Syndemic factors associated with adult sexual HIV risk behaviors in a sample of Latino men who have sex with men in New York City

Objective: Syndemic theory has been proposed as a framework for understanding the role of multiple riskfactors driving the HIV epidemic among sexual and gender minority individuals. As yet, the frameworkhas been relatively absent in research on Latinos/as.Methods: We used logistic regression to assess relationships among cumulative syndemic conditions –including clinically significant depression, high-risk alcohol consumption, discrimination, and childhoodsexual abuse – engagement with multiple partners and condomless anal intercourse (CAI) in a sample of176 Latino men who have sex with men (MSM) in New York City.Results: In bivariate analyses, an increase in the number of syndemic factors experienced was associatedwith an increased likelihood of reporting multiple partners and CAI. In multivariable analyses, participantswith 2, 3, and 4 factors were significantly more likely to report multiple partners than those with 0(aOR = 4.66, 95% CI [1.29, 16.85); aOR = 7.28, 95% CI [1.94, 27.28] and aOR = 8.25, 95% CI [1.74, 39.24]respectively; p \u3c 0.05. Regarding CAI, only participants with 3 and 4 factors differed from those with 0aOR = 7.35, 95% CI [1.64, 32.83] and OR = 8.06, 95% CI [1.39, 46.73] respectively.Conclusions: Comprehensive approaches that address syndemic factors, and capitalize on resiliency, areneeded to address the sexual health needs of Latino MSM

Syndemic factors associated with adult sexual HIV risk behaviors in a sample of Latino men who have sex with men in New York City

Objective: Syndemic theory has been proposed as a framework for understanding the role of multiple riskfactors driving the HIV epidemic among sexual and gender minority individuals. As yet, the frameworkhas been relatively absent in research on Latinos/as.Methods: We used logistic regression to assess relationships among cumulative syndemic conditions –including clinically significant depression, high-risk alcohol consumption, discrimination, and childhoodsexual abuse – engagement with multiple partners and condomless anal intercourse (CAI) in a sample of176 Latino men who have sex with men (MSM) in New York City.Results: In bivariate analyses, an increase in the number of syndemic factors experienced was associatedwith an increased likelihood of reporting multiple partners and CAI. In multivariable analyses, participantswith 2, 3, and 4 factors were significantly more likely to report multiple partners than those with 0(aOR = 4.66, 95% CI [1.29, 16.85); aOR = 7.28, 95% CI [1.94, 27.28] and aOR = 8.25, 95% CI [1.74, 39.24]respectively; p \u3c 0.05. Regarding CAI, only participants with 3 and 4 factors differed from those with 0aOR = 7.35, 95% CI [1.64, 32.83] and OR = 8.06, 95% CI [1.39, 46.73] respectively.Conclusions: Comprehensive approaches that address syndemic factors, and capitalize on resiliency, areneeded to address the sexual health needs of Latino MSM

Combination of Tocilizumab and Steroids to Improve Mortality in Patients with Severe COVID-19 Infection : A Spanish, Multicenter, Cohort Study

We aimed to determine the impact of tocilizumab use on severe COVID-19 (coronavirus disease 19) pneumonia mortality. We performed a multicentre retrospective cohort study in 18 tertiary hospitals in Spain from March to April 2020. Consecutive patients admitted with severe COVID-19 treated with tocilizumab were compared to patients not treated with tocilizumab, adjusting by inverse probability of the treatment weights (IPTW). Tocilizumab's effect in patients receiving steroids during the 48 h following inclusion was analysed. During the study period, 506 patients with severe COVID-19 fulfilled the inclusion criteria. Among them, 268 were treated with tocilizumab and 238 patients were not. Median time to tocilizumab treatment from onset of symptoms was 11 days [interquartile range (IQR) 8-14]. Global mortality was 23.7%. Mortality was lower in patients treated with tocilizumab than in controls: 16.8% versus 31.5%, hazard ratio (HR) 0.514 [95% confidence interval (95% CI) 0.355-0.744], p < 0.001; weighted HR 0.741 (95% CI 0.619-0.887), p = 0.001. Tocilizumab treatment reduced mortality by 14.7% relative to no tocilizumab treatment [relative risk reduction (RRR) 46.7%]. We calculated a number necessary to treat of 7. Among patients treated with steroids, mortality was lower in those treated with tocilizumab than in those treated with steroids alone [10.9% versus 40.2%, HR 0.511 (95% CI 0.352-0.741), p = 0.036; weighted HR 0.6 (95% CI 0.449-0.804), p < 0.001] (interaction p = 0.094). These results show that survival of patients with severe COVID-19 is higher in those treated with tocilizumab than in those not treated and that tocilizumab's effect adds to that of steroids administered to non-intubated patients with COVID-19 during the first 48 h of presenting with respiratory failure despite oxygen therapy. Randomised controlled studies are needed to confirm these results. European Union electronic Register of Post-Authorization Studies (EU PAS Register) identifier, EUPAS34415 The online version of this article (10.1007/s40121-020-00373-8) contains supplementary material, which is available to authorized users

Acute flaccid myelitis:cause, diagnosis, and management

Acute flaccid myelitis (AFM) is a disabling, polio-like illness mainly affecting children. Outbreaks of MM have occurred across multiple global regions since 2012, and the disease appears to be caused by non-polio enterovirus infection, posing a major public health challenge. The clinical presentation of flaccid and often profound muscle weakness (which can invoke respiratory failure and other critical complications) can mimic several other acute neurological illnesses. There is no single sensitive and specific test for MM, and the diagnosis relies on identification of several important clinical, neuroimaging, and cerebrospinal fluid characteristics. Following the acute phase of AFM, patients typically have substantial residual disability and unique long-term rehabilitation needs. In this Review we describe the epidemiology, clinical features, course, and outcomes of AFM to help to guide diagnosis, management, and rehabilitation. Future research directions include further studies evaluating host and pathogen factors, including investigations into genetic, viral, and immunological features of affected patients, host-virus interactions, and investigations of targeted therapeutic approaches to improve the long-term outcomes in this population

Genetic landscape of 6089 inherited retinal dystrophies affected cases in Spain and their therapeutic and extended epidemiological implications

Inherited retinal diseases (IRDs), defined by dysfunction or progressive loss of photoreceptors, are disorders characterized by elevated heterogeneity, both at the clinical and genetic levels. Our main goal was to address the genetic landscape of IRD in the largest cohort of Spanish patients reported to date. A retrospective hospital-based cross-sectional study was carried out on 6089 IRD affected individuals (from 4403 unrelated families), referred for genetic testing from all the Spanish autonomous communities. Clinical, demographic and familiar data were collected from each patient, including family pedigree, age of appearance of visual symptoms, presence of any systemic findings and geographical origin. Genetic studies were performed to the 3951 families with available DNA using different molecular techniques. Overall, 53.2% (2100/3951) of the studied families were genetically characterized, and 1549 different likely causative variants in 142 genes were identified. The most common phenotype encountered is retinitis pigmentosa (RP) (55.6% of families, 2447/4403). The most recurrently mutated genes were PRPH2, ABCA4 and RS1 in autosomal dominant (AD), autosomal recessive (AR) and X-linked (XL) NON-RP cases, respectively; RHO, USH2A and RPGR in AD, AR and XL for non-syndromic RP; and USH2A and MYO7A in syndromic IRD. Pathogenic variants c.3386G > T (p.Arg1129Leu) in ABCA4 and c.2276G > T (p.Cys759Phe) in USH2A were the most frequent variants identified. Our study provides the general landscape for IRD in Spain, reporting the largest cohort ever presented. Our results have important implications for genetic diagnosis, counselling and new therapeutic strategies to both the Spanish population and other related populations.This work was supported by the Instituto de Salud Carlos III (ISCIII) of the Spanish Ministry of Health (FIS; PI16/00425 and PI19/00321), Centro de Investigación Biomédica en Red Enfermedades Raras (CIBERER, 06/07/0036), IIS-FJD BioBank (PT13/0010/0012), Comunidad de Madrid (CAM, RAREGenomics Project, B2017/BMD-3721), European Regional Development Fund (FEDER), the Organización Nacional de Ciegos Españoles (ONCE), Fundación Ramón Areces, Fundación Conchita Rábago and the University Chair UAM-IIS-FJD of Genomic Medicine. Irene Perea-Romero is supported by a PhD fellowship from the predoctoral Program from ISCIII (FI17/00192). Ionut F. Iancu is supported by a grant from the Comunidad de Madrid (CAM, PEJ-2017-AI/BMD7256). Marta del Pozo-Valero is supported by a PhD grant from the Fundación Conchita Rábago. Berta Almoguera is supported by a Juan Rodes program from ISCIII (JR17/00020). Pablo Minguez is supported by a Miguel Servet program from ISCIII (CP16/00116). Marta Corton is supported by a Miguel Servet program from ISCIII (CPII17/00006). The funders played no role in study design, data collection, data analysis, manuscript preparation and/or publication decisions

Could dietary nitrate affect dementia development?

The authors reported no funding received for this study.Manuscript (Preprint

Efecto de la pérdida prematura de molares primarios sobre la relación horizontal incisiva

La pérdida prematura de molares primarios predispone a maloclusiones incluyendo apiñamiento, impactación de dientes permanentes y alteración de la relación molar y canina. El objetivo del presente estudio es determinar el efecto de las pérdidas prematuras de molares primarios sobre la relación incisiva horizontal. El estudio es documental, retrospectivo y observacional. Se evaluaron los registros ortodóncicos (historias clínicas, fotografías y radiografías) de 209 pacientes con edades entre 4 a 15 años. La relación incisiva horizontal se consideró normal (grupo 1) cuando hubo contacto entre en borde incisal del incisivo inferior con la cara palatina del superior, aumentada (grupo 2) cuando había distancia positiva entre ellos y negativa (grupo 3) cuando los bordes incisales se encontraban a tope o en mordida cruzada. Los datos se analizaron utilizando coeficiente Pearson (p≤0,001). El 22% (45 pacientes) presentó pérdidas prematuras. La prevalencia de pérdidas prematuras no tuvo diferencia significativa entre géneros y fue mayor en el grupo de 7 a 9 años. De los pacientes con pérdidas prematuras, 6 (13,3%) se clasificó en el grupo 1; 12 (26,7%) en el grupo 2 y 27 (60%) en el grupo 3. Hubo asociación positiva entre el número de molares perdidos y la presencia de mordida cruzada anterior, siendo la media de molares perdidos mayor (4, 7) en el grupo 3. Se demostró que las pérdidas prematuras de molares primarios tienen una relación estadísticamente significativa con la mordida cruzada anterior, siendo posible que la falta de soporte oclusal posterior favorezca el desplazamiento protrusivo de la mandíbula

Efeito da perda prematura de molares decíduos na sobressaliência

A perda precoce de molares decíduos predispõe as maloclusões, entre estas o apinhamento dentário, impactação de dentes permanentes e alteração da relação molar e canino. O objetivo do estudo foi determinar o efeito das perdas precoces dos molares decíduos na relação horizontal incisiva. O estudo é do tipo documentado, retrospetivo e observacional. Foram avaliados os registros ortodônticos (histórias clínicas, fotografias e radiografias) de 209 pacientes na faixa etária de 4 a 15 anos de idade. A relação incisiva horizontal foi considerada normal para os pacientes do GRUPO 1, com contato entre a face incisal dos incisivos inferiores e a face palatina dos incisivos superiores. No GRUPO 2, a relação incisiva horizontal foi considerada aumentada, com distância positiva entre eles e no GRUPO 3, a relação incisiva horizontal foi considerada negativa quando as faces incisais dos incisivos superiores e inferiores se encontravam a topo ou em mordida cruzada. Os dados foram analisados através do coeficiente Pearson (p ≤ 0,001). Na análise dos dados coletados, o total de quarenta e cinco pacientes (22%) apresentaram perdas prematuras. A prevalência destas perdas não apresentou diferença significativa entre sexos e foi maior no grupo de faixa etária de 7 a 9 anos de idade. Dos pacientes com perda prematura seis (13,3%) foram clasificados no GRUPO 1; doze (26,7%) no GRUPO 2 e vinte e sete (60%) no GRUPO 3. A relação entre o número de molares perdidos e a presença de mordida cruzada anterior foi encontrada, e a média de molares perdidos (4,7) foi maior no GRUPO 3. Os resultados mostraram que as perdas precoces dos molares decíduos apresentam uma relação estatisticamente significante com a mordida cruzada anterior, sugerindo que a falta de suporte oclusal pode favorecer o desenvolvimento protrusivo da mandibula

Effect of copper and cyanide on some immunological parameters and stress in rainbow trout (Oncorhynchus mykiss)

The effect of sublethal concentrations of two common chemicals, copper and cyanide, frequently associated with environmental pollution of freshwater systems, on the immune response of juvenile rainbow trout (Oncorhynchus mykiss) was studied. Total immunoglobulin (IgM) and mitogenic response of lymphocytes from the pronephros to Concavalin A (ConA), phytohaemaglutinin (PHA) and lipopolysacharide (LPS) were measured at 1, 3, 8 h and 1, 3, 7, 14 and 21 days of exposure. After 21 days, fish were challenged with Saprolegnia parasitica and the same immunological parameters were analysed 3 h and 7, 14 and 21 days after challenge. No changes in the immune parameters were observed, except an increase in the Ig levels in fish exposed to copper, although both toxic chemicals and the challenge with Saprolegnia induced a significant increase in the cortisol levels. Saprolegniosis was not found in fish exposed to copper or cyanide while a low percentage of infected fish was observed in the control group. The apparent lack of correlation between stress and immune response during copper and cyanide exposure may suggest a direct effect of these toxicants instead of a stress mediated mechanism. © 1992 Academic Press Ltd