Relationship Between Bone Mineral Density and Angiotensin Converting Enzyme Polymorphism in Hypertensive Postmenopausal Women

Producción CientíficaThe purpose of this study was to assess the relationship between bone mineral density and insertion/ deletion (I/D) angiotensin converting enzyme polymorphism (ACE) in hypertensive postmenopausal women.2015-09-0

Effect of Quinapril, Quinapril-Hydrochlorothiazide, and Enalapril on the Bone Mass of Hypertensive Subjects: Relationship With Angiotensin Converting Enzyme Polymorphisms

Producción CientíficaBackground: Many alterations in extracellular metabolism of calcium have been associated to hypertension, but the number of studies relating this disease with osteoporosis is extremely low. This study clarifies the therapeutic effect of three treatments— quinapril, quinapril hydrochlorothiazide (HCTZ), enalapril—on bone remodeling markers, bone mineral density (BMD) in hypertensive patients, and relationship with angiotensin converting enzyme (ACE) polymorphism.2015-09-0

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

La optimización del proceso de certificación de inexistencia de restos arqueológicos y el desarrollo de los proyectos de inversión en las regiones de Arequipa, Moquegua y Tacna

El presente trabajo de investigación titulado "La optimización del proceso de certificación de inexistencia de restos arqueológicos y el desarrollo de los proyectos de inversión en las regiones de Arequipa, Moquegua y Tacna", busca identificar elementos de mejora en el proceso seguido para la obtención de uno de los trámites requeridos por el Estado, en materia de cultura, fundamental para la viabilización de proyectos de inversión: el certificado de inexistencia de restos arqueológicos (CIRA); lo que ha permitido formular una serie de propuestas para otorgarle mayor efectividad a dicho proceso. La investigación es el resultado de haber efectuado una adecuada contrastación de la realidad constatada con los usuarios directamente vinculados con dicho proceso, y el marco técnico normativo identificado; todo bajo la mirada actual de modernización de la gestión pública, basada en planificación y simplificación administrativa, teniendo como finalidad el coadyuvar a los agentes económicos a invertir en el desarrollo de sus regiones, en este caso, Arequipa, Moquegua y Tacna. Con tal motivo, el presente documento busca que la contrastación facilite el análisis de la realidad problemática a través de la investigación efectuada, para generar una respuesta a la siguiente pregunta: ¿La optimización del proceso del certificado de inexistencia de restos arqueológicos (CIRA) incide en el desarrollo de los proyectos de inversión de las regiones Arequipa, Moquegua y Tacna? El principal objetivo es determinar cómo la mejora del proceso de expedición del certificado de inexistencia de restos arqueológicos, contribuye con los inversionistas, a fin que puedan desarrollar proyectos de inversión en las Regiones de Arequipa, Moquegua y Tacna. Para esto se plantea la hipótesis que la optimización del proceso del CIRA incide en el desarrollo de los proyectos de inversión en las Regiones de Arequipa, Moquegua y Tacna, siendo el tipo de investigación explicativo, de diseño transeccional, con metodología correlacional. La muestra comprende 112 empresas (entre privadas, entidades del Estado y personas naturales que solicitan el CIRA), el instrumento aplicado es una encuesta de 15 preguntas.Trabajo de investigació

Risk of recurrence after discontinuing anticoagulation in patients with COVID-19- associated venous thromboembolism: a prospective multicentre cohort studyResearch in context

Background: The clinical relevance of recurrent venous thromboembolism (VTE) after discontinuing anticoagulation in patients with COVID-19-associated VTE remains uncertain. We estimated the incidence rates and mortality of VTE recurrences developing after discontinuing anticoagulation in patients with COVID-19-associated VTE. Methods: A prospective, multicenter, non-interventional study was conducted between March 25, 2020, and July 26, 2023, including patients who had discontinued anticoagulation after at least 3 months of therapy. All patients from the registry were analyzed during the study period to verify inclusion criteria. Patients with superficial vein thrombosis, those who did not receive at least 3 months of anticoagulant therapy, and those who were followed for less than 15 days after discontinuing anticoagulation were excluded. Outcomes were: 1) Incidence rates of symptomatic VTE recurrences, and 2) fatal PE. The rate of VTE recurrences was defined as the number of patients with recurrent VTE divided by the patient-years at risk of recurrent VTE during the period when anticoagulation was discontinued. Findings: Among 1106 patients with COVID-19-associated VTE (age 62.3 ± 14.4 years; 62.9% male) followed-up for 12.5 months (p25-75, 6.3–20.1) after discontinuing anticoagulation, there were 38 VTE recurrences (3.5%, 95% confidence interval [CI]: 2.5–4.7%), with a rate of 3.1 per 100 patient-years (95% CI: 2.2–4.2). No patient died of recurrent PE (0%, 95% CI: 0–7.6%). Subgroup analyses showed that patients with diagnosis in 2021–2022 (vs. 2020) (Hazard ratio [HR] 2.86; 95% CI 1.45–5.68) or those with isolated deep vein thrombosis (vs. pulmonary embolism) (HR 2.31; 95% CI 1.19–4.49) had significantly higher rates of VTE recurrences. Interpretation: In patients with COVID-19-associated VTE who discontinued anticoagulation after at least 3 months of treatment, the incidence rate of recurrent VTE and the case-fatality rate was low. Therefore, it conceivable that long-term anticoagulation may not be required for many patients with COVID-19-associated VTE, although further research is needed to confirm these findings. Funding: Sanofi and Rovi, Sanofi Spain