13 research outputs found

    Higher COVID-19 pneumonia risk associated with anti-IFN-α than with anti-IFN-ω auto-Abs in children

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    We found that 19 (10.4%) of 183 unvaccinated children hospitalized for COVID-19 pneumonia had autoantibodies (auto-Abs) neutralizing type I IFNs (IFN-alpha 2 in 10 patients: IFN-alpha 2 only in three, IFN-alpha 2 plus IFN-omega in five, and IFN-alpha 2, IFN-omega plus IFN-beta in two; IFN-omega only in nine patients). Seven children (3.8%) had Abs neutralizing at least 10 ng/ml of one IFN, whereas the other 12 (6.6%) had Abs neutralizing only 100 pg/ml. The auto-Abs neutralized both unglycosylated and glycosylated IFNs. We also detected auto-Abs neutralizing 100 pg/ml IFN-alpha 2 in 4 of 2,267 uninfected children (0.2%) and auto-Abs neutralizing IFN-omega in 45 children (2%). The odds ratios (ORs) for life-threatening COVID-19 pneumonia were, therefore, higher for auto-Abs neutralizing IFN-alpha 2 only (OR [95% CI] = 67.6 [5.7-9,196.6]) than for auto-Abs neutralizing IFN-. only (OR [95% CI] = 2.6 [1.2-5.3]). ORs were also higher for auto-Abs neutralizing high concentrations (OR [95% CI] = 12.9 [4.6-35.9]) than for those neutralizing low concentrations (OR [95% CI] = 5.5 [3.1-9.6]) of IFN-omega and/or IFN-alpha 2

    Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

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    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

    Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

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    Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

    Monitoring swelling and deswelling of thin polymer films by microcantilever sensors

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    Microcantilever based sensors are promising devices because they are fast, low cost, portable and allow measuring extremely small quantities of substances in gas or liquid phase that are not detectable by other methods. In this work we investigate the swelling and deswelling behavior of poly(hydroxyl ethyl methacrylate), PHEMA, films with three different average molecular masses deposited onto bare silicon microcantilevers, a hydrophilic substrate, and onto polystyrene (PS) coated microcantilevers, which is a hydrophobic substrate, under humidity cycles by monitoring the deflections resulting from differential surface stress. The results found in the present study demonstrate that the micromechanical response observed are related not only to the polymer molecular weight, but also to the polymer-interface phenomena and environment-polymer interface that can play a crucial role on the signal transduction. Ellipsometric measurements evidenced that the swelling of PHEMA films with intermediate molecular weight at 80% RH follows Fickian diffusion mechanism. Nevertheless, due to the weak optical contrast or film homogeneity shorter or longer chains than PHEMA-300 could not be investigated by ellipsometry. PHEMA films deposited onto PS surfaces presented dewetting, which limited the ellipsometric measurements. In comparison to ellipsometry, monitoring swelling behavior of PHEMA by nanomechanical responses is more advantageous because it is faster and less restricted. © 2014 Elsevier B.V. All rights reserved.The authors acknowledge the financial support from the Brazilian Agency CNPq through the grants #560565/2010-0 and #209693/2012-6 and the financial support from the Spanish Science Ministry through projects #PIB2010BZ-00510); and from European Research Council through Starting Grant NANOFORCELLS (ERC-StG-2011-278860).Peer Reviewe

    Hydration Induced Stress on DNA Monolayers Grafted on Microcantilevers

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    Surface tethered single-stranded DNA films are relevant biorecognition layers for oligonucleotide sequence identification. Also, hydration induced effects on these films have proven useful for the nanomechanical detection of DNA hybridization. Here, we apply nanomechanical sensors and atomic force microscopy to characterize in air and upon varying relative humidity conditions the swelling and deswelling of grafted single stranded and double stranded DNA films. The combination of these techniques validates a two-step hybridization process, where complementary strands first bind to the surface tethered single stranded DNA probes and then slowly proceed to a fully zipped configuration. Our results also demonstrate that, despite the slow hybridization kinetics observed for grafted DNA onto microcantilever surfaces, ex situ sequence identification does not require hybridization times typically longer than 1 h, while quantification is a major challenge.This work was supported by the ERC Starting Grant “NANOFORCELLS” (ERC-StG-2011-278860) and Projects INMUNO-SWING ITP-2011-0821-010000, FORCEFORFUTURE CSD2010-00024, and MAT2012-36197.Peer reviewe

    Minimally invasive surgery versus laparotomy in women with high risk endometrial cancer: A multi-center study performed in Argentina

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    Objective: Compare the perioperative outcomes and disease-free survival between minimally invasive and open surgery in women with stage I–II high-risk endometrial cancer. Methods: A retrospective, cohort study was performed involving twenty-four centers from Argentina. Patients with grade 3 endometrioid, serous, clear cell, undifferentiated carcinoma or carcinosarcoma who underwent hysterectomy, bilateral salpingo-oophorectomy, and staging between January 2010–2018 were included. Cox hazard regression analysis and Kaplan-Meier curves evaluated the association of surgical technique with survival. Results: Of 343 eligible patients, 214 (62 %) underwent open surgery and 129 (38 %) underwent laparoscopic surgery. No significant differences were seen between the two groups with respect to greater or equal grade III Clavien-Dindo postoperative complications (11 % in the open surgery group vs 9 % minimally invasive surgery group; P = 0.34) Minimally invasive surgery was not associated with worse disease-free survival at four years (79.14 % [95 % CI 69.42– 86.08] vs 78.80 % [95 % CI 70.61–84.96]), (p = 0.25), even after creating a Cox proportional model (hazard ratio [HR] 1.08 95 % CI 0.63–1.84); (p = 0.76). Conclusion: There was no difference between postoperative complications nor oncologic outcomes comparing minimally invasive and open surgery among patients with high-risk endometrial cancer

    I Premio Nacional de Educación para el Desarrollo "Vicente Ferrer" 2009 : buenas prácticas

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    La Agencia Española de Cooperación Internacional para el Desarrollo (AECID) junto con el Ministerio de Educación convoca anualmente los premios de educación para el desarrollo que están dirigidos a todos los centros docentes españoles sostenidos con fondos públicos que impartan educación infantil, educación primaria, educación secundaria obligatoria, bachillerato y formación profesional. Se recogen las buenas prácticas de los docentes premiados en esta segunda edición. Docentes que en el ejercicio de su función educadora han convertido el proceso educativo en un proceso dinámico e interactivo que permite al alumnado desarrollar un conocimiento crítico de nuestro mundo. Profesores y profesoras que han estimulado la participación del alumnado en la construcción de estructuras sociales más justas y solidarias, y han promovido actuaciones basadas en el principio de la corresponsabilidad de todos los actores implicados.MECDES

    Grado de implementación de las estrategias preventivas del síndrome post-UCI: estudio observacional multicéntrico en España

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    Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain

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