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RESÚMENActores de diferentes sectores que trabajamos para mejorar la vida de los niños y adolescentes en las ciudades de América Latina, destacamos la importancia de revisar la agenda de salud urbana priorizando la salud de los niños y adolescentes con vistas a sociedades más equitativas, sostenibles y saludables. Razones para ello se relacionan con la creciente evidencia sobre 1) la relación existente entre los entornos urbanos y las disparidades de salud en las primeras etapas de la vida; 2) el papel clave que jugaron los entornos urbanos para los niños y adolescentes durante las primeras etapas de la pandemia; 3) el potencial que tienen las intervenciones urbanas dirigidas a niños y adolescentes para reducir las disparidades entre ellos y la población urbana en general.

(Lancet. 2023;401:447–457)In 2021, COVID-19 during pregnancy was reported to be associated with an increased risk of maternal and neonatal outcomes. The SARS-CoV-2 virus has undergone genetic mutations since then and the subsequent impact of the omicron variant on maternal and neonatal health wasunknown. This study aimed to analyze the effects on maternal and perinatal outcomes of omicron during pregnancy as well as vaccine efficacy.

Mannose‐binding lectin (MBL) is synthesized by the liver and binds to microbes. MBL2gene polymorphisms produce intermediate/low/null or normal MBLserum levels (MBL‐deficient or MBL‐sufficient phenotypes, respectively). We aimed to evaluate the incidence and severity of infection, rejection, and survival within 1 year after liver transplantation (LT) according to donor and recipient MBL2gene polymorphisms. A repeated‐event analysis for infection episodes (negative binomial regression, Andersen–Gill model) was performed in 240 LTs. Four hundred twenty‐eight infectious episodes (310 bacterial, 15 fungal, 65 cytomegalovirus [CMV]‐related, and 38 viral non–CMV‐related episodes) and 48 rejection episodes were recorded. The main bacterial infections were urinary (n = 82, 26%) and pneumonia (n = 69, 22%). LTrecipients of MBL‐deficient livers had a higher risk of bacterial infection (incidence rate ratio [IRR]1.48 [95% confidence interval 1.04–2.09], p = 0.028), pneumonia (IRR2.4 [95% confidence interval 1.33–4.33], p = 0.013), and septic shock (IRR5.62 [95% confidence interval 1.92–16.4], p = 0.002) compared with recipients of MBL‐deficient livers. The 1‐year bacterial infection–related mortality was higher in recipients of MBL‐deficient versus MBL‐sufficient livers (65.8% vs. 56.1%, respectively; p = 0.0097). The incidence of rejection, viral, or fungal infection was similar in both groups. Recipient MBL2genotype did not significantly increase the risk of bacterial infection. LTrecipients of MBL‐deficient livers have a higher risk of bacterial infection, pneumonia, septic shock, and 1‐year bacterial infection–related mortality after LT. Liver transplant recipients of mannose‐binding lectin–deficient donors have a higher risk of bacterial infection and septic shock, and a higher one‐year bacterial infection–related mortality, which increase when both donor and recipient carry a deficient mannose‐binding lectin genotype and the recipient's MELD at transplant is >22.

A 41 year old female intravenous drug user, with a remote history of a mechanical St Jude aortic valve replacement, was admitted to our institution with a 10 day history [...]

The value of transient elastography (TE) to assess clinical outcomes in hepatitis C recurrence after liver transplantation (LT) has not been explored so far. We studied 144 hepatitis C–infected and 48 non–hepatitis C virus (HCV)-infected LT recipients and evaluated the prognostic value of TE 1 year after transplantation to predict clinical decompensations and graft and patient survival. In HCV patients, cumulative probabilities of liver decompensation 5 years after LT were 8% for patients with liver stiffness measurement (LSM) <8.7 kilopascals (kPa) versus 47% for patients with LSM ≥ 8.7 kPa (p < 0.001). Five-year graft and patient cumulative survival were 90% and 92% in patients with LSM < 8.7 kPa (p < 0.001) and 63% and 64% in patients with LSM ≥ 8.7 kPa, respectively (p < 0.001). Patients with low LSM 1 year after LT had excellent outcomes independently from receiving antiviral treatment or achieving sustained virological response (SVR). In contrast, graft survival significantly improved in patients with LSM ≥ 8.7 kPa who achieved SVR. No association between outcomes and LSM at 12 months was observed in non-HCV patients. In conclusion, LSM 1 year after LT is a valuable tool to predict hepatitis C-related outcomes in recurrent hepatitis C and can be used in clinical practice to identify the best candidates for antiviral therapy.

IL28B gene polymorphisms are associated with the response to antiviral therapy in hepatitis C patients. We investigated the influence of IL28B polymorphisms on the response to therapy before and after liver transplantation (LT). Genotyping of SNPs rs8099917 and rs12979860 was performed in 128 HCV‐infected liver transplant recipients and in their donors; all patients underwent antiviral treatment after LT. The prevalence of genotypes rs12979860CC and rs8099917TT was higher in donors than in recipients (50% vs.19%, p < 0.001 and 67% vs. 38%, p < 0.001, respectively). Response to antiviral therapy was significantly higher for recipient genotype rs12979860CC as compared to rs12979860CT/TT both before (100% vs. 48% p = 0.013) and after LT (59% vs. 25% p = 0.002). The figures were almost identical for SNP rs8099917. Sustained virological response after LT was particularly high in patients with favorable recipient and donor genotypes (p < 0.01 for both SNPs). In a subgroup of 34 patients treated while awaiting LT, a favorable donor IL28B genotype was associated with an improved virological response after LT. Our results support a major role of recipient IL28B genotype in the response to antiviral treatment for hepatitis C recurrence. Interestingly, donor genotype also seems to influence the response pattern, especially in recipients who have a favorable IL28B genotype.

Neutralizing antibody (nAb) activity during the course of natural infection is believed to be crucial to combating virus propagation. The aim of this study was to measure the impact of nAb response on HCV early kinetics and genetic evolution in the liver transplantation (LT) setting. A cohort of 28 patients undergoing LT for HCV‐related cirrhosis was included in the study. Viral load, nAb titers and hypervariable region 1 (HVR1) sequences were determined in serum samples obtained before and at different time points after LT. Serum nAb titers were assessed using HCV pseudoparticles (HCVpp). HVR1 sequences were obtained by direct sequencing. Patients were classified according to viral kinetic patterns (plateau or increasing), during the first week after LT. All patients demonstrated high titers of nAbs before LT, although this was not associated with early kinetic patterns or HVR1 evolution during the first week after LT. We found that in patients with plateau HCV early kinetics, the virus required adaptive mutations, while in those with increasing viral loads, the HVR1 region remained largely conserved (p = 0.015). These data suggest that HCV adaptation via selection of the best‐fitted variants may account for early viral kinetics following LT.

Layer-by-layer (LbL) assembly has been utilized to fabricate an ultrathin film of polyelectrolytes. The architecture was composed of chitosan and organophosphorus hydrolase polycations along with thioglycolic acid-capped CdSe quantum dots (QDs) as the polyanion. The topography of the films was studied using epifluorescence microscopy imaging. The photoluminescence property of the functionalized QDs improved when sandwiched between the polycation layers. The enhanced optical property of QDs allowed easy monitoring of LbL growth and detection of paraoxon with high sensitivity. The presence of organophosphorus compounds was confirmed through UV−vis and emission spectroscopies.