BACKGROUND: As the vaccination campaign against COVID-19 progresses, it becomes crucial to comprehend the lasting effects of vaccination on safeguarding against new infections or reinfections. OBJECTIVE: This study aimed to assess the risk of new SARS-CoV-2 infections based on the number of vaccine doses, prior infections, and other clinical characteristics. METHODS: We defined a cohort of 800 health care workers in a 24-month study (March 2020 to December 2022) in northern Barcelona to determine new infections by SARS-CoV-2. We used extended Cox models, specifically Andersen-Gill (AG) and Prentice-Williams-Peterson, and we examined the risk of new infections. The AG model incorporated variables such as sex, age, job title, number of chronic conditions, vaccine doses, and prior infections. Additionally, 2 Prentice-Williams-Peterson models were adjusted, one for those individuals with no or 1 infection and another for those with 2 or 3 infections, both with the same covariates as the AG model. RESULTS: The 800 participants (n=605, 75.6% women) received 1, 2, 3, and 4 doses of the vaccine. Compared to those who were unvaccinated, the number of vaccine doses significantly reduced (P<.001) the risk of infection by 66%, 81%, 89%, and 99%, respectively. Unit increase in the number of prior infections reduced the risk of infection by 75% (P<.001). When separating individuals by number of previous infections, risk was significantly reduced for those with no or 1 infection by 61% (P=.02), and by 88%, 93%, and 99% (P<.001) with 1, 2, 3, or 4 doses, respectively. In contrast, for those with 2 or 3 previous infections, the reduction was only significant with the fourth dose, at 98% (P<.001). The number of chronic diseases only increased the risk by 28%-31% (P<.001) for individuals with 0-1 previous infections. CONCLUSIONS: The study suggests that both prior infections and vaccination status significantly contribute to SARS-CoV-2 immunity, supporting vaccine effectiveness in reducing risk of reinfection for up to 24 months after follow-up from the onset of the pandemic. These insights contribute to our understanding of long-term immunity dynamics and inform strategies for mitigating the impact of COVID-19.

AIM: To study the prevalence of MIH and caries in 6- and 12-year-old schoolchildren and their association with ethnic disparities and other relevant factors. BACKGROUND: In recent years, there has been uneven improvement in school children’s oral health, highlighting inequalities in access to dental care and health outcomes, particularly among ethnic minorities. The most prevalent oral disease in childhood, caries, is preventable, as its risk factors are well known. However, MIH, a common condition affecting the enamel of permanent incisors and/or molars, has no established aetiology or preventive measures. METHODS: A cross-sectional study among schoolchildren was conducted in 725 children from Masnou (Barcelona, 2013) and in 577 children from Sant Andreu de Llavaneres (Barcelona, 2018-2020). Data collection was carried out by means of clinical examination and a selfreferenced questionnaire. Oral health outcomes included: presence of dental caries, presence of MIH, hypomineralised second primary molars (HSPM). All variables were analysed according to ethnic disparities and other variables such as socioeconomics, diet, hygiene habits, plaque and access to dental services. We performed multivariate Poisson regression models with robust variance to examine ethnic disparities in MIH and caries. CONCLUSION: This cross-sectional study based in Catalonia, Spain showed that there are ethnic disparities in caries as observed with other child’s diseases; however, they do not seem to follow the same pattern for MIH. More studies are needed (i) to explore how MIH behaves among populations in terms of inequality; (ii) to study the aetiological factors of MIH; and (iii) to identify potential factors associated with MIH and caries that have not been studied and that may contribute to the observed ethnic disparities.

The objective was to describe the experiences of people living with neuropsychological symptomatology associated with long-covid, as well as identifying the barriers they encounter in their daily lives and the strategies they develop to deal with them. This is a descriptive qualitative study following an interpretative phenomenological perspective wich was held in Primary Care cin the Northern Metropolitan Area of Barcelona and the Germans Trias i Pujol University Hospital (Badalona, Spain). A total of 34 adults with any persistent neuropsychological symptoms of covid-19 (>12 weeks since disease onset) participated. In-depth individual interviews were conducted following a script of open-ended questions to elicit their narratives around the research objective. A total of 3 clusters detailing the life impact of long-covid and its neuropsychological symptomatology were identified: long-covid as life-breaking and life-changing; coping strategies; and (ac)knowledge (of) the emerging subjectivity. From the participants’ accounts and the existing literature emerges the relevance of critically integrating lessons learned from analogous syndromes such as fibromyalgia and chronic fatigue, as well as involving patients in the design and implementation (even at the consultation level) of clinical practices that raise awareness of these neuropsychological sequelae (psychoeducation) both to other patients and to caregivers and professionals. This would facilitate a greater and better specialised psychological approach and reduce the stigma that still accompanies the condition. .

BACKGROUND: The COVID-19 pandemic’s long-term mental health implications are increasingly concerning, especially among patients suffering post-acute sequelae of SARS-CoV-2 infection: Long COVID (LC) patients. AIM: This study explores the presence and distribution of anxiety, depression, and stress in LC individuals with cognitive complaints in northern Barcelona (Spain). DESIGN & SETTINGS: This cross-sectional study involved 155 diagnosed LC individuals from the “Aliança ProHEpiC-19 Cognitiu (APC)” project. METHOD: Demographic data and health behavior variables were collected, and the Depression, Anxiety, and Stress Scale (DASS-21) was self-administered to assess mental health. Descriptive statistics, chi-squared tests, and Poisson regression models were used for data analysis. RESULTS: ‘Severe’ stress and ‘Extremely Severe’ anxiety were prevalent in the sample. There were significant differences in anxiety and depression based on age and job role, with older individuals and non-healthcare workers showing higher relative risks. CONCLUSIONS: Our study highlights the significant mental health burden in LC patients, underscoring the need for targeted interventions, especially among adults over 45 years old and non-healthcare workers. Further research is needed to better understand LC’s complex mental health impacts and develop effective clinical management strategies.

The small intestine bacterial overgrowth (SIBO) is a clinical disorder resulting from colonization of the small intestine by an excessive number of microorganisms or by unusual microorganisms. When they are methane producers it is called intestinal methanogen overgroth (IMO). Known risk factors are congenital or acquired anatomical alterations, motility alterations, some systemic and autoimmune diseases, those that cause alterations in biliopancreatic secretions, hypochlorhydria and some drugs. It causes abdominal pain and distension, bloating, diarrhea, nausea, and weight loss, which can occur in different diseases or with intestinal malabsorption. In IMO there may be constipation. Suggestive analytical data may be iron deficiency, anemia, deficiency of fat-soluble vitamins or B-12. The breath test with detection of exhaled H-2 is the most accessible technique, but requires rigorous performance and interpretation. The central treatment is oral antibiotics, rifaximin of choice, but they are empirical and should only be prescribed in the event of high clinical suspicion. (c) 2024 Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of the Epley maneuver, performed by family doctors or emergency physicians, for adults with benign paroxysmal positional vertigo.

Introduction Chronic kidney disease (CKD) patients may develop kidney failure (KF), receiving renal replacement therapy (RRT) in some cases. The Kidney Failure Risk Equation (KFRE-4), predicting RRT risk, is widely validated but not in a primary care Mediterranean European population. We aim to recalibrate KFRE-4 accordingly, considering death as a competing risk, to improve performance. Additionally, we recalibrate KFRE-4 for predicting KF, including all patients reaching CKD stage 5, not just those on RRT. Methods Retrospective cohort study including individuals aged >= 50 years with confirmed glomerular filtration rate (eGFR) <60 mL/min/1.73m2 and measured albumin-to-creatinine ratio (ACR). Dataset was split into training and test sets. New KFRE-4 models were developed in the training set and performance was evaluated in the test set: Base hazard adapted-KFRE (Basic-RRT), Cox reestimation (Cox- RRT), Fine and Gray RRT reestimation (FG-RRT), and Fine and Gray KF reestimation (FG-KF). Results Among 165,371 primary care patients (58.1% female; mean age 78.1 years; mean eGFR 47.3 mL/min/1.73m2, median ACR 10.1 mg/g), original KFRE-4 showed good discrimination but poor calibration, overestimating RRT risk. Basic-RRT showed poorer performance. Cox-RRT and FG-RRT, enhancing the influence of old age and female sex, diminished overprediction. FG-RRT, considering death as a competing risk, resulted the best RRT model. Age and sex had less impact on KF prediction. Conclusion A fully tailored recalibration model diminished RRT overprediction. Considering death as a competing event optimizes performance. Recalibrating for KF prediction offers a more inclusive approach in primary care, addressing the needs of women and elderly.