Evidence for positive selection of hepatitis A virus antigenic variants in vaccinated men-having-sex-with men patients: implications for immunization policies

Background: A huge outbreak in the men-having-sex-with-men (MSM) has hit Europe during the years 2016-2018. Outbreak control has been hampered by vaccine shortages in many countries, and to minimize their impact, reduction of antigen doses has been implemented. However, these measures may have conse-quences on the evolution of hepatitis A virus (HAV), leading to the emergence of antigenic variants. Cases in vac-cinated MSM patients have been detected in Barcelona, opening the possibility to study HAV evolution under immune pressure. Methods: We performed deep-sequencing analysis of ten overlapping fragments covering the complete capsid coding region of HAV. A total of 14578255 reads were obtained and used for the analysis of virus evolution in vaccinated versus non-vaccinated patients. We estimated maximum and minimum mutation frequencies, and Shan-non entropy in the quasispecies of each patient. Non-synonymous (NSyn) mutations affecting residues exposed in the capsid surface were located, with respect to epitopes, using the recently described crystal structure of HAV, as an indication of its potential role in escaping to the effect of vaccines. Findings: HAV evolution at the quasispecies level, in non-vaccinated and vaccinated patients, revealed higher diversity in epitope-coding regions of the vaccinated group. Although amino acid replacements occurring in and around the epitopes were observed in both groups, their abundance was significantly higher in the quasispecies of vaccinated patients, indicating ongoing processes of fixation. Interpretation: Our data suggest positive selection of antigenic variants in some vaccinated patients, raising concerns for new vaccination polices directed to the MSM group

Creació de vídeos de tècniques de bioquímica i de bases de dades de preguntes comentades

El treball dut a terme s'emmarca en un objectiu general de producció de materials perquè s'utilitzin com a eines per afavorir l'autoaprenentatge en un entorn de docència semipresencial. S'han fet dos vídeos de dues tècniques experimentals fonamentals en bioquímica: la cromatografia i la fixació de radiolligands. Ambdós vídeos corresponen a la filmació d'experiments que implicaven manipulacions sofisticades i es van dur a terme en els laboratoris docents de la Unitat de Bioquímica de Medicina. S'ha confeccionat una base de dades de preguntes de resposta múltiple que consta actualment de 200 preguntes de bioquímica i biologia molecular classificades i revisades. La utilització tutoritzada dels vídeos i de les preguntes, juntament amb l'avaluació de la comprensió de sessions presencials mitjançant un test ràpid i també l'apropament del coneixement bioquímic a coneixements intuïtius habituals, han permès millorar el rendiment acadèmic de l'alumnat, ja que se n'ha incrementat el nombre que superen les assignatures i també la proporció d'alumnat amb bones qualificacions.El trabajo llevado a cabo se enmarca en un objetivo general de producción de materiales para que se utilicen como herramientas para favorecer el autoaprendizaje en un entorno de docencia semipresencial. Se han hecho dos vídeos de dos técnicas experimentales fundamentales en bioquímica: la cromatografía y la fijación de radio-ligandos. Ambos vídeos corresponden a la filmación de experimentos que implicaban manipulaciones sofisticadas y se llevaron a cabo en los laboratorios docentes de la Unidad de Bioquímica de Medicina. Se ha confeccionado una base de datos de preguntas de respuesta múltiple que consta actualmente de 200 preguntas de bioquímica y biología molecular clasificadas y revisadas. La utilización tutorizada de los vídeos y de laspreguntas, junto con la evaluación de la comprensión de sesiones presenciales mediante un test rápido y también el acercamiento del conocimiento bioquímico a conocimientos intuitivos habituales, han permitido mejorar el rendimiento académico del alumnado, ya que se ha incrementado el número que superan las asignaturas y también la proporción de alumnado con buenas calificaciones.The general objective of this project is the production of materials for use as toolsfor promoting independent learning in a semi-distance learning environment. Two videos were produced of two basic experimental techniques in Biochemistry: chromatography and radioligand binding. Both videos include the filming of experiments that involved sophisticated manipulations which had to be carried out in the teaching laboratories of the Biochemistry Unit in the Faculty of Medicine. A data-base of multiple choice questions was produced. This currently consists of 200 classified and reviewed Biochemistry and Molecular Biology questions. Supervised use of the video and the questions, together with assessment of understanding of presence sessions by means of a Rapid Test and linking biochemical knowledge to normal intuitive knowledge, has led to an improvement in the academic performance of the students, as it has increased the number of students passing the subject as well as the proportion of students with good grades

Prenatal diagnosis of Kagami-Ogata Syndrome

Kagami-Ogata syndrome (KOS14) is a rare congenital disorder associated with defective genomic imprinting of the chromosome 14q32 domain. Typical features include polyhydramnios, small and bell-shaped thorax, coat-hanger ribs, dysmorphic facial features, abdominal wall defects, placentomegaly, severe postnatal respiratory distress and intellectual disability. To the best of our knowledge, this may be the first case where ultrasound findings such as: severe polyhydramnios, a small bell- shaped thorax, a protuberant abdomen and characteristic dysmorphic face prompted directed family interrogation finally leading to the prenatal diagnosis of KOS14

Detection of norovirus in saliva samples from acute gastroenteritis cases and asymptomatic subjects : Association with age and higher shedding in stool

Norovirus infections are a leading cause of acute gastroenteritis outbreaks worldwide and across all age groups, with two main genogroups (GI and GII) infecting humans. The aim of our study was to investigate the occurrence of norovirus in saliva samples from individuals involved in outbreaks of acute gastroenteritis in closed and semiclosed institutions, and its relationship with the virus strain, virus shedding in stool, the occurrence of symptoms, age, and the secretor status of the individual. Epidemiological and clinical information was gathered from norovirus outbreaks occurring in Catalonia, Spain during 2017-2018, and stool and saliva samples were collected from affected and exposed resident individuals and workers. A total of 347 saliva specimens from 25 outbreaks were analyzed. Further, 84% of individuals also provided a paired stool sample. For GII infections, norovirus was detected in 17.9% of saliva samples from symptomatic cases and 5.2% of asymptomatic individuals. Positivity in saliva occurred in both secretors and nonsecretors. None of the individuals infected by norovirus GI was positive for the virus in saliva. Saliva positivity did not correlate with any of the studied symptoms but did correlate with age ≥ 65 years old. Individuals who were positive in saliva showed higher levels of virus shedding in stool. Mean viral load in positive saliva was 3.16 ± 1.08 log10 genome copies/mL, and the predominance of encapsidated genomes was confirmed by propidium monoazide (PMA)xx-viability RTqPCR assay. The detection of norovirus in saliva raises the possibility of oral-to-oral norovirus transmission during the symptomatic phase and, although to a lesser extent, even in cases of asymptomatic infections

Integrated genomic surveillance enables tracing of person-to-person SARS-CoV-2 transmission chains during community transmission and reveals extensive onward transmission of travel-imported infections, Germany, June to July 2021

BackgroundTracking person-to-person SARS-CoV-2 transmission in the population is important to understand the epidemiology of community transmission and may contribute to the containment of SARS-CoV-2. Neither contact tracing nor genomic surveillance alone, however, are typically sufficient to achieve this objective.AimWe demonstrate the successful application of the integrated genomic surveillance (IGS) system of the German city of Düsseldorf for tracing SARS-CoV-2 transmission chains in the population as well as detecting and investigating travel-associated SARS-CoV-2 infection clusters.MethodsGenomic surveillance, phylogenetic analysis, and structured case interviews were integrated to elucidate two genetically defined clusters of SARS-CoV-2 isolates detected by IGS in Düsseldorf in July 2021.ResultsCluster 1 (n = 67 Düsseldorf cases) and Cluster 2 (n = 36) were detected in a surveillance dataset of 518 high-quality SARS-CoV-2 genomes from Düsseldorf (53% of total cases, sampled mid-June to July 2021). Cluster 1 could be traced back to a complex pattern of transmission in nightlife venues following a putative importation by a SARS-CoV-2-infected return traveller (IP) in late June; 28 SARS-CoV-2 cases could be epidemiologically directly linked to IP. Supported by viral genome data from Spain, Cluster 2 was shown to represent multiple independent introduction events of a viral strain circulating in Catalonia and other European countries, followed by diffuse community transmission in Düsseldorf.ConclusionIGS enabled high-resolution tracing of SARS-CoV-2 transmission in an internationally connected city during community transmission and provided infection chain-level evidence of the downstream propagation of travel-imported SARS-CoV-2 cases

Prediction of neonatal respiratory morbidity by quantitative ultrasound lung texture analysis: a multicenter study.

BACKGROUND: Prediction of neonatal respiratory morbidity may be useful to plan delivery in complicated pregnancies. The limited predictive performance of the current diagnostic tests together with the risks of an invasive procedure restricts the use of fetal lung maturity assessment. OBJECTIVE: The objective of the study was to evaluate the performance of quantitative ultrasound texture analysis of the fetal lung (quantusFLM) to predict neonatal respiratory morbidity in preterm and early-term (<39.0 weeks) deliveries. STUDY DESIGN: This was a prospective multicenter study conducted in 20 centers worldwide. Fetal lung ultrasound images were obtained at 25.0-38.6 weeks of gestation within 48 hours of delivery, stored in Digital Imaging and Communication in Medicine format, and analyzed with quantusFLM. Physicians were blinded to the analysis. At delivery, perinatal outcomes and the occurrence of neonatal respiratory morbidity, defined as either respiratory distress syndrome or transient tachypnea of the newborn, were registered. The performance of the ultrasound texture analysis test to predict neonatal respiratory morbidity was evaluated. RESULTS: A total of 883 images were collected, but 17.3% were discarded because of poor image quality or exclusion criteria, leaving 730 observations for the final analysis. The prevalence of neonatal respiratory morbidity was 13.8% (101 of 730). The quantusFLM predicted neonatal respiratory morbidity with a sensitivity, specificity, positive and negative predictive values of 74.3% (75 of 101), 88.6% (557 of 629), 51.0% (75 of 147), and 95.5% (557 of 583), respectively. Accuracy was 86.5% (632 of 730) and positive and negative likelihood ratios were 6.5 and 0.3, respectively. CONCLUSION: The quantusFLM predicted neonatal respiratory morbidity with an accuracy similar to that previously reported for other tests with the advantage of being a noninvasive technique

Los inmigrantes viajeros

ObjetivosCaracterizar a los inmigrantes viajeros y los desplazamientos internacionales que realizan. Identificar los viajes de riesgo que efectúa dicha población, así como valorar las actividades preventivas internacionales quereciben en relación con las aplicadas a viajeros autóctonosDiseñoEstudio observacional retrospectivoEmplazamientoUnidad de Salud Internacional (USAI) de Santa Coloma de Gramenet (Barcelona). Ámbito Sanitario del Barcelonès Nord i Maresme. División de Atención Primaria. Institut Català de la SalutParticipantesPacientes visitados desde junio de 1999 a junio de 2002 (n = 1.163) en la USAI. Se definieron dos grupos según su procedencia: nacidos en la Unión Europea (grupo autóctono; n0 = 1.019) o fuera de ella (grupo inmigrante; n1 = 144)Medidas principalesEdad, país de origen, tiempo de residencia en España, intervalo entre consulta/viaje, motivo del viaje, destino, duración del viaje, tipo de viaje, estancia en zona rural o aislada, exposición a paludismo, vacunaciones y quimioprofilaxis antipalúdica prescritas y riesgo global del viajeResultadosLos inmigrantes residen en el extranjero durante más tiempo que los autóctonos (media, 43,5 días; intervalo de confianza [IC] del 95%, 37,9-49,1 y 15,8 días; IC del 95%, 14,9-16,7, respectivamente; p < 0,0001). Los períodos comprendidos entre el viaje y la consulta a la USAI son globalmente similares en ambos grupos (media de 26,8 días para inmigrantes y 30,41 días para autóctonos; p = NS), aunque los inmigrantes consultan con mayor frecuencia para períodos menores de 15 y 7 días (p < 0,005). Residieron en zonas de alta transmisión palúdica el 31,9% (IC del 95%, 24,4-39,6) de los inmigrantes frente al 21,3% (IC del 95%, 18,8-23,8) de los autóctonos (p = 0,04). En conjunto, los inmigrantes realizaron un mayor número de viajes de riesgo que los autóctonos (un 54,8 frente al 43,1%; p < 0,01). No se hallaron diferencias significativas entre ambos gruposen cuanto a la calidad en la administración de las vacunaciones internacionales prescritas. El cumplimiento de la pauta de quimioprofilaxis antipalúdica fue menor en el grupo de inmigrantes respecto al de autóctonos (el 36 frente al 84%; p < 0,005)ConclusionesCabe considerar el colectivo inmigrante de nuestro ámbito como un grupo de riesgo para la adquisición e importación de enfermedades tropicales durante sus desplazamientos internacionales. Conformanun a población en la que se debería priorizar la recepción de medidas preventivas internacionalesObjectivesTo characterise travelling immigrants and the international movements they undertake.To identify the risk journeys that this population makes and to assess the international preventive activities for them compared with those for autochthonous travellersDesign.Retrospective, observational studySettingUnit of International Health (UIH) at Santa Coloma de Gramenet (Barcelona), in the Barcelonès Nord i Maresme Health Area, Primary Care Division of the Catalan Instituteof HealthParticipantsPatients seen between June 1999 and June 2002 (n=1163) at the UIH. They were divided into two groups, depending on their origins: those born inside (autochthonous group;no=1019) or outside (immigrant group; n1=144)the European UnionMain measurementsAge, country of origin,length of residence in Spain, interval between consultation and journey, reason for journey,destination, duration of the journey, kind of journey, stay in rural or isolated area, exposure to malaria, vaccinations and anti-malaria chemoprophylaxis prescribed, and overall risk of journeyResultsImmigrants spent more time abroad than autochthonous people (mean 43.5 days;95% CI, 37.9-49.1; and 15.8 days, 95% CI, 14.9-16.7, respectively; P<.0001). Periods between the journey and the consultation at the UIH were generally similar in the two groups (mean of 26.8 days for immigrants and 30.41 days for autochthonous people; ns), although the immigrants consulted more often in periods of less than 15 and 7 days (P<.005). 31.9% of immigrants stayed in areas of high malariatransmission (95% CI, 24.4%-39.6%) vs 21.3%(95% CI, 18.8%-23.8%) of authochthonous people (P=.04).Overall, immigrants made more risk journeys than autochthonous people (54.8% vs 43.1%; P<.01). No significant differences between the two groups were found in terms of quality in the administration of the international vaccinations prescribed. Compliance with the guidelines for anti-malaria chemoprophylaxis was less in the immigrant group than in the autochthonous one (36% vs 84%; P<.005)ConclusionsThe immigrant group in our environment needs to be thought of as a risk group for catching and importing tropical diseases during their international movements.They form a population for whom international preventive measures should be prioritise

Los inmigrantes viajeros

Objetivos. Caracterizar a los inmigrantes viajeros y los desplazamientos internacionales que realizan. Identificar los viajes de riesgo que efectúa dicha población, así como valorar las actividades preventivas internacionales que reciben en relación con las aplicadas a viajeros autóctonos. Diseño. Estudio observacional retrospectivo. Emplazamiento. Unidad de Salud Internacional (USAI) de Santa Coloma de Gramenet (Barcelona). Ámbito Sanitario del Barcelonès Nord i Maresme. División de Atención Primaria. Institut Català de la Salut. Participantes. Pacientes visitados desde junio de 1999 a junio de 2002 (n = 1.163) en la USAI. Se definieron dos grupos según su procedencia: nacidos en la Unión Europea (grupo autóctono; n0 = 1.019) o fuera de ella (grupo inmigrante; n1 = 144). Medidas principales. Edad, país de origen, tiempo de residencia en España, intervalo entre consulta/viaje, motivo del viaje, destino, duración del viaje, tipo de viaje, estancia en zona rural o aislada, exposición a paludismo, vacunaciones y quimioprofilaxis antipalúdica prescritas y riesgo global del viaje. Resultados. Los inmigrantes residen en el extranjero durante más tiempo que los autóctonos (media, 43,5 días; intervalo de confianza [IC] del 95%, 37,9-49,1 y 15,8 días; IC del 95%, 14,9-16,7, respectivamente; p < 0,0001). Los períodos comprendidos entre el viaje y la consulta a la USAI son globalmente similares en ambos grupos (media de 26,8 días para inmigrantes y 30,41 días para autóctonos; p = NS), aunque los inmigrantes consultan con mayor frecuencia para períodos menores de 15 y 7 días (p < 0,005). Residieron en zonas de alta transmisión palúdica el 31,9% (IC del 95%, 24,4-39,6) de los inmigrantes frente al 21,3% (IC del 95%, 18,8-23,8) de los autóctonos (p = 0,04). En conjunto, los inmigrantes realizaron un mayor número de viajes de riesgo que los autóctonos (un 54,8 frente al 43,1%; p < 0,01). No se hallaron diferencias significativas entre ambos grupos en cuanto a la calidad en la administración de las vacunaciones internacionales prescritas. El cumplimiento de la pauta de quimioprofilaxis antipalúdica fue menor en el grupo de inmigrantes respecto al de autóctonos (el 36 frente al 84%; p < 0,005). Conclusiones. Cabe considerar el colectivo inmigrante de nuestro ámbito como un grupo de riesgo para la adquisición e importación de enfermedades tropicales durante sus desplazamientos internacionales. Conforman una población en la que se debería priorizar la recepción de medidas preventivas internacionales

Propiedades mecánicas de las uniones soldadas mediante láser de diferentes metales utilizados en prótesis bucal

Se han realizado diferentes uniones soldadas, mediante láser, entre los diferentes metales y aleaciones más utilizados en la prótesis bucal. Los metales utilizados han sido aleación de oro, aleación de paladio, cromo-cobalto y titanio puro; las soldaduras se realizaron entre los diferentes metales (soldadura heterogénea ) y entre el mismo metal (soldadura homogénea). Se realizaron ensayos mecánicos de tracción y se determinaron la tensión máxima y la deformación a rotura de todas las soldaduras. Se compararon los resultados de las muestras soldadas con la coladas. Mediante microscopía electrónica de barrido se estudiaron las fracturas de las diferentes uniones