[Cryptogenic new-onset super-refractory status epilepticus following SARS-CoV-2 vaccination. A case report]. / Estado epiléptico superrefractario de nueva aparición criptógeno tras vacunación contra el SARS-CoV-2. A propósito de un caso.

INTRODUCTION: New-onset super-refractory status epilepticus (NOSRSE) is a neurological emergency characterised by the development of status epilepticus in a patient without epilepsy or any known prior neurological disease and with no clear structural, toxic or metabolic cause, which recurs after 24 hours of induced coma. The most common identifiable cause is inflammatory-autoimmune. Consequently, we present a case of NOSRSE related to SARS-CoV-2 vaccination as an opportunity to investigate the dysimmune origin of this pathology. CASE REPORT: We report the case of a 40-year-old male who presented at the emergency department with fever and headache with no clear source of infection. His personal history included bacterial meningitis in childhood without any sequelae and protein S deficiency without treatment at the time, as well as vaccination with ChAdOx1 nCoV-19 21 days earlier. He was initially diagnosed with a urinary tract infection and treated with cefuroxime. Two days later, he was taken back to the emergency department with confusional symptoms and tonic-clonic seizures. He did not respond to midazolam and finally required sedation and orotracheal intubation for refractory status epilepticus. While in hospital, he required a number of lines of antiepileptic drugs, ketamine, a ketogenic diet, immunotherapy and plasmapheresis in order to successfully limit NOSRSE. The aetiological study offered normal results for serology, antineuronal antibodies in serum and cerebrospinal fluid, transthoracic echocardiography, testicular ultrasound and computed tomographic angiography. Only the control MRI scan showed a diffuse and bilateral alteration of the right hemispheric cortex and thalamic pulvinar as the only finding. CONCLUSION: It is crucial to report suspected adverse reactions associated with SARS-CoV-2 vaccination, thereby allowing continued monitoring of the risk/benefit ratio of vaccination.

TITLE: Estado epiléptico superrefractario de nueva aparición criptógeno tras vacunación contra el SARS-CoV-2. A propósito de un caso.Introducción. El estado epiléptico superrefractario de nueva aparición (NOSRSE) es una emergencia neurológica caracterizada por el desarrollo de estado epiléptico en un paciente sin epilepsia ni enfermedad neurológica previa conocida y sin clara causa estructural, tóxica o metabólica, que recurre tras 24 horas del coma inducido. La causa identificable más frecuente es la inflamatoria-autoinmune. En consecuencia, planteamos un caso de NOSRSE relacionado con la vacunación para el SARS-CoV-2 como una oportunidad de indagar el origen disinmune de esta patología. Caso clínico. Varón de 40 años que acude al servicio de urgencias refiriendo fiebre y cefalea sin claro foco infeccioso. Entre sus antecedentes personales destacamos una meningitis bacteriana en la infancia sin secuelas y un déficit de proteína S sin tratamiento en ese momento, así como vacunación con ChAdOx1 nCoV-19 21 días antes. Fue inicialmente diagnosticado de infección del tracto urinario y tratado con cefuroxima. Dos días después, se le llevó de nuevo a urgencias con cuadro confusional y crisis tonicoclónicas, sin respuesta al midazolam, y requirió finalmente sedación e intubación orotraqueal por estado epiléptico refractario. Durante su ingreso requirió múltiples líneas de antiepilépticos, quetamina, dieta cetógena, inmunoterapia y plasmaféresis para conseguir limitar el NOSRSE. El estudio etiológico ofrecía normalidad de los resultados de serología, anticuerpos antineuronales en el suero y líquido cefalorraquídeo, ecocardiografía transtorácica, ecografía testicular y angiotomografía computarizada. Únicamente la resonancia magnética de control mostró una alteración difusa y bilateral de la corteza hemisférica y pulvinar talámica derecha como único hallazgo. Conclusión. Es crucial notificar las sospechas de reacciones adversas asociadas a la vacunación frente al SARS-CoV-2, permitiendo así una supervisión continuada de la relación riesgo/beneficio de ésta.

Perception of training and job perspectives among final-year residents in the specialty of Endocrinology and Nutrition

Introduction: The medical specialisation model in Spain is carried out in the context of specialised health training, through the residency programme. The aim of the study is to analyse, by an anonymous survey, the opinion on three aspects among final-year residents in Endocrinology and Nutrition (E&N): self-assessment of the knowledge acquired, working prospects, care and training consequences arising from the pandemic COVID-19. Material(s) and Method(s): Cross-sectional observational study using a voluntary and anonymous online survey, shared among final-year national interns in the last year of the E&N programme, carried out between June-July 2021. Result(s): 51 responses were obtained, 66% of the fourth-year residents. Overall perception of their knowledge was 7.8 out of 10. Most external rotations were in thyroid and nutrition areas. A total of 96.1% residents, carried out some activity associated with COVID-19, with a training deterioration of 6.9 out of 10. 88.2% cancelled their rotations and 74.5% extended their working schedule. The average negative emotional impact was 7.3 out of 10. 80.4% would like to continue in their training hospital, remaining 45.1%. 56.7% have an employment contract of less than 6 months, most of them practising Endocrinology. Conclusion(s): The perception of the knowledge acquired during the training period is a "B". Residents consider that the pandemic has led to a worsening of their training, generating a negative emotional impact. Employment outlook after completing the residency can be summarised as: temporality, practice of Endocrinology and interhospital mobility.Copyright © 2022 SEEN y SED

Learning Outcomes in Virtual Laboratories for Engineering Subjects as a COVID 19 Paradigm

The research was applied to the Faculties of Engineering, who took on the challenge in the process of student knowledge acquisition, fostering skills and attitudes that typically require a practical and laboratory component, in a virtual learning environment. The purpose was to evaluate the levels of achievement of practical learning in virtual laboratories (VL) with the use of computer software, as a challenge for the educational sector during the pandemic in such a way that they must be maintained, enhanced and adapted to the new reality due to positive result in engineering subjects. For the investigation, the students of the first and sixth cycle engineering subjects of the Ricardo Palma University (URP) and the National Technological University of Lima Sur (UNTELS) were selected as samples. The methodology considered two phases, in the first the characteristics of the sample were determined and in the second the questionnaire and rubric were applied. The questionnaire with a Likert scale to the indicators (availability of computer equipment, simulation software, laboratory guides and practical learning) and the rubric to determine the learning results through the diagnostic, formative and summative evaluation carried out by the teacher in the virtual laboratory. The results showed a high percentage at the level of good (achieved) and in some subjects an excellent level (outstanding achievement) was obtained, however, there is still work to be done on learning that is in process and at the beginning, as a need for improve the pedagogical strategies (methodologies, tools and didactic components) that the virtual, blended and face-to-face teaching-learning process will demand, from now on. © 2022 Latin American and Caribbean Consortium of Engineering Institutions. All rights reserved.

Dietary Patterns and Dietary Recommendations Achievement From Latin American College Students During the COVID-19 Pandemic Lockdown

This study aimed to compare the diet quality of different dietary patterns among college students from Latin American countries, including vegetarians, vegans, and omnivores during the COVID-19 pandemic. A cross-sectional, observational, multicenter study was conducted including a non- probabilistic sample of university students from 10 countries. University students were invited to participate in the study through social network platforms. Participants were self-reported to have followed a specific dietary pattern;either the Prudent diet, Western diet, Ovo-dairy-vegetarian diet, Fish-vegetarian diet, Strict vegetarian diet (vegan) or other. The last three patterns (vegetarians and vegans) were grouped as following a plant-based diet. A self-assessment survey was used to evaluate healthy eating habits using a questionnaire with values between 1 (do not consume) and 5 (consume) for a total of 9–45 points (higher values represent better eating habits). Unhealthy habits were assessed with nine questions. A total of 4,809 students filled out the questionnaire, and the majority of them were females (73.7%). A high percentage have been in lockdown for more than 5 months and were in lockdown when the survey was released. 74.3% were self-reported to follow a prudent diet, while 11.4% reported following a western dietary pattern and 8.8% a plant-based diet. When compliance with healthy and unhealthy dietary habits was analyzed, although all groups had low compliance, the plant-based diet group (56.09 ± 6.11) performed better than the Western diet group (48.03 ± 5.99). The total diet quality score was significantly higher for plant-based diet followers, who also tended to better achieve the recommendations than omnivorous students, especially the ones following a western diet. These results present evidence that young adults such as college-aged students have unhealthy dietary habits. However, the ones who follow a plant-based diet such as vegetarians and vegans exhibit better scores and healthier dietary conducts. Copyright © 2022 Murillo, Gómez, Durán-Agüero, Parra-Soto, Araneda, Morales, Ríos-Castillo, Carpio-Arias, Cavagnari, Nava-González, Bejarano-Roncancio, Núñez-Martínez, Cordón-Arrivillaga, Meza-Miranda, Mauricio-Alza and Landaeta-Díaz.

Perception of training and job perspectives among final-year residents in the specialty of Endocrinology and Nutrition

Introduction: The medical specialisation model in Spain is carried out in the context of specialised health training, through the residency programme. The aim of the study is to analyse, by an anonymous survey, the opinion on three aspects among final-year residents in Endocrinology and Nutrition (E&N): self-assessment of the knowledge acquired, working prospects, care and training consequences arising from the pandemic COVID-19. Materials and methods: Cross-sectional observational study using a voluntary and anonymous online survey, shared among final-year national interns in the last year of the E&N programme, carried out between June-July 2021. Results: 51 responses were obtained, 66% of the fourth-year residents. Overall perception of their knowledge was 7.8 out of 10. Most external rotations were in thyroid and nutrition areas. A total of 96.1% residents, carried out some activity associated with COVID-19, with a training deterioration of 6.9 out of 10. 88.2% cancelled their rotations and 74.5% extended their working schedule. The average negative emotional impact was 7.3 out of 10. 80.4% would like to continue in their training hospital, remaining 45.1%. 56.7% have an employment contract of less than 6 months, most of them practising Endocrinology. Conclusion: The perception of the knowledge acquired during the training period is a “B”. Residents consider that the pandemic has led to a worsening of their training, generating a negative emotional impact. Employment outlook after completing the residency can be summarised as: temporality, practice of Endocrinology and interhospital mobility.

PEDIATRIC OPIOID ANALGESIA SELF-INSTRUCTION SYSTEM (PEDOASIS): AN EFFECTIVE EDUCATION TOOL

Background: Many children with cancer, survivors of childhood cancer, and patients with sickle cell disease experience pain, yet receive inadequate pain management due to health care provider lack of knowledge and comfort. Pain management using opioids is a required competency for pediatric hematology/oncology (PHO) fellows, yet knowledge gaps persist. Objectives: Pediatric Opioid Analgesia Self-Instruction System (PedOASIS) is an interactive, case-based education tool for independent learning by post-graduate medical trainees which has undergone pilot testing and validity and reliability testing. The goal of this study was to evaluate its efficacy in increasing PHO fellows' knowledge and comfort with using opioids to manage pain. Design/Method: PHO fellows were recruited from 74 ACGMEaccredited US programs during the 2019-2020 academic year. Participants were randomized to receive access to PedOASIS (intervention) or usual PHO training (control). Participants completed surveys at enrollment, immediately after distribution of the tool, and 6 months later. Surveys assessed subjective comfort with prescribing opioids and objective knowledge, using a version of the questions from the tool. Results: At baseline, mean scores on the 10-question knowledge assessment did not significantly differ by level of training (first year: 5.05, second year 5.74, third/fourth year: 5.58;p = 0.410) or between groups (intervention: 5.38, control: 5.5;p = 0.795). Following intervention, mean score was significantly higher in the intervention group (8.91) vs. controls (5.38;p < .0001). Six months later, scores in both groups decreased but remained significantly higher in the intervention group (6.91) compared to baseline (p = 0.0002) and compared to controls (4.91, p < .0001). Fellows indicated comfort with selecting opioid and starting dose for an opioid-naive patient at baseline but less with rotating opioids. Intervention group reported significant increases in comfort dosing opioids after exposure to the tool (p = 0.022) and in rotating opioids (p = 0.054) following the intervention. Conclusion: Use of PedOASIS was associated with improvement in scores on validated knowledge questions and in comfort using opioids for pain management in PHO fellows exposed to the tool compared to fellows without the tool. These findings suggest that this is a valid, reliable, and effective curricular tool. The use of self-directed learning has been associated with increased knowledge gains when compared to traditional didactic methods. The asynchronous learning structure is useful in the setting of the ongoing SARS-CoV19 pandemic, which has necessitated significant alterations in medical education. Based on these results, we suggest that PedOASIS is an effective and relevant addition to the PHO fellowship curriculum.

Analysis of warm and cool events in the Gulf of Papagayo through diving data: A Citizen Science approach

Introduction: In January 2011 and as a Citizen Science initiative, the owners of the Deep Blue Diving Shop in Playa del Coco, Guanacaste, Costa Rica, began to collect daily temperature data in the seawater column during their diving activities, to inform tourists before traveling to Costa Rica and help them properly select their diving equipment and thus maximize the enjoyment of the experience in the Gulf of Papagayo. This data collection remained constant until January 2020 due to the COVID-19 pandemic. Objective: Identify cold and warm events of the sub-surface temperature of the sea in the Gulf of Papagayo, Guanacaste, Costa Rica and their relationship with known sources of climate variability as El Niño-Southern Oscillation (ENSO) and synoptic systems such as incursions of cold fronts in the Caribbean Sea. Methods: Sea Subsurface Temperature data corresponding to the lowest temperature of the seawater column were used, at an approximate depth of 25-35m. Observations were made daily, from 01/01/2011 to 01/31/2020. Results: The mean temperature was 25.7 °C. Cooler temperatures were observed in February-March, below 22.5 °C with a secondary minimum in July. There were two peaks in May and August with temperatures above 27.4 °C. The drops during cold events reached 16-17 °C. All cold events were associated with the passage of cold fronts through the Caribbean Sea, due to reinforcement in the intensity of the trade winds, with a zonal component from the East, which causes seasonal upwelling. The warm events presented temperatures at their maximum of 30-31 °C. The latter events were associated with the development and maturity of warm El Niño-type ENSO events. ENSO is an important modulator of sea temperature variability in the Gulf of Papagayo, since El Niño events are related to positive anomalies in sea temperature in the Eastern Tropical Pacific. Conclusions: The Citizen Science initiative presented in this study proved to be very useful for monitoring sea temperature in the Gulf of Papagayo. The results of this study indicate that Dive Masters can provide data on sea temperature of sufficient quality and with high temporal resolution. Divers can profitably support monitoring and Citizen Science can contribute positively to social well-being by influencing the questions that are being addressed and by giving people a voice in local environmental decision-making. The information generated in this study returns to the tour operators and enhance the understanding of the variability observed in the data collected by them, a knowledge that is later transmitted to their clients to improve their experience. © 2021, Universidad de Costa Rica. All rights reserved.

The quinoa at the time of COVID-19: new coordination between Andean producers. (Agriculture et syst..mes alimentaires face .. la Covid-19.) [French]

Quinoa has been cultivated for millennia in the Andes since its domestication on the shores of Lake Titicaca, between Peru and Bolivia. As a rustic crop of the Andean highlands, it has conquered the international market for less than thirty years. Today, Peru has become the world's leading producer and the majority of its production is exported. Produced locally by small-scale farmers and consumed globally, quinoa reflects the context of the globalization of agriculture and food. The COVID-19 crisis has also affected Peru and it raises questions about the robustness and resilience of export food chains. This opinion article looks back at debates organized in May-June 2020 in Peru. After recalling the general context of the cultivation of quinoa and the link between COVID-19, agriculture and biodiversity, we highlight the links between health crisis, agricultural crisis and food crisis. This global pandemic offers us the opportunity to question the current agricultural models to draw lessons to build the future. The projection of new solidarities through a collective trademark appears to carry a transnational territorial project at Andean level. Accompanying the actors to make it an inclusive development model requires adapted participatory tools.

Corticosteroid Safety in COVID-19 Patients: A Pharmacovigilance Study: An International Journal of Medical Toxicology and Drug Experience

Background/Introduction: The use of oral and intravenous corticosteroids as a treatment for SARS-CoV-2 infection has been shown to inhibit the exaggerated inflammatory response, reducing symptoms and days of hospitalization of patients. However, its use is controversial because not enough clinical studies have been made to verify the safety of the drugs. Objective/Aim: To assess the safety profile of glucocorticoid treatment, at high and low doses, in suspected and/or confirmed patients with COVID-19 at the Ignacio Chavez National Institute of Cardiology, determining the most frequent side effects in patients, and assessing whether the administration of the drugs represents a greater benefit than the risk of presenting these effects. Methods: 366 patients were evaluated and divided into 3 groups: use of methylprednisolone (155 mg average) every 24 h for 3 days, dexamethasone (6 mg) every 24 h for 10 days, and patients with no use of corticosteroids. 87 patients in the study where excluded for meeting exclusion criteria. Hyperglycemia was evaluated in terms of its harshness and severity in relation to the maximum glucose level that the patients presented during the first 10 days after the start of treatment. Drug-associated hyperglycemia was not considered in patients admitted with hyperglycemic uncontrolled levels greater than 200 mg/dL Results: We observed that the cumulative incidence of hyperglycemia in the group with high doses of corticosteroids (methylprednisolone 155 mg day average) is 70%, low doses of corticosteroids (Dexamethasone 6 mg/day) is 67% and that of the group without corticosteroids is 31%. Based on the results or the 95% confidence interval calculation for estimating the risk of infections and hyperglycemia after the use of methylprednisolone and dexamethasone in the patients evaluated, it was observed that there is a risk of these effects occurring after the use of corticosteroids. However, it is not possible to define whether the use of any of the drugs represents a greater risk within this group of drugs, since the interval between the two groups of drugs is similar. Conclusion: The use of glucocorticoids at high and low doses as a treatment for COVID-19 disease has been shown to be effective in reducing symptoms and days of hospitalization in these patients. However, based on the results obtained, it was concluded that the use of these drugs can cause changes in the basal glucose of patients, in addition to increasing the risk of contracting in-hospital infections due to immunosuppression secondary to the use of glucocorticoids.

Conflict resolution under the COVID-19 pandemic

Purpose: This paper aims to analyze conflict resolution strategies among individuals who encountered disputes with family, neighbors, workmates, businesses, strangers, government authorities or other members in their communities during the COVID-19 pandemic. Design/methodology/approach: Applying a difference-in-difference approach by sex, the authors use a representative panel of adults living in 82 cities from across Mexico to measure changes in antisocial strategies (violence) and prosocial strategies (non-confrontational methods and dialogue) to resolve disputes. Findings: During the COVID-19 pandemic, men reduced their use of violence by 19.6% while women did so by 17.4%. There was a parallel rise in non-confrontational strategies used to solve conflicts equal to 73.6% for men and 62% for women. The use of dialogue as a tool for resolving disputes increased by more in cities that banned the sale of alcohol. Alternative Twitter data corroborates the main findings, suggesting that individuals are becoming more prosocial during the pandemic. Originality/value: To the knowledge, this is the first empirical study to analyze changes in strategies for conflict resolution as a consequence of the COVID-19 pandemic. This paper contributes to the literature by demonstrating how individuals adapt their dispute strategies under extraordinary circumstances such as a pandemic, with a focus on a middle-income setting. © 2021, Emerald Publishing Limited.

Challenges and stressors of covid-19 kidney and transplant patients: A mixed methods study

Purpose: To assess the unique needs of at-risk kidney and transplant patients and their caregivers during COVID-19, we established a telephone Listening Center enabling them to share about challenges seeking care, common stressors, and opportunities for healthcare delivery improvement. Methods: We conducted a mixed methods study where participants answered open and closed-ended questions about their health, financial, and emotional challenges during COVID-19. Data from open-ended questions were analyzed using thematic analysis. Descriptive statistics were run for quantitative items to explore frequencies of COVID-related stressors. Results: The 111 participants varied by race/ethnicity [Hispanic (29%), White (24%), Asian (23%), Black (23%), Other (1%)], with most being English-speakers (85%). Many participants experienced health, financial, or emotional COVID-19 related stressors (Table). Patients reported severe limitations due to need for social distancing, inability to go to overcrowded medical settings and public spaces, and difficulty receiving assistance replacing in-home dialysis supplies, childcare support, or help with home repairs. Using the Patient Health Questionnaire (PHQ4), 30% of participants reported feeling depressed and 35% reported feeling anxious on several to most days. Participants sought emotional support from family, friends, and communities of faith using facetime and zoom. Patients wanted a centralized place to receive COVID-19 updates, recommendations for safe activities, flexibility to choose online or in person medical visits, and regular follow up from their kidney/ transplant specialists related to COVID-19. Conclusions: Over 40% of patients reported fear, frustration, loneliness, and postponed medical visits due to COVID-19. Needs-based interventions include mental health resources, education, and support for care transitions may be helpful, particularly as the pandemic continues. (Table Presented).

Information-seeking behavior during COVID-19: Opportunities for communication and care transition improvements

Purpose: To learn more about how at-risk dialysis and transplant patients sought health information during COVID-19 and what was most helpful, we conducted a mixed-methods study of people contacting a telephone COVID-19 Kidney & Transplant Listening Center. Methods: Participants answered a survey in English or Spanish, including openended and closed-item questions assessing the types of COVID-19 related care transition experiences they had, their telehealth comfort using the Unified Theory of Acceptance and Use of Technology (UTAUT), what types of questions they had, and information-seeking behavior. Thematic analysis was conducted and descriptive statistics were run for quantitative items. Results: 111 participants completed the survey. They were primarily Englishspeakers (84.85%) and of Hispanic/Latino (26.13%), White (24.35%) Black (23.42%) and Asian (23.42%) race/ethnicities, with an average age of 50 years, and with either a bachelor's degree or higher (51.96%). Participants consumed health information at least two times weekly via internet (56.57%), television (40.57%), or print sources (31.13%). They were more likely to learn about health issues from news media (78.38%) than healthcare institutions (57.66%). Nearly 70% talked about health issues with family/friends twice a week. Most patients had experienced a change in care during the pandemic (66.3%), and 44.14% said they had postponed a medical visit. Questions that were raised related to their vaccine priority, higher risk of death as a transplant patient during COVID-19, and how to stay safe at dialysis. A third (28.57%) agreed they could not find specific health information they needed. Participants with high school (HS) degrees or less were less likely to agree that the amount of information they had to make health choices was helpful (P=0.002). Generally, participants believed they had the necessary resources (95.23%) and knowledge (93.27%) to access telehealth, however, those with HS degrees (p=0.002) or Medicare (P<0.001) were less confident. Finally, they reported that a website with FAQs answered by experts (68.47%) or a live chat for questions (67.57%) would be helpful. Conclusions: During the pandemic, patients engaged in high levels of health information seeking weekly, often from media sources versus healthcare institutions that have more accurate kidney-related recommendations.

Concerns and difficulties associated with the COVID-19 pandemic among older adults with cancer in Mexico

Background: The COVID-19 pandemic has impacted the well-being of people not only due to the disease but also because of stay-at-home orders, social distancing, unemployment, and different kinds of loses. Older adults have particularly suffered during the pandemic, with increased health-related concerns and anxiety leading to increased vulnerability. However, little is known about the effects of the pandemic on older adults with cancer living in developing countries. They are facing issues related to their diagnosis and treatment, as well as the effects of the pandemic on their care and on the well-being of their families. To improve care for this vulnerable population, we studied the concerns and difficulties associated with COVID-19 among older Mexican adults with cancer. Methods: We included patients age ≥65 with the 10 most common tumors in Mexico according to GLOBOCAN and within 3-24 months of cancer diagnosis at two public hospitals in Mexico City. Patients were contacted telephonically and asked to complete a survey reporting the difficulties encountered during the COVID-19 pandemic and to rate their concerns associated with cancer care management using a 0-10 Likert-type scale, with higher ratings meaning increased concerns. Focused interviews were used to describe the individual experience of selected patients and their relatives related to COVID-19 and cancer care. Results: Between April 20, 2020 and December 1, 2021, 67 patients (mean age 71.9, min 65, max 90;35.8% female;62.7% living with a partner) were included. The most common tumors were prostate (43%), colon (16%), and lung (12%). 46% had Stage IV disease, and 61% had a life expectancy of more than a year. Twenty-five percent of patients reported encountering at least one difficulty in obtaining cancer care due to the COVID-19 pandemic. 43% of the patients reported difficulties with accessing follow-up cancer care;39% reported issues with obtaining medications, including chemotherapy;and 34% reported problems obtaining medical care in general, including oncology visits. Regarding concerns, 33% of the patients reported being 'very worried' or 'extremely worried' about the COVID-19 pandemic. The most relevant concerns were related to getting infected with COVID-19 (or having a family member who became infected) (mean rating 7.9, SD 2.9);not being able to pay for cancer treatments or medical care (mean rating 6.9, SD 3.5);and worsening of cancer due to delayed care during the pandemic (mean rating 6.6, SD 3.7). Conclusions: A significant proportion of older adults with cancer in Mexico faced difficulties obtaining cancer treatment and followup care during the COVID-19 pandemic. Their most relevant concerns included getting infected, financial losses, and progression of disease. Creating systems to provide continued cancer care for vulnerable populations in developing countries is essential to face the COVID-19 pandemic.

Developing an Optical Interferometric Detection Method based biosensor for detecting specific SARS-CoV-2 immunoglobulins in Serum and Saliva, and their corresponding ELISA correlation.

The standard rapid approach for the diagnosis of coronavirus disease 2019 (COVID-19) is the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA. The detection of specific anti-SARS-CoV-2 immunoglobulins is crucial for screening people who have been exposed to the virus, whether or not they presented symptoms. Recent publications report different methods for the detection of specific IgGs, IgMs, and IgAs against SARS-CoV-2; these methods mainly detect immunoglobulins in the serum using conventional techniques such as rapid lateral flow tests or enzyme-linked immunosorbent assay (ELISA). In this article, we report the production of recombinant SARS-CoV-2 spike protein and the development of a rapid, reliable, cost-effective test, capable of detecting immunoglobulins in serum and saliva samples. This method is based on interferometric optical detection. The results obtained using this method and those obtained using ELISA were compared. Owing to its low cost and simplicity, this test can be used periodically for the early detection, surveillance, detection of immunity, and control of the spread of COVID-19.

[Secondary hemophagocytic lymphohistiocytosis and cytokine release syndrome in COVID-19, the same or different entities?]

BACKGROUND: Excessive release of cytokines in severe COVID-19 resembles secondary hemophagocytic lymphohistiocytosis (sHLH). AIM: To compare the clinical and laboratory characteristics between sHLH and cytokine release syndrome (CRS) in COVID-19. METHODS: A review of articles in the PubMed database was performed, using the following keywords "HLH and COVID", "HScore in COVID". Articles available until July 16, 2020 were included. RESULTS: A comparative table was prepared based on the diagnostic criteria of the HLH 2004 protocol, HScore and characteristics of the CRS-COVID-19. Eighteen variables are used for comparison. DISCUSSION: The CRS in COVID-19 presented similarity with the CRS of sHLH;however, it cannot be stated that they are the same entity. Case reports of sHLH in COVID-19 are small. HScore is a tool that could guide the diagnosis of sHLH in the context of CRS-COVID-19, in a more practical way than the classic criteria described in HLH-2004;however, its application in COVID-19 is limited due to the absence of key features of the hyperinflammatory state of COVID-19 that are included in HLH. CONCLUSIONS: CRS-COVID-19 is not synonymous with sHLH. Although this last entity may or may not be present in the severe COVID-19.