Higher COVID-19 pneumonia risk associated with anti-IFN-α than with anti-IFN-ω auto-Abs in children

We found that 19 (10.4%) of 183 unvaccinated children hospitalized for COVID-19 pneumonia had autoantibodies (auto-Abs) neutralizing type I IFNs (IFN-alpha 2 in 10 patients: IFN-alpha 2 only in three, IFN-alpha 2 plus IFN-omega in five, and IFN-alpha 2, IFN-omega plus IFN-beta in two; IFN-omega only in nine patients). Seven children (3.8%) had Abs neutralizing at least 10 ng/ml of one IFN, whereas the other 12 (6.6%) had Abs neutralizing only 100 pg/ml. The auto-Abs neutralized both unglycosylated and glycosylated IFNs. We also detected auto-Abs neutralizing 100 pg/ml IFN-alpha 2 in 4 of 2,267 uninfected children (0.2%) and auto-Abs neutralizing IFN-omega in 45 children (2%). The odds ratios (ORs) for life-threatening COVID-19 pneumonia were, therefore, higher for auto-Abs neutralizing IFN-alpha 2 only (OR [95% CI] = 67.6 [5.7-9,196.6]) than for auto-Abs neutralizing IFN-. only (OR [95% CI] = 2.6 [1.2-5.3]). ORs were also higher for auto-Abs neutralizing high concentrations (OR [95% CI] = 12.9 [4.6-35.9]) than for those neutralizing low concentrations (OR [95% CI] = 5.5 [3.1-9.6]) of IFN-omega and/or IFN-alpha 2

The impact of chronic wounds treatment with moist wounds’ healing in the Galician sanitary expenditure

RESUMEN: Introducción: Las heridas crónicas son una patología con gran repercusión en la vida del paciente y con un peso importante dentro del ámbito sanitario. Por ello, también suponen una carga para el paciente y un coste importante para el sistema sanitario, sobre todo porque son en cierta medida evitables. Los apósitos de cura en ambiente húmedo (ACH) son productos ampliamente utilizados tanto en la prevención como en el tratamiento de lesiones relacionadas con la dependencia, heridas crónicas e incluso heridas agudas. Debido a que los recursos económicos son limitados se requiere una buena gestión en la adquisición de ACH siempre con la finalidad de obtener el mejor producto para el paciente. Objetivos: Principal: Determinar el gasto sanitario destinado a la compra de material relacionado con cura en ambiente húmedo en los años 2017 a 2020 inclusive, en la Sanidad Pública de Galicia. Secundarios: • Identificar el gasto en cada nivel de atención sanitaria (Atención Especializada. Atención Primaria y Residencias Sociosanitarias). • Determinar el número de intervenciones de enfermería con CAH en base al consumo de apósitos secundarios Metodología: Estudio observacional descriptivo. Los datos se han extraído de dos programas informáticos: el Sistema de Análisis Complejo de Información del SERGAS (SIAC) y el Programa de Gestión y Catalogación de productos sanitarios (LOGAS). Se ha realizado el análisis estadístico con EPIDAT 17. Resultados: El gasto en ACH en Galicia en el periodo de estudio fue de 19.247.656,48 euros. con un leve incremento anual, sin superar el presupuesto destinado a la compra de estos productos. Sin embargo el reparto entre los niveles asistenciales ha sido desigual, destacando Atención Primaria que acapara más de la mitad del gasto. En cuanto a las intervenciones de enfermería han ido aumentado a lo largo de los años en las áreas sanitarias con mayor envejecimiento poblacional. Conclusiones: El gasto en ACH en Galicia no ha sobrepasado el presupuesto inicial del expediente de contratación. Atención Primaria acapara gran parte del consumo de ACH lo que, sumado al gran número de intervenciones de enfermería, sugiere que, además del aspecto económico, es preciso tener en cuenta múltiples factores en el tratamiento y cuidado de las heridas crónicas, primando el enfoque preventivo y la compra de productos que minimicen el número de cambios de apósitos.ABSTRACT: Introduction. Chronic wounds are a pathology with a great impact on the patient's life and with an enormous weight within the health field. For this reason, they also represent a burden for the patient and a significant cost for the health system, mainly because they are, to a certain extent, avoidable. Moist Healing (MAC) dressings are widely used products in both prevention and treatment of dependency-related injuries, chronic wounds and even acute wounds. Due to the limited economic resources, it is necessary a good management in the acquisition of ACH, always with the aim of obtaining the best product for the patient. Objectives: Main objetive: To determine the health expenditure destined to the purchase of material related to curing in a humid environment between 2017 and 2020, in the Public Health of Galicia. Secondary objectives: • To identify the amount of spending at each level of health care (Specialized Care, Primary Care and Nursing Homes.). • To determine the number of nursing interventions with CAH based on the consumption of secondary dressings Methodology: Descriptive observational study. The data has been extracted from two computer programs: the SERGAS Complex Information Analysis System (SIAC) and the Health Products Management and Cataloging Program (LOGAS). Statistical analysis has been performed with EPIDAT 17 Results: The expenditure on ACH in Galicia during the study period was about 19,247,656.48 euros. with a slight annual increase, without exceeding the budget allocated to the purchase of these products. However, the distribution between care levels has been unequal, highlighting Primary Care, which accounts for more than half of the expenditure. Related to nursing interventions, they have been increasing over the years in the health areas with the highest population aging Conclusions. Expenditure on ACH in Galicia has not exceeded the initial budget of the contracting file. Primary Care accounts for a large part of the consumption of ACH, which, added to the large number of nursing interventions, suggests that, in addition to the economic aspect, multiple factors must be taken into account in the treatment and care of chronic wounds, prioritizing the preventive approach and the purchase of products that minimize the number of dressing changes.Máster en Gestión Integral e Investigación de las Heridas Crónica