Determinants of early antibody responses to COVID-19 mRNA vaccines in a cohort of exposed and naïve healthcare workers.

BACKGROUND: Two doses of mRNA vaccination have shown >94% efficacy at preventing COVID-19 mostly in naïve adults, but it is not clear if the second dose is needed to maximize effectiveness in those previously exposed to SARS-CoV-2 and what other factors affect responsiveness. METHODS: We measured IgA, IgG and IgM levels against SARS-CoV-2 spike (S) and nucleocapsid (N) antigens from the wild-type and S from the Alpha, Beta and Gamma variants of concern, after BNT162b2 (Pfizer/BioNTech) or mRNA-1273 (Moderna) vaccination in a cohort of health care workers (N=578). Neutralizing capacity and antibody avidity were evaluated. Data were analyzed in relation to COVID-19 history, comorbidities, vaccine doses, brand and adverse events. FINDINGS: Vaccination induced robust IgA and IgG levels against all S antigens. Neutralization capacity and S IgA and IgG levels were higher in mRNA-1273 vaccinees, previously SARS-CoV-2 exposed, particularly if symptomatic, and in those experiencing systemic adverse effects (p<0·05). A second dose in pre-exposed did not increase antibody levels. Smoking and comorbidities were associated with 43% (95% CI, 19-59) and 45% (95% CI, 63-18) lower neutralization, respectively, and 35% (95% CI, 3-57%) and 55% (95% CI, 33-70%) lower antibody levels, respectively. Among fully vaccinated, 6·3% breakthroughs were detected up to 189 days post-vaccination. Among pre-exposed non-vaccinated, 90% were IgG seropositive more than 300 days post-infection. INTERPRETATION: Our data support administering a single-dose in pre-exposed healthy individuals as primary vaccination. However, heterogeneity of responses suggests that personalized recommendations may be necessary depending on COVID-19 history and life-style. Higher mRNA-1273 immunogenicity would be beneficial for those expected to respond worse to vaccination and in face of variants that escape immunity such as Omicron. Persistence of antibody levels in pre-exposed unvaccinated indicates maintenance of immunity up to one year. FUNDING: This work was supported by Institut de Salut Global de Barcelona (ISGlobal) internal funds, in-kind contributions from Hospital Clínic de Barcelona, the Fundació Privada Daniel Bravo Andreu, and European Institute of Innovation and Technology (EIT) Health (grant number 20877), supported by the European Institute of Innovation and Technology, a body of the European Union receiving support from the H2020 Research and Innovation Programme. We acknowledge support from the Spanish Ministry of Science and Innovation and State Research Agency through the "Centro de Excelencia Severo Ochoa 2019-2023" Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. L. I. work was supported by PID2019-110810RB-I00 grant from the Spanish Ministry of Science & Innovation. Development of SARS-CoV-2 reagents was partially supported by the National Institute of Allergy and Infectious Diseases Centers of Excellence for Influenza Research and Surveillance (contract number HHSN272201400008C). The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of the manuscript.

Eating disorders in sports and football: An updated review / Trastornos de la conducta alimentaria en el deporte y en el fútbol: Una revisión actualizada / Transtornos do comportamento alimentario no esporte e futebol: Uma revisão atualizada

Disordered eating behaviours and eating disorders (EDs) are prevalent among athletes both at clinical and subclinical levels. This review briefly summarizes and updates the main findings on EDs in sports, with a specific focus on football, a largely ignored athletic modality in which EDs are common and more frequent than expected. We begin presenting EDs in sports and their prevalence. We review the traditional classifications of sports as "low-" and "high-risk" athletic modalities based on prevalence rates and examine recent findings that question the utility of classifying sports and estimating an athlete’s vulnerability for developing an ED based only on such dimension. We then focus on other more decisive risk factors involved in the predisposition, precipitation and maintenance of an ED in sports, including socio-cultural, psychosocial, behavioural and athletic-contextual factors. We reflect on current trends in sports and football that may contribute to an increased risk for EDs. Next, recommendations for preventing and managing EDs in sports are discussed, stressing the importance of reducing putative risk factors. Finally, we attend to future areas of research that may enrich our knowledge on this topic, including methodological, empirical and conceptual issues that may lead to further advancements in research and intervention

Los comportamientos alimentarios alterados y los trastornos de la conducta alimentaria (TCAs) tienen una alta prevalencia entre los deportistas tanto a niveles clínicos como subclínicos. Esta revisión resume y actualiza los principales hallazgos sobre TCAs en el deporte, con un énfasis en el fútbol, una modalidad ignorada en la que son comunes y más frecuentes de lo esperado. Comienza presentando los TCAs en el ámbito deportivo y su prevalencia. Se presenta la clasificación tradicional de los deportes como de "alto" y "bajo" riesgo y resultados recientes que cuestionan su utilidad y la de estimar la vulnerabilidad de los deportistas a partir de esta dimensión únicamente. Se comentan otros factores de riesgo más decisivos implicados en la predisposición, aparición y mantenimiento de los TCAs en deportistas, incluyendo factores socio-culturales, psicosociales, comportamentales y deportivos-contextuales. Se reflexiona sobre tendencias actuales en el deporte y en el fútbol que pueden contribuir a un incremento del riesgo de TCAs. Se proponen recomendaciones para la prevención y manejo de los TCAs en el ámbito deportivo. Finalmente, se comentan futuras áreas de investigación que pueden enriquecer nuestro conocimiento sobre esta área, incluyendo cuestiones metodológicas, empíricas y conceptuales que pueden generar importantes avances tanto en investigación como en intervención

Os comportamentos alimentares desordenados e os transtornos do comportamento alimentario (TCAs) têm uma alta prevalência entre os atletas em níveis clínicos e subclínicos. Esta revisão resume e atualiza as principais descobertas sobre TCAs no esporte, com ênfase em futebol, uma modalidade atlética amplamente ignorada em que os TCAs são comuns e mais freqüentes do que o esperado. Começa com uma apresentação de os TCAs no esporte e sua prevalência. Revisamos as classificações tradicionais dos esportes como modalidades atléticas de "baixo" e "alto" risco com base nas taxas de prevalência e examinamos descobertas recentes que questionam a utilidade de classificar esportes assim e de estimar a vulnerabilidade dos atletas para desenvolver um TCA baseada apenas nessa dimensão. Para continuar, enfocamos outros fatores de risco mais decisivos envolvidos na predisposição, na precipitação e na manutenção de um TCA no esporte, incluindo fatores sócio-culturais, psicossociais, comportamentais e atléticos-contextuais. Refletimos sobre tendências atuais nos esportes e no futebol que podem contribuir para um risco aumentado para um TCA. Recomendações para a prevenção e manejo de TCAs nos esportes são propostas, destacando a importância de reduzir fatores de risco putativos. Finalmente, são discutidas futuras áreas de investigação que podem enriquecer o nosso conhecimento sobre esse tema, incluindo questões metodológicas, empíricas e conceituais que podem levar a avanços significativos em investigação e intervenção

Trapeziectomy With Ligament Reconstruction and Tendon Interposition Versus a Trapeziometacarpal Prosthesis for the Treatment of Thumb Basal Joint Osteoarthritis.

Numerous surgical procedures have been described to treat trapeziometacarpal osteoarthritis, but no approach is currently considered superior. Good long-term outcomes have been reported with multiple procedures. No studies have been published comparing outcomes of the Arpe joint replacement (Biomet, Valence, France) with those of ligament reconstruction and tendon interposition (LRTI) using the Burton-Pellegrini technique. The study objective was to compare clinical outcomes between these techniques. Sixty-five patients with Eaton stage III osteoarthritis of the thumb were included in this retrospective follow-up study. Patients were assigned to LRTI (LRTI group) or total joint replacement (Arpe group) and were followed for a mean of 4.8 years. The LRTI group included 34 patients and the Arpe group included 31. Clinical outcome variables were determined preoperatively and every 6 months postoperatively. Pain relief and functional improvement were similar between groups. Pinch strength and range of motion were superior in the Arpe group. Metacarpophalangeal hyperextension appeared to be prevented in the Arpe group but increased over the follow-up period in the LRTI group. However, the complication rate was higher in the Arpe group. Arthroplasty with the Arpe prosthesis can be considered in selected patients who require greater strength and range of motion, although it has been associated with a higher complications rate. [Orthopedics. 2017; 40(4):e681-e686.].

Effect of contact lens use on Computer Vision Syndrome.

PURPOSE: To analyse the relationship between Computer Vision Syndrome (CVS) in computer workers and contact lens use, according to lens materials. METHODS: Cross-sectional study. The study included 426 civil-service office workers, of whom 22% were contact lens wearers. Workers completed the Computer Vision Syndrome Questionnaire (CVS-Q) and provided information on their contact lenses and exposure to video display terminals (VDT) at work. CVS was defined as a CVS-Q score of 6 or more. The covariates were age and sex. Logistic regression was used to calculate the association (crude and adjusted for age and sex) between CVS and individual and work-related factors, and between CVS and contact lens type. RESULTS: Contact lens wearers are more likely to suffer CVS than non-lens wearers, with a prevalence of 65% vs 50%. Workers who wear contact lenses and are exposed to the computer for more than 6 h day(-1) are more likely to suffer CVS than non-lens wearers working at the computer for the same amount of time (aOR = 4.85; 95% CI, 1.25-18.80; p = 0.02). CONCLUSIONS: Regular contact lens use increases CVS after 6 h of computer work.

Síndrome de apnea obstructiva del sueño en niños (SAOS) / Obstructive sleep apnea syndrome in children (OSAS)

El síndrome de la apnea obstructiva del sueño (SAOS) es ocasionado por una obstrucción de las vías aéreas superiores, resultado de un desequilibrio entre la fuerza de succión respiratoria y la compensación de los músculos dilatadores faríngeos. El diagnóstico positivo es establecido por el registro polisomnográfico nocturno durante el sueño que define las características y la severidad de esta enfermedad. El objetivo del siguiente artículo es difundir los diversos aspectos clínicos y diagnósticos de una enfermedad recientemente descripta de alta prevalencia y que cruza las fronteras de múltiples especialistas (pediatras, neurólogos, neumólogos, otorrinolaringólogos, psiquiatras, psicólogos, odontoestomatólogos, ortodoncistas), así contribuiremos a su diagnóstico precoz a partir de los niños que roncan, evitando las importantes secuelas del SAOS infantil...

Tratamiento psicológico de las náuseas y vómitos anticipatorios inducidos por quimioterapia por radioterapia / No disponible

La emesis producida por la quimioterapia y radioterapia puede afectar significativamente la calidad de vida de los pacientes con cáncer. La emesis anticipatoria es una respuesta condicionada que aparece en pacientes antes de recibir el ciclo de quimioterapia ya que se basa en un aprendizaje de una experiencia negativa con dicho tratamiento. El objetivo de este artículo es revisar los tratamientos eficaces, farmacológicos y psicológicos, para el control de la emesis anticipatoria. El mejor tratamiento para prevenir la emesis anticipatoria es el control de la emesis aguda y tardía. Los nuevos fármacos antieméticos, como el palonosetrón o el aprepitant, suelen evitar las náuseas y los vómitos por la quimioterapia, pero no mejoran las náuseas y vómitos anticipatorios. Las intervenciones conductuales, como la relajación muscular progresiva y el entrenamiento en desensibilización sistemática, deben considerarse métodos importantes para la prevención y el tratamiento de la emesis anticipatoria (AU)

Chemotherapy-induced or radiotherapy-induced nausea and vomiting can significantly affect patients´ quality of life. Anticipatory emesis is a conditioned response which occurs before patients receive their next chemotherapy cycle. It is based on the learning of a patient´s negative experience. The aim of this article is to review effective treatments, pharmacological and psychological, for the control of anticipatory emesis. The best treatment to prevent anticipatory emesis is the control of acute and delayed emesis. The new antiemetic drugs, palonosetron and aprepitant, are usually able to prevent nausea and vomiting from chemotherapy, but not to improve anticipatory nausea and vomiting. Behavioral interventions such as progressive muscle relaxation training and systematic desensitization should be considered important methods for preventing and treating anticipatory emesis (AU)

Stabilisation of sewage sludge and vinasse bio-wastes by vermicomposting with rabbit manure using Eisenia fetida.

Changes in the chemical characteristics and biological parameters of Eisenia fetida were assessed by VER using (CO+VE) rabbit manure (Vo) spiked with sewage sludge (SS) or vinasse (V). Seven mixtures were used: Vo, control; Vo+SS at 10%, 30%, and 50% (SS1, SS2, and SS3); Vo+V at 10%, 30%, and 50% (V1, V2, and V3). SS vermicomposts had higher humus, nutrient and total metal contents, but less soluble salts (EC) than V vermicomposts. The number and weight of worms were higher in Vo, followed by SS, at decreasing doses. V3 showed the smallest number and size. The EC of the initial mixtures explained reduced weight, whereas EC and avP2O5 accounted for lower numbers. Vermicomposting is an efficient biowaste recycling technology, but the total amount and composition of soluble salts in food influence the quality of end products and are of primary importance for biological parameters of worms.

Influence of organic matter transformations on the bioavailability of heavy metals in a sludge based compost.

The agricultural use of anaerobically digested sewage sludge (ADSS) as stable, mature compost implies knowing its total content in heavy metals and their bioavailability. This depends not only on the initial characteristics of the composted substrates but also on the organic matter transformations during composting which may influence the chemical form of the metals and their bioavailability. The objective of this work was to examine the relationships between the changes in the organic matter content and humus fractions, and the bioavailability of heavy metals. A detailed sampling at 0, 14, 84, and 140 days of the composting process was performed to measure C contents in humic acids (HAs), fulvic acids, (FAs) and humin, the total content of Zn, Pb, Cu, Ni, and Cd, and also their distribution into mobile and mobilisable (MB), and low bioavailability (LB) forms. Significant changes of C contents in HA, FA, and Humin, and in the FA/HA, HA/Humin and C(humus)/TOC ratios were observed during composting. The MB and LB fractions of each metal also varied significantly during composting. The MB fraction increased for Zn, Cu, Ni, and Cd, and the LB fraction increased for Pb. Stepwise linear regressions and quadratic curve estimation conducted on the MB and LB fractions of each metal as dependent on the measured organic variables suggested that Zn bioavailability was mainly associated to percentage of C in FAs. Bioavailability of Cu, Ni and Cd during composting was associated to humin and HAs. Pb concentration increased in the LB form, and its variations followed a quadratic function with the C(humus)/TOC ratio. Our results suggest that the composting process renders the metals in more available forms. The main forms of metal binding in the sludge and their availability in the final compost may be better described when metal fractionation obtained in sequential extraction and humus fractionation during composting are considered together.

Advances in validating SALTIRSOIL at plot scale: first results.

SALTIRSOIL (SALTs in IRrigated SOILs) is a model for the medium to long term simulation of soil salinity in irrigated, well-drained lands. Once the algorithms were verified, the objective of our study was to validate SALTIRSOIL under one of several water quality and management scenarios in Mediterranean agriculture. Because drip and surface are the most common irrigation systems in irrigated agriculture in Valencia (Spain), the validation was performed with climate, soil, irrigation water (composition and management) and crop (species and management) information from an experimental plot surface irrigated with well water and planted with watermelon that has been monitored since the late spring of 2007. To carry out the validation, first we performed a global sensitivity analysis (GSA). Second, we compared simulated soil saturation extract composition against measured data. According to the GSA, SALTIRSOIL calculations of soil salinity seem to be most affected by climate (rainfall and evapotranspiration) with 60% of explained soil salinity variance, water salinity with 26% of explained variance, and then irrigation with 4%. According to the closeness of the first comparisons between predictions and measurements, SALTIRSOIL does not seem to be affected by any systematic error, and as a consequence, neither inclusion of new parameters nor calibration of the others already included would be needed at least for surface irrigation. The validation of SALTIRSOIL continues under other water quality and irrigation management scenarios.

Evaluación de la astenia en pacientes oncológicos avanzados y una propuesta de protocolo de intervención psicológica / No disponible

La astenia es un síntoma con una elevada incidencia en pacientes con cáncer. Es un fenómeno multifactorial que deteriora la calidad de vida del paciente, con repercusiones físicas, psicológicas, sociales y laborales. Es uno de los síntomas que más preocupan al enfermo, incluso más que el dolor, y al que se le presta poca atención. Por tanto se infravalora su importancia y no se aplican los medios diagnósticos necesarios para identificar sus causas y poder disminuirlas en la medida de lo posibl (AU)

Fatigue is a symptom with a high incidence in patients with cancer. It is a multifactorial phenomenon, which deteriorates the quality of life of patients, from physical, psychological, social and working points of view. It is one of the symptoms that most concern the patient, even more than pain, medically it is paid little attention, therefore underestimating its importance and not applying the diagnostic tools necessary to identify its causes and to reduce it as far as possible. The aim of this paper is to assess the subjective perception of fatigue in advanced cancer patients, the subjective distress that produces the situation they are living and to assess whether they use strategies to minimize the feeling of tiredness. We consider it necessary to establish a consensus on the measuring instruments used to compare results.We have developed a psychological intervention guideline for management fatigue by promoting the adaptation and adjustment of advanced cancer patients to illness and therefore increase sense of well being and quality of life (AU)

Rupture of small finger flexor tendons secondary to asymptomatic nonunion of the hamate hook.

The incidence of fractures of the hamate hook (hamulus) has been reported to be between 2% and 4% of all carpal fractures. Untreated hamulus nonunion can cause attritional rupture of the ulnar digits' flexor digitorum profundum tendons. Rupture of flexor tendons due to nonunion of the hook of the hamate is an uncommon injury. Most surgeons treat the tendon lesion by a graft, transfer of the superficial flexor of the ring finger, or terminolateral suture of the distal stump of the deep flexor tendon of the little finger to the deep flexor tendon of the ring finger. This article reports a case of a 52-year-old right-handed man who presented with weakness of grip and loss of active flexion of both distal and proximal interphalangeal joints of the right small finger lasting 2 weeks due to grip strength while working. The clinical history and the physical examination were dissonant, and a computed tomography scan revealed a nonunion of the hamulus. Intraoperatively, the nonunion of the hamate hook was identified and the bony ossicle excised. The flexor digitorum profundus and superficialis to the small finger were both ruptured. The flexor digitorum profundus tendon was repaired with a termino-terminal suture. The patient returned to work within 3 months without restriction. Six months postoperatively, the patient had no pain and achieved full active flexion of the small finger.

Cáncer de pulmón microcítico: Revisión / Small-cell-lung cancer: a review

El 20% de todos los cánceres de pulmón son de células pequeñas (CPCP). Más de la mitad ocurren en mayores de 60 años. Debido a su diseminación muy rápida, la mayoría presentan síntomas al diagnóstico (90). Estos síntomas pueden derivarse de su extensión locorregional, de las metástasis o tener un origen paraneoplásico. La anamnesis y la exploración física completas son esenciales para la evaluación inicial y el manejo adecuado. Además, de un análisis sanguíneo con determinación de enzimas como la lactato deshidrogenasa, que tiene valor pronóstico, la tomografía axial computerizada (TAC) torácica y abdominal, la gammagrafía ósea, y la TAC o la resonancia magnética (RM) cerebral permiten una estadificación óptima. Aunque el CPCP es un tumor quimio y radio sensible, se han realizado muy pocos avances en los últimos años y su mortalidad es muy elevada. El objeto de este trabajo es revisar todos estos aspectos relacionados con el CPCP

Twenty percent of all lung cancers are of small cells (CPCP). More than half occur to people aged 60 and more. Due to its fast dissemination, most of them show symptoms when diagnosed (90%). These symptoms can be derived from its locoregional extension, metastases or can have a paraneoplastical origin. Anamnesis and thorough physical exploration are essential for the initial evaluation and adequate treatment. In addition to a blood analysis with determination of enzymes such as lactate dehydrogenase which helps in prognosis, thorax and abdominal computed tomography (CT), bone gammagraphy and cerebral CT or magnetic resonance imaging (MRI) allow optimum estadification. Although CPCP is chemo- and radio-sensitive, small progress has been achieved in the last years and its mortality rate is high. The objective of this paper is to revise all these aspects related to CPCP

Adhesión de resinas compuestas a esmalte y dentina con sistemas de autograbado / Bond strength of composite resins to enamel and dentin with self-etching systems

El objetivo de este trabajo fue determinar y comparar los valores de resistencia adhesiva obtenidos con una resina compuesta aplicada sobre esmalte y dentina humanos, tratados con distintos productos de autograbado. Se fijaron probetas de composite (P60 3M ESPE) sobre superficies planas de esmalte y dentina. Los adhesivos utilizados fueron: EXM 318 (experimental); self-etch adhesive (3M ESPE); AdheSE self-etching adhesive (Ivoclar Vivadent); SE-Bond (ColtÞne); Tyrian SPE & One Step Plus (Bisco); Simplicity (Apex); Contax (DMG Hamburg); Futurabond (VOCO) y One Coat SE (ColtÞne). Luego de 24 horas de almacenamiento en agua destilada a 37ºC se determinó la resistencia adhesiva bajo tensiones de corte. El análisis de varianza mostró el efecto significativo de los factores tejido dentario, material y la interacción entre ambos. De acuerdo con los resultados obtenidos en el presente trabajo,

Adhesión de resinas compuestas a esmalte y dentina con sistemas de autograbado / Bond strength of composite resins to enamel and dentin with self-etching systems

El objetivo de este trabajo fue determinar y comparar los valores de resistencia adhesiva obtenidos con una resina compuesta aplicada sobre esmalte y dentina humanos, tratados con distintos productos de autograbado. Se fijaron probetas de composite (P60 3M ESPE) sobre superficies planas de esmalte y dentina. Los adhesivos utilizados fueron: EXM 318 (experimental); self-etch adhesive (3M ESPE); AdheSE self-etching adhesive (Ivoclar Vivadent); SE-Bond (Coltène); Tyrian SPE & One Step Plus (Bisco); Simplicity (Apex); Contax (DMG Hamburg); Futurabond (VOCO) y One Coat SE (Coltène). Luego de 24 horas de almacenamiento en agua destilada a 37ºC se determinó la resistencia adhesiva bajo tensiones de corte. El análisis de varianza mostró el efecto significativo de los factores tejido dentario, material y la interacción entre ambos. De acuerdo con los resultados obtenidos en el presente trabajo, los adhesivos de autograbado alcanzaron valores de adhesión más elevados en dentina que en tejido adamantino