3 research outputs found

    De Nueva Espa√Īa a M√©xico : El universo musical mexicano entre centenarios (1517-1917)

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    742 p√°gs. Im√°genes color y b/n. Partituras musicales.El fen√≥meno de las conmemoraciones culturales siempre ha sido un terreno abonado para la producci√≥n cultural y art√≠stica del que se han valido los Estados para ofrecer interpretaciones legitimadoras e ideologizadas de la historia, articuladas en torno a las ideas de memoria, naci√≥n y progreso. El presente volumen, resultado de una triple conmemoraci√≥n (el centenario de la Revoluci√≥n Mexicana y la publicaci√≥n de la primera historia de la m√ļsica en M√©xico de Alba Herrera ‚Äď1917‚Äď, por un lado; y la llegada del militar andaluz Francisco Hern√°ndez de C√≥rdoba a la costa de la pen√≠nsula del Yucat√°n ‚Äď1517‚Äď, por otro), presenta una visi√≥n retrospectiva de la historia musical mexicana a lo largo de esas cuatro centurias. Frente a la r√≠gida divisi√≥n cronol√≥gica impuesta por ciertas narrativas, se ofrece as√≠ una noci√≥n inclusiva, actual e informada del universo musical mexicano en toda su multiplicidad y riqueza de matices, integrando las √©pocas colonial e independiente como lo que realmente son: partes constitutivas de la memoria musical, hist√≥rica, cultural y pol√≠tica del pa√≠s, con las luces y las sombras propias de cualquier otro periodo

    Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

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    IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non‚Äďcritically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n‚ÄČ=‚ÄČ257), ARB (n‚ÄČ=‚ÄČ248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n‚ÄČ=‚ÄČ10), or no RAS inhibitor (control; n‚ÄČ=‚ÄČ264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support‚Äďfree days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support‚Äďfree days among critically ill patients was 10 (‚Äď1 to 16) in the ACE inhibitor group (n‚ÄČ=‚ÄČ231), 8 (‚Äď1 to 17) in the ARB group (n‚ÄČ=‚ÄČ217), and 12 (0 to 17) in the control group (n‚ÄČ=‚ÄČ231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support‚Äďfree days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

    Effect of Antiplatelet Therapy on Survival and Organ Support‚ÄďFree Days in Critically Ill Patients With COVID-19