Reduced mortality in COVID-19 patients treated with colchicine: Results from a retrospective, observational study

Objectives Effective treatments for coronavirus disease 2019 (COVID-19) are urgently needed. We hypothesized that colchicine, by counteracting proinflammatory pathways implicated in the uncontrolled inflammatory response of COVID-19 patients, reduces pulmonary complications, and improves survival. Methods This retrospective study included 71 consecutive COVID-19 patients (hospitalized with pneumonia on CT scan or outpatients) who received colchicine and compared with 70 control patients who did not receive colchicine in two serial time periods at the same institution. We used inverse probability of treatment propensity-score weighting to examine differences in mortality, clinical improvement (using a 7-point ordinary scale), and inflammatory markers between the two groups. Results Amongst the 141 COVID-19 patients (118 [83.7%] hospitalized), 70 (50%) received colchicine. The 21-day crude cumulative mortality was 7.5% in the colchicine group and 28.5% in the control group (P = 0.006; adjusted hazard ratio: 0.24 [95%CI: 0.09 to 0.67]); 21-day clinical improvement occurred in 40.0% of the patients on colchicine and in 26.6% of control patients (adjusted relative improvement rate: 1.80 [95%CI: 1.00 to 3.22]). The strong association between the use of colchicine and reduced mortality was further supported by the diverging linear trends of percent daily change in lymphocyte count (P = 0.018), neutrophilto- lymphocyte ratio (P = 0.003), and in C-reactive protein levels (P = 0.009). Colchicine was stopped because of transient side effects (diarrhea or skin rashes) in 7% of patients. Conclusion In this retrospective cohort study colchicine was associated with reduced mortality and accelerated recovery in COVID-19 patients. This support the rationale for current larger randomized controlled trials testing the safety/efficacy profile of colchicine in COVID-19 patients. Copyright

EBUS-TBNA in PET-positive lymphadenopathies in treated cancer patients

Mediastinal lymph node enlargement is common in the follow-up of patients with previously treated malignancies. The aim of this study is to assess the role of endobronchial ultrasound (EBUS) transbronchial needle aspiration (TBNA) for cyto-histological evaluation of positron emission tomography with 18fluorodeoxyglucose (PET) positive mediastinal and hilar lymph nodes developed in patients with previous malignancies. All EBUS-TBNA cases performed from January 2012 to May 2016 were retrospective reviewed. Results of EBUS-TBNA in patients with mediastinal and/or hilar lymphadenopathies were analysed. Non-malignant cytopathologies were confirmed with surgical procedures or clinical and radiological follow-up. Among 1780 patients, 176 were included in the analysis. 103 of these (58.5%) had a diagnosis of tumour recurrence whereas 73 (41.5%) had a different diagnosis: 63 (35.8%) had a non-neoplastic diagnosis and 8 patients (4.6%) had a different cell type malignancy. Samples were false-negative in 5 (2.8%) out of 176 patients. The overall sensitivity, specificity, negative predicted value and diagnostic accuracy were 95.7% (95% CI 90.2-98.6%), 100% (95% CI 94.0-100%), 92.3% (95% CI 83.2-96.7%) and 97.2% (95% CI 93.5-98.8%), respectively. EBUS-TBNA demonstrated a pathological diagnosis different from the previous tumour in a large percentage of patients, confirming its strategic role in the management of patients with previously treated malignancies

Science and technology of BOREXINO: A Real time detector for low-energy solar neutrinos: A Real Time Detector for Low Energy Solar Neutrinos

BOREXINO, a real-time device for low energy neutrino spectroscopy is nearing completion of construction in the underground laboratories at Gran Sasso, Italy (LNGS). The experiment's goal is the direct measurement of the flux of 7Be solar neutrinos of all flavors via neutrino-electron scattering in an ultra-pure scintillation liquid. Seeded by a series of innovations which were brought to fruition by large scale operation of a 4-ton test detector at LNGS, a new technology has been developed for BOREXINO. It enables sub-MeV solar neutrino spectroscopy for the first time. This paper describes the design of BOREXINO, the various facilities essential to its operation, its spectroscopic and background suppression capabilities and a prognosis of the impact of its results towards resolving the solar neutrino problem. BOREXINO will also address several other frontier questions in particle physics, astrophysics and geophysics

On the nucleation of non-Andersonian faults along phyllosilicate-rich mylonite belts

The weakness of fault zones is generally explained by invoking an elevated fluid pressure or the presence of extremely weak minerals in a continuous fault gouge horizon. This allows for faults to slip under an unfavourable normal to shear stress ratio, in contrast to E. M. Anderson\u2019s theory of faulting. However, these mechanisms do not explain why faults should nucleate in such an orientation as to make them misoriented and non-Andersonian. Here we present a weakening mechanism, involving the mechanical anisotropy of phyllosilicate-bearing mylonite belts, which is likely to influence the nucleation of faults in addition to their subsequent activity. Considering three natural examples from the Alps (the Simplon, Brenner and Sprechenstein- Mules fault zones) and a review of laboratory tests on anisotropic rocks, we apply anisotropic slip tendency analysis and show that misoriented weak faults can nucleate along a sub-planar phyllosilicate-rich mylonitic foliation, constituting a large-scale mechanical anisotropy belt and preventing the development of Andersonian optimally oriented faults