Cooperación española AECID ? fortalecimiento de las políticas públicas de género para la prevención y protección del derecho a una vida libre de violencia

La realidad de género en nuestro país es bastante compleja. Los indicadores socio-económicos corroboran las brechas existentes entre hombres y mujeres. Estas desigualdades de género se expresan en el limitado acceso de la mayoría de mujeres ecuatorianas y minorías sexuales al ejercicio de sus derechos básicos, y en la oferta restringida de condiciones que permitan y faciliten dicho ejercicio. Asimismo, un indicador crítico respecto a género es la violencia. 46% de mujeres en el país han sufrido violencia física, psicológica o sexual en algún momento de su vida. La violencia de género es a la vez un medio de la perpetuación de la discriminación de las mujeres y una consecuencia de su subordinación, la misma que se encuentra naturalizada o normalizada en el imaginario de nuestra sociedad. Frente a esta realidad, en la Constitución de 2008 se dieron avances respecto a las políticas de género, ya que en ella se consagraron como principios fundamentales la igualdad ante la ley tanto formal como material, la no discriminación por sexo, género, orientación sexual, o portar VIH; entre otros. Asimismo, el Estado ecuatoriano asume por primera vez la responsabilidad por los derechos de las mujeres reconocidos a nivel nacional e internacional; como por ejemplo, el derecho a protección y a vivir libres de violencia, garantizando así el acceso a una justicia sensible a sus necesidades junto con medidas para prevenir, eliminar y sancionar toda forma de violencia contra la mujer

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele