Lenalidomide and dexamethasone with or without clarithromycin in patients with multiple myeloma ineligible for autologous transplant: a randomized trial

Although case-control analyses have suggested an additive value with the association of clarithromycin to continuous lenalidomide and dexamethasone (Rd), there are not phase III trials confirming these results. In this phase III trial, 286 patients with MM ineligible for ASCT received Rd with or without clarithromycin until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS). With a median follow-up of 19 months (range, 0-54), no significant differences in the median PFS were observed between the two arms (C-Rd 23 months, Rd 29 months; HR 0.783, p = 0.14), despite a higher rate of complete response (CR) or better in the C-Rd group (22.6% vs 14.4%, p = 0.048). The most common G3-4 adverse events were neutropenia [12% vs 19%] and infections [30% vs 25%], similar between the two arms; however, the percentage of toxic deaths was higher in the C-Rd group (36/50 [72%] vs 22/40 [55%], p = 0.09). The addition of clarithromycin to Rd in untreated transplant ineligible MM patients does not improve PFS despite increasing the ?CR rate due to the higher number of toxic deaths in the C-Rd arm. Side effects related to overexposure to steroids due to its delayed clearance induced by clarithromycin in this elderly population could explain these results. The trial was registered in clinicaltrials.gov with the name GEM-CLARIDEX: Ld vs BiRd and with the following identifier NCT02575144. The full trial protocol can be accessed from ClinicalTrials.gov. This study received financial support from BMS/Celgene

Autoantibodies against type I IFNs in patients with critical influenza pneumonia

In an international cohort of 279 patients with hypoxemic influenza pneumonia, we identified 13 patients (4.6%) with autoantibodies neutralizing IFN-alpha and/or -omega, which were previously reported to underlie 15% cases of life-threatening COVID-19 pneumonia and one third of severe adverse reactions to live-attenuated yellow fever vaccine. Autoantibodies neutralizing type I interferons (IFNs) can underlie critical COVID-19 pneumonia and yellow fever vaccine disease. We report here on 13 patients harboring autoantibodies neutralizing IFN-alpha 2 alone (five patients) or with IFN-omega (eight patients) from a cohort of 279 patients (4.7%) aged 6-73 yr with critical influenza pneumonia. Nine and four patients had antibodies neutralizing high and low concentrations, respectively, of IFN-alpha 2, and six and two patients had antibodies neutralizing high and low concentrations, respectively, of IFN-omega. The patients' autoantibodies increased influenza A virus replication in both A549 cells and reconstituted human airway epithelia. The prevalence of these antibodies was significantly higher than that in the general population for patients 70 yr of age (3.1 vs. 4.4%, P = 0.68). The risk of critical influenza was highest in patients with antibodies neutralizing high concentrations of both IFN-alpha 2 and IFN-omega (OR = 11.7, P = 1.3 x 10(-5)), especially those <70 yr old (OR = 139.9, P = 3.1 x 10(-10)). We also identified 10 patients in additional influenza patient cohorts. Autoantibodies neutralizing type I IFNs account for similar to 5% of cases of life-threatening influenza pneumonia in patients <70 yr old

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

patterns of arthropod diversity in contrasting habitats of el pedregal de san angel, a preserve in mexico city

We studied the community of arthropods inhabiting the ecological preserve El Pedregal de San Angel, in Mexico City. We estimated morphospecies richness, abundance, and diversity patterns in two contrasting habitats, open and closed, during four seasons of the year. Because closed-habitat sites have greater net primary productivity than open habitats, we predicted arthropod diversity would be greater in closed than in open habitats. Morphospecies richness of Acari and Arachnida was similar in both types of habitats throughout the year, whereas richness of some orders of Insecta such as Coleoptera, Diptera, Hemiptera, and Hymenoptera was greatest in open habitats. Mites were the most abundant arthropods and were always more abundant in open than closed habitats. Diversity of arthropods was greater in closed habitats during fall and spring, suggesting that habitat characteristics related to primary productivity might affect this community. We suggest that studies of patterns of arthropod diversity and factors associated with the maintenance of such diversity should be considered in the preservation of these organisms and of their natural habitats

Determinación del factor de conversión de nitrógeno a proteína en huevos de Coturnix coturnix L. (codorniz japonesa)

En el presente trabajo se determin&oacute; el factor de conversi&oacute;n de nitr&oacute;geno en huevos de Coturnix coturnix L. (codorniz japonesa). Se analizaron 850 huevos de Coturnix coturnix L., se determin&oacute; el pH de m&aacute;xima precipitaci&oacute;n y extracci&oacute;n mediante el m&eacute;todo Kjeldahl, a diferentes pH &aacute;cidos y b&aacute;sicos. Los factores de conversi&oacute;n proteica encontrados para clara y yema fueron 6,33 y 6,30 respectivamente. Estos resultados justifican su consumo comparado a otras fuentes alimenticias, altas en prote&iacute;nas en la dieta human

Determinación del factor de conversión de nitrógeno a proteína en huevos de Coturnix coturnix L. (codorniz japonesa)

En el presente trabajo se determin&oacute; el factor de conversi&oacute;n de nitr&oacute;geno en huevos de Coturnix coturnix L. (codorniz japonesa). Se analizaron 850 huevos de Coturnix coturnix L., se determin&oacute; el pH de m&aacute;xima precipitaci&oacute;n y extracci&oacute;n mediante el m&eacute;todo Kjeldahl, a diferentes pH &aacute;cidos y b&aacute;sicos. Los factores de conversi&oacute;n proteica encontrados para clara y yema fueron 6,33 y 6,30 respectivamente. Estos resultados justifican su consumo comparado a otras fuentes alimenticias, altas en prote&iacute;nas en la dieta human

Composition and functional groups of epiedaphic ants (Hymenoptera: Formicidae) in irrigated agroecosystem and in nonagricultural areas Composição e grupos funcionais de formigas epiedáficas (Hymenoptera: Formicidae) em agroecossistema irrigado e em áreas não agrícolas

The objective of this work was to evaluate the species composition and functional groups of ants in nonagricultural (NA) and in irrigated areas (S, seasonal irrigation; P, irrigation with well water; W, irrigation with wastewater) in an arid agricultural region in central Mexico, throughout 2005 and 2006. A total of 52,358 ants belonging to 6 subfamilies, 21 genera and 39 species was collected using pitfall traps. The species best represented in all plots were: Forelius pruinosus, Pheidole obtusospinosa, Monomorium minimum and Dorymyrmex spp. NA plots recorded the highest density of ants. The highest values for diversity (H') and equitativity (J') were recorded in NA and P plots, while the lowest were recorded in W plots. Cluster analysis showed two different groups regarding species composition: NA-S and W-P. Functional groups recorded were: dominant Dolichoderinae, three species; subordinate Camponotini, five species; hot climate specialists, three species; tropical climate specialists, seven species; cold climate specialists, five species; cryptic species, one species; opportunists, six species; generalized Myrmicinae, nine species. Agricultural activity affects the structure of the ant community with epiedaphic forage, and the constant use of irrigation wastewater in conjunction with intense agricultural practices has negative effect upon species richness of epiedaphic ants.<br>O objetivo deste trabalho foi avaliar a composição de espécies e os grupos funcionais de formigas em áreas não agrícolas (NA) e em áreas irrigadas (S, irrigação sazonal; P, irrigação com águas de poço; W, irrigação com água residuária) em uma região agrícola de clima árido da região Central do México durante 2005 e 2006. Um total de 52.358 formigas pertencentes a 6 subfamílias, 21 gêneros e 39 espécies foi coletado por meio de armadilhas Pitfall. As espécies mais bem representadas em todas as parcelas foram: Forelius pruinosus, Pheidole obtusospinosa, Monomorium minimum e Dorymyrmex spp. As parcelas NA registraram a maior densidade de formigas. Os maiores valores de diversidade (H') e equitatividade (J') foram observados nas parcelas NA e P, e os menores, nas parcelas W. A análise de cluster mostrou grupos diferentes quanto à composição de espécies: NA-S e W-P. Os grupos funcionais registrados foram: Dolichoderinae dominantes, três espécies; Camponotini subordinadas, cinco espécies; especialistas de clima quente, três espécies; especialistas de clima tropical, sete espécies; especialistas de clima frio, cinco espécies; espécies crípticas, uma espécie; oportunistas, seis espécies; Myrmicinae generalizados, nove espécies. A atividade de agricultura afeta a estrutura das comunidades das formigas epiedáficas e a utilização constante de irrigação com água residuária, em conjunto com práticas agrícolas intensas tem um efeito negativo na riqueza de espécies de formigas epiedáficas