Multidisciplinary approach of the sequelae one month after hospital discharge in patients with severe bilateral COVID-19 pneumonia, are there differences depending on the respiratory therapy used during admission to intensive care?

OBJECTIVE: To describe the sequelae one month after hospital discharge in patients who required admission to Intensive Care for severe COVID 19 pneumonia and to analyze the differences between those who received therapy exclusively with high-flow oxygen therapy compared to those who required invasive mechanical ventilation. DESIGN: Cohort, prospective and observational study. SETTING: Post-intensive care multidisciplinary program. PATIENTS OR PARTICIPANTS: Patients who survived admission to the intensive care unit (ICU) for severe COVID 19 pneumonia from April 2020 to October 2021. INTERVENTIONS: Inclusion in the post-ICU multidisciplinary program. MAIN VARIABLES OF INTEREST: Motor, sensory, psychological/psychiatric, respiratory and nutritional sequelae after hospital admission. RESULTS: 104 patients were included. 48 patients received high-flow nasal oxygen therapy (ONAF) and 56 invasive mechanical ventilation (IMV). The main sequelae found were distal neuropathy (33.9% IMV vs 10.4% ONAF); brachial plexopathy (10.7% IMV vs 0% ONAF); decrease in grip strength: right hand 20.67kg (±8.27) in VMI vs 31.8kg (±11.59) in ONAF and left hand 19.39kg (±8.45) in VMI vs 30.26kg (±12.74) in ONAF; and limited muscle balance in the lower limbs (28.6% VMI vs 8.6% ONAF). The differences observed between both groups did not reach statistical significance in the multivariable study. CONCLUSIONS: The results obtained after the multivariate study suggest that there are no differences in the perceived physical sequelae one month after hospital discharge depending on the respiratory therapy used, whether it was high-flow nasal oxygen therapy or prolonged mechanical ventilation, although more studies are needed to be able to draw conclusions.

Food Security and Nutrition in Mexico During the SARS-CoV-2 Pandemic: Systematic Review.

Introduction: The food security and nutrition of individuals was affected due to the coronavirus (COVID-19) pandemic. Increased food insecurity limits individuals from having a full and dignified quality of life. Objective(s): To assess the access and availability of food security in the Mexican population affected by the COVID-19 pandemic in Mexico through a literature review. Methodology: Literature review in databases such as: PubMed, Science Direct, Scielo, FAO, UN, ENSANUT, Salud Publica de Mexico and CONACYT. The search for information was carried out from November 2021 to May 2022, considering articles published from March 2020 and in relation to the health contingency period. A search equation was used for the search and, in addition, the methodological evaluation of Munns et al. was applied. Articles in Spanish and English were included, with content referring to Mexico. Result(s): A total of 274 articles were identified in databases;based on the eligibility criteria, surveys and/or articles on nutrition, food security and lifestyle during the pandemic in Mexico were considered. Articles were excluded for having another study design (2), title (100), abstract (82), non-relevant information (54) and (9) for full text, because they did not meet the proposed characteristics. Finally, 10 articles were selected for the literature review. With this, the data showed that the COVID-19 pandemic caused diverse affectations in the Mexican territory, this was evidenced after an increase in food insecurity and changes in lifestyle. Conclusion(s): Food security and nutrition of individuals were affected in the Mexican population, due to economic issues, changes in dietary patterns, as well as job losses and loss of income.Copyright © 2022 Asociacion Espanola de Dietistas-Nutricionistas. All rights reserved.

Cognitive impairment in long COVID syndrome patients one year after infection

Introduction: Patients with acute COVID syndrome have significant cognitive impairment. Although different research had focused on assessing the condition of these patients in the hospital period and in the short term, there are no studies that evaluated these alterations in the long term. The cognitive impairment of long COVID patients may be an important factor for the development of intervention programmes tailored to this population. Objetive: The main objetive of this study was to evaluate the presence of cognitive impairment in long COVID syndrome patients one year after infection. Patients and Methods: In this observational study, long COVID patients were included. These patients were evaluated one year after infection and they were compared to a control group matched by age and gender. Anxiety, depression, memory and concentration problems were measured with items from a comprehensive multi-system telephone screening tool called COVID-19 Yorkshire Rehabilitation Screening (C19-YRS). Result(s): A total of 455 patients and 451 controls were included in this study. Anxiety (p<0,05), depression (p<0,001), memory (p<0,001) and concentration (p<0,001) had shown significant results compared to the control group. Conclusion(s): This study found that long COVID syndrome patients had significant cognitive impairment one year after infection, with increased levels of anxiety, depression and difficulties in concentration and decreased memory. Early interventions for cognitive impairment may improve or prevent further deterioration.

Impact of the state of alarm after COVID-19 on the habitual consumption of video games in primary schoolchildren

The health situation resulting from COVID-19 is affecting lifestyles starting from the earliest stages of life. Therefore, the aim was to analyse primary schoolchildren's habitual video game consumption after the end of the state of alarm caused by COVID-19. To this end, a cross-sectional study comprising 125 primary schoolchildren was designed. To measure their video game consumption, the Questionnaire on video game consumption habits was used. The Student's t-test revealed significant differences in all dimensions in favour of the boys (p < .001, for all). Additionally, those aged 11-12 years yielded higher scores in the degree of attraction to video games (p < .05), level of concern about video games (p < .05), and rate of habitual video game consumption (p < .05). In conclusion, the results of this study are in line with scientific literature, indicating greater video game consumption in boys and older schoolchildren.

[Multidisciplinary approach of the sequelae one month after hospital discharge in patients with severe bilateral COVID-19 pneumonia, are there differences depending on the respiratory therapy used during admission to intensive care?] / Valoración multidisciplinar de las secuelas al mes del alta hospitalaria por neumonía grave COVID-19, ¿existen diferencias en función de la terapia respiratoria empleada durante su ingreso en Cuidados Intensivos?

Objective: To describe the sequelae one month after hospital discharge in patients who required admission to intensive care for severe COVID-19 pneumonia and to analyze the differences between those who received therapy exclusively with high-flow oxygen therapy compared to those who required invasive mechanical ventilation. Design: Cohort, prospective and observational study. Setting: Post-intensive care multidisciplinary program. Patients or participants: Patients who survived admission to the intensive care unit (ICU) for severe COVID-19 pneumonia from April 2020 to October 2021. Interventions: Inclusion in the post-ICU multidisciplinary program. Main variables of interest: Motor, sensory, psychological/psychiatric, respiratory and nutritional sequelae after hospital admission. Results: One hundred and four patients were included. 48 patients received high-flow nasal oxygen therapy (ONAF) and 56 invasive mechanical ventilation (IMV). The main sequelae found were distal neuropathy (33.9% IMV vs. 10.4% ONAF); brachial plexopathy (10.7% IMV vs. 0% ONAF); decrease in grip strength: right hand 20.67 kg (± 8.27) in VMI vs. 31.8 kg (± 11.59) in ONAF and left hand 19.39 kg (± 8.45) in VMI vs. 30.26 kg (± 12.74) in ONAF; and limited muscle balance in the lower limbs (28.6% VMI vs. 8.6% ONAF). The differences observed between both groups did not reach statistical significance in the multivariable study. Conclusions: The results obtained after the multivariate study suggest that there are no differences in the perceived physical sequelae one month after hospital discharge depending on the respiratory therapy used, whether it was high-flow nasal oxygen therapy or prolonged mechanical ventilation, although more studies are needed to be able to draw conclusions.

ICT and functional diversity. Reference values for the diagnosis and training of Canarian teachers

The health situation resulting from Covid-19 has led to a pedagogical transformation in the context of education, taking teaching from face-to-face to telematic. Therefore, the aim was to provide percentile values of the diagnostic questionnaire and teacher training for the incorporation of ICT in students with functional diversity considering gender, years of experience, educational stage and type of island. Method: a descriptive cross-sectional study was designed with a sample of 678 teachers. The questionnaire used was called Diagnosis and teacher training for the incorporation of ICT in students with functional diversity. The Hotelling test showed significant differences for the variables sex (F= 9.915;p < 0,001), years of experience (F= 5.318;p < 0,001), educational stage (F= 7.916;p < 0,001) and type of island (F= 5.812;p < 0,001). In conclusion, this study provides updated percentiles in a population of teachers in the Canary Islands regarding the diagnosis and training for the incorporation of ICT in students with functional diversity considering gender, years of experience, educational stage and type of island. © 2022 Authors. All rights reserved.

Digital Education before Covid 19 in the administrative economic area

The aim of this work is to analyze the impact of adaptive learning forced by Covid-19 at the Faculty of Administrative Economic Sciences of the Autonomous University of Carmen. For this study, we approach the theoretical concepts with a documentary review, subsequently a descriptive analysis of a sample of 291 students was made. The results show that most of the students developed a satisfactory performance, preferably using the Teams platform, although platforms were also used as support. This concludes that the university community quickly adapted to the virtual environment imposed by the pandemic. © GKA Ediciones, authors.

Unusual thyroid carcinoma metastasis in paranasal sinuses and parapharyngeal space

The prevalence of follicular cell-derived thyroid carcinoma with an unusual pattern in its metastatic spread is relatively unknown, and therefore its clinicopathological characteristics are not well defined and represent uncertainty in diagnosis and treatment. In this report, two cases of metastasis in the paranasal sinuses and one of metastasis in the parapharyngeal space are described. In the first case, given the extension of the lesion to the cavernous sinus, surgical resection was not possible and external radiotherapy management was determined. However, the patient died of COVID-19. In the second case, the patient underwent endoscopic release of the left maxillary nerve and partial resection of the tumor as a palliative measure, clinical improvement was observed, and he subsequently received 30Gy external radiotherapy. The third case was managed surgically using a minimally invasive approach using robotic transoral surgery, which was successful. Metastasis in the paranasal sinuses and parapharyngeal space due to differentiated thyroid carcinoma represents an unusual scenario. Its characterization and management will always be a challenge, but new minimally invasive techniques play an increasingly promising role. © 2022 EDIZIONI MINERVA MEDICA.

CANOPY-N: A phase II study of canakinumab (CAN) or pembrolizumab (PEM), alone or in combination, as neoadjuvant therapy in patients (pts) with resectable stage Ib-IIIa non-small cell lung cancer (NSCLC)

Background: CAN is a monoclonal antibody that inhibits proinflammatory IL-1beta-driven pathways that may play a role in tumor growth in early-stage NSCLC. Preclinical data suggest targeting IL-1beta could decrease inflammation and immunosuppression in the tumor microenvironment (TME). Method(s): CANOPY-N (NCT03968419) is a phase II, randomized, open-label study of neoadjuvant CAN, PEM or CAN+PEM in resectable NSCLC. Eligibility: Stage IB-IIIA NSCLC;treatment (tx) naive;ECOG PS 0-1;and eligible for planned resection 4-6 weeks after first dose. Pts were randomized 2:2:1 to the tx arms: CAN, CAN+PEM or PEM. CAN and PEM were both given as two 200 mg doses once every 3 weeks. Primary endpoint: major pathological response (MPR) rate based on central review. Key secondary endpoints: overall response rate (ORR), surgical feasibility rate, and safety. Changes in CD8+ T cell, tumor-associated macrophage (TAM) and regulatory T cell (Treg) levels, among others, were assessed in exploratory biomarker analyses. Result(s): 88 pts enrolled across 3 arms: CAN (n=35), CAN+PEM (n=35) and PEM (n=18). 87 pts completed planned neoadjuvant tx. Four pts did not have surgery: 3 due to disease progression (CAN) and 1 to pt decision (CAN+PEM). MPR rates were 2.9% (CAN), 17.1% (CAN+PEM) and 11.1% (PEM). ORRs were 0% (CAN), 8.6% (CAN+PEM) and 11.1% (PEM). Gr >=3 AEs occurred in 37.1%, 28.6% and 22.2% of pts, of which 0%, 11.4% and 11.1% were tx related, in the CAN, CAN+PEM and PEM arms, respectively. Decreases in TAMs and Tregs were seen in CAN arms whereas increases in CD8+ T cells were seen in PEM arms. Modulations were more pronounced with CAN+PEM (Table). [Formula presented] Conclusion(s): CANOPY-N did not meet the primary endpoint of MPR rate, with minimal clinical efficacy and no increase in CD8+ T cells with CAN alone. No new safety signals were seen. IL-1beta inhibition impacted inflammation and immunosuppression in the TME. Clinical trial identification: CACZ885V2201C / NCT03968419. Editorial acknowledgement: Editorial assistance was provided by Ollie Butlin, MSc of Articulate Science Ltd., and was funded by Novartis Pharmaceuticals Corporation. Legal entity responsible for the study: Novartis Pharmaceuticals Corporation. Funding(s): Novartis Pharmaceuticals Corporation. Disclosure: T.S.K. Mok: Financial Interests, Personal, Invited Speaker: AbbVie, ACEA Pharma, Alpha Biopharma, Amgen, Amoy Diagnostics, BeiGene, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Daiichi Sankyo, Fishawack Facilitate, InMed Medical Communication, Lunit USA, Inc., Merck Serono, MSD, Roche, MD Health, Medscape/WebMD, PeerVoice, Touch Medical Media, Permanyer SL, Prime Oncology, Research to Practice, Sanofi-Aventis, Takeda, PER, Daz Group, Lucence Health Inc., Janssen Pharmaceutical NV, Jiahui Holdings Co., LiangYiHui Healthcare, Merck Pharmaceuticals HK Ltd, MiRXES, Novartis, OrigiMed Co. Ltd., Pfizer, Shanghai BeBirds Translation & Consulting Co., Ltd., Taiho Pharmaceutical Co., Ltd, AstraZeneca;Financial Interests, Personal, Advisory Board: AbbVie, ACEA Pharma, Alpha Biopharma, Amgen, Amoy Diagnostics, BeiGene, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Blueprint Medicines, Berry Oncology, CStone Pharma, Daiichi Sankyo, Fishawack Facilitate, Eisai, Gritstone Oncology, Guardant Health, G1 Therapeutics, Hengrui, Ignyta, IQVIA, Incyte Corporation, Inivata, Janssen, Loxo Oncology, Qiming Dev., Lunit USA, Inc., Merck Serono, MSD, Roche, Mirati Therapeutics, MoreHealth, Novartis, OrigiMed, Puma Tech., Sanofi-Aventis, Takeda, Virtus Medical, Yuhan, Curio Science, Bayer Healthcare Pharmaceuticals Ltd., Covidien LP, C4 Therapeutics, Cirina Ltd., Da Volterrra, F. Hoffmann-La Roche Ltd / Genentech, Gilead Sciences, Lucence Health Inc., Medscape LLC / WebMD, MiRXES, OSE Immunotherapeutics, Pfizer, SFJ Pharmaceutical Ltd., Synergy Research, Tigermed, Vertex Pharmaceuticals, Berry Oncology, D3 Bio Ltd., Lakeshore Biotech;Financial Interests, Personal, Invited Speaker, Former known as Hutchison Chi-Med: HutchMed;F nancial Interests, Personal, Officer, Chairman: ACT Genomics-Sanomics Group;Financial Interests, Personal, Stocks/Shares: Sanomics Ltd., Biolidics Ltd., Aurora Tele-Oncology, AstraZeneca;Financial Interests, Personal, Stocks/Shares, Former known as Hutchison Chi-Med: HutchMed;Financial Interests, Institutional, Funding, For clinical trials performed at CUHK: Merck Serono, AstraZeneca, BMS, MSD, Novartis, Pfizer, Roche, SFJ Pharmaceuticals, XCovery, Takeda, G1 Therapeutics, Clovis Oncology;Non-Financial Interests, Personal, Advisory Role: geneDecode;Non-Financial Interests, Personal, Other, Invited Speaker: AstraZeneca, Aurora Tele-Oncology, Lunit USA, Inc., Sanomics Ltd.;Non-Financial Interests, Personal, Leadership Role, Term ended on 30 June 2022: American Society of Clinical Oncology (ASCO);Non-Financial Interests, Personal, Leadership Role: Asian Thoracic Oncology Research Group (ATORG), Chinese Lung Cancer Research Foundation Limited (CLCRF), Hong Kong Cancer Fund (HKCF), Hong Kong Cancer Therapy Society (HKCTS), St. Stephen's College & Prep. School (Hong Kong);Non-Financial Interests, Personal, Leadership Role, Term ended: Chinese Society of Clinical Oncology (CSCO);Non-Financial Interests, Personal, Leadership Role, Term ended on 30 April 2019: International Association for the Study of Lung Cancer (IASLC). M. Tsuboi: Financial Interests, Personal, Invited Speaker, Lecture: Johnson & Johnson Japan;Financial Interests, Personal, Advisory Board, Lectures, Advisory boards: AstraZeneca KK, Chugai Pharmaceutical CO.,LTD, MSD;Financial Interests, Personal, Invited Speaker, Lectures: Eli Lilly Japan, Bristol Myers Squibb KK, Teijin Pharma, Taiho Pharma, Medtronic Japan, ONO Pharmaceutical CO.,LTD;Financial Interests, Personal, Advisory Board, Advisory boards: Novartis;Financial Interests, Personal, Invited Speaker: Daiichi-Sankyo company limited, MSD, AstraZeneca, Novartis;Financial Interests, Institutional, Research Grant: Beohringer-Ingelheim Japan, MSD, AstraZeneca KK, Ono Pharmaceutical CO.,LTD, Bristol Myers Squibb KK, Novartis;Financial Interests, Institutional, Invited Speaker: Eli Lilly Japan. J.M. Lee: Financial Interests, Personal, Advisory Board: Bristol Myers Squibb, Astrazeneca, Roche/Genentech, Novartis;Financial nterests, Personal, Invited Speaker, LCMC3, LCMC4, NAUTIKA-1: Roche/Genentech;Financial Interests, Personal, Invited Speaker, CANOPY-N, GEOMETRY-1: Novartis. E.S. Kim: Financial Interests, Personal, Other, Consulting/Research: Regeneron, Takeda, Novartis. J. Zhang: Financial Interests, Personal, Advisory Board: AstraZeneca, Bayer, Biodesix, Bristol Myers Squibb, Cardinal Health, Daiichi Sankyo, Hengrui Therapeutics, Eli Lilly, Mirati, Nexus Health, Novartis, Novocure, Sanofi, Takeda Oncology;Financial Interests, Personal, Invited Speaker: AstraZeneca, MJH Life Sciences, Regeneron, Sanofi;Financial Interests, Institutional, Research Grant, PI and Sponsor: AstraZeneca, Biodesix, Nilogen, Genentech;Financial Interests, Institutional, Invited Speaker: Hengrui Therapeutics, Mirati, Novartis, Abbvie, BeiGene, Merck;Financial Interests, Institutional, Research Grant, PI, basic science research: Mirati;Non-Financial Interests, Personal, Member, American Society of Clinical Oncology: ASCO;Non-Financial Interests, Personal, Member, American Association for Cancer Research: AACR;Non-Financial Interests, Personal, Member, International Association for the Study of Lung Cancer: IASLC;Non-Financial Interests, Personal, Member, Chinese American Hematologist and Oncologist Network: CAHON. J. Duan: Financial Interests, Personal, Stocks/Shares: Novartis Pharmaceuticals Corporation. C. Lobetti-Bodoni: Financial Interests, Personal, Full or part-time Employment, Clinical Development Medical Director: Novartis Oncology;Financial Interests, Personal, Stocks/Shares: Novartis Oncology;Other, Personal, Other, My husband is a Roche employer: Roche;Other, Personal, Other, My husband had consultancy in the last two years with these companies: Sanofi and Takeda;Other, Personal, Other, My husband ha honoraria in the last 2 years with these companies: Takeda, Jansenn-Cilag Ltd;Other, Personal, Other, My husband owns stock of this company: Harlock Helatcare Consulting Ltd. J.C. Brase: Financial Interests, Personal, Full or part-time Employment: Novartis;Financial Interests, Personal, Stocks/Shares: Novartis. A. Savchenko: Financial Interests, Personal, Full or part-time Employment: Novartis;Financial Interests, Personal, Stocks/Shares: Novartis. P. Garrido Lopez: Financial Interests, Personal, Advisory Board: Abbvie, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, BMS, GlaxoSmithKline, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, Takeda, sanofi;Financial Interests, Personal, Invited Speaker: AstraZeneca, Janssen, MSD, Novartis, Pfizer, Roche, Takeda, Novartis, IO Biotech;Financial Interests, Personal, Advisory Board, Spouse: Boehringer Ingelheim, Gebro, Janssen, Nordic;Financial Interests, Personal, Invited Speaker, Spouse: Boehringer Ingelheim, Janssen;Financial Interests, Personal, Other, Data monitoring committee for a clinical trial in 2020: Novartis;Financial Interests, Personal, Other, Lung Cancer Medical Education TASC Committee 2021: Janssen;Financial Interests, Institutional, Invited Speaker: Novartis, Janssen, AstraZeneca, Pfizer, Blue print, Apollomics, Amgen, Array Biopharma;Financial Interests, Personal, Invited Speaker, study entitled JNJ-372: Janssen;Non-Financial Interests, Personal, Leadership Role, Council member as Women for Oncology Committee ChairFellowship and Award Committee and Press CommitteeFaculty for lung and other thoracic tumours: ESMO;Non-Financial Interests, Personal, Leadership Role, President of the Spanish Federation of Medical Societies (FACME): FACME;Other, Personal, Other, My son is working in the pharma company TEVA as an engineer. I do not have any kind ofrelationship with TEVA: TEVA;Non-Financial Interests, Personal, Leadership Role, Former President of Spanish Medical Oncology SocietyMember of the Spanish National Health Advisory Board: SEOM;Non-Financial Interests, Personal, Leadership Role, Member of the Scientific Committee of the Spanish Against Cancer Research Foundation (aecc) and also Borad member: AECC;Non-Financial Interests, Personal, Leadership Role, IASLC Women in Tho acic Oncology Working Group Member: IASLC. All other authors have declared no conflicts of interest. Copyright © 2022

Multidisciplinary approach of the sequelae one month after hospital discharge in patients with severe bilateral COVID-19 pneumonia, are there differences depending on the respiratory therapy used during admission to intensive care? Valoración multidisciplinar de las secuelas al mes del alta hospitalaria por neumonía grave COVID-19, ¿existen diferencias en función de la terapia respiratoria empleada durante su ingreso en Cuidados Intensivos?

Graphical Objective To describe the sequelae one month after hospital discharge in patients who required admission to Intensive Care for severe COVID 19 pneumonia and to analyze the differences between those who received therapy exclusively with high-flow oxygen therapy compared to those who required invasive mechanical ventilation. Design Cohort, prospective and observational study. Setting Post-intensive care multidisciplinary program. Patients or participants Patients who survived admission to the intensive care unit (ICU) for severe COVID 19 pneumonia from April 2020 to October 2021. Interventions Inclusion in the post-ICU multidisciplinary program. Main variables of interest Motor, sensory, psychological/psychiatric, respiratory and nutritional sequelae after hospital admission. Results 104 patients were included. 48 patients received high-flow nasal oxygen therapy (ONAF) and 56 invasive mechanical ventilation (IMV). The main sequelae found were distal neuropathy (33.9% IMV vs 10.4% ONAF);brachial plexopathy (10.7% IMV vs 0% ONAF);decrease in grip strength: right hand 20.67 kg (+/- 8.27) in VMI vs 31.8 kg (+/- 11.59) in ONAF and left hand 19.39 kg (+/- 8.45) in VMI vs 30.26 kg (+/- 12.74) in ONAF;and limited muscle balance in the lower limbs (28.6% VMI vs 8.6% ONAF). The differences observed between both groups did not reach statistical significance in the multivariable study. Conclusions The results obtained after the multivariate study suggest that there are no differences in the perceived physical sequelae one month after hospital discharge depending on the respiratory therapy used, whether it was high-flow nasal oxygen therapy or prolonged mechanical ventilation, although more studies are needed to be able to draw conclusions.

Linking communication in crisis and citizen mental health. Ecuador study case

In the context of the pandemic, the government of Ecuador had the challenge of implementing an emergency plan to mitigate the ravages of confinement and the risk of contagion. This research analyses the communication strategies implemented by the Government of Ecuador on Twitter during the first six months of the Covid-19 pandemic in 2020. It analyses how empathy with citizens was not achieved, the shortcomings of the strategy implemented in the Andean country and its repercussions on the mental processes of citizens. © GKA Ediciones, authors.

Breakthrough COVID-19 infection after vaccination in people with multiple sclerosis on disease modifying therapies in Latin America: data from RELACOEM registry

Introduction: In this study we aimed to monitor the risk of breakthrough COVID-19 infection in pwMS on different Disease Modifying Therapies (DMT) included in RELACOEM, a LATAM registry of MS and NMOSD patients infected with and vaccinated against COVID-19. Method(s): retrospective cohort study conducted between May 2021 and December 2021. The primary outcome was the appearance of infection during the follow-up time (at least three months after complete vaccination (second dose)). Specific information was requested (vaccine received, dose, date, symptoms, COVID- 19 infection, need for hospitalization, ventilatory assistance, treatment, and evolution). The primary objective of the analysis was to compare the incidence of breakthrough SARS-CoV-2 infections among the vaccinated pwMS in each DMT group. These conditions entail a PCR-confirmed test, and a time lag of at least 14 days from a full vaccination cycle (after the second vaccination dose). Cumulative incidence was reported by Kaplan Meier survival curves as well as incidence density. Result(s): A total of 857 pwMS patients from eight countries in LATAM were included. Mean age was 44.3 +/-12 years. The most frequent treatment used was fingolimod in 171 (19.9%). Most frequent first and second dose received was Astra-Zeneca (33%). During follow-up, a total of 28 COVID-19 cases were observed for a total exposure time of 150.965 days. The overall cumulative incidence was 3.2% (SE 0.22%) with an overall incidence density (ID) of 1.8 x 10.000 patients/day (95%CI 0.2-3.2). Compared to other DMTs, the incidence rate of breakthrough infections was significantly higher on ocrelizumab (6.02 (95%CI=5.65-7.16, RR=5.17 95%CI 3.27-7.12) and rituximab (6.94 (95%CI=6.15-9.12, RR= 5.93 95%CI 3.55-7.32) compared with other DMTs. No significant differences in the risk of breakthrough were observed for vaccine subtypes. Conclusion(s): An increased risk of breakthrough COVID-19 infections was observed in patients treated with ocrelizumab and rituximab.

Longitudinal humoral immune response against COVID-19 adenovirus-based vaccines in patients with multiple sclerosis from Argentina undergoing immunosuppressive treatment

Introduction: Most reports related to humoral immune response to COVID 19 vaccines in people with Multiple Sclerosis (pwMS) were performed on mRNA-based vaccines. Objective(s): to analyze the longitudinal humoral immune responses to adenovirus-based vaccines (Sputnik V and AZD1222) in pwMS under different diseases modifying therapies (DMTs) Methods: IgG anti- SARS-COV-2 spike titers in a cohort of 101 pwMS and 28 healthy controls (HC) were measured 6 weeks after vaccination using the COVID-AR kit according to the manufacture instructions. Both patients and controls received two or three doses of Sputnik, AZD1222 or a mixed schedule (MS) of both vaccines. The neutralizing capacity was evaluated by measuring antibody neutralizing titers using SARS COV-2 pseudotyped particles. Result(s): 60.5% of pwMS were female, mean EDSS: 2.49 +/-1.5, age: 36.6 +/-10.7, disease duration 7.6 +/- 5.1 years. DMTs: 45 pwMS were under fingolimod, 23 under dimethyl fumarate, 14 under cladribine and 19 under antiCD20 monoclonal antibodies. Vaccines: 35.7% Sputnik V, 51.9% AZD1222 and 12.4 % MS. No antibody response to a 2nd dose was found in 41.3% of pwMS under fingolimod and 73.6% under antiCD20. We found a correlation between lower lymphocyte count and lower antibody titers in pwMS under fingolimod (r: 0.67, 95% CI: 0.46-0.81, p=<=0.0001). A correlation was also found between the antibody titer and the last dose of antiCD20 (r: 0.49, 95% CI: 0.03-0.7, p=0.03). In March 2022, 57 pwMS received their 3nddose, 6 patients under fingolimod and 7 under antiCD20 remained without any antibody response. We did not find differences in the neutralization capacity with different DMT and or vaccines. Multivariate regression analysis showed antiCD20 (beta= -,349, 95% CI: -3655.6-369.01, p=0.017) and fingolimod (beta=-,399, 95% CI: -3363.8-250.9, p=0.023) treatments as independent factor associated with low antibody response (r2 adjusted=0.157). Conclusion(s): This is the first report of longitudinal humoral immune response of patients under adenovirus-based vaccines, specially Sputnik V, that demonstrate that these vaccines have similar results to those obtained with mRNA-based vaccines.

Breakthrough COVID-19 infection after vaccination in patients with NMOSD in Latin America: data from RELACOEM registry

Objective: The objective of the study was to evaluate the incidence of COVID-19 infections after vaccination in NMOSD patients included in RELACOEM, a LATAM registry of MS and NMOSD patients infected and vaccinated for COVID-19. Method(s): Retrospective cohort study developed between May 2021 to December 2021. The primary outcome was the appearance of infection during the follow up time (at least three months after complete vaccination (second dose)). Data was collected through the contact between the treating physician and the patient. Specific information was requested (vaccine received, dose, date, symptoms, COVID-19 infection, need for hospitalization, ventilatory assistance, treatment, and evolution). The primary objective of the analysis was to compare the incidence of breakthrough SARS-CoV-2 19 infections among the vaccinated pwMS in each DMT group. These conditions entail a PCR-confirmed test, and a time lag of at least 14 days from a full vaccination cycle (after the second vaccination dose). Cumulative incidence was reported by Kaplan Meier survival curves as well as incidence density. Result(s): A total of 49 NMOSD patients from eight countries in LATAM were included. Mean age was 43.8 +/-13 years. The most frequent treatment use was rituximab in 29 (59.2%). The mean follow up after the second dose was 149 +/- 32 days. Most frequent first and second dose received was Pfizer (28.6%), followed by Sinopharm (24.5%). During follow up a total of 2 COVID-19 cases were observed for a total exposure time of 8627 days. Cumulative incidence was 4.1% (SE 0.87%) with an overall incidence density of 2.31 x 10.000 patients/day (95%CI 1.13-3.71). Both cases occurred in patients under rituximab (2/29, exposure time 4208, IR 4.7 x 10,000 patients/day 95%CI 3.5-5.1). No hospitalizations were reported for both cases. Conclusion(s): We observed an ID of COVID-19 infection after vaccination of 2.31 x 10.000 patients/day in NMOSD patients.

Case of Cushing's Disease That Presented as Diabetic Ketoacidosis and Successfully Treated With Stereotactic Radiosurgery During the COVID-19 Pandemic

Background: Although Cushing's disease is known to impair glucose metabolism, diabetic ketoacidosis (DKA) as its initial presentation has been reported in only a few case reports. The first-line treatment for Cushing's disease is transsphenoidal surgery, but safety concerns during the COVID-19 pandemic has led to the utilization of other treatment options. We present a case of Cushing's disease that presented initially as DKA and was successfully treated with stereotactic radiosurgery. Case Presentation: Our patient was a 36-year-old female known to have diabetes mellitus and hypertriglyceridemia for one year. She presented with one-week history of generalized weakness, blurring of vision, and elevated blood pressure. Her blood glucose level was high at 523 mg/dL, associated with ketosis and metabolic acidosis. She was diagnosed with diabetic ketoacidosis which resolved after hydration and intravenous insulin administration. Further history revealed that she has been experiencing progressive weight gain and infertility for the past five years. She had cushingoid features including obesity, scalp hair thinning, moon facies, acne, hirsutism, and buffalo hump. Midnight salivary cortisol was high at 9.34 ng/mL (0.20-4. 00 ng/mL). Low dose dexamethasone suppression test showed an unsuppressed serum cortisol level at 31.2 mcg/dL (<1.8 mcg/dL). Adrenocorticotropic hormone (ACTH) level was high at 88.5 pg/mL (<46 pg/mL) and pituitary magnetic resonance imaging (MRI) showed an enlarged pituitary gland measuring 13.4 mm in the craniocaudal dimension with leftward displacement of the pituitary stalk. She was diagnosed with Cushing's disease and was initially advised transsphenoidal surgery. Due to concerns of COVID-19 transmission, the team and the patient decided to do stereotactic radiosurgery (SRS). The procedure was performed without complication. At 2 months follow-up, there was noted improvement of blurring of vision, normalization of cortisol level to 20.72 mcg/dL (4.30-22.40 mcg/dL), and a decreased ACTH level at 62.19 pg/mL. There was a 4 mm decrease in the craniocaudal dimension of the pituitary gland on repeat pituitary MRI. Thyroid stimulating hormone (TSH) level normalized from 0.209 to 0.647 uIU/mL (0.55-4.78 uIU/mL), and the glycohemoglobin decreased from 11.5% to 6.3%. Hypertension was controlled on one medication. Conclusion: Stereotactic radiosurgery is usually reserved as a secondary option to transsphenoidal surgery. On average, normalization of cortisol levels after SRS takes 14 months. In our patient, the serum cortisol decreased to within normal levels at only 2 months after SRS. While a longer follow-up is desirable in order to assess the durability of control of hypercortisolemia, our case demonstrates that stereotactic radiosurgery is a safe and effective treatment option for Cushing's disease during the COVID-19 pandemic, when safety protocols and decreased hospital and patient resources might hinder the performance of transsphenoidal surgery.Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Case Study - Understanding the Correlation Between the Components of an Emergency Resuscitator

Given the high spread of Covid-19, many hospitals suffered from a shortage of ventilators to treat patients. Consequently, emergency resuscitators (ER) became popular as a cheaper and easier to manufacture option that would satisfy the need for ventilators in hospitals. These devices are characterized by an automated mechanism that tightens a Bag valve mask (BVM), commonly known as a manual resuscitator. The ERs main components are the controller, sensors, the Human Machine Interface (HMI), and the motor. For the effective design of these devices, the team must understand the relationship between components. In the iterative process of designing, changing one part can easily affect the operation of other components. This is the most critical points of the case study presented since it is not feasible to replace a component without considering the requirements of the other parts that make up the final product. Using a resuscitator developed by a Puerto Rican company as an example, if changes were to be made, to keep the current sensors, a Programmable Logic Controller (PLC) should be used as a controller. Changing the PLC affects the sensors and limits the options of the HMIs since many of them are designed to work with the same brand. On the other hand, when selecting the motor, the communication method and compatibility with the controller must be considered. For these reasons, this paper presents a case study to share the compatibility issues that are faced when developing this type of device. © 2022 IISE Annual Conference and Expo 2022. All rights reserved.

Teacher residencies and remote teaching. What reflective training are we accompanying?

We present a systematization of our experience as a team responsible for teaching residencies in two university teacher trainings in Argentina. We focus on the period of social isolation during the covid-19 pandemic and ask ourselves about the reflective training achieved within the framework of our position in Latin American Popular Education and the learnings that emerge from the experience. We describe and analyze our courses, from which emerge (added and crossed by the context and the limitations linked to technological media) difficulties for critical reflection in general, for active and involved participation by residents, for the real encounter between subjects of the educational situation (both within our courses and in the development of residences with secondary students), for the development of educational proposals that transcend the traditional view of teaching. We were unable to guarantee equal opportunities among residents, since the residences were developed in differentiated educational circuits, with very diverse pedagogical encounters.We remain dissatisfied with the place that we managed to give to popular education, with the quality of the training offered, with the possible transformations achieved in this "remote emergency residence", where the encounter, empathy, dialogue, corporality (fundamental for our education proposal) were strongly diminished.We consider it is essential to recover a critical look at what remote teaching (and not distance education) implies, the ideological aspects of the use of technology, the possibilities of access to it, and the construction of unprecedented viable in this particular context.

CHANGES TO SOCIAL WORK TRAINING AND RESEARCH PRACTICES GENERATED BY COVID-19: OPPORTUNITIES, DILEMMAS AND CHALLENGES FOR SOCIAL RESEARCH

Introduction. This article presents the results of research on the conditions of Social Work teachers and students who conducted scientific research or final degree projects during the COVID-19 pandemic. We adopted the comprehensive perspective of the social sciences, inspired by authors who question technical-instrumental rationality and advance, instead, the need for a practical-reflexive rationale, in both Social Work professional practice and training. The authors involved came from the disciplines of Philosophy, Sociology and Social Work, and their postures were based on the concepts of "practical knowledge" "reflective process", "reflexivity" and "knowledge in action". Methodology. The methodological design was based on an emic reading of reality. A simple convenience random sample was used, applying the following criteria: geographical location, job position within the universities and research experience. The documentary review technique was implemented to analyse 42 thesis projects. Semi-structured interviews were conducted with seven academic-researchers-from four Latin American countries - and eleven Social Work students who complied with the following criteria: being in the final semester of their degree;belonging to a university in the city of Guayaquil;and researching topics related to the pandemic. Results. Four dimensions were considered: context, research practice, teachers' scientific production, the tutoring of the academic production of senior students and Social Work research training. The voices expressing the daily implications of the pandemic were found to present clear alterations in the case of those who were carrying out a research project or training new researchers. The personal dynamics resulting from the virus have redirected and, above all, produced learning. Such learning fosters a possible description, explanation and understanding of new dynamics to form and produce knowledge. Discussion and conclusions. Novel research challenges or dilemmas have emerged in Social Work research. The pandemic-as a sociohistorical and bio-psycho-social phenomenon-has evidenced that social inequalities and vulnerabilities are not only of a physical or material nature. Nor do they depend solely on access to technological resources (a computer, a mobile phone, internet, energy service). This fact could, perhaps, lead to changes in research budgets in order to provide these material means to the people involved. They also exist on another level: the subjective level, in which culture, territory, class or gender, among others, determine more complex vulnerabilities than that of the symbolic world to which they belong. And they cannot be solved simply by resorting to material or technological investments.

Collaboration experience between hospitals and long-term care facilities for the care of COVID-19 patients

Background: The disease produced by SARSCoV- 2 has led to severe situations and mortality in elderly people. The objective of this study was to describe the collaboration between hospital professionals and nursing homes when applying preventive measures for the transmission of COVID-19 and in the assistance of institutionalized patients.