Positive Serology Research Articles

No impact of a positive Chlamydia trachomatis serology on live-birth rate after intra-uterine insemination

ObjectiveTo study the impact of a CT serology on intrauterine insemination (IUI) cumulative live-birth rate (cLBR) in women with documented bilateral tubal patency. DesignCohort study SubjectsInfertile women with documented bilateral tubal patency and medical indication of IUI matched on the following criteria: woman's age, number of cycles completed and number of motile sperm inseminated (NMSI). ExposureThis retrospective, observational and monocentric cohort study compared women with positive CT serology matched 1:1 to control women with negative CT serology. Main outcome measuresCumulative LBR, rates of clinical pregnancy, spontaneous abortion, biochemical pregnancy. ResultsA total of 71 women in the CT positive group were matched to 71 women in the negative CT group, leading to compare 136 cycles per group. No statistically significant difference was observed between groups regarding the demographic and medical characteristics of couples. Cumulative LBR per woman was similar in both groups with 32.4% (n = 23) in the negative serology group Vs 25.4% (n = 18) in the positive CT group (NS). The rates of clinical pregnancy, spontaneous abortion, biochemical pregnancy were comparable between the two groups. ConclusionIn a population of infertile women with patent tubes, our study suggests that the serological status for CT has no impact on the IIU cLBR.

Diagnostic Yield of the Number of Duodenal Biopsies in Celiac Disease

Abstract Background The diagnosis of celiac disease relies on a combination of clinical evaluation, serological testing, and histopathological examination of duodenal biopsies. However, there is ongoing debate regarding the optimal number of duodenal biopsies required for an accurate diagnosis, as well as the isolated yield of water interface directed biopsy. Aim The primary objective is to determine the cumulative benefit of multiple duodenal biopsies, establishing the specificity and sensitivity of each biopsy separately with focus on the isolated yield of water interface directed biopsy. Methods A Cross-sectional study conducted on 22 children with symptoms and signs suggestive of celiac disease (CD) and positive serology with antitissue transglutaminase antibodies at the pediatric gastrointestinal endoscopy Unit at EL Demerdash Hospital, Ain Shams University for 6 months. four biopsies were taken, one from duodenal bulb, and 2 from rest of duodenum and the fourth one using water immersion technique visualizing the most affected area. Results Among the 22 enrolled children, 18 patients were histopathologically positive for celiac disease and 4 children were negative. The bulb, duodenal, and water interface biopsies were positive in 94.4%, 88.8%, and 66.7% respectively, of those positively diagnosed as celiac disease by Marsh criteria. In addition, bulb, and duodenal biopsies have the highest sensitivity of 94.4%, and 88.9%, respectively, also, they have the highest accuracy. Duodenal bulb biopsies were capable alone to diagnose 17 out of 18 definite cases. The missed case diagnosis was reached either by water interface or any random duodenal biopsy. Conclusion Bulb biopsy showed to be the most accurate in diagnosing celiac disease, on the contrary, water interface biopsy was not sensitive in diagnoses, so the celiac diagnostic efficacy can be reached by assessment of 2 duodenal biopsies, one of them from the duodenal bulb.

Clinical Characteristics and Outcome of Brucella Endocarditis: A Case Series.

Brucella endocarditis is a rare complication with a high mortality risk. This research aims to evaluate patients diagnosed with Brucella Endocarditis and review clinical characteristics, diagnosis, and treatment strategies to serve as a foundation for future research in managing Brucella endocarditis and improving patient care and outcomes. This retrospective study reviewed the medical records of patients diagnosed with Brucella endocarditis from 2011 to 2022. The study included patients of all ages and genders who were diagnosed based on positive serum serology or blood culture in conjunction with clinical presentation. Diagnostic criteria for endocarditis were based on evidence of endocardial involvement, as confirmed by echocardiographic findings consistent with infective endocarditis. Descriptive statistics were used for data analysis. Nine patients were included in this study. The most common presenting symptom was shortness of breath. Treatment regimens included Doxycycline and Rifampicin, always in combination with other antibiotics. Surgical intervention was necessary for two-thirds of the patients. Complications, such as septic shock, stroke, and heart failure, were observed in most cases. Six patients achieved clinical and microbiological cures, while one-third of the patients died. The deaths were primarily attributed to patients being deemed unsuitable for surgery due to a high surgical risk, based on their comorbidities and clinical assessments. This study highlights the importance of initiating an appropriate antibiotic regimen in a timely manner. Particularly in patients with pre-existing heart diseases, surgical intervention can significantly improve patient outcomes and reduce complications associated with Brucella endocarditis.

Anemia hemolítica en la infancia secundaria a neumonía por Mycoplasma pneumoniae

Autoimmune hemolytic anemia is rare in childhood with an incidence of approximately 0.8-1.25 cases per 100,000 children and is the most frequent cause of extracorpuscular hemolytic anemia, having a higher incidence between 3 and 4 years of age. Most of them are idiopathic, although they can also be secondary to autoimmune diseases, lymphoproliferative syndromes, tumors or infections (notably Mycoplasma and Epstein-Barr). They usually present as a self-limiting condition associated with a viral infection. Children under 2 years of age and adolescents frequently present chronic forms, associated or not, with systemic diseases, especially immunodeficiencies or autoimmune disorders. We present the case of an 11-year-old male patient, diagnosed with pneumonia with positive serologies for Mycoplasma and Cytomegalovirus, who developed autoimmune hemolytic anemia and required blood transfusion.

Evaluation of risk for bronchiolitis obliterans syndrome after allogeneic hematopoietic cell transplantation with myeloablative conditioning regimens

Bronchiolitis obliterans syndrome (BOS), as chronic manifestation of graft-versus-host disease (GVHD), is a debilitating complication leading to lung function deterioration in patients after allogeneic hematopoietic cell transplantation (allo-HCT). In the present study, we evaluated BOS development risk in patients after receiving myeloablative conditioning (MAC) regimens. We performed a retrospective analysis of patients undergoing allo-HCT, who received MAC with busulfan/cyclophosphamid (BuCy, n = 175) busulfan/fludarabin (FluBu4, n = 29) or thiotepa/busulfan/fludarabine (TBF MAC, n = 37). The prevalence of lung disease prior allo-HCT, smoking status, GvHD prophylaxis, HCT-CI score, EBMT risk score and GvHD incidence varied across the groups. The cumulative incidence of BOS using the NIH diagnosis consensus criteria at 2 years after allo-HCT was 8% in FluBu4, 23% in BuCy and 19% in TBF MAC (p = 0.07). In the multivariate analysis, we identified associated factors for time to BOS such as FEV1<median (99% of predicted) (HR = 2.39, p = 0.004), CMV patient serology positivity (HR = 2.11, p = 0.014), TLC < 80% of predicted (HR = 0.12, p = 0.02) and GvHD prophylaxis with in vivo T-cell depletion (HR = 0.29, p = 0.001) as predictors of BOS. In summary, we identified risk factors for BOS development in patients receiving MAC conditioning. These findings might serve to identify patients at risk, who might benefit from closely monitoring or early therapeutic interventions.

Seroprevalence of Anti-SARS-CoV-2 IgG Antibodies among Children attending the Pediatric Hospital in Bamako, Mali (BamaCoV-Kids Study).

This study aimed to assess the seroprevalence of SARS-CoV-2 among children attending pediatric consultations in Bamako, Mali, using a rapid diagnostic test (RDT) on fingertip or venous blood samples. A single-center, prospective cross-sectional study was conducted from May to September 2022 at the Pediatric Hospital in Bamako, Mali. Children aged 1 to 15 years underwent phlebotomy or fingertip blood sampling for SARS-CoV-2 antibody testing using the Abbott Panbio COVID-19 IgG/IgM Test. Demographic data and potential risk factors were collected. Categorical variables were compared using Fisher's exact test, and quantitative variables were analyzed using the Mann-Whitney test. A total of 315 children were included, with a median age of 6 years (range 3-9 years); 45.7% (144/315) were younger than 6 years, and 54% (170/315) were male. The majority lived in urban areas (89.9%) and used public transportation (85.7%). The overall seroprevalence was 63.5%, with a higher seroprevalence observed among children aged 6 years and older compared to those under 6 years. The odds of having a positive serology were approximately twice as high in children aged ≥6 years in both univariate (OR 1.99; 95% CI: 1.25-3.17; P=0.0014) and multivariable analyses (OR 2.05; 95% CI: 1.26-3.32; P=0.0038). No significant differences in seropositivity were found for other demographic or risk factors. A substantial proportion of children in Bamako showed evidence of past SARS-CoV-2 infection, underscoring the importance of continued surveillance and preventive measures in this population.

Seropositivity of West Nile virus among acute febrile patients in Ilorin, Nigeria.

West Nile Virus (WNV), a member of Flaviviridae family, is one of the most widely distributed arboviruses in the world. In developing countries like Nigeria, fever resulting from the WNV infection is often presumptively ascribed to malaria or typhoid due to misdiagnosis and low-level awareness of the viral infection. This study determined the prevalence of WNV IgM and IgG antibodies among febrile patients in the Ilorin metropolis. A total of two hundred (200) blood samples were collected from consenting patients and each serum was screened for anti-WNV IgM and IgG antibodies using indirect enzyme-linked immunosorbent assay (ELISA). Statistical correlation and logistic regression analysis were conducted. Overall, 6% (12/200) anti-WNV IgM seropositivity rate was recorded amongst the acute febrile patients with higher prevalence (6.30%) in females than in males (5.45%). Anti-WNV IgG positivity rate of 52% (104/200) was recorded, with 50.67% positivity rate in males and 38.95% in female participants. The convalescence phase posited by the 5.4% (11/200) co-detection of anti-WNV IgG and IgM antibodies among the participants was recorded. A statistical correlation was noticed with the age and religion of respondents to WNV serological positivity while gender, occupation, use of mosquito nets and formal education had no positive correlation at p < 0.05. However, based on odd ratio at 95% CI and logistic regression coefficients, the evaluated risk factors such as blood transfusion, residency, malaria parasite, and proximity to stagnant water and bush were significant to anti-WNV IgG and IgM positivity. The findings of this study show the circulation of WNV in the study area. There is an urgent need for clinicians/physicians to include screening for the West Nile virus in cases of febrile patients before the commencement of treatment.

Symptom burden, coagulopathy and heart disease after acute SARS-CoV-2 infection in primary practice

SETANTA (Study of HEarT DiseAse and ImmuNiTy After COVID-19 in Ireland) study aimed to investigate symptom burden and incidence of cardiac abnormalities after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/COVID-19 and to correlate these results with biomarkers of immunological response and coagulation. SETANTA was a prospective, single-arm observational cross-sectional study condcuted in a primary practice setting, and prospectively registered with ClinicalTrials.gov (identifier: NCT04823182). Patients with recent COVID-19 infection (≥ 6 weeks and ≤ 12 months) were prospectively enrolled. Primary outcomes of interest were markers of cardiac injury detected by cardiac magnetic resonance imaging (CMR), which included left ventricular ejection fraction, late gadolinium enhancement and pericardial abnormalities, as well as relevant biomarkers testing immunological response and coagulopathy. 100 patients (n = 129 approached) were included, amongst which 64% were female. Mean age of the total cohort was 45.2 years. The median (interquartile range) time interval between COVID-19 infection and enrolment was 189 [125, 246] days. 83% of participants had at least one persistent symptom, while 96% had positive serology for prior SARS-CoV-2 infection. Late gadolinium enhancement, pericardial effusion, was present in 2.2% and 8.3% respectively, while left ventricular ejection fraction was below the normal reference limit in 17.4% of patients. Von Willebrand factor antigen was elevated in 32.7% of patients and Fibrinogen and D-Dimer levels were found to be elevated in 10.2% and 11.1% of patients, respectively. In a cohort of primary practice patients recently recovered from SARS-CoV-2 infection, prevalence of persistent symptoms and markers of abnormal coagulation were high, despite a lower frequency of abnormalities on CMR compared with prior reports of patients assessed in a hospital setting.Trial Registration: Clinicaltrials.gov, NCT04823182 (prospectively registered on 30th March 2021).

Clinical and laboratory characteristics of Toxocara canis infection among children in Ho Chi Minh City, Vietnam.

This study determines the clinical and paraclinical characteristics of children with Toxocara canis infection and serum eosinophil cut-off values for predicting toxocariasis in the group displaying symptoms of itching, urticaria and erythema. A cross-sectional study was conducted during March and April 2023 with a sample size of 986 children aged 3-15 y. In total, 140 (14.2%) of the 986 participants had anti-T canis antibodies. The most frequently experienced symptoms in this group were itching (10.1%), abdominal pain (8.2%) and urticaria (3.3%). The rate of IgE increased (37%), and the rates of mild and high eosinophilia were 38% and 2.2%, respectively. There were significant differences in IgE concentration and eosinophil count, and for both IgE concentration and eosinophil count between the two groups with and without toxocariasis. The optimal threshold for eosinophil to predict toxocariasis was 0.38 K/µL, with itching, urticaria and erythema resulting in a sensitivity of 61.5%, a specificity of 82.1% and a receiver operating characteristic curve (area under the curve) of 0.71. This study confirmed a positive association between IgE concentration, eosinophil count and positive serology for T. canis. A general blood count, including eosinophils, is a simple test that can be performed in hospitals. Clinicians should target and screen for T.oxocara canis infection when children display clinical symptoms of itching, urticaria, erythema and eosinophilia. NCT05208333.

Clinical characterization of brucellosis in children from non-pastoral areas: a report of five cases

BackgroundBrucellosis is a global public health concern and occurs mainly in young adults and the elderly, with children having a lower incidence, thus often leading to delayed treatment. This study aimed to describe the epidemiologic features and clinical characteristics of brucellosis in children.MethodsIn this retrospective study, the clinical data of five children diagnosed with brucellosis in Anhui Provincial Children’s Hospital between January 1, 2021 and December 30, 2022 were analyzed.ResultsAll five cases were from non-pastoral areas, among which three have a history of livestock exposure and originated from the countryside. All patients had medium-high grade fever, mostly accompanied by night sweats and malaise, and three had joint pains. Laboratory tests showed that their white blood cell count was normal or mildly raised, with lymphocytes as the predominant cell population. Four patients had anemia, four had aspartate aminotransferase and alanine aminotransferase abnormality, and two had elevated ferritin levels. All blood samples were positive for Brucella culture, one of which had positive bone marrow culture, and all had positive serology test results. All patients were treated with rifampicin, in combination with sulfamethoxazole or doxycycline for 6 weeks following diagnosis. Four children had a good prognosis, but one child had recurrent joint pain.ConclusionsThe epidemiologic history of children from non-pastoral areas with brucellosis is often unclear; clinical manifestations and laboratory tests lack specificity; and they are easily delayed diagnosis. Clinicians should remain vigilant regarding the possibility of this disease in children with fever of unknown origin. The epidemiological history should be investigated in detail to improve the diagnostic ability of brucellosis. We recommend emphasizing serological testing. Children with brucellosis who receive timely diagnosis and standardized treatment can expect a favorable prognosis.

Tanto va la gatta al lardo che ci lascia lo zampino

The case describes a seven-year-old boy with a painful swelling in the right armpit. After excluding a neoplastic condition and noting recent contact with cats, Cat Scratch Disease was diagnosed, confirmed by positive serology for Bartonella henselae. Treatment with azithromycin led to improvement.

243. IS MUCOSAL CHANGE IN COELIAC DISEASE RESTRICTED TO SMALL BOWEL? STUDY OF OESOPHAGEAL MUCOSAL CHANGES IN CHILDREN WITH COELIAC DISEASE

Abstract Introduction Celiac disease (CeD) may cause changes throughout the gastrointestinal tract. It is not known whether the oesophageal mucosa is involved in CeD. The purpose of this prospective study was to study the mucosal changes in oesophagus in children with CeD. Materials &amp; Methods The mucosal changes in the esophagus was prospectively investigated in 126 children with CeD during 192 upper GI endoscopies performed to obtain duodenal biopsy specimens and was compared with findings in 49 children who underwent endoscopy for upper GI complaints without CeD (non-CeD patients) during one year. Children were diagnosed as cases of CeD based on the modified ESPGHAN criteria and positive serology. Duodenal histologic lesions were classified as proposed by our group. Results The mean age of CeD children (M:F::71:55) at presentation was 6.7 + 3.3 years. 54/126 (42.9%) of CeD and 23/49 (46.9%) of non-CeD patients showed normal oesophageal mucosa. The prevalence of lymphocytic oesophagitis (LyE) was higher in CeD (11.9%) than non-CeD (2.1%) patients. The prevalence of oeosinophilic oesophagitis, follicular oesophagitis, reflux oesophagitis and non-specific oesophageal mucosal changes were similar in both groups. All but one child with LyE showed classic duodenal histologic lesion. Conclusions Our findings showed that the oesophageal mucosa can be damaged in CeD patients and that the prevalence of LyE is higher with CeD. Awareness of potential coexistence of oesophageal lesions in CeD should promote optimal diagnosis of these conditions. Routine oesophageal biopsies may be warranted when investigating for CeD.

Donor-derived bartonellosis in solid organ transplant recipients from unhoused donors in Alberta

Bartonella quintana infection is rarely described to be transmitted through solid organ transplant (SOT). We report a cluster of using donor-derived B quintana infection and the attack rate from Bartonella seropositive donors. In this retrospective study of SOT recipients that received an organ from an unhoused deceased donor (UDD) in Alberta in 2022-2023, serology testing for Bartonella was performed indirect immunofluorescent assay on UDDs and recipients of UDDs with positive serology. Titers ≥1:64 were considered positive. During the study period, 31/32 UDDs were tested for immunoglobulin G to Bartonella (20 negative, 11 positive for B quintana and/or B henselae). Thirty-two organs were transplanted from the 11 seropositive donors. Six SOT recipients developed bartonellosis secondary to B quintana (4 SOT recipients received organs from 3 seropositive donors, and 2 SOT recipients from 1 UDD with no stored sample for testing). The attack rate for clinical disease from positive donors was 12.5% (4/32). The main presentation was skin nodules/papules (median 5.5 months) with bacillary angiomatosis in 4/6. Bartonella serology was positive in 5/6 SOT recipients (initially negative in 2) and blood B quintana quantitative polymerase chain reaction in 1. None had visceral involvement. All donors had history of substance use. This outbreak of bartonellosis reinforces the potential for unexpected donor-transmitted infections. Clinicians should be aware of high transmission of B quintana through transplant from infected UDDs.

Sécurité Transfusionnelle En Milieu Rural En République Démocratique Du Congo: Plaidoyer pour un dépistagesystématique des hépatites virales B, C et pour la fidélisation des donneurs de sang

Introduction: Transfusional safety remains a major concern in our environment where the permanent availability of the screening tests is not always guaranteed. The first aim of this work is to highlight the prevalence of HBV, HCV and HIV infections and to encourage systematic screening for these viruses. The second aim is to identify the risk incurred by the transfused person depending on whether the blood donor is a loyal blood donor or an improvised familialblood donor. Methods:We conducted a multicentric cross-sectional study at health centers and hospitals performing blood transfusion in Uvira, Kiliba and Lemera (Eastern D.R. Congo) between January 2018 and December 2022. Thirteen thousand and sixty-two blood donors were recruited. Statistical analyzes were done using the Epi Info 7.2 software and the corrected Chi-square or exact Fischer test (when recommended) was used to search for an association between the epidemiological variables. Measurement of association strength by Odds Ratios (95% confidence intervals) was used to compare frequencies observed across donor categories based on the presence of infectious markers. The threshold of significance was set at p &lt;0.05. Results:On a total of 13062 donors, 483 (3.7%) were HIV-positive, 837 (6.4%) seropositive to HBV, and 208 (1.6%) HCV-positive. Among these infected donors (n=1528), 68.39 % N=1045) was infected by the viruses of the hepatitis. Compared to loyal donors, paid donors had 14.38 times the risk of having positive HIV serology (OR = 14.38 [5.16-40.06]), 6.53 and 30.89 times the risk for HBV (OR = 6.53 [3.20-13.34]) and HCV (OR = 30.89 [6.95-283.72]). Conclusion:In rural health zones we studied, blood receivers are at high risk of contamination with HIV, hepatitis by blood given by an unreliable blood donor. Transfusion safety measures should be strengthened by obligatory and systematic HBV and HCV research as well as HIV

Temporal Association Between COVID-19 Immunoglobulin-G Antibody Induced Focal Cerebral Arteriopathy and New-Onset Acute Ischemic Stroke in a Pediatric: Is it Causal or Coincidental?

ABSTRACT Focal cerebral arteriopathies, vasculitis, microangiopathies, coagulopathies, and in-situ microthrombi leading to territorial infarction of neural tissues are some of the most recent instances which are reported as a consequence of the infection caused by the novel coronavirus (SARS-CoV-2). Acute ischemic stroke (AIS) is one of the major neurological manifestations that have been linked with COVID-19. We describe a case of a 5-year-old boy who had an acute-onset of bilateral arm and leg weakness due to a posterior circulatory ischemic stroke that was temporally associated with COVID-19 Immunoglobulin-G antibody-induced cerebral arteriopathies and vasculitis. Laboratory examination was suggestive of elevated D-dimer levels to 3302 ng/ml, elevated C-reactive protein to 10 mg/dl, and elevated fibrinogen levels to 433 mg/dl. He had a negative COVID-19 nasopharyngeal polymerase chain reaction and positive COVID-19 serologies. Focal cerebral arteriopathy and AIS were managed by administering early antithrombotics, steroids, and multivitamins. On routine follow-ups, the patient remained free from new neurological and functional deficits. Although many hypotheses are proposed to explain the causal relationship between the two, it could as well be sheer coincidence.

Timing is essential: Humoral and cellular responses to SARS-CoV-2 vaccination in a cohort of patients with auto-immune diseases treated with rituximab

Rituximab (RTX), an anti CD20 monoclonal antibody, is now a gold standard treatment for several auto-immune and chronic inflammatory diseases. Receiving RTX exposes patients to more severe infections as vaccinations become virtually inefficient in terms of B cell responses. During the COVID-19 crisis, RTX–exposed patients exhibited more severe forms of the disease, and in some cases, the introduction of RTX was delayed or avoided to protect patients as much as possible against SARS-CoV-2 infections. We retrospectively collected cellular and humoral responses from thirteen patients with dermatological and rheumatological autoimmune diseases who had been vaccinated after receiving RTX. Memory T cells subsets from patients that exposed to RTX showed few differences when compared to a cohort of healthy donors. The IFNᵧ ELISpot assay using SARS-CoV-Prot_S1 showed that eight patients exhibited a positive response that was neither correlated to the time between RTX infusion and the sampling nor to the time between RTX and the vaccination. Conversely, analysis of the SARS-CoV-2 serology showed a clearly lower binding antibody units per mL in case of recent RTX infusion. The safe threshold forconsistently positive serology was to vaccinate at least 300 days after RTX infusion (p = 0.02). Our data illustrate the difficulty in obtaining a satisfactory response to vaccination after RTX treatment within almost a year after the latest infusion, and emphasize the need to better evaluate the risk of relapses in auto-immune diseases before administering RTX in order to maintain RTX only in patients whose medical situation requires it.

Acute leptospirosis in horses: A retrospective study of 11 cases (2015-2023).

Reports of leptospirosis in horses are limited. To describe the clinical and diagnostic findings of acute systemic leptospirosis in horses. Eleven client-owned horses presented to an equine hospital because of acute onset of disease between 2015 and 2023. Retrospective case series. Horses diagnosed with leptospirosis by 1 or more of urine PCR, serologic microscopic agglutination test (MAT), and histopathology. Common clinical signs included lethargy (10), anorexia (10), fever (9), tachypnea (9), abnormal lung sounds (9), and epistaxis (6). Acute kidney injury was present in all cases. Evidence of pulmonary hemorrhage and liver disease was found in 8 (73%) and 6 (55%) horses, respectively. In 6 (55%) horses, kidneys, lungs, and liver were affected. Urine quantitative polymerase chain reaction for detection of pathogenic Leptospira spp. was positive in 6 (55%) cases. On serology Leptospira interrogans serovar Australis, Autumnalis, and Bratislava accounted for 86% of all titers ≥1 : 800. Overall case fatality rate was 4/11 (36%). Main findings on necropsy were tubular necrosis, interstitial nephritis, hemorrhage in the alveoli, pulmonary edema, periportal hepatitis and necrosis, cholestasis, and cholangitis. Leptospirosis should be considered as a differential diagnosis in horses with evidence of acute systemic inflammation and acute renal injury, epistaxis, or hepatic disease. For increased likelihood of identifying positive cases, both MAT serology and urine PCR should be performed.

Safety and tolerability of immune checkpoint inhibitors in people with HIV infection and cancer: insights from the national prospective real-world OncoVIHAC ANRS CO24 cohort study

BackgroundImmune checkpoint inhibitors (ICIs) have been a major advance in cancer management. However, we still lack prospective real-world data regarding their usage in people with HIV infection (PWH).MethodsThe ANRS CO24...

COVID-19 throughout pandemic waves and virus variants: a real-life experience in an Italian hospital.

New therapies and vaccines changed the management of COVID-19. The aim of this retrospective study was to describe characteristics, in-hospital mortality and its predictors in patients with moderate/severe COVID-19, considering the 4 different pandemic waves and viral variants' prevalence from February 2020 to January 2022. Among 1135 patients included, 873 (77%) had at least one comorbidity, 177 (16%) were immunocompromised. From waves 1 to 4, patients with severe respiratory failure and ICU admission decreased over time (p < 0.001), like the length of in-hospital stay (p < 0.001). Despite a reduction of in-hospital mortality from 19% to 11%, increased risk of death was related to older age and immunocompromising conditions, especially during the 4th wave (HR = 5.07 and HR = 10.86, p < 0.001 respectively) while remdesivir treatment in the 3rd wave (HR = 0.41, p = 0.010) and positive serology (aHR = 0.66, p = 0.027) were protective for survival. These data support the need for tailoring vaccine campaign for future COVID-19 waves.

A study of predictors of retention to naltrexone maintenance therapy in patients with opioid use disorder: a prospective study

ObjectivesNaltrexone prophylaxis is a well-established treatment for opioid use disorder. Our study aimed to track patients on naltrexone and investigate the factors predictive of retention.Materials and methodsThe study comprised 100 participants initiated on naltrexone, who underwent a 12-week follow-up. We analyzed a range of socio-demographic and clinical variables at 04 and 12 weeks to compare those who remained in treatment program with those who experienced relapse.ResultsThe results revealed a predominantly young, unmarried, male, rural-dwelling sample with heroin as the primary opioid. Intravenous use was common (75%), with 57% of the participants exhibiting positive serology results for infections by hepatitis C (HCV), hepatitis B (HBV), and/or human immunodeficiency virus (HIV), and a significant proportion initiating opioids before the age of 20 (31%). The retention rates at 04 and 12 weeks were 83% and 64%, respectively. Several socio-clinical factors including age of initiation of use, rural residence, and comorbid psychiatric illness significantly influenced retention at 04 and 12 weeks.ConclusionThe findings highlight the importance of tailored interventions that take into consideration the age, residence, socio-economic status, and psychiatric comorbidity to enhance retention rates. Identifying these factors can help improve the effectiveness of treatment programs and promote sustained recovery efforts.