Impact of SARS-CoV-2 pandemic among health care workers in a secondary teaching hospital in Spain.

BACKGROUND: The COVID-19 pandemic has posed a huge challenge to healthcare systems and their personnel worldwide. The study of the impact of SARS-CoV-2 infection among healthcare workers (HCW), through prevalence studies, will let us know viral expansion, individuals at most risk and the most exposed areas in healthcare organizations. The aim of this study is to gauge the impact of SARS-CoV-2 pandemic in our hospital workforce and identify groups and areas at increased risk. METHODS AND FINDINGS: This is a cross-sectional and incidence study carried out on healthcare workers based on molecular and serological diagnosis of SARS-CoV-2 infection. Of the 3013 HCW invited to participate, 2439 (80.9%) were recruited, including 674 (22.4%) who had previously consulted at the Occupational Health Service (OHS) for confirmed exposure and/or presenting symptoms suggestive of COVID-19. A total of 411 (16.9%) and 264 (10.8%) healthcare workers were SARS-CoV-2 IgG and rRT-PCR positive, respectively. The cumulative prevalence considering all studies (IgG positive HCW and/or rRT-PCR positive detection) was 485 (19.9%). SARS-CoV-2 IgG-positive patients in whom the virus was not detected were 221 (9.1%); up to 151 of them (68.3%) did not report any compatible symptoms nor consult at the OHS for this reason. Men became more infected than women (25% vs 18.5%, p = 0.0009), including when data were also classified by age. COVID-19 cumulative prevalence among the HCW assigned to medical departments was higher (25.2%) than others, as well as among medical staff (25.4%) compared with other professional categories (p<0.01). CONCLUSIONS: The global impact of the COVID-19 pandemic on HCW of our centre has been 19.9%. Doctors and medical services personnel have had the highest prevalence of SARS-CoV-2 infection, but many of them have not presented compatible symptoms. This emphasizes the performance of continuous surveillance methods of the most exposed health personnel and not only based on the appearance of symptoms.

Diagnostic model of visceral leishmaniasis based on bone marrow findings. Study of patients with clinical suspicion in which the parasite is not observed.

BACKGROUND: Visceral Leishmaniasis (VL) is a serious protozoal disease endemic in diverse areas, including the southern area of Madrid (Spain), where an outbreak was detected in 2009. The objective of this work is to analyze bone marrow alterations in VL patients and elaborate a diagnostic model with the aim to improve the early detection of this disease. The usual diagnostic methods, as the observation of the parasite on a bone marrow aspirate, have frequent false negatives, and the high sensitivity methods, as PCR and ELISA, are delayed or are not always available. METHODS: This observational study evaluated bone marrow parameters of adult patients with clinical suspicion of VL, in which a bone marrow aspiration was performed but Leishmania was not directly observed, during the period 2009-2014. The patients finally diagnosed of VL by other methods (VL group, n=41), and the patients in which the VL was not diagnosed (non-VL group, n=20) were compared. A multivariant model was elaborated and externally validated. RESULTS: The final multivariant model includes percentage of myeloid series, percentage of plasma cells and quantification of megakaryocytes in the bone marrow, with an area under the ROC curve of 0.87 (0.78-0.96). The model performed well in the external validation. CONCLUSION: In cases of VL suspicion and when the parasite is not observed in the bone marrow aspiration, the proposed model could be useful in discriminating between patients with and without VL, allowing to take a therapeutic decision while awaiting the definitive diagnosis.

Evaluation of a Method for Long-Term Cryopreservation of Fungal Strains.

The conservation of microorganisms is essential for their in-depth study. However, today's most widely used conservation methods, based on the use of distilled water, soil, oils, or silica, do not guarantee the stability of fungal cells, especially dermatophytes. This problem led us to evaluate the conservation capacity of a cryogenic vials system containing glass beads covered in a cryopreservant hypertonic solution as an alternative method of storage of fungal cells at -80°C. Up to 570 strains of fungi belonging to 27 different species, isolated from clinical samples, were inoculated into cryotubes containing 25 glass beads covered in a cryopreserving hypertonic solution. Suspensions were mixed vigorously and the cryopreserving solution was discarded. The tubes were frozen at -80°C for a period of 42 months and periodically, a glass bead was removed from each cryotube and inoculated onto Sabouraud dextrose agar, and incubated at 30°C for 7-14 days to evaluate the number of colonies recovered, their purity, and phenotypic characteristics. All yeast isolates were recovered, unlike 2 isolates (4.4%) of the mold group and 21 (10.7%) of the dermatophytes. Survival rates were close to 100% for yeasts and molds, with expiration times being estimated for almost indefinite stocks, and 62% for dermatophytes, with an average expiration date of 25.5 years. The phenotypic characteristics remained comparable to those of the strains before storage. Conservation at -80°C using cryogenic vials is a reliable and efficient system for the conservation of fungal collections, and although the behavior differs by groups, stratified survival data are obtained to avoid extinction.

Periodontal and biochemical bone metabolism assessment on a chronic oral anticoagulation population treated with dicoumarins

BACKGROUND: The aim is to evaluate periodontal alteration and biochemical markers associated with bone turnover in chronic oral with dicoumarins anticoagulant treatment patients. MATERIAL AND METHODS: 80 patients treated with oral anticoagulants were divided into 2 cohort: Group A (n = 36) 6 month to 1 year with anticoagulant treatment and Group B (n = 44) > 2 years with anticoagulant treatment. Clinical evaluation included: Clinical attachment level (CAL), plaque index (PI) and gingival index (GI). Analytically biochemical parameters of bone remodeling (calcium and phosphorus), formation (total acid phosphatase, alkaline phosphatase and osteocalcin) and resorption (tartrate-resistant acid phosphatase and beta-crosslaps) were evaluated. RESULTS: High values of PI (67-100%) especially in men and in Group B were observed. Men with anticoagulation treatment length showed an increased GI (49.167 vs 78.083) while Group B women showed a decreased GI in comparison with Group A (59.389 vs 42.120). Women presented a greater average CAL than men as well as Group B vs Group A but without statistical significance. All biochemical markers were decreased respect to values of general population. Osteocalcin in Group B women showed a statistically significant outcome vs Group A (p = 0.004). Acid phosphatase (total and tartrate-resistant) has a slight increase in Group B women versus Group A, and Beta-crosslap showed lower values in Group A men than Group B and slightly lower in Group A women versus Group B, without statistical significance. CONCLUSIONS: Patients showed a slight to moderate degree of periodontal affectation, especially gingivitis related to bacterial plaque. Periodontal disorders tended to be more severe in Group B. While bone remodeling showed an overall decrease with greater affectation of bone neoformation phenomena, bone destruction tended to recover and normalize in time

Prevalencia y significado clínico de los anticuerpos antifosfolipídicos en la hepatitis crónica por virus C / Prevalence and clinical significance of antiphospholipid antibodies in chronic hepatitis C

Fundamento: Estudiar la prevalencia de anticuerpos antifosfolipídicos y analizar su relación con la progresión de la hepatitis crónica por virus C. Métodos: Se incluyen 128 pacientes con hepatopatía crónica por VHC (edad 46 [14] años, 70 varones), no tratados con interferón y un grupo control sano de 93 personas. Analizamos los factores de riesgo, la duración de la enfermedad, el consumo de alcohol, la cifra de plaquetas, ALT, ARN del VHC en suero e hígado y anticuerpos antinucleares, el grado de inflamación y el estadio de fibrosis en la biopsia hepática, el estadio de Child-Pugh, la existencia de hipertensión portal y descompensaciones previas. Estudiamos la presencia de anticoagulante lúpico y anticuerpos anticardiolipina (ACA) IgG e IgM. En los pacientes con anticuerpos anticardiolipina positivos se detectó la presencia de anti-ß glucoproteína I mediante ELISA. Resultados: Presentaron anticuerpos antifosfolipídicos positivos 31/128 (25 por ciento; intervalo de confianza [IC] del 95 por ciento: 17,8-33,4). La prevalencia de anticuerpos anticardiolipina IgG fue significativamente mayor en pacientes (22 por ciento) que en controles 3/93 (3,2 por ciento), p < 0,05; en cambio, no encontramos diferencias en la prevalencia de anticuerpos anticardiolipina IgM ni de anticoagulante lúpico. No encontramos diferencias en las cifras de ALT, viremia, carga viral en hígado, plaquetas o ANA en los pacientes con anticuerpos anticardiolipina IgG o sin ellos, tampoco apreciamos relación con la edad, la duración de la infección, el consumo de alcohol ni los factores de riesgo. En 4 de 44 pacientes (9 por ciento, IC del 95 por ciento: 2,5-21,7) con fibrosis F1, en 7 de 39 (18 por ciento; IC del 95 por ciento: 7,5-33,5) con F2 y en 17 de 45 (38 por ciento; IC del 95 por ciento: 23,8-53,5) con cirrosis encontramos anticuerpos anticardiolipina IgG positivo (p < 0,005). La presencia de ACA IgG se relacionó de forma significativa con la existencia de hipertensión portal, de disfunción hepática y antecedentes de descompensación. En 10 de 23 pacientes (43,5 por ciento; IC del 95 por ciento: 23,2-65,5) con ACA positivo se detectaron anticuerpos anti-ß2 glucoproteína I. Conclusiones: La cuarta parte de los pacientes con hepatitis crónica por VHC presentan anticuerpos antifosfolipídicos. Estos anticuerpos podrían estar implicados en la progresión de la enfermedad. (AU)