High Hepatitis B Prevalence and Vaccination Needs Among Transgender Women and Men Sex Workers in Barcelona, Spain.

Background: Transgender women sex workers (TWSWs) and men sex workers (MSWs) are especially vulnerable to acquiring hepatitis B virus (HBV) infection. We aimed to describe HBV prevalence (hepatitis B surface antigen [HBsAg] and core antibody [HBcAb]) and associated risk factors for HBV exposure (HBcAb), to assess vaccination status and risk factors for no prior vaccination, and to compare HBV prevalence and vaccination status between TWSWs and MSWs. Methods: The SexCohort study was advertised to TWSWs and MSWs through several communication channels. At cohort entry through 2 community-based organizations in Barcelona, the study population was screened for HBV and other sexually transmitted infections, and an epidemiological questionnaire was administered (n = 271). Results: Overall, 93.0% of participants were migrants, mostly from South and Central American countries. HBsAg prevalence was 1.9% (TWSWs, 2.4%; vs MSWs, 0.9%; P = .42), and previous exposure to HBV was 31.8% (TWSWs, 38.5%; vs MSWs, 20.8%; P = .002). Over 5 years of sex work (adjusted odds ratio [aOR], 9.35), prior exposure to Treponema pallidum (aOR, 3.49), and treatment with anxiolytic drugs (aOR, 3.23) were associated with HBV exposure. Overall, 33.7% of participants exhibited immunity from vaccination (TWSWs, 30.8%; vs MSWs, 38.61%; P < .001), while 34.4% were candidates to HBV vaccination (TWSWs, 30.8%; vs MSWs, 40.6%; P < .001). Never having been on pre-exposure prophylaxis for HIV (odds ratio [OR], 4.23) and non-Spanish origin (OR, 5.00) were associated with no prior HBV vaccination. Conclusions: There is a need to reinforce screening and vaccination programs aimed at TWSWs and MSWs as integrated services offered at the community centers commonly accessed by these populations.

Prevalence of latent and overt polyautoimmunity in type 1 diabetes: A systematic review and meta-analysis.

BACKGROUND: Patients afflicted by type 1 diabetes (T1D) exhibit polyautoimmunity (PolyA). However, the frequency and distribution of PolyA in T1D is still unknown. OBJECTIVE: We conducted a systematic review and meta-analysis to define the prevalence of latent and overt PolyA in individuals with T1D. METHODS: Following PRISMA guidelines, a comprehensive search across medical databases identified studies on latent and overt PolyA in T1D. Two researchers independently screened, extracted data, and assessed study quality. A random effects model was utilized to calculate the pooled prevalence, along with its corresponding 95 % confidence interval (CI), for latent PolyA and overt PolyA. Meta-regression analysis was conducted to study the effect of study designs, age, sex, and duration of disease on pooled prevalence. RESULTS: A total of 158 articles, encompassing a diverse composition of study designs were scrutinized. The analysis included 270,890 individuals with a confirmed diagnosis of T1D. The gender was evenly distributed (50.30 % male). Notably, our analysis unveiled an overt PolyA prevalence rate of 8.50 % (95 % CI, 6.77 to 10.62), with North America having the highest rates (14.50 %, 95 % CI, 7.58 to 24.89). This PolyA profile was further characterized by a substantial incidence of concurrent autoimmune thyroid disease (7.44 %, 95 % CI, 5.65 to 9.74). Moreover, we identified a notable prevalence of latent PolyA in the T1D population, quantified at 14.45 % (95 % CI, 11.17 to 18.49) being most frequent in Asia (23.29 %, 95 % CI, 16.29 to 32.15) and Oceania (21.53 %, 95 % CI, 16.48 to 27.62). Remarkably, this latent PolyA phenomenon primarily featured an array of autoantibodies, including rheumatoid factor, followed by Ro52, thyroid peroxidase antibodies, and thyroglobulin antibodies. Duration of the disease was associated with a highest frequency of latent (ß: 0.0456, P-value: 0.0140) and overt PolyA (ß: 0.0373, P-value: 0.0152). No difference in the pooled prevalence by study design was observed. CONCLUSION: This meta-analysis constitutes a substantial advancement in the realm of early detection of PolyA in the context of T1D. Individuals with T1D should regularly undergo assessments to identify potential concurrent autoimmune diseases, especially as they age.

Pentoxifylline and Norcantharidin Modify p62 Expression in 2D and 3D Cultures of B16F1 Cells.

Three-dimensional cell cultures have improved the evaluation of drugs for cancer therapy, due to their high similarity to solid tumors. In melanoma, autophagy appears to show a dual role depending on the progression of the disease. p62 protein has been proposed for the evaluation of autophagic flux since its expression is an indicator of the state of autophagy. Pentoxifylline (PTX) and Norcantharidin (NCTD) are drugs that have been shown to possess anticancer effects. In this work, we used B16F1 mouse melanoma cells in two-dimensional (2D) monolayer cultures and three-dimensional (3D) spheroids to test the effect of PTX and NCTD over the p62 expression. We analyzed the effect on p62 expression through Western blot and immunofluorescence assays. Our results indicate that PTX decreases p62 expression in both cell culture models, while Norcantharidin increases its expression in 3D cultures at 24 h. Therefore, these drugs could have a potential therapeutic use for the regulation of autophagy in melanoma, depending on the state of evolution of the disease.

A clinical utility evaluation of dual HIV/Syphilis point-of-care tests in non-clinical settings for screening for HIV and syphilis in men who have sex with men.

BACKGROUND: Dual point-of-care tests (POCTs) for the simultaneous detection of antibodies to HIV and syphilis have been developed. Since community-based organisations (CBO) are effective providers of HIV and syphilis testing among men who have sex with men (MSM), evaluation of the utility of these dual tests at CBO testing services is a high priority. The aim of this study is to determine the feasibility of performing dual HIV-syphilis POCT testing among both users and providers at these non-clinical sites. METHODS: This evaluation assessed the utility of two lateral flow immunochromatographic antibody technologies for dual screening for HIV/syphilis among MSM seeking testing in four CBO testing services in Spain, Slovenia, Latvia, and Ukraine. The study's conceptual framework divides the concept of feasibility into two inter-related domains, acceptability, and usability and further breaks it down into six subdomains: learnability, willingness, suitability, satisfaction, efficacy, and effectiveness. The feasibility analysis was performed by calculating the median score in 3 stages (for individual questions, subdomains, and domains), using a summated scores method. RESULTS: The final sample included 844 participants, 60 of which were found to be HIV test positive (7.1%) and 61 (7.2%) positive on testing for syphilis. There was a small difference (1.1%) when comparing the results of the two dual POCTs under evaluation to the tests routinely used at each site. The inter-rater agreement showed a high concordance between two independent readings. The analysis of the feasibility for the users of the services indicated good satisfaction, suitability, and willingness. In addition, among 18 providers the total mean score showed good acceptability and usability, good willingness, easy learnability, high suitability, and good efficacy, but lower satisfaction and effectiveness. The operational characteristics of both dual study POCTs were well evaluated by providers. CONCLUSIONS: The introduction of dual HIV and syphilis  POCTs in CBO testing services for screening of MSM is feasible, with a high acceptability and usability both for users and providers. Implementation of dual POCTs for HIV and syphilis in CBO testing services is an opportunity for scaling up integrated HIV/syphilis testing for MSM.

Predictors of mortality in hospitalised patients with COVID-19: a 1-year case-control study.

BACKGROUND: A paucity of predictive models assessing risk factors for COVID-19 mortality that extend beyond age and gender in Latino population is evident in the current academic literature. OBJECTIVES: To determine the associated factors with mortality, in addition to age and sex during the first year of the pandemic. DESIGN: A case-control study with retrospective revision of clinical and paraclinical variables by systematic revision of clinical records was conducted. Multiple imputations by chained equation were implemented to account for missing variables. Classification and regression trees (CART) were estimated to evaluate the interaction of associated factors on admission and their role in predicting mortality during hospitalisation. No intervention was performed. SETTING: High-complexity centre above 2640 m above sea level (masl) in Colombia. PARTICIPANTS: A population sample of 564 patients admitted to the hospital with confirmed COVID-19 by PCR. Deceased patients (n=282) and a control group (n=282), matched by age, sex and month of admission, were included. MAIN OUTCOME MEASURE: Mortality during hospitalisation. MAIN RESULTS: After the imputation of datasets, CART analysis estimated 11 clinical profiles based on respiratory distress, haemoglobin, lactate dehydrogenase, partial pressure of oxygen to inspired partial pressure of oxygen ratio, chronic kidney disease, ferritin, creatinine and leucocytes on admission. The accuracy model for prediction was 80.4% (95% CI 71.8% to 87.3%), with an area under the curve of 78.8% (95% CI 69.63% to 87.93%). CONCLUSIONS: This study discloses new interactions between clinical and paraclinical features beyond age and sex influencing mortality in COVID-19 patients. Furthermore, the predictive model could offer new clues for the personalised management of this condition in clinical settings.

Behavioral Management of Respiratory/Phonatory Dysfunction for Dysarthria Associated With Neurodegenerative Disease: A Systematic Review.

PURPOSE: This systematic review represents an update to previous reviews of the literature addressing behavioral management of respiratory/phonatory dysfunction in individuals with dysarthria due to neurodegenerative disease. METHOD: Multiple electronic database searches and hand searches of prominent speech-language pathology journals were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. RESULTS: The search yielded 1,525 articles, from which 88 met inclusion criteria and were reviewed by two blinded co-investigators. A large range of therapeutic approaches have been added to the evidence base since the last review, including expiratory muscle strength training, singing, and computer- and device-driven programs, as well as a variety of treatment modalities, including teletherapy. Evidence for treatment in several different population groups-including cerebellar ataxia, myotonic dystrophy, autosomal recessive spastic ataxia of Charlevoix-Saguenay, Huntington's disease, multiple system atrophy, and Lewy body dementia-were added to the current review. Synthesis of evidence quality provided strong evidence in support of only one behavioral intervention: Lee Silverman Voice Treatment Program (LSVT LOUD) in people with Parkinson's disease. No other treatment approach or population included in this review demonstrated more than limited evidence, reflecting that these approaches/populations require urgent further examination. CONCLUSION: Suggestions about where future research efforts could be significantly strengthened and how clinicians can apply research findings to their practice are provided. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24964473.

Conversion of a classical microbiology laboratory to a total automation laboratory enhanced by the application of lean principles.

Laboratory automation in microbiology improves productivity and reduces sample turnaround times (TATs). However, its full potential can be unlocked through the optimization of workflows by adopting lean principles. This study aimed to explore the relative impact of laboratory automation and continuous improvement events (CIEs) on productivity and TATs. Laboratory automation took place in November 2020 and consisted of the introduction of WASPLab and VITEK MS systems. CIEs were run in May and September 2021. Before the conversion, the laboratory processed about ~492 samples on weekdays and had 10 full-time equivalent (FTE) staff for a productivity of 49 samples/FTE/day. In March 2021, after laboratory automation, the caseload went up to ~621 while the FTEs decreased to 8.5, accounting for productivity improvement to 73 samples/FTE/day. The hypothetical productivity went up to 110 samples/FTE/day following CIEs, meaning that the laboratory could at that point deal with a caseload increase to ~935 with unchanged FTEs. Laboratory conversion also led to an improvement in TATs for all sample types. For vaginal swabs and urine samples, median TATs decreased from 70.3 h [interquartile range (IQR): 63.5-93.1] and 73.7 h (IQR: 35.6-50.7) to 48.2 h (IQR: 44.8-67.7) and 40.0 h (IQR: 35.6-50.7), respectively. Automation alone was responsible for 37.2% and 75.8% of TAT reduction, respectively, while the remaining reduction of 62.8% and 24.2%, respectively, was achieved due to CIEs. The laboratory reached productivity and TAT goals predefined by the management after CIEs. In conclusion, automation substantially improved productivity and TATs, while the subsequent implementation of lean management further unlocked the potential of laboratory automation.IMPORTANCEIn this study, we combined total laboratory automation with lean management to show that appropriate laboratory work organization enhanced the benefit of the automation and substantially contributed to productivity improvements. Globally, the rapid availability of accurate results in the setting of a clinical microbiology laboratory is part of patient-centered approaches to treat infections and helps the implementation of antibiotic stewardship programs backed by the World Health Organization. Locally, from the point of view of laboratory management, it is important to find ways of maximizing the benefits of the use of technology, as total laboratory automation is an expensive investment.

An Online HIV Self-Sampling Strategy for Gay, Bisexual and Other Men Who Have Sex with Men and Trans Women in Spain.

We aimed to evaluate the feasibility of an online self-sampling pilot intervention for HIV testing addressed to gay, bisexual, and other men who have sex with men (GBMSM) and trans women (TW) users of dating apps in Spain. The website https://www.testate.org/ was designed to offer self-sampling kits for HIV testing and online consultation of the results. It was advertised on gay dating apps. Participants requested the delivery of a saliva self-sampling kit by mail and a postage-paid envelope to send the sample to the reference laboratory. An anonymous acceptability survey was conducted. The cascade of care was estimated. From November 2018 to December 2021, 4623 individual users ordered self-sampling kits, 3097 returned an oral fluid sample to the reference laboratory (67.5% return rate). 87 reactive results were detected. 76 were confirmed to be HIV-positive, we estimated an HIV prevalence of 2.45% (95% CI 1.9-3.0%). 100% of those referred to specialized care are in treatment. 45.8% of participants took more than one test. 23 incident cases were detected among repeat testers, of which 20 were confirmed. The estimated incidence was 1.00 confirmed case per 100 individual-years of follow-up. 98.01% of participants would recommend it to a friend. The most identified advantages were convenience and privacy. We demonstrated that the online offer of oral self-sampling kits for HIV detection and reporting results online among GBMSM and TW users of dating apps is feasible. The intervention counted with a high acceptability and high efficacy (in terms of reactivity, confirmation and linkage to care rates).

Surgical and audiologic outcomes following revision cochlear implantation in children.

INTRODUCTION: The incidence of cochlear implantation failure is rare; however, complications can arise in which revision surgery becomes necessary. The purpose of this study is to review our institutional experience with revision cochlear implantation to further understand the surgical and audiological outcomes after cochlear implant failure. METHODS: This is a retrospective review of patients who underwent revision cochlear implantation from 2014 to 2022 at a single institution. RESULTS: Twenty-one patients required reimplantation within the 8-year study period. During this time frame, a total of 202 cochlear implants were implanted in 171 pediatric patients, resulting in a reimplantation rate of 5.9 %. Our reimplantation patient population were majority white (61.9 %), female (52.4 %), and insured by Medicaid (61.9 %). The average age at implantation was 54.8 months ±47.5 months and the average age at reimplantation was 100.1 months ±55.9 months. The average time between initial implantation and reimplantation was 46.2 months ±30.2 months. The most common sign of failure was abnormal impedances (47.6 %). Reimplantation was required more often for hard failure (76.2 %), which occurred secondary to trauma in 56.3 % of patients, and occurred more frequently in those ages 5-7. Operative findings were unremarkable in 81 % of patients. Those with audiologic data were noted to have stable or improved thresholds after their revision surgery. Three of the 21 patients discontinued use of their processor on the revised ear. Of these, two had known trauma associated with implant failure that was not immediately addressed. CONCLUSION: We noted increased rates of hard failure, most commonly secondary to trauma. We noted that majority of those who discontinued use of their implant after revision surgery had associated traumatic injuries that ultimately delayed their presentation and surgery.

Chitosan from Marine Amphipods Inhibits the Wilt Banana Pathogen Fusarium oxysporum f. sp. Cubense Tropical Race 4.

In this work, we extracted chitosan from marine amphipods associated with aquaculture facilities and tested its use in crop protection. The obtained chitosan was 2.5 ± 0.3% of initial ground amphipod dry weight. The chemical nature of chitosan from amphipod extracts was confirmed via Raman scattering spectroscopy and Fourier transform infrared spectroscopy (FTIR). This chitosan showed an 85.7-84.3% deacetylation degree. Chitosan from biofouling amphipods at 1 mg·mL-1 virtually arrested conidia germination (ca. sixfold reduction from controls) of the banana wilt pathogenic fungus Fusarium oxysporum f. sp cubense Tropical Race 4 (FocTR4). This concentration reduced (ca. twofold) the conidia germination of the biocontrol fungus Pochonia chlamydosporia (Pc123). Chitosan from amphipods at low concentrations (0.01 mg·mL-1) still reduced FocTR4 germination but did not affect Pc123. This is the first time that chitosan is obtained from biofouling amphipods. This new chitosan valorizes aquaculture residues and has potential for biomanaging the diseases of food security crops such as bananas.

Vulnerabilidad frente al VIH, clamidia y gonococia según el lugar donde se ejerce el trabajo sexual / HIV, Chlamydia and gonorrhoea vulnerability depending to sex work site

IntroducciónLas mujeres que ejercen el trabajo sexual (MTS) son una de las poblaciones clave en la monitorización y la evaluación del VIH y otras infecciones de transmisión sexual (ITS). Factores socioeconómicos, estructurales y asociados al ámbito de trabajo influyen en la exposición a estas infecciones. Los objetivos del estudio fueron describir y comparar características sociales, conductas de riesgo y prevalencia del VIH, clamidia y gonococia según el lugar de realización del trabajo sexual (calle o carretera, clubs, pisos).MétodosEstudio transversal en 400MTS en Cataluña. Se recogieron características sociodemográficas, del trabajo sexual y conductuales mediante entrevista personal y muestras de fluido oral y orina para determinar la prevalencia de ITS.ResultadosLas MTS que ejercen en la calle o en la carretera presentaron condiciones más precarias y mayor vulnerabilidad relacionada con factores socioeconómicos: población más envejecida, con nivel de estudios inferior y menor retribución económica por su servicio. Se observaron otros factores asociados al estilo de vida o conductuales: mayor consumo de drogas por vía parenteral, mayor tiempo de trabajo sexual o vulnerabilidades asociadas a una serie de determinantes a nivel estructural o sociales: menor acceso a servicios de salud, mayor proporción de relaciones forzadas y estancia en prisión. La prevalencia global de VIH, clamidia y gonococia fue del 3,0, del 1,8% y del 0,5%, respectivamente, y superiores en las mujeres que ejercían en la calle-carretera: 5,6%, 1,9% y 1,2%, respectivamente.ConclusiónLa información generada en este estudio será clave para el diseño de intervenciones preventivas específicas dirigidas a este colectivo.

IntroductionWomen sex workers (WSW) are one of key population on the HIV and other sexually transmitted infections (STIs) monitoring and evaluation. Socioeconomic, structural factors and other factors associated with the workplace influence exposure to these infections. The objectives of this study were to describe and compare the social characteristics, risk behaviours and HIV, Chlamydia and gonorrhoeae prevalence according to sex work site (street or highway, clubs and flats).MethodsCross-sectional study on 400WSW in Catalonia. Socio-demographic, sex work and behavioral characteristics were collected through personal interview. Oral fluid and urine samples were collected to determine STI prevalence.ResultsWSW that exercised in the street or highway presented more precarious conditions and a greater vulnerability related to socioeconomic factors: older population, with a lower education level and with less economic remuneration for their service. Other factors associated with lifestyle or behaviour was also observed: greater injecting drug use, longer sex work or vulnerabilities associated with structural or social determinants: less access to health services, higher proportion of forced relations and stay in prison. The overall HIV, Chlamydia and gonorrhoeae prevalence was 3.0%, 1.8% and 0.5%, respectively, and higher in women who exercised on the street or highway: 5.6%, 1.9% and 1.2%, respectively.ConclusionThe information generated in this study will be useful for the design specific preventive interventions aimed at this group.

Nutritional risk and clinical outcomes in critically ill adult patients with COVID-19 / Riesgo nutricional y resultados clínicos de pacientes adultos críticamente enfermos con COVID-19

Introduction: the COVID-19 pandemic put the world's population at risk. As the relationship between nutritional risk and clinical outcomes in critically ill patients with COVID-19 is still poorly understood, a multidisciplinary research team of the Argentine Society of Intensive Care (SATI) conducted a multicenter study aimed to define nutritional features, and to evaluate the relationship between nutritional risk and relevant clinical outcomes for COVID-19 patients in an intensive care unit (ICU). Methods: a multicenter, prospective, observational study including twelve Argentinian ICUs was conducted between March and October 2020. Inclusion criteria were: adult patients older than 18 years who were admitted to the ICU with a COVID-19 diagnosis were included. Clinical data included comorbidities scores, and nutritional screening tools such as the Subjective Global Assessment (SGA), the Nutritional Risk Screening (NRS) 2002, and the modified NUTRIC score (mNUTRIC SCORE) were used. In addition, clinical outcomes including overall mortality, mechanical ventilation (MV) days, and ICU and hospital length of stay (LOS) were recorded. Results: a total of 285 ICU patients met our inclusion criteria. Mean age was 61.24 (SD = 14.6) years; APACHE-II, 14.2 (SD = 6.6); Charlson Comorbidity Index (CCI), 2.3 (SD = 2.3). Most patients were admitted from the emergency room to the ICU. Hypertension, obesity, and diabetes were the most common comorbidities. Nutritional assessment showed that 36.9 % were SGA B+C, and 46 % were obese. Mean ICU LOS was 22.2 (SD = 19.5), and hospital LOS was 28.1 (SD = 21.9) days. Of all patients, 90.2 % underwent MV, and MV days were 20.6 (SD = 15.6). (AU)

Introducción: la pandemia de COVID-19 puso en riesgo a la población mundial. Dado que la relación entre el riesgo nutricional y los resultados clínicos en pacientes críticos con COVID-19 es aún poco conocida, un equipo de investigación multidisciplinario de la Sociedad Argentina de Cuidados Intensivos (SATI) realizó un estudio multicéntrico con el objetivo de definir las características nutricionales y evaluar la relación entre el riesgo nutricional y los resultados clínicos relevantes para los pacientes de la unidad de cuidados intensivos (UCI) de COVID-19. Métodos: entre marzo y octubre de 2020 se realizó un estudio observacional prospectivo y multicéntrico que incluyó 12 UCI argentinas. Criterios de inclusión: se incluyeron pacientes adultos mayores de 18 años que habían ingresado en la UCI con diagnóstico de COVID-19. Se utilizaron datos clínicos que incluían scores de comorbilidades, herramientas de cribado nutricional como la Evaluación Global Subjetiva (EGS) y el Cribado de Riesgo Nutricional (NRS) 2002, y la puntuación NUTRIC. Además. Se registraron los resultados clínicos, incluida la mortalidad, los días de ventilación mecánica (VM) y la duración de la estancia en la UCI y hospitalaria en general. Resultados: en total, 285 pacientes en UCI cumplieron nuestros criterios de inclusión. La edad media fue de 61,24 (DE = 14,6) años, la puntuación APACHE-II de 14,2 (DE = 6,6) y el índice de comorbilidad de Charlson (ICC) de 2,3 (DE = 2,3). La mayoría de los pacientes ingresaron desde la sala de emergencias a la UCI. La hipertensión, la obesidad y la diabetes fueron las comorbilidades más frecuentes. La evaluación nutricional mostró que el 36,9 % eran VGS B + C y el 46 % eran obesos. La estancia en la UCI fue de 22,2 (DE = 19,5) y la hospitalaria de 28,1 (DE = 21,9) días. El 90,2 % se sometieron a VM, siendo la media de días de VM de 20,6 (DE = 15,6). (AU)

Prescripción del ejercicio en el paciente oncológico. Revisión sistemática / Prescription of exercise in cancer patients. Systematic review

Antecedentes y objetivo El cáncer es una enfermedad considerada como la segunda causa de muerte a nivel mundial; sus diferentes subtipos requieren una variedad de intervenciones que dependen de factores pronósticos, lo que obliga a que, dentro de los componentes propios de la prescripción del ejercicio, sea necesario brindar atención a la especificidad del entrenamiento y considerar las diferencias entre los pacientes de cáncer, para adaptar los programas de ejercicio físico de acuerdo a la condición particular de cada usuario. El presente estudio establece los parámetros de prescripción del ejercicio físico en diferentes condiciones de cáncer según lo reportado en la literatura científica en el periodo 2011-2019. Materiales y métodos Se realizó una revisión sistemática, con búsqueda de artículos en las principales bases de datos biomédicas. Los términos de búsqueda comprendieron combinaciones de descriptores de ciencias de la salud – DeCS en idioma español e inglés. Se aceptaron artículos correspondientes a estudios de investigación de diferente diseño, realizados en pacientes con patología oncológica de cualquier naturaleza en los que la intervención fisioterapéutica fuera basada en la prescripción del ejercicio. Resultados Se incluyeron 16 estudios, de los cuales se obtuvieron datos concluyentes respecto a variables de prescripción del ejercicio a tenerse en cuenta en el momento de establecer un programa orientado a pacientes oncológicos, cuyos efectos se potencian con ejercicios aeróbicos y de resistencia muscular, desarrollados en un periodo mínimo de 3 sesiones semanales, durante 24 semanas. La intensidad del ejercicio aeróbico y de resistencia se establece a partir de variables objetivas como la frecuencia cardíaca máxima y la resistencia máxima (AU)

Background and objective Cancer is a disease considered the second cause of death worldwide; its different subtypes require a variety of interventions that depend on prognostic factors. This means that within the components of the prescription of exercise, specificity of training and the differences between cancer patients must be considered to adapt physical exercise programmes according to the particular condition of each user. The present study establishes the prescription parameters of physical exercise in different cancer conditions as reported in the scientific literature in the period 2011-2019. Materials and methods A systematic review was carried out with search for articles. The search terms comprised combinations of health sciences descriptors - DeCS in Spanish and English. Articles corresponding to research studies of different design, carried out in patients with oncological pathology of any nature, in which the physiotherapeutic intervention was based on the prescription of exercise, were accepted. Results Sixteen studies were included, from which conclusive data were obtained regarding exercise prescription variables to be taken into account when establishing a programme for cancer patients, whose effects are enhanced with aerobic and muscular resistance exercises, developed over a minimum period of 3 weekly sessions, for 24 weeks. The intensity of aerobic and endurance exercise is established from objective variables such as maximum heart rate and maximum resistance. Conclusions Exercise is highlighted as a safe and beneficial complementary intervention strategy that seeks to promote an improved clinical, emotional and participatory condition, supervised by physiotherapy professionals (AU)

Panorama mundial de las diferentes plataformas de vacunas contra el COVID-19: revisión y reflexión de la literatura actual / Worldwide Overview of the Different COVID-19 Vaccine Platforms: A Review and Reflection on the Current Evidence

RESUMEN Las vacunas son productos biológicos que contienen antígenos que buscan generar protección contra a la exposición real de un agente patógeno. En cuanto a su importancia, hacen parte de las intervenciones más costo-efectivas en salud pública, siendo superadas únicamente por el agua potable. A grandes rasgos, podemos dividir las vacunas en vivas atenuadas e inactivadas; no obstante, el nuevo coronavirus ha producido la emergencia de plataformas innovadoras que utilizan mecanismos intracelulares y moleculares con el mismo objetivo de generar inmunidad. Se realizó una búsqueda sistemática de la literatura utilizando las bases de datos electrónicas Pubmed, Scopus y Web of Science. Todos los tipos de diseño de estudio fueron considerados, sin embargo, se prefierieron aquellos redactados en idioma inglés o español. Se hace una revisión de la literatura presente sobre las plataformas existentes para generar inmunidad frente al coronavirus SARS-CoV-2 y se desarrolla cada una según su ruta y forma de acción en aquellas basadas en subunidades proteicas, vector viral recombinante, ácidos nucleicos, virus inactivados, partículas virales y virus vivos atenuados. Los mecanismos por los cuales dichas vacunas generan inmunogenicidad son diferentes, no obstante, la constante inserción de mutaciones por parte del virus sigue siendo un objeto de interés y preocupación por los investigadores.

ABSTRACT Vaccines are biological products containing antigens that aim to generate protection against real exposure to an infectious pathogen. They constitute the most cost-effective interventions in public health, being surpassed only by drinking water. Generally speaking, we can divide the vaccines into live attenuated and inactive; However, the new coronavirus has produced innovative platforms that use intracellular and molecular mechanisms with the same objective of generating immunity. A systematic literature search was carried out using the PUBMED, SCOPUS, and Web of Science electronic databases. All types of study design were selected, those written in English or Spanish were prioritized. We reviewed the existing platforms to generate immunity against the SARS-CoV-2 coronavirus. Each one is developed according to its route and form of action, and can be classified as protein subunits, recombinant viral vector, nucleic acids, inactivated viruses, viral particles, and live attenuated viruses. The mechanisms by which these vaccines generate immunogenicity are different; however, the constant insertion of mutations by the virus remains an object of interest and concern for researchers.

Oferta de la prueba del VIH en fluido oral en actividades de acercamiento y consulta de los resultados online: intervención piloto en Cataluña / Outreach HIV testing using oral fluid and online consultation of the results: Pilot intervention in Catalonia

INTRODUCCIÓN: El objetivo de la intervención fue describir la viabilidad y la rentabilidad de la oferta de la prueba del VIH en intervenciones de acercamiento (outreach) y posterior consulta de los resultados a través de una página web segura. MÉTODOS: Se ofreció la autotoma de muestra «in situ» para detección del VIH en fluido oral a hombres que tienen sexo con hombres (HSH), trabajadores/as sexuales migrantes y mujeres trans reclutados en lugares de ocio y sexo. Cuatro ONG colaboradoras reclutaron a las personas participantes y les asistieron para que se dieran de alta en la web del estudio (www.swab2know.eu) a través de una tablet o el smartphone del mismo participante. Las muestras se enviaron al laboratorio de referencia y los resultados se publicaron en la página web. RESULTADOS: Se reclutó a 834 participantes (612 HSH, 203 mujeres trabajadoras sexuales y 19 mujeres trans). En total se detectaron 22 resultados reactivos (2,6%): 21 entre los HSH (3,4%) y uno en una mujer trans (5,3%). Mientras que el 82,6% de los HSH consultó su resultado, solamente el 39,9 y el 26,3% de las mujeres trabajadoras sexuales y las mujeres trans, respectivamente, consultaron su resultado. CONCLUSIONES: Ofrecer la autotoma de muestra en actividades de acercamiento, el envío y el análisis en un laboratorio de referencia y la posterior consulta de los resultados online es viable. Se detectó un elevado porcentaje de usuarios con un resultado reactivo para el VIH entre los HSH y las mujeres trans

INTRODUCTION: The aim of the intervention was to describe the feasibility and cost-effectiveness of offering HIV testing in outreach interventions and subsequent consultation of the results through a secure web page. METHODS: The HIV test was offered "in situ" to men who have sex with men (MSM), migrant sex workers and trans women recruited in places of leisure and sex. Four collaborating NGOs recruited the participants and assisted them to register on the study website (www.swab2know.eu) through a tablet or the smartphone of the same participant. The samples were sent to the reference laboratory and the results were published on the website. RESULTS: 834 participants (612 MSMs, 203 women sex workers and 19 trans women) were recruited. In total 22 reagent results (2.6%) were detected: 21 among MSMs (3.4%) and 1 in a trans women (5.3%). While 82.6% of MSMs consulted their outcome, only 39.9% and 26.3% of women sex workers and trans women respectively consulted their outcome CONCLUSIONS: Providing self-sampling in outreach activities, dispatch and analysis in a reference laboratory as well as online communication of test results is feasible. A high proportion of participants with a HIV reactive result were detected among MSMs and trans women

Primeros datos de prevalencia de Chlamydia trachomatis, otras ITS y coinfecciones en gestantes menores de 25 años en Cataluña / First data of Chlamydia trachomatis and other STI prevalence and co-infections in pregnant women under 25 years in Catalonia, Spain

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Mujeres que usan drogas inyectadas y violencia: Necesidad de una respuesta integrada / Women who inject drugs and violence: Need for an integrated response

El objetivo de este estudio fue describir la prevalencia de violenciafísica y/o sexual experimentada por mujeres que usan drogas porvía inyectada (MUDVI) e identificar factores asociados. Se realizó unestudio transversal en 120 MUDVI usuarias de centros de reducción dedaños mediante un cuestionario anónimo y recogida de muestras defluido oral para estimar la prevalencia del VIH y de la hepatitis C. Losfactores asociados a la presencia de violencia se analizaron medianteun modelo de regresión de Poisson con varianza robusta univariante ymultivariante, obteniendo razones de prevalencia (RP) y sus intervalosde confianza al 95%. Los resultados muestran que la prevalencia de agresiones en los últimos 12 meses fue del 45,8% (42,2% agresionesfísicas y 11,9% agresiones sexuales). A nivel multivariante, las variablesasociadas a la presencia de violencia fueron estar sin domicilio fijo(RP=1,59; IC: 1,07-2,38), ejercer el trabajo sexual (RP=1,65; IC: 1,19-2,29), haber sufrido alguna infección de transmisión sexual (RP=1,49;IC: 1,04-2,15) y/o inyectarse drogas no de forma diaria (RP=2,29;IC: 1,49-3,54). Este estudio pone de manifiesto la importancia deestablecer protocolos de detección, y derivación a la red de atencióna la violencia de género, dentro de los centros de la red de atencióna las drogodependencias, así como el desarrollo de estrategiasmultinivel que tengan en cuenta no solamente factores individualessino también otros aspectos sociales y/o estructurales que puedenestar jugando un papel relevante a la hora de abordar este problema. (AU)

The aim of this study was to describe the prevalence of physical and/or sexual violence experienced by women who inject drugs (WWID)and identify associated factors. A cross-sectional study was conductedamong 120 WWID in a network of harm reduction centres using ananonymous questionnaire. Oral fluid samples were also collectedto estimate the prevalence of HIV and hepatitis C. Univariate andmultivariate Poisson regression models with robust variance wereperformed to identify the factors associated with experiencingviolence, obtaining prevalence ratios (PR) and their 95% confidenceintervals. The results showed that the prevalence of violence reportedby WWID in the last 12 months was 45.8% (42.2% physical and 11.9%sexual aggression). In multivariate analysis, variables associated withexperiencing violence were homelessness (PR = 1.59; CI: 1.07-2.38),reporting exchanges of sex for money or drugs (PR = 1.65; CI: 1.19-2.29), reporting a previous sexually transmitted infection (PR =1.49; CI: 1.04-2.15) and/or injecting drugs less frequently than daily(RP = 2.29; CI: 1.49-3.54). This study highlights the importance ofestablishing detection protocols and systems of referral to the networkof attention to women suffering violence, within the centres of thedrug addiction care network, as well as the development of multilevelstrategies that take into account not only individual factors but alsoother social and/or structural aspects that may be playing a relevantrole in addressing this problem. (AU)

Cribado del VIH en espacios de ocio en Barcelona y Sitges en hombres que tienen sexo con hombres / HIV screening in leisure spaces in Barcelona and Sitges in men who have sex with men

Se describe la implementación del trabajo de campo de una prueba piloto cuyo objetivo fue fomentar el diagnóstico precoz de la infección por el virus de la inmunodeficiencia humana (VIH) ofreciendo una prueba de cribado en los locales y zonas de cruising (zonas de contacto sexual al aire libre) frecuentados por hombres que tienen sexo con hombres (HSH) en la ciudad de Barcelona y en Sitges, y consultando el resultado a través de la página web del proyecto. La prueba piloto resultó viable y contó con la aceptabilidad del colectivo al que va dirigida

Description of the implementation of the field work of a pilot intervention whose objective was to promote the early diagnosis of HIV infection by offering a screening test for HIV in gay venues and cruising areas (outdoor sexual contact areas) frequented by men who have sex with men (MSM) in the city of Barcelona and Sitges, and consulting the result through the project website. The pilot intervention was viable and counted with the acceptability of the target group

Pooling of urine samples for molecular detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium as a screening strategy among young adults in Catalonia / Pooling de muestras de orina para la detección molecular de Chlamydia trachomatis, Neisseria gonorrhoeae y Mycoplasma genitalium como estrategia de cribado entre la población joven en Cataluña

INTRODUCTION: Bacterial sexually transmitted infections (STIs) have an important impact on reproductive health, highlighting the increase in Chlamydia trachomatis infection rates among young people. To reduce the costs of STI detection, the pooling strategy is beneficial for high-throughput tests in low-prevalence populations using non-invasive samples. OBJECTIVES: (1) To describe the performance of a 7-STI PCR assay using the pooling of three urine samples to detect C. trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium; (2) to estimate the cost saving of the pooling strategy; (3) to describe the prevalence, risk factors and coinfections of C. trachomatis, N. gonorrhoeae and M. genitalium in young people ≤ 25 years in Catalonia. METHODS: cross-sectional prevalence study conducted in 2016 among young people ≤ 25 years of age seen in sexual and reproductive health centres throughout Catalonia from pools of three urine samples. A standardized questionnaire was used to collect clinical-epidemiological and behavioural variables. RESULTS: 1032 young people were tested. The prevalence of C. trachomatis, N. gonorrhoeae and M. genitalium was 8.5%, 0.6% and 3.5%, respectively. The pooling strategy provided a 33% savings in reagent costs. CONCLUSIONS: The pooling strategy implemented for epidemiological studies in our context provides a savings that has an impact on the viability of STI detection programmes. In the same way, this study shows that C. trachomatis prevalence continues to increase in this population and, for the first time in Catalonia, the prevalence of M. genitalium in young people is shown

INTRODUCCIÓN: Las infecciones bacterianas de transmisión sexual (ITS) tienen un impacto importante en la salud reproductiva, destacando el aumento en las tasas de infección por Chlamydia trachomatis entre los jóvenes. Para reducir los costes de detección de las ITS, la estrategia de agrupación de muestras (pooling) es beneficiosa para pruebas de alto rendimiento en poblaciones de baja prevalencia utilizando muestras no invasivas. OBJETIVOS: 1) Describir el rendimiento de un ensayo de PCR 7-STI utilizando el pooling de 3 muestras de orina para detectar Chlamydia trachomatis, Neisseria gonorrhoeae y Mycoplasma genitalium; 2) Estimar el ahorro de la estrategia de pooling; 3) Describir la prevalencia, los factores de riesgo y las coinfecciones de Chlamydia trachomatis, Neisseria gonorrhoeae y Mycoplasma genitalium en jóvenes ≤ 25 años en Cataluña. MÉTODOS: Estudio transversal de prevalencia realizado durante 2016 entre jóvenes ≤ 25 años atendidos en centros de salud sexual y reproductiva en todo el territorio catalán a partir de pools de 3 muestras de orina. Se utilizó un cuestionario estandarizado para recopilar variables clínico-epidemiológicas y de comportamiento. RESULTADOS: Se testaron 1032 jóvenes. La prevalencia de Chlamydia trachomatis, Neisseria gonorrhoeae y Mycoplasma genitalium fue del 8,5, 0,6 y 3,5%, respectivamente. La estrategia de pooling proporcionó un ahorro del 33% en los costos de reactivo. CONCLUSIONES: La estrategia de pooling llevado a cabo para estudios epidemiológicos en nuestro contexto proporciona un ahorro que tiene un impacto en la viabilidad de los programas de detección de las ITS. De la misma manera, en este estudio se observa que la prevalencia de Chlamydia trachomatis continúa aumentando en esta población y, por primera vez en Cataluña, se determina la prevalencia de Mycoplasma genitalium en la población joven

Frecuencia De Casos Juveniles Con Enfermedad De Huntington En Población Mexicana / Frequency Of Juvenile Huntington´S Disease In A Mexican Population

Resumen Objetivo: El propósito de este estudio es determinar la prevalencia de casos juveniles en una muestra de sujetos mexicanos con enfermedad de Huntington (EH) confirmada molecularmente. Métodos: Se incluyeron pacientes con inicio clínico antes de los 21 años de edad que acudieron a la clínica de trastornos del movimiento del Instituto Nacional de Neurología y Neurocirugía. La información demográfica y clínica se obtuvo de la revisión de expedientes. Resultados: Se revisaron un total de 198 casos de pacientes con diagnóstico de EH, de los cuales el 6.5% (n=13) correspondió a formas juveniles. La media de edad para el inicio de síntomas fue de 17.8 ± 3.9 años. La puntuación media del UHDRS-motor fue de 46.2 ± 17.4 puntos. El síntoma motor predominante fue corea en el 53.8% de los casos. El 84.6% de los afectados presentó al menos una alteración neuropsiquiátrica. Conclusión: Se detectó que el fenotipo motor de estos pacientes fue dominantemente corea, contrario a lo reportado mundialmente hasta ahora, es decir, nuestro grupo presentó clínica motora atípica de EHJ.

Abstract Objective: The purpose of this study is to know the prevalence of juvenile cases in a sample of mexican subjects with confirmed Huntington Disease (HD). Methods: Patients with clinical debut before 21 years of age were included who attended at movement disorders clinic of the National Institute of Neurology and Neurosurgery. The demographic and clinical information was obtained from the review of files. Results: A total of 198 cases of patients diagnosed with HD were reviewed, of which 6.5% (n = .13) corresponded to juvenile forms. The mean age for the onset of symptoms was 17.8 ± 3.9 years. The mean score of the UHDRS-motor was 46.2 ± 17.4 points. The predominant motor symptom was chorea in (53.8%) of the cases. 84.6% of those affected presented at least one neuropsychiatric disorder. Conclusion: It was detected that the dominant motor phenotype of these patients was chorea compared to the world reports until now, accordingly to that, our group of juvenile HD shows atypical motor clinical.