Tocilizumab in COVID-19: Factors Associated With Mortality Before and After Treatment

We thank Pablo Lardelli Claret for his helpful advice in statistical methods. We also acknowledge the staff of Hospital Universitario Virgen de las Nieves who took (and are taking) care of the COVID-19 patients.Tocilizumab (TCZ) has been administered in SARS-CoV-2 pneumonia but the factors associated with mortality before and after treatment remain unclear. Cox regression models were used to estimate the predictors of time to death in a cohort of hospitalized patients with COVID-19 receiving TCZ. In addition, the mean differences between discharged and deceased patients in laboratory parameters measured before and 3, 6 and 9 days after TCZ administration were estimated with weighted generalized estimation equations. The variables associated with time to death were immunosuppression (Hazard Ratio-HR 3.15; 95% confidence interval-CI 1.17, 8.51), diabetes mellitus (HR 2.63; 95% CI 1.23–5.64), age (HR 1.05; 95% CI 1.02–1.09), days since diagnosis until TCZ administration (HR 1.05, 95% CI 1.00–1.09), and platelets (HR 0.27; 95% CI: 0.11, 0.69). In the post-TCZ analysis and compared to discharged patients, deceased patients had more lactate dehydrogenase (p 0.013), troponin I (p 0.013), C-reactive protein (p 0.013), neutrophils (p 0.024), and fewer platelets (p 0.013) and lymphocytes (p 0.013) as well as a lower average PaO2/FiO2 ratio. In conclusion, in COVID-19 diagnosed patients receiving TCZ, early treatment decreased the risk of death, while age, some comorbidities and baseline lower platelet counts increased that risk. After TCZ administration, lower platelet levels were again associated with mortality, together with other laboratory parameters

A aderência à actividade física numa idade precoce influencia o envelhecimento activo?

Resumen: Introducción: Realizamos este estudio sustentado en torno al sinónimo de salud que representa el deporte y la actividad física, que cobra aún más relevancia en el sector de la población de la edad adulta y vejez. Objetivos: con el objetivo de destacar el aspecto positivo que relaciona el ejercicio físico con el envejecimiento activo de excelencia. Métodos: para ello, llevamos a cabo un trabajo de revisión sistemática de investigaciones que hayan valorado los porcentajes de práctica de actividad física en dichas poblaciones. Así también, se comparan los datos con los de investigaciones que hayan evaluado la adquisición y mantenimiento de hábitos de vida saludable en escolares, para ofrecer una perspectiva del mantenimiento en el futuro, es decir a lo largo de la vida. Resultados y discusión: una vez finalizado el estudio, las investigaciones científicas confirman, según las cifras, extraídas y comparadas de los diferentes estudios; indican que mayormente los jóvenes, que tienen adquirido el hábito de actividad física, suelen mantener esos hábitos durante toda la vida y un porcentaje alto, continúan con un envejecimiento más saludable. Conclusiones: por lo tanto, se confirma que, el hábito de práctica de actividad física, adquirido en edades tempranas favorece un envejecimiento activo.Abstract: Introduction: We carried out this study based on the synonym of health that represents sport and physical activity, which becomes even more relevant in the sector of the population of adulthood and old age. Aim: With the aim of highlighting the positive aspect that relates physical exercise with active aging of excellence. Methods: To do this, we carried out a systematic review of research that has assessed the percentages of practicing physical activity in these populations. Likewise, the data is compared with research that has evaluated the acquisition and maintenance of healthy lifestyle habits in schoolchildren, to offer a perspective of maintenance in the future, that is, throughout life. Results & discussion: Once the study is completed, the scientific investigations confirm, according to the figures, extracted and compared from the different studies; indicate that mostly young people, who have acquired the habit of physical activity, tend to maintain these habits throughout life and a high percentage, continue with healthier aging. Conclusions: Therefore, it is confirmed that the habit of practicing physical activity, acquired at an early age, favors active aging.Resumo: Introdução: Realizamos este estudo com base no sinônimo de saúde que representa esporte e atividade física, o que se torna ainda mais relevante no setor da população adulta e idosa. Objetivos: com o objetivo de destacar o aspecto positivo que relaciona o exercício físico ao envelhecimento ativo de excelência. Métodos: para isso, realizamos uma revisão sistemática de pesquisas que avaliaram os percentuais de prática de atividade física nessas populações. Da mesma forma, os dados são comparados com pesquisas que avaliaram a aquisição e manutenção de hábitos de vida saudáveis em escolares, para oferecer uma perspectiva de manutenção no futuro, ou seja, ao longo da vida. Resultados e discussão: uma vez concluído o estudo, as investigações científicas confirmam, de acordo com as figuras, extraídas e comparadas dos diferentes estudos; indicam que a maioria dos jovens, que adquiriram o hábito de atividade física, tendem a manter esses hábitos ao longo da vida e uma alta porcentagem continua com um envelhecimento mais saudável. Conclusões: portanto, confirma-se que o hábito de praticar atividade física, adquirido em idade precoce, favorece o envelhecimento ativo

A escola como agente de socialização e sua influência na aquisição e manutenção de hábitos saudáveis e não saudáveis

Introducción: Mediante ciertos entes de la sociedad que llamamos “agentes” se realiza la socialización, porque permiten que ésta tenga lugar, dichos agentes son por excelencia, la familia, el “grupo de pares”, la escuela y los medios de comunicación. A través de este trabajo de investigación concretamente estudiaremos la influencia que uno de ellos, la escuela, tiene sobre la adquisición y mantenimiento de hábitos saludables y no saludables en el alumnado de Educación Secundaria. La información para comprobar el grado de influencia se obtiene a través de las opiniones del profesorado de Educación Física expresadas en un Grupo de Discusión, así como, de las respuestas del alumnado a los ítems de un cuestionario validado debidamente.Introduction: Through certain entities of the society that we call "agents", socialization takes place, because they allow it to take place, these agents are par excellence, the family, the "peer group", the school and the media. Through this research work we will concretely study the influence that one of them, the school, has on the acquisition and maintenance of healthy and unhealthy habits in Secondary Education students. The information to check the degree of influence is obtained through the opinions of the Physical Education teachers expressed in a Discussion Group, as well as the responses of the students to the items of a duly validated questionnaire.Introdução: Por meio de certas entidades da sociedade que chamamos de "agentes", ocorre a socialização, porque permitem que ela ocorra, esses agentes são por excelência, a família, o "grupo de pares", a escola e a mídia. Através deste trabalho de investigação iremos estudar concretamente a influência que um deles, a escola, tem na aquisição e manutenção de hábitos saudáveis e não saudáveis nos alunos do Ensino Secundário. As informações para checar o grau de influência são obtidas através das opiniões dos professores de Educação Física expressos em um Grupo de Discussão, bem como das respostas dos alunos aos itens de um questionário devidamente validado

Impact of confinement on the development of the physical education in primary and secondary education

[Resumen] Debido a la pandemia por el COVID-19, el estado de alarma y el confinamiento domiciliario, la docencia pasó a ser virtual en cuestión de unos pocos días y los docentes tuvieron que adaptar todo su trabajo de manera inexorable. Ante esta situación totalmente inédita en la historia de nuestro sistema educativo mediante esta investigación se ha indagado y descrito el impacto del periodo de confinamiento en el currículo escolar de educación física en Educación Primaria (EP) y Educación Secundaria obligatoria (ES). El instrumento utilizado ha sido un cuestionario realizado en Google Forms mediante la técnica Delphi. La muestra está́ compuesta por 100 docentes de las etapas de Educación Primaria y Educación Secundaria en España, en concreto en la comunidad autónoma Andaluza. Entre las principales conclusiones destacamos que el profesorado ha considerado que los objetivos de salud y los de condición física, fueron los objetivos más trabajados del área. Los docentes consideran que no se consiguieron llevar a cabo los tiempos motrices establecidos, ni la programación, pero si se consiguió que el alumnado realizara una tarea semanal con una implicación de aproximadamente una hora. Se concluyo que el impacto en el aprendizaje fue grande pues no se consiguieron trabajar todos los contenidos y las tareas planteadas no eran evaluables.[Abstract] Due to the COVID-19 pandemic, the state of alarm and home confinement, teaching became virtual in a matter of a few days and teachers had to adapt all their work inexorably. Faced with this totally unprecedented situation in the history of our educational system, this research has been used to investigate and describe the impact of the period of confinement on the school curriculum of physical education in primary and compulsory secondary education. The instrument used was a questionnaire made in Google Forms using the Delphi technique. The sample consisted of 100 teachers of the Primary Education (PE) and Secondary Education (SE) stages in Spain, specifically in the autonomous community of Andalusia. Among the main conclusions we highlight that the teachers considered that the objectives of health and physical condition were the most worked objectives in the area. The teachers consider that they did not manage to carry out the established motor times, nor the programming, but they did get the students to carry out a weekly task with an involvement of approximately one hour. It was concluded that the impact on learning was great because not all the contents were worked on and the tasks set were not evaluable

Niveles psicosociales y de actividad física en opositores de educación primaria

The selection process for teachers in Spain involves a great deal of academic preparation on the part of the applicant, which can lead to the appearance of negative emotional states together with a high level of sedentary lifestyles. The objectives of the research are to study the levels of physical activity, resilience, stress and burnout syndrome in terms of the calls for primary education competitive examinations and to study the relationship between physical activity, burnout syndrome, resilience and stress. A cross-sectional study was proposed in a sample of 4,117 candidates for the primary education competitive examination. The instruments used were the Perceived Stress Scale, the Maslach Burnout Inventory and the Connor-Davidson Resilience Scale. A higher level of burnout (p < .05) and physical activity practice (p < .05) is observed for participants who have taken the teacher's competitive examination more than others. Furthermore, negative relationships of resilience with stress (r = − .522; p < .01) and physical activity (r = − .166; p < .01) are evident. Finally, it is concluded that the most experienced candidates in the teacher competition process show higher levels of burnout, stress and physical activity time.El proceso selectivo de docentes en España implica una gran preparación académica por parte del aspirante, pudiendo generar la aparición de estados emocionales negativos junto con un mayor nivel de sedentarismo. Los objetivos del estudio son estudiar los niveles de actividad física, resiliencia, estrés y síndrome de burnout en función de las convocatorias presentadas a las oposiciones de educación primaria y estudiar la relación entre práctica de actividad física, síndrome de burnout, resiliencia y estrés. Se ha propuesto un estudio descriptivo, comparativo y transversal en una muestra de 4,117 opositores al cuerpo de educación primaria. Los instrumentos empleados han sido la Escala de Estrés Percibido, el Inventario de Burnout de Maslach y la Escala de Resiliencia Connor-Davidson. Se observa un mayor nivel de burnout (p < .05) y práctica de actividad física (p < .05) para los participantes que más veces han realizado la prueba de oposición docente. Además, se evidencian relaciones negativas de la resiliencia con el estrés (r = − .522; p < .01) y la práctica de actividad física (r = − .166; p < .01). Se concluye que los opositores más experimentados en el proceso de oposición muestran mayores niveles de burnout y estrés junto con un mayor tiempo de actividad física.Actividad Física y Deport

Injury prevention programmes in the physical education classroom. A systematic review

[Resumen] Las lesiones musculoesqueléticas están relacionadas en gran medida con la práctica de actividad físico-deportiva. En el caso de los niños y adolescentes se vinculan al ejercicio que realizan en el transcurso de las clases de Educación Física o las actividades deportivas extraescolares. En esta revisión sistemática, el objetivo de investigación es conocer la tipología lesional existente en el contexto escolar educativo y los programas de prevención vinculados a la descripción de las lesiones que se producen en él y conocer los programas de prevención que se implementan por docentes de Educación Física en el transcurso de sus clases. Se realizó una búsqueda de literatura científica durante los meses de enero y febrero del año 2023 en las bases de datos Web of Science, SCOPUS y PubMed. Como motores de búsqueda se utilizaron las siguientes palabras clave: "injur*", "prevent*”, “program*" y "physical education"; empleándose el operador boleano “and”. Como conclusión destaca la necesidad de continuar investigando y desarrollando programas efectivos de prevención de lesiones en el ámbito escolar y deportivo con el fin de proteger la salud y seguridad de los estudiantes.[Abstract] Musculoskeletal injuries are largely related to the practice of physical-sporting activity. In the case of children and adolescents, they are linked to the exercise they carry out during Physical Education classes or extracurricular sports activities. In this systematic review, the aim of the research is to find out about the types of injuries that exist in the educational school context and the prevention programmes linked to the description of the injuries that occur in it and to find out about the prevention programmes that are implemented by Physical Education teachers in the course of their classes. A search of scientific literature was carried out during the months of January and February 2023 in the Web of Science, SCOPUS and PubMed databases. The following keywords were used as search engines: " injur* ", " prevent* ", " program* " and " physical education ", using the Boolean operator "and". In conclusion, it highlights the need to continue researching and developing effective injury prevention programmes in schools and sports in order to protect the health and safety of students

Replication Study Of Polymorphisms Associated With Response To Methotrexate In Patients With Rheumatoid Arthritis

About 70 genetic studies have already addressed the need of biomarkers to predict the response of patients with rheumatoid arthritis (RA) to methotrexate (MTX) treatment. However, no genetic biomarker has yet been sufficiently validated. Here, we aimed to replicate a selection of 25 SNPs in the largest collection of patients up to date, which consisted of 915 patients treated with MTX. The change in disease activity (measured as.DAS28) from baseline was considered the primary outcome. In addition, response according to widely used criteria (EULAR) was taken as secondary outcome. We considered consistency between outcomes, P values accounting for the number of SNPs, and independence from potential confounders for interpretation of the results. Only the rs1801394 SNP in MTRR fulfilled the high association standards. Its minor allele was associated with less improvement than the major allele according to.DAS28 (p = 0.0016), and EULAR response (p = 0.004), with independence of sex, age, baseline DAS28, smoking, seropositivity, concomitant corticosteroid use or previous treatments. In addition, previous evidence suggests the association of this SNP with response to MTX in another autoimmune disease, juvenile idiopathic arthritis, and with high intracellular folate levels, which could contribute to poor response

Lack of replication of interactions between polymorphisms in rheumatoid arthritis susceptibility: case–control study

[Abstract] INTRODUCTION: Approximately 100 loci have been definitively associated with rheumatoid arthritis (RA) susceptibility. However, they explain only a fraction of RA heritability. Interactions between polymorphisms could explain part of the remaining heritability. Multiple interactions have been reported, but only the shared epitope (SE) × protein tyrosine phosphatase nonreceptor type 22 (PTPN22) interaction has been replicated convincingly. Two recent studies deserve attention because of their quality, including their replication in a second sample collection. In one of them, researchers identified interactions between PTPN22 and seven single-nucleotide polymorphisms (SNPs). The other showed interactions between the SE and the null genotype of glutathione S-transferase Mu 1 (GSTM1) in the anti-cyclic citrullinated peptide-positive (anti-CCP+) patients. In the present study, we aimed to replicate association with RA susceptibility of interactions described in these two high-quality studies. METHODS: A total of 1,744 patients with RA and 1,650 healthy controls of Spanish ancestry were studied. Polymorphisms were genotyped by single-base extension. SE genotypes of 736 patients were available from previous studies. Interaction analysis was done using multiple methods, including those originally reported and the most powerful methods described. RESULTS: Genotypes of one of the SNPs (rs4695888) failed quality control tests. The call rate for the other eight polymorphisms was 99.9%. The frequencies of the polymorphisms were similar in RA patients and controls, except for PTPN22 SNP. None of the interactions between PTPN22 SNPs and the six SNPs that met quality control tests was replicated as a significant interaction term--the originally reported finding--or with any of the other methods. Nor was the interaction between GSTM1 and the SE replicated as a departure from additivity in anti-CCP+ patients or with any of the other methods. CONCLUSIONS: None of the interactions tested were replicated in spite of sufficient power and assessment with different assays. These negative results indicate that whether interactions are significant contributors to RA susceptibility remains unknown and that strict standards need to be applied to claim that an interaction exists.Instituto de Salud Carlos III; 11/01048Instituto de Salud Carlos III; 12/01909Instituto de Salud Carlos III; RD12/0009/000

Reforestation model with native plants of the Jaraba swamp through the IEP

La sequía en época de verano ocasionada por la acción directa del sol sobre las costas a causa de la perdida de vegetación en las mismas, es una realidad que afecta a las poblaciones ribereñas en la actualidad. Los programas de reforestación son herramientas útiles en la mejora de la calidad de vida de las diferentes partes del mundo afectadas por esta realidad. Este estudio tuvo como propósito diseñar un modelo de reforestación con plantas nativas de la ciénaga de Jaraba mediante la Investigación como Estrategia Pedagógica (IEP). La metodología se orientó bajo el enfoque cualitativo, utilizando el tipo de investigación acción, desde un diseño descriptivo, exploratorio. Para la recolección de datos se utilizaron técnicas como; análisis documental a partir de la implementación de un software que analiza las características de los arbustos y semillas propicias para la reforestación. La población estuvo conformada por cincuenta (50) estudiantes de la IED Antonio Bruges Carmona sede ERM de Jaraba del Municipio de Santa Ana Magdalena. Dando como resultados la creación de un vivero natural con diferentes especies de plantas seleccionadas para este modelo ecológico. Llegando a la conclusión que existe la necesidad de fortalecer la cultura ambiental por parte de los habitantes y visitantes en las orillas de la ciénaga, donde se vierte toda clase de desechos que difícilmente alcanzarán un nivel de degradación.The drought in summer time caused by the direct action of the sun on the coasts because of the loss of vegetation in them, is a reality that affects the riverside populations at present. Reforestation programs are useful tools in improving the quality of life in different parts of the world affected by this reality. The purpose of this study was to design a reforestation model with native plants of the Jaraba swamp through Research as a Pedagogic Strategy (IEP). The methodology was oriented under the qualitative approach, using the type of action research, from a descriptive, exploratory design. For the collection of data, techniques such as; documentary analysis based on the implementation of software that analyzes the characteristics of shrubs and seeds that are conducive to reforestation. The population was conformed by fifty (50) students of the IED Antonio Bruges Carmona ERM headquarters of Jaraba of the Municipality of Santa Ana Magdalena, giving as results the creation of a natural nursery with different species of plants selected for this ecological model. Reaching the conclusion that there is a need to strengthen the environmental culture on the part of the inhabitants and visitors on the banks of the swamp, where all kinds of waste that will hardly reach a level of degradation are poured

TRAF1/C5 but Not PTPRC Variants Are Potential Predictors of Rheumatoid Arthritis Response to Anti-Tumor Necrosis Factor Therapy

Background. The aim of our work was to replicate, in a Southern European population, the association reported in Northern populations between PTPRC locus and response to anti-tumor necrosis factor (anti-TNF) treatment in rheumatoid arthritis (RA). We also looked at associations between five RA risk alleles and treatment response. Methods. We evaluated associations between anti-TNF treatment responses assessed by DAS28 change and by EULAR response at six months in 383 Portuguese patients. Univariate and multivariate linear and logistic regression analyses were performed. In a second step to confirm our findings, we pooled our population with 265 Spanish patients. Results. No association was found between PTPRC rs10919563 allele and anti-TNF treatment response, neither in Portuguese modeling for several clinical variables nor in the overall population combining Portuguese and Spanish patients. The minor allele for RA susceptibility, rs3761847 SNP in TRAF1/C5 region, was associated with a poor response in linear and logistic univariate and multivariate regression analyses. No association was observed with the other allellic variants. Results were confirmed in the pooled analysis. Conclusion. This study did not replicate the association between PTPRC and the response to anti-TNF treatment in our Southern European population. We found that TRAF1/C5 risk RA variants potentially influence anti-TNF treatment response.This work was supported by a grant from Harvard-Portugal Program HMSP-ICS/SAU-ICT/0002/2010. Daniel H. Solomon received support for this work from the NIH (K24-AR-055989). Elizabeth W. Karlson received support for this work from NIH (K24-AR-AR0524). Reuma.pt received unrestricted grants from Abbott, Bristol-Myers Squibb, Merck Sharp and Dohme, Pfizer, Roche, and UCB Pharma