CoronaVac-vaccinated kidney transplant recipients with hybrid immunity have strong neutralizing responses against Omicron and Mu variants of SARS-CoV-2.

Neutralizing antibody (nAb) responses against SARS-CoV-2 variants after inactivated virus vaccine (CoronaVac) in kidney transplant recipients (KTRs) with or without SARS-CoV-2 infection history remains unclear. We aimed to evaluate the neutralizing antibody responses against emerging SARS-CoV-2 variants after two doses of CoronaVac in these patients. 22.2% of participants had hybrid immunity. Anti-spike IgG antibodies were evidenced in 44% of the patients. nAbs against B.1.111, Mu, and Omicron were detected in 28.5%, 17.9%, and 21.4% of naïve KTRs, respectively. Furthermore, nearly 100% of KTRs with hybrid immunity had nAbs against the variants evaluated. Thus, a significant proportion of infection-naïve KTRs had no detectable nAb titers against Mu and Omicron variants after two doses of the CoronaVac vaccine. However, the nAb titers were significantly higher in patients with hybrid immunity, and it was no association between the immunosuppressive regimen and the seropositivity rate of anti-SARS-CoV-2 neutralizing antibodies. Therefore, hybrid KTRs are protected against COVID-19 by emerging variants able to escape from vaccine-elicited nAbs such as Mu and Omicron.

Low Performance of Sinovac Vaccine Particularly With Belatacept Therapy in a Study With Different Types of COVID-19 Vaccines in Transplanted Patients.

The huge impact of SARS-CoV-2 infections on organ transplant recipients makes it necessary to optimize vaccine efficacy in this population. To effectively implement multiple strategies, it is crucial to understand the performance of each type of available vaccine. In our study, the antibody titer was measured, and the presence of antibodies against SARS-CoV-2 was evaluated after 90 days of immunization; furthermore, the differences between hybrid immunity, immunity by vaccination, and immunosuppressant type were identified. As a result, of the patients included in this study (n = 160), 53% showed antibodies against SARS-CoV-2 90 days after the first dose in patients who had completed the vaccination schedule. Antibody titers were higher in patients with hybrid immunity, and the proportion of nonresponsive patients was higher among those who received the immunosuppressant belatacept in their post-transplant regimen (P = .01). Only 15% of patients treated with this medicine seroconverted and patients vaccinated with CoronaVac and treated with belatacept showed no response. In conclusion, a reduced response to vaccines against SARS-CoV-2 was identified in the transplant population, and this response varied with the type of vaccine administered and the immunosuppressive treatment.

Breakthrough Infections Following mRNA SARS-CoV-2 Vaccination in Kidney Transplant Recipients.

BACKGROUND: The clinical effectiveness of coronavirus disease 2019 (COVID-19) vaccination in kidney transplant (KT) recipients is lower than in the general population. METHODS: From April to October 2021, 481 KT recipients with COVID-19, included in the Spanish Society of Nephrology COVID-19 Registry, were analyzed. Data regarding vaccination status and vaccine type were collected, and outcomes of unvaccinated or partially vaccinated patients (n = 130) were compared with fully vaccinated patients (n = 351). RESULTS: Clinical picture was similar and survival analysis showed no differences between groups: 21.7% of fully vaccinated patients and 20.8% of unvaccinated or partially vaccinated died (P = 0.776). In multivariable analysis, age and pneumonia were independent risk factors for death, whereas vaccination status was not related to mortality. These results remained similar when we excluded patients with partial vaccination, as well as when we analyzed exclusively hospitalized patients. Patients vaccinated with mRNA-1273 (n = 213) showed a significantly lower mortality than those who received the BNT162b2 vaccine (n = 121) (hazard ratio: 0.52; 95% confidence interval, 0.31-0.85; P = 0.010). CONCLUSIONS: COVID-19 severity in KT patients has remained high and has not improved despite receiving 2 doses of the mRNA vaccine. The mRNA-1273 vaccine shows higher clinical effectiveness than BNT162b2 in KT recipients with breakthrough infections. Confirmation of these data will require further research taking into account the new variants and the administration of successive vaccine doses.

[The Medical-Pharmaceutical Department of the Junta for aid to Spanish Republicans, Mexico delegation]. / El Servicio Médico-Farmacéutico de la Junta de Auxilio a los republicanos españoles, delegación de Mexico.

Between 1940 and 1942, the Mexican delegation of the Junta for Aid to Spanish republicans founded and supported its own Medical-Pharmaceutical Department in Mexico City, formed by recently exiled Spanish professionals. It initially dealt with home medical care, charging for each medical service performed by specialists and each drug prescription. It later included a polyclinic with a staff of specialists and its own pharmacy. Finally, a small hospital and a laboratory for medical tests were planned, but circumstances prevented the project from getting under way. The study addresses the reasons for the birth of the Medical Pharmaceutical Service, its funding, organization and functioning, the professionals on whom it depended, its lines of action and its immediate projects. It also covers the main problems faced during its development and the reasons for its forced dissolution.

Two decades of analysis of peritonitis in peritoneal dialysis in Andalusia: Epidemiological, clinical, microbiological and progression aspects.

BACKGROUND: This study focuses on the main complication associated with peritoneal dialysis, peritonitis. Its relevance derives from its high morbidity, the negative effect it has on the peritoneum as a dialysis membrane and its financial cost. METHODS: Analytical, non-interventional, observational cohort study, whose main objective is the analysis of peritonitis in patients on peritoneal dialysis in Andalusia from 1 January 1999 to 31 December 2017, with a total of 2904 peritonitis cases. The database used is the Andalusian Autonomous Transplant Coordination Information System (SICATA). OBJECTIVES: To ascertain how the rate of peritonitis is evolving in our community, analyse descriptive data pertaining to patients and peritonitis, ascertain the course of these infectious complications and analyse the factors that influence these cases of peritonitis and their outcomes: germ, hospitalisation and date. RESULTS: The rate of peritonitis decreased progressively during the study period, from 0.7 peritonitis per patient in 1999 to 0.33 at the end of the period. Most infections were treated on an outpatient basis (72.5%). The most common germs were Gram-positive (55.9%), including coagulase-negative staphylococci (28.1%). Most cases of peritonitis progressed to healing (77.8%). The factors that significantly influence the need for hospitalisation and peritonitis progression were the causative germ and associated exit site infection. CONCLUSIONS: In our population, the rate of peritonitis decreased progressively during the study period, meeting guideline recommendations.

[The "Chapter on health preservation" in the Kitab al-taysir fi l-mudawat wa-l-tadbir by Avenzoar (1095-1162)]. / El "Capítulo sobre la conservación de la salud" del Kitab al-taysir al-taysir fi l-mudawat wa-l-tadbir de Avenzoar (c. 1095-1162).

The Kitab al-taysir fi l-mudawat wa-l-tadbir (The Method of Preparing Medicines and Diet) was written in Arabic by Avenzoar (1095-1162). It has yet to be translated into any Western modern language, and we wish to take on this task. We begin by offering an annotated Spanish translation (with commentary) of its preliminary "Chapter on the preservation of health". The Al-mohad caliph 'Abd al-Mu'min, for whom Avenzoar served as court physician, requested the book for his personal use. The work begins with this chapter, which contains measures for preventing and curing certain diseases. This section is followed by the main body of the book. It consists of a complete list of diseases working from head to toe and including their description, symptoms and treatment. The translated chapter is an atypical and concise treatise on the subject. It is presented in a quasi-aphoristic style that appears to have been used by Avenzoar to rapidly deal with the prevention area, in order to concentrate his efforts on what is surely one of the finest and most extensive mediaeval nosographies. We make this claim because our author does not exclusively use for this purpose the so-called "non-naturals"--the usual focus of health preservation measures of the time. Rather, he makes wide use of simple medicines with preventative ends--an unusual practice. Moreover, he indiscriminately intersperses prevention elements with others that are intended to cure. In order to better understand the meaning of this text, we previously refer to the foundations of health preservation practices in the mediaeval world, to the reasons why Avenzoar wrote the Kitab al-taysir fi l-mudawat wa-l-tadbir, and to the characteristics of its translated chapter. We also examine the medical sources and contents of this chapter.

Autotrasplante renal por aneurisma de arteria renal en un paciente con riñón funcional único: reporte de un caso / Renal autotransplantation in a patient with renal artery aneurysm and a single functional kidney

El autotrasplante renal es un procedimiento quirúrgico poco frecuente, especialmente, cuando el paciente tiene un solo riñón funcional y su indicación es alguna anormalidad vascular compleja. En el presente artículo, se presenta un paciente a quien se practicó una nefrectomía más reconstrucción vascular ex vivo y autotrasplante renal. Además, se reporta su evolución hasta el octavo año después de la cirugía.

Renal autotransplantation is a surgical procedure performed with very low frequency, especially in cases in which the patient has a solitary kidney and in which the procedure is indicated by a vascular abnormality. In this article, we report the case of a 52 year-old patient undergoing a nephrectomy incision with ex-vivo repair of a renal aneurysm plus autotransplantation. Additionally, we report the evolution after surgery at the 8th year of follow up