Examining the immune signatures of SARS-CoV-2 infection in pregnancy and the impact on neurodevelopment: Protocol of the SIGNATURE longitudinal study.

The COVID-19 pandemic represents a valuable opportunity to carry out cohort studies that allow us to advance our knowledge on pathophysiological mechanisms of neuropsychiatric diseases. One of these opportunities is the study of the relationships between inflammation, brain development and an increased risk of suffering neuropsychiatric disorders. Based on the hypothesis that neuroinflammation during early stages of life is associated with neurodevelopmental disorders and confers a greater risk of developing neuropsychiatric disorders, we propose a cohort study of SARS-CoV-2-infected pregnant women and their newborns. The main objective of SIGNATURE project is to explore how the presence of prenatal SARS-CoV-2 infection and other non-infectious stressors generates an abnormal inflammatory activity in the newborn. The cohort of women during the COVID-19 pandemic will be psychological and biological monitored during their pregnancy, delivery, childbirth and postpartum. The biological information of the umbilical cord (foetus blood) and peripheral blood from the mother will be obtained after childbirth. These samples and the clinical characterisation of the cohort of mothers and newborns, are tremendously valuable at this time. This is a protocol report and no analyses have been conducted yet, being currently at, our study is in the recruitment process step. At the time of this publication, we have identified 1,060 SARS-CoV-2 infected mothers and all have already given birth. From the total of identified mothers, we have recruited 537 SARS-COV-2 infected women and all of them have completed the mental health assessment during pregnancy. We have collected biological samples from 119 mothers and babies. Additionally, we have recruited 390 non-infected pregnant women

Predictores de riesgo en una cohorte española con cardiolaminopatías. Registro REDLAMINA

[Abstract] Introduction and objectives. According to sudden cardiac death guidelines, an implantable cardioverter-defibrillator (ICD) should be considered in patients with LMNA-related dilated cardiomyopathy (DCM) and ≥ 2 risk factors: male sex, left ventricular ejection fraction (LVEF) < 45%, nonsustained ventricular tachycardia (NSVT), and nonmissense genetic variants. In this study we aimed to describe the clinical characteristics of carriers of LMNA genetic variants among individuals from a Spanish cardiac-laminopathies cohort (REDLAMINA registry) and to assess previously reported risk criteria. Methods. The relationship between risk factors and cardiovascular events was evaluated in a cohort of 140 carriers (age ≥ 16 years) of pathogenic LMNA variants (54 probands, 86 relatives). We considered: a) major arrhythmic events (MAE) if there was appropriate ICD discharge or sudden cardiac death; b) heart failure death if there was heart transplant or death due to heart failure. Results. We identified 11 novel and 21 previously reported LMNA-related DCM variants. LVEF < 45% (P = .001) and NSVT (P < .001) were related to MAE, but not sex or type of genetic variant. The only factor independently related to heart failure death was LVEF < 45% (P < .001). Conclusions. In the REDLAMINA registry cohort, the only predictors independently associated with MAE were NSVT and LVEF < 45%. Therefore, female carriers of missense variants with either NSVT or LVEF < 45% should not be considered a low-risk group. It is important to individualize risk stratification in carriers of LMNA missense variants, because not all have the same prognosis.[Resumen] Introducción y objetivos. Según las guías de muerte súbita, se debe considerar un desfibrilador automático implantable (DAI) para los pacientes con miocardiopatía dilatada debida a variantes en el gen de la lamina (LMNA) con al menos 2 factores: varones, fracción de eyección del ventrículo izquierdo (FEVI) < 45%, taquicardia ventricular no sostenida (TVNS) y variantes no missense. Nuestro objetivo es describir las características clínicas de una cohorte española de pacientes con cardiolaminopatías (registro REDLAMINA) y evaluar los criterios de riesgo vigentes. Métodos. Se evaluó la relación entre factores de riesgo y eventos cardiovasculares en una cohorte de 140 portadores de variantes en LMNA (54 probandos, 86 familiares, edad ≥ 16 años). Se consideró: a) evento arrítmico mayor (EAM) si hubo descarga apropiada del DAI o muerte súbita, y b) muerte por insuficiencia cardiaca, incluidos los trasplantes. Resultados. Se identificaron 11 variantes nuevas y 21 previamente publicadas. La FEVI < 45% (p = 0,001) y la TVNS (p < 0,001) se relacionaron con los EAM, pero no el sexo o el tipo de variante (missense frente a no missense). La FEVI < 45% (p < 0,001) fue el único factor relacionado con la muerte por insuficiencia cardiaca. Conclusiones. En el registro REDLAMINA, los únicos 2 predictores asociados con EAM fueron la TVNS y la FEVI < 45%. No se debería considerar grupo de bajo riesgo a las portadoras de variantes missense con TVNS o FEVI < 45%. Es importante individualizar la estratificación del riesgo de los portadores de variantes missense en LMNA, porque no todas tienen el mismo pronóstico.This study received a grant from the Proyecto de investigación de la Sección de Insuficiencia Cardiaca 2017 from the Spanish Society of Cardiology and grants from the Instituto de Salud Carlos III (ISCIII) [PI14/0967, PI15/01551, AC16/0014] and ERA-CVD Joint Transnational Call 2016 (Genprovic). Grants from the ISCIII and the Ministerio de Economía y Competitividad de España (Spanish Department of Economy and Competitiveness) are supported by the Plan Estatal de I+D+i 2013-2016: Fondo Europeo de Desarrollo Regional (FEDER) “Una forma de hacer Europa”

Examining the immune signatures of SARS-CoV-2 infection in pregnancy and the impact on neurodevelopment: Protocol of the SIGNATURE longitudinal study

The COVID-19 pandemic represents a valuable opportunity to carry out cohort studies that allow us to advance our knowledge on pathophysiological mechanisms of neuropsychiatric diseases. One of these opportunities is the study of the relationships between inflammation, brain development and an increased risk of suffering neuropsychiatric disorders. Based on the hypothesis that neuroinflammation during early stages of life is associated with neurodevelopmental disorders and confers a greater risk of developing neuropsychiatric disorders, we propose a cohort study of SARS-CoV-2-infected pregnant women and their newborns. The main objective of SIGNATURE project is to explore how the presence of prenatal SARS-CoV-2 infection and other non-infectious stressors generates an abnormal inflammatory activity in the newborn. The cohort of women during the COVID-19 pandemic will be psychological and biological monitored during their pregnancy, delivery, childbirth and postpartum. The biological information of the umbilical cord (foetus blood) and peripheral blood from the mother will be obtained after childbirth. These samples and the clinical characterisation of the cohort of mothers and newborns, are tremendously valuable at this time. This is a protocol report and no analyses have been conducted yet, being currently at, our study is in the recruitment process step. At the time of this publication, we have identified 1,060 SARS-CoV-2 infected mothers and all have already given birth. From the total of identified mothers, we have recruited 537 SARS-COV-2 infected women and all of them have completed the mental health assessment during pregnancy. We have collected biological samples from 119 mothers and babies. Additionally, we have recruited 390 non-infected pregnant women.This work has received support from the Fundación Alicia Koplowitz to realize the epigenetic wide association study and to the clinical assessment to the children. This work has also received public support from the Consejería de Salud y Familias para la financiación de la investigación, desarrollo e innovación (i + d + i) biomédica y en ciencias de la salud en Andalucía (CSyF 2021 - FEDER). Grant Grant number PECOVID- 0195-2020. Convocatoria financiada con Fondo Europeo de Desarrollo Regional (FEDER) al 80% dentro del Programa Operativo de Andalucía FEDER 2014-2020. Andalucía se mueve con Europa. NG-T received payment under Rio Hortega contract CM20-00015 with the Carlos III Health Institute.Peer reviewe

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

RESULTADOS CLÍNICOS POSTQUIRÚRGICOS EN PACIENTES CON LESIONES DE LIGAMENTO CRUZADO POSTERIOR SOMETIDOS A CIRUGÍA DE RECONSTRUCCIÓN ARTROSCÓPICA CON EL USO DE INJERTO HTH, ALOINJERTO Y AUTOINJERTO.

I. RESUMEN. EVOLUCIÓN CLÍNICA POSTQUIRÚRGICA DE LOS PACIENTES CON LESIÓN DE LIGAMENTO CRUZADO POSTERIOR, SOMETIDOS A CIRUGÍA DE RECONSTRUCCIÓN ARTROSCÓPICA CON EL USO DE INJERTO HTH, ALOINJERTO Y AUTOINJERTO. Introducción: La prevalencia de la lesión del ligamento cruzado posterior comprenden el 3% de lesiones de rodilla en la población general, comprenden el 3.5% al 7.5% de las lesiones relacionadas con el trauma. La reconstrucción artroscópica hoy en día es el estándar de oro de tratamiento. Objetivo: Observar la evolución clínica postquirúrgica de los pacientes con lesión de ligamento cruzado posterior, sometidos a cirugía de reconstrucción artroscópica con el uso de aloinjerto o autoinjerto e injerto HTH. Material y métodos: se realizó un estudio retrospectivo, observacional y transversal, multicentrico en un periodo de 5 años. Se estudiaron 51 pacientes, intervenidos quirúrgicamente para reconstrucción de ligamento cruzado Posterior con aloinjerto autoinjerto e injerto HTH. Resultados: La etiología principal en nuestro medio fue por accidentes automovilísticos con el 70.6%. El sexo masculino, la rodilla derecha, edad de 25 a 41 años fueron los datos que predominaron en la población estudiada. De acuerdo a las escalas de Lysholm e IKDC, el aloinjerto y el autoinjerto mostraron resultados excelentes en más del 74.1% y en el 88.09% de los pacientes estudiados respectivamente, mientras con el injerto HTH hubo un 33.3% de resultados satisfactorios. Más del 85% de los pacientes mostraron una evolución clínica postquirúrgica satisfactoria, encontrando posterior a la cirugía una rodilla normal en las evaluaciones aplicadas. Conclusiones: La evolución clínica posquirúrgica de los pacientes es adecuada y similar a la reportada por la literatura internacional. Las escalas Lysholm e IKDC son estudios excelentes para la evaluación de la rodilla de los pacientes posquirúrgicos sometidos a reconstrucción del ligamento cruzado posterior, la mejor técnica evaluada por los test IKDC y LYSHOLM fue con autoinjerto o injerto de isquiotibiales, el injerto de isquiotibiales presenta una mayor estabilidad postquirúrgico evaluada en un tiempo de 6 meses

La sociedad de Extremadura desde la sociología. Claves para entender una realidad social en transformación

El libro que presentamos parte de un prólogo del Presidente de la Junta de Extremadura, don Guillermo Fernández Vara, que al aceptar nuestra petición de prologar este trabajo, da una vez más, muestra de la cercanía de su acción política e institucional a la realidad social de nuestra tierra. En “La sociedad de Extremadura desde la sociología”, se analizan los modelos socioeconómicos de la región en la segunda mitad del siglo XX, desde la visión sociológica del “atraso” regional, por José Antonio Pérez Rubio. También se estudia la pandemia de COVID-19, con una mirada desde la perspectiva sociológica, por parte de José Ignacio Urquijo Valdivielso, estudioso de la “sociología de las religiones” y preocupado por la lógica de la creación de los sistemas de valores en la sociedad actual, un ejemplo de esto es el capítulo sobre el impacto de COVID-19. El libro incluye dos capítulos del Tomás Calvo Buezas. El profesor Calvo, en este libro, realiza dos transcendentales aportaciones, la primera de ella relativa a los valores y opiniones de los jóvenes de España y de Extremadura, sobre la inmigración y el racismo. La segunda, como buen conocedor que es del sistema educativo de Cuba, los estrechos vínculos de España con el país caribeño. El capítulo del profesor Francisco Javier Monago Lozano, es una de las contribuciones más destacadas, ya que hoy nadie habla de movilidad social en Extremadura; mientras a nivel nacional e internacional, bajo la denominación de “ascensor social”, todos se refieren al declive de las clases medias. El historiador y sociólogo Guillermo León Cáceres, profesional comprometido con la lucha por la recuperación de la memoria histórica, ofrece un análisis de la conformación de ese movimiento en Extremadura, así como su activismo y el impacto de este en la esfera pública. Los sociólogos y antropólogos Juan Manuel Caso Mateos y Martín Gómez-Ullate, mediante el método del caso aplicado al estudio de la “movida cacereña”, abordan las bases de la cultura e identidad social en ese periodo histórico. La profesora Rocío Blanco Gregory, lleva a cabo una novedosa investigación relativa a la emigración joven cualificada, que tiene un alcance internacional y comparativo con dos regiones del sur de Europa como son Extremadura en España y La Campania en Italia. El capítulo muestra los factores estructurales y las razones individuales que predisponen a la movilidad territorial entre los jóvenes más cualificados. La profesora, y decana del Colegio de Sociólogos y Politólogos de Extremadura, Eva María Flores Guerrero, hace un balance de las variables que están determinado el problema demográfico de Extremadura. Finalmente, el profesor Marcelo Sánchez-Oro Sánchez, presidente de la Asociación de Sociología de Extremadura (ACISE) explica, con datos, que la Extremadura de hoy, es la historia de un éxito colectivo, basado en la equidad social y en niveles, inusitados para la región, de igualdad y bienestar, soportado todo ello en una amplia clase media. Esto significa que el cambio experimentado por Extremadura, en los últimos decenios, no tienen referencia en toda nuestra historia.The book we are presenting is based on a prologue by the President of the Regional Government of Extremadura, Mr. Guillermo Fernández Vara, who by accepting our request to write the prologue to this work, once again demonstrates the closeness of his political and institutional action to the social reality of our land. In "La sociedad de Extremadura desde la sociología", José Antonio Pérez Rubio analyses the socio-economic models of the region in the second half of the 20th century, from the sociological viewpoint of regional "backwardness". The COVID-19 pandemic is also studied from a sociological perspective by José Ignacio Urquijo Valdivielso, a scholar of the "sociology of religions" and concerned with the logic of the creation of value systems in today's society, an example of which is the chapter on the impact of COVID-19. The book includes two chapters by Tomás Calvo Buezas. Professor Calvo, in this book, makes two transcendental contributions, the first concerning the values and opinions of young people in Spain and Extremadura on immigration and racism. The second, as a connoisseur of Cuba's educational system, the close ties between Spain and the Caribbean country. The chapter by Professor Francisco Javier Monago Lozano is one of the most outstanding contributions, since today no one talks about social mobility in Extremadura, while at the national and international level, under the term "social lift", everyone refers to the decline of the middle classes. The historian and sociologist Guillermo León Cáceres, a professional committed to the struggle for the recovery of historical memory, offers an analysis of the formation of this movement in Extremadura, as well as its activism and its impact on the public sphere. Sociologists and anthropologists Juan Manuel Caso Mateos and Martín Gómez-Ullate, using the case method applied to the study of the "movida cacereña", address the foundations of culture and social identity in this historical period. Professor Rocío Blanco Gregory carries out a novel research project on qualified young emigration, which has an international and comparative scope with two regions in southern Europe, Extremadura in Spain and Campania in Italy. The chapter shows the structural factors and individual reasons that predispose the most qualified young people to territorial mobility. Eva María Flores Guerrero, professor and dean of the College of Sociologists and Political Scientists of Extremadura, takes stock of the variables that are determining the demographic problem in Extremadura. Finally, Professor Marcelo Sánchez-Oro Sánchez, President of the Association of Sociology of Extremadura (ACISE) explains, with data, that the Extremadura of today is the story of a collective success story, based on social equity and levels of equality and well-being, unheard of for the region, all supported by a large middle class. This means that the change experienced by Extremadura in recent decades is unparalleled in our history.La presente publicación ha sido posible gracias a la financiación concedida por la Consejería de Economía, Ciencia y Agenda Digital de la Junta de Extremadura y por el Fondo Europeo de Desarrollo Regional de la Unión Europea a través de la ayuda de referencia GR21161peerReviewe

COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization

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