Risk Measurement of Perinatal and Neonatal Morbidity Characteristics and Applicability of GAIA Case Definitions: Results and Lessons Learnt of a Hospital-Based Prospective Cohort Study in the Valencia Region (2019-2020).

Post-marketing safety surveillance of new vaccines aimed to be administered during pregnancy is crucial to orchestrate efficient adverse events evaluation. This is of special relevance in the current landscape of new vaccines being introduced in the pregnant women population, and particularly due to the recent administration of COVID-19 vaccines in pregnant women. This multi-center prospective cohort study, nested within the WHO-Global Vaccine Safety-MCC study, involved two hospitals in the Valencia region. Hereby, the incidence rates of seven perinatal and neonatal outcomes in the Valencia region are presented. The pooled data analysis of the two Valencian hospitals allowed the estimation of incidence rates in the Valencia Region (per 1000 live births): 86.7 for low birth weight, 78.2 for preterm birth, 58.8 for small for gestational age, 13 for congenital microcephaly, 0.4 for stillbirth, 1.2 for neonatal death and 6.5 for neonatal infection. These figures are in line with what is expected from a high-income country and the previously reported rates for Spain and Europe, except for the significantly increased rate for congenital microcephaly. Regarding the data for maternal immunization, the vaccination status was collected for 94.4% of the screened pregnant women, highlighting the high quality of the Valencian Vaccine Registry. The study also assessed the Valencian hospitals' capacity for identifying and collecting data on maternal immunization status, as well as the applicability of the GAIA definitions to the identified outcomes.

Seguridad de las actividades extraescolares en tiempos de pandemia por SARS-CoV-2. Estudio prospectivo en población pediátrica / Safety of extracurricular activities in times of pandemic by SARS-CoV-2. Prospective study in paediatric population

Introducción: la epidemia de la enfermedad por coronavirus 2019 ha obligado a implementar diferentes medidas para mitigar el impacto de un aumento inevitable de casos de COVID-19, como fue el cierre de los colegios. A su reapertura, dado que la actividad deportiva en la infancia y adolescencia es clave para su óptimo desarrollo, nos planteamos: ¿son seguras las actividades extraescolares deportivas en tiempos de COVID? Material y métodos: estudio observacional descriptivo longitudinal. Se siguió a 717 escolares deportistas y monitores de una asociación deportiva municipal que participaron en alguna de las actividades deportivas ofrecidas durante el periodo de septiembre a diciembre del año 2020. Ante un caso positivo, se contactó con la familia, cumplimentando la hoja de recogida de datos y realizando seguimiento de los menores. Resultados: de los 679 escolares deportistas y 38 adultos monitores estudiados, únicamente se registró un caso de infección por virus SARS-CoV-2. El caso fue un jugador de baloncesto de 13 años por un contacto familiar, la sintomatología fue leve y tanto él como su grupo de convivencia estable mantuvieron 10 días de cuarentena sin aparición de nuevos casos positivos. Conclusiones: nuestros resultados indican que si la práctica deportiva se realiza en grupos controlados, en medios optimizados y respetando las normas sanitarias, pueden ser espacios seguros para nuestra población pediátrica, con una baja tasa de transmisión del virus SARS-CoV-2. No hemos observado ningún brote en nuestra muestra habiendo implantado las medidas preventivas oportunas y siendo los niños excelentes cumplidores de las mismas. No obstante, es importante disponer de un registro preciso del alumnado existente para el rastreo de contactos e incidir tanto en las medidas generales de prevención como en las específicas para actividades deportivas para minimizar los riesgos (AU)

Introduction: the coronavirus disease 2019 pandemic has compelled the implementation of various measures to mitigate the impact of an inevitable increase in COVID-19 cases, such as the closure of schools. Upon their reopening, given that physical activity in childhood and adolescence is crucial for optimal development, we considered whether extracurricular athletic activities are safe in the COVID age. Material and methods: we conducted a longitudinal, observational and descriptive study. We followed up 717 students and instructors from a municipal sports organization that participated in sports activities offered between September and December 2020. When a positive case was identified, the staff contacted the family, filling in the data collection form and monitoring the students. Results: there was only 1 detected case SARS-CoV-2 infection among the 679 students and 38 adult instructors included in the study. It occurred in an adolescent aged 13 years that played basketball and acquired the infection from a family member and developed mild symptoms; both the boy and the peers in his consistent contact group were quarantined for 10 days without identification of additional cases. Discussion: our results suggests that if athletic activities are carried out in controlled groups in optimised environments and adhering to health standards, sports facilities can be safe spaces for the paediatric population with a low SARS-CoV-2 transmission rate. We did not identify any outbreaks in the sample, having implemented the appropriate preventive measures and verified strict adherence by the students. Nevertheless, it is important to keep accurate records of current students for contact tracing and to guide the implementation of preventive measures, both general and specific to particular sports activities, with the aim of minimising risk (AU)

Utilidad de la ecografía torácica en infección neonatal por SARS-CoV-2 / Usefulness of chest ultrasound in a neonatal infection due to SARS-CoV-2

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Utilidad de la ecografía torácica en infección neonatal por SARS-CoV-2 / Usefulness of chest ultrasound in a neonatal infection due to SARS-CoV-2

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Is psycho-physical stress a risk factor for stroke? A case-control study.

BACKGROUND: Chronic stress is associated with cardiovascular diseases, but the link with stroke has not been well established. Stress is influenced by life-style habits, personality type and anxiety levels. We sought to evaluate psycho-physical stress as a risk factor for stroke, while assessing gender influences. METHODS: Case-control study. cases: patients (n=150) aged 18-65, admitted consecutively to our Stroke Unit with the diagnosis of incident stroke. CONTROLS: (n=300) neighbours (paired with case ±5 years) recruited from the census registry. STUDY VARIABLES: socio-demographic characteristics, vascular risk factors, psychophysical scales of H&R (Holmes & Rahe questionnaire of life events), ERCTA (recall scale of type A behaviour), SF12 (QoL scale), GHQ28 (general health questionnaire). Statistical analyses included conditional multiple logistic regression models. RESULTS: Mean age was 53.8 years (SD: 9.3). Compared with controls, and following adjustment for confounding variables, significant associations between stroke and stress were: H&R values >150 OR=3.84 (95% CI 1.91 to 7.70, p<0.001); ERCTA (values >24) OR=2.23 (95% CI 1.19 to 4.18, p=0.012); mental SF12 (values >50) OR=0.73 (95% CI 0.39 to 1.37, p=0.330); psychological SF12 (values >50) OR=0.66 (95% CI 0.33 to 1.30, p=0.229), male gender OR=9.33 (95% CI 4.53 to 19.22, p<0.001), high consumption of energy-providing beverages OR=2.63 (95% CI 1.30 to 5.31, p=0.007), current smoker OR=2.08 (95% CI 1.01 to 4.27, p=0.046), ex-smoker OR=2.35 (95% CI 1.07 to 5.12, p=0.032), cardiac arrhythmia OR=3.18 (95% CI 1.19 to 8.51, p=0.022) and Epworth scale (≥9) OR=2.83 (95% CI 1.03 to 7.78, p=0.044). CONCLUSIONS: Compared with healthy age-matched individuals, stressful habits and type A behaviour are associated with high risk of stroke. This association is not modified by gender.

Agreement between information provided by stroke patients and their relatives on psychophysical and vascular risk factors.

BACKGROUND: In studies examining vascular risk factors and the effects of stress in stroke patients, information sometimes has to be provided by a close relative. OBJECTIVES: The present study was designed to assess agreement between the information provided by a stroke patient and his/her next-of-kin or other close relative on prior vascular risk factors and situations of psychophysical stress based on a standardized interview within 72 h after stroke. DESIGN: Case-control observational study. PARTICIPANTS AND SETTINGS: All patients with incident stroke aged 18-65 years admitted to our centre were enrolled as cases, and their coinhabiting relatives as controls. The study was conducted from January to June 2008. METHODS: A structured questionnaire about vascular risk factors and psychophysical stress factors were obtained from the participants within 72 h after stroke. Subjects were required to grade themselves or their relatives using validated Spanish versions of the Life Events Stress Scale of Holmes and Rahe, Goldberg's General Health Questionnaire GHQ-28 and the SF-12 Health Survey, as well as the Spanish Type A Behaviour Scale. The questionnaires were self-administered. Cases and controls completed the same questionnaires and which were administered with a time difference of no longer than 24 h between the two groups of subjects. Risk factors were analyzed by determining kappa statistics and interclass correlation coefficients (ICC). Bland-Altman plots were used to examine the scores obtained in graded scales. RESULTS: 25 patients and 25 relatives were recruited. Agreement between cases and controls was good for reported atrial fibrillation, diabetes, alcohol consumption and smoking (range 0.83-1.0). ICC were low for the questionnaires Holmes-Rahe Life Events (0.26; 95%CI: 0.08-0.57), General Health GHQ-28 (0.39; 95%CI: 0.03-0.67) and SF12 Health Survey (0.52; 95%CI: 0.16-0.76 and 0.35; 95%CI: 0.06-0.66), and good for the Type A Behaviour Scale ERCTA (0.62; 95%CI: 0.32-0.81). CONCLUSIONS: The information obtained from family members on patient risk factors could be considered reliable, while that related to psychophysical aspects was not sufficiently reliable for research purposes. Agreement assessments could be useful to avoid misclassification biases.