Effectiveness of tixagevimab/cilgavimab in reducing SARS-CoV-2 infections, hospitalizations and mortality in inmunocompromised patients. / Efectividad de tixagevimab/cilgavimab en la reducción de la infección, ingresos hospitalarios y mortalidad por SARS-CoV-2 en pacientes inmunodeprimidos.

INTRODUCTION: Inmunocompromised people have higher SARS-CoV-2 morbi-mortality and they are subsidiary to receive pre-exposure prophylaxis. The objective of this study is to evaluate the effectiveness of tixagevimab/cilgavimab (Evusheld) in preventing SARS-CoV-2 infections, hospitalizations and mortality in immunocompromised patients. MATERIALS AND METHODS: 119 immunocompromised people>18 years old eligible of receiving Evusheld were followed for 6 months. People with previous SARS-CoV-2 infection or incomplete vaccination regimen were exluded. A total of 19 people who received Evusheld were matched by propensity score, using a 1:1 ratio, with another 19 people who did not receive Evusheld. Sociodemographic, related to SARS-CoV-2 risk factors and related to immunosuppression variables were included. The dependent variables were infection, hospitalization, and mortality related to SARS-CoV-2. Statistical analyzes were performed using SPSS Statistics 19.0, STATA 11.0, and the R statistical package. RESULTS: In total, 4 people in the Evusheld group and 11 in the control group had SARS-CoV-2 infection, showing an incidence rate of 3.87 and 13.62 per 100 person-months, respectively. The HR (Hazard Ratio) was 0.29 (95% CI=0.09-0.90) for SARS-CoV-2 infection, 0.37 (0.07-1.92) for SARS-CoV-2 hospitalization and, 0.23 (0.03-2.09) for SARS-CoV-2 mortality in the Evusheld group compared to control group. CONCLUSIONS: This study demonstrates that Evusheld reduces the SARS-CoV-2 infections.

HIV-positive women have higher prevalence of comorbidities and anticholinergic burden: assessment of the HIV-positive population from Menorca (Balearic Islands).

Currently, the management of comorbidities and polypharmacy in HIV-infected patients requires a coordinated action, with special focus on gender differences. Observational, cross-sectional study was conducted to study the HIV population from Menorca (Illes Balears). Adult HIV-positive individuals on antiretroviral treatment attending the pharmacy service from Hospital Mateu Orfila (Menorca) were included. In a single visit, demographical and clinical characteristics, comorbidities and cotreatments were collected. Anticholinergic burden (Drug Burden Index, DBI), drug-to-drug interactions (BOT PLUS database) and symptoms associated with HIV treatment (HIV-SI index) were assessed. A total of 223 patients were included, 68.2% men, with a median age of 53.00 (44.50-58.00) years, median BMI of 24.07, 47.73% smokers and 9.90% drug consumers. Women had more advanced stages of the disease and significantly more symptoms (cough and anxiety) versus men (p = .033 and p = .048, respectively). Moreover higher exposures to anticholinergic drugs (DBI 0.51 vs. 0.27) were reported, together with more frequency of drug-to-drug interactions (57.7% vs. 37.5%; p = .005) that increased with age. Red interactions were more frequently reported in PI (2.69%), NNRTIs (1.92%) and booster drugs (1.92%). These results support the need to implement specific measures for the management of HIV-infected women and tools to assess polypharmacy and risk of drug-to-drug interactions.

The role of anti-hypertensive treatment, comorbidities and early introduction of LMWH in the setting of COVID-19: A retrospective, observational study in Northern Italy.

BACKGROUND: There is a great deal of debate about the role of cardiovascular comorbidities and the chronic use of antihypertensive agents (such as ACE-I and ARBs) on mortality on COVID-19 patients. Of note, ACE2 is responsible for the host cell entry of the virus. METHODS: We extracted data on 575 consecutive patients with laboratory-confirmed SARS-CoV-2 infection admitted to the Emergency Department (ED) of Humanitas Center, between February 21 and April 14, 2020. The aim of the study was to evaluate the role of chronic treatment with ACE-I or ARBs and other clinical predictors on in-hospital mortality in a cohort of COVID-19 patients. RESULTS: Multivariate analysis showed that a chronic intake of ACE-I was associated with a trend in reduction of mortality (OR: 0.53; 95% CI: 0.27-1.03; p = 0.06), differently from a chronic intake of ARB (OR: 1.1; 95% CI: 0.5-2.8; p=0.8). Increased age (ORs ranging from 3.4 to 25.2 and to 39.5 for 60-70, 70-80 and >80 years vs <60) and cardiovascular comorbidities (OR: 1.90; 95% CI: 1.1-3.3; p = 0.02) were confirmed as important risk factors for COVID-19 mortality. Timely treatment with low-molecular-weight heparin (LMWH) in ED was found to be protective (OR: 0.36; 95% CI: 0.21-0.62; p < 0.0001). CONCLUSIONS: This study can contribute to understand the reasons behind the high mortality rate of patients in Lombardy, a region which accounts for >50% of total Italian deaths. Based on our findings, we support that daily intake of antihypertensive medications in the setting of COVID-19 should not be discontinued and that a timely LMWH administration in ED has shown to decrease in-hospital mortality.

A Case-Crossover Study to Investigate the Effects of Atmospheric Particulate Matter Concentrations, Season, and Air Temperature on Accident and Emergency Presentations for Cardiovascular Events in Northern Italy.

Atmospheric particulate matter (PM) has multiple adverse effects on human health, high temperatures are also associated with adverse health outcomes, and the frequency of cardiovascular events (CVEs) varies with season. We investigated a hypothesized increase in PM-related accident and emergency (A&E) presentations for CVE with high temperature, warm season, days of high influenza incidence, and in people with a cancer diagnosis, using a time-stratified case-crossover study design. Outcomes were associations of A&E presentation for CVE with atmospheric PM ≤ 10 µm (PM10), season, and air temperature. PM10 levels in the municipality of residence (exposure variable) were estimated by modeling data from local monitoring stations. Conditional logistic regression models estimated odds ratios (OR) with 95% confidence intervals (CI) for presentations in relation to supposed influencers, adjusting for confounders. Study participants were all who presented at the A&E of a large hospital near Milan, Italy, for a CVE (ICD-9: 390-459) from 1st January 2014 to 31st December 2015. There were 1349 A&E presentations for CVE in 2014-2015 and 5390 control days. Risk of A&E presentation was significantly increased on hot days with OR 1.34 (95%CI 1.05-1.71) per 10 µg/m3 PM10 increment (as mean PM10 on day of presentation, and 1 and 2 days before (lags 0-2)), and (for lag 0) in autumn (OR 1.23, 95%CI 1.09-1.37) and winter (OR 1.18, 95%CI 1.01-1.38). Risks were also significantly increased when PM10 was on lag 1, in people with a cancer diagnosis in the spring and summer months (1.88, 95%CI 1.05-3.37), and on days (lags 0-2) of high influenza incidence (OR 2.34, 95%CI 1.01-5.43). PM10 levels exceeded the 50 µg/m3 "safe" threshold recommended by the WHO and Italian legislation for only 3.8% of days during the warm periods of 2014-2015. Greater risk of A&E presentation for CVE in periods of high PM10 and high temperature suggests that "safe" thresholds for PM10 should be temperature-dependent and that the adverse effects of PM10 will increase as temperatures increase due to climate change.

Blood zinc levels and cognitive and functional evaluation in non-demented older patients.

A complete battery of geriatric and psychometric tests was used to determine whether plasma-borne zinc (Zn), a key ion in neuroplasticity, can be associated with the severity of functional, psychological and cognitive impairment in non-demented older individuals. There was a significant positive correlation between plasma Zn levels and the concentration subcategory measured with the Mini-Mental State Examination (MMSE) test (p < 0.001), but not the total MMSE score, and the levels were significantly reduced in polymedicated patients (defined as concurrent administration of >5 drugs). No correlations were found between plasma Zn levels and depressive symptoms measured with the Yesavage scale for geriatric depression or the Barthel Index - a measurement of the ability of individuals to perform the activities of daily living. Depressive symptoms were associated with poor sleep quality and polymedication (p < 0.001 and p < 0.05, respectively). Our results suggest that peripheral Zn concentration may play a role in the physiopathology of some domain of cognitive function. No correlation to depressive symptoms in the geriatric population under antidepressant drug treatment was observed. However, further studies are needed to understand the relationship between circulating Zn and concentration deficits in order to determine whether Zn represents a candidate early biomarker for cognitive impairment.

Sobrecargas e interferencias como factor de riesgo de la enfermedad periodontal / Overloads and interferences as risk factors in periodontal disease

Fundamento: Las periodontopatías figuran entre las afecciones más comunes del género humano, constituyendo el segundo problema de salud bucal a escala mundial. Objetivo: Evaluar la relación existente entre la presencia de sobrecargas e interferencias oclusales, con el agravamiento de la enfermedadperiodontal. Métodos: Estudio descriptivo, analítico, de los pacientes (100) que acudieron al servicio dePeriodoncia de la Clínica de Especialidades de Cienfuegos, durante el período comprendido de enero de2002 a enero de 2007, con diagnóstico de periodontitis e interferencias y sobrecargas oclusales. Se analizaron lasvariables: profundidad de la bolsa, retracción gingival y movilidad dentaria, y se detectaron diferencias entre losgrupos de dientes con y sin presencia de sobrecargas e interferencias oclusales respecto a estas variables.Resultados: Se observaron diferenciasestadísticamente significativas para ambos grupos (dientes con y sin presencia de sobrecargas einterferencias oclusales) al analizar cada una de las variables. Conclusión: Los resultados obtenidos avalanla asociación entre estos factores de riesgo y el agravamiento de la enfermedad periodontal(AU)

Background: Peridontal diseases are among the most common diseases affecting human beings, and are thesecond major buccal health problem worldwide. Objective: To assess the relation between occlusion overloads and interferences and periodontal disease severity. Method: Descriptive, retrospective analytical study of 100 patients who attended to the PeriodontalConsultation in Cienfuegos Dental Clinic between January, 2002 and January, 2007, with diagnosis of periodontitis and occlusal overload and interferences.The variables were: periodontal pocket, gingival retraction, dental mobility, and differences between teeth groups with and without occlusal overload andinterferences were determined, according to these variables. Results: There were significant differencesbetween both groups (with and without overloads and interferences) regarding each variable. Conclusions: Our results show the relation between these two factors and periodontal disease(AU)

Higiene bucal y tabaquismo como factores de riesgo de enfermedad periodontal / Oral hygiene and smoking habit as risk factors of periodontal disease

Fundamento: Las periodontopatías representan una de las afecciones más comunes del género humano, se observan más frecuentemente después de los 35 años. El tabaquismo constituye unos de los factores de riesgomás asociado con el desarrollo de la enfermedad periodontal. Objetivo: Caracterizar la relación entre el estado periodontal y la higiene bucal en pacientes fumadores. Método: Estudio descriptivo, epidemiológico y transversal, en adultos fumadores (95) del municipio Palmira durante el período enero a noviembre de 2007. Se aplicó el índice de tratamiento periodontal en lacomunidad y el índice de higiene bucal simplificado. Resultados: Se obtuvo una alta prevalencia de la enfermedad periodontal (85,2 por ciento); a medida que fue mayor la intensidad del tabaquismo, se observó mayor deterioro del hábito de higiene bucal. Conclusiones: El estudio muestra una relación importante entre la condición periodontal de los pacientes fumadores, el grado de higiene bucal e intensidad del tabaquismo(AU)

Background: Periodontal diseases are among the most common diseases affecting human beings, and these aremore frequent after the age of 35. Smoking habit is one of the risk factors usually linked with the development ofthese diseases. Objective: To characterize the relation between periodontal condition and buccal hygiene in patients with smoking habit. Method: Descriptive, cross -sectional, epidemiological study including 95 smokers from Palmira municipality; January-November, 2007. Peridontal treatment index was used in the community, as well as the simplified buccal hygiene index. Results: There was high prevalence of periodontal disease (85,2 percent); buccal hygiene was directly related with smokinghabit. Conclusions: The study shows an important relation between the periodontal disease in smokers, buccal hygiene and smoking habit intensity(AU)

Vertical scar mastopexy with an implant.

We describe a technique for the correction of ptotic and hypoplastic breasts that combines the vertical scar technique with the insertion of a subpectoral saline implant. This operation consists of a vertical elliptical skin incision through which we make a subpectoral pocket, insert a smooth surface implant, sit the patient up, and mark a new nipple placement. We then remove a wedge of breast tissue above the areola to position it at the marked spot. This simple technique has few complications and a high level of patient satisfaction.

Consumo de alimentos en toxicómanos de las Islas Baleares sometidos a tratamiento de rehabilitación mediante metadona / Food consumption patterns among drug abusers involved in a methadone treatment program in the Balearic Islands

Fundamentos: Este trabajo tuvo como objetivo evaluar el consumo de alimentos en una muestra de drogadictos de Islas Baleares sometidos a tratamiento de rehabilitación por metadona y analizar su posible desviación respecto a las Recomendaciones. Métodos: Para conocer el consumo de alimentos se utilizó un cuestionario semicuantitativo de frecuencia de consumo que incluía 145 ítems alimentarios y grupos de alimentos y que recogía también la ración consumida de cada alimento. En el estudio participaron drogadictos adscritos al programa de metadona (n=32: 17 varones y 15 mujeres, 20-48 años; tras depuración de los datos, la muestra final fue 27, 16 varones y 11 mujeres). El protocolo de estudio incluía también la medición de peso, altura, índice de masa corporal (IMC), tiempo de consumo de drogas, tiempo de tratamiento con metadona y con quien convivía el sujeto. Los resultados se compararon con los datos de la población aparentemente sana de las Islas Baleares (Estudio ENIB, 1999-2000). Resultados: El IMC medio se inscribe dentro del normo-peso, pero se encuentra muy cercano a su límite inferior. El consumo de cereales, carne, pescado, legumbres, fruta, frutos secos, verduras-hortalizas y patatas fue menos frecuente y los productos lácteos, azucarados, grasas de adición y las bebidas alcohólicas y no alcohólicas más frecuente en los toxicómanos que en la población general de las Islas Baleares. Las mujeres han consumido más azúcares y dulces y que los varones han registrado un mayor consumo de bebidas alcohólicas. Conclusiones: Los toxicómanos sometidos a un programa de deshabituación por metadona presentan déficits vitamínicos y minerales, en especial para zinc, yodo y las vitaminas D y E y, además, el ácido fólico y la vitamina A en las mujeres. Se recomienda moderar el consumo de productos azucarados y de bebidas alcohólicas e incrementar el consumo de verduras, frutas y pescado en esta población (AU)