Influence of socio-affective factors on quality of life in woman diagnosed with fibromyalgia

Introduction: Fibromyalgia is a disease that involves chronic pain, with high prevalence in the female population and great impact on the bio-psycho-social sphere of people affected by it. However, few studies have analyzed the possible influence of socio-affective factors on the quality of life of people who suffer from this disease. Objective: The aim of this study was to determine the relationships between the impact of this disease on the lives of people with fibromyalgia and these variables. Specifically, we analyzed the quality of partner relationship, perceived loneliness, life satisfaction, and perceived socio-family situation. Method: A descriptive-correlational cross-sectional design was used. The sample consisted of 69 women diagnosed with fibromyalgia. The participants completed different questionnaires that measured their happiness, satisfaction with life, perceived loneliness, quality of partner relationship, socio-family valuation, and the impact of fibromyalgia. Results: The quality of partner relationship, perceived loneliness and socio-family valuation seem to be good predictors of subjective happiness, life satisfaction, and the impact that fibromyalgia has on people’s lives, in the sense that the more positive the valuation of the couple relationship and of the socio-family situation, and the lower the perceived loneliness, people feel happier, more satisfied with their lives and the lower the impact that fibromyalgia has on their lives. Conclusion: The 50% of satisfaction with life can be explained from the scores obtained in perceived loneliness and the quality of partner relationship. In this sense, perceived loneliness was a good predictor of the impact of fibromyalgia on the lives of these patients

Brote de eritema infeccioso en un centro de salud urbano

ObjetivosAnalizar las características clínicas y serológicas de un brote de eritema infeccioso en pacientes que acudieron a las 2 consultas de pediatría del Centro de Salud de Soria Norte.DiseñoEstudio descriptivo, transversal.EmplazamientoConsultas de pediatría del Centro de Salud de Soria Norte.PacientesUna vez sospechado el brote, se estudiaron niños con clínica sugestiva de eritema infeccioso que acudieron sucesivamente a las 2 consultas de pediatría de Soria Norte durante los meses de abril a agosto de 1998 y consintieron en la práctica de analítica.IntervencionesSe realizó registro de síntomas clínicos, serología, hemograma y evolución de 25 pacientes.ResultadosSe estudiaron 25 pacientes del total de casos, confirmando nuestra sospecha diagnóstica en un 84% de los casos. No se observaron diferencias en ambos sexos, con una edad media de 6,1 años, y DE, 2,015. El signo clínico más constante fue el exantema en mejillas, presente en un 100% de los casos confirmados, seguido de exantema en tronco y extremidades en un 57,1%, adenopatías en un 9,5% y fiebre en un 4,7%. En ningún caso se objetivaron complicaciones.ConclusionesLos resultados de este trabajo permiten confirmar la existencia de un brote de eritema infeccioso en nuestro medio. Consideramos útil la confirmación serológica para constatar la presencia de un brote y poder realizar un enfoque terapéutico (frente a complicaciones posibles) y preventivo adecuado. Destacamos el carácter, en general, benigno de la enfermedad.ObjectivesTo analyse the clinical and serological characteristics of an outbreak of infectious erythema in patients attending the two paediatrics clinics at the Soria Norte Health Centre.DesignCross-sectional, descriptive study.SettingPaediatrics clinics of the Soria Norte Health Centre.PatientsOnce the outbreak was suspected, the study was conducted on children with a clinical picture suggesting infectious erythema who attended successively two Soria Norte paediatrics clinics between April and August 1998 and who consented to the analyses.InterventionsThe clinical symptoms, serology, haemogram and evolution of 25 patients were recorded.Results25 patients of the total were studied and diagnostic suspicion was confirmed in 84% of the cases. There were no differences between sexes, with an average age of 6.1, SD 2.015. The most constant clinical sign was exanthem on the cheeks, present in 100% of the cases confirmed, followed by 57% exanthem on the trunk and limbs, 9.5% adenopathies and 4.7% temperature. No complications were found in any case.ConclusionsThe results of this study confirm the existence of an outbreak of infectious erythema in our area. Serological confirmation of an outbreak is useful and can lay the basis for a proper therapeutic and preventive focus (against possible complications). We highlight the generally benign nature of the disease

Papel de la emergencia en la gestión del problema social del anciano

Introduction: Currently, in our society there is an increase in the percentage of the population over 65 years of age. Zamora is in second place in Spain with regard to this data. The number of calls made to the 112 centre in Castilla y León, with a final diagnosis of a social problem, is increasing according to the register since 2016. Although it is not an urgent medical pathology, it generates the mobilization of emergency health resources and the situation is increasing in the same way; taking into account that resources are limited, can there be an imbalance between the demand and the services offered? Is the EMU the final solution in the global management of the social problem? To analyse, in Zamora, that the increase of this population, entails an increase of final diagnoses: social problem; 2. To demonstrate that the use of the resources that currently exist for the global management of the problem is not sufficient, generates an overload of the Emergency Services and affects the sustainability of the Spanish Health System; 3. Methods: Descriptive observational study of the population over 65 years of age in Zamora who made calls to 112 in Castile and Leon and whose diagnosis was considered a social problem from January 2106 to September 2019. Results: Increase of 52 incidents with “social problem”.The frequency is higher in men than in women. More than half of the 60 EMU interventions were discharged on site. Conclusions The over-demand of emergency services may lead to the dilemma “The tragedy of the commons”, described by Garrett Hardin in 1968. Therefore, good orientation, education and training in social and health care, and the development of a plan with resources such as a multidisciplinary referral service: “Social Unit”, would increase the efficiency of care for the elderly with social problems.Introducción. - Actualmente, en nuestra sociedad hay un aumento del porcentaje de la población mayor de 65 años. Zamora se sitúa en segundo puesto de España referente a este dato. El número de llamadas realizadas al centro 112 de Castilla y León, con diagnóstico final problema social, va aumentando según el registro desde 2016. A pesar de no ser una patología médica urgente, genera movilización de recursos sanitarios de urgencia y la situación va in crescendo de la misma forma; teniendo en cuenta que los recursos son limitados, ¿puede producirse un desequilibrio entre la demanda y los servicios ofertados? ¿En la gestión global del problema social es la UME la solución final? Objetivos. - 1. Analizar, en Zamora, que el incremento de esta población, conlleva el aumento de diagnósticos finales: problema social; 2. Demostrar que la utilización de los recursos que existen en la actualidad para la gestión global del problema no es suficiente, genera sobrecarga de los Servicios de Urgencia y afecta a la sostenibilidad del Sistema Sanitario español; 3. Proponer soluciones alternativas. Método. - Estudio descriptivo observacional de la población mayor de 65 años de Zamora que realizó llamadas al 112 de Castilla y León cuyo diagnóstico fue considerado: problema social, desde enero de 2106 a septiembre de 2019. Resultados. - aumento de 52 incidentes con “problema social”. La frecuencia es mayor en hombres que en mujeres. De las 60 intervenciones de la UME, más de la mitad fueron dados de alta in situ. Conclusiones La sobredemanda de servicios de Urgencias y Emergencias, puede desembocar en el dilema “La tragedia de los comunes”, descrito por Garrett Hardin en 1968. Por tanto, una buena orientación, educación y formación sociosanitaria, y la elaboración de un Plan con recursos tipo servicio multidisciplinar de derivación: “Unidad Social”, aumentaría la eficiencia de la atención al anciano con problema social

Antibody response in patients admitted to the hospital with suspected SARS-CoV-2 infection: results from a multicenter study across Spain

Aim: To evaluate the serological response against SARS-CoV-2 in a multicenter study representative of the Spanish COVID pandemic. Methods: IgG and IgM + IgA responses were measured on 1466 samples from 1236 Spanish COVID-19 patients admitted to the hospital, two commercial ELISA kits (Vircell SL, Spain) based on the detection of antibodies against the viral spike protein and nucleoprotein, were used. Results: Approximately half of the patients presented antibodies (56.8% were IgM + IgA positive and 43.0% were IgG positive) as soon as 2 days after the first positive PCR result. Serological test positivity increased with time from the PCR test, and 10 days after the first PCR result, 91.5% and 88.0% of the patients presented IgM + IgA and IgG antibodies, respectively. Conclusion: The high values of sensitivity attained in the present study from a relatively early period of time after hospitalization support the use of the evaluated serological assays as supplementary diagnostic tests for the clinical management of COVID-19

Prognostic factors of a lower CD4/CD8 ratio in long term viral suppression HIV infected children

Background Combination antiretroviral therapy (cART) is associated with marked immune reconstitution. Although a long term viral suppression is achievable, not all children however, attain complete immunological recovery due to persistent immune activation. We use CD4/CD8 ratio like a marker of immune reconstitution. Methods Perinatal HIV-infected children who underwent a first-line cART, achieved viral suppression in the first year and maintained it for more than 5 years, with no viral rebound were included. Logistic models were applied to estimate the prognostic factors, clinical characteristics at cART start, of a lower CD4/CD8 ratio at the last visit. Results 146 HIV-infected children were included: 77% Caucasian, 45% male and 28% CDC C. Median age at cART initiation was 2.3 years (IQR: 0.5-6.2). 42 (30%) children received mono-dual therapy previously to cART. Time of undetectable viral load was 9.5 years (IQR: 7.8, 12.5). 33% of the children not achieved CD4/CD8 ratio >1. Univariate analysis showed an association between CD4/CD8 <1 with lower CD4 nadir and baseline CD4; older age at diagnosis and at cART initiation; and a previous exposure to mono-dual therapy. Multivariate analysis also revealed relationship between CD4/CD8 <1 and lower CD4 nadir (OR: 1.002, CI 95% 1.000-1.004) as well as previous exposure to mono-dual therapy (OR: 0.16, CI 95% 0.003-0.720). Conclusions CD4/CD8 > 1 was not achieved in 33% of the children. Lower CD4 nadir and previous exposure to suboptimal therapy, before initiating cART, are factors showing independently association with a worse immune recovery (CD4/CD8 < 1)

Water Vapor Vertical Profiles on Mars in Dust Storms Observed by TGO/NOMAD

It has been suggested that dust storms efficiently transport water vapor from the near‐surface to the middle atmosphere on Mars. Knowledge of the water vapor vertical profile during dust storms is important to understand water escape. During Martian Year 34, two dust storms occurred on Mars: a global dust storm (June to mid‐September 2018) and a regional storm (January 2019). Here we present water vapor vertical profiles in the periods of the two dust storms (Ls = 162–260° and Ls = 298–345°) from the solar occultation measurements by Nadir and Occultation for Mars Discovery (NOMAD) onboard ExoMars Trace Gas Orbiter (TGO). We show a significant increase of water vapor abundance in the middle atmosphere (40–100 km) during the global dust storm. The water enhancement rapidly occurs following the onset of the storm (Ls~190°) and has a peak at the most active period (Ls~200°). Water vapor reaches very high altitudes (up to 100 km) with a volume mixing ratio of ~50 ppm. The water vapor abundance in the middle atmosphere shows high values consistently at 60°S‐60°N at the growth phase of the dust storm (Ls = 195°–220°), and peaks at latitudes greater than 60°S at the decay phase (Ls = 220°–260°). This is explained by the seasonal change of meridional circulation: from equinoctial Hadley circulation (two cells) to the solstitial one (a single pole‐to‐pole cell). We also find a conspicuous increase of water vapor density in the middle atmosphere at the period of the regional dust storm (Ls = 322–327°), in particular at latitudes greater than 60°S

SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome

The aim was to assess the ability of nasopharyngeal SARS-CoV-2 viral load at first patient’s hospital evaluation to predict unfavorable outcomes. We conducted a prospective cohort study including 321 adult patients with confirmed COVID-19 through RT-PCR in nasopharyngeal swabs. Quantitative Synthetic SARS-CoV-2 RNA cycle threshold values were used to calculate the viral load in log10 copies/mL. Disease severity at the end of follow up was categorized into mild, moderate, and severe. Primary endpoint was a composite of intensive care unit (ICU) admission and/or death (n = 85, 26.4%). Univariable and multivariable logistic regression analyses were performed. Nasopharyngeal SARS-CoV-2 viral load over the second quartile (≥ 7.35 log10 copies/mL, p = 0.003) and second tertile (≥ 8.27 log10 copies/mL, p = 0.01) were associated to unfavorable outcome in the unadjusted logistic regression analysis. However, in the final multivariable analysis, viral load was not independently associated with an unfavorable outcome. Five predictors were independently associated with increased odds of ICU admission and/or death: age ≥ 70 years, SpO2, neutrophils > 7.5 × 103/µL, lactate dehydrogenase ≥ 300 U/L, and C-reactive protein ≥ 100 mg/L. In summary, nasopharyngeal SARS-CoV-2 viral load on admission is generally high in patients with COVID-19, regardless of illness severity, but it cannot be used as an independent predictor of unfavorable clinical outcome

Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity components. Dendritic cells (DCs) play a key role in the defense against viral infections, for instance plasmacytoid DCs (pDCs), have the capacity to produce vast amounts of interferon-alpha (IFN-α). In COVID-19 there is a deficit in DC numbers and IFN-α production, which has been associated with disease severity. In this work, we described that in addition to the DC deficiency, several DC activation and homing markers were altered in acute COVID-19 patients, which were associated with multiple inflammatory markers. Remarkably, previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+ myeloid DCs and pDCs seven months after SARS-CoV-2 infection. Moreover, the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients, while no restoration of integrin β7 and indoleamine 2,3-dyoxigenase (IDO) levels were observed. These findings contribute to a better understanding of the immunological sequelae of COVID-19

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020.

Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3–5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes. © 2021, The Author(s), under exclusive licence to Springer Nature Limited