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Aim/Introduction: The aim of the study was to assess the presence of lymph node uptake (LNU) in patients who had received a COVID-19 vaccine and to evaluate its association with patient characteristics, type of vaccines, and PET/CT radiotracers. Material(s) and Method(s): 361 patients who underwent a PET/CT scan with 18F-FDG (FDG), 68Ga-PSMA (PSMA), or 11C-Choline (CHOL) performed in two EARL PET/CT accredited centers, from May to July 2021, and who had received single or double dose of COVID-19 vaccine (mRNA-based and viral-vector) were selected. Data from age, tumor histology, type of vaccine, location of LNU and time from vaccination (time- Vacc) were prospectively collected. A retrospective analysis of scans was conducted evaluating the presence/absence of LNU (chisquare test). Additionally we performed a semiquantitative analysis (SUVmax of LNU), to explore possible differences according to type and number of vaccination doses, time-Vacc, patient age and tumor hystologies (independent t-tests). Result(s): From the 361 eligible subjects (median age: 67 years), 319 (88%) underwent PET/CT with FDG, 23 (6.3%) with PSMA, 19 (5,2%) with CHOL. 296 (82%) subjects received mRNA-based vaccine, 62 (17%) viral-vector (V-V) and 3 (1%) received mixed vaccines. Positive LNU was seen in 203 subjects (56.2%) independently of vaccine types (mRNA=59.68, V-V=55.7, p=0.74) and number of doses (1 dose: V-V=56.76%, mRNA=58.62 p=0.83;2 doses: mRNA=55%). Similar frequency of LNU positivity was observed using FDG and CHOL (57.6% and 57.8%, respectively), while with PSMA only 34.8% showed LNU positivity. LNU limited to ipsilateral axillar region was the most frequent location (global: 70.44%;FDG:69.6%;CHOL:63.6%;PSMA:100%), followed by both ipsilateral axillar and retropectoral region (global: 18.72%;CHOL: 36.4%). Positive LNU was less frequent in older patients (p=0.007), and ranged between 40 to 68% among the neoplastic pathologies, with the exception of multiple myeloma (15.8%;p=0.001). Positive LNU appeared in most cases in the first week post-vaccination (82%), persisted in second and third week (68.49%, 62.64%), and decreased after the fourth week (38.8%). Moreover, an inverse correlation between the time-Vacc and the SUVmax value calculated in the LNU using FDG (2.82 +/- 1.44;p=0.008) was observed. Conclusion(s): Patients referred to a FDG or CHOL PET scan due to diverse neoplastic diseases displayed high percentage of axillar LNU one week after COVID-19 vaccination, independently of vaccine type and number of doses. Our results also suggest a lower percentage of positive LNU in older subjects, patients with multiple myeloma, and when using PSMA-PET.
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In times of pandemic, the educational process underwent important changes where technology and the internet stood out. Because of this, this research proposes to analyze the development of school activities through social networks during the Covid-19 pandemic: A look from the perception of the students of Basic Education of the educational unit "Tulcán”, of the community "El Guayabo”, Riochico parish of the Portoviejo canton. The study was conducted with a postpositivist approach, using qualitative methodology, addressing the phenomenological interpretive method. The technique of in-depth interviewing aimed at students was used considering a randomly selected sample of five fifth-grade and five sixth-grade students as key informants. As a result, it can be highlighted that social networks during the Covid-19 pandemic, have become an instrument for collaborative learning, evidencing that children mostly prefer to carry out activities in person, due to the lack of understanding of the tasks taught by teachers, concluding that the use of social networks can be important for some activities, but it is not the best option for all activities that explain concepts and procedures. © 2022,Revista de Ciencias Sociales.All Rights Reserved.
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Introduction. Solid organ transplant recipients were excluded from the pivotal clinical trials of COVID-19 vaccines. Therefore, the safety and efficacy data of the different types of available vaccines in this susceptible population is scarce. The goal of the present analysis was to evaluate the humoral response to the COVID-19 vaccines in orthotopic liver transplant (OLT) recipients. Methods. Participants were included from February to September 2021. No prioritized vaccination was performed for OLT patients, and they were included in the regular schedule according to age and place of residency. Controls were otherwise healthy people, mainly family members of patients. All subjects completed the full vaccination schemes, and blood samples were taken after at least 15 days of the complete vaccine doses. The samples were analyzed according to the manufacturer instructions using Liaison XL platform from DiaSorin, LIAISON® SARS-CoV-2 S1/S2 IgG (DiaSorin S.p.A., Italy), and SARS-COV-2 IgG II Quant (COV-2 IgG II) (Abbott Diagnostics, IL, USA). Results. In all, 187 participants (133 OLT, 54 controls, median age: 60 years, 58.8% women) were included for the analysis;74.3% had at least one comorbidity (31.6% had hypertension, 32.6% diabetes, 7% neoplasia, and 23% obesity). By vaccine brands, 50.3% received Pfizer-BioNTech, 13.9% received Oxford-AstraZeneca, 10.7% received Sinovac, 7.0% Cansino;16% Sputnik-V and 2.1% received Moderna. The serologic response in OLT patients was lower than in controls (median 549 AU/mL vs. 3450 AU/mL, respectively;p 0.001). A positive humoral response was found in 133 OLT individuals: 89.2% with Pfizer-BioNTech, 60% Oxford-AstraZeneca, 76.9% Sinovac, 55.6% Cansino, 68.2% Sputnik-V, and 100% with Moderna. In controls, only Cansino had a 75% humoral response;all other vaccines had a 100% response. In a multivariable model adjusted for relevant confounders, the antecedent of COVID-19 and Pfizer-BioNTech inoculation were associated positively with the serologic response, while the use of prednisone (compared with other immunosuppressants) interfere with this response. Conclusion. The serologic response to COVID-19 vaccines in OLT patients is lower than otherwise healthy controls. In these patients, the Pfizer-BioNTech vaccine was associated with a higher serologic response. Other variables significantly associated with the humoral response were the COVID-19 antecedent (positively) and prednisone exposure (negatively). At the moment, further analysis is necessary to determine whether this serological response is associated with SARS-COV2 infection or reinfection. (Figure Presented)
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Introduction: SARS-CoV-2 has caused the first pandemic of the 21st century with a toll of more than 5 million deaths. Although Mexico is one of the most affected countries, no information regarding liver transplant (LT) recipients is available to date. A higher risk of developing COVID-19 has been reported for these subjects in the literature (cumulative incidence 837.41 cases/105 patients vs. 311.93 cases/105 patients). However, a lower mortality has also been reported (18% vs 27.0% among patients older than 60 years, with no deaths recorded in younger LT recipients). This work aims to further examine these trends. Methods: The study was performed in a single center of liver transplantation in Mexico City. The records of all the LT recipients above 18 years old with COVID-19 confirmed by reverse transcription-polymerase chain reaction assay (RT-PCR) between March 2020 and November 2021 were included. Demographic data, comorbidities, cause and date of LT, the immunosuppressive therapy (IT), vaccination status, severity, indication and availability of intensive care unit (ICU) beds, and mortality were extracted. The main outcome was death. Secondary outcomes were severity and need of ICU. Results: Seventy-four LT recipients with SARS-CoV-2 infection were considered. The median age was 54.5 years (45.0-61.3) and 39 patients were men (52.7%). The predominant etiology in our cohort was HCV (27.0%) followed by NASH (21.6%). Mean time from transplantation to infection was 56.2 weeks (33-80). Twenty-one patients had at least 1 vaccine dose at the time of infection (28.4%);15 had a complete scheme (20.2%). Twenty-one (28.4%) patients had severe COVID-19 (Table 1). Overall mortality was 8.10%. No IT treatment was associated with a better or worse prognosis for the whole cohort. Among the vaccinated patients, 4 (19%) had severe COVID-19 with a mean age of 61 years (59-64) and 3 died (mortality 14.3%);All of them had a complete vaccination scheme (1 with BNT162b2, 2 with ChAdOx1 nCoV19) and were taking mycophenolate mofetil (MMF). Among the unvaccinated, 17 patients had a severe illness (32.8%) (Figure 1), mean age of 55 years (50-63) and 3 died (mortality 5.6%). However, none of the latter had an ICU bed available. Conclusions: We present the characteristics of LT recipients with SARS-CoV-2 infection at the largest LT center in Mexico. Overall mortality (8%) was lower than that reported in other cohorts of LT recipients and no patient under 57 years old died. A significant numerical reduction in severe cases and the need for critical care was found among vaccinated patients. An association was found between the use of MMF and mortality among vaccinated patients SARS-CoV-2 vaccination should be encouraged and its access guaranteed among LT recipients. (Figure Presented) (Table Presented)
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Introduction: The retina is a highly specialized sense organ subjected to constant exposure to systemic toxins and oxidative stress. The frequency and etiology of drug-induced retinopathy, as well as the number of new potential drugs involved, are largely unknown. Objective: Describe the most frequent drug-induced retinal disorders and the drugs implicated gathered through the spontaneous report registry of the Spanish System of Pharmacovigilance (SSP). Methods: All spontaneous reported cases describing Retinal structural change, deposit and degeneration, Retinopathies not elsewhere classified, and Retinal bleeding and vascular disorders (excluded retinopathy) (MedDRA-HLT) in the SSP database from 1983 to January 2022 were selected. Medical devices and marketing authorisation holder cases were excluded. The variables studied were age and sex of the patients, characteristics of adverse drug reactions (ADRs) (seriousness, outcome) and suspect drugs (active substance, anatomical therapeutic chemical code, previous knowledge of drug-reaction association, rechallenge and existence of alternative causes). Results: Out of 175 spontaneous reports (0.1% of the spontaneous reports in the SSP database) that describe 210 ocular ADRs and/or adverse events, the most frequent (MedDRA-HLT) were retinal bleeding and vascular disorders (111, 52.9%), ocular structural change, deposit and degeneration (59, 28.1%) and vision disorders (12, 5.7%). For MedDRA-PT;retinal vein thrombosis (38, 18.1%), retinal detachment (22, 10.5%) and retinal hemorrhage (20, 9.5%). In only 8 cases (3.8%) drug administration was ophthalmic. Patient's median age was 57.65 (IQR 48-67.5) years;68.6% (120) were adults and 56.6% (99) were women. 153 reports (87.4%) were serious. 10.9% (19) cases resolved after withdrawal of the suspect drug and 12.6% (22) resolved with sequelae. A total of 220 drugs were suspected, of which 55 (25%) were COVID-19 vaccines -vector vaccine ChAdOx1 nCoV-19/AZD1222, Oxford-AstraZeneca (27) and mRNA vaccine BNT162b2, Pfizer- BioNTech (23)-, followed by sex hormones (21), immunostimulants (16) and antiprotozoals (14). Of the 175 reports, 56% (98) were poorly or unknown ADR associations. Alternative causes were excluded in 46 (26.3%) cases of which 12 (26%) were poorly or unknown ADR associations and no cases had a positive rechallenge. Conclusion: Our study shows that drug-induced retinopathy is an infrequent but serious complication. In the SSP database more than half of ADRs were retinal bleeding and vascular disorders. A quarter of the suspected drugs were new COVID-19 vaccines, followed by other drugs for which retinal disorders are well known. Although striking, it is important to contextualize this data in the current situation, considering the particularities of pharmacovigilance in vaccines, the massive rollout campaign and the nascent and evolving data on COVID-19 vaccines. Thus, further studies are needed to confirm such associations. Moreover, clinicians should be aware of drug-induced retinal disorders, even when not listed in the product information leaflet.
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Objective: To determine the prevalence of anxiety in ophthalmologists during the COVID-19 (coronavirus disease 2019) pandemic, exposed to severe acute respiratory syndrome by coronavirus type 2 (SARS-CoV-2) working in respiratory triage and outpatient ophthalmology consultation at the Hospital Central Militar in Mexico City. Material and methods: Observational, cross-sectional, descriptive and prospective study, in which a descriptive survey was applied via internet evaluating two anxiety scales (Hamilton scale and generalized anxiety disorder [GAD-7) scale). Results: Thirty-one subjects responded, 17 (54.84%) female and 14 (45.16%) male. Minimum age was 25 years and maximum age was 49 years, with an average age of 34.5 years.The survey consisted of 24 questions, of which 21 were obtained from both anxiety scales (Hamilton + GAD-7) and the remaining three were of epidemiological interest. By rating both scales separately, we observed an average score of 5.16 for the GAD-7 scale and of 8.45 for the Hamilton scale, reflecting a minimal group anxiety. Using the GAD-7 scale, we observed an anxiety prevalence of 48% (15 physicians). Of the diagnosed cases, 9 (60%) met a score listed as mild anxiety, 5 (53%) as moderate and 1 (7%) as severe. On the Hamilton scale, the prevalence was of 83% (26 physicians). Of the diagnosed cases, 23 (88%) had minimal anxiety, 2 (8%) had minimal-moderate anxiety and 1 (4%) had severe anxiety. Conclusion: The prevalence of anxiety in ophthalmologists, using the GAD-7 and Hamilton scales was of 48% and 83%, respectively, and most cases were of mild intensity.
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Objective: To determine the prevalence of anxiety in ophthalmologists during the COVID-19 (coronavirus disease 2019) pandemic, exposed to severe acute respiratory syndrome by coronavirus type 2 (SARS-CoV-2) working in respiratory triage and outpatient ophthalmology consultation at the Hospital Central Militar in Mexico City. Material and methods: Observational, cross-sectional, descriptive and prospective study, in which a descriptive survey was applied via internet evaluating two anxiety scales (Hamilton scale and generalized anxiety disorder [GAD-7) scale). Results: Thirty-one subjects responded, 17 (54.84%) female and 14 (45.16%) male. Minimum age was 25 years and maximum age was 49 years, with an average age of 34.5 years.The survey consisted of 24 questions, of which 21 were obtained from both anxiety scales (Hamilton + GAD-7) and the remaining three were of epidemiological interest. By rating both scales separately, we observed an average score of 5.16 for the GAD-7 scale and of 8.45 for the Hamilton scale, reflecting a minimal group anxiety. Using the GAD-7 scale, we observed an anxiety prevalence of 48% (15 physicians). Of the diagnosed cases, 9 (60%) met a score listed as mild anxiety, 5 (53%) as moderate and 1 (7%) as severe. On the Hamilton scale, the prevalence was of 83% (26 physicians). Of the diagnosed cases, 23 (88%) had minimal anxiety, 2 (8%) had minimal-moderate anxiety and 1 (4%) had severe anxiety. Conclusion: The prevalence of anxiety in ophthalmologists, using the GAD-7 and Hamilton scales was of 48% and 83%, respectively, and most cases were of mild intensity.