Nucleated red blood cells as a novel indicator of CD34+ cell content in umbilical cord blood.

BACKGROUND: Umbilical cord blood (UCB) has become an important source of transplantable CD34+ hematopoietic progenitor cells. Cord blood banks (CBBs) can increase their efficiency by minimizing the processing of UCB units with low CD34+ content, which have a lower likelihood of transplant utilization. We sought to identify a readily available preprocessing metric that would correlate with CD34+ cell counts, without the cost of additional analysis. STUDY DESIGN AND METHODS: Data were compiled for 131 UCB units processed at the regional CBB. Preprocessing hematologic metrics, including complete blood count and differential, were compared to postprocessing CD34+ cell quantities. The data were divided into six groups of varying preprocessing metrics, then compared for significant differences in postprocessing CD34+ cell quantities to develop a screening guidance. RESULTS: UCB units with nucleated RBC (nRBC) content of 15% or greater were found to have a significant increase in CD34+ cell percentage (p < 0.00001) and total CD34+ cell content (p < 0.0001). Units with preprocessing total nucleated cell count (TNC) of ≥ 1.50 × 109 with nRBC content of 15% or greater, and for TNC ≥ of 2.00 × 109 with nRBC content less than15%, had a significant increase in CD34+ content (p < 0.05 and p < 0.001, respectively). Applied as a screening guideline, these units had an increase in mean CD34+ content from 6.24 × 106 to 9.27 × 106 . Units originally in the bottom and top quartiles of CD34+ content constitute 5% and 53% of processed units meeting these TNC/nRBC criteria, respectively. CONCLUSION: These screening criteria utilizing nRBC provides a guideline that public CBBs may use to increase their efficiency by minimizing the processing of UCB units with lower CD34+ cell content.

Synchronous Mediastinal and Central Nervous System Involvement in Rosai-Dorfman Disease: A Case Report.

Rosai-Dorfman disease (RDD) is a rare disorder characterized by the proliferation and accumulation of histiocytes, primarily within lymph node sinuses. Uncommonly, other extranodal sites, such as the central nervous system, can also be affected. Here, we document the case of a 61-year-old woman presenting with dizziness, confusion, and headaches. Magnetic resonance imaging (MRI) showed an extra-axial avidly enhancing mass in the left parietal region presumed to be a meningioma based solely on its imaging appearance. The patient underwent surgical resection, and histopathological examination showed enlarged histiocytes positive for S100, CD68, and CD163 and negative for CD1a, consistent with RDD. She was followed up with a positron emission tomography/computed tomography (PET/CT) to evaluate other disease activity sites. A single mediastinal node was identified adjacent to the atriocaval junction intensely fluorodeoxyglucose avid. The patient underwent robotic node excision, with pathology analysis compatible with RDD. We emphasize the need to increase recognition of RDD on differential brain lesions, especially meningiomas, and suggest PET/CT as a valid tool to search for other disease activity lesions.

Coinfection of SARS-CoV-2 with other respiratory pathogens in outpatients from Ecuador.

Worldwide, the COVID-19 pandemic caused by SARS-CoV-2 has enormously impacted healthcare systems, especially in low and middle-income countries. Coinfections with respiratory pathogens in COVID-19 patients may contribute to worse outcomes. This study identified the presence of 12 viral coinfections and pneumococcal carriers among individuals with SARS-CoV-2 infection in outpatient and community settings in Ecuador. From January 2020 to November 2021, 215 nasopharyngeal and nasal swabs were taken from individuals who reported symptoms of COVID-19 or had known exposure to someone with confirmed or suspected COVID-19. One hundred fifty-eight tested positive for SARS-CoV-2 by RT-qPCR and coinfections were detected in 12% (19/158) of SARS-CoV-2-positive patients; the most frequent coinfection was with influenza A virus at 4.4% (7/158; 95% CI: 1.2-7.6), followed by respiratory syncytial virus with 3.1% (5/158; 95% CI: 0.4-5.8), and finally rhinovirus and human coronavirus NL63 with 1.2% (2/158). Pneumococcal carriage was detected in 3.7% (6/158; 95% CI: 0.76-6.64) of SARS-CoV-2 cases. Influenza B, adenovirus, human metapneumovirus (HMPV), parainfluenza virus types 1, 2, and 3, and human coronavirus HKU1 were undetected. To our knowledge, this is the first study of coinfection of SARS-CoV-2 and respiratory pathogens performed on outpatients in Latin America. The high proportion of outpatients with viral coinfections reported in our cohort allows us to suggest that testing for SARS-CoV-2 and other common respiratory pathogens should be carried out to ensure accurate diagnoses, prompt patient treatment, and appropriate isolation.

Fast, cheap and sensitive: Homogenizer-based RNA extraction free method for SARS-CoV-2 detection by RT-qPCR.

Background: The SARS-CoV-2 gold standard detection method is an RT-qPCR with a previous step of viral RNA extraction from the patient sample either by using commercial automatized or manual extraction kits. This RNA extraction step is expensive and time demanding. Objective: The aim of our study was to evaluate the clinical performance of a simple SARS-CoV-2 detection protocol based on a fast and intense sample homogenization followed by direct RT-qPCR. Results: 388 nasopharyngeal swabs were analyzed in this study. 222 of them tested positive for SARS-CoV-2 by the gold standard RNA extraction and RT-qPCR method, while 166 tested negative. 197 of those 222 positive samples were also positive for the homogenization protocol, yielding a sensitivity of 88.74% (95% IC; 83.83 - 92.58). 166 of those negative samples were also negative for the homogenization protocol, so the specificity obtained was 97% (95% IC; 93.11 - 99.01). For Ct values below 30, meaning a viral load of 103 copies/uL, only 4 SARS-CoV-2 positive samples failed for the RNA extraction free method; for that limit of detection, the homogenizer-based method had a sensitivity of 97.92% (95% CI; 96.01 - 99.83). Conclusions: Our results show that this fast and cheap homogenization method for the SARS-CoV-2 detection by RT-qPCR is a reliable alternative of high sensitivity for potentially infectious SARS-CoV-2 positive patients. This RNA extraction free protocol would help to reduce diagnosis time and cost, and to overcome the RNA extraction kits shortage experienced during COVID-19 pandemic.

Predictors of sleep pattern disturbances. Results from a third-level university hospital.

INTRODUCTION: Obesity is considered an epidemic condition. It is related to the increased prevalence of chronic degenerative diseases, but there are no studies in the Mexican paediatric population on its relationship with sleep disorders. AIM OF THE STUDY: We sought to determine the prevalence of sleep disorders in paediatrics, as well as factors for their development. MATERIAL AND METHODS: An observational, analytical, retrospective study, was performed including patients aged 2 to 16 years, between March 2019-2021. The Paediatric Sleep Questionnaire was used to assess the presence of sleep disorders. RESULTS: Sixty-four patients were included, 27 (42.18%) of whom had sleep disorder criteria. Among these, obesity, i.e. weight percentile ≥ 75 and body mass index percentile ≥ 93.5, was a risk factor. Normal weight was protective. CONCLUSIONS: Obesity in paediatric patients may favour the appearance of sleep disorders; screening could favour early diagnosis, correct treatment, and better life quality.

Clinical Performance of Three Commercial SARS-CoV-2 Rapid Antigen Tests for Community-Dwelling Individuals in a Tropical Setting.

During the second year of the COVID-19 pandemic, the use of Rapid Diagnosis Antigen Tests (RDAgTs) for SARS-CoV-2 detection has substantially increased as some of the brands available in the market were certified for clinical use by international regulatory agencies. RDAgTs are a fast and cheap tool for SARS-CoV-2 surveillance with great potential to improve testing capacities in middle- and low-income countries compared to the gold standard RT-qPCR. However, as the clinical performance of RDAgTs has been shown to vary greatly between the commercial brands available, evaluation studies are necessary. Moreover, the available evaluation has been done in high-income countries while SARS-CoV-2 transmission is also actively happening in developing countries, many of which are located in tropical latitudes where cross-reactivity with other infectious agents is highly prevalent, which could compromise RDAgT specificity. Moreover, unreported mutations and/or new SARS-CoV-2 variants may compromise RDAgT sensitivity as genomic surveillance is limited in these settings. Here we describe a multicenter and manufacturer-independent evaluation of the clinical performance and analytical sensitivity of three different RDAgTs brands available in South America from three companies, Rapigen (South Korea), SD-Biosensor (South Korea), and Certest (Spain), compared to the gold standard RT-qPCR. A total number of 1,646 nasopharyngeal swabs from community-dwelling individuals were included in the study, and 379 of them were SARS-CoV-2 positive by RT-qPCR. The overall sensitivity for each RDAgT was 79% (IC95%: 72 - 86.2), 64.2% (IC95%: 56.7 - 71.6), and 45.8% (IC95%: 35.8 - 55.8) for SD-Biosensor, Certest, and Rapigen, respectively. The overall specificity for each RDAgT was 100%, 97.7% (IC95%: 96.8 - 98.6), and 100% for SD-Biosensor, Certest, and Rapigen, respectively. However, the limit of detection (LoD) to achieve a sensitivity over 90% was substantially lower for Certest RDAgT (102 copies/uL) compared to SD-Biosensor (103 copies/uL) or Rapigen (106 copies/uL) RDAgTs, considering that the gold standard RT-qPCR method used in this study has a high sensitivity of 97.7% and low LoD of 5 copies/uL. Additionally, the Certest RDAgT also showed an improved sensitivity up to 79.7% (IC95%: 70.2 - 89.2) for symptomatic individuals. Finally, the slight reduction in specificity for Certest RDAgTs was only associated with one of the laboratories performing this study, pointing out the need for locally assessed evaluation for RDAgTs like this one carried out in Ecuador. In conclusion, two of the three the RDAgTs tested in this study are a fast, cheap, and point of care tool for SARS-CoV-2 surveillance and reliable enough to detect SARS-CoV-2 infectious individuals.

[Dietary training for school food service providers in support of the Acuerdo Nacional para la Salud Alimentaria]. / Capacitación alimentaria a comodatarios en apoyo al Acuerdo Nacional para la Salud Alimentaria.

BACKGROUND: To address the problem of overweight and obesity in Mexico, in 2010 the Acuerdo Nacional para la Salud Alimentaria was published. At school level, food service providers were considered essential to comply with certain commitments. The goal of this intervention was to train school food service providers in school eating establishments (SEE) as to the criteria in the general guidelines for the sale and distribution of food in schools of basic education. METHODS: 13 SEE in San Luis Potosi participated. Based on an initial diagnosis, a class-workshop of 5 sessions was designed. Knowledge regarding food was evaluated at the beginning and end of the sessions. The percentage of adherence regarding general hygiene and food preparation and distribution was obtained at the beginning, one month, and two months post-intervention. RESULTS: School food service providers had little knowledge on the objectives of the Acuerdo in food groups and combination, as well as reading labels; there were significant changes in the last two after intervention. The initial percentage of overall hygiene compliance was 60 %, with an increase of almost 20 % post-training. The preparation and distribution of food did not show significant changes. CONCLUSIONS: School food service providers acquired knowledge about the guidelines that a SEE comply with, without putting them into practice, given the economic impact that it implies.

Introducción: en apoyo a la problemática de sobrepeso y obesidad en México, en el 2010 se publicó el Acuerdo Nacional para la Salud Alimentaria. A nivel escolar, los comodatarios se consideraron fundamentales para cumplir con ciertos compromisos. El objetivo de esta intervención fue capacitar a comodatarios de los Establecimientos de Consumo Escolar (ECE) en cuanto a los criterios establecidos en los "Lineamientos Generales para el Expendio y Distribución de Alimentos en Planteles de Educación Básica." Métodos: participaron 13 ECE en San Luis Potosí. Con base en un diagnóstico inicial, se diseñó un curso-taller de 5 sesiones. Se evaluaron conocimientos en materia alimentaria al inicio y al final de las sesiones. Se obtuvo el porcentaje de apego en cuanto a higiene general, preparación y distribución de alimentos, al inicio, al mes y a los dos meses postintervención. Resultados: los comodatarios presentaron pocos conocimientos en los objetivos que persigue el "Acuerdo" en grupos y combinación de alimentos así como en lectura de etiquetas; con cambios significativos en los dos últimos tras la intervención. El porcentaje inicial de cumplimiento en higiene general fue del 60 %, con un incremento de casi 20 % postcapacitación. La preparación y distribución de alimentos no presentaron cambios significativos. Conclusiones: los comodatarios adquirieron conocimientos sobre los lineamientos que debe cubrir un ECE, sin ponerlos en práctica, dado el impacto que ello implica en su economía.