Study of the application of the guide for the care of people attacked by animals potentially transmitting rabies, in Bucaramanga and the metropolitan area from January to June 2008

El presente estudio observacional de tipo descriptivo tuvo como objetivo verificar la aplicación de la guía para atención de personas agredidas por animales potencialmente transmisores de Rabia en las instituciones de salud de la ciudad de Bucaramanga y el Área Metropolitana e identificar posibles eventos adversos asociados al tratamiento. Metodología se tomo una muestra de 117 pacientes seleccionados por muestreo probabilístico aleatorio simple, tomados de la base de datos del SIVIGILA de La Secretaria de Salud Departamental considerando un nivel de confianza del 95% de perspectiva esperada para la correcta aplicación de la guía para la atención. La recolección de datos se realizo por medio de encuestas a los pacientes escogidos y encuestas a las IPS donde fueron atendidos los mismos y se realizo una lista de chequeo en caso de verificar evento adverso a la aplicación del tratamiento. Se codificó y sistematizó la información obtenida mediante las bases de datos realizadas en Excel. Resultados muestran las dificultades y las anormalidades que se están presentando en la atención de estos pacientes tanto en las IPS como en la secretaria de salud en cuanto a la oportunidad en la atención y él diligenciamiento de la entrega de medicamentos. Conclusiones: Existe una alto índice de accidentes rábicos que no están siendo tratadas con la importancia y el manejo adecuado por las entidades pertinentes. Hay falencias notables en los programas de vigilancia y control de rabia a nivel departamental, falta de capacitación al personal en manejo de guía de atención, falta de oportunidad y satisfacción de las necesidades de los pacientes.Universidad CESINTRODUCCION 12 1. MARCO REFERECIAL 14 1.1 LA RABIA COMO PROBLEMA DE SALUD PÚBLICA 18 1.1. 2 Tendencia epidemiológica de la rabia canina en Colombia 19 2. MARCO LEGAL 23 3. MARCO TEORICO 26 3.1 HISTORIA DE LA RABIA 26 3.1.2 DEFINICIÓN 31 3.1.3. AGENTE ETIOLOGICO 32 4. OBJETIVOS 57 4.1 OBJETIVO GENERAL 57 4.2 OBJETIVOS ESPECIFICOS 57 5. METODOLOGIA 58 6. RESULTADOS 62 6.1. Resultados de encuestas aplicadas a pacientes 62 6.2 Resultados de encuestas aplicadas a Instituciones Prestadoras de servicios de Salud 75 6.3 Resultado de indicadores 90 7. ANALISIS DE RESULTADOS 91 8. HALLAZGOS 96 10. RECOMENDACIONES 98 BIBLIOGRAFÍA 99 ANEXOS 103EspecializaciónThe present observational descriptive study aimed to verify the application of the guide for the care of people attacked by animals potentially transmitting rabies in the health institutions of the city of Bucaramanga and the Metropolitan Area and to identify possible adverse events associated with the treatment. Methodology A sample of 117 patients selected by simple random probability sampling was taken, taken from the SIVIGILA database of the Department of Health, considering a 95% confidence level of expected perspective for the correct application of the guide for care . Data collection was carried out through surveys of the chosen patients and surveys of the IPS where they were treated and a checklist was made in case of verifying an adverse event to the application of the treatment. The information obtained through the databases made in Excel was codified and systematized. Results show the difficulties and abnormalities that are occurring in the care of these patients both in the IPS and in the health secretary in terms of the opportunity in the care and the completion of the delivery of medications. Conclusions: There is a high rate of rabies accidents that are not being treated with the importance and proper management by the relevant entities. There are notable shortcomings in the department-level rabies surveillance and control programs, lack of training for staff in managing care guidelines, lack of opportunity and satisfaction of patients' needs.Modalidad Presencia

La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia en municipios de Boyacá y Arauca.

El presente trabajo se enfocó en temáticas de abordaje en cuanto al acompañamiento psicosocial en escenarios de violencia a partir de enfoques narrativos, se realiza la presentación de un caso sobre el conflicto armado, y sus diferentes conflictos que impactaron en ellos y que genero a la población para enfrentar cada uno de estos impactos. Es importante recalcar que el caso al que vamos a dirigirnos es una caso real, de acercamiento al que lograremos tener cercanía e identificar aspectos impactantes a los cuales se somete una comunidad, bajo el regir de ciertos problemas como lo es ser cómplices de un actor armado, sus consecuencias, y para ello tendremos preguntas tanto estratégicas, circulares y reflexivas que aportarán para dar soluciones a los casos en situación d crisis. Contribuyendo así a fortalecer la calidad de vida de cada uno de los afectados para generar en ellos un reconstrucción de una vida social. Para finalizar se implementará una reflexión por medio de la herramienta foto voz, la cual nos servirá para narrar y expresar cada una de las imágenes de violencia a la que queremos llegar.The present work focused on topics of approach in terms of psychosocial accompaniment in scenarios of violence from narrative approaches, the presentation of a case on the armed conflict, and its different conflicts that impacted on them and that generated the population to face each of these impacts. It is important to emphasize that the case we are going to address is a real case, approach to which we will achieve closeness and identify impacting aspects to which a community is subjected, under the rule of certain problems such as being accomplices of an armed actor , its consequences, and for that we will have strategic, circular and reflective questions that will contribute to give solutions to the cases in crisis situation. Contributing this way to strengthen the quality of life of each of those affected to generate in them a reconstruction of a social life. Finally, a reflection will be implemented through the photo voice tool, which will serve to narrate and express each of the images of violence we want to reach

La Imagen Y La Narrativa Como Herramientas Para El Abordaje Psicosocial En Escenarios De Violencia. Departamentos De Cesar, Guajira Y Norte De Santander

En este trabajo final del curso de Diplomado de Profundización Acompañamiento Psicosocial en Escenarios de Violencia como opción de grado, se estructura mediante un análisis que reúne aspectos psicosociales posterior a los eventos traumáticos ocasionado por el conflicto armado, derivándose diversas problemáticas relacionada con la salud física y mental, economía, desempleo, vivienda, desplazamiento forzado, desarraigo cultural y territorial que desestabilizan las emociones y otros aspectos fortalecedores del bienestar psicosocial de las víctimas. Desde el enfoque narrativo se profundiza en las subjetividades manifestadas por las victimas con el fin de evitar que el problema no pase a definir a la persona y a limitar sus maneras de percibir la realidad, antes por el contrario extraer la posibilidad de abrir la historia en que las victimas narren sus vivencias para generar relatos alternos para no opacar sus proyectos de vida; por lo cual se promueven acciones y estrategias que brinden acompañamiento para la auto comprensión y re significación de las situaciones victimizantes, removiendo emociones que al mismo tiempo son de análisis para sustraer las capacidades y habilidades autogestoras de la realidad presente. Como caso a estudiar para el ejercicio académico se propone el relato 5: Carlos Arturo, tomado del libro, Voces: Relatos de violencia y esperanza en Colombia, editado por el Banco mundial en el año 2009, siendo una historia real bajo los sucesos de violencia del conflicto armado en Colombia; y evidenciando la violación de los derechos humanos nacional e internacionalmente. Aquí se plantean preguntas de tipos estratégicas, circulares y reflexivas con el fin de ahondar en el estado de resiliencia del sobreviviente como mecanismo de autogestión. Posteriormente se aborda el caso Pandurí, en la cual se identifican afectaciones y emergentes psicosociales, impactos de estigmatización, acciones de apoyo en situación de crisis y estrategias que apoyen al proceso de acompañamiento psicosocial a las víctimas para afrontar la crisis emocional provocada por la violencia. Por otro lado, se socializa como complementario el informe analítico y reflexivo de la experiencia de foto voz realizada en el paso 3.In this final work of Diploma of Deepening Psychosocial Accompaniment in Violence Scenarios as a degree option, we structure through an analysis that implicate psychosocial aspects, after a traumatics events occasioned by the armed conflicts, this situacions gave rise various problems related with the physical and mental health, economy, unemployment, living place, forced displacement, cultural uprooting, territorial disarray that destabilize emotions and another reinforcing aspects of the victims welfare psychosocial. From the narrative approach, we deepen in the victims subjectivities, in order to avoid that the problem do not define the person and limited their ways of reality perception, in opposite, we extract the possibilities to open the history so that the victims tell their experiences, to generate a altern relates, so as not overshadow their lives projects for wich, we promotes actions and strategics to give support for their self-realization and redefinition of the victimization situations, to remove emotion that at the same time serve to analyze and subtract their habilities, and capacities self-advocates of the present reality. As a case to study, for academic exercise, we propose the relate number five: “Carlos Arturo, taken from the book, Voices: Violence and Hope story in Colombia, edited by World Bank in 2009, this real history under violence events of the colombian armed conflict and proving the violation of the national and international rights. In this document, we propose strategic, round and reflexive questions to verify the survivor resilience state, as self-management mechanism. Then, we study the Pandurí case, in this case, we identify the injuries and psychosocial emergent, stigmatization impacts, support actions in crisis situations and strategic that supported the victims psychosocial accompanying to facing the emotional crisis brought about for the violence. On the other hand, as a complement, we socialize an analytical and reflexive report: the photo voice experience made in the step 3

Evaluación del efecto de la naturaleza del polímero en las propiedades físico- mecánicas de laminillas de desintegración oral

Las laminillas de rápida desintegración oral son definidas como preparaciones sólidas formuladas con polímeros de origen natural o sintético que contienen fármacos y aditivos que están destinadas a disolverse en la boca. El objetivo del presente estudio fue evaluar las diferencias en propiedades físico-mecánicas entre laminillas base de desintegración oral elaboradas con diversos polímeros. Métodos: Las laminillas fueron elaboradas mediante el método de vaciado en placa. Se emplearon polímeros como almidón, carragenano, carboximetilcelulosa (CMC), goma guar y xantana, pectina rápida y lenta, pululano y polivinilpirrolidona (PVP), solos o en combinación con CMC. Se utilizó propilenglicol como plastificante. Se evaluó: capacidad de formación de película, apariencia visual, tiempo de desintegración, resistencia al plegado, índice de hinchamiento y erosión. Resultados: Almidón, pectina lenta y PVP tuvieron una pobre capacidad de formación de película, las laminillas formuladas con pectina lenta con CMC, pectina rápida y pululano destacaron por su transparencia. Las laminillas de pectina rápida y pululano mostraron tiempos de desintegración bajos. Las laminillas elaboradas con almidón con CMC, pectina rápida y pululano obtuvieron los menores índices de hinchamiento y los mayores de erosió

La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamento de Cundinamarca, Colombia y Ciudad de París, Francia

El presente documento recoge las diferentes experiencias y conocimientos adquiridos a lo largo del diplomado: Acompañamiento psicosocial en escenarios de violencia, resaltando diferentes herramientas de intervención como lo son el enfoque narrativo y la foto intervención. Por un lado, se presenta el caso de Carlos Arturo, un joven de catorce años, víctima del conflicto armado quien sufrió secuelas psicosociales por desplazamiento forzado y afectaciones físicas. A partir de este caso se plantean tres acciones de intervención y se estudia la pregunta como herramienta de análisis. Además, se reflexiona acerca del caso de Peñas Coloradas, una comunidad que es desalojada de su tierra por dedicarse al cultivo de coca, ya que no tenían otros recursos para resurgir laboralmente y son condenados de guerrilleros. Después de analizar este caso se plantean tres estrategias intervención además de la reflexión de los impactos psicosociales que sufre esta población. Finalmente, se presenta un estudio analítico y reflexivo de la experiencia de la foto voz realizada en la ciudad de Bogotá, Colombia y París, Francia, en diferentes escenarios que tienen como común denominador una situación de violencia, estos lugares también se caracterizan por haber transformado ese dolor en historias de esperanza.This document gathers different experiences and knowledge we acquired throughout the course: Psychosocial accompaniment in scenarios of violence, highlighting the intervention tools such as the Narrative Approach and the Photo Voice. On the first hand, it presents the case of Carlos Arturo, a 14-year-old victim of the armed conflict, who suffered psychosocial sequels due to forced migration and physical affectations. Based on this case, three actions are proposed, as well as the question is studied as a tool for analysis from the Narrative Approach. In addition, the case of Peñas Coloradas was also discussed. This community was evicted from their land for cultivating coca, since they had no other resources to recover their labor and were condemned as guerrillas (as a terrorist group). After analyzing this case, three strategies for intervention are proposed, as well the psychosocial impacts suffered by this population were analyzed. Finally, we present an analytical and reflective comment of the experience of the Photo Voice that each of us had in different scenarios of Bogota, Colombia and one scenario in Paris, France. All these events have as common denominator: a situation of violence, but they have managed to transform that pain to overcome the trauma and create new stories

Evaluation of Genotoxic and Cytotoxic Effects in Human Peripheral Blood Lymphocytes Exposed In Vitro to Neonicotinoid Insecticides News

Calypso (thiacloprid), Poncho (clothianidin), Gaucho (imidacloprid), and Jade (imidacloprid) are commercial neonicotinoid insecticides, a new class of agrochemicals in México. However, genotoxic and cytotoxic studies have not been performed. In the present study, human peripheral blood lymphocytes (PBL) were exposed in vitro to different concentrations of the four insecticides. The genotoxic and cytotoxic effects were evaluated using the alkaline comet and trypan blue dye exclusion assays. DNA damage was evaluated using two genotoxicity parameters: tail length and comet frequency. Exposure to 9.5 × 10−6 to 5.7 × 10−5 M Jade; 2.8 × 10−4 to 1.7 × 10−3 M Gaucho; 0.6 × 10−1 to 1.4 × 10−1 M Calypso; 1.2 × 10−1 to 9.5 × 10−1 M Poncho for 2 h induced a significant increase DNA damage with a concentration-dependent relationship. Jade was the most genotoxic of the four insecticides studied. Cytotoxicity was observed in cells exposed to 18 × 10−3 M Jade, 2.0 × 10−3 M Gaucho, 2.0 × 10−1 M Calypso, 1.07 M Poncho, and cell death occurred at 30 × 10−3 M Jade, 3.3 × 10−3 M Gaucho, 2.8 × 10−1 M Calypso, and 1.42 M Poncho. This study provides the first report of genotoxic and cytotoxic effects in PBL following in vitro exposure to commercial neonicotinoid insecticides

Inhibition of ATG3 ameliorates liver steatosis by increasing mitochondrial function

Non-alcoholic fatty liver disease (NAFLD) is a major health threat in both developed and developing countries and is a precursor of the more advanced liver diseases, including non-alcoholic steatohepatitis (NASH), cirrhosis, and liver cancer. Currently, understanding the multiple and complex molecular pathways implicated in NAFLD onset and progression is a major priority. The transcription factor p63, which belongs to a family comprising p53, p63, and p73,1 is one of many factors that contributes to the development of liver steatosis. The role of p63 as a tumor suppressor and in cell maintenance and renewal is well studied, but we have recently reported that it is also relevant in the control of lipid metabolism.2 p63 encodes multiple isoforms that can be grouped into 2 categories; isoforms with an acidic transactivation domain (TA) and those without this domain (domain negative). The TAp63α isoform is elevated in the liver of animal models of NAFLD as well as in liver biopsies from obese patients with NAFLD. Furthermore, downregulation of p63α in the liver attenuates liver steatosis in diet-induced obese (DIO) mice, while the activation of TAp63α increases hepatic fat content, mediated by the activation of IKKβ and endoplasmic reticulum stress.2 A specialized form of autophagy that degrades lipid droplets, termed “lipophagy”, is a major pathway of lipid mobilization in hepatocytes. Lipophagy is elevated in hepatoma cells upon exposure to free fatty acids,3 and reduces the fatty acid load in mouse hepatocytes.4 Its impairment has been associated with the development of fatty liver and insulin resistance3,5; in contrast, the autophagic flux is increased during the activation of hepatic stellate cells.6 In the present study, we used an unbiased proteomics approach to gain insight into novel proteins modulating lipid metabolism in the liver of mice with genetic knockdown or overexpression of TAp63α. We found that autophagy-related gene 3 (ATG3) was upregulated by TAp63α activation and downregulated after p63α inhibition. ATG3 is elevated in several animal models of NAFLD and in the liver of patients with NAFLD. Genetic overexpression of ATG3 increased the lipid load in hepatocytes, while its repression alleviated TAp63α- and diet-induced steatosis. ATG3 exerted its role in lipid metabolism by regulating SIRT1 and mitochondrial function. Collectively, these findings identify ATG3 as a novel factor implicated in the development of steatosisThis work has been supported by grants from FEDER/Ministerio de Ciencia, Innovación y Universidades-Agencia Estatal de Investigación (PA: RTI2018-095134-B-100; DS and LH: SAF2017-83813-C3-1-R; MLMC: RTC2019-007125-1; CD: BFU2017-87721; ML: RTI2018–101840-B-I00; GS; PID2019-104399RB-I00; RN: RTI2018-099413-B-I00 and RED2018-102379-T; MLMC: SAF2017-87301-R; TCD: RTI2018-096759-A-100), FEDER/Instituto de Salud Carlos III (AGR: PI19/00123), Xunta de Galicia (ML: 2016-PG068; RN: 2015-CP080 and 2016-PG057), Fundación BBVA (RN, GS and MLM), Proyectos Investigación en Salud (MLMC: DTS20/00138), Sistema Universitario Vasco (PA: IT971-16); Fundación Atresmedia (ML and RN), Fundación La Caixa (M.L., R.N. and M.C.), Gilead Sciences International Research Scholars Program in Liver Disease (MVR), Marató TV3 Foundation (DS: 201627), Government of Catalonia (DS: 2017SGR278) and European Foundation for the Study of Diabetes (RN and GS). This research also received funding from the European Community’s H2020 Framework Programme (ERC Synergy Grant-2019-WATCH- 810331, to RN, VP and MS). Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Hepáticas y Digestivas (CIBERehd) and CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERdem). CIBERobn, CIBERehd and CIBERdem are initiatives of the Instituto de Salud Carlos III (ISCIII) of Spain which is supported by FEDER funds. We thank MINECO for the Severo Ochoa Excellence Accreditation to CIC bioGUNE (SEV-2016-0644)S

Tocilizumab in refractory Caucasian Takayasu's arteritis: a multicenter study of 54 patients and literature review

Objective: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu's arteritis (TAK) in clinical practice. Methods: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZMONO) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZCOMBO) was performed. Results: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5-50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0-31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5-50.0) to 5.0 (0.0-5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0-14.0) months. Twenty-three (42.6%) patients were on TCZMONO and 31 (57.4%) on TCZCOMBO: MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). Patients on TCZCOMBO were younger [38.0 (27.0-46.0) versus 45.0 (38.0-57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0-38.0) versus 6.0 (1.0-23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7-5.6) versus 1.3 (0.3-3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. Conclusion: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin.Funding: This work was partially supported by RETICS Programs, RD08/0075 (RIER), RD12/0009/0013 and RD16/0012 from “Instituto de Salud Carlos III” (ISCIII) (Spain)

FULL Investiga Enero a Junio 2020 Número 1

Contiene: A propósito del coronavirus: pandemia o acontecimiento / Carol Fernandez Jaimes -- Desarrollo de nuevos materiales en el contexto de la IV Revolución Industrial y sus efectos en el COVID-19 / Jesús Manuel Gutiérrez Bernal -- El virus que coronó la vulnerabilidad de la formación remota en la educación Chilena y Colombiana” / Marcelo Palominos Bastias, Lupe García Cano y Víctor Martínez Gutiérrez -- Intuiciones psicosociales sobre la pandemia en el Siglo XXI / Rocío Venegas Luque -- Pensar la economía en tiempos de crisis / Oscar Esteban Morillo Martínez -- Acercamiento al concepto de educación superior en el marco normativo de la educación inclusiva en Colombia / Jose Escobar Romero -- Educación para la paz y la resiliencia en infancias vulneradas, fase II / Ana Dolores Gómez Romero -- Fútbol, de la mediatización global al lavado deportivo / Luis Francisco Buitrago -- Antea, proyecto de investigación que pone en reto a la comunicación como escenario para la transformación ambiental / Janneth Arley Palacios Chavarro -- Del desarrollo económico al desarrollo sos- tenible y el papel de la educación ambiental / Gloria Castaño-Camacho y Rosa Eugenia Reyes Gil -- Investigación en el ámbito turístico y gastronómico / Jesús Alexis Barón Chivara y Sandra Patricia Cote Daza -- Mercado de trabajo y empleabilidad de los profesionales en Colombia / Orlando Salinas Gómez -- El rol de la investigación contable en la academia y la sociedad / Paula Andrea Navarro Pérez -- Hacia la formación competitiva y de desarrollo empresarial / Melva Inés Gómez Caicedo y Diana Geraldine Jiménez García -- El comercio internacional como motor del crecimiento económico / José Vidal Castaño Ramírez -- Hacia el concepto transformacional de la educación superior inclusiva en el contexto colombiano / Castelblanco Daniela, Coronado Laura, Jiménez Wendy, Ocampo Yessica, Pachón Jose, Reyes María, Sánchez Vanesa -- La Inteligencia Artificial como quehacer investigativo y de formación al servicio de la humanidad en el seno del Semillero SofIA / Lucy Nohemy Medina Velandia -- “Un nuevo mundo”. Historieta ilustrada sobre el COVID-19 -- Camilo Rojas Zapata.Fundación Universitaria los Libertadore

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