Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Niveles de microriego y su efecto sobre el crecimiento y productividad de árboles de aguacate

Avocado (Persea americana Mill. cv. Simmonds) is an important fruit among consumers in Puerto Rico and in the Hispanic community in the United States. During the last years, orchard establishment has increased considerably in Puerto Rico, where production of this fruit is third behind mango and oranges. Currently growers need to deal with lack of information on proper irrigation management in orchards under conditions observed in Puerto Rico. Typically, growers are encouraged to adopt an irrigation scheduling method to ensure tree establishment and adequate productivity, and thus to reduce problems associated with improper irrigation management. The Universities of Puerto Rico and Florida recommend the use of tensiometers to schedule irrigation for fruit trees. An avocado orchard was established during 2001 for evaluating the effect of soil water tension measured by tensiometers on growth and productivity of avocado trees under microirrigation. The predominant soil series at the experimental site is Coto clay, classified as Typic Eutrustox. Planting distance was 9.1 m x 9.1 m. Trees were submitted to two microirrigation treatments scheduled by using tensiometers installed at 30-cm and 45-cm depths. Trees were irrigated when tensiometer readings reached a low depletion level (10 to 15 kPa) or a high depletion level (40 to 45 kPa). A rainfed treatment was included as check. Variables measured were canopy volume, fruit weight and number, and irrigation applied. Canopy volume of trees growing under rainfed conditions was significantly lower than that of trees submitted to either 10 to 15 kPa or 40 to 45 kPa microirrigation treatment. Trees submitted to 40 to 45 kPa showed the maximum canopy volume, 148 m3/tree, which was not significantly different from that of trees submitted to 10 to 15 kPa. Only in 2005, trees irrigated at low depletion levels produced 68 fruits per tree, an amount which was significantly greater than that of the other two irrigation treatments. In general, avocado trees submitted to high depletion level significantly increased their growth and yield.El aguacate (Persea americana Mill. cv. Simmonds) es una fruta de mucha importancia en Puerto Rico y en la comunidad Latina en los Estados Unidos. En los últimos años, el establecimiento de huertos de aguacate en Puerto Rico ha aumentado considerablemente; la producción de esa fruta se colocó tercera, después de la de mango y la de las chinas. Para asegurar el establecimiento de los árboles, la productividad y la reducción de los problemas asociados al manejo inapropiado del riego, se promueve que los productores adopten algún método para calendarizar el microriego. La Universidad de Puerto Rico y la Universidad de Florida recomiendan el uso de tensiómetros para calendarizar el microriego en árboles frutales. En el 2001 se sembró un huerto de aguacate para establecer un experimento para evaluar el efecto de la tensión hídrica, medida con tensiómetros, en el crecimiento y productividad de árboles de aguacate bajo microriego. La serie de suelo predominante en el predio experimental es Coto arcilloso, clasificado como Typic Eutrustox. La distancia de siembra de los árboles fue de 9.1 m x 9.1 m. Los árboles se sometieron a dos tratamientos de microriego calendarizados utilizando tensiómetros instalados a 30 y 45 cm de profundidad. En ambos tratamientos, los árboles se regaban cuando la tensión hídrica del suelo alcanzaba los valores críticos predeterminados, entre 10 y 15 kPa y entre 40 y 45 kPa. Se incluyó un tercer tratamiento sin riego como testigo. Las variables utilizadas para medir la respuesta de los árboles a los tratamientos de microriego fueron rendimiento, volumen de la copa, número y peso de frutas por árbol, y la cantidad de riego aplicada. El volumen de la copa de los árboles a los cuales no se les aplicaba microriego fue significativamente menor que el de los árboles con los dos tratamientos de microriego probados. El volumen de la copa máximo registrado fue de 148 m3/árbol, obtenido cuando la tensión hídrica del suelo alcanzaba de 40 a 45 kPa; éste no fue significativamente diferente al obtenido cuando se regaba a 10 a 15 kPa. El rendimiento más alto fue 84 kg/árbol y se observó en los árboles regados cuando la tensión superaba los 40 a 45 kPa. Solo en el 2005, el número de frutas por árbol en el tratamiento 10 a 15 kPa superó significativamente a los demás tratamientos, con 68 frutas por árbol. En términos generales, los árboles de aguacate sometidos a una tensión hídrica en el suelo de 40 a 45 kPa produjeron significativamente mayor crecimiento y rendimiento

Rapid decrease in titer and breadth of neutralizing anti-HCV antibodies in HIV/HCV-coinfected patients who achieved SVR

The main targets for neutralizing anti-hepatitis C virus (HCV) antibodies (HCV-nAbs) are the E1 and E2 envelope glycoproteins. We have studied the characteristics of HCV-nAbs through a retrospective study involving 29 HIV/HCV-coinfected patients who achieved sustained virological response (SVR) with peg-IFNα + ribavirin anti-HCV therapy. Plasma samples at baseline and week 24 after SVR were used to perform neutralization assays against five JFH1-based HCV recombinant viruses coding for E1 and E2 from genotypes 1a (H77), 1b (J4), 2a (JFH1), 3a (S52) and 4a (ED43). At baseline, the majority of plasma samples neutralized 1a, 1b, 2a, and 4a, but not 3a, genotypes. Twenty-four weeks following SVR, most neutralizing titers declined substantially. Furthermore, titers against 3a and 2a were not detected in many patients. Plasma samples with high HCV-nAb titers neutralized all genotypes, and the highest titers at the starting point correlated with the highest titers at week 24 after SVR. In conclusion, high titers of broad-spectrum HCV-nAbs were detected in HIV/HCV-coinfected individuals, however, those titers declined soon after SVR

Plan integral de atención a la accidentabilidad 2007-2012

Publicado en la página web de la Consejería de Igualdad, Salud y Políticas Sociales: www.juntadeandalucia.es/salud (Consejería de Igualdad, Salud y Políticas Sociales / Ciudadanía / Quiénes somos / Planes y Estrategias)YesEl Plan Integral de Atención a la Accidentabilidad se centra en tres líneas de trabajo simultáneas, que se corresponden con las distintas fases que rodean a un accidente, es decir antes, durante y después de que el mismo ocurra. Por ello, una de las líneas está precisamente dirigida, a través de acciones preventivas intersectoriales, a evitar que el accidente se produzca. Para cuando el accidente desafortunadamente no ha podido ser evitado, el Plan desarrolla una segunda línea destinada a la prestación de la mejor asistencia posible, potenciando la coordinación de los distintos servicios y dispositivos implicados. La tercera línea, por último, es la que plantea, tras el alta, las actuaciones necesarias que garanticen la continuidad asistencial en el domicilio en función de las secuelas

Impact of late presentation of HIV infection on short-, mid- and long-term mortality and causes of death in a multicenter national cohort : 2004-2013

To analyze the impact of late presentation (LP) on overall mortality and causes of death and describe LP trends and risk factors (2004-2013). Cox models and logistic regression were used to analyze data from a nation-wide cohort in Spain. LP is defined as being diagnosed when CD4 < 350 cells/ml or AIDS. Of 7165 new HIV diagnoses, 46.9% (CI:45.7-48.0) were LP, 240 patients died.First-year mortality was the highest (aHR = 10.3[CI:5.5-19.3]); between 1 and 4 years post-diagnosis, aHR = 1.9(1.2-3.0); an

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

CatedresBackground: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). Methods: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. Results: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. Conclusions: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women

Prediction of long-term outcomes of HIV-infected patients developing non-AIDS events using a multistate approach

Outcomes of people living with HIV (PLWH) developing non-AIDS events (NAEs) remain poorly defined. We aimed to classify NAEs according to severity, and to describe clinical outcomes and prognostic factors after NAE occurrence using data from CoRIS, a large Spanish HIV cohort from 2004 to 2013. Prospective multicenter cohort study. Using a multistate approach we estimated 3 transition probabilities: from alive and NAE-free to alive and NAE-experienced ("NAE development"); from alive and NAE-experienced to death ("Death after NAE"); and from alive and NAE-free to death ("Death without NAE"). We analyzed the effect of different covariates, including demographic, immunologic and virologic data, on death or NAE development, based on estimates of hazard ratios (HR). We focused on the transition "Death after NAE". 8,789 PLWH were followed-up until death, cohort censoring or loss to follow-up. 792 first incident NAEs occurred in 9.01% PLWH (incidence rate 28.76; 95% confidence interval [CI], 26.80-30.84, per 1000 patient-years). 112 (14.14%) NAE-experienced PLWH and 240 (2.73%) NAE-free PLWH died. Adjusted HR for the transition "Death after NAE" was 12.1 (95%CI, 4.90-29.89). There was a graded increase in the adjusted HRs for mortality according to NAE severity category: HR (95%CI), 4.02 (2.45-6.57) for intermediate-severity; and 9.85 (5.45-17.81) for serious NAEs compared to low-severity NAEs. Male sex (HR 2.04; 95% CI, 1.11-3.84), ag

Effect of accompanying antiretroviral drugs on virological response to pegylated interferon and ribavirin in patients co-infected with HIV and hepatitis C virus

The effects of antiretroviral drugs on the response to pegylated interferon plus ribavirin remain uncertain. We evaluated whether antiretroviral drugs affected the response to pegylated interferon plus ribavirin in patients co-infected with HIV and hepatitis C virus (HCV). We conducted a retrospective analysis of two cohorts of HIV/HCV-co-infected patients treated with pegylated interferon plus ribavirin between 2001 and 2007 in Spain. The outcome measure was sustained virological response (SVR). Logistic regression models were used to test possible associations between non-response and pre-treatment characteristics, including accompanying antiretroviral drugs. The study sample comprised 1701 patients: 63% were infected with HCV genotype (G) 1 or 4 and 88% were taking highly active antiretroviral therapy (HAART). Factors independently associated with increased odds of SVR were G2 or 3, HVC RNA <500,000 IU/mL and CDC clinical category A or B. When we adjusted for these prognostic factors and dose of ribavirin/kg, the adjusted odds ratio (AOR) of SVR for patients without HAART was 1.31 [95% confidence interval (CI) 0.91-1.88; P = 0.144]. Taking the backbone of tenofovir and lamivudine/emtricitabine as a reference, we found that, with the exception of regimens including zidovudine, the effect of other nucleoside reverse transcriptase inhibitor backbones had little effect on SVR. The AOR of SVR for zidovudine and lamivudine was 0.65 (95% CI 0.46-0.93, P = 0.017). We carried out several sensitivity analyses, the results of which were consistent with the findings of the primary analysis. In conclusion, our results suggest that, with the exception of regimens including zidovudine, accompanying antiretroviral drugs have little effect on the virological response to pegylated interferon plus ribavirin in HIV/HCV-co-infected patients.5.068 JCR (2011) Q1, 7/70 Infectious diseases, 18/114 Microbiology, 20/261 Pharmacology & pharmac