Inefficient Induction of Neutralizing Antibodies against SARS-CoV-2 Variants in Patients with Inflammatory Bowel Disease on Anti-Tumor Necrosis Factor Therapy after Receiving a Third mRNA Vaccine Dose.

Management of inflammatory bowel disease (IBD) often relies on biological and immunomodulatory agents for remission through immunosuppression, raising concerns regarding the SARS-CoV-2 vaccine's effectiveness. The emergent variants have hindered the vaccine neutralization capacity, and whether the third vaccine dose can neutralize SARS-CoV-2 variants in this population remains unknown. This study aims to evaluate the humoral response of SARS-CoV-2 variants in patients with IBD 60 days after the third vaccine dose [BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna)]. Fifty-six subjects with IBD and 12 healthy subjects were recruited. Ninety percent of patients with IBD (49/56) received biologics and/or immunomodulatory therapy. Twenty-four subjects with IBD did not develop effective neutralizing capability against the Omicron variant. Seventy percent (17/24) of those subjects received anti-tumor necrosis factor therapy [10 = adalimumab, 7 = infliximab], two of which had a history of COVID-19 infection, and one subject did not develop immune neutralization against three other variants: Gamma, Epsilon, and Kappa. All subjects in the control group developed detectable antibodies and effective neutralization against all seven SARS-CoV-2 variants. Our study shows that patients with IBD might not be protected against SARS-CoV-2 variants, and more extensive studies are needed to evaluate optimal immunity.

Knowledge among Puerto Rican Women about Risk of Infertility Associated with Overweight and Obesity.

OBJECTIVE: Our study sought to evaluate how aware the women attending gynecology clinics at the University of Puerto Rico Medical Sciences Campus (UPRMSC) were of the association between infertility and excess body weight (i.e., overweight and obesity). METHODS: Women 21 years old and older attending gynecology clinics at UPR-MSC were invited to participate in this study (n = 234). A self-administered survey was provided to all the women. Logistic regression models were performed to determine associations. RESULTS: About 56.8% of the women were found to be aware of the effects of obesity on fertility; their main source of medical information was their primary doctor. The odds (adjusted for age and annual income) of being aware of the association between obesity and infertility were about 2.41 (95% CI: 1.07-5.42) times higher in women with a BMI greater than or equal to 25 kg/m2 than they were in those with a BMI of less than 25 kg/m2. An interaction by age group (adjusted for BMI) was found for the association between annual income and knowledge of the obesity-infertility association (OR≥40 years old: 3.51, 95% CI: 1.41-8.72; OR<40 years old: 0.57, 95% CI: 0.15-2.13). CONCLUSION: Our study revealed that there is a lack of knowledge regarding the effects of obesity on fertility and identifies characteristics associated with this knowledge. The contents of health-care-provider counseling and the barriers affecting communication between patients and health care providers could be assessed in further studies.

Knowledge and Use of Folic Acid among Women Attending the high-Risk Prenatal Clinics at the Adults University Hospital in Puerto Rico.

INTRODUCTION: Pregnancies affected with neural tube defects (NTDs) are mostly associated to maternal deficiency of folic acid (FA). Although supplementation is recommended for all women of childbearing age, the incidence of NTDs in Puerto Rico has not shown a significant decrease. OBJECTIVE: The goal of this study was to assess the awareness and level of knowledge of FA supplementation among women attending prenatal clinics, and correlate this knowledge with the source ofinformation and the actual use of FA. A secondary objective was to corroborate or abrogatethe association of the lack of FA supplementation with the occurrence of unplanned pregnancies. METHODS: This descriptive study was conducted at the High-Risk Prenatal Care Clinicsof the Adults University Hospital from August 2015 to November 2015. The answers to a non-validated self-administered questionnaire were assessed and then analyzed with Epi Info 7. RESULTS: From a total of 200 Hispanic female participants, 87.0% were Puerto Rican, most (69.0%) had an education above high school level and 54.5% had a low-income status. Overall, 66.5% were taking FA at the time of the interview, 77% understood that the best time to start FA supplementation was prior to conception, but only 23% of the participants actually began preconceptional FA intake. Unplanned pregnancies were reported in 70.5%. Most referred to have received information about FA benefits from a healthcare professional, yet many could not identify all of FA benefits. CONCLUSION: Although most participants were aware of the best time to begin FA supplementation, the majority began intake once pregnancy was discovered; timing related to the 70.5% unplanned pregnancies. Information received is not sufficient sincemost women are not entirely clear about the benefits of FA supplementation, despite their source of information. In caring for women of childbearing age, further investigation is required to optimize educational strategies and methodologies.