Success and Survivorship Following Charcot Reconstruction: A Review of 151 Cases.

Charcot neuroarthropathy is a debilitating condition that frequently leads to skeletal deformity and pedal ulceration in the insensate foot. Results are often poor and no clear guidelines for surgical management exist. Additionally, amputation rates vary widely making it difficult to accurately inform patients of risks. Few studies have assessed outcomes to identify patients for whom reconstruction is likely to fail. The literature is limited, with small sample sizes and mortality infrequently addressed. We performed a retrospective observational study of patients with Charcot neuroarthropathy to assess overall amputation and mortality rates at 30 days, 1 year, and 3 years postreconstruction and evaluated associated risk factors. Rates of infection, re-ulceration, and return to walking were also assessed. We identified 151 patients over a 5-year period. Demographic and clinical characteristics were collected. Descriptive statistics, Cox proportional hazard model, and logistic regression were used. Overall, 22 (14.6%) patients died, and 23 (15.2%) patients advanced to limb amputation postoperatively. End-stage renal disease, peripheral vascular disease, reconstruction during active phase Charcot process, and reconstruction at the ankle or subtalar joint were all associated with poor outcomes. The risk of mortality was 2.5 times higher in patients with end-stage renal disease, and 3.4 times higher among patients with peripheral vascular disease. Patients with ankle or subtalar joint reconstruction were 70% less likely to return to walking compared to medial column reconstruction. Due to these findings, we suggest that patients with such comorbidities be advised of increased risk for complications including failure to return to walking, amputation, and death.

Laparoscopic near-total splenectomy: a single-center experience of a standardized procedure.

Background: Near-total splenectomy (NTS) represents an innovative and effective surgery technique for spleen disease, reducing the risk of severe infections and thromboembolic events after total splenectomy. The authors reported a laparoscopic near-total splenectomy (LNTS) surgical experience following the optimal results of the open approach, describing a standardized and effective minimally invasive technique with the purpose of preserving a minimal residual spleen.Material and methods: From November 2006 to September 2016, 15 patients with splenic and hematologic disease underwent LNTS, according to a laparoscopic procedure developed by the authors. The end criterion was to conserve a remanent spleen of 10-15 cm3 in size.Results: Patient age ranged between 18 and 59 years. Mean operative time was 70 ± 20 min. Mean hospital stay was 3.46 (range 3-7) days. One complication occurred during the surgery for a lesion of the inferior polar artery with need of a total splenectomy. No conversion to open surgery was necessary.Conclusions: LNTS is a safe and effective technique for the management of splenic and hematologic disease with a low intra- and post-operative complication rate, and it can minimize the late sequelae of secondary splenectomy. However, it requires further studies with more cases to evaluate its role.

Morphologic and molecular diagnostic criteria of malignancies in biliary strictures.

The differential diagnosis of benign and malignant biliary strictures is not always feasible and still represents a major diagnostic challenge, mainly due to the scarcity of the tissue retrieved for proper cytological or histopathological diagnosis. The present review focuses on morphological criteria in the diagnosis of biliary strictures, in the course of primary sclerosing cholangitis and other pathologies, starting from the limits of the cytological and histological evaluation, as well as the ancillary methodologies currently available in Pathology laboratories The current guidelines suggest fluorescence in situ hybridization for the analysis of chromosomes 3, 7, and 17 polysomies and deletion of the 9p21 locus; however, other more promising techniques are on the horizon for both patient care and research purposes, such as Next-Generation Sequencing, able to analyze multiple genes simultaneously in a cost-effective fashion. Lastly, the most recent approaches proposed in the literature for the differential diagnosis of biliary stricture are described, such as circulating tumor DNA, miRNAs, and DNA methylation, among others.

[Effect of previous exposure to COVID-19, occurrence of spikes, and type of vaccine on the humoral immune response of institutionalized older adults]. / Efecto de la exposición previa a COVID-19, ocurrencia de brotes y tipo de vacuna en la respuesta inmune humoral de adultos mayores institucionalizados.

This study evaluated the explanatory factors of humoral immune response in older adults admitted to long-term care institutions in Buenos Aires, Argentina, up to 180 days after vaccination. An open-label, prospective, multicenter cohort study was conducted with volunteers who received two doses of the Sputnik V, Sinopharm, or AZD1222 vaccines. Plasma samples were analyzed at 0 and 21 days after the first dose, 21 days after the second dose, and 120 and 180 days after the first dose. Marginal linear models and generalized additives mixed models were adjusted to determine the behavior of anti-spike IgG antibody concentration over time according to exposure group (naïve/no-naïve) and vaccine. Occurrence of an outbreak of COVID-19 in long-term care institutions and comorbidities were the covariates analyzed. A total of 773 participants were included, with a mean age of 83 years (IQR: 76-89). Results showed that antibody levels in the naïve: Sinopharm group were significantly lower to the other groups (p < 0.05). Antibody levels in the no-naïve: Sinopharm group were similar to those in the naïve group who received AZD1222 (p = 0.945) or Sputnik V (p = 1). Participants exposed to outbreaks in long-term care institutions had significantly higher antibody levels, regardless of exposure group and vaccine (p < 0.001). In conclusion, previous exposure to COVID-19, type of vaccine, and admittance into a long-term care institution with a history of outbreaks are factors to be considered in future epidemic events with transmission dynamics and immunological mechanisms similar to COVID-19, in populations similar to the one analyzed.

El objetivo de este trabajo fue evaluar los factores explicativos de la respuesta inmune humoral en adultos mayores de establecimientos de estancia prolongada de Buenos Aires, Argentina, hasta 180 días post vacunación. Se utilizó un diseño de cohorte abierta, prospectiva, multicéntrica, con voluntarios que recibieron dos dosis de vacunas Sputnik V, Sinopharm o AZD1222. Se analizaron muestras de plasma en los tiempos 0, 21 días post primera dosis, 21 días post segunda dosis, 120 y 180 días post primera dosis. Se ajustaron modelos lineales marginales y aditivos generalizados mixtos para evaluar el comportamiento de la concentración de anticuerpos IgG anti-Spike en el tiempo según grupo de exposición (naïve/no-naïve) y vacuna. Las covariables analizadas fueron: ocurrencia de brote de COVID-19 en establecimientos de estancia prolongada y comorbilidades. Se incluyeron en el análisis 773 participantes con una mediana de edad de 83 años (RIQ: 76-89). Al final del estudio, los niveles de anticuerpos del grupo naïve: Sinopharm fueron significativamente menores que el resto de los grupos (p < 0,05); los del no-naïve: Sinopharm resultaron similares a los naïve que recibieron AZD1222 (p = 0,945) o Sputnik V (p = 1). Los participantes expuestos a brotes en establecimientos de estancia prolongada presentaron niveles de anticuerpos significativamente mayores, independientemente del grupo de exposición y la vacuna (p < 0,001). Concluimos que la exposición previa a COVID-19, el tipo de vacuna y la pertenencia a un establecimiento de estancia prolongada con antecedente de brote son factores a considerar frente a futuros eventos epidémicos con dinámicas de transmisión y mecanismos inmunológicos similares al COVID-19, en poblaciones similares a la analizada en este trabajo.

Este estudo teve como objetivo avaliar os fatores explicativos da resposta imune humoral em idosos em instituições de longa permanência em Buenos Aires, Argentina, até 180 dias após a vacinação. Foi realizado um estudo de coorte aberto, prospectivo e multicêntrico, com voluntários que receberam duas doses das vacinas Sputnik V, Sinopharm ou AZD1222. As amostras de plasma foram analisadas nos tempos 0, 21 dias após a primeira dose, 21 dias após a segunda dose, 120 e 180 dias após a primeira dose. Os modelos lineares marginais e os aditivos generalizados mistos foram ajustados para determinar o comportamento da concentração de anticorpos IgG anti-Spike ao longo do tempo de acordo com o grupo de exposição (naïve/no-naïve) e vacina. As covariáveis analisadas foram ocorrência de pico de COVID-19 nas instituições de longa permanência e comorbidades. Foram incluídos 773 participantes, com média de idade de 83 anos (IIQ: 76-89). Os resultados apontaram níveis de anticorpos do grupo naïve: Sinopharm significativamente mais baixos do que os outros grupos (p < 0,05); e as variáveis do grupo no-naïve: Sinopharm foram semelhantes à do grupo naïve que recebeu AZD1222 (p = 0,945) ou Sputnik V (p = 1). Os participantes expostos a picos nas instituições de longa permanência apresentaram níveis de anticorpos significativamente maiores, independentemente do grupo de exposição e da vacina (p < 0,001). Conclui-se que a exposição prévia à COVID-19, tipo de vacina e adesão a uma instituição de longa permanência com histórico de pico são fatores a serem considerados em futuros eventos epidêmicos com dinâmica de transmissão e mecanismos imunológicos semelhantes à COVID-19, em populações semelhantes à analisada neste trabalho.

Mortality in Patients with 22q11.2 Rearrangements.

The 22q11.2 region is highly susceptible to genomic rearrangements leading to multiple genomic disorders, including 22q11.2 microdeletion syndrome (22q11.2 DS) (MIM# 188400), 22q11.2 microduplication syndrome (MIM# 608363), supernumerary der(22)t(11;22) syndrome (also known as Emanuel Syndrome; MIM# 609029), and Cat Eye Syndrome (MIM# 115470). In this study, we present data on causes of mortality, average age of death, and the existing associated risk factors in patients with 22q11.2 rearrangements. Our cohort included 223 patients (120 males and 103 females) with confirmed diagnoses of 22q11.2 rearrangements diagnosed through molecular techniques (FISH, MLPA, and CMA). Relatives from patients who have been molecularly confirmed with 22q11.2 rearrangements have also been added to the study, regardless of the presence or absence of symptoms. Of these 223 individuals, 21 (9.4%) died. Deceased patients' rearrangements include 19 microdeletions, 1 microduplication, and 1 patient with a marker chromosome. The median age of death was 3 months and 18 days (ranging from 3 days to 34 years). There were 17 patients who died at pediatric age (80.95%), 3 died at adult age (14.28%), and for 1 of whom, the age of death is unknown (4.76%). Eighteen patients were White Mediterranean (European non-Finnish) (85.71%) whereas three were Amerindian (South American) (14.28%). Mortality from cardiac causes accounted for 71.42%. The second most frequent cause of death was sepsis in two patients (9.52%). One patient died from respiratory failure (4.76%) and one from renal failure (4.76%). Information regarding the cause of death was not available in two patients (9.52%). Most patients who died were diagnosed within the first week of life, the majority on the first day. This study adds additional information on mortality in one of the largest cohorts of patients with 22q11.2 rearrangements in more than 30 years of follow-up.

A population-based comparison of weight and weight perceptions among overweight and obese Mexican and Mexican-American men.

OBJECTIVE: To examine actual and perceived weight in national cohorts of Mexican-origin adult men in Mexico and the United States (US). MATERIALS AND METHODS: We used the 2001-06 National Health and Nutrition Examination Survey and the 2006 Mexican National Health and Nutrition Survey. RESULTS: The prevalence of overweight or obesity (OO) in Mexicans was 65% and in Mexican-Americans was 72%. OO Mexican-American men were more likely than OO Mexican men (56 vs. 49%) to perceive themselves as "overweight". Among OO men from both populations, those who had been screened for OO by a health provider were almost seven times more likely to have accurate weight perceptions. Only 9% of OO men in Mexico and 25% in the US recalled having been screened for weight. CONCLUSION: Weight misperceptions were common in both populations but more prevalent in Mexico; low screening by providers may contribute to poor weight control in both countries.

Snijders Blok-Campeau Syndrome: Description of 20 Additional Individuals with Variants in CHD3 and Literature Review.

Snijders Blok-Campeau syndrome (SNIBCPS, OMIM# 618205) is an extremely infrequent disease with only approximately 60 cases reported so far. SNIBCPS belongs to the group of neurodevelopmental disorders (NDDs). Clinical features of patients with SNIBCPS include global developmental delay, intellectual disability, speech and language difficulties and behavioral disorders like autism spectrum disorder. In addition, patients with SNIBCPS exhibit typical dysmorphic features including macrocephaly, hypertelorism, sparse eyebrows, broad forehead, prominent nose and pointed chin. The severity of the neurological effects as well as the presence of other features is variable among subjects. SNIBCPS is caused likely by pathogenic and pathogenic variants in CHD3 (Chromodomain Helicase DNA Binding Protein 3), which seems to be involved in chromatin remodeling by deacetylating histones. Here, we report 20 additional patients with clinical features compatible with SNIBCPS from 17 unrelated families with confirmed likely pathogenic/pathogenic variants in CHD3. Patients were analyzed by whole exome sequencing and segregation studies were performed by Sanger sequencing. Patients in this study showed different pathogenic variants affecting several functional domains of the protein. Additionally, none of the variants described here were reported in control population databases, and most computational predictors suggest that they are deleterious. The most common clinical features of the whole cohort of patients are global developmental delay (98%) and speech disorder/delay (92%). Other frequent features (51-74%) include intellectual disability, hypotonia, hypertelorism, abnormality of vision, macrocephaly and prominent forehead, among others. This study expands the number of individuals with confirmed SNIBCPS due to pathogenic or likely pathogenic variants in CHD3. Furthermore, we add evidence of the importance of the application of massive parallel sequencing for NDD patients for whom the clinical diagnosis might be challenging and where deep phenotyping is extremely useful to accurately manage and follow up the patients.

Self-handicapping strategies in educational context: construction and validation of the Brazilian Self-Handicapping Strategies Scale (EEAPREJ).

Self-handicapping strategies refer to the set of choices and attitudes adopted to minimize blame for failure and increase the value of success in achievement situations. This paper aims to describe the stages of construction and the psychometric analysis of a scale to measure the self-handicapping strategies of university students. In study 1, the major steps for the construction of the scales and initial results are reported. The internal consistency indices were acceptable and the principal component analysis revealed factors with little explanation of data variance. In study 2, data from a sample of 834 students from several undergraduate courses of different Brazilian universities were subjected to exploratory factor analysis using the minimum rank factor analysis (MRFA) method and the matrix of polychoric correlations. The parallel analysis criterion for factor retention indicated the one-factor solution as the best fit to data. The importance of having a valid and reliable measure to assess self-handicapping strategies in educational contexts and the promising use of the scale in actions to improve learning in higher education are discussed.

Humoral response and neutralising capacity at 6 months post-vaccination against COVID-19 among institutionalised older adults in Argentina.

The COVID-19 pandemic has particularly affected older adults residing in nursing homes, resulting in high rates of hospitalisation and death. Here, we evaluated the longitudinal humoral response and neutralising capacity in plasma samples of volunteers vaccinated with different platforms (Sputnik V, BBIBP-CorV, and AZD1222). A cohort of 851 participants, mean age 83 (60-103 years), from the province of Buenos Aires, Argentina were included. Sequential plasma samples were taken at different time points after vaccination. After completing the vaccination schedule, infection-naïve volunteers who received either Sputnik V or AZD1222 exhibited significantly higher specific anti-Spike IgG titers than those who received BBIBP-CorV. Strong correlation between anti-Spike IgG titers and neutralising activity levels was evidenced at all times studied (rho=0.7 a 0.9). Previous exposure to SARS-CoV-2 and age <80 years were both associated with higher specific antibody levels. No differences in neutralising capacity were observed for the infection-naïve participants in either gender or age group. Similar to anti-Spike IgG titers, neutralising capacity decreased 3 to 9-fold at 6 months after initial vaccination for all platforms. Neutralising capacity against Omicron was between 10-58 fold lower compared to ancestral B.1 for all vaccine platforms at 21 days post dose 2 and 180 days post dose 1. This work provides evidence about the humoral response and neutralising capacity elicited by vaccination of a vulnerable elderly population. This data could be useful for pandemic management in defining public health policies, highlighting the need to apply reinforcements after a complete vaccination schedule.

Influence of the Compaction Method in the Volumetric Design of Cold Recycled Mixtures with Emulsion.

Compaction of cold asphalt mixtures is a subject that has not been thoroughly studied, and, for this reason, requires new efforts from researchers to have a better understanding. Unlike hot mixtures, cold mixtures and mainly recycled mixtures require specific considerations for compaction. There is a lack of consensus about the methodology to select the optimum premix water and emulsion contents. In the absence of specific regulations, the use of soil tests or hot mixtures procedures is common. For these reasons, this investigation's main goal was to evaluate two compaction methods used to design cold recycled mixtures with emulsion: the modified Proctor procedure and the gyratory compaction. It was concluded that both methods could be useful to study compactability since consistent results were obtained by applying the maximum bulk density criterion. However, the higher bulk densities achieved, the smaller specimens used, and the suitability of the gyratory specimens to be later tested for mechanical properties make them preferable to the modified Proctor samples. A new approach has been proposed using iso-density lines on dual-axis premix water content-emulsion content graphs that facilitates the study of the influence on compactability of these two factors combined. These contributions can alleviate the laboratory works during the design of cold recycled asphalt mixtures and contribute to a more in-depth knowledge of the combined effect of premix water and emulsion contents on the compactability of cold recycled mixtures with emulsion.

Prospective cohort study in the early stage of the COVID-19 pandemic, General Pueyrredón, Argentina (INECOVID): infection dynamics and risk factors. / Estudio de cohortes prospectivo en etapa temprana de la pandemia COVID-19, Partido de General Pueyrredón, Argentina (INECOVID): dinámica de infección y factores de riesgo.

OBJECTIVE: To establish the magnitude and risk factors for SARS-CoV-2 infection in the General Pueyrredón, Buenos Aires, Argentina: the INECOVID study. METHODS: Prospective cohort designed with participants from the District general population. The follow-up period was from June 22nd to December 18th, 2020, with a minimum appointment interval of 21 days. Data were obtained via questionnaires and serum or plasma samples. The primary event was considered as the time to seroconversion (IgG) as evidence of SARS-CoV-2 infection. The accumulated risk of infection was estimated using the Kaplan Meier method. Cox models were built with time-dependent variables. RESULTS: 345 participants were recruited (n=222 women, 64.3%; 123 men, 35.7%), with a median age of 45 years in women (Interquartile range: 19) and 49 in men (Interquartile range: 26). 12.8% of participants (n=44) had evidence of SARS-CoV-2 infection [incidence density of 9.1 cases (women: 11.1, men: 5.1) per 10,000 person-day]. 36.4% of the cases (n=16) were asymptomatic. The following factors were associated to the risk of infection: being in close contact of a confirmed COVID-19 case (HR=5.56; 95%CI 2.85-10.83), being a health worker (HR=2.93; 95%CI 1.55-5.52), living in crowded conditions (HR=2.23; 95%CI 1.13-4.49), and age (HR=0.98; 95%CI 0.95-1.00). CONCLUSION: The identified risk factors endorse the protection policies and protocols adopted by the Argentinian sanitary authorities for the general population and the care programs for health workers in the pre-vaccination phase.

OBJETIVO: Establecer la magnitud y los factores de riesgo de infección por SARS-CoV-2 en el Partido de General Pueyrredón, Buenos Aires, Argentina: estudio INECOVID. MÉTODOS: Diseño de cohortes prospectivo con participantes de población general del partido. El período de seguimiento fue del 22 de junio al 18 de diciembre de 2020, con un intervalo mínimo de citación de 21 días. Los datos se obtuvieron mediante cuestionarios y muestras de suero o plasma. El evento primario fue el tiempo hasta la seroconversión (IgG) como evidencia de infección por SARS-CoV-2. Se estimó el riesgo acumulado de infección por el método de Kaplan Meier. Se construyeron modelos de Cox con variables tiempo-dependientes. RESULTADOS: Fueron reclutados 345 participantes (n=222 mujeres, 64,3%; 123 hombres, 35,7%), con una edad mediana de 45 años en mujeres (Rango intercuartílico: 19) y 49 en hombres (Rango intercuartílico: 26). El 12,8% de los participantes (n=44) tuvieron evidencia de infección por SARS-CoV-2 [densidad de incidencia de 9,1 casos (mujeres: 11,1, hombres: 5,1) por 10.000 personas-días]. El 36,4% de los casos (n=16) fueron asintomáticos. Se mostraron asociados al riesgo de infección: ser contacto estrecho de un caso confirmado de COVID-19 (HR=5,56; IC95% 2,85­10,83), ser trabajador de salud (HR=2,93; IC95% 1,55-5,52), vivir en hacinamiento (HR=2,23; IC95% 1,13­4,49) y edad (HR=0,98; IC95% 0,95­1,00). CONCLUSIÓN: Los factores de riesgo de infección hallados avalan las políticas y protocolos de protección adoptados por las autoridades sanitarias de Argentina para la población general y los programas de atención a los trabajadores de la salud en la etapa pre-vacunación.

Objective and subjective social class gradients for substance use among Mexican adolescents.

This study examines the shape of social class gradients for substance use among Mexican adolescents. Substance use and objective and subjective indicators of social class were assessed in house-to-house surveys conducted with 7614 Mexican adolescents in 2004. The sample was designed to be representative of the poorest urban communities in seven Mexican states. The prevalence of current smoking was 16.8%, alcohol consumption was 30.2%, and drug use was 4.6%. Multiple logistic regressions are used to estimate the associations of objective indicators of socioeconomic status (SES) and subjective social status (SSS)-at both community and societal levels-and smoking, alcohol and drug use. Adolescents who perceived themselves as higher in social status in reference to their local community reported more smoking and drinking. Our findings were similar when we used objective measures of SES, such as maternal education and total monthly household expenditures per person. In contrast, adolescents who perceived that they had high social standing in reference to Mexican society as a whole were less likely to report being current smokers and drinkers. We found no significant association between social status and drug use. Research into how adolescents perceive themselves in reference to their peer communities may help strengthen programs and policies aimed at promoting health in vulnerable adolescent populations.

Incidence and Risk Factors of Symptomatic Venous Thromboembolism Following Foot and Ankle Surgery.

BACKGROUND:: The incidence rate of venous thrombotic events (VTEs) following foot and ankle surgery is low. Currently, there is no consensus regarding postoperative prophylaxis or evidence to support risk stratification. METHODS:: A 2-part study assessing the incidence and factors for the development of VTE was conducted: (1) a retrospective observational cohort study of 22 486 adults to calculate the overall incidence following foot and/or ankle surgery from January 2008 to May 2011 and (2) a retrospective matched case-control study to identify risk factors for development of VTE postsurgery. One control per VTE case matched on age and sex was randomly selected from the remaining patients. RESULTS:: The overall incidence of VTE was 0.9%. Predictive risk factors in bivariate analyses included obesity, history of VTE, history of trauma, use of hormonal replacement or oral contraception therapy, anatomic location of surgery, procedure duration 60 minutes or more, general anesthesia, postoperative nonweightbearing immobilization greater than 2 weeks, and use of anticoagulation. When significant variables from bivariate analyses were placed into the multivariable regression model, 4 remained statistically significant: adjusted odds ratio (aOR) for obesity, 6.1; history of VTE, 15.7; use of hormone replacement therapy, 8.9; and postoperative nonweightbearing immobilization greater than 2 weeks, 9.0. The risk of VTE increased significantly with 3 or more risk factors ( P = .001). CONCLUSION:: The overall low incidence of VTE following foot and ankle surgery does not support routine prophylaxis for all patients. Among patients with 3 or more risk factors, the use of chemoprophylaxis may be warranted. LEVEL OF EVIDENCE:: Level III, retrospective case series.

Efecto de la exposición previa a COVID-19, ocurrencia de brotes y tipo de vacuna en la respuesta inmune humoral de adultos mayores institucionalizados / Effect of previous exposure to COVID-19, occurrence of spikes, and type of vaccine on the humoral immune response of institutionalized older adults / Efeito da exposição prévia à COVID-19, ocorrência de picos e tipo de vacina na resposta imune humoral de adultos idosos institucionalizados

Resumen: El objetivo de este trabajo fue evaluar los factores explicativos de la respuesta inmune humoral en adultos mayores de establecimientos de estancia prolongada de Buenos Aires, Argentina, hasta 180 días post vacunación. Se utilizó un diseño de cohorte abierta, prospectiva, multicéntrica, con voluntarios que recibieron dos dosis de vacunas Sputnik V, Sinopharm o AZD1222. Se analizaron muestras de plasma en los tiempos 0, 21 días post primera dosis, 21 días post segunda dosis, 120 y 180 días post primera dosis. Se ajustaron modelos lineales marginales y aditivos generalizados mixtos para evaluar el comportamiento de la concentración de anticuerpos IgG anti-Spike en el tiempo según grupo de exposición (naïve/no-naïve) y vacuna. Las covariables analizadas fueron: ocurrencia de brote de COVID-19 en establecimientos de estancia prolongada y comorbilidades. Se incluyeron en el análisis 773 participantes con una mediana de edad de 83 años (RIQ: 76-89). Al final del estudio, los niveles de anticuerpos del grupo naïve: Sinopharm fueron significativamente menores que el resto de los grupos (p < 0,05); los del no-naïve: Sinopharm resultaron similares a los naïve que recibieron AZD1222 (p = 0,945) o Sputnik V (p = 1). Los participantes expuestos a brotes en establecimientos de estancia prolongada presentaron niveles de anticuerpos significativamente mayores, independientemente del grupo de exposición y la vacuna (p < 0,001). Concluimos que la exposición previa a COVID-19, el tipo de vacuna y la pertenencia a un establecimiento de estancia prolongada con antecedente de brote son factores a considerar frente a futuros eventos epidémicos con dinámicas de transmisión y mecanismos inmunológicos similares al COVID-19, en poblaciones similares a la analizada en este trabajo.

Abstract: This study evaluated the explanatory factors of humoral immune response in older adults admitted to long-term care institutions in Buenos Aires, Argentina, up to 180 days after vaccination. An open-label, prospective, multicenter cohort study was conducted with volunteers who received two doses of the Sputnik V, Sinopharm, or AZD1222 vaccines. Plasma samples were analyzed at 0 and 21 days after the first dose, 21 days after the second dose, and 120 and 180 days after the first dose. Marginal linear models and generalized additives mixed models were adjusted to determine the behavior of anti-spike IgG antibody concentration over time according to exposure group (naïve/no-naïve) and vaccine. Occurrence of an outbreak of COVID-19 in long-term care institutions and comorbidities were the covariates analyzed. A total of 773 participants were included, with a mean age of 83 years (IQR: 76-89). Results showed that antibody levels in the naïve: Sinopharm group were significantly lower to the other groups (p < 0.05). Antibody levels in the no-naïve: Sinopharm group were similar to those in the naïve group who received AZD1222 (p = 0.945) or Sputnik V (p = 1). Participants exposed to outbreaks in long-term care institutions had significantly higher antibody levels, regardless of exposure group and vaccine (p < 0.001). In conclusion, previous exposure to COVID-19, type of vaccine, and admittance into a long-term care institution with a history of outbreaks are factors to be considered in future epidemic events with transmission dynamics and immunological mechanisms similar to COVID-19, in populations similar to the one analyzed.

Resumo: Este estudo teve como objetivo avaliar os fatores explicativos da resposta imune humoral em idosos em instituições de longa permanência em Buenos Aires, Argentina, até 180 dias após a vacinação. Foi realizado um estudo de coorte aberto, prospectivo e multicêntrico, com voluntários que receberam duas doses das vacinas Sputnik V, Sinopharm ou AZD1222. As amostras de plasma foram analisadas nos tempos 0, 21 dias após a primeira dose, 21 dias após a segunda dose, 120 e 180 dias após a primeira dose. Os modelos lineares marginais e os aditivos generalizados mistos foram ajustados para determinar o comportamento da concentração de anticorpos IgG anti-Spike ao longo do tempo de acordo com o grupo de exposição (naïve/no-naïve) e vacina. As covariáveis analisadas foram ocorrência de pico de COVID-19 nas instituições de longa permanência e comorbidades. Foram incluídos 773 participantes, com média de idade de 83 anos (IIQ: 76-89). Os resultados apontaram níveis de anticorpos do grupo naïve: Sinopharm significativamente mais baixos do que os outros grupos (p < 0,05); e as variáveis do grupo no-naïve: Sinopharm foram semelhantes à do grupo naïve que recebeu AZD1222 (p = 0,945) ou Sputnik V (p = 1). Os participantes expostos a picos nas instituições de longa permanência apresentaram níveis de anticorpos significativamente maiores, independentemente do grupo de exposição e da vacina (p < 0,001). Conclui-se que a exposição prévia à COVID-19, tipo de vacina e adesão a uma instituição de longa permanência com histórico de pico são fatores a serem considerados em futuros eventos epidêmicos com dinâmica de transmissão e mecanismos imunológicos semelhantes à COVID-19, em populações semelhantes à analisada neste trabalho.

Predictive Potential of Motivation to Learn in the use of Learning Strategies / Potencial Preditivo da Motivação para Aprender no Uso das Estratégias de Aprendizagem

Abstract This paper investigates motivation to learn and learning strategies in a sample of 353 Brazilian students in elementary and secondary education. Data were collected through the Motivation to learn scale and two Learning Strategies Assessment Scales, one for elementary school and another for high school. Learning goals and use of metacognitive strategies were predominant in the sample. Significant positive and negative correlations between the subscales were found. Two models emerged explaining 33% and 37% of the variance in the use of learning strategies that can be attributed to motivation to learn factors. The study underscores the importance of motivation to learn for engaging students in strategic behavior.

Resumo O artigo investigou a motivação para aprender e as estratégias de aprendizagem em uma amostra de 353 estudantes do ensino fundamental e médio brasileiro. Foram utilizadas a Escala de avaliação da motivação para a aprendizagem e uma Escala de Avaliação das Estratégias de Aprendizagem para o Ensino Fundamental e outra para o Ensino Médio. A Meta Aprender e as estratégias metacognitivas foram predominantes na amostra. Foram encontradas correlações positivas e negativas significativas entre as subescalas e emergiram dois modelos que explicaram 33% e 37% da variância no uso de estratégias de aprendizagem que podem ser atribuídos aos fatores da motivação. O estudo reforçou a importância da motivação para aprender no engajamento dos estudantes em comportamentos estratégicos.

Self-handicapping strategies in educational context: construction and validation of the Brazilian Self-Handicapping Strategies Scale (EEAPREJ)

Abstract Self-handicapping strategies refer to the set of choices and attitudes adopted to minimize blame for failure and increase the value of success in achievement situations. This paper aims to describe the stages of construction and the psychometric analysis of a scale to measure the self-handicapping strategies of university students. In study 1, the major steps for the construction of the scales and initial results are reported. The internal consistency indices were acceptable and the principal component analysis revealed factors with little explanation of data variance. In study 2, data from a sample of 834 students from several undergraduate courses of different Brazilian universities were subjected to exploratory factor analysis using the minimum rank factor analysis (MRFA) method and the matrix of polychoric correlations. The parallel analysis criterion for factor retention indicated the one-factor solution as the best fit to data. The importance of having a valid and reliable measure to assess self-handicapping strategies in educational contexts and the promising use of the scale in actions to improve learning in higher education are discussed.

Male cytogenetic evaluation prior to assisted reproduction procedures performed in Mar del Plata, Argentina.

OBJECTIVE: This paper aimed to estimate the frequency of occurrence and the types of chromosomal abnormalities found in 141 infertile men with abnormal semen parameters. METHODS: the frequency and type of chromosomal abnormalities were determined with male mitotic karyotype analysis from peripheral blood through chromosome banding techniques before assisted reproduction procedures. RESULTS: In this series of 141 infertile men, 19 (13%) had chromosomal anomalies and 35 (25%) had polymorphic variants. The main chromosome abnormalities were reciprocal translocations and marker chromosomes in mosaic. CONCLUSIONS: These results stress the relevance of cytogenetic studies for infertile males as a diagnostic tool and a valuable input in genetic counseling.

Estudio de cohortes prospectivo en etapa temprana de la pandemia COVID-19, Partido de General Pueyrredón, Argentina (INECOVID): dinámica de infección y factores de riesgo / Prospective cohort study in the early stage of the COVID-19 pandemic, General Pueyrredón, Argentina (INECOVID): infection dynamics and risk factors

RESUMEN: Objetivo: Establecer la magnitud y los factores de riesgo de infección por SARS-CoV-2 en el Partido de General Pueyrredón, Buenos Aires, Argentina: estudio INECOVID. Métodos: Diseño de cohortes prospectivo con participantes de población general del partido. El período de seguimiento fue del 22 de junio al 18 de diciembre de 2020, con un intervalo mínimo de citación de 21 días. Los datos se obtuvieron mediante cuestionarios y muestras de suero o plasma. El evento primario fue el tiempo hasta la seroconversión (IgG) como evidencia de infección por SARS-CoV-2. Se estimó el riesgo acumulado de infección por el método de Kaplan Meier. Se construyeron modelos de Cox con variables tiempo-dependientes. Resultados: Fueron reclutados 345 participantes (n=222 mujeres, 64,3%; 123 hombres, 35,7%), con una edad mediana de 45 años en mujeres (Rango intercuartílico: 19) y 49 en hombres (Rango intercuartílico: 26). El 12,8% de los participantes (n=44) tuvieron evidencia de infección por SARS-CoV-2 [densidad de incidencia de 9,1 casos (mujeres: 11,1, hombres: 5,1) por 10.000 personas-días]. El 36,4% de los casos (n=16) fueron asintomáticos. Se mostraron asociados al riesgo de infección: ser contacto estrecho de un caso confirmado de COVID-19 (HR=5,56; IC95% 2,85-10,83), ser trabajador de salud (HR=2,93; IC95% 1,55-5,52), vivir en hacinamiento (HR=2,23; IC95% 1,13-4,49) y edad (HR=0,98; IC95% 0,95-1,00). Conclusión: Los factores de riesgo de infección hallados avalan las políticas y protocolos de protección adoptados por las autoridades sanitarias de Argentina para la población general y los programas de atención a los trabajadores de la salud en la etapa pre-vacunación.

ABSTRACT Objective: To establish the magnitude and risk factors for SARS-CoV-2 infection in the General Pueyrredón, Buenos Aires, Argentina: the INECOVID study. Methods: Prospective cohort designed with participants from the District general population. The follow-up period was from June 22nd to December 18th, 2020, with a minimum appointment interval of 21 days. Data were obtained via questionnaires and serum or plasma samples. The primary event was considered as the time to seroconversion (IgG) as evidence of SARS-CoV-2 infection. The accumulated risk of infection was estimated using the Kaplan Meier method. Cox models were built with time-dependent variables. Results: 345 participants were recruited (n=222 women, 64.3%; 123 men, 35.7%), with a median age of 45 years in women (Interquartile range: 19) and 49 in men (Interquartile range: 26). 12.8% of participants (n=44) had evidence of SARS-CoV-2 infection [incidence density of 9.1 cases (women: 11.1, men: 5.1) per 10,000 person-day]. 36.4% of the cases (n=16) were asymptomatic. The following factors were associated to the risk of infection: being in close contact of a confirmed COVID-19 case (HR=5.56; 95%CI 2.85-10.83), being a health worker (HR=2.93; 95%CI 1.55-5.52), living in crowded conditions (HR=2.23; 95%CI 1.13-4.49), and age (HR=0.98; 95%CI 0.95-1.00). Conclusion: The identified risk factors endorse the protection policies and protocols adopted by the Argentinian sanitary authorities for the general population and the care programs for health workers in the pre-vaccination phase.

Abordaje epidemiológico en establecimiento de estancia prolongada de adultos mayores con antecedente de brote de COVID-19 / Epidemiological approach in a long-term care facility for the elderly with antecedent of COVID-19 outbreak

INTRODUCCIÓN: Durante la pandemia de enfermedad por el nuevo coronavirus (COVID-19) los adultos mayores residentes en instituciones semicerradas y su personal de salud constituyen una subpoblación vulnerable con riesgo elevado de hospitalización y muerte. OBJETIVO: Describir el abordaje epidemiológico efectuado en un establecimiento de estancia prolongada para adultos mayores bajo vigilancia activa, en el aglomerado urbano Mar del Plata-Batán, en diciembre de 2020. MÉTODOS: La estrategia de abordaje combinó la indicación de aislamiento de los casos sospechosos, la realización de reacción en cadena de la polimerasa en tiempo real (RT-PCR) y la detección de anticuerpos del tipo inmunoglobulina G (IgG). RESULTADOS: Se detectaron 4 casos de infección por el nuevo coronavirus (SARS-CoV-2) por RT-PCR en miembros del personal de salud; solo 1 tenía antecedente de detección por RT-PCR durante el brote inicial ocurrido 95 días antes; los resultados en los residentes fueron negativos. Se encontraron 40 casos con anticuerpos de tipo IgG (63,5%); 12 de ellos (30%) no tenían antecedente de detección mediante RT-PCR en ninguno de los brotes. DISCUSIÓN: Los hallazgos indican que el hecho de haber atravesado un primer episodio de brote en el establecimiento confirió inmunidad a personas que no habían tenido manifestaciones clínicas de la enfermedad, lo cual, probablemente, contribuyó a evitar la propagación del segundo brote entre los residentes

Laparoscopic treatment of unicentric Castleman's disease with abdominal localization.

We report a case of unicentric Castleman's disease (angiofollicular lymph node hyperplasia) with abdominal localization, that was treated laparoscopically. The patient, a 23-year-old male, was referred to our unit for subtle symptoms of recurrent palpitations and vague abdominal pain. His physician had prescribed an abdominal echtomograph, which showed a mass located at the lower and anterior lower splenic pole. In order to reach a definite diagnosis and prescribe adequate treatment, a diagnostic laparoscopy was performed. Exploration of the abdominal cavity helped detect a well-vascularized solid round mass at the level of the left hypochondrium, with a vascular pedicle; the lesion was detached, and the pedicle sectioned using an Endo-GIA 40. The postoperative course was regular and the patient was discharged on postoperative day 2. The laparoscopic approach enabled the resection of the lesion (with consequent histological diagnosis) and exploration of the peritoneal cavity with the advantages of minimal invasiveness, magnified images, and more rapid recovery). The pathology was totally resolved, with satisfactory results in terms of recovery, postoperative pain, and cosmesis.