Trends in suicidal behavior among hospitalized adolescents in Spain over two decades.

BACKGROUND: Suicide ranks as a leading cause of premature death among adolescents globally. Understanding the trends and key determinants of suicidal behavior in youth are critical for implementing educational policies and supporting preventive strategies in schools. METHODS: This retrospective study examined all hospitalizations due to suicidal behavior in children and adolescents aged 11 to 18 years in Spain, using data from the Spanish National Registry of Hospital Discharges spanning 2000 to 2021. RESULTS: Over the 22-year study period, there were 2,015,589 hospitalizations among adolescents in Spain, with 118,609 (5.9 %) cases involving mental disorders. There were 2855 admissions with suicidal behavior, constituting 2.4 % of the hospitalizations among youth with mental disorders. Girls represented 73.4 % of all hospitalizations, with a median age of 16 years. Admissions for suicidal behavior saw a four-fold increase during the last decade (p < 0.001). The in-hospital mortality rate for adolescents with suicidal behavior doubled that of those hospitalized for other mental disorders. During the first year of the COVID-19 pandemic, admissions of adolescents with suicidal behavior decreased, only to surge by 2.5-fold during 2021. CONCLUSION: Hospital admissions for suicidal behavior among adolescents have risen in Spain over the last two decades. Girls represented 73.4 % of these admissions, yet in-hospital mortality was more frequent in boys.

Real-Time Wavefront Sensing at High Resolution with an Electrically Tunable Lens.

We have designed, assembled, and evaluated a compact instrument capable of capturing the wavefront phase in real time, across various scenarios. Our approach simplifies the optical setup and configuration, which reduces the conventional capture and computation time when compared to other methods that use two defocused images. We evaluated the feasibility of using an electrically tunable lens in our camera by addressing its issues and optimizing its performance. Additionally, we conducted a comparison study between our approach and a Shack-Hartmann sensor. The camera was tested on multiple targets, such as deformable mirrors, lenses with aberrations, and a liquid lens in movement. Working at the highest resolution of the CMOS sensor with a small effective pixel size enables us to achieve the maximum level of detail in lateral resolution, leading to increased sensitivity to high-spatial-frequency signals.

An Encoder-Decoder Architecture within a Classical Signal-Processing Framework for Real-Time Barcode Segmentation.

In this work, two methods are proposed for solving the problem of one-dimensional barcode segmentation in images, with an emphasis on augmented reality (AR) applications. These methods take the partial discrete Radon transform as a building block. The first proposed method uses overlapping tiles for obtaining good angle precision while maintaining good spatial precision. The second one uses an encoder-decoder structure inspired by state-of-the-art convolutional neural networks for segmentation while maintaining a classical processing framework, thus not requiring training. It is shown that the second method's processing time is lower than the video acquisition time with a 1024 × 1024 input on a CPU, which had not been previously achieved. The accuracy it obtained on datasets widely used by the scientific community was almost on par with that obtained using the most-recent state-of-the-art methods using deep learning. Beyond the challenges of those datasets, the method proposed is particularly well suited to image sequences taken with short exposure and exhibiting motion blur and lens blur, which are expected in a real-world AR scenario. Two implementations of the proposed methods are made available to the scientific community: one for easy prototyping and one optimised for parallel implementation, which can be run on desktop and mobile phone CPUs.

Wavefront Characteristics of a Digital Holographic Optical Element.

In this study, a 50 × 50 mm holographic optical element (HOE) with the property of a spherical mirror was recorded digitally on a silver halide photoplate using a wavefront printing method. It consisted of 51 × 96 hologram spots with each spot measuring 0.98 × 0.52 mm. The wavefronts and optical performance of the HOE were compared with those of reconstructed images from a point hologram displayed on DMDs of different pixel structures. The same comparison was also performed with an analog-type HOE for a heads-up display and with a spherical mirror. A Shack-Hartmann wavefront sensor was used to measure the wavefronts of the diffracted beams from the digital HOE and the holograms as well as the reflected beam from the analog HOE and the mirror when a collimated beam was incident on them. These comparisons revealed that the digital HOE could perform as a spherical mirror, but they also revealed astigmatism-as in the reconstructed images from the holograms on DMDs-and that its focusability was worse than that of the analog HOE and the spherical mirror. A phase map, i.e., the polar coordinate-type presentation of the wavefront, could visualize the wavefront distortions more clearly than the reconstructed wavefronts obtained using Zernike polynomials. The phase map revealed that the wavefront of the digital HOE was more distorted than those of the analog HOE and the spherical mirror.

Mastocitosis crónica. Presentación de un caso y revisión de la literatura

La mastocitosis cutánea crónica es una genodermatosis de etiología desconocida y que se encuentra dentro del grupo de enfermedades raras o poco frecuentes. Se caracterizan por el crecimiento y acumulación de causa desconocida de mastocitos en piel y otros órganos y se manifiesta como una urticaria pigmentosa. Se presenta el caso de un paciente de sexo masculino, con lesiones eritematopapulosas en región de las manos que fue extendiéndose a todo el cuerpo y cuero cabelludo que al desaparecer quedaban manchas hipercrómicas con signo de Darier positivo. Se confirmó el diagnóstico de urticaria pigmentosa mediante biopsia de la piel. Es una enfermedad rara con una baja incidencia, la forma cutánea tiene un pronóstico favorable, por lo que resulta de vital importancia conocer y diagnosticar de forma precoz esta entidad con un manejo multidisciplinario para prevenir las manifestaciones sistémicas que aparecen. Llevar un tratamiento sintomático permitirá una mejor calidad de vida en los infantes. Se presenta el caso porque al considerarse la mastocitosis una enfermedad rara la prevalencia e incidencia de estos casos es muy baja.

Chronic cutaneous mastocytosis is a genodermatosis of unknown etiology and that is within the group of rare or infrequent diseases. They are characterized by the growth and accumulation of mast cells in the skin and other organs of unknown cause and manifest as urticaria pigmentosa. The case of a male patient is presented, with erythematopapular lesions in the region of the hands that spread to the entire body and scalp that, when they disappeared, left hyperchromic spots with Darier's sign: positive. The diagnosis of urticaria pigmentosa was confirmed by skin biopsy. It is a rare disease with a low incidence, the cutaneous form has a favorable prognosis, so it is of vital importance to know and diagnose this entity early with a multidisciplinary management to prevent the systemic manifestations that appear. Taking a symptomatic treatment will allow a better quality of life in infants. The case is presented because mastocytosis is considered a rare disease, the prevalence and incidence of these cases is very low.

Gender differences in professional social responsibility: Are women more responsible at work than men?

Introduction: There is overwhelming evidence that companies with women on their boards of directors have higher levels of Corporate Social Responsibility. The relation between professional women and collective or organisational responsibility has been widely studied. However, to date there has been little research into the individual attitudes of women towards social responsibility. The purpose of this study is to analyse the differences in attitudes towards social responsibility between men and women in their professional life. Methods: A study sample (N = 524; 347 women; M edad = 37) was assembled using the LinkedIn social media platform and participants, after providing their informed consent, were asked to answer the Professional Social Responsibility Questionnaire. Results: The results showed significant differences in Professional Social Responsibility between men and women, with moderate effect (t (522) = 2.078; p = 0.038; η 2 = 0.191), in favour of women. The women participants scored higher in the dimensions Discovery of Personal Values (t (522) = 2.342; p = 0.020; η 2 = 0.216) and Social Awareness (t (522) = 2.179; p = 0.030; η 2 = 0.201), both with representative effect sizes. Discussion: These results suggest that the greater commitment to Corporate Social Responsibility of companies with women on their boards of directors is due, in part, to the greater individual or personal social responsibility of women. Higher levels of Discovery of Personal Values and Social Awareness amongst women may also result in better decision-making, ultimately accruing to the benefit of the company in terms of its financial results and reputation.

Susceptibility to hepatitis B virus infection in adults living in Spain.

BACKGROUND: A protective hepatitis B virus (HBV) vaccine has been available for four decades. Universal HBV vaccination of infants is recommended by the WHO since the 1990s. Furthermore, HBV immunization is advised for all adults with high-risk behaviours and no seroprotection. However, HBV vaccine coverage remains globally suboptimal. The advent of new more efficacious trivalent HBV vaccines has renewed the interest in HBV vaccination. At present, the extent of current HBV susceptibility in adults remains unknown in Spain. METHODS: HBV serological markers were assessed on a large and representative sample of adults in Spain, including blood donors and individuals belonging to high-risk groups. Serum HBsAg, anti-HBc and anti-HBs were tested in specimens collected during the last couple of years. RESULTS: From 13 859 consecutive adults tested at seven cities across the Spanish geography, overall 166 (1.2%) had positive HBsAg. Past HBV infection was recognized in 14% and prior vaccine immunization in 24%. Unexpectedly, 37% of blood donors and 63% of persons belonging to high-risk groups had no serum HBV markers and therefore were potentially HBV susceptible. CONCLUSION: Roughly 60% of adults living in Spain seem to be HBV susceptible. Waning immunity might be more common than expected. Hence, HBV serological testing should be performed at least once in all adults regardless of risk exposures. HBV vaccine full courses or boosters should be administered to all adults lacking serological evidence of HBV protection.

Tasa de filtración glomerular como estimador de la hipertensión en enfermedades renales y cardiovasculares / Glomerular filtration rate as an estimator of renal and cardiovascular diseases such as hypertension

Introducción: Las fórmulas para la estimación de la tasa de filtración glomerular son fundamentales para estimar el curso de enfermedades renales; incluso ha sido de gran ayuda para obtener datos de prevalencia. Las ecuaciones comparadas con otros métodos son una forma económica y rápida para dar una estimación de la función renal. Objetivo: Describir la utilización de diferentes fórmulas para calcular la tasa de filtración glomerular relacionada con la hipertensión arterial y otras patologías renales y cardiovasculares. Metodología: Se realizó la búsqueda de artículos de investigación en bases de datos como PubMed, Science-Direct, Embase y otras, se estableció un tiempo de publicación entre los años 2018-2022 y se seleccionaron 42 artículos científicos relacionados con el tema. Resultados: La hipertensión arterial es una situación que incrementa el riesgo tanto de enfermedad cardiovascular como de deterioro de la función renal, por lo que en los pacientes hipertensos se espera una relación estrecha en la expresión de ambas patologías. Existen factores que alteran los valores de la creatinina sérica como la dieta, el ejercicio, la edad, el género, la masa muscular, enfermedades musculares y medicamentos. El impacto de la hipertensión en la función renal está descrito además de la relación entre el deterioro de la función renal y el incremento del riesgo cardiovascular; es por esto que en los últimos años la estimación de la función renal se ha incorporado como un marcador de morbilidad y mortalidad cardiovascular. Conclusiones: La estimación de la tasa de filtración glomerular es importante en varios contextos clínicos, en especial en aquellos pacientes con enfermedades que afectan la función glomerular, la creatinina es el biomarcador más usado a pesar de sus evidentes limitaciones.

Introduction: Formulas for estimating glomerular fil-tration rate are fundamental for estimating the course of renal diseases; they have even been of great help in obtaining prevalence data. Equations compared with other methods are an economical and fast way to give an estimation of renal function. Objective: Describe the use of different formulas to calculate the glomerular filtration rate related to high blood pressure and other kidney or cardiovascular pa-thologies. Methodology: Research articles were searched in da-tabases such as PubMed, Science-Direct, Embase and others, a publication time was established between the years 2018-2022 and 42 scientific articles related to the topic were selected. Results: Arterial hypertension is a situation that in-creases the risk of both cardiovascular disease and re-nal function deterioration, so in hypertensive patients a close relationship in the expression of both pathologies is expected. There are factors that alter serum creati-nine values such as diet, exercise, age, gender, muscle mass, muscle diseases and medications. The impact of hypertension on renal function has been described in addition to the relationship between the deterioration of renal function and the increase in cardiovascular risk; this is why in recent years the estimation of renal func-tion has been incorporated as a marker of cardiovascu-lar morbidity and mortality. Conclusions: The estimation of glomerular filtration rate is important in several clinical contexts, especia-lly in those patients with diseases that affect glomerular function; creatinine is the most widely used biomarker despite its obvious limitations

Late presentation of human T-lymphotropic virus type 1 infection in Spain reflects suboptimal testing strategies.

OBJECTIVES: Although only 10% of persons infected with human T-lymphotropic virus type 1 (HTLV-1) may develop virus-associated illnesses over their lifetime, missing the earlier diagnosis of asymptomatic carriers frequently leads to late presentation. METHODS: A nationwide HTLV-1 register was created in Spain in 1989. We examined the main demographics and clinical features at the time of the first diagnosis for more than three decades. RESULTS: A total of 428 individuals infected with HTLV-1 had been reported in Spain until the end of 2021. Up to 96 (22%) individuals presented clinically with HTLV-1-associated conditions, including subacute myelopathy (57%), T-cell lymphoma (34%), or Strongyloides stercoralis infestation (8%). Since 2008, HTLV-1 diagnosis has been made at blood banks (44%) or clinics (56%). Native Spaniards and Sub-Saharan Africans are overrepresented among patients presenting with HTLV-1-associated illnesses suggesting that poor epidemiological and/or clinical suspicion, which led to the late presentation are more frequent in them than carriers from Latin America (LATAM) (31.7% vs 20.4%, respectively; P = 0.015). CONCLUSION: HTLV-1 infection in Spain is frequently diagnosed in patients presenting with characteristic illnesses. Although screening in blood banks mostly identifies asymptomatic carriers from LATAM, a disproportionately high number of Spaniards and Africans are diagnosed too late at the time of clinical manifestations. Expanding testing to all pregnant women and clinics for sexually transmitted infections could help to unveil HTLV-1 asymptomatic carriers.

Papel de los exosomas en la angiogénesis, revascularización y respuesta inmune / Role of exosomes in angiogenesis, revascularization and immune response

Introducción: Los exosomas son vesículas extracelulares de tamaño nanométrico, que se generan cuando los endosomas multivesiculares se fusionan con la membrana plasmática y el contenido de las vesículas intraluminales se libera en el espacio extracelular. Son producidos por casi todos los tipos de células, en condiciones fisiológicas y patológicas. Transportan proteínas, lípidos y ácido ribonucleico (ARN) no codificante, desde la célula madre hasta la célula receptora, estos son considerados un punto clave en la regeneración de tejidos, lo que se ha demostrado en una serie de estudios, con diferentes tejidos corporales, como piel, cartílago, pancreático y tejidos cardiovasculares. Objetivo: Explicar los aspectos generales y posibles usos de los exosomas en el campo médico. Métodos: Se realizó una búsqueda de información mediante consulta en las bases de datos SciELO PubMed, Science Direct y Lilacs, en los idiomas español e inglés, con diferentes combinaciones de palabras claves y términos MESH como: exosomes, neovascularization, wound healing, immunity, micro RNA, immunology, therapy, classification. Se efectuó un análisis y resumen de la información revisada. Conclusiones: En la actualidad, los exosomas se han convertido en objeto de investigación para diversos tratamientos, medicamentos y uso como marcadores moleculares. Se destacan en terapias contra el cáncer, la inmunomodulación, la estimulación o supresión de la angiogénesis, regeneración cutánea, cicatrización y curación de heridas; por lo que de forma general resultan prometedores en el ámbito de las ciencias médicas(AU)

Introduction: Exosomes are nano-sized extracellular vesicles, which are generated when multivesicular endosomes fuse with the plasma membrane and the content of intraluminal vesicles released into the extracellular space. Are produced by almost all types of cells, under physiological and pathological conditions and they transport proteins, lipids and non-coding RNA (ribonucleic acid), from the stem cell to the recipient cell, these are considered a key point in tissue regeneration, which has been shown in a series of studies, with different body tissues, such as skin, cartilage, pancreatic and cardiovascular tissues. Objective: To explain the general aspects and possible uses of exosomes in the medical field. Methods: A search for information was carried out by consulting the Scielo, PubMed, ScienceDirect and Lilacs databases, in Spanish and English, with different combinations of keywords and MESH terms such as: exosomes, neovascularization, wound healing, immunity, microRNA, immunology, therapy, classification. Then, an analysis and summary of the reviewed information was carried out. Conclusions: Currently, exosomes have become the object of research for various treatments, drugs, and their use as molecular markers. They stand out in cancer therapies, immunomodulation, stimulation or suppression of angiogenesis, skin regeneration, and wound healing, which is why they are generally promising in the field of medical sciences(AU)

Impact of COVID19 pandemic on the incidence of health-care associated Clostridioides difficile infection.

OBJECTIVE: To investigate the impact of COVID19 pandemic on the incidence of health-care associated Clostridioides difficile infection (HA-CDI). METHODS: Retrospective study conducted in the Hospital Universitario de Valme (HUV) and the Hospital General Universitario de Alicante (HGUA) in Spain between January 2019 and February 2021. The study period was divided into non-COVID19 period (2019 and months from 2020 to 2021 with ≤30 hospitalized COVID19 patients) and COVID19 period (months from 2020 to 2021 with >30 COVID19 patients). HA-CDI incidence rates (IR) were calculated as the number of new CDI cases per 10.000 occupied bed-days (OBD) and antimicrobial consumption by means of the defined daily dose (DDD) per 1000 OBD. RESULTS: During the COVID19 period, HA-CDI IR in the HUV was 2.6 per 10.000 OBD, which was lower than what was observed during the non-COVID19 period (4.1 per 10.000 OBD; p = 0.1). In the HGUA, HA-CDI IR during COVID19 period was 3.9 per 10.000 OBD, which was not significantly different to the IR observed during the non-COVID19 period (3.7 per 10.000 OBD; p = 0.8). There was a slight increase in the total antibiotic consumption during COVID19 period in both hospitals, with significant increases of certain high-risk antibiotics as cephalosporins. CONCLSUSIONS: HA-CDI incidence has not increased during the COVID19 pandemic in two tertiary centers in Spain, in spite of a slightly higher antibiotic consumption during the COVID19 period in both hospitals. These findings suggest that, in the presence of strict infection control measures, hospital antibiotic consumption might have a lower impact than expected on HA-CDI.

[Valproic Acid Could Help in the Fight Against COVID-19: a case-control study]. / El ácido valproico podría ayudar en la lucha contra el COVID-19: un estudio de casos y controles.

OBJECTIVE: There is early evidence about Valproic acid (VPA) antiviral effect. Our aim was to investigate the incidence and severity of SARS-CoV-2 infection in VPA users as compared with the general population. MATERIAL AND METHODS: A case-control study nested within a cohort, carried out between March 1 and December 17, 2020. Retrospectively, we identified confirmed SARS-CoV-2 infection patients exposed to VPA in our health department (defined as case). We ascertained VPA regimen (all the time (AT)(292 days) or at least 20% of the study period (notAT)(≥58 days) and if VPA levels were in therapeutic range (ATR) (50-100 mcg/mL) in the last 24 months. We calculated the cumulative incidence of SARS-CoV-2 infection and hospital admission in the cases, comparing it with the general unexposed VPA population (controls). RESULTS: During the study period, 6183 PCR+ were detected among 281035 inhabitants, of these, 746 were hospitalized. 691 patients were on VPA notAT and 628 (90.1%) AT. The indication for VPA use was epilepsy in 54.9%. The incidence of PCR+ was 1.736 % (OR 0.785 (95%CI 0.443-1.390) and 1.910 % (OR 0.865 (95%CI 0.488-1.533), on VPA notAT and VPA AT patients, respectively vs. 2.201% in people without VPA regimen. Those patients with VPA ATR had a lower risk of PCR + (OR 0.233 (95%CI 0.057-0.951) notAT; OR 0.218 (95%CI 0.053-0.890) AT). Hospital admission incidence was lower in patient on VPA (OR was 0.543 (95% CI 0.076 to 3.871). CONCLUSION: Patients with VPA within the therapeutic range had a reduction of SARS-Cov-2 infection incidence greater than 75%. There is a downward trend in the risk of COVID-19 admission by SARS-CoV-2 in patients on VPA therapy. These findings warrant further investigation.

Hospitalized patients with breakthrough COVID-19: Clinical features and poor outcome predictors.

OBJECTIVES: To describe breakthrough COVID-19 infection in patients who needed hospitalization and the factors associated with poor outcomes. METHODS: We conducted a retrospective study on patients hospitalized with COVID-19 between December 27, 2020, and October 17, 2021, with either a complete vaccination (CV) scheme (diagnosed 2 weeks after the second dose of the Pfizer/Moderna/AstraZeneca or first dose of the Janssen vaccine was administered) or a partial vaccination (PV) scheme. The main outcomes were all-cause mortality and the need for invasive mechanical ventilation (IMV). The baseline factors associated with the outcomes were analyzed by multiple logistic regression to estimate the odds ratios (odds ratio [OR]; 95% confidence interval [CI]). RESULTS: A total of 145 (101 CV) patients were included. The CV subgroup was mainly composed of older males with high comorbidity (Charlson Index ≥3, 72%; immunosuppression, 20%) and with bilateral pneumonia in 63.4%. Limited therapeutic effort (LTE) was agreed upon for 28% of the patients. In the CV subgroup, endotracheal intubation was required in 10.9% of patients, reaching 15.3% when excluding LTE patients; the global mortality was 22.8%, reaching 41.4% in the subgroup with LTE. Although the patients with PV were younger and had fewer comorbidities, the main outcomes did not differ significantly between the CV and PV groups. The predictors of poor outcomes were age ≥ 65 years, confusion, ferritin > 500 mg/L, extensive lung infiltrates, and a Charlson Index ≥ 3. CONCLUSIONS: Patients with CV hospitalized because of breakthrough COVID-19 infection tend to be older persons, with comorbidities, and have a high mortality.

Mother-to-child transmission of HIV infection and its associated factors in the district of Bilene, Gaza Province-Mozambique.

BACKGROUND: Mother-to-child transmission of HIV infection is a significant problem in Mozambique. This study aims to determine the risk factors associated with mother-to-child transmission of HIV in rural Mozambique. METHODS: Retrospective case-control study in a rural area of Bilene District, on the coast of southern Mozambique, performed from January 2017 to June 2018. The analysis considered the clinical data of HIV exposed children with definitive HIV positive results and their respective infected mothers (cases), and the data of HIV exposed children with definitive HIV negative results and their respective infected mothers (controls) registered in At Risk Child Clinics from 1st January 2017 to 30th June 2018 at the Macia and Praia de Bilene health facilities in Bilene district, Gaza province-Mozambique. RESULTS: Ninety pregnant women with HIV were involved in the study, including 30 who had transmitted the infection to their children and 60 who had not. Statistical analysis, adjusted for maternal age and gestational age at first antenatal care visit, showed that independent risk factors for transmission were gestational age at first visit (adjusted odds ratio [aOR] 1.19, 95% confidence interval [CI] 1.05-1.36), non-adherence to combination antiretroviral therapy (56.7% vs. 5%; aOR 14.12, 95% CI 3.15-63.41); a viral load of 1000 copies/mL or more (90% vs. 5%; aOR: 156, 95% CI 22.91-1,062) and female sex of the neonate (80% vs. 51.7%; aOR: 4.43, 95% CI 1.33-15.87). CONCLUSION: A high viral load and non-adherence to antiretroviral therapy are important predictors of mother-to-child HIV transmission.

Latin American Origin Is Not Associated with Worse Outcomes among Hospitalized Patients with COVID-19 in a Public Healthcare System.

Exploring differences in clinical outcomes based on race and origin among patients hospitalized for COVID-19 is a controversial issue. The ALC COVID-19 Registry includes all confirmed COVID-19 patients admitted to hospital from 3 March 2020 to 17 December 2020. The data were obtained from electronic health records in order to evaluate the differences in the clinical features and outcomes among European and Latin American patients. The follow-ups occurred after 156 days. A propensity score weighting (PSW) logistic regression model was used to estimate the odds ratio (OR, 95% CI) for Latin American origin and outcome associations. Of the 696 patients included, 46.7% were women, with a median age of 65 (IQR 53-67) years, 614 (88.2%) were European, and 82 (11.8%) were Latin American. Latin American patients were younger, with fewer comorbidities, and a higher incidence of extensive pneumonia. After adjusting for residual confounders, Latin American origin was not associated with an increased risk of death (PSW OR 0.85 (0.23-3.14)) or with the need for invasive mechanical ventilation (PSW OR 0.35 (0.12-1.03)). Latin American origin was associated with a shorter hospital stay, but without differences in how long the patient remained on mechanical ventilation. In a public healthcare system, the rates of death or mechanical ventilation in severe COVID-19 cases were found to be comparable between patients of European and Latin American origins.

Medium-term serostatus in Spanish case series recovered from SARS-CoV-2 infection.

The medium-term serologic response of SARS-CoV-2 infection recovered individuals is not well known. The aims were to quantify the incidence of seropositive failure in the medium term in a cohort of patients with different COVID-19 severity and to analyze its associated factors. Patients who had recovered from mild and severe forms of SARS-CoV-2 infection in an Academic Spanish hospital (March 12-May 2, 2020), were tested for total anti-SARS-CoV-2 antibodies by electrochemiluminescence immunoassay (Elecsys Anti-SARS-CoV-2 test; Roche Diagnostics GmbH). The non-seropositive status (seropositive failure) incidence (95% CI) was determined. Associations were tested by multiple logistic regression in a global cohort and severe pneumonia subpopulation. Of 435 patients with PCR-confirmed SARS-CoV-2, a serological test was carried out in 325: 210 (64.6%) had severe pneumonia (hospitalized patients), 51 (15.7%) non-severe pneumonia (managed as outpatients), and 64 (19.7%) mild cases without pneumonia. After a median (IQR) of 76 days (70-83) from symptom onset, antibody responses may not consistently develop or reach levels sufficient to be detectable by antibody tests (non-seropositive incidence) in 6.9% (95% CI, 4.4-10.6) and 20.3% (95% CI, 12.2-31.7) of patients with and without pneumonia, respectively. Baseline independent predictors of seropositive failure were higher leukocytes and fewer days of symptoms before admission, while low glomerular filtrate and fever seem associated with serologic response. Age, comorbidity or immunosuppressive therapies (corticosteroids, tocilizumab) did not influence antibody response. In the medium-term, SARS-CoV-2 seropositive failure is not infrequent in COVID-19 recovered patients. Age, comorbidity or immunosuppressive therapies did not influence antibody response.

Longitudinal study based on a safety registry for malaria patients treated with artenimol-piperaquine in six European countries.

BACKGROUND: European travellers to endemic countries are at risk of malaria and may be affected by a different range of co-morbidities than natives of endemic regions. The safety profile, especially cardiac issues, of artenimol (previously dihydroartemisinin)-piperaquine (APQ) Eurartesim® during treatment of uncomplicated imported falciparum malaria is not adequately described due to the lack of longitudinal studies in this population. The present study was conducted to partially fill this gap. METHODS: Participants were recruited through Health Care Provider's safety registry in 15 centres across 6 European countries in the period 2013-2016. Adverse events (AE) were collected, with a special focus on cardiovascular safety by including electrocardiogram QT intervals evaluated after correction with either Bazett's (QTcB) or Fridericia's (QTcF) methods, at baseline and after treatment. QTcB and/or QTcF prolongation were defined by a value > 450 ms for males and children and > 470 ms for females. RESULTS: Among 294 participants, 30.3% were women, 13.7% of Caucasian origin, 13.5% were current smoker, 13.6% current alcohol consumer and 42.2% declared at least one illness history. The mean (SD) age and body mass index were 39.8 years old (13.2) and 25.9 kg/m2 (4.7). Among them, 75 reported a total of 129 AE (27 serious), 46 being suspected to be related to APQ (11 serious) and mostly labelled as due to haematological, gastrointestinal, or infection. Women and Non-African participants had significantly (p < 0.05) more AEs. Among AEs, 21 were due to cardiotoxicity (7.1%), mostly QT prolongation, while 6 were due to neurotoxicity (2.0%), mostly dizziness. Using QTcF correction, QT prolongation was observed in 17/143 participants (11.9%), only 2 of them reporting QTcF > 500 ms (milliseconds) but no clinical symptoms. Using QTcB correction increases of > 60 ms were present in 9 participants (6.3%). A trend towards increased prolongation was observed in those over 65 years of age but only a few subjects were in this group. No new safety signal was reported. The overall efficacy rate was 255/257 (99.2%). CONCLUSIONS: APQ appears as an effective and well-tolerated drug for treatment of malaria in patients recruited in European countries. AEs and QT prolongation were in the range of those obtained in larger cohorts from endemic countries. Trial registration This study has been registered in EU Post-Authorization Studies Register as EUPAS6942.

Post-acute COVID-19 syndrome. Incidence and risk factors: A Mediterranean cohort study.

OBJECTIVES: This study aims to analyze the incidence of Post-acute COVID-19 syndrome (PCS) and its components, and to evaluate the acute infection phase associated risk factors. METHODS: A prospective cohort study of adult patients who had recovered from COVID-19 (27th February to 29th April 2020) confirmed by PCR or subsequent seroconversion, with a systematic assessment 10-14 weeks after disease onset. PCS was defined as the persistence of at least one clinically relevant symptom, or abnormalities in spirometry or chest radiology. Outcome predictors were analyzed by multiple logistic regression (OR; 95%CI). RESULTS: Two hundred seventy seven patients recovered from mild (34.3%) or severe (65.7%) forms of SARS-CoV-2 infection were evaluated 77 days (IQR 72-85) after disease onset. PCS was detected in 141 patients (50.9%; 95%CI 45.0-56.7%). Symptoms were mostly mild. Alterations in spirometry were noted in 25/269 (9.3%), while in radiographs in 51/277 (18.9%). No baseline clinical features behaved as independent predictors of PCS development. CONCLUSIONS: A Post-acute COVID-19 syndrome was detected in a half of COVID19 survivors. Radiological and spirometric changes were mild and observed in less than 25% of patients. No baseline clinical features behaved as independent predictors of Post-acute COVID-19 syndrome development.

Lipoarabinomannan Antigen Assay (TB-LAM) for Diagnosing Pulmonary Tuberculosis in Children with Severe Acute Malnutrition in Mozambique.

BACKGROUND: Tuberculosis (TB) and malnutrition are important causes of morbidity and mortality in children in the developing world. AIMS: To assess the prevalence of pulmonary TB in severely malnourished children and evaluate TB detection using the urine lipoarabinomannan antigen assay (TB-LAM). METHODS: A retrospective analysis was conducted in all pediatric inpatients with severe acute malnutrition at a rural health center in Mozambique, from February to August 2018. All children underwent a physical examination and chest X-ray, and their nasopharyngeal aspirates and stool specimens were studied for mycobacterial culture and subjected to the Xpert MTB/RIF assay. TB-LAM tests were performed on urine. RESULTS: Of 45 included cases, 17 (37.8%) were clinically diagnosed as pulmonary TB. None of these were detected by the Xpert MTB test; 4 (8.9%) nasopharyngeal aspirates were TB-culture positive. Seventeen patients (37.8%)-all clinically diagnosed with TB-tested positive on the TB-LAM, while 23 (51.1%) were negative. In 5 (11.1%), the urine LAM was not done. CONCLUSION: Although our sample size was small, TB was diagnosed and treated in more than a third of included children. The urine TB-LAM test showed a perfect correlation with clinical diagnosis of childhood TB. LAY SUMMARY: Severe acute malnutrition makes children more vulnerable to tuberculosis (TB) infections, but it is difficult to detect TB in children because they cannot always cough up phlegm, which is used in diagnostic processes. This study aimed to find out how many severely malnourished children had TB in Gaza, Mozambique, and to test the accuracy of a less-used diagnostic test: the lipoarabinomannan assay (TB-LAM). Of the 45 severely malnourished children who were admitted to our hospital, 17 were diagnosed with TB by their doctor. The TB-LAM corroborated the clinical diagnosis in all cases, while the other tests (Xpert MTB/RIF assay) and cultures failed to detect most of them. Overall, more than a third of severely malnourished children had TB, and the TB-LAM test-a simple, point-of-care method-was a highly accurate way to diagnose them. While larger studies are needed to confirm these results, our findings suggest that the TB-LAM could vastly improve TB diagnosis in malnourished children.