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Introduction: The right to pre-professional practices protected under Peruvian Law allows the student in the last year of the human medicine career to begin to participate in health care procedures and interventions under the guidance of a tutor. Objective: to determine the factors associated with low knowledge of biosafety in medical interns at a university in Peru in the context of the covid-19 pandemic. Methods: an observational, prolective and cross-sectional design was carried out. The sample consisted of 336 human medicine interns, who were selected by simple random probabilistic sampling. A valid and reliable instrument was used to determine the level of knowledge in biosafety. A bivariate and multiple logarithmic binary regression model was used to calculate the crude and adjusted prevalence ratio with their respective 95% confidence intervals for the factors associated with the level of knowledge in biosafety. Results: high, medium and low levels of knowledge of 44.6%, 26.8% and 28.6% respectively were found. Married marital status (RPA 0.418, 95% CI 0.181 – 0.968), living with people at risk for severe symptoms from covid-19 (RPA 0.472, 95% CI 0.344–0.647), undergoing medical internship in a hospital, and having been diagnosed by covid-19 in the last 12 months (RPA 0.586, 95% CI 0.387–0.887) were associated with a level of knowledge under biosafety by multiple logarithmic binary regression model. Discussion: married marital status, living with people at risk for severe symptoms of covid-19, undergoing medical internship in a hospital center and having been diagnosed with covid-19 have an inversely proportional relationship with low knowledge in biosafety. In medical interns in the context of the covid-19 pandemic. © 2022, Faculty of Medical Sciences, Santa Rosa del Aguaray Branch, National University of Asuncion. All rights reserved.
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Background/Aims Patients with immune-mediated rheumatic diseases (IMRD) are commonly treated with immunosuppressors and are prone to infections. Recently introduced mRNA SARS-Cov2 vaccines have demonstrated extraordinary efficacy across all ages. Immunosuppressed patients were excluded from phase III trials with SARS-We aim to fully characterize B and T cell immune responses elicited by mRNA SARS-Cov2 vaccines in patients with rheumatic diseases under immunotherapies, and to identify which drugs reduce vaccine's immunogenicity. Methods Humoral, CD4 and CD8 immune responses were investigated in 147 SARS-Cov2-naive patients with selected rheumatic diseases under immunosuppression after a two-dose regimen of SARS-Cov2 mRNA vaccine. Responses were compared with age, gender, and diseasematched IMRD patients not receiving immunosuppressors and with healthy controls Results IMRD patients showed decreased seroconversion rates (63% vs 100%, p=0.04) and cellular immune responses (59% vs 100%, p=0.007). Patients on methotrexate achieved seroconversion in 62% of cases and cellular responses in 80% of cases. Abatacept deeply affected humoral and cellular responses. Rituximab (31% responders) and belimumab (50% responders) showed severely impaired humoral responses but cellular responses were often preserved. Antibody titers were reduced with mycophenolate and azathioprine but preserved with leflunomide. Conclusion IMRD patients exhibit impaired SARS-CoV-2 vaccine-immunogenicity, variably reduced with immunosuppressors. Among commonly used therapies, abatacept and B-cell depleting therapies show the most deleterious effects, while anticytokines preserved immunogenicity. The effects of cumulative methotrexate and glucocorticoid doses on immunogenicity should be considered. Humoral and cellular responses are weakly correlated, but CD4 and CD8 tightly correlate. Seroconversion alone might not reflect the vaccine's immunogenicity.
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The COVID-19 pandemic has been characterized by the high number of infected cases due to its rapid spread around the world, with more than 6 million of deaths. Given that we are all at risk of acquiring this disease and that vaccines do not completely stop its spread, it is necessary to continue proposing tools that help mitigate it. This is the reason why it is ideal to develop a method for early detection of the disease, for which this work uses the Stanford University database to classify patients with SARS-CoV-2, also commonly called as COVID-19, and healthy ones. In order to do that we used a densely connected neural network on a total of 77 statistical features, including permutation entropy, that were contrasted from two different time windows, extracted from the heart rate of 24 COVID patients and 24 healthy people. The results of the classification process reached an accuracy of 86.67% and 100% of precision with the additional parameters of recall and F1-score being 80% and 88.89% respectively. Finally, from the ROC curve for this classification model it could be calculated an AUC of 0.982. © 2022 Creative Commons.
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Euglycaemic diabetic ketoacidosis (EDK) is a complication of diabetes mellitus (DM) that is associated with high morbidity and mortality if it is not treated early and vigorously. Pregnancy is a risk factor for developing EDK, with a higher incidence than the general population, and is associated with high maternal-foetal mortality and morbidity (till 35%). In the absence of marked hyperglycaemia, delays in the diagnosis and treatment of this entity may occur. SARS-CoV-2 infection has also been associated with the development of EDK, so in a pregnant COVID+ patient with a history of DM, EDK should be suspected if metabolic acidosis with a high anion gap develops. We present the case of a 36-year-old woman, 32 weeks pregnant, with a history of DM, who developed EDK in the context of SARS-CoV-2 infection. © 2022 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo
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Biosafety measures are the set of minimum behaviors to be adopted, in order to reduce or eliminate risks to personnel, the community and the environment. Veterinary laboratories handle biological materials that can pose biological risks for both animals and humans, so that professionals in these laboratories are exposed to a variety of risks to their health related to their work. The objective of this work was to evaluate the risk in the quality control of viral vaccines through the use of BIOGAVAL method, a convenient and reliable way to assess the risk of exposure to biological agents. The study was carried out in the Base Business Unit Quality Control of the Production Company of Viral and Bacterial Vaccines which belongs to LABIOFAM. The study sample consisted was 18 workers, dispersed in three areas. For values above 12 of the biological action level, preventive measures are required to reduce exposure to Avulavirus, Pestivirus and Coronavirus, while for Alphavirus immediate corrective measures actions are required as it represents an intolerable risk situation.Copyright © 2023, Finlay Ediciones. All rights reserved.
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Due to the rapid spread of the COVID-19, scientists are constantly monitoring the evolution of the number of infections in a region. In particular, the basic reproductive number (R0) is studied, because it indicates if the number of cases will increase and the infection will last, or if it will decrease and stability will be reached. The present contribution is focused on forecasting this ratio, based on the extreme gradient boosting tree approach. Gradient reinforcement trees are used. Using public data of the COVID-19 outbreak in the Caribbean and some countries, this value is computed. © 2022 IEEE.
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The Covid-19 confinement has forced certain human groups to look for alternatives to socialize. University communities did not stay out of this context. The presence of student communities called 'confessions' whose purpose is to anonymously express their problems, desires and interests stands out. The main objective of this research is to determine the topics that highlight the cultural aspects and interests of these communities. Confessions pages from 5 Spanish-speaking countries were analyzed. Experiments were carried out on Facebookand Instagram posts using word embeddings and KMeans to cluster the semantic vector space. Anew evaluation approach based on the state-of-the-art was proposed that allow us to select and analyze topic models through specific keywords. As a result, topics of general interest were identified for each community such as 'Academic life', 'Relationships', 'Politics' and 'Personal problems'. The results vary by country. The collected dataset is publicly available1 for any academic purposes. © 2022 IEEE.
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Objective To assess adaptive immunity to SARS-CoV-2 in anti-CD20 treated individuals with mRNA vaccination. Background Anti-CD20 therapies attenuate humoral responses to vaccines. However, their effect on T cell responses is less clear. We examined B and T cell responses following COVID-19 vaccination in patients receiving anti-CD20 therapy for multiple sclerosis (MS) and other autoimmune inflammatory neurologic diseases (AINDs, e.g., autoimmune encephalitis, stiff person syndrome, etc.). Design/Methods MS and AIND patients on anti-CD20 therapies were prospectively enrolled for longitudinal analysis of antibody and T cell responses after a 3rd COVID-19 vaccination. Serum antibodies against the receptorbinding domain of the S1 spike protein (RBD-S1 IgG), neutralizing antibodies, and SARS-CoV-2 CD8 T cell responses, using activationinduced markers (AIM) and INF-gamma release assays (EUROIMMUN, Germany), were measured at various time points including prevaccination, post initial vaccination series, and 4 and 12 weeks after 3rd dose. Results Thirty-four MS and AIND participants are enrolled. Results for these patients (mean age 52 years-old, 79% female, 21 Pfizer, 13 Moderna) demonstrated attenuated RBD IgG antibody responses. However, a robust CD8 T cell response was observed, following a two-dose series, compared to non-immunosuppressed, age-matched vaccinated controls or unvaccinated with severe SARS-CoV-2 infection (p = 0.01). T cell response was sustained long-term (>12 weeks post 3rd dose) in all 11 anti-CD20 patients analyzed thus far. Collections are completed for all participants at 12 weeks and analysis to be completed by 05/15/22. Further analysis includes correlation of the INF- gamma release assay compared to RBD-CD8 T cell response detected by AIM assay. Conclusions Results suggest that patients treated with anti-CD20 therapy generate a robust CD8 T cell response to SARS-CoV-2 mRNA after three doses but remain with attenuated humoral immune responses. Our observational study will provide important data to guide vaccine management in patients on or anticipating anti-CD20 therapy.
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The theme of the correlated consequences Covid’s pandemic a problems of a lot of present time for the scientific international community are 19. For the severe consequences that you have left him the human being, he is for it that investigation aimed at designing a methodology from a pedagogic perspective for the evaluation of the consequences in the mental health caused by the social isolation in covid’s pandemic 19 in the adult elders of the group Santa Teresita of the Niño Jesús of Julio Andrade’s Parish Church. I eat the one that necessary methods of empiric type like the observation and theoreticians were for where it the inductive deductive, analytical systemic;sane thai thai constituted the development of investigation. The utilized methodology was the mixed quantitative cuali, affirmed under the fact-finding ty-pes descriptive of transverse type, utilizing like instrument of information the opinion poll;That way than himself I evidence than 80 % of the investigated people no physical activity, according to the bibliography, does not accomplish the exercise you obey a fundamental role in the quality of life of the older adult it enables the continuity of force and the mobility, provide a dream without interruptions (allowing to leave sleeping pills without difficulty), improve the state of mind, the stress diminishes, you prevent some diseases and generate recreational environments, the risk of mortality for diseases lessens host cardiovasculares.En to it you developed a proposal based in the pedagogic perspective of the evaluation with the purpose to diminish, the effects in the mental health once 19 were caused by the isolation of the pandemic of the Covid. © 2022, University of Cienfuegos, Carlos Rafael Rodriguez. All rights reserved.
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The coronavirus (SARS-CoV-2) pandemic has been a challenge for medicine over the last year. Although a recent entity, the exhaustive study it has undergone has revealed frequent complications, such as thrombotic and embolic phenomena. Other complications such as acute coronary syndrome or coronary vasospasm have been described, but are much less frequent. The latter has a pathophysiology that is not fully known, along with significant morbidity and mortality, so its early detection and management is important. We present the case of a 77-year-old man who presented coronary spasm of the right coronary artery associated with severe SARS-CoV-2 infection. © 2021 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo
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Aims To fully characterise B-cell and T-cell immune responses elicited by mRNA SARS-CoV-2 vaccines in patients with rheumatic diseases under immunotherapies, and to identify which drugs reduce vaccine's immunogenicity. Methods Humoral, CD4 and CD8 immune responses were investigated in 100 naive patients with SARS-CoV-2 with selected rheumatic diseases under immunosuppression after a two-dose regimen of SARS-CoV-2 mRNA vaccine. Responses were compared with age, gender and disease-matched patients with IMRD not receiving immunosuppressors and with healthy controls. Results Patients with IMRD showed decreased seroconversion rates (80% vs 100%, p=0.03) and cellular immune responses (75% vs 100%, p=0.02). Patients on methotrexate achieved seroconversion in 62% of cases and cellular responses in 80% of cases. Abatacept decreased humoral and cellular responses. Rituximab (31% responders) and belimumab (50% responders) showed impaired humoral responses, but cellular responses were often preserved. Antibody titres were reduced with mycophenolate and azathioprine but preserved with leflunomide and anticytokines. Conclusions Patients with IMRD exhibit impaired SARS-CoV-2 vaccine immunogenicity, variably reduced with immunosuppressors. Among commonly used therapies, abatacept and Bcell depleting therapies show deleterious effects, while anticytokines preserved immunogenicity. The effects of cumulative methotrexate and glucocorticoid doses on immunogenicity should be considered. Humoral and cellular responses are weakly correlated, but CD4 and CD8 tightly correlate. Seroconversion alone might not reflect the vaccine's immunogenicity.
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A pesar de las campañas oficiales de vacunación dirigidas a la población por parte de las autoridades sanitarias, aún se identifican personas que no han recibido ninguna dosis de vacuna o que registran pauta incompleta. El objetivo del presente trabajo es exponer la campaña de captación (catch-up) frente a COVID-19 en pacientes hospitalizados. Métodos: Se revisaron los calendarios de vacunación COVID-19 de los pacientes que estaban hospitalizados entre el 08/11/2021 y el 27/06/2022 justo en el momento en que el paciente se encontraba en el centro asistencial. En aquellos que no presentaban registro de vacunación COVID-19 o que presentaban pauta incompleta se registraba en la hoja de evolución clínica ofreciendo la vacuna COVID-19 durante la estancia hospitalaria o su programación tras el alta. El facultativo y la enfermera le trasladaban esta información al paciente haciendo hincapié en esta medida preventiva. Si el paciente accedía a vacunarse, se contactaba con la Unidad de Vacunas para proceder a la vacunación. Resultados: Se evaluaron un total de 2.961 pacientes. De ellos, 2.700 (91,18%) estaban correctamente vacunados según las indicaciones de vacunación vigentes. De los 261 (8,81%) restantes, 174 (66,66%) estaban pendientes de alguna dosis mientras que 87 (33,33%) habían rechazado vacunación. Tras registrar y ofrecerles la vacunación de manera oportunista a propósito de su hospitalización se consiguió que 66 (37,93%) de los que registraban vacunación incompleta continuaran con la pauta antes del alta hospitalaria y que 16 (18,39%) de los que habían rechazado previamente la vacunación, iniciaran la pauta durante su ingreso. La estrategia consiguió el catch-up frente a COVID-19 en 82 (31,41%) pacientes. Conclusiones: La presente campaña de catch-up se considera efectiva. La vacunación oportunista durante la hospitalización debe tenerse en cuenta como una estrategia útil para la mejora de las coberturas de vacunación globales.
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Individual responsibility implies horizontality of participation in the formulation of small models of self-care and local decision-making of what and how to do for prevention, however, in addition to the deployment of education and social communication formulas that provide important tools so that each citizen knows what humanity is facing and to generate shared responsibilities (Rios, 2020), in a practical sense, in a certain percentage of citizens, it has been possible to observe the abandonment of elementary aspects of social coexistence in times of pandemic. This topic has raised interesting controversies that take up a set of valid questions. The present work takes as its starting point two questions to which it does not attempt to answer, but rather fulfill a guiding function for the arguments presented here: Why are there human groups that do not consciously act on the global call for vaccination? Why do human groups persist in dispensing with biosafety measures, not abiding by health guidelines? Our concern when carrying out this analysis arose from understanding that, as is the case in various parts of the world, the Ecuadorian provinces with similar community mitigation measures presented very different trends in infection rates. As far as we know, there is no epidemiological model that can help us understand this phenomenon.
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Background: Patients with immune-mediated rheumatic diseases (IMRD) are commonly treated with immunosuppressors and prone to infections. Recently introduced mRNA SARS-Cov2 vaccines have demonstrated extraordinary efficacy across all ages. Immunosuppressed patients were excluded from phase III trials with SARS-Cov2 mRNA vaccines. Objectives: To fully characterize B and T cell immune responses elicited by mRNA SARS-Cov2 vaccines in patients with rheumatic diseases under immunotherapies, and to identify which drugs reduce vaccinés immunogenicity. Methods: Humoral, CD4 and CD8 immune-responses were investigated in 100 SARS-Cov2-naïve patients with selected rheumatic diseases under immunosup-pression after a two-dose regimen of SARS-Cov2 mRNA vaccine. Responses were compared with age, gender, and disease-matched IMRD patients not receiving immunosuppressors and with healthy controls. Results: IMRD patients showed decreased seroconversion rates (80% vs 100%, p= 0.03) and cellular immune responses (75% vs 100%, p= 0.02). Patients on methotrexate achieved seroconversion in 62% of cases and cellular responses in 80% of cases. Abatacept decreased humoral and cellular responses. Rituximab (31% responders) and belimumab (50% responders) showed impaired humoral responses, but cellular responses were often preserved. Antibody titers were reduced with mycophenolate and azathioprine but preserved with lefunomide and anticytokines. Conclusion: IMRD patients exhibit impaired SARS-CoV-2 vaccine-immuno-genicity, variably reduced with immunosuppressors. Among commonly used therapies, abatacept and B-cell depleting therapies show deleterious effects, while anticytokines preserved immunogenicity. The effects of cumulative meth-otrexate and glucocorticoid doses on immunogenicity should be considered. Humoral and cellular responses are weakly correlated, but CD4 and CD8 tightly correlate. Seroconversion alone might not refect the vaccine's immunogenicity.
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Introduction: Currently, major depressive disorder generates a high burden of disease in the general population, which is usually higher in medical students. The Patient Health Questionnaire-9 (PHQ-9) is a widely used instrument in the general population to assess the severity of depression in primary care. Objective: To validate the factorial structure of the PHQ-9 questionnaire in human medicine interns at a reference university in Peru. Methods: An observational, cross-sectional and instrumental design was used. We worked with a sample of 343 human medicine interns. From the responses to the questionnaire, the Cronbach's alpha coefficient was calculated, as well as the factorial analysis to determine the construct validity of this instrument in the target population. Results: Cronbach's alpha coefficient was 88.2%, the item/test conversion coefficients presented values greater than 0.5. A value greater than 0.05 was obtained for the chi2 goodness-of-fit test for the model, as well as results greater than 0.9 for the model's goodness-of-fit coefficients. Conclusion: The factorial structure of the PHQ-9 has adequate validity and reliability in the population of human medicine interns.
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Objective: To assess adaptive immunity to SARS-CoV-2 in anti-CD20 treated individuals with mRNA vaccination as it relates to spike binding IgG, neutralizing antibody titers, and T cell response. Background: Anti-CD20 therapies attenuate humoral responses to vaccines. Their effect on T cell responses is unclear. We examined B and T cell responses with COVID-19 vaccination in patients receiving anti-CD20 therapy for multiple sclerosis (MS) and other autoimmune inflammatory neurologic diseases (AINDs). Design/Methods: Patients on anti-CD20 therapies were prospectively enrolled for longitudinal analysis of antibody and T cell responses before and after COVID-19 vaccination. Serum antibodies against the receptor-binding domain of the S1 spike protein (RBD-S1 IgG), neutralizing antibodies, and SARS-CoV-2 CD4 and CD8 T cell levels responses using activation-induced markers and INF-gamma release assay were measured at various time points including pre-vaccination, less than 12 weeks and greater than 12 weeks post initial vaccination series, and 4 and 12 weeks after 3rd “booster” vaccination. Results: Twenty-five MS and AIND participants are enrolled as of 10/11/21 with projected enrollment complete by December 2021 (50-60 total). Preliminary results for 17 of these patients (mean age 44 years-old, 83% female, 16 Pfizer, 1 Moderna) demonstrated attenuated RBD IgG antibody responses. However, CD8 T cell response is robust compared to non-immunosuppressed, age-matched controls (n=22) less than 12 weeks after two dose series (p value = 0.0069) and sustained long-term (>12 weeks) in all eight anti-CD20 patients tested thus far. Additional analysis will include comparison between pre and post 3rd vaccination at 4- and 12-week timepoints. Conclusions: Early results suggest that patients treated with anti-CD20 therapy generate a robust CD8 T cell response to SARS-CoV-2 mRNA post initial series of vaccination but remain with attenuated humoral immune responses. Our observational study will provide important data to guide vaccine management in patients on or anticipating anti-CD20 therapy.