Associations of Incomplete SARS-CoV-2 Vaccination among Patients with Unstable Housing in Houston.

Vaccination is a safe and effective way to protect against SARS-CoV-2. Two of the three authorized SARS-CoV-2 vaccines require two doses, presenting logistical challenges. Those with unstable housing face barriers that amplify these challenges. In this study, we utilized a database maintained by Healthcare for the Homeless-Houston to determine the rates of partial vaccination among those with unstable housing in Houston (n=294). We then performed post-hoc analyses to identify predictors of partial vaccination. Our key finding was that 30% of those with unstable housing missed their second dose, a proportion far higher than the national average. Those with permanent supportive housing and those who had a Harris County Gold Card (financial assistance for health care costs) were more likely to return for dose two, while those who were younger, living on the streets, or staying in a temporary homeless shelter were more likely to miss the second dose.

Heberprot P en lesión grave de la mano e injerto bipediculado al abdomen. Presentación de caso / Heberprot P in serious hand injury and bipedicular graft to the abdomen. Case report

RESUMEN Fundamento: El Heberprot P es una terapia que contribuye a la reparación de tejidos dañados. Su utilización en las lesiones ortopédicas de los miembros superiores es muy reciente y de escasa publicación. Objetivo: Describir la evolución de una paciente con lesión grave del dorso de la mano derecha en el que se utilizó el Heberprot P, seguido de injerto pediculado. Presentación de caso: Paciente que sufrió accidente con lesión grave en la mano derecha. Se realizó diagnóstico clínico e imagenológico con pérdida de piel, tejido celular subcutáneo y fractura del cuarto y quinto metacarpianos, se le aplicó procedimiento quirúrgico. Evolucionó de forma tórpida con infección profunda, pérdida de tendones extensores y exposición ósea, se decidió iniciar tratamiento con Heberprot P para incentivar tejido de granulación; 21 días después se logró cubrir las estructuras óseas, se operó los tendones y cobertura cutánea con injerto bipediculado al abdomen con evolución favorable. La paciente se reincorporó a su actividad social y laboral a los 10 meses. Conclusiones: El Heberprot P aceleró la cicatrización de tejidos, asociado a colgajos a distancia facilitó una evolución satisfactoria y evitó la amputación, disminuyó estadía hospitalaria, asimismo propició la reincorporación a la vida social y laboral.

ABSTRACT Background: Heberprot P is a therapy that contributes to the repairing of damaged tissues. Its use in orthopedic injuries of the upper limbs is very recent and of little publication. Objective: To describe the evolution of a patient with a serious injury to the back of the right hand in which the Heberprot P was used, followed by a pedicle graft. Case report: Patient who suffered an accident with a serious right hand injury. Clinical and imaging diagnosis was made with skin loss, subcutaneous cellular tissue and fracture of the fourth and fifth metacarpals, a surgical procedure was applied. It evolved torpidly with deep infection, loss of extensor tendons and bone exposure, it was decided to start treatment with Heberprot P to stimulate granulation tissue; 21 days later, the bone structures were covered, the tendons and skin coverage were operated with a bipedicular graft to the abdomen with a favorable evolution. The patient returned to her social and work activity at 10 months. Conclusions: Heberprot P accelerated tissue healing, associated with remote flaps, facilitated a satisfactory evolution and avoided amputation, decreased hospital stay, and also favored return to social and work life.