTS: The median age was 69.8 + 9.5 years, with the sex ratio being 88/49 [male/female]. Whereas more than one-third of the patients were classified as malnourished based on the Global Leadership Initiative on Malnutrition GLIM-CT criteria using L3-SMI [n = 36.5%], fewer patients were classified as malnourished based on GLIM-BIA using SMI-BIA [n = 19.0%]. According to the CT analysis [low SMI-L3], 52 [38.0%] patients were diagnosed as having poor muscle mass, whereas only 18 [13.1%] patients were identified as having low muscle mass using BIA [low SMIBIA]. The measured SMI showed a positive association with SMI-CT in all patients [r = 0.63, p < 0.001]. Using Bland-Altman evaluation, a significant mean bias of 0.45 + 1.41 kg/m2 [95% CI 0.21-0.70; p < 0.001] between SMI-BIA and SMI-CT was reported. Receiver operating characteristic (ROC) curves were generated to detect poor muscle mass using SMI-BIA with CT as the gold standard. The area under the curve (AUC) for SMI-BIA in identifying poor muscle mass was 0.714 (95% CI: 0.624-0.824), with a good cut-off value of 8.1 kg/m2, yielding a sensitivity of 68.3% and a specificity of 66.9%. CONCLUSIONS: BIA generally overestimates skeletal muscle mass in colorectal cancer patients when contrasted to CT. As a result, BIA may underestimate the prevalence of poor muscle mass and malnutrition according to the GLIM criteria in this patient population.

Long-Term Risks of Benign and Malign Complications after Endoscopic Sphincterotomy in the Management of Benign Biliopancreatic Pathology: A Cohort Study.

BACKGROUND:  Endoscopic retrograde cholangiopancreatography (ERCP) is the preferred technique for treating pathologies of the bile duct. It has been suggested that this procedure, combined with sphincterotomy, may influence the subsequent development of long-term complications. The main objective of this study was to determine the long-term complications of biliopancreatic disease after ERCP and their potential association with the development of biliopancreatic neoplasms. METHODS:  This retrospective cohort study included 576 patients who underwent ERCP (referred to as index ERCP) with sphincterotomy for benign biliary disease, with a minimum follow-up period of more than 2 years. RESULTS:  The incidence of long-term benign and neoplastic pathologies after ERCP was analyzed. The most common findings were recurrence of choledocholithiasis in 70 patients (12.1%), cholangitis "sine materia" in 27 patients (4.7%), and acute pancreatitis in 8 patients (1.4%). Eight patients (1.4%) developed hepatobiliopancreatic neoplasms, including 4 cases of pancreatic neoplasms (0.7%), 1 cholangiocarcinoma (0.2%), 1 ampulloma (0.2%), and 2 intrahepatic neoplasms (0.3%). Multivariate analysis revealed that factors such as age over 50 years, previous biliary surgery, diversion of the bile duct (BD) to the digestive tract, dilation of the BD, stent placement, biopsy, and cholecystectomy were factors associated with an increased risk of long-term benign complications. CONCLUSION:  Endoscopic retrograde cholangiopancreatography with sphincterotomy is associated with an increased long-term risk of subsequent benign biliopancreatic disease. However, our data do not allow us to establish a direct relationship with the development of biliopancreatic neoplasms.

Mechanical Stretch Induces Senescence of Lung Epithelial Cells and Drives Fibroblast Activation by Paracrine Mechanisms.

Severe lung injury requiring mechanical ventilation may lead to secondary fibrosis. Senescence, a cell response characterized by cell cycle arrest and a shift towards a proinflammatory/profibrotic phenotype, is one of the involved mechanisms. Here, we explore the contribution of mechanical stretch as trigger of senescence of the respiratory epithelium and its link with fibrosis. Human lung epithelial cells and fibroblasts were exposed in vitro to mechanical stretch, and senescence assessed. In addition, fibroblasts were exposed to culture media preconditioned by senescent epithelial cells and their activation was studied. Transcriptomic profiles from stretched, senescent epithelial cells and activated fibroblasts were combined to identify potential activated pathways. Finally, the senolytic effects of digoxin were tested in these models. Mechanical stretch induced senescence in lung epithelial cells, but not in fibroblasts. This stretch-induced senescence has specific features compared to senescence induced by doxorubicin. Fibroblasts were activated after exposure to supernatants conditioned by epithelial senescent cells. Transcriptomic analyses revealed notch signaling as a potential responsible for the epithelial-mesenchymal crosstalk, as blockade of this pathway inhibits fibroblast activation. Treatment with digoxin reduced the percentage of senescent cells after stretch and ameliorated the fibroblast response to preconditioned media. These results suggest that lung fibrosis in response to mechanical stretch may be caused by the paracrine effects of senescent cells. This pathogenetic mechanism can be pharmacologically manipulated to improve lung repair.

Centrally administered growth hormone secretagogue receptor antagonist DLys decreases alcohol intake and preference in male mice.

Alcohol use disorder (AUD) is a highly prevalent public health problem. The ghrelin system has been identified as a potential target for therapeutic intervention for AUD. Previous work showed that systemic administration of the growth hormone secretagogue receptor (GHSR) antagonist DLys reduced alcohol intake and preference in male mice. Yet, it is unclear whether central or peripheral GHSRs mediated these effects. We hypothesized that alcohol consumption is driven by central GHSRs and addressed this hypothesis by testing the effects of central administration of DLys. Male C57BL/6J mice consumed alcohol in a two-bottle choice procedure (10% ethanol versus water). DLys (2 nmol) was administered intracerebroventricularly for 7 days to examine alcohol intake and preference. DLys decreased alcohol intake and preference but had no effect on food intake. The effects on alcohol intake and preference persisted after several administrations, indicating lack of tolerance to DLys' effects. These results suggest that central administration of DLys is sufficient to reduce alcohol drinking and that DLys remains effective after several administrations when given intracerebroventricularly. Moreover, this work suggests that the effects of intracerebroventricularly administered DLys are specific to alcohol and do not generalize to other calorie-driven behaviors.

Proposing an AI Passport as a Mitigating Action of Risk Associated to Artificial Intelligence in Healthcare.

The integration of Artificial Intelligence (AI) in healthcare signifies a substantial shift, offering benefits to patients and healthcare systems while also introducing new risks. The emphasis on patient safety and performance standards is pivotal, especially with the European Union's strides towards regulating AI through the AI Act. This act focuses on classifying AI systems based on risk levels, mandating stringent requirements for high-risk AI, enhancing transparency, and ensuring ethics in AI applications. The concept of an "AI passport" is introduced as a living document detailing the AI system's purpose, ethical declarations, training, evaluation, and potential biases. This passport aims to enhance transparency and safety in medical AI applications, serving as a comprehensive record for patients, clinicians, and stakeholders. The AI passport, structured in JSON format, encapsulates key information about the AI system as a mechanism for continuous performance evaluation and transparency. This initiative may represent a significant step towards mitigating the risks associated with AI in healthcare, emphasizing the importance of accountability, transparency, and patient safety in the development and application of AI technologies.

Adjuvant-Induced Autoimmune Syndrome: A Bibliometric Analysis.

The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) encompasses various autoimmune conditions triggered by exposure to substances with adjuvant activity. Despite its potential relevance to public health, global scientific production on ASIA syndrome is significantly limited. This knowledge gap underscores the need for a comprehensive bibliometric assessment to understand global research in this field. Therefore, this article aims to conduct a bibliometric analysis to identify and evaluate research trends related to ASIA syndrome worldwide. A Scopus search identified scientific documents published between 2010 and 2022. A total of 2,133 articles meeting inclusion criteria were selected and analyzed for scientific production, authors, and institutions. Two-hundred fifty six documents were analyzed, mostly journal articles with multiple authors. The year with the highest publications was 2023, marking a notable increase since 2021. Italy and Israel had the most documents and citations, correlating with authors Yehuda Shoenfeld (Israel) and Carlo Perricone (Italy). Standout journals are "The Journal of Immunologic Research" and "Lupus." Relevant affiliations include Tel-Aviv University and the National Autonomous University of Mexico. This article identifies and analyzes scientific trends associated with ASIA syndrome. Despite increased publications, this field remains controversial and lacks full acceptance within the medical and scientific community, as evidenced by limited scientific production compared to other pathologies. These findings may motivate researchers to generate impactful publications, contributing to the global knowledge expansion on this syndrome.

Vital Signs: Trends and Disparities in Childhood Vaccination Coverage by Vaccines for Children Program Eligibility - National Immunization Survey-Child, United States, 2012-2022.

Introduction: The Vaccines for Children (VFC) program was established in 1994 to provide recommended vaccines at no cost to eligible children and help ensure that all U.S. children are protected from life-threatening vaccine-preventable diseases. Methods: CDC analyzed data from the 2012-2022 National Immunization Survey-Child (NIS-Child) to assess trends in vaccination coverage with ≥1 dose of measles, mumps, and rubella vaccine (MMR), 2-3 doses of rotavirus vaccine, and a combined 7-vaccine series, by VFC program eligibility status, and to examine differences in coverage among VFC-eligible children by sociodemographic characteristics. VFC eligibility was defined as meeting at least one of the following criteria: 1) American Indian or Alaska Native; 2) insured by Medicaid, Indian Health Service (IHS), or uninsured; or 3) ever received at least one vaccination at an IHS-operated center, Tribal health center, or urban Indian health care facility. Results: Overall, approximately 52.2% of U.S. children were VFC eligible. Among VFC-eligible children born during 2011-2020, coverage by age 24 months was stable for ≥1 MMR dose (88.0%-89.9%) and the combined 7-vaccine series (61.4%-65.3%). Rotavirus vaccination coverage by age 8 months was 64.8%-71.1%, increasing by an average of 0.7 percentage points annually. Among all children born in 2020, coverage was 3.8 (≥1 MMR dose), 11.5 (2-3 doses of rotavirus vaccine), and 13.8 (combined 7-vaccine series) percentage points lower among VFC-eligible than among non-VFC-eligible children. Conclusions and implications for public health practice: Although the VFC program has played a vital role in increasing and maintaining high levels of childhood vaccination coverage for 30 years, gaps remain. Enhanced efforts must ensure that parents and guardians of VFC-eligible children are aware of, have confidence in, and are able to obtain all recommended vaccines for their children.

Prevalence of transthyretin cardiac amyloidosis in patients with heart failure with preserved ejection fraction: the PRACTICA study.

INTRODUCTION AND OBJECTIVES: Transthyretin cardiac amyloidosis (ATTR-CA) is a frequent cause of heart failure with preserved ejection fraction (HFpEF). This study sought to determine the prevalence of ATTR-CA among HFpEF patients in a multicenter nationwide study. METHODS: Consecutive ambulatory or hospitalized patients aged ≥ 50 years with HFpEF and left ventricle hypertrophy ≥ 12mm were studied at 20 Spanish hospitals. Screening for cardiac amyloidosis was initiated according to the usual clinical practice of each center. Positive scintigraphs were centrally analyzed. RESULTS: 422 patients were included, of whom 387 underwent further screening for cardiac amyloidosis. A total of 65 patients (16.8%) were diagnosed with ATTR-CA, none below 75 years. There was an increase of prevalence with age. Of them, 60% were male, with a mean age of 85.3±5.2 years, mean left ventricle ejection fraction of 60.3±7.6% and a mean maximum left ventricle wall thickness of 17.2 [12-25] mm. Most of the patients were New York Heart Association class II (48.4%) or III (46.8%). Besides being older than non-ATTR-CA patients, ATTR-CA patients had higher median NT-proBNP levels (3801 [2266-7132] vs 2391 [1141-4796] pg/mL; P=.003). There was no statistical difference in the prevalence of ATTR-CA by sex (19.7% for men and 13.8% for women, P=.085). A ∼7% (4/56) of the patients exhibited a genetic variant (ATTRv). CONCLUSIONS: This multicenter nationwide study found a prevalence of 16.8%, confirming that ATTR-CA is a significant contributor to HFpEF in male and female patients with left ventricle hypertrophy and more than 75 years.