[Tuberculosis and socioeconomic factors in spanish population: a systematic review.] / Tuberculosis y factores socioeconómicos en la población española: una revisión sistemática.

OBJECTIVE: There are different socioeconomic variables which determine tuberculosis's epidemiology, diagnosis and treatment. The objective of this paper was to analize these effects in the last years in Spain. METHODS: A systematic review was conducted. Screened studies were original articles written in English or Spanish and published between 2007 and 2020. Searching was performed in Pubmed and Web of Science databases. STROBE criteria were followed to analyze studies's quality, and studies included in the review had 15 points or more. RESULTS: 23 articles were selected, and were classified in different topics. Foreigners's proportion with tuberculosis changed in different autonomous communities between 10%-50%. There were diagnostic delay for this group compared to natives. This group had higher incidence of resistance to isoniazid, but without a clear increase in multidrug resistance. There were less adherence to tuberculosis's treatment in case of immigration, drug addiction, HIV coinfection, or lack of family support. Under-reporting of tuberculosis cases varied between 18%-28%, and it was higher in cases of social marginality, HIV coinfection, Spanish nationality or male sex. There were also other social risk groups in which the diagnostic approach to tuberculosis was relevant, such as in schools and health centers. Tuberculosis was one of the most frequent HIV associated diseases, although screening tests were not performed in almost 18%, depending on the concurrence of social risk factors. CONCLUSIONS: Tuberculosis's incidence, diagnosis, and treatment are influenced by a lot of social and economic factors, which determine the approach to this disease.

OBJETIVO: Existen diferentes variables socioeconómicas que condicionan la epidemiología, diagnóstico y tratamiento de la tuberculosis. El objetivo del siguiente trabajo fue analizar dichos factores en los últimos años en España. METODOS: Se realizó una revisión sistemática de artículos originales escritos en inglés o castellano, entre los años 2007 y 2020. La búsqueda se realizó en las bases de datos Pubmed y Web of Science. Se siguieron los criterios STROBE para analizar la calidad de los estudios y seleccionando para su inclusión en la revisión aquellos que obtuvieron 15 puntos o más. RESULTADOS: Se analizaron 23 artículos, dividiendo las conclusiones por áreas temáticas. La proporción de personas extranjeras con tuberculosis varió en las diferentes comunidades autónomas entre un 10% y un 50%, pudiendo existir demora diagnóstica en este grupo respecto a los autóctonos y presentando mayor incidencia de resistencia a isoniacida, pero sin claro aumento en la multirresistencia. Se halló menor cumplimiento del tratamiento antituberculoso en caso de migración, adicción a drogas, coinfección de tuberculosis y VIH o falta de apoyo familiar. La infranotificación de casos de tuberculosis varió entre un 18% y un 28%, siendo mayor en casos de marginalidad social, coinfección de tuberculosis y VIH, nacionalidad española o sexo varón. La tuberculosis fue una de las enfermedades asociadas a VIH más frecuentes, aunque no se realizaron pruebas de cribado en casi el 18%, según la concurrencia de factores sociales de riesgo. CONCLUSIONES: En la incidencia, diagnóstico y tratamiento de la tuberculosis influyen numerosos factores sociales y económicos que condicionan su abordaje.

Tuberculosis y factores socioeconómicos en la población española: una revisión sistemática / Tuberculosis and socioeconomic factors in spanish population: a systematic review

FUNDAMENTOS: Existen diferentes variables socioeconómicas que condicionan la epidemiología, diagnóstico y tratamiento de la tuberculosis. El objetivo del siguiente trabajo fue analizar dichos factores en los últimos años en España. MÉTODOS: Se realizó una revisión sistemática de artículos originales escritos en inglés o castellano, entre los años 2007 y 2020. La búsqueda se realizó en las bases de datos Pubmed y Web of Science. Se siguieron los criterios STROBE para analizar la calidad de los estudios y seleccionando para su inclusión en la revisión aquellos que obtuvieron 15 puntos o más. RESULTADOS: Se analizaron 23 artículos, dividiendo las conclusiones por áreas temáticas. La proporción de personas extranjeras con tuberculosis varió en las diferentes comunidades autónomas entre un 10% y un 50%, pudiendo existir demora diagnóstica en este grupo respecto a los autóctonos y presentando mayor incidencia de resistencia a isoniacida, pero sin claro aumento en la multirresistencia. Se halló menor cumplimiento del tratamiento antituberculoso en caso de migración, adicción a drogas, coinfección de tuberculosis y VIH o falta de apoyo familiar. La infranotificación de casos de tuberculosis varió entre un 18% y un 28%, siendo mayor en casos de marginalidad social, coinfección de tuberculosis y VIH, nacionalidad española o sexo varón. La tuberculosis fue una de las enfermedades asociadas a VIH más frecuentes, aunque no se realizaron pruebas de cribado en casi el 18%, según la concurrencia de factores sociales de riesgo. CONCLUSIONES: En la incidencia, diagnóstico y tratamiento de la tuberculosis influyen numerosos factores sociales y económicos que condicionan su abordaje.(AU)

BACKGROUND: There are different socioeconomic variables which determine tuberculosis’s epidemiology, diagnosis and treatment. The objective of this paper was to analize these effects in the last years in Spain. METHODS: A systematic review was conducted. Screened studies were original articles written in English or Spanish and published between 2007 and 2020. Searching was performed in Pubmed and Web of Science databases. STROBE criteria were followed to analyze studies’s quality, and studies included in the review had 15 points or more. RESULTS: 23 articles were selected, and were classified in different topics. Foreigners’s proportion with tuberculosis changed in different autonomous communities between 10%-50%. There were diagnostic delay for this group compared to natives. This group had higher incidence of resistance to isoniazid, but without a clear increase in multidrug resistance. There were less adherence to tuberculosis’s treatment in case of immigration, drug addiction, HIV coinfection, or lack of family support. Under-reporting of tuberculosis cases varied between 18%-28%, and it was higher in cases of social marginality, HIV coinfection, Spanish nationality or male sex. There were also other social risk groups in which the diagnostic approach to tuberculosis was relevant, such as in schools and health centers. Tuberculosis was one of the most frequent HIV associated diseases, although screening tests were not performed in almost 18%, depending on the concurrence of social risk factors. CONCLUSIONS: Tuberculosis’s incidence, diagnosis, and treatment are influenced by a lot of social and economic factors, which determine the approach to this disease.(AU)

SARS-CoV-2 Delta-variant breakthrough infections in nursing home residents at midterm after Comirnaty® COVID-19 vaccination.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant breakthrough infections in nursing home residents following vaccination with Comirnaty® COVID-19 vaccine were characterized. In total, 201 participants (median age, 87 years; range, 64-100; 133 female) from two nursing homes in the Valencian community (Spain) were included. SARS-CoV-2-Spike (S) antibody responses were determined by a lateral flow immunocromatography (LFIC) assay and by quantitative electrochemiluminescent assay in LFIC-negative participants. SARS-CoV-2-S-IFNγ T cells were enumerated by flow cytometry in 10 participants. Nasopharyngeal SARS-CoV-2 RNA loads were quantified by real-time polymerase chain reaction assays. Vaccine breakthrough COVID-19 due to the Delta variant occurred in 39 residents (median age, 87 years; range, 69-96; 31 female) at a median of 6.5 months after vaccination (nine requiring hospitalization). Breakthrough infections occurred at a higher rate (p < 0.0001) in residents who had not been previously infected with SARS-CoV-2 (naïve) (33/108; 18%) than in those with prior diagnosis of SARS-CoV-2 infection (experienced) (6/93; 6.4%), and were more likely (p < 0.0001) to develop in residents who tested negative by LFIC (20/49) at 3 months after vaccination as compared to their LFIC-positive counterparts (19/142). Among LFIC-negative residents, a trend towards lower plasma anti-RBD antibody levels was noticed in those developing breakthrough infection (p = 0.16). SARS-CoV-2 RNA loads in nasopharyngeal specimens were lower in SARS-CoV-2-experienced residents (p < 0.001) and in those testing positive by LFIC (p = 0.13). The frequency of SARS-CoV-2-S-reactive T cells at 3 months was similar in LFIC-negative residents with (n = 7) or without (n = 3) breakthrough infection. Prior history of SARS-CoV-2 infection and detection of S-reactive antibodies by LFIC at 3 months is associated with a lower risk of Delta-variant breakthrough infection in nursing home residents at midterm after Comirnaty® COVID-19 vaccination.

Commercial Interferon-gamma release assay to assess the immune response to first and second doses of mRNA vaccine in previously COVID-19 infected versus uninfected individuals.

We analysed immunological response during vaccination by using quantitative anti-spike IgG antibodies (qAbs) and Interferon-gamma (IFNγ) production by SARS-CoV-2-specific CD4+ and CD8+ T cells (QuantiFERON® assay). Blood samples were collected at four time points: a day before the reception of first (T0) and second (T1) BNT162b2 doses, 14 (T2) and 28 days (T3) after second dose. Fifty individuals were included: 34 previously infected by SARS-CoV-2 (CoV2+) and 16 that were not (CoV2-). Among CoV2+, we only observed significant differences after the first dose in both qAbs and IFNγ+ T cells. CoV2- showed differences after each dose, and the response was lower than CoV2+. Older people presented a higher response in CoV2+, while in CoV2, young people responded best. Our results suggest that the second BNT162b2 vaccine dose is not a priority in people with previous COVID-19. QuantiFERON® is a good option to monitor T-cell immunity to SARS-CoV-2.

Lotus japonicus NOOT-BOP-COCH-LIKE1 is essential for nodule, nectary, leaf and flower development.

The NOOT-BOP-COCH-LIKE (NBCL) genes are orthologs of Arabidopsis thaliana BLADE-ON-PETIOLE1/2. The NBCLs are developmental regulators essential for plant shaping, mainly through the regulation of organ boundaries, the promotion of lateral organ differentiation and the acquisition of organ identity. In addition to their roles in leaf, stipule and flower development, NBCLs are required for maintaining the identity of indeterminate nitrogen-fixing nodules with persistent meristems in legumes. In legumes forming determinate nodules, without persistent meristem, the roles of NBCL genes are not known. We thus investigated the role of Lotus japonicus NOOT-BOP-COCH-LIKE1 (LjNBCL1) in determinate nodule identity and studied its functions in aerial organ development using LORE1 insertional mutants and RNA interference-mediated silencing approaches. In Lotus, LjNBCL1 is involved in leaf patterning and participates in the regulation of axillary outgrowth. Wild-type Lotus leaves are composed of five leaflets and possess a pair of nectaries at the leaf axil. Legumes such as pea and Medicago have a pair of stipules, rather than nectaries, at the base of their leaves. In Ljnbcl1, nectary development is abolished, demonstrating that nectaries and stipules share a common evolutionary origin. In addition, ectopic roots arising from nodule vascular meristems and reorganization of the nodule vascular bundle vessels were observed on Ljnbcl1 nodules. This demonstrates that NBCL functions are conserved in both indeterminate and determinate nodules through the maintenance of nodule vascular bundle identity. In contrast to its role in floral patterning described in other plants, LjNBCL1 appears essential for the development of both secondary inflorescence meristem and floral meristem.

Do people with epilepsy have a different lifestyle?

BACKGROUND: Epilepsy is one of the most common neurological diseases. Its high prevalence, economic relevance and impact on daily life make it crucial that we study this condition in further detail. Our study seeks to investigate whether the lifestyle of people diagnosed with epilepsy is different to that of people without epilepsy, in order to better understand our patients. METHODS: We designed and delivered a questionnaire about quality of life and daily habits to patients from our hospital's Epilepsy Unit. We also delivered the questionnaire to a control group with similar demographic characteristics. Lifestyle differences between patients and control group members were analyzed. Patients were further divided according to the type of epilepsy, time since diagnosis, seizure frequency and pharmacotherapy. RESULTS: A total of 278 people were interviewed (85 patients, 193 controls). There was no difference in educational level, marital status and healthy habits (sports, reading and diet) between the groups. However, patients with epilepsy were more often unemployed (p<0.05) and had a healthier lifestyle (lower body mass index, lower alcohol consumption and a tendency towards smoking less). Anxiolytic-antidepressant intake was higher in patients with epilepsy. In terms of the type of epilepsy, patients with focal epilepsy exercised more than those with generalized epilepsy; no other statistically significant differences were found between the individuals studied. DISCUSSION: Epilepsy diagnosis does not seem to negatively alter the daily life of patients; in fact, many adopt a healthier lifestyle after diagnosis. The risk of antidepressant/anxiolytic intake is, however, higher, which could reflect the impact this chronic condition still has at a social level.

NSTEMI During a Stress Echocardiogram With Dobutamine: Where Is the Problem?

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Alergia conjuntival: formas clínicas / Allergic conjunctivitis: clinical types and therapy

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