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Background: Migrants are disproportionately affected by several infectious diseases differing the risk within migrant groups. This study aimed to estimate the prevalence of six chronic infections in asymptomatic migrants attended at primary care or specialized units where health assessments are offered. Methods: A multicentric cross-sectional study was conducted to estimate the prevalence of human immunodeficiency virus (HIV), hepatitis B and C virus, Strongyloides stercoralis, Schistosoma spp., and Trypanosoma cruzi infections in the migrant population who participated in a screening programme implemented at six primary health care centres, and two infectious diseases outpatient clinics in Catalonia, Spain. Results: Of the 314 recruited migrants, 284 (90.4 %) were tested for at least one infection. The prevalence of the infections was as follows: 1.8 % for HIV, 1.8 % for chronic hepatitis B virus, 14.1 % for previous exposure to a hepatitis B virus infection, 0.4 % for hepatitis C virus infection, 2.6 % for S.stercoralis infection, and 7.0 % for T.cruzi infection. No cases infected with Schistosoma spp. were reported. A higher prevalence of HIV, hepatitis B and C virus was observed in Sub-Saharan Africans, whereas a higher prevalence of S.stercoralis and T.cruzi infections was reported in migrants from Latin-America and the Caribbean. Conclusion: Findings suggest a high burden of the studied infections, including parasitic infections, in the migrant population with variations within migrant groups based on areas of birth.

Background: We aimed to evaluate the performance of a novel multiplex serological assay, able to simultaneously detect IgG of six infections, as a screening tool for imported diseases in migrants. Methods: Six panels of 40 (n = 240) anonymized serum samples with confirmed infections were used as positive controls to assess the multiplex assay's sensitivity. One panel of 40 sera from non-infected subjects was used to estimate the seropositivity cutoffs, and 32 non-infected sera were used as negative controls to estimate each serology's sensitivity and specificity. The multi-infection screening test was validated in a prospective cohort of 48 migrants from endemic areas.The sensitivity of the Luminex assay was calculated as the proportion of positive results over all positive samples identified by reference tests. The specificity was calculated using 32 negative samples. Uncertainty was quantified with 95 % confidence intervals using receiver operating characteristic analyses. Results: The sensitivity/specificity were 100 %/100 % for HIV (gp41 antigen), 97.5 %/100 % for Hepatitis B virus (HBV-core antigen), 100 %/100 % for Hepatitis C virus (HCV-core antigen), 92.5 %/90.6 % for strongyloidiasis [31-kDa recombinant antigen (NIE)], 97.5 %/100 % for schistosomiasis (combined serpin Schistosoma mansoni and S.haematobium antigens) and 95 %/90.6 % for Chagas disease [combined Trypanosoma cruzi kinetoplastid membrane protein-11 (KMP11) and paraflagellar rod proteins 2 (PFR2) antigens].In the migrant cohort, antibody response to the combination of the T.cruzi antigens correctly identified 100 % individuals, whereas HBV-core antigen correctly identified 91.7 % and Strongyloides-NIE antigen 86.4 %. Conclusions: We developed a new, robust and accurate 8-plex Luminex assay that could facilitate the implementation of screening programmes targeting migrant populations.

Background: The objective of the study was to identify clinical and demographic factors predictive of hospitalization in primary healthcare patients diagnosed with suspected COVID-19 at the beginning of the pandemic. Methods: A retrospective cohort study design was used. Patients attended in Casanova primary healthcare centre (CAP) (Barcelona, Spain) for symptoms compatible with possible or confirmed SARS-CoV-2 infection between February 24 and May 30, 2020, were included. Data was collected through the electronic medical record and by telephone interview. Results: 518 patients were included, of whom 283 (54.6%) were female. The median age was 50.2 years and 19.3% were aged ≥65 years: 79% were followed on an outpatient basis while the rest were hospitalized. Predictive factors for hospital admission were male sex, older age, a history of ischemic heart disease and the presence of dyspnoea, haemoptysis, nausea and vomiting, with a sensitivity of 48% and a specificity of 95.4%. Odynophagia and nasal congestion were predictors of a good prognosis. Mortality was 2.3% and 25% of deaths did not occur in hospital. Conclusions: Nearly 80% of primary healthcare patients received only outpatient care. Male sex, older age, a history of ischemic heart disease and symptoms like dyspnoea, haemoptysis, nausea and vomiting could lead to a greater risk of an unfavorable evolution during COVID-19. Patients with at least one of the above factors, which correlate with a higher hospital admission rate, should receive a closer follow-up to early detect when they can benefit from a hospital evaluation based on their clinical evolution. Resumen: Introducción: El objetivo del estudio fue identificar factores clínicos y demográficos predictivos de hospitalización en pacientes de atención primaria con diagnóstico de sospecha de COVID-19 al inicio de la pandemia. Métodos: Cohorte retrospectiva, con pacientes atendidos en el centro de atención primaria (CAP) de Casanova (Barcelona, España) por síntomas compatibles con infección por SARS-CoV-2, entre 24 de febrero y 30 de mayo de 2020. Los datos se recogieron de la historia clínica electrónica y mediante entrevista telefónica. Resultados: Se incluyeron 518 pacientes. 283 (54.6%) fueron mujeres. La edad media fue 50.2 años. Un 19.3% tenían 65 años o más. El 79% se siguieron de forma ambulatoria y el resto ingresaron en el hospital. Los factores predictivos de ingreso fueron sexo masculino, edad, antecedentes de cardiopatía isquémica y la presencia de disnea, hemoptisis, náuseas o vómitos, con una sensibilidad del 48% y una especificidad del 95.4%. Odinofagia y congestión nasal fueron factores predictores de buen pronóstico. La mortalidad fue del 2.3%. El 25% de los pacientes que fallecieron no lo hicieron en el ámbito hospitalario. Conclusiones: Casi el 80% de los pacientes atendidos en Atención Primaria recibieron únicamente atención ambulatoria. Sexo masculino, edad avanzada, antecedente de cardiopatía isquémica y síntomas como disnea, hemoptisis, náuseas y vómitos, podrían conllevar un mayor riesgo de evolución desfavorable. Los pacientes con al menos uno de los factores anteriores, deben recibir un seguimiento más estrecho para detectar precozmente cuándo pueden beneficiarse de una evaluación hospitalaria en función de su evolución clínica.

Summary: High-risk neuroblastomas typically display an undifferentiated or poorly differentiated morphology. It is therefore vital to understand molecular mechanisms that block the differentiation process. We identify an important role for oncogenic ALK-ERK1/2-SP1 signaling in the maintenance of undifferentiated neural crest-derived progenitors through the repression of DLG2, a candidate tumor suppressor gene in neuroblastoma. DLG2 is expressed in the murine “bridge signature” that represents the transcriptional transition state when neural crest cells or Schwann cell precursors differentiate to chromaffin cells of the adrenal gland. We show that the restoration of DLG2 expression spontaneously drives neuroblastoma cell differentiation, highlighting the importance of DLG2 in this process. These findings are supported by genetic analyses of high-risk 11q deletion neuroblastomas, which identified genetic lesions in the DLG2 gene. Our data also suggest that further exploration of other bridge genes may help elucidate the mechanisms underlying the differentiation of NC-derived progenitors and their contribution to neuroblastomas.