Recommendations for Future Articles on Knowledge, Attitudes and Practices in IJMS

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Use of tocilizumab in kidney transplant recipients with COVID-1

Acute respiratory distress syndrome associated with coronavirus infection is related to a cytokine storm with large interleukin-6 (IL-6) release. The IL-6-receptor blocker tocilizumab may control the aberrant host immune response in patients with coronavirus disease 2019 (COVID-19) . In this pandemic, kidney transplant (KT) recipients are a high-risk population for severe infection and showed poor outcomes. We present a multicenter cohort study of 80 KT patients with severe COVID-19 treated with tocilizumab during hospital admission. High mortality rate was identified (32.5%), related with older age (hazard ratio [HR] 3.12 for those older than 60 years, P = .039). IL-6 and other inflammatory markers, including lactic acid dehydrogenase, ferritin, and D-dimer increased early after tocilizumab administration and their values were higher in nonsurvivors. Instead, C-reactive protein (CRP) levels decreased after tocilizumab, and this decrease positively correlated with survival (mean 12.3 mg/L in survivors vs. 33 mg/L in nonsurvivors). Each mg/L of CRP soon after tocilizumab increased the risk of death by 1% (HR 1.01 [confidence interval 1.004-1.024], P = .003). Although patients who died presented with worse respiratory situation at admission, this was not significantly different at tocilizumab administration and did not have an impact on outcome in the multivariate analysis. Tocilizumab may be effective in controlling cytokine storm in COVID-19 but randomized trials are needed

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Rescate simbólico de opción de vida para la población de Trujillo, Valle

IP 1125-11-037-98v.1. Informe tecnico final -- v.2. Trujillo : un diagnostico para la comprension de los desastres sociales / Manuel Restrepo Yusti ; Elementos de un diagnostico desdela escuela / Magdala Velazquez ; Un modelo de intervencion psicosocial para poblaciones afectadas por laviolencia / Eduardo Botero Toro, Rodrigo Solis Villa -- v.3. Informe asesoria en planeacion y formulaciondeproyectos colectivos Corpopaz / Martha Lya Velasquez T. ; La planeacion y la gestion local como espacio para la concertacion y la democracia / Martha Lya Velasquez ; Propuesta de intervencion en el proyecto ecoturistico del municipio Tamauca, Trujillo, Valle / Orlando Naranjo ... [et al.] ; Proyecto granja integral San Francisco BPIN/ Corpopaz -- v.4 Escritura y experiencia : Trujillo, Valle / Martha Lopez Castaño ; Modelodeatencionpsicosocial. Serie: del lenguaje / Martha Lopez Castaño -- Des-construccion del legado patriarcal/Martha Lopez Castaño ; Etica y afeccion / Martha Lopez Castaño ; La creacion, herramienta para fortalecerlas ganasde vivir / Enrique A. Velasquez R. -- v.5. Modelo de intervencion psicosocial para poblacionesafectadas por la violencia / Eduardo Botero Toro, Rodrigo Solis Villa ; La creacion, herramienta parafortalecer las ganas de vivir / Enrique Velasquez Ruiz ; Escritura y experiencia. Modelo de atencion psicosocial.Serie: dellenguaje / Martha Lopez Castaño.LIBRO: Duelo, acontecimiento y vida : consideraciones sobre laatencion psicosocial : caso Trujillo - Valle;/ Eduardo Botero Toro ... [et al.]. -- Santafe de Bogotá :EsapPublicaciones, 2000. -- 195 p. ; 24 cm. --;ISBN 9586521125

Polifonía para pensar una pandemia

Polifonía para pensar una pandemia expresa, a través de diversas voces, las experiencias e inquietudes, los desafíos y aportes que desde distintas perspectivas disciplinares y humanas intentan nombrar, aprehender algo de aquello desvelado por la inusitada situación que nos embarga, la cual ha tocado a todos y cada de uno nosotros de diferentes formas, mostrándonos empero, de modo implacable, la fragilidad de la existencia y la responsabilidad que, como sociedades y habitantes de nuestro planeta, tenemos en las diversas esferas que configuran nuestras vidas. Estas voces se suman a aquellas que, desde otras latitudes, han contribuido a la reflexión y el análisis de esta experiencia sui generis; esperamos que resuenen a partir de ello otros ecos y otras disonancias

Diversidad biológica y cultural del sur de la Amazonia colombiana

La gran cuenca amazónica compartida por Brasil, Colombia, Perú, Bolivia, Venezuela, Ecuador y las tres Guyanas, contiene una de las mayores riquezas biológicas y culturales del planeta y es considerada parte de la seguridad ecológica global. Constituye el 45% de los bosques tropicales del mundo, es una de las áreas silvestres más extensas y de mayor reserva de agua dulce del planeta, su sistema hídrico es el mayor tributario de todos los océanos, alberga aún, cerca de 379 grupos étnicos y en cuanto a endemismo, no existe otra región que se le aproxime. En Colombia, la Amazonia a lo largo de la historia ha sufrido distintos procesos de intervención antrópica: la conquista; la colonización; el auge del caucho y la quina; la explotación maderera, petrolera; la implementación de cultivos de uso ilícito y de sistemas productivos no aptos a las condiciones del medio natural; entre otros, son procesos que han socavado tanto los recursos biológicos como los culturales. Conscientes de la problemática actual de la Amazonia así como de la importancia que reviste para el mundo y para el país, la Corporación para el Desarrollo Sostenible del Sur de la Amazonia –Corpoamazonia– y el Instituto de Investigación de Recursos Biológicos Alexander von Humboldt –IAvH-, firmaron en el año 2004 un convenio con el n de aunar esfuerzos para formular el plan de acción en biodiversidad en la región sur de la Amazonia colombiana (departamentos de Caquetá, Putumayo y Amazonas). El plan de acción, busca posicionar la biodiversidad en el desarrollo regional y contribuir a un mayor conocimiento y a unas mejores prácticas de conservación y utilización sostenible de los recursos biológicos y culturales de este importante espacio geográfico. Desarrolla a escala regional, la Política Nacional en Biodiversidad y la Propuesta Técnica de Plan de Acción Nacional en Biodiversidad – Biodiversidad siglo XXI -

Morichales, cananguchales y otros palmares inundables de Suramérica. Parte II: Colombia, Venezuela, Brasil, Perú, Bolivia, Paraguay, Uruguay y Argentina

El libro está dividido en cuatro partes. En la primera sección se incluye un análisis muy completo sobre el estado del conocimiento, uso y conservación de Mauritia flexuosa en Suramérica. En la segunda parte se consideran varios casos de estudio (11) sobre comunidades de plantas asociadas, demografía, polinizadores, aves y mamíferos relacionados, así como temas de manejo y ecoturismo en palmares de Mauritia flexuosa. La tercera sección incluye aportes de varios países sobre otros palmares, principalmente de Astrocaryum jauari, Butia odorata, B. paraguayensis, Copernicia alba, C. tectorum, Euterpe oleracea, Manicaria saccifera, Mauritiella aculeata y Roystonea oleracea. También se aporta información de 25 especies adicionales de palmas, incluyendo los usos, dinámica de poblaciones, biología reproductiva, florística de humedales asociados y conservación, entre otros aspectos. Por último, en la cuarta parte se dan las conclusiones y recomendaciones para la conservación de los palmares inundables en Suramérica.Bogotá, D. C

Clinical Presentation and Short- and Long-term Outcomes in Patients With Isolated Distal Deep Vein Thrombosis vs Proximal Deep Vein Thrombosis in the RIETE Registry

International audienceImportance: Insufficient data exist about the clinical presentation, short-term, and long-term outcomes of patients with isolated distal deep vein thrombosis (IDDVT), that is, thrombosis in infrapopliteal veins without proximal extension or pulmonary embolism (PE).Objective: To determine the clinical characteristics, short-term, and 1-year outcomes in patients with IDDVT and to compare the outcomes in unadjusted and multivariable adjusted analyses with patients who had proximal DVT.Design, setting, and participants: This was a multicenter, international cohort study in participating sites of the Registro Informatizado Enfermedad Tromboembólica (RIETE) registry conducted from March 1, 2001, through February 28, 2021. Patients included in this study had IDDVT. Patients with proximal DVT were identified for comparison. Patients were excluded if they had a history of asymptomatic DVT, upper-extremity DVT, coexisting PE, or COVID-19 infection.Main outcomes and measures: Primary outcomes were 90-day and 1-year mortality, 1-year major bleeding, and 1-year venous thromboembolism (VTE) deterioration, which was defined as subsequent development of proximal DVT or PE.Results: A total of 33 897 patients were identified with isolated DVT (without concomitant PE); 5938 (17.5%) had IDDVT (mean [SD] age, 61 [17] years; 2975 male patients [50.1%]), and 27 959 (82.5%) had proximal DVT (mean [SD] age, 65 [18] years; 14 315 male patients [51.2%]). Compared with individuals with proximal DVT, those with IDDVT had a lower comorbidity burden but were more likely to have had recent surgery or to have received hormonal therapy. Patients with IDDVT had lower risk of 90-day mortality compared with those with proximal DVT (odds ratio [OR], 0.47; 95% CI, 0.40-0.55). Findings were similar in 1-year unadjusted analyses (hazard ratio [HR], 0.52; 95% CI, 0.46-0.59) and adjusted analyses (HR, 0.72; 95% CI, 0.64-0.82). Patients with IDDVT had a lower 1-year hazard of VTE deterioration (HR, 0.83; 95% CI, 0.69-0.99). In 1-year adjusted analyses of patients without an adverse event within the first 3 months, IDDVT was associated with lower risk of VTE deterioration (adjusted HR, 0.48; 95% CI, 0.24-0.97). By 1-year follow-up, symptoms or signs of postthrombotic syndrome were less common in patients with IDDVT (47.6% vs 60.5%).Conclusions and relevance: Results of this cohort study suggest that patients with IDDVT had a less ominous prognosis compared with patients with proximal DVT. Such differences were likely multifactorial, including the differences in demographics, risk factors, comorbidities, particularly for all-cause mortality, and a potential association of thrombus location with VTE deterioration and postthrombotic syndrome. Randomized clinical trials are needed to assess the optimal long-term management of IDDVT