Obstetric Outcomes in Women with Rheumatic Disease and COVID-19 in the Context of Vaccination Status

OBJECTIVE: To describe obstetric outcomes based on COVID-19 vaccination status, in women with rheumatic and musculoskeletal diseases (RMDs) who developed COVID-19 during pregnancy. METHODS: Data regarding pregnant women entered into the COVID-19 Global Rheumatology Alliance registry from 24 March 2020-25 February 2022 were analysed. Obstetric outcomes were stratified by number of COVID-19 vaccine doses received prior to COVID-19 infection in pregnancy. Descriptive differences between groups were tested using the chi -square or Fisher's exact test. RESULTS: There were 73 pregnancies in 73 women with RMD and COVID-19. Overall, 24.7% (18) of pregnancies were ongoing, while of the 55 completed pregnancies 90.9% (50) of pregnancies resulted in livebirths. At the time of COVID-19 diagnosis, 60.3% (n = 44) of women were unvaccinated, 4.1% (n = 3) had received one vaccine dose while 35.6% (n = 26) had two or more doses. Although 83.6% (n = 61) of women required no treatment for COVID-19, 20.5% (n = 15) required hospital admission. COVID-19 resulted in delivery in 6.8% (n = 3) of unvaccinated women and 3.8% (n = 1) of fully vaccinated women. There was a greater number of preterm births (PTB) in unvaccinated women compared with fully vaccinated 29.5% (n = 13) vs 18.2%(n = 2). CONCLUSION: In this descriptive study, unvaccinated pregnant women with RMD and COVID-19 had a greater number of PTB compared with those fully vaccinated against COVID-19. Additionally, the need for COVID-19 pharmacological treatment was uncommon in pregnant women with RMD regardless of vaccination status. These results support active promotion of COVID-19 vaccination in women with RMD who are pregnant or planning a pregnancy

La renovación de la palabra en el bicentenario de la Argentina : los colores de la mirada lingüística

El libro reúne trabajos en los que se exponen resultados de investigaciones presentadas por investigadores de Argentina, Chile, Brasil, España, Italia y Alemania en el XII Congreso de la Sociedad Argentina de Lingüística (SAL), Bicentenario: la renovación de la palabra, realizado en Mendoza, Argentina, entre el 6 y el 9 de abril de 2010. Las temáticas abordadas en los 167 capítulos muestran las grandes líneas de investigación que se desarrollan fundamentalmente en nuestro país, pero también en los otros países mencionados arriba, y señalan además las áreas que recién se inician, con poca tradición en nuestro país y que deberían fomentarse. Los trabajos aquí publicados se enmarcan dentro de las siguientes disciplinas y/o campos de investigación: Fonología, Sintaxis, Semántica y Pragmática, Lingüística Cognitiva, Análisis del Discurso, Psicolingüística, Adquisición de la Lengua, Sociolingüística y Dialectología, Didáctica de la lengua, Lingüística Aplicada, Lingüística Computacional, Historia de la Lengua y la Lingüística, Lenguas Aborígenes, Filosofía del Lenguaje, Lexicología y Terminología

La expresión de las desigualdades sociales en la mortalidad infantil. Información epidemiológica en regiones seleccionadas de la provincia de Santa Fe (Argentina)

El presente artículo plasma los hallazgos más importantes de una serie de tres estudios epidemiológicos destinados a elaborar el perfil de la mortalidad infantil en función de las condiciones de vida en regiones seleccionadas de Argentina, con el propósito de identificar las desigualdades sociales entre distintos grupos de población. Metodología: se realizaron tres estudios epidemiológicos con diseño ecológico que utilizan datos censales y estadísticas vitales como fuentes secundarias. Resultados: los hallazgos confirmaron un fuerte gradiente desfavorable en la mortalidad infantil para quienes se hallan en desventajas sociales. La gravedad de las disparidades observadas en la mortalidad infantil se hace más aguda cuando se aborda la mortalidad posneonatal. La alta proporción de muertes consideradas reducibles va acompañada asimismo por una profunda asimetría entre los grupos. Discusión: la elección de la mortalidad infantil como problema desde la perspectiva de las desigualdades no es ni original ni la confirmación de un gradiente inverso entre las condiciones de vida y los valores de la tasa de mortalidad infantil. Sin embargo, se destaca la necesidad de dar visibilidad y de cuantificar las desigualdades e inequidades entre grupos en espacios sociales concretos de planificación e intervención sanitari

Memory reconsolidation as a tool to endure encoding deficits in elderly.

Normal aging involves changes in the ability to acquire, consolidate and recall new information. It has been recently proposed that the reconsolidation process is also affected in older adults. Reconsolidation is triggered after reminder presentation, allowing memories to be modified: they can be impaired, strengthened or changed in their content. In young adults it was previously shown that the presentation of repetitive reminders induces memory strengthening one day after reactivation and the presentation of at least one reminder increases memory persistence several days after reactivation. However, until now this process has remained elusive in older adults. We hypothesize that older adults need a stronger reminder to induce memory strengthening through the reconsolidation process than young adults. To test this, we perform a three-day experiment. On day 1, participants learned 15 sound-word associations, on day 2 they received no reminders (NR group), one reminder (R group) or two rounds of reactivations (Rx2 group). Finally, they were tested on day 7. We found that, contrary to our hypothesis, older adults show a memory improvement triggered by repeated labilization/reconsolidation processes to an equal extent than young adults. These results open new perspectives into the use of reconsolidation to improve daily acquired information and the development of therapeutic home used tools to produce memory enhancement in healthy older adults or those with cognitive decline

Desafíos actuales en la clínica de la reproducción humana asistida

Este libro reúne una serie de escritos destinados a pensar el rol, la función y el lugar del/a profesional de la psicología en el ámbito de la reproducción humana asistida. Está organizado en tres partes: teórica, práctica e interdisciplina. La primera parte recoge el aporte de psicólogos y psicoanalistas, que ponen a trabajar nociones teóricas claves, en un intento por deshabitar los lugares comunes de estar a ''favor'' o en ''contra'', en los escenarios producidos por las biotecnologías reproductivas.La segunda parte reúne el trabajo de un colectivo de psicólogas y psicoanalistas que se han dedicado a pensar la mejor manera de sistematizar la evaluación psicológica en el campo de la reproducción humana asistida en Argentina, teniendo en cuenta las particularidades de todos los actores involucrados (donantes de gametos, receptores, comitentes, usuarios y/o pacientes de TRHA). La tercera y última parte de este libro está destinada a presentar una interlocución con otras disciplinas como la Sociología, la Antropología, el Derecho y la Medicina. El dispositivo de la medicina reproductiva se sostiene en un complejo entramado de prácticas y discursos, lo que requiere saberes situados, contextuados y la consolidación del trabajo interdisciplinario. Esta compilación forma parte del Proyecto de Desarrollo Estratégico Circuitos de la reproducción asistida: una matriz de toma de decisiones e intervenciones sobre el origen, financiado por la Secretaria de Ciencia y Técnica de la Universidad de Buenos Aires y dirigido por la Doctora Natacha Salomé Lima (UBA-CONICET).Fil: Alaniz, Rocío B.. Sociedad Argentina de Medicina Reproductiva; Argentina. Sociedad Argentina de Psicología de la Reproducción Humana y Asistida; ArgentinaFil: Barontini, Marta Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro Interdisciplinario de Investigaciones en Psicología Matemática y Experimental Dr. Horacio J. A. Rimoldi; Argentina. Universidad de Buenos Aires; Argentina. Sociedad Argentina de Medicina Reproductiva; ArgentinaFil: Gallo, Dolores. Sociedad Argentina de Psicología de la Reproducción Humana y Asistida; Argentina. Universidad de Buenos Aires; Argentina. Sociedad Argentina de Medicina Reproductiva; ArgentinaFil: Jadur, Silvia. Centro Argentino de Psicología y Reproducción; Argentina. Sociedad Argentina de Medicina Reproductiva; ArgentinaFil: Johnson, María Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones y Estudio sobre Cultura y Sociedad. Centro de Investigaciones de la Facultad de Psicología - Grupo Vinculado CIPSI; Argentina. Universidad Nacional de Córdoba; ArgentinaFil: Jurkowski, Ludmila. Universidad de Belgrano; Argentina. Sociedad Argentina de Medicina Reproductiva; ArgentinaFil: Kletnicki, Armando Benjamín. Universidad de Buenos Aires; Argentina. Centro de Salud Mental Nro. 3 "Dr. A. Ameghino”; Argentina. Universidad de Buenos Aires. Rectorado. Secretaria de Ciencia y Técnica; ArgentinaFil: Legarralde, Rocío Magalí. Universidad de Buenos Aires. Rectorado. Secretaria de Ciencia y Técnica; ArgentinaFil: Lima, Natacha Salomé. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Rectorado. Secretaria de Ciencia y Técnica; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; Argentina. Sociedad Argentina de Medicina Reproductiva; ArgentinaFil: Montesano, Haydée Susana. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Carrera de Trabajo Social. Cátedra de Psicología Social Institucional I; Argentina. Universidad de Buenos Aires. Rectorado. Secretaria de Ciencia y Técnica; ArgentinaFil: Moyano Vargas, Carolina. Universidad de Buenos Aires; Argentina. Gobierno de la Ciudad Autonoma de Buenos Aires. Ministerio de Salud.; Argentina. Cámara de Comercio de Estados Unidos en la Argentina; ArgentinaFil: Navés, Flavia Andrea. Sociedad Argentina de Medicina Reproductiva; Argentina. Sociedad Argentina de Psicología de la Reproducción Humana y Asistida; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Carrera de Trabajo Social. Cátedra de Psicología Social Institucional I; Argentina. Universidad de Belgrano; Argentina. Universidad de Buenos Aires. Rectorado. Secretaria de Ciencia y Técnica; ArgentinaFil: Pérez, Diana. Sociedad Argentina de Medicina Reproductiva; Argentina. Universidad de Belgrano; ArgentinaFil: Pomba, Chiara. Universidad Abierta Interamericana; ArgentinaFil: Romero, Guadalupe. Universidad de Buenos Aires. Rectorado. Secretaria de Ciencia y Técnica; ArgentinaFil: Rossi, Mariela. Sociedad Argentina de Medicina Reproductiva; Argentina. Universidad de Buenos Aires; Argentina. Universidad Nacional de San Martín; ArgentinaFil: Rossi, Pamela. Hospital Italiano Regional del Sur; Argentina. Sociedad Argentina de Psicología de la Reproducción Humana y Asistida; ArgentinaFil: Terrado, Guillermo. Sociedad Argentina de Preservación de la Fertilidad; Argentina. Sociedad Argentina de Medicina Reproductiva; ArgentinaFil: Viera Cherro, Mariana. Universidad de la República; UruguayFil: Wang, Laura. Universidad de Belgrano; Argentina. Instituto de Ginecología y Fertilidad; Argentina. Sociedad Argentina de Medicina Reproductiva; Argentin

Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study

An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was limited to immunocompetent patients tested for bacterial CAP agents within 24 h of admission. The CAP CPGs evaluated included the following: the 2007 and 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA), the European Respiratory Society (ERS), and selected country-specific CPGs. Among 2564 patients enrolled, 35.3% had an identifiable pathogen. Streptococcus pneumoniae (8.2%) was the most frequently identified pathogen, followed by Pseudomonas aeruginosa (4.1%) and Klebsiella pneumoniae (3.4%). CPGs appropriately recommend covering more than 90% of all the potential pathogens causing CAP, with the exception of patients enrolled from Germany, Pakistan, and Croatia. The 2019 ATS/IDSA CPGs appropriately recommend covering 93.6% of the cases compared with 90.3% of the ERS CPGs (p < 0.01). S. pneumoniae remains the most common pathogen in patients hospitalized with CAP. Multinational CPG recommendations for patients with CAP seem to appropriately cover the most common pathogens and should be strongly encouraged for the management of CAP patients.info:eu-repo/semantics/publishedVersio

Aspiration risk factors, microbiology, and empiric antibiotics for patients hospitalized with community-acquired pneumonia

Background: Aspiration community-acquired pneumonia (ACAP) and community-acquired pneumonia (CAP) in patients with aspiration risk factors (AspRFs) are infections associated with anaerobes, but limited evidence suggests their pathogenic role. Research question: What are the aspiration risk factors, microbiology patterns, and empiric anti-anaerobic use in patients hospitalized with CAP? Study design and methods: This is a secondary analysis of GLIMP, an international, multicenter, point-prevalence study of adults hospitalized with CAP. Patients were stratified into three groups: (1) ACAP, (2) CAP/AspRF+ (CAP with AspRF), and (3) CAP/AspRF- (CAP without AspRF). Data on demographics, comorbidities, microbiological results, and anti-anaerobic antibiotics were analyzed in all groups. Patients were further stratified in severe and nonsevere CAP groups. Results: We enrolled 2,606 patients with CAP, of which 193 (7.4%) had ACAP. Risk factors independently associated with ACAP were male, bedridden, underweight, a nursing home resident, and having a history of stroke, dementia, mental illness, and enteral tube feeding. Among non-ACAP patients, 1,709 (70.8%) had CAP/AspRF+ and 704 (29.2%) had CAP/AspRF-. Microbiology patterns including anaerobes were similar between CAP/AspRF-, CAP/AspRF+ and ACAP (0.0% vs 1.03% vs 1.64%). Patients with severe ACAP had higher rates of total gram-negative bacteria (64.3% vs 44.3% vs 33.3%, P = .021) and lower rates of total gram-positive bacteria (7.1% vs 38.1% vs 50.0%, P 50% in all groups) independent of AspRFs or ACAP received specific or broad-spectrum anti-anaerobic coverage antibiotics. Interpretation: Hospitalized patients with ACAP or CAP/AspRF+ had similar anaerobic flora compared with patients without aspiration risk factors. Gram-negative bacteria were more prevalent in patients with severe ACAP. Despite having similar microbiological flora between groups, a large proportion of CAP patients received anti-anaerobic antibiotic coverage

Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients

BACKGROUND: The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. METHODS: We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor. RESULTS: At least 1 risk factor for immunocompromise was recorded in 18% of the 3702 patients enrolled. The prevalences of risk factors significantly differed across continents and countries, with chronic steroid use (45%), hematological cancer (25%), and chemotherapy (22%) the most common. Among immunocompromised patients, community-acquired pneumonia (CAP) pathogens were the most frequently identified, and prevalences did not differ from those in immunocompetent patients. Risk factors for immunocompromise were independently associated with neither Pseudomonas aeruginosa nor non-community-acquired bacteria. Specific risk factors were independently associated with fungal infections (odds ratio for AIDS and hematological cancer, 15.10 and 4.65, respectively; both P = .001), mycobacterial infections (AIDS; P = .006), and viral infections other than influenza (hematological cancer, 5.49; P &lt; .001). CONCLUSIONS: Our findings could be considered by clinicians in prescribing empiric antibiotic therapy for CAP in immunocompromised patients. Patients with AIDS and hematological cancer admitted with CAP may have higher prevalences of fungi, mycobacteria, and noninfluenza viruses

International prevalence and risk factors evaluation for drug-resistant Streptococcus pneumoniae pneumonia

Objective: Streptococcus pneumoniae is the most frequent bacterial pathogen isolated in subjects with Community-acquired pneumonia (CAP) worldwide. Limited data are available regarding the current global burden and risk factors associated with drug-resistant Streptococcus pneumoniae (DRSP) in CAP subjects. We assessed the multinational prevalence and risk factors for DRSP-CAP in a multinational point-prevalence study. Design: The prevalence of DRSP-CAP was assessed by identification of DRSP in blood or respiratory samples among adults hospitalized with CAP in 54 countries. Prevalence and risk factors were compared among subjects that had microbiological testing and antibiotic susceptibility data. Multivariate logistic regressions were used to identify risk factors independently associated with DRSP-CAP. Results: 3,193 subjects were included in the study. The global prevalence of DRSP-CAP was 1.3% and continental prevalence rates were 7.0% in Africa, 1.2% in Asia, and 1.0% in South America, Europe, and North America, respectively. Macrolide resistance was most frequently identified in subjects with DRSP-CAP (0.6%) followed by penicillin resistance (0.5%). Subjects in Africa were more likely to have DRSP-CAP (OR: 7.6; 95% CI: 3.34-15.35, p < 0.001) when compared to centres representing other continents. Conclusions: This multinational point-prevalence study found a low global prevalence of DRSP-CAP that may impact guideline development and antimicrobial policies. Published by Elsevier Ltd on behalf of The British Infection Association