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

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase

Propiedades fundamentales de cúmulos estelares azules, compactos y de alto brillo superficial en la Nube Mayor de Magallanes

Integrated spectroscopy in the optical range (3600-6800Å) of a sample of 29 blue compact and high surface brightness Large Magellanic Cloud (LMC) star clusters is presented. Cluster reddening values were estimated using the avaible interstellar extinction maps, while cluster ages were derived from template matching and equivalent width (EW) methods. In the latter case, age-metallicity calibrations were used together with diagnostic diagrams involving the sum of Ews of selected spectral lines ( K CaII, G band (CH), MgI, Hβ, Hγ and Hδ. The derived cluster ages range from 5 to 800 Myr, a good agreement between the results of the two methods being obtained. The present cluster sample complements previous ones, in an attempt to provide a spectral library with several clusters per age interval.DOI: http://dx.doi.org/10.5377/ce.v1i1.606 Ciencias Espaciales 1(1) 2009 Presentamos espectros integrados en el rango óptico (3600-6800Å) de 29 cúmulos azules compactos y de alto brillo superficial de la Nube Mayor de Magallanes (NMM). Estimamos enrojecimiento a partir del método de ajuste de templates y usando mapas de extinción interestelar en la región de los cúmulos, las edades la determinamos a partir del método de ajuste de templates y de los anchos equivalentes (AEs). En este último caso, usamos calibraciones empíricas en función de la edad, junto con diagrama de diagnóstico que involucran la suma de AEs de características espectrales seleccionadas (K CaII, G band (CH), MgI, Hβ, Hγ and Hδ. El rango de edades derivadas oscila entre ~5 millones y 800 millones de años. Obtuvimos un buen acuerdo entre los resultados de los dos métodos. Los espectros obtenidos mejoran y complementan las bases de datos espectrales actualmente existente para la NMM.DOI: http://dx.doi.org/10.5377/ce.v1i1.606Ciencias Espaciales 1(1) 200

Further developments in star cluster spectral libraries

We present flux-calibrated integrated spectra in the optical spectral range of galactic open clusters (GOCs) and Magellanic Cloud (MC) stellar clusters (SCs) obtained at CASLEO (Argentina). The SC parameters were derived using the equivalent-width (EW) method and the template-matching procedure by comparing the line strengths and continuum distribution of the cluster spectra with those of template spectra with known parameters. MC cluster reddening values were also estimated by interpolation between the available extinction maps. The derived ages for the GOCs range from 3 Myr to 4 Gyr, while those of the MC SCs vary from 3 Myr to 7 Gyr. E(B − V ) colour-excess values in the MCs appear to be all lower than 0.17 mag, while those of the GOCs range from 0.00 to 2.40 mag. The present data led us to upgrade the spectral libraries of reference spectra or templates of solar and MC metallicities.Fil: Ahumada, Andrea Veronica. Universidad Nacional de Cordoba. Observatorio Astronomico de Cordoba; ArgentinaFil: Claria Olmedo, Juan Jose. Universidad Nacional de Cordoba. Observatorio Astronomico de Cordoba; ArgentinaFil: Bica, Eduardo. Universidade Federal do Rio Grande do Sul,; BrasilFil: Piatti, Andres Eduardo. Consejo Nacional de Investigaciónes Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Astronomía y Física del Espacio. - Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Astronomía y Física del Espacio; ArgentinaFil: Santos Jr., Joâo F. C.. Universidade Federal do Minas Gerais; BrasilFil: Talavera, M. Lorena. Observatorio Astronomico Centroamericano de Suyapa; HondurasFil: Palma, Tali. Universidad Nacional de Cordoba. Observatorio Astronomico de Cordoba; ArgentinaFil: Pavani, Daniela B.. Universidade Federal de Pelotas; BrasilFil: Parisi, M. Celeste. Universidad Nacional de Cordoba. Observatorio Astronomico de Cordoba; ArgentinaFil: Torres, M. Cristina. Universidad Nacional de Cordoba. Observatorio Astronomico de Cordoba; ArgentinaFil: Dutra, Carlos M.. Universidade Federal do Pampa; Brasi

Sugar-sweetened beverages and colorectal cancer risk in the California Teachers Study.

BackgroundThe association between sugar-sweetened beverage (SSB) consumption and colorectal cancer (CRC) risk remains unclear and published data are limited.MethodsThe analytic cohort included 99,798 women, free of cancer at baseline, from the California Teachers Study, a longitudinal cohort comprised of 133,477 female teachers and administrators who were active or recently retired members of the California State Teachers Retirement System in 1995. SSB consumption constituted caloric soft drinks, sweetened bottled waters and teas, and fruit drinks, derived from a self-administered food frequency questionnaire. Consumption was divided into four categories: Rare or never, >rare/never to ResultsA total of 1,318 incident CRC cases were identified over 20 years of follow-up (54.5% proximal colon and 45.5% distal colorectum). Compared with rare/never consumers, the multivariable-adjusted HRs (95% CI) were 1.14 (0.86, 1.53) for total CRC; 1.11 (0.73, 1.68) for proximal colon; and 1.22 (0.80, 1.86) for distal colorectum cancers among women consuming ≥ 1 serving/day of SSBs.ConclusionSSBs were not significantly associated with CRC risk. The biological effects of high SSB consumption make it important to continue to evaluate whether SSBs are associated with CRC. Additionally, future studies should further assess SSBs in large, racial/ethnically diverse cohorts of males and females, and, if feasible, address changes in SSB consumption over time

Rivaroxaban with or without aspirin in stable cardiovascular disease

BACKGROUND: We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. METHODS: In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction. The study was stopped for superiority of the rivaroxaban-plus-aspirin group after a mean follow-up of 23 months. RESULTS: The primary outcome occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (379 patients [4.1%] vs. 496 patients [5.4%]; hazard ratio, 0.76; 95% confidence interval [CI], 0.66 to 0.86; P<0.001; z=−4.126), but major bleeding events occurred in more patients in the rivaroxaban-plus-aspirin group (288 patients [3.1%] vs. 170 patients [1.9%]; hazard ratio, 1.70; 95% CI, 1.40 to 2.05; P<0.001). There was no significant difference in intracranial or fatal bleeding between these two groups. There were 313 deaths (3.4%) in the rivaroxaban-plus-aspirin group as compared with 378 (4.1%) in the aspirin-alone group (hazard ratio, 0.82; 95% CI, 0.71 to 0.96; P=0.01; threshold P value for significance, 0.0025). The primary outcome did not occur in significantly fewer patients in the rivaroxaban-alone group than in the aspirin-alone group, but major bleeding events occurred in more patients in the rivaroxaban-alone group. CONCLUSIONS: Among patients with stable atherosclerotic vascular disease, those assigned to rivaroxaban (2.5 mg twice daily) plus aspirin had better cardiovascular outcomes and more major bleeding events than those assigned to aspirin alone. Rivaroxaban (5 mg twice daily) alone did not result in better cardiovascular outcomes than aspirin alone and resulted in more major bleeding events