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

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Actualización del sistema de información laboral con procesamiento analítico en línea en la secretaria del trabajo y previsión social.

Tesina (Ingeniería en Informática ), Instituto Politécnico Nacional, UPIICSA, 2010, 1 archivo PDF, (113 páginas), tesis.ipn.m

Inoculación micorrízico arbuscular en portainjertos de plantas de aguacate cv �Hass� en viveros de Michoacán, México

El objetivo de este estudio fue evaluar el desempeño de 12 inoculantes de hongos micorrízicos arbusculares (HMA) en el desarrollo de portainjertos de plantas de aguacate cv. �Hass� en etapa de vivero. El experimento fue llevado a cabo en Uruapan, Michoacán, México, utilizanso plantas de 60 días de edad, recientemente injertados. Los 12 tratamientos se distribuyeron en un diseño completamente al aleatorio, con 6 repeticiones: A) Gigaspora gigantea; B) Acaulospora delicata; C) Rhizophagus fasciculatus (foráneo); D) Consorcio de Veracruz MTZ1-UV; E) Rhizophagus fasciculatus; F) Rhizophagus irregularis 28-A; G) comunidad nativa de AMF; H) Rhizophagus irregularis (MUCL); I) Rhizophagus fasciculatus + Azospirillum; J) Sclerocystis aff. rubiformis; K) Acaulospora laevis; L) Scutellospora pellucida; y M) testigo. La altura de las plantas, diámetro de los tallos y número de hojas fueron medidos cada 2 semanas durante 5 meses, después de lo cual las plantas fueron cosechadas y se dtermino el peso seco del tallo y de la raíz. Las mediciones periódicas a lo largo del experimento, demostraron que Acaulospora delicata y el testigo tuvieron un mejor desempeño en la altura de las plantas, Scutellospora pellucida en lo referente al diámetro del tallo y el testigo en el número de hojas. En la cosecha, las plantas inoculadas con Rhizophagus intraradices 28-A y Scutellospora pellucida tuvieron 2 veces más peso del tallo y de la raíz con relación a los otros tratamientos. Además, se concluye que la inoculación del cuello de la raíz de las plantas recientemente injertadas, mostró respuestas claras a la inoculación con cepas eficientes de hongos micorrízicos, aunque pasaron 6 meses para que las diferencias fueran evidentes.The aim of this study was to evaluate the performance of twelve inoculants of arbuscular mycorrhizal fungi (AMF) in the development of avocado rootstock cv. �Hass� in the nursery stage. The experiment was conducted in Uruapan, Michoacán, Mexico, using 60-days-old, newly grafted rootstocks. The 12 treatments were in a completely randomized design with 6 replications: A) Gigaspora gigantea; B) Acaulospora delicata; C) Rhizophagus fasciculatus (foreign); D) MTZ1-UV Consortium from Veracruz; E) Rhizophagus fasciculatus; F) Rhizophagus irregularis 28-A; G) Native AMF community; H) Rhizophagus irregularis (MUCL); I) Rhizophagus fasciculatus + Azospirillum; J) Sclerocystis aff. rubiformis; K) Acaulospora laevis; L) Scutellospora pellucida; M) Control. Plant height, stem diameter and number of leaves were measured every two weeks for 5 months, after which plants were harvested and shoot and root dry weight were also measured. Periodical measurements showed that Acaulospora delicata and the control performed better in terms of plant height, Scutellospora pellucida in terms of stem diameter and the control in the number of leaves along the experiment. At harvest, plants inoculated withRhizophagus intraradices 28-A and Scutellospora pellucida had twice as large shoot and root weights as the rest of plants. We conclude that stem collar inoculation of recently grafted plants showed clear responses to inoculation with efficient strains of mycorrhizal fungi even though it took over six months before differences became evident

Anuario del Centro de Estudios Martianos (Vol. 26 2003)

El Anuario del Centro de Estudios Martianos es la publicación insignia de esta institución y heredera directa del Anuario Martiano de la Biblioteca Nacional José Martí, que se publicó entre 1969 y 1977, bajo la dirección del poeta y ensayista Cintio Vitier. Desde que salió a la luz su primera entrega, en 1978, se han publicado treinta y cinco números, en los que aparecen artículos y ensayos de importantes estudiosos de la vida y obra del Apóstol, en Cuba y el resto del mundo. En sus secciones fijas (Otros textos de José Martí, Documentos, Estudios y aproximaciones, Vigencias, Publicaciones, Bibliografía, Constante) y los apartados especiales, los lectores pueden conocer disímiles temas del quehacer martiano internacional, en el año que termina además de mantenerse al tanto de las últimas contribuciones de los promotores e investigadores de la obra martiana en el orbe

Neotropical freshwater fisheries : A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

Vorapaxar in the secondary prevention of atherothrombotic events

Item does not contain fulltextBACKGROUND: Thrombin potently activates platelets through the protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin through antagonism of PAR-1. METHODS: We randomly assigned 26,449 patients who had a history of myocardial infarction, ischemic stroke, or peripheral arterial disease to receive vorapaxar (2.5 mg daily) or matching placebo and followed them for a median of 30 months. The primary efficacy end point was the composite of death from cardiovascular causes, myocardial infarction, or stroke. After 2 years, the data and safety monitoring board recommended discontinuation of the study treatment in patients with a history of stroke owing to the risk of intracranial hemorrhage. RESULTS: At 3 years, the primary end point had occurred in 1028 patients (9.3%) in the vorapaxar group and in 1176 patients (10.5%) in the placebo group (hazard ratio for the vorapaxar group, 0.87; 95% confidence interval [CI], 0.80 to 0.94; P<0.001). Cardiovascular death, myocardial infarction, stroke, or recurrent ischemia leading to revascularization occurred in 1259 patients (11.2%) in the vorapaxar group and 1417 patients (12.4%) in the placebo group (hazard ratio, 0.88; 95% CI, 0.82 to 0.95; P=0.001). Moderate or severe bleeding occurred in 4.2% of patients who received vorapaxar and 2.5% of those who received placebo (hazard ratio, 1.66; 95% CI, 1.43 to 1.93; P<0.001). There was an increase in the rate of intracranial hemorrhage in the vorapaxar group (1.0%, vs. 0.5% in the placebo group; P<0.001). CONCLUSIONS: Inhibition of PAR-1 with vorapaxar reduced the risk of cardiovascular death or ischemic events in patients with stable atherosclerosis who were receiving standard therapy. However, it increased the risk of moderate or severe bleeding, including intracranial hemorrhage. (Funded by Merck; TRA 2P-TIMI 50 ClinicalTrials.gov number, NCT00526474.)