ABSTRACT Dialysis-associated immune dysfunction makes chronic kidney disease patients both susceptible to severe Coronavirus disease 19 (Covid19) and to a weaker response to vaccination. Previously infected patients are thought to sustain stronger and more durable humoral responses than vaccinated patients. Four months after a two dose-regimen of the Pfizer/BioNTech SARS-CoV-2 mRNA vaccine (BNT162b2), we evaluated the SARS-CoV-2 spike immunoglobin G (IgG-S1) antibody levels in previously infected peritoneal dialysis patients and compared them with infection naïve PD patients. A total of 79 peritoneal dialysis patients were analyzed, of which 11 had a previous history of Covid19. We have verified that the median titer of the IgG-S1 in previously infected patients (14310 AU/mL) was significantly superior to that in infection naïve patients (760,05 AU/mL) (p < 0,001). Previous Covid19 was the only significant predictor of IgG-S1 levels in a multivariate linear regression model (p < 0,001). These results may impact vaccination strategies for peritoneal dialysis patients regarding the future administration of BNT162b2 booster doses. In conclusion, previously infected peritoneal dialysis patients who have completed a two-dose regimen of the BNT162b2 may be well suited without a third, booster dose for longer than infection naïve peritoneal dialysis patients. This strategy could make additional doses available around the world.

ABSTRACT: The increase in substance use among Colombian indigenous people is currently a public health issue. Colombian Law has recognized that addiction is a mental health disorder, it has elevated mental health to the category of a fundamental right and has incorporated multiple norms to ensure the right to health for indigenous people. However, there is still in this regard a disconnect between what the law states and how it is being implemented. This article holds that one of the main reasons behind this disconnect is associated to the limitations of the models explaining the nature of addiction that have permeated Colombian Law. It also argues that the Convention on the Rights of Persons with Disabilities is the legal norm which enables the best understanding of the phenomenon of addiction, since it allows to see addiction as the result of a series of socially-caused vulnerabilities that erode -but do not extinguish- autonomy, and as such it fosters the adoption of solutions that seek the elimination of those vulnerabilities and the implementation of treatments that do not deny the addicts’ agency.

RESUMEN: El incremento del consumo de sustancias psicoactivas entre los pueblos indígenas de Colombia es un problema en ascenso. El ordenamiento jurídico colombiano ha reconocido la adicción como enfermedad mental, ha elevado el derecho a la salud mental a la categoría de derecho fundamental, y ha incorporado normas para garantizar el derecho a la salud de los pueblos indígenas. Sin embargo, todavía existe en esta materia una brecha entre las normas y su aplicación. Este artículo sostiene que una de las principales razones detrás de esa desconexión entre las normas y la realidad está ligada a las limitaciones de los modelos acerca de la naturaleza de la adicción que han permeado el ordenamiento colombiano, y argumenta que la Convención sobre los Derechos de las Personas con Discapacidad es el instrumento normativo que permite comprender mejor el fenómeno de las adicciones. Esto por cuanto dicho instrumento permite ver la adicción como el resultado de vulnerabilidades socialmente causadas, que confluyen para socavar -mas no extinguir- la autonomía del individuo. Por esta razón, analizar la adicción desde la óptica de este tratado, es el primer paso para acuñar soluciones encaminadas a combatir esas vulnerabilidades, y brindarle tratamiento al adicto sin negarle su carácter de agente moral.

ABSTRACT Introduction and objectives: The diagnostic test of COVID-19 with the highest sensitivity is a nasopharyngeal sample using a swab for subsequent study using RT-PCR. The objective of our work is to explain in detail the most appropriate way to perform this technique. Material and methods: We present a retrospective study of 17 patients. Finally, two patients were excluded. The patients were 34-72 years old. A Polysomnography was done, and hypopneaapnea index was 7,32±8,71. Discussion and conclusions: This a secure technique and can be reproduced in all ENT services. DISE less us individualize chirurgical treatment and avoid us unnecessary patients' operations.

RESUMEN Introducción y objetivos: Somnoscopy can Valore the possible obstruction in superior aerodigestive tract, that lead to obstructive sleep apnea syndrome (OSAS). Our objective is showing our experience using the somnoscopy or DISE (drug induced sleep endoscopy). Material y métodos: Presentamos un estudio retrospectivo de 17 pacientes de los que se excluyen finalmente 2. La edad de los pacientes varió de 34 a 72 años. Se practica polisomnografía previa y el IAH medio fue 7,32±8,71. Discusión y conclusión: La DISE es una técnica segura, reproducible y aplicable en cualquier servicio de ORL. Así mismo, permite individualizar el tratamiento quirúrgico y probablemente evitar cirugías innecesarias.