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

Roberto Ceamanos Lloréns, Militancia y universidad. La construcción de la historia obrera en Francia

L’historiographie permet aux historiens de profession de se rencontrer et d’échanger des préoccupations et des interrogations intellectuelles. Si les historiens encouragent la pratique de l’histoire de l’historiographie, ce n’est pas uniquement par générosité et par appétit de savoir, c’est parce que, à travers elle, la communauté des historiens y définit en grande partie son identité et ses propres processus de reconnaissance. Il n’est pas nécessaire de rappeler que, au siècle dernier, les h..

Cervantès et la France

Depuis 1614, date à laquelle paraît la traduction française, par César Oudin, de la première partie de Don Quichotte, l’intérêt suscité par Cervantès de l’autre côté des Pyrénées ne s’est jamais démenti. Sous le titre « Cervantès et la France » sont réunies ici sept des contributions à une rencontre qui s’est tenue à la Casa de Velázquez les 6 et 7 juin 2005. Sont examinées successivement les traductions de Don Quichotte, les adaptations théâtrales jouées au XVIIe et au XVIIIe siècle, la libre méditation des romanciers du Siècle des lumières, l’admiration qu’inspirent à Flaubert Cervantès et son chef d’œuvre, l’apport de l’iconographie, de Lagniet, Coypel et Natoire jusqu’à Daumier et Doré, les travaux de l’hispanisme académique, d’Alfred Morel-Fatio à Pierre Vilar et, finalement, les interprétations proposées par des lecteurs venus d’autres horizons, tels que René Girard, Marthe Robert, Michel Foucault, plus intéressés par don Quichotte que par Don Quichotte, plus attirés par le personnage que par le roman qui porte son nom. Desde 1614, año en que sale a la luz la traducción francesa, por César Oudin, de la primera parte del Quijote, el interés despertado por Cervantes allende los Pirineos no se ha desmentido nunca. Con el título de « Cervantes y Francia », se publican aquí siete de las contribuciones a un encuentro que se celebró en la Casa de Velázquez los días 6 y 7 de junio de 2005. Se examinan sucesivamente las traducciones del Quijote, las adaptaciones teatrales representadas en los siglos XVII y XVIII, la huella que se observa en la novelística del Siglo de las Luces, la admiración que suscitan en Flaubert Cervantes y su obra maestra, la aportación de la iconografía, desde Lagniet, Coypel y Natoire hasta Daumier y Doré, la labor del hispanismo académico, desde Alfred Morel-Fatio hasta Pierre Vilar y, finalmente, las interpretaciones de lectores procedentes de otros horizontes, como René Girard, Marthe Robert, Michel Foucault, más interesados por don Quijote que por el Quijote, más atraídos por el protagonista que por la novela que lleva su nombre. Since the French translation by César Oudin of the first part of Don Quixote first appeared in 1614, the interest aroused by Cervantes north of the Pyrenees has never faltered. Under the title «Cervantes and France» we have collected seven of the contributions to a meeting that was held at the Casa de Velázquez on 6 and 7 June 2005. These examine firstly translations of Don Quixote, then stage adaptations performed in the 17th and 18th centuries, the free reflection of novelists in the Age of Enlightenment, the admiration that Flaubert felt for Cervantes and his master-work, the influence of imagery, from Lagniet, Coypel and Natoire to Daumier and Doré, the works of academic Hispanists, from Morel-Fatio to Pierre Vilar, and finally, the interpretations proposed by readers hailing from other fields, such as René Girard, Marthe Robert or Michel Foucault, more interested in don Quixote than in Don Quixote – i.e. more attracted by the character than by the novel that bears his name

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective