Persistence of Anti-S1 IgG against SARS-CoV-2 Eight Months after the Booster Dose of Vaccine in Naive and Previously Infected Healthcare Workers.

Our aim was to evaluate the immune response of healthcare workers included in the RIPOVAC study, after receiving a booster dose (third dose), in terms of intensity and persistence of induced antibodies. In the second phase of the RIPOVAC study, between December 2021 and January 2022, eight months after the second dose, 389 voluntary, immunocompetent, non-pregnant healthcare workers received a booster dose of SARS-CoV-2 vaccine, and a serum sample was obtained. Two groups of patients were established: with and without previous SARS-CoV-2 infection. In order to quantify anti-S1 IgG (AU/mL) we used CMIA (Abbott). All of the health workers were anti-S IgG positive 8 months after receiving the booster dose of the vaccine, with a mean of 17,040 AU/mL. In 53 patients without previous infection, antibody levels increased by a mean of 10,762 AU/mL. This figure is seven times higher than the one produced after the second dose (1506 AU/mL). The booster dose produces a robust elevation of the antibody level, which persists at 8 months, with levels significantly higher than those reached after the second dose, which allow one to predict a persistence of more than one year. The study demonstrates the efficacy of the booster dose of anti-SARS-CoV-2 vaccines.

[Risk factors related to functionality and quality of life in people over 65 years of age with hip fracture.] / Factores de riesgo relacionados con la funcionalidad y la calidad de vida en mayores de 65 años con fractura de cadera.

OBJECTIVE: Hip fracture (HF) in the elderly carries high mortality and decreases functionality and quality of life after one year. The aim of this paper was to identify risk factors that influenced functionality (Barthel) and quality of life (EQ-5D) of the elderly with osteoporotic HF. METHODS: A prospective observational study was made in people over 65 years of age with HF between October 2017 and November 2018. Clinical information was collected from the digital medical record and the scales were measured by telephone at four times: baseline, one month, six months and twelve months. Statistical analysis was made thanks to SPSS vs 25.0. Multivariate analysis was performed using a generalized linear model for repeated measures to determine the relationship of risk factors with functionality and quality of life. RESULTS: Functionality showed significant differences (p<0.001) between baseline measurement and one month (90 points vs 50); baseline and at twelve months (90 vs 60 points); and that of the month and at twelve months (50 points vs 60). Quality of life also presented significant differences (p<0.001) between baseline and one month (0.587 vs 0.113); and baseline and twelve months (0.220). The functionality should be in transfused and with high surgical risk (p<0.05) and the quality of life will arrive in high surgical risk (p=0.017). Those older than 85 years were the ones who recovered the least after one year, as well as patients with delirium on admission and those who received transfusions. Patients with iron therapy recovered better at six months compared to those who did not and maintained this improvement at twelve months. CONCLUSIONS: Among the main risk factors are advanced age, male sex, transfused, high surgical risk, delirium on admission and malnutrition.

OBJETIVO: La fractura de cadera (FC) en mayores de 65 años conlleva alta mortalidad y una disminución de la funcionalidad y la calidad de vida al año. El objetivo de este estudio fue identificar factores de riesgo que influyeran en la funcionalidad (Barthel) y en la calidad de vida (EQ-5D) en mayores de 65 años con FC osteoporótica. METODOS: Se realizó un estudio observacional prospectivo en mayores de 65 años con FC entre octubre de 2017 y noviembre de 2018. Desde la historia clínica digital se recogió la información clínica y telefónicamente se midieron las escalas en cuatro momentos: basal, un mes, seis meses y doce meses. El análisis estadístico se efectuó mediante el programa informático SPSS (versión 25.0). Se realizó análisis multivariante mediante un modelo lineal generalizado para medidas repetidas para determinar la relación de los factores de riesgo con la funcionalidad y la calidad de vida. RESULTADOS: La funcionalidad presentó diferencias estadísticamente significativas (p<0,001) entre la medición basal y al mes (90 puntos frente a 50), la basal y a los doce meses (90 frente a 60 puntos), y la del mes y a los doce meses (50 puntos frente a 60). La calidad de vida también presentó diferencias estadísticamente significativas (p<0,001) entre el basal y al mes (0,587 frente a 0,113) y la basal y a los doce meses (0,220). La funcionalidad disminuyó en transfundidos y con riesgo quirúrgico alto (p<0,05) y la calidad de vida decreció en riesgo quirúrgico alto (p=0,017). Los mayores de 85 años fueron los que menos recuperaron al año, al igual que los pacientes con delirium al ingreso y los transfundidos. Los pacientes con ferroterapia se recuperaron mejor a los seis meses respecto a los que no y mantuvieron esta mejoría a los doce meses. CONCLUSIONES: Entre los principales factores de riesgo están la edad avanzada, el sexo masculino, ser transfundidos, el riesgo quirúrgico alto, el delirium al ingreso y la desnutrición.

Assessment of humoral immune response to two mRNA SARS-CoV-2 vaccines (Moderna and Pfizer) in healthcare workers fully vaccinated with and without a history of previous infection.

AIMS: Presence of anti-S1 region of SARS-CoV-2 spike protein was analysed, at two and eight months, in 477 immunocompetent healthcare workers in Zaragoza, Spain, vaccinated with mRNA-1273 (Moderna) or BNT162b2 (Pfizer). METHODS AND RESULTS: Antibody analysis was performed with Alinity i System (Abbott). At 2 months, 100% of vaccinated had anti-S1 IgG (mean = 13,285 AU ml-1 ). This value was significantly higher with Moderna (18,192 AU ml-1 ) than with Pfizer (10,441 AU ml-1 ). The mean value of anti-S1 IgG after vaccination was significantly higher in patients with than without previous infection (18,539 vs. 7919 AU ml-1 ); in both groups was significantly higher with Moderna than with Pfizer (21,881 vs. 15,733 AU ml-1 and 11,949 vs. 6387 AU ml-1 ), respectively. At 8 months, 100% of patients were IgG positive, with higher levels with Moderna than with Pfizer. Nevertheless, in ensemble of cases, a mean decrease of antibody levels of 11,025 AU ml-1 was observed. CONCLUSION: At 2 and 8 months after vaccination, IgG response persists with both vaccines but with important decrease which suggests the need for revaccination. SIGNIFICANCE AND IMPACT OF STUDY: The study contributes to know the immune status after vaccination with two of more used anti-SARS-CoV-2 vaccines. This knowledge is important for establishing the best vaccination strategy.

Factores de riesgo relacionadoscon la funcionalidad y la calidadde vida en mayores de 65 añoscon fractura de cadera / Risk factors related to functionality and quality of life in people over 65 years of age with hip fracture

FUNDAMENTOS: La fractura de cadera (FC) en mayores de 65 años conlleva alta mortalidad y una disminución de la funcionalidad y la calidad de vida al año. El objetivo de este estudio fue identificar factores de riesgo que influyeran en la funcionalidad (Barthel) y en la calidad de vida (EQ-5D) en mayores de 65 años con FC osteoporótica. MÉTODOS: Se realizó un estudio observacional prospectivo en mayores de 65 años con FC entre octubre de 2017 y noviembre de 2018. Desde la historia clínica digital se recogió la información clínica y telefónicamente se midieron las escalas en cuatro momentos: basal, un mes, seis meses y doce meses. El análisis estadístico se efectuó mediante el programa informático SPSS (versión 25.0). Se realizó análisis multivariante mediante un modelo lineal generalizado para medidas repetidas para determinar la relación de los factores de riesgo con la funcionalidad y la calidad de vida. RESULTADOS: La funcionalidad presentó diferencias estadísticamente significativas (p<0,001) entre la medición basal y al mes (90 puntos frente a 50), la basal y a los doce meses (90 frente a 60 puntos), y la del mes y a los doce meses (50 puntos frente a 60). La calidad de vida también presentó diferencias estadísticamente significativas (p<0,001) entre el basal y al mes (0,587 frente a 0,113) y la basal y a los doce meses (0,220). La funcionalidad disminuyó en transfundidos y con riesgo quirúrgico alto (p<0,05) y la calidad de vida decreció en riesgo quirúrgico alto (p=0,017). Los mayores de 85 años fueron los que menos recuperaron al año, al igual que los pacientes con delirium al ingreso y los transfundidos. Los pacientes con ferroterapia se recuperaron mejor a los seis meses respecto a los que no y mantuvieron esta mejoría a los doce meses. CONCLUSIONES: Entre los principales factores de riesgo están la edad avanzada, el sexo masculino, ser transfundidos, el riesgo quirúrgico alto, el delirium al ingreso y la desnutrición.(AU)

BACKGROUND: Hip fracture (HF) in the elderly carries high mortality and decreases functionality and quality of life after one year. The aim of this paper was to identify risk factors that influenced functionality (Barthel) and quality of life (EQ-5D) of the elderly with osteoporotic HF. METHODS: A prospective observational study was made in people over 65 years of age with HF between October 2017 and November 2018. Clinical information was collected from the digital medical record and the scales were measured by telephone at four times: baseline, one month, six months and twelve months. Statistical analysis was made thanks to SPSS vs 25.0. Multivariate analysis was performed using a generalized linear model for repeated measures to determine the relationship of risk factors with functionality and quality of life. RESULTS: Functionality showed significant differences (p<0.001) between baseline measurement and one month (90 points vs 50); baseline and at twelve months (90 vs 60 points); and that of the month and at twelve months (50 points vs 60). Quality of life also presented significant differences (p<0.001) between baseline and one month (0.587 vs 0.113); and baseline and twelve months (0.220). The functionality should be in transfused and with high surgical risk (p<0.05) and the quality of life will arrive in high surgical risk (p=0.017). Those older than 85 years were the ones who recovered the least after one year, as well as patients with delirium on admission and those who received transfusions. Patients with iron therapy recovered better at six months compared to those who did not and maintained this improvement at twelve months. CONCLUSIONS: Among the main risk factors are advanced age, male sex, transfused, high surgical risk, delirium on admission and malnutrition.(AU)

The efficacy of adding group behavioral activation to usual care in patients with fibromyalgia and major depression: design and protocol for a randomized clinical trial.

BACKGROUND: Fibromyalgia and major depression frequently co-occur. Patients with both conditions have a worse prognosis and higher disability, and their treatment options are scarce. Behavioral activation (BA) may be an especially useful intervention for these patients, as it targets mechanisms of action that seem to be common to both disorders. Nevertheless, its efficacy has not been examined in people with both conditions. We describe the design and rationale of a randomized clinical trial aimed to evaluate the efficacy of adding BA (applied in groups) to usual care in order to reduce the severity of depressive symptoms (primary outcome) among Chilean women with fibromyalgia and major depression (N = 90). Pain intensity, fibromyalgia impact, pain catastrophizing and hypervigilance, physical health symptoms, environmental reward, and BA will be evaluated as secondary outcomes. METHODS: Women will be randomized to an experimental arm (n = 45) which will receive usual care (UC) for fibromyalgia with comorbid depression plus BA; and a comparison arm, which will receive only UC for fibromyalgia with comorbid depression (n = 45). Outcome assessment will take place at four time points: (1) at baseline, (2) when the experimental arm is under treatment (between sessions 6 and 7), (3) immediately after the experimental arm complete the treatment, and (4) at a 3-month follow-up. The following instruments will be used: Chilean version of the Patient Health Questionnaire-9 (PHQ-9), Composed Pain Intensity Index, Fibromyalgia Impact Questionnaire Revised (FIQ-R), Pain Catastrophizing Scale (PCS), Pain Vigilance and Awareness Questionnaire (PVAQ), Patient Health Questionnaire (PHQ-15), Reward Probability Index (RPI), and the Activation subscale of the Behavioral Activation for Depression Scale (BADS). DISCUSSION: We expect that, after treatment, the group receiving BA should experience greater reductions in the primary and secondary outcomes than the group receiving only UC. These reductions should be both statistically and clinically significant and will be maintained at follow-up. This study will contribute to facilitate the integrated treatment of fibromyalgia and depression. TRIAL REGISTRATION: ClinicalTrials.gov under the name "Testing Interventions for Patients with Fibromyalgia and Depression," Identifier: NCT03207828 . Registered on 5 July 2017 (last update posted 21 September 2017).

Evidence for early cytotoxic aggregates in transgenic mice for human transthyretin Leu55Pro.

Familial amyloidotic polyneuropathy (FAP) is a lethal autosomal dominant disorder characterized by systemic extracellular deposition of transthyretin (TTR) amyloid fibrils. Several groups have generated transgenic mice carrying human TTR Val30Met, the most common mutation in FAP. To study amyloidogenicity and cytotoxicity of different TTRs, we produced transgenic mice expressing human TTR Leu55Pro, one of the most aggressive FAP-related mutations. TTR deposition and presence of amyloid fibrils was investigated and compared to animals carrying the human TTR Val30Met gene kept under the same conditions. Deposition in a C57BL/6J background (TTR-Leu55Pro mice) and in a TTR-null background [TTR-Leu55Pro X TTR-knockout (KO) mice] was compared. Animals in a C57BL/6J background presented early (1 to 3 months) nonfibrillar TTR deposition but amyloid was absent. In a TTR-null background, presence of amyloid fibrils was detected starting at 4 to 8 months with a particular involvement of the gastrointestinal tract and skin. This data suggested that TTR homotetramers are more prone to fibril formation than TTR murine wild-type/human mutant heterotetramers. The nature of the deposited material was further investigated by immunocytochemistry. Both amorphous aggregates and small TTR fibrils were present in TTR-Leu55Pro X TTR-KO transgenics. We observed that these TTR deposits mimic the toxic effect of TTR deposits in FAP: animals with TTR deposition, present approximately twofold increased levels of nitrotyrosine in sites related to deposition. The TTR-Leu55Pro X TTR-KO mice here described are an important tool for the dual purpose of investigating factors involved in amyloidogenesis and in cytotoxicity of deposited TTR.