Background/Objectives
The safety and immunogenicity of the BNT162b2 coronavirus disease 2019 (COVID‐19) vaccine in older adults with different frailty and disability profiles have not been well ...determined. Our objective was to analyze immunogenicity of the BNT162b2 mRNA COVID‐19 vaccine in older adults across frailty and disability profiles.
Design
Multicenter longitudinal cohort study.
Setting and participants
A total of 134 residents aged ≥65 years with different frailty and disability profiles in five long‐term care facilities (LTCFs) in Albacete, Spain.
Intervention and measurements
Residents were administered two vaccine doses as per the label, and antibody levels were determined 21.9 days (SD 9.3) after both the first and second dose. Functional variables were assessed using activities of daily living (Barthel Index), and frailty status was determined with the FRAIL instrument. Cognitive status and comorbidity were also evaluated.
Results
Mean age was 82.9 years (range 65–99), and 71.6% were female. The mean antibody titers in residents with and without previous COVID‐19 infection were 49,878 AU/ml and 15,274 AU/ml, respectively (mean difference 34,604; 95% confidence interval CI: 27,699–41,509). No severe adverse reactions were observed, after either vaccine dose. Those with prevaccination COVID‐19 had an increased antibody level after the vaccine (B = 31,337; 95% CI: 22,725–39,950; p < 0.001). Frailty, disability, older age, sex, cognitive impairment, or comorbidities were not associated with different antibody titers.
Conclusions
The BNT162b2 mRNA COVID‐19 vaccine in older adults is safe and produces immunogenicity, independently of the frailty and disability profiles. Older adults in LTCFs should receive a COVID‐19 vaccine.
Chronic graft-versus-host disease (GVHD) is the leading cause of later illness and death after allogeneic hematopoietic stem-cell transplantation. We hypothesized that the inclusion of antihuman ...T-lymphocyte immune globulin (ATG) in a myeloablative conditioning regimen for patients with acute leukemia would result in a significant reduction in chronic GVHD 2 years after allogeneic peripheral-blood stem-cell transplantation from an HLA-identical sibling.
We conducted a prospective, multicenter, open-label, randomized phase 3 study of ATG as part of a conditioning regimen. A total of 168 patients were enrolled at 27 centers. Patients were randomly assigned in a 1:1 ratio to receive ATG or not receive ATG, with stratification according to center and risk of disease.
After a median follow-up of 24 months, the cumulative incidence of chronic GVHD was 32.2% (95% confidence interval CI, 22.1 to 46.7) in the ATG group and 68.7% (95% CI, 58.4 to 80.7) in the non-ATG group (P<0.001). The rate of 2-year relapse-free survival was similar in the ATG group and the non-ATG group (59.4% 95% CI, 47.8 to 69.2 and 64.6% 95% CI, 50.9 to 75.3, respectively; P=0.21), as was the rate of overall survival (74.1% 95% CI, 62.7 to 82.5 and 77.9% 95% CI, 66.1 to 86.1, respectively; P=0.46). There were no significant between-group differences in the rates of relapse, infectious complications, acute GVHD, or adverse events. The rate of a composite end point of chronic GVHD-free and relapse-free survival at 2 years was significantly higher in the ATG group than in the non-ATG group (36.6% vs. 16.8%, P=0.005).
The inclusion of ATG resulted in a significantly lower rate of chronic GVHD after allogeneic transplantation than the rate without ATG. The survival rate was similar in the two groups, but the rate of a composite end point of chronic GVHD-free survival and relapse-free survival was higher with ATG. (Funded by the Neovii Biotech and the European Society for Blood and Marrow Transplantation; ClinicalTrials.gov number, NCT00678275.).
Multiple myeloma is a very heterogeneous disease with variable survival. Despite recent progress and the widespread use of new agents, patients with relapsed and refractory disease have a poor ...outcome. Immunomodulatory drugs play a key role in both the front-line and the relapsed/refractory setting. The combination of pomalidomide (POM) and dexamethasone is safe and effective in relapsed and refractory patients, even in those with high-risk cytogenetic features. Furthermore, it can be used in most patients without the need to adjust according to the degree of renal failure. In order to further improve the results, POM-based triplet therapies are currently used. This article highlights the most relevant issues of POM and POM-based combinations in the relapsed/refractory multiple myeloma setting, from a pharmacological and clinical point of view.
Intra-abdominal epithelioid angiosarcoma Torres Jurado, Manuel José; López Sánchez, Jaime; Quiñones Sampedro, José Edecio ...
Revista española de enfermedades digestivas,
12/2022, Letnik:
114, Številka:
12
Journal Article
Recenzirano
Odprti dostop
The epithelioid angiosarcoma is a type of sarcoma is very rare (<1 % of all sarcomas). The most frequent location is in extremities, therefore is the axial region less common.Differential diagnosis ...with other histologic variants of intra-abdominal hepatic and splenic angiosarcomas is essential. Surgery is the treatment of choice, and there is no current evidence on the management of cases with locoregional or distant involvement.
Abstract
Despite the wide biodiversity of avian species of zootechnical interest in Spain, projects aimed at characterizing these genotypes and their products are necessary. External and internal egg ...quality traits were measured in 819 eggs laid by hens of 10 different genotypes: White, Franciscan, Black and Partridge varieties of Utrerana, Blue Andalusian, Spanish White-Faced, Andalusian Tufted White and Black varieties, Araucana; and Leghorn Lohmann LSL-Classic lineage (commercial hybrid line) hen breeds. After multicollinearity analysis of egg quality-related traits was performed (VIF ≤ 4), major diameter, minor diameter, egg weight, and albumen height were deemed redundant explanatory variables and discarded. A stepwise discriminant canonical analysis was developed to cluster eggs across hen genotypes considering egg quality attributes. Shell a* and b* variables reported the highest discriminant power (Wilks’ lambda: 0.699 and 0.729, respectively). The first two discriminant functions captured 60.48% of the variance across groups (F1: 39.36%; F2: 21.12%). Clear quality differentiation signs are evidenced for Mediterranean native breeds’ eggs when compared to Leghorn’s eggs. Consequently, this evidence of egg quality differentiation may favor the standardization of breed- and variety-linked distinctive products, which may open new market opportunities based on the existence of a wide spectrum of diet or culinary applications.
Background
Older adults are at the highest risk of severe disease and death due to COVID‐19. Randomized data have shown that baricitinib improves outcomes in these patients, but focused stratified ...analyses of geriatric cohorts are lacking. Our objective was to analyze the efficacy of baricitinib in older adults with COVID‐19 moderate‐to‐severe pneumonia.
Methods
This is a propensity score PS‐matched retrospective cohort study. Patients from the COVID‐AGE and Alba‐Score cohorts, hospitalized for moderate‐to‐severe COVID‐19 pneumonia, were categorized in two age brackets of age <70 years old (86 with baricitinib and 86 PS‐matched controls) or ≥70 years old (78 on baricitinib and 78 PS‐matched controls). Thirty‐day mortality rates were analyzed with Kaplan–Meier and Cox proportional hazard models.
Results
Mean age was 79.1 for those ≥70 years and 58.9 for those <70. Exactly 29.6% were female. Treatment with baricitinib resulted in a significant reduction in death from any cause by 48% in patients aged 70 or older, an 18.5% reduction in 30‐day absolute mortality risk (n/N: 16/78 20.5% baricitinib, 30/78 38.5% in PS‐matched controls, p < 0.001) and a lower 30‐day adjusted fatality rate (HR 0.21; 95% CI 0.09–0.47; p < 0.001). Beneficial effects on mortality were also observed in the age group <70 (8.1% reduction in 30‐day absolute mortality risk; HR 0.14; 95% CI 0.03–0.64; p = 0.011).
Conclusions
Baricitinib is associated with an absolute mortality risk reduction of 18.5% in adults older than 70 years hospitalized with COVID‐19 pneumonia.
Despite Ecuador having a wide biodiversity of zootechnical species, characterization studies of these genetic resources are scarce. The objective of this research was to perform the biometric ...characterization of the Creole hen population through 14 quantitative zoometric measures. We evaluated 207 hens and 37 roosters from Ecuador's three agro-ecological regions: the Sierra (highlands) region (Bolivar, Chimborazo, Tungurahua and Cotopaxi provinces); the Costa (coastal) region (Guayas); and the Oriente Amazonian region (Morona Santiago). Sexual dimorphism was assessed using one-way analysis of variance (ANOVA). Body dimensions were generally significantly higher for males (
< 0.05), especially for length of head, beak, neck, dorsum, tarsus, thigh, leg, and middle finger. Then, individuals were biometrically clustered into populations after a stepwise canonical discriminant analysis (CDA) computing interpopulation Mahalanobis distances. Agroecologically-based structured populations were identified when zoometrical criteria were used to classify the animals. Cotopaxi and Tungurahua provinces were reported to be the most distant from the rest, with a slight differentiation of the Morona Santiago province population from those in Guayas, Chimborazo and Bolívar. Conclusively, Ecuadorian Creole hens were higher than longer contrasting light hen breeds, which favors their dual-purpose aptitude. Hence, the development of selection programs aimed at Ecuadorian differentiated entity of production of eggs and meat across agro-ecological areas is feasible.
Prognostic factors of poor outcome in patients with hematological malignancies and COVID-19 are poorly defined.
This was a Spanish transplant group and cell therapy (GETH) multicenter retrospective ...observational study, which included a large cohort of blood cancer patients with laboratory-confirmed SARS-CoV-2 infection through PCR assays from March 1st 2020 to May 15th 2020.
We included 367 pediatric and adult patients with hematological malignancies, including recipients of autologous (ASCT) (n = 58) or allogeneic stem cell transplantation (allo-SCT) (n = 65) from 41 hospitals in Spain. Median age of patients was 64 years (range 1-93.8). Recipients of ASCT and allo-SCT showed lower mortality rates (17% and 18%, respectively) compared to non-SCT patients (31%) (p = 0.02). Prognostic factors identified for day 45 overall mortality (OM) by logistic regression multivariate analysis included age > 70 years odds ratio (OR) 2.1, 95% confidence interval (CI) 1.2-3.8, p = 0.011; uncontrolled hematological malignancy (OR 2.9, 95% CI 1.6-5.2, p < 0.0001); ECOG 3-4 (OR, 2.56, 95% CI 1.4-4.7, p = 0.003); neutropenia (< 0.5 × 10
/L) (OR 2.8, 95% CI 1.3-6.1, p = 0.01); and a C-reactive protein (CRP) > 20 mg/dL (OR 3.3, 95% CI 1.7-6.4, p < 0.0001). In multivariate analysis of 216 patients with very severe COVID-19, treatment with azithromycin or low dose corticosteroids was associated with lower OM (OR 0.42, 95% CI 0.2-0.89 and OR 0.31, 95% CI 0.11-0.87, respectively, p = 0.02) whereas the use of hidroxycloroquine did not show significant improvement in OM (OR 0.64, 95% CI 0.37-1.1, P = 0.1).
In most patients with hematological malignancies COVID-19 mortality was directly driven by older age, disease status, performance status, as well as by immune (neutropenia) parameters and level of inflammation (high CRP). Use of azithromycin and low dose corticosteroids may be of value in very severe COVID-19.
This study aimed to develop a tool to perform the morphological characterization of Sureña and Utrerana breeds, two endangered autochthonous breeds ascribed to the Mediterranean trunk of Spanish ...autochthonous hens and their varieties (n = 608; 473 females and 135 males). Kruskal–Wallis H test reported sex dimorphism pieces of evidence (p < 0.05 at least). Multicollinearity analysis reported (variance inflation factor (VIF) >5 variables were discarded) white nails, ocular ratio, and back length (Wilks’ lambda values of 0.191, 0.357, and 0.429, respectively) to have the highest discriminant power in female morphological characterization. For males, ocular ratio and black/corneous and white beak colors (Wilks’ lambda values of 0.180, 0.210, and 0.349, respectively) displayed the greatest discriminant potential. The first two functions explained around 90% intergroup variability. A stepwise discriminant canonical analysis (DCA) was used to determine genotype clustering patterns. Interbreed and varieties proximity was evaluated through Mahalanobis distances. Despite the adaptability capacity to alternative production systems ascribed to both avian breeds, Sureña and Utrerana morphologically differ. Breed dimorphism may evidence differential adaptability mechanisms linked to their aptitude (dual purpose/egg production). The present tool may serve as a model for the first stages of breed protection to be applicable in other endangered avian breeds worldwide.
Background
There is incomplete information regarding evolution of antibody titers against SARS‐CoV‐2 after a two‐dose strategy vaccination with BNT162b2 in older adults in long‐term care facilities ...(LTCFs) with frailty, disability, or cognitive impairment. We aimed to determine IgG antibody titer loss in older adults in LTCFs.
Methods
This is a multicenter longitudinal cohort study including 127 residents (90 females and 37 males) with a mean age of 82.7 years (range 65–99) with different frailty and disability profiles in two LTCFs in Albacete, Spain. Residents received two doses of BNT162b2 as per label, and antibody levels were determined 1 and 6 months after the second dose. Age, sex, previous history of coronavirus disease 2019 (COVID‐19), comorbidity (Charlson Index), performance in activities of daily living (Barthel Index), frailty (FRAIL instrument), and cognitive status were assessed.
Results
The mean antibody titers 1 and 6 months after the second vaccine dose were 32,145 AU/ml (SD 41,206) and 6182 AU/ml (SD 13,316), respectively. Across all participants, the median antibody titer loss measured 77.6% (interquartile range IQR 23.8%). Notably, the decline of titers in individuals with pre‐vaccination COVID‐19 infection was significantly lower than in those without a history of SARS‐CoV‐2 infection (72.2% vs. 85.3%; p < 0.001). The median titer decrease per follow‐up day was 0.47% (IQR 0.14%) and only pre‐vaccination COVID‐19 was associated with lower rate of antibody decline at 6 months (hazard ratio 0.17; 95% confidence interval 0.07–0.41; p < 0.001). Frailty, disability, older age, cognitive impairment, or comorbidity were not associated with the extent of antibody loss.
Conclusions
Older adults in LTCFs experience a rapid loss of antibodies over the first 6 months after the second dose of BNT162b2 vaccine. Only pre‐vaccination COVID‐19 is associated with a slower rate of antibody decrease. Our data support immunization with a third dose in this vulnerable, high‐risk population.
PDF
