Instrumentos de diagnóstico de la vulnerabilidad durante el período perinatal

El presente documento es el resultado de la reflexión común de los profesionales y académicos involucrados en el proyecto CAPEvFAIR, sobre los instrumentos para el diagnóstico de la vulnerabilidad de la díada madre-hijo durante el período perinatal. El documento empieza con una descripción de la fase de diagnóstico de la vulnerabilidad durante la perinatalidad dentro del marco lógico del proyecto, seguido por las cuestiones que se tuvieron en cuenta al describir los instrumentos de diagnóstico específicos para cada grupo objetivo (madres con adicción, madres adolescentes, madres migrantes, madres en situaciones de pobreza). La presentación sintética y la descripción de los instrumentos son sistematizadas dependiendo de los grupos objetivo, gracias a la contribución de las organizaciones que cuentan con experiencia trabajando con aspectos específicos de la vulnerabilidad, compañeros en el proyecto CAPEvFAIR desde Francia, España, Italia y Rumanía. Este material puede ser usado por varios especialistas que trabajan con la madre y su hijo durante el período perinatal, como fuente de inspiración para adaptar los instrumentos proporcionados a contextos específicos. Las plantillas de los instrumentos descritos se presentan en los anexos del documento.Proyecto Europeo CapeVfair. Erasmus

Instrumentos de evaluación. Evaluación de la vulnerabilidad de madres e hijos durante el período perinatal

Este texto es el resultado de un trabajo colectivo entre cuatro equipos de profesionales de distintas nacionalidades en la combinación entre la práctica profesional y las perspectivas teóricas. El documento pretende resaltar los diferentes objetos y marcos teóricos involucrados y analizar su complementariedad y diferencias mediante el análisis de los instrumentos para la evaluación de la vulnerabilidad que cada equipo ha adoptado durante la práctica profesional.Proyecto Europeo CapeVfair. Erasmus

Instrumento de Acompañamiento. El proceso de acompañamiento en situaciones de vulnerabilidad en el periodo perinatal

El documento que presentamos se centra en los procesos de acompañamiento de las mujeres y sus hijos e hijas en situación de vulnerabilidad durante el periodo perinatal. Para su elaboración se ha realizado una revisión del concepto de acompañamiento y un análisis de las diferentes herramientas de acompañamiento que utilizan los profesionales del proyecto CAPEvFAIR. La revisión teórica ha permitido enmarcar el concepto, los objetivos y los aspectos claves para desarrollar procesos de acompañamiento que contribuyen a mejorar el bienestar de este colectivo y, por ende, a reducir la vulnerabilidad. La reflexión y el debate continuado entre los investigadores universitarios y los profesionales que participan en el proyecto CAPEvFAIR han nutrido todo este proceso generando un nuevo marco donde inscribir la intervención del profesional surgido del diálogo entre teoría y práctica. Este marco del acompañamiento aporta una nueva visión de la intervención profesional centrada en el colectivo y el período específico que nos ocupa aquí. Este material puede ser utilizado por los diferentes profesionales que trabajan e intervienen en el proceso de acompañamiento durante el período perinatal de madres, hijos e hijas en situación de vulnerabilidad. El documento, a parte del marco general, ofrece diferentes instrumentos que cada profesional podrá adaptar a su contexto, a las necesidades de la población con la que interviene y a la realidad específica del país en el que se aplique. El documento que se ofrece debe interpretarse como una herramienta para orientar a los y las profesionales en su tarea de acompañamiento a este colectivo.Proyecto Europeo CapeVfair. Erasmus

Las competencias profesionales para la atención durante el período perinatal en situaciones de vulnerabilidad

El proyecto CAPEvFAIR ha dedicado el Intellectual Output 5 (de ahora en adelante IO5) a las competencias profesionales. El enfoque de competencias permite mejorar los procesos y la calidad de los servicios, así como incorporar nuevas competencias acordes con la realidad y la revisión de las intervenciones profesionales implementadas con un colectivo específico. Así pues, el presente documento ofrece un marco comprehensivo de las competencias que los profesionales ponen en juego cuando atienden a mujeres y a sus hijos e hijas en situaciones de vulnerabilidad durante el período perinatalProyecto Europeo CapeVfair. Erasmus

The Immune, Inflammatory and Hematological Response in COVID-19 Patients, According to the Severity of the Disease

Introduction: The aim of this study was to evaluate the immune and inflammatory responses in COVID-19 patients by dosing specific IgM and IgG total antibodies and interleukin 6, correlating them with the hematological and biochemical blood parameters and comparing them by the form of the disease. Materials and methods: One hundred twenty-five patients with polymerase chain reaction-confirmed COVID-19, hospitalized between 15.03.2020 and 1.07.2020 in the Clinical Hospital of Infectious Diseases “Sf. Parascheva” Iaşi, were tested by chemiluminescence for the presence of anti-SARS-CoV-2 IgM and IgG and IL-6 in the serum. The results were correlated with the results of the CBC count and serum biochemical parameters detected on the admission day. The patients presented different forms of the disease (asymptomatic, mild, moderate, severe, and critical) according to World Health Organization (WHO) criteria for the clinical management of COVID-19. Results: The amplitude of the immune response was directly correlated with the form of the disease. In the asymptomatic/mild form patients, the IL-6 and CRP concentrations were significantly higher and eosinophil count was significantly lower compared with the reference interval. In the moderate form, the concentrations of IL-6, CRP, and IgG were significantly higher, compared with the reference interval, while eosinophil count and eGFR were significantly lower. In severe/critical COVID-19 patients, IL-6, CRP, NLR, PLR, glucose, AST, urea, creatinine, and eGFR were significantly higher compared with the reference interval, while eosinophil count was significantly lower. IL-6 boosted in all forms of COVID-19, with a major increase in severe and critical patients. IL-6, neutrophil count, % neutrophils, NLR, PLR, CRP, AST, and urea increased with the severity of the SARS-CoV-2 infection, and the lymphocyte count, % lymphocytes, eosinophil count, % eosinophils, and hemoglobin decreased with the increased severity of COVID-19. Conclusions: The amplitude and the moment of appearance of the immune response depended on the form of the disease. IgM generally occurred in the first 14 days of illness, and IgG appeared beginning with the second week of disease. IgG titer increased rapidly until the fourth week of disease and decreased slowly after 4 weeks. The amplitudes of all the tested inflammatory and serological markers depended on the COVID-19 form, increasing somewhat in the moderate forms and even more in the critical ones. The lymphocyte and eosinophil count are able to predict the risk of severe COVID-19

The Immune, Inflammatory and Hematological Response in COVID-19 Patients, According to the Severity of the Disease

Introduction: The aim of this study was to evaluate the immune and inflammatory responses in COVID-19 patients by dosing specific IgM and IgG total antibodies and interleukin 6, correlating them with the hematological and biochemical blood parameters and comparing them by the form of the disease. Materials and methods: One hundred twenty-five patients with polymerase chain reaction-confirmed COVID-19, hospitalized between 15.03.2020 and 1.07.2020 in the Clinical Hospital of Infectious Diseases “Sf. Parascheva” Iaşi, were tested by chemiluminescence for the presence of anti-SARS-CoV-2 IgM and IgG and IL-6 in the serum. The results were correlated with the results of the CBC count and serum biochemical parameters detected on the admission day. The patients presented different forms of the disease (asymptomatic, mild, moderate, severe, and critical) according to World Health Organization (WHO) criteria for the clinical management of COVID-19. Results: The amplitude of the immune response was directly correlated with the form of the disease. In the asymptomatic/mild form patients, the IL-6 and CRP concentrations were significantly higher and eosinophil count was significantly lower compared with the reference interval. In the moderate form, the concentrations of IL-6, CRP, and IgG were significantly higher, compared with the reference interval, while eosinophil count and eGFR were significantly lower. In severe/critical COVID-19 patients, IL-6, CRP, NLR, PLR, glucose, AST, urea, creatinine, and eGFR were significantly higher compared with the reference interval, while eosinophil count was significantly lower. IL-6 boosted in all forms of COVID-19, with a major increase in severe and critical patients. IL-6, neutrophil count, % neutrophils, NLR, PLR, CRP, AST, and urea increased with the severity of the SARS-CoV-2 infection, and the lymphocyte count, % lymphocytes, eosinophil count, % eosinophils, and hemoglobin decreased with the increased severity of COVID-19. Conclusions: The amplitude and the moment of appearance of the immune response depended on the form of the disease. IgM generally occurred in the first 14 days of illness, and IgG appeared beginning with the second week of disease. IgG titer increased rapidly until the fourth week of disease and decreased slowly after 4 weeks. The amplitudes of all the tested inflammatory and serological markers depended on the COVID-19 form, increasing somewhat in the moderate forms and even more in the critical ones. The lymphocyte and eosinophil count are able to predict the risk of severe COVID-19

The Role of the Gut Microbiome in Psychiatric Disorders

The role of the gut microbiome in mental health has been of great interest in the past years, with several breakthroughs happening in the last decade. Its implications in several psychiatric disorders, namely anxiety, depression, autism and schizophrenia, are highlighted. In this review were included relevant studies on rodents, as well as human studies. There seems to be a connection between the gut microbiome and these pathologies, the link being emphasized both in rodents and humans. The results obtained in murine models align with the results acquired from patients; however, fewer studies regarding anxiety were conducted on humans. The process of sequencing and analyzing the microbiome has been conducted in humans for several other pathologies mentioned above. Additionally, the possible beneficial role of probiotics and postbiotics administered as an aid to the psychiatric medication was analyzed

Anti-RBD IgA and IgG Response and Transmission in Breast Milk of Anti-SARS-CoV-2 Vaccinated Mothers

The appearance of the severe acute respiratory syndrome virus-2 (SARS-CoV-2) has had a significant impact on the balance of public health and social life. The data available so far show that newborns and young children do not develop severe forms of COVID-19, but a small proportion of them will still need hospitalization. Even though young children represent an important vector of the infection, vaccination at such a young age was not yet considered. Thus, the question of whether potentially protective antibodies against SARS-CoV-2 could be provided to them via breast milk or across the placenta, as “passive immunity”, still stands. Materials and Methods: Between January–July 2021, we have conducted a prospective study that aimed to measure the immunoglobulin (Ig) A and IgG anti-SARS-CoV-2 titers in the breast milk of 28 vaccinated lactating mothers, sampled at 30 and 60 days after the second dose of the anti-SARS-CoV-2 Pfizer or Moderna mRNA vaccines. Anti-RBD reactive IgA and IgG antibodies were detected and quantified by a sandwich enzyme-linked immunosorbent assay. Results: Anti-RBD IgA and IgG were present in all breast milk samples, both in the first and in the second specimens, without a significant difference between those two. The anti-RBD IgA titers were approximately five-times higher than the anti-RBD IgG ones. The anti-RBD IgA and IgG titers were correlated with the infants’ age, but they were not correlated with the vaccine type or mother’s age. The anti-RBD IgA excreted in milk were inversely correlated with the parity number. Conclusions: Anti-SARS-CoV-2 IgA and IgG can be found in the milk secretion of mothers vaccinated with mRNA vaccines and, presumably, these antibodies should offer protection to the newborn, considering that the antibodies’ titers did not decrease after 60 days. The antibody response is directly proportional to the breastfed child’s age, but the amount of anti-RBD IgA decreases with the baby’s rank. The antibody response did not depend on the vaccine type, or on the mother’s age

SARS-CoV-2 Seroprevalence in Children under 5 Years Old—A Regional Seroepidemiological Study

Background and Objectives: The aim of this research was to assess the spread of SARS-CoV-2 infection; the study was motivated by parental hesitancy regarding child vaccination, and the potential passive immunity of infants acquired through breastfeeding from mothers vaccinated against COVID-19 or infected with SARS-CoV-2. Materials and Methods: We quantified the anti-SARS-CoV-2 immunoglobulin G (IgG) titer in the serum of 743 children under 5 years old, hospitalized between 1 August 2022, and 15 September 2023. Results: Among the participants, 52.76% had an anti-SARS-CoV-2 IgG titer that exceeded the reactivity threshold of the kit used, with an average of 1558.01 U/mL across the entire group. By age-specific categories, SARS-CoV-2 antibody prevalence was 43.04% for 0–12 months, 42.22% for 12–24 months, 61.67% for 24–36 months, 65.17% for 36–48 months, and 68.55% for 48–59 months. Gender analysis revealed 55.32% male participants, with a 52.07% seropositivity rate. Notably, IgG titer correlated positively with the child’s age. Gender, admission diagnosis, and emergency department presentation were not variation factors of the IgG titer. Conclusions: The majority of children in the study group demonstrated IgG against SARS-CoV-2, and this rate increased with the child’s age. Also, the IgG titer increased with the child’s age

Diagnosis, Management, and Prognosis of Cystic Fibrosis-Related Liver Disease in Children

Cystic fibrosis (CF) is a multifaceted disorder predominantly investigated for its pulmonary manifestations, yet patients with CF also exhibit a spectrum of extrapulmonary manifestations, notably those involving the hepatobiliary system. The latter constitutes the third leading cause of morbidity and mortality in individuals with CF. Cystic fibrosis-related liver disease (CFLD), with an escalating prevalence, manifests diverse clinical presentations ranging from hepatomegaly to cirrhosis and hepatopulmonary syndrome. Consequently, early detection and appropriate management are imperative for sustaining the health and influencing the quality of life of CF patients afflicted with CFLD. This review aims to consolidate existing knowledge by providing a comprehensive overview of hepatobiliary manifestations associated with CF. It delineates the clinical hepatobiliary manifestations, diagnostic methodologies, incorporating minimally invasive markers, and therapeutic approaches, encompassing the impact of novel CFTR modulators on CFLD. Given the exigency of early diagnosis and the intricate management of CFLD, a multidisciplinary team approach is essential to optimize care and enhance the quality of life for this subset of patients. In conclusion, recognizing CF as more than solely a pulmonary ailment, the authors underscore the imperative for further clinical investigations to establish a more robust evidence base for CFLD management within the continuum of this chronic disease