Acute and long-term immune responses to SARS-CoV-2 infection in unvaccinated children and young adults with inborn errors of immunity.

Purpose: To describe SARS-CoV-2 infection outcome in unvaccinated children and young adults with inborn errors of immunity (IEI) and to compare their specific acute and long-term immune responses with a sex-, age-, and severity-matched healthy population (HC). Methods: Unvaccinated IEI patients up to 22 years old infected with SARS-CoV-2 were recruited along with a cohort of HC. SARS-CoV-2 serology and ELISpot were performed in the acute phase of infection (up to 6 weeks) and at 3, 6, 9, and 12 months. Results: Twenty-five IEI patients (median age 14.3 years, min.-max. range 4.5-22.8; 15/25 males; syndromic combined immunodeficiencies: 48.0%, antibody deficiencies: 16.0%) and 17 HC (median age 15.3 years, min.-max. range 5.4-20.0; 6/17 males, 35.3%) were included. Pneumonia occurred in 4/25 IEI patients. In the acute phase SARS-CoV-2 specific immunoglobulins were positive in all HC but in only half of IEI in whom it could be measured (n=17/25): IgG+ 58.8% (10/17) (p=0.009); IgM+ 41.2% (7/17)(p<0.001); IgA+ 52.9% (9/17)(p=0.003). Quantitative response (index) was also lower compared with HC: IgG IEI (3.1 ± 4.4) vs. HC (3.5 ± 1.5)(p=0.06); IgM IEI (1.9 ± 2.4) vs. HC (3.9 ± 2.4)(p=0.007); IgA IEI (3.3 ± 4.7) vs. HC (4.6 ± 2.5)(p=0.04). ELISpots positivity was qualitatively lower in IEI vs. HC (S-ELISpot IEI: 3/11, 27.3% vs. HC: 10/11, 90.9%; p=0.008; N-ELISpot IEI: 3/9, 33.3% vs. HC: 11/11, 100%; p=0.002) and also quantitatively lower (S-ELISpot IEI: mean index 3.2 ± 5.0 vs. HC 21.2 ± 17.0; p=0.001; N-ELISpot IEI: mean index 9.3 ± 16.6 vs. HC: 39.1 ± 23.7; p=0.004). As for long term response, SARS-CoV-2-IgM+ at 6 months was qualitatively lower in IEI(3/8, 37.5% vs. 9/10 HC: 90.0%; p=0.043), and quantitatively lower in all serologies IgG, M, and A (IEI n=9, 1.1 ± 0.9 vs. HC n=10, 2.1 ± 0.9, p=0.03; IEI n=9, 1.3 ± 1.5 vs. HC n=10, 2.9 ± 2.8, p=0.02; and IEI n=9, 0.6 ± 0.5 vs. HC n=10, 1.7 ± 0.8, p=0.002 -respectively) but there were no differences at remaining time points. Conclusions: Our IEI pediatric cohort had a higher COVID-19 pneumonia rate than the general age-range population, with lower humoral and cellular responses in the acute phase (even lower compared to the reported IEI serological response after SARS-CoV-2 vaccination), and weaker humoral responses at 6 months after infection compared with HC.

[Multislice CT in a diagnostic imaging department: radiation doses delivered in 1 year.]. / Tomografía computarizada multicorte en un servicio de radiodiagnóstico: estudio de las dosis impartidas durante 1 año.

OBJECTIVE: To determine the usage of CT in our diagnostic imaging department and the dose of radiation CT delivered to patients. MATERIAL AND METHODS: We carried out two studies, a retrospective study on the administrative data from one year and a prospective study over one month, to determine the amount of activity of the two multislice CT scanners in our department. We recorded the total number of examinations, the different types of examination performed, and the age distributions of the patients examined. We used these data and the results of dosimetric measurements to estimate the typical radiation dose for each type of examination, its contribution to the collective radiation dose, and the total collective radiation dose from CT examinations at our hospital. RESULTS: The retrospective study found that 15038 examinations were performed in 12678 patients in one year. The most common CT examinations were cranial (38.2%), abdomen-pelvis (17.5%), chest-abdomen (11.7%), chest (9.3%), and lumbar-sacral spine (6.8%). Some protocols used doses of radiation that were higher than those recommended by European experts. The total collective dose of radiation delivered to patients at our hospital by CT was estimated at 70 person.Sv. Abdomen-pelvis examinations contributed 31% of the total dose. CONCLUSIONS: This study has provided detailed knowledge about the use of CT in our diagnostic imaging department, about the dose of radiation delivered, and about possibilities for improving the use of our CT scanners.

Image quality in conventional lumbar spine radiography: evaluation using the post-processing tool Diamond View.

Conventional radiography contributes for the majority of examinations in radiology departments. Based on the European Commission Quality Criteria we evaluated the effects on image quality when applying the new post-processing tool Diamond View (Siemens AG Medical Solutions, Germany) to conventional lumbar spine radiographs. 100 digital image pairs in two directions in two planes of lumbar spine radiographs were prospectively evaluated by two radiologists. Statistical analysis was performed with a p-value<.05 considered as significant. Images were evaluated on basis of the modified imaging Quality Criteria by the Commission of the European Communities, rated on a five-point scale. Statistical analysis showed an overall tendency for improved image quality of Diamond View (DV) for all criteria. Significant differences could be found in most of the criteria. Additional phantom analyses supported the advantage of DV. In conclusion DV improves image quality in conventional lumbar spine radiographs.