An analysis of antibody responses and clinical sequalae of the Sinopharm HB02 COVID19 vaccine in dialysis patients in the United Arab Emirates.

AIM: To establish the responses to the Sinopharm HB02 COVID-19 vaccination in the dialysis population, which are not well established. We examined the humoral responses to the Sinopharm COVID vaccine in haemodialysis patients. METHODS: Standard vaccinations (two doses at interval of ~21 days) were given to all consenting haemodialysis patients on dialysis (n = 1296). We measured the antibody responses at 14-21 days after the second vaccine to define the development of anti-spike antibodies >15 AU/ml after vaccination and observed the clinical effects of vaccination. RESULTS: Vaccination was very well tolerated with few side-effects. In those who consented to antibody measurements, (n = 446) baseline sampling showed 77 had positive antibodies, yet received full vaccination without any apparent adverse events. Positive anti-spike antibodies developed in 50% of the 270 baseline negative patients who had full sampling, compared with 78.1% in the general population. COVID infection continues to occur in both vaccinated and unvaccinated individuals, but in the whole group vaccination appears to have been associated with a reduction in the case fatality rate. CONCLUSION: The humoral immune responses to standard HB02 vaccination schedules are attenuated in a haemodialysis cohort, but likely the vaccine saves lives. We suggest that an enhanced HB02 vaccination course or antibody checking may be prudent to protect this vulnerable group of patients. We suggest a booster dose of this vaccine at 3 months should be given to all dialysis patients, on the grounds that it is well tolerated even in those with good antibody levels and there may be a survival advantage.

The association between pregnancy intendedness and experiencing symptoms of postpartum depression among new mothers in the United States, 2009 to 2011: A secondary analysis of PRAMS data.

Postpartum depression (PPD) is a form of major depressive disorder affecting approximately 13% of women worldwide. Unintended pregnancies, reaching close to 50% of the pregnancies in the United States, have become a major health concern. While many physiologic and psychosocial causes have been analyzed, few studies have examined the relationship between unintended pregnancy and symptoms of PPD.A cross-sectional study was conducted using surveillance data from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS) from 2009 to 2011. The PRAMS population-based random sample included women who have had recent live births and is representative of 78% of the United States population. The chi-squared test was used to examine bivariate associations. Binary logistic regression was utilized to study unadjusted and adjusted associations between PPD and pregnancy intendedness, as well as other demographic and clinical characteristics of mothers in the sample. Multicollinearity in the adjusted model was evaluated using variance inflation factors. Sampling weights were used to account for PRAMS' complex sampling design.Of the 110,231 mothers included in the sample, only 32.3% reported desiring the pregnancy at the time of conception. Women with pregnancies categorized as mistimed: desired sooner, mistimed: desired later, or unwanted were 20% (adjusted odds ratio [AOR] = 1.2; 95% confidence interval [CI]: 1.1-1.3), 30% (AOR = 1.3; 95% CI: 1.2-1.4), and 50% (AOR = 1.5; 95% CI: 1.3-1.7) more likely to experience symptoms of PPD, respectively, compared to women with desired pregnancies. Other factors found to be associated with experiencing symptoms of PPD were a gestational age of <27 weeks (AOR = 3.1; 95% CI: 2.5-4.0), having a previous history of depression (AOR = 1.8; 95% CI: 1.6-2.0), and being abused during or before pregnancy (AOR = 1.6; 95% CI: 1.4-2.0).We found that women with mistimed or unwanted pregnancies were more likely to experience symptoms of PPD. Our findings support the current US Preventive Services Task Force and American Academy of Pediatrics recommendations for an integrated approach to screening for depression, aiding in the maximization of intervention and early referral for women at risk for PPD.

Examining the association between possessing a regular source of healthcare and adherence with cancer screenings among Haitian households in Little Haiti, Miami-Dade County, Florida.

Immigrant minorities regularly experience higher incidence and mortality rates of cancer. Frequently, a variety of social determinants create obstacles for those individuals to get the screenings they need. This is especially true for Haitian immigrants, a particularly vulnerable immigrant population in South Florida, who have been identified as having low cancer screening rates. While Haitian immigrants have some of the lowest cancer screening rates in the country, there is little existing literature that addresses barriers to cancer screenings among the population of Little Haiti in Miami-Dade County, Florida. The objective of this study was to evaluate the association between having a regular source of healthcare and adherence to recommended cancer screenings in the Little Haiti population of Miami.This secondary analysis utilized data collected from a random-sample, population-based household survey conducted from November 2011 to December 2012 among a geographic area approximating Little Haiti in Miami-Dade County, Florida. A total of 421 households identified as Haitian. The main exposure of interest was whether households possessed a regular source of care. Three separate outcomes were considered: adherence with colorectal cancer screening, mammogram adherence, and Pap smear adherence. Analysis was limited to households who met the age criteria for each outcome of interest. Bivariate associations were examined using the chi square test and Fisher exact test. Binary logistic regression was used to estimate unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs).After adjusting for the head of household's education and household insurance status, households without a regular source of care were significantly less likely to adhere with colorectal cancer screening (OR = 0.33; 95% CI: 0.14-0.80) or mammograms (OR = 0.28; 95% CI: 0.11-0.75). Households with insurance coverage gaps were significantly less likely to adhere with mammograms (OR = 0.40; 95% CI: 0.17-0.97) or Pap smears (OR = 0.28; 95% CI: 0.13-0.58).Our study explored adherence with multiple cancer screenings. We found a strong association between possessing a regular source of care and adherence with colorectal cancer screening and mammogram adherence. Targeted approaches to improving access to regular care may improve adherence to cancer screening adherence among this unique immigrant population.

Racial/ethnic disparities in annual mammogram compliance among households in Little Haiti, Miami-Dade County, Florida: An observational study.

INTRODUCTION: Breast cancer is the most commonly diagnosed cancer and the 2nd leading cause of cancer-related deaths among women in the U.S. Although routine screening via mammogram has been shown to increase survival through early detection and treatment of breast cancer, only 3 out of 5 women age ≥40 are compliant with annual mammogram within the U.S. and the state of Florida. A breadth of literature exists on racial/ethnic disparities in compliance with mammogram; however, few such studies include data on individual Black subgroups, such as Haitians. This study assessed the association between race/ethnicity and annual mammogram compliance among randomly selected households residing in the largely Haitian community of Little Haiti, Miami-Dade County (MDC), Florida. METHODS: This study used cross-sectional, health data from a random-sample, population-based survey conducted within households residing in Little Haiti between November 2011 and December 2012 (n = 951). Mammogram compliance was defined as completion of mammogram by all female household members within the 12 months prior to the survey. The association between mammogram compliance and race/ethnicity was assessed using binary logistic regression models. Potential confounders were identified as factors that were conservatively associated with both compliance and race/ethnicity (P ≤ 0.20). Analyses were restricted to households containing at least 1 female member age ≥40 (n = 697). RESULTS: Overall compliance with annual mammogram was 62%. Race/ethnicity was significantly associated with mammogram compliance (P = 0.030). Compliance was highest among non-Hispanic Black (NHB) households (75%), followed by Hispanic (62%), Haitian (59%), and non-Hispanic White (NHW) households (51%). After controlling for educational level, marital status, employment status, the presence of young children within the household, health insurance status, and regular doctor visits, a borderline significant disparity in mammogram compliance was observed between Haitian and NHB households (adjusted odds ratio = 1.63, P = 0.11). No other racial/ethnic disparities were observed. DISCUSSION: Compliance with annual mammogram was low among the surveyed households in Little Haiti. Haitian households underutilized screening by means of annual mammogram compared with NHB households, although this disparity was not significant. Compliance rates could be enhanced by conducting individualized, mammogram screening-based studies to identify the reasons behind low rate of compliance among households in this underserved, minority population.

Knowledge of Latin American Obstetricians and Gynecologists regarding Heavy Menstrual Bleeding.

Background. Heavy menstrual bleeding (HMB) is a common gynecological complaint affecting quality of life. Objectives. To assess knowledge on diagnosis and treatments of HMB of Latin American (LA) obstetricians and gynecologists (OBGYNs). Methods. A survey was conducted during a scientific meeting, organized to provide updated information on topics of reproductive medicine to OBGYNs from 12 LA countries who were invited to respond to a multiple-choice questionnaire. Results. Of the 210 OBGYNs participating in the survey, from 169 (80.4%) to 203 (96.7%) answered the questions. Most respondents (80%) gave accurate answers regarding the amount of blood loss which defines HMB, underreported the proportion of women who consulted due to HMB, and were aware that the use of combined oral contraceptives (COCs) with ethynyl estradiol is not an adequate treatment in women with HMB. Female OBGYNs and those who worked in the private sector were more prone to report a higher possibility of improvement of HMB with a COC that contained estradiol valerate and dienogest or with a levonorgestrel-releasing intrauterine system. Conclusions. In general, the respondents were aware of the importance of HMB in gynecological practice and of the new medical treatments and underreported the proportion of women who consulted due to HMB.

Association of gender and length of stay among Puerto Ricans hospitalized with decompensated heart failure.

Heart failure (HF) is a serious, chronic, and progressive condition which may require hospitalization if decompensated. Each year, in the UnitedStates, there are approximately 1 million hospitalizations due to decompensated HF at a cost of $39 billion. Because limited information examining the association between gender and length of stay (LOS) is available in the published literature for Puerto Ricans hospitalized with decompensated HF, we aim to investigate gender differences related to LOS in this population.This study is a secondary data analysis of the Puerto Rico Cardiovascular Disease Surveillance System database, which is a nonconcurrent prospective study carried out in 2007 and 2009. LOS was dichotomized into ≤5 days or ≥6 days (extended) categories. The χ test was used to examine associations between categorical variables. Binary logistic regression was used to estimate unadjusted and adjusted odds ratios of extended LOS. Collinearity was assessed using Pearson correlation coefficients. A P value of 0.05 and 95% confidence intervals were used to evaluate statistical significance.A total of 1724 patients (47.6% women) comprised our study population. The average age of women was 72.5 ±â€Š13.4 years; the average age of men was 67.2 ±â€Š14.5 years. For both women and men, median LOS was 5 days (interquartile range = 5 days). Women were more likely than men to have diabetes mellitus, hypertension, and dyslipidemia, but current smoking was higher in men than in women. The proportion of patients with extended LOS was similar for men (43.3%) and women (45.1%) (P = 0.448). Likewise, the odds for extended LOS was comparable for both genders (OR = 1.1, 95% CI = 0.9, 1.4). Patients admitted with recurrent decompensated HF hospitalizations had shorter LOS than patients with initial episodes (OR = 0.7, 95% CI = 0.6, 0.9). However, factors that prolonged the LOS included the presence of renal failure (OR = 1.7; 95% IC = 1.3, 2.1) and ejection fraction (EF) <35% (OR 0.7; 95% CI 0.6, 0.9).Although we were not able to find statistically significant association between LOS and gender in Puerto Rican patients hospitalized with decompensated HF our findings suggest that incidental episodes and having an EF <35% increase the odds of extended LOS.

Factors Associated with Compliance of Blood Stool Test and Use of Colonoscopy in Underserved Communities of North Miami-Dade County, Florida.

INTRODUCTION: Only two-thirds of U.S. adults are compliant with screening for colorectal cancer. This study identified factors of blood stool test (BST) compliance and colonoscopy use among randomly selected households in Miami-Dade County, Florida. METHODS: This study used cross-sectional data collected 10/2009-04/2010. Analyses were restricted to 1,118 single-family homes containing a minimum of one member ≥ 50 years. RESULTS: Half of households were compliant with BST (55%) or completed colonoscopy (55%). Factors associated with BST compliance included retirement (adjusted odds ratio[AOR]=1.57**), being uninsured (AOR=0.64**), diagnosed morbidities (AOR=1.68**), fruit/vegetable consumption (AOR=1.60**), and using alternative medicines (AOR=1.36*). Factors associated with colonoscopy included Hispanic ethnicity (AOR=0.56**), lower education (AOR=0.66*), being single (AOR=0.65*), retirement (AOR=2.01***), being uninsured (AOR=0.61**), diagnosed morbidities (AOR=2.13***), former smoking (AOR=1.94**), and fruit/vegetable consumption (AOR=1.75***)(*p<.05;**p<.01;***p<.001). CONCLUSION: This is the first study of factors of BST and colonoscopy in Miami-Dade County. These findings provide a basis for community-based interventions aimed at increasing screening within this population.

Factors affecting compliance with colorectal cancer screening among households residing in the largely Haitian community of Little Haiti, Miami-Dade County, Florida: an observational study.

The United States Black population is disproportionately affected by colorectal cancer (CRC) in terms of incidence and mortality. Studies suggest that screening rates are lower among Blacks compared with non-Hispanic Whites (NHWs). However, studies on CRC screening within Black subgroups are lacking. This study examined disparities in blood stool test (BST) compliance and colonoscopy use by race/ethnicity (Haitian, NHW, non-Hispanic Black [NHB], and Hispanic) among randomly selected households in Little Haiti, Miami-Dade County, Florida.This study used cross-sectional, health and wellness data from a random-sample, population-based survey conducted within 951 households in Little Haiti between November 2011 and December 2012. BST compliance and colonoscopy use were self-reported and defined, conservatively, as the use of BST within the past 2 years and the ever use of colonoscopy by any household member. Factors associated with BST compliance and colonoscopy use were identified using logistic regression models. Analyses were restricted to households containing at least 1 member ≥50 years (n = 666).Nearly half of the households were compliant with BST (rate [95% confidence interval (CI)] = 45% [41%-49%]) and completed colonoscopy (rate [95% CI] = 53% [49%-58%]). Compliance with BST was not associated with race/ethnicity (P = 0.76). Factors independently associated with BST compliance included low educational attainment (adjusted odds ratio [AOR] = 0.63, P = 0.03), being single (AOR = 0.47, P = 0.004), retirement (AOR = 1.96, P = 0.01), and the presence of diagnosed health problems (AOR = 1.24, P = 0.01). Colonoscopy use was lower among Haitian households (46%) compared with NHW (63%), NHB (62%), and Hispanic households (54%) (P = 0.002). Factors independently associated with colonoscopy use included identifying as NHB (compared with Haitian) (AOR = 1.80, P = 0.05), being single (AOR = 0.44, P = 0.001), retirement (AOR = 1.86, P = 0.02), lack of continuous insurance (AOR = 0.45, P < 0.001), and the presence of diagnosed health problems (AOR = 1.44, P < 0.001) and physical limitations/disabilities (AOR = 1.88, P = 0.05).Compliance with BST and use of colonoscopy are low within households in the Little Haiti community. Significant disparities in the use of colonoscopy exist between Haitian and NHB households. Barriers and facilitators of colonoscopy within each racial/ethnic group need to be identified as the next step to developing culturally appropriate, community-based interventions aimed at increasing colonoscopy use in this large minority population.

Monitorización del PH fetal intraparto: relaciones con la frecuencia cardiaca y valoración del recien nacido; inforem preliminar / Intrapartum fetal PH monitoring: relations with fetal heart rat and newborn evaluation; preliminary report

Se analiza la importancia de la monitorización del pH fetal en muestra de cuero cabelludo en 15 pacientes con diagnóstico de sufrimiento fetal agudo intraparto, ya sea por alteraciones en la frecuencia cardíaca fetal y/o presencia de meconio en el líquido amniótico, a las cuales se les permitió continuar su trabajo de parto una vez se estableció el valor de pH fetal. Nueve de estas pacientes tuvieron parto espontáneo, y sólo 2 reuieron operación cesárea y no por indicación de sufrimiento fetal, sino por desproporción céfalo-pélvica. Los 15 recién nacidos se valoraron con Apgar mayor o igual a 7/10 y no presentaron ninguna complicación en el período post-natal. Finalmente, se sugiere la monitorización del pH fetal en muestra de cuero cabelludo, como un parámetro importante en el manejo de las pacientes con diagnóstico de sufrimiento fetal agudo intraparto, logrando así una reducción de la operación cesárea y asegurando una disminución en la morbilidad fetal