Shorter duration of symptoms before remdesivir has been associated with better outcomes. Our goal was to evaluate variables associated with the need of ICU admission in a cohort of hospitalized ...patients for COVID-19 under remdesivir including the period from symptoms onset to remdesivir.
We conducted a retrospective multicentric study analysing all patients admitted with COVID-19 in 9 Spanish hospitals who received treatment with remdesivir in October 2020. The main outcome was the need of ICU admission after 24 h of the first dose of remdesivir.
In our cohort of 497 patients, the median of days from symptom onset to remdesivir was 5 days, and 70 of them (14.1%) were later admitted into ICU. The clinical outcomes associated with ICU admission were days from symptoms onset (5 vs. 6; p = 0.023), clinical signs of severe disease (respiratory rate, neutrophil count, ferritin levels and very-high mortality rate in SEIMC-Score) and the use of corticosteroids and anti-inflammatory drugs before ICU. The only variable significatively associated with risk reduction in the Cox-regression analyses was ≤ 5 days from symptoms onset to RDV (HR: 0.54, CI95%: 0.31-0.92; p = 0.024).
For patients admitted to the hospital with COVID-19, the prescription of remdesivir within 5 days from symptoms onset diminishes the need of ICU admission.
There is no reliable microbiological marker to guide the indication and the response to antiviral treatment in patients with coronavirus disease 2019 (COVID-19). We aimed to evaluate the dynamics of ...subgenomic RNA (sgRNA) in patients with COVID-19 before and after receiving treatment with remdesivir.
We included consecutive patients admitted for COVID-19 who received remdesivir according to our institutional protocol and accepted to participate in the study. A nasopharyngeal swab for quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) was collected at baseline and after 3 and 5 days of treatment with remdesivir. Genomic and sgRNA were analyzed in those samples and main comorbidities and evolution were collected for the analyses. The main outcomes were early discharge (≤10 days) and 30-day mortality.
A total of 117 patients were included in the study, of whom 24 had a negative sgRNA at baseline, with 62.5% (15/24) receiving early discharge (≤10 days) and no deaths in this group. From the 93 remaining patients, 62 had a negative sgRNA at day 5 with 37/62 (59.6%) with early discharge and a mortality rate of 4.8% (3/62). In the subgroup of 31 patients with positive sgRNA after 5 days of remdesivir, the early discharge rate was 29% (9/31) and the mortality rate was 16.1% (5/31). In multivariable analyses, the variables associated with early discharge were negative sgRNA at day 3 and not needing treatment with corticosteroids or intensive care unit admission.
Qualitative sgRNA could help in monitoring the virological response in patients who receive remdesivir. Further studies are needed to confirm these findings.
La Falla de San Marcos (FSM) es una estructura que atraviesa al estado de Coahuila con rumbo general NW-SE. Esta estructura forma parte de un sistema de fallas normales en el Jurásico Medio con una ...reactivación en el Jurásico Tardío, condicionó el depósito de unidades carbonatadas durante el Cretácico Temprano y se reactivó como falla inversa posiblemente en el Paleógeno. El límite nororiental de la plataforma de Coahuila coincide con la traza de la FSM y en la localidad de Las Palomas, Coahuila, es donde mejor se expone. En este sitio las capas de la Formación Cupido cabalgan sobre lutitas calcáreas pelágicas, a las cuales nos referimos informalmente como Capas Cerro La Bruja (CCLB). Esta unidad se correlaciona con la Formación Eagle Ford en la cuenca de Sabinas al norte y con la Formación Indidura en la cuenca de Parras, al sur. Las CCLB se observan subhorizontales sobre la plataforma de Coahuila, ya que sólo se acortaron en los 400 metros más próximos a la traza de la FSM. La actividad de la falla provocó el desarrollo de pliegues tipo chevron, los cuales se disponen en una cuña de deformación limi-tada por una falla basal que separa a las rocas plegadas de aquellas no plegadas. Un análisis detallado de pliegues permitió estimar un acor-tamiento horizontal de alrededor de 500 metros. Considerando que sólo hay una generación de pliegues en las CCLB y que el acortamiento fue causado por la actividad de la FSM. Basado en la estimación de este acortamiento, se propone un nuevo método para estimar el desplazamiento mínimo de la traza frontal del sistema de la FSM, el cual toma en cuenta el acortamiento de las CCLB y la inclinación de la falla. Dicho método permitió estimar un desplazamiento mínimo de 1300 m sobre el plano frontal de la falla, lo cual es consistente con las estimaciones de más de 3000 m, realizadas por autores previos para todo el sistema de fallas. La estimación de desplazamiento a lo largo de fallas mayores siempre ha sido un reto en el análisis estructural, por lo cual consideramos que nuestro nuevo método puede ser una valiosa herramienta para determinar desplazamiento sobre fallas mayores.
The San Marcos fault (SMF) cuts across Coahuila state along a NW-SE trend. This long-lived structure is part of a Middle Jurassic normal fault system, with a Late Jurassic reactivation, which constrained the deposition of Early Cretaceous red beds and carbonate deposits and was reactivated as reverse fault during Paleogene. The SMF coincides with the northwestern boundary of the Coahuila platform, with its best exposure at Las Palomas village. The Cupido Formation thrust over pelagic limestone, in a locality which was studied in detail and informally referred as Cerro La Bruja beds (CCLB). This unit correlates with the Eagle Ford Formation (EFF) in the Sabinas Basin to the north and with the Indidura Formation in the Parras Basin, to the south, all of Turonian age. The CCLB are involved in kilometer scale folding in both basins. However, these rocks are sub-horizontal in the Coahuila platform, where they were shortened only 400 m in the closest position to the SMF, showing chevron folds within a deformation wedge limited by a basal fault separating folded rocks from unfolded rocks underneath. Near the fault plane and along the thicker portion of the wedge, folds are tighter compared to the furthermost portion. Based on a detailed fold shortening analysis in the CCLB, a horizontal shortening of about 500 meters was estimated for these beds. If we assume that only one folding generation is present in the CCLB and that this shortening event was the result of the SMF activity, we propose a new method to estimate the minimum displacement on the frontal fault, which considers folds of CCLB and the fault plane inclination. A minimum displacement of 1300 m is calculated along the fault plane, showing consistency with estimations of at least 3000 m suggested by previous authors for the entire fault system. Fault displacement estimates have always been a challenge in structural analysis, and that is the reason why we consider that our new method has potential to become a valuable tool in fault kinematic analysis.
Controversial results on remdesivir efficacy have been reported. We aimed to report our real-life experience with the use of remdesivir from its availability in Spain.
We performed a descriptive ...study of all patients admitted for ≥48 hours with confirmed COVID-19 who received remdesivir between the 1st of July and the 30th of September 2020.
A total of 123 patients out of 242 admitted with COVID-19 at our hospital (50.8%) received remdesivir. Median age was 58 years, 61% were males and 56.9 % received at least one anti-inflammatory treatment. No adverse events requiring remdesivir discontinuation were reported. The need of intensive care unit admission, mechanical ventilation and 30-days mortality were 19.5%, 7.3% and 4.1%, respectively.
In our real-life experience, the use of remdesivir in hospitalized patients with COVID-19 was associated with a low mortality rate and good safety profile.
Exercise capacity in people with haemophilia: A systematic review Cruz‐Montecinos, Carlos; Núñez‐Cortés, Rodrigo; Vasconcello‐Castillo, Luis ...
Haemophilia : the official journal of the World Federation of Hemophilia,
November 2022, 2022-11-00, 20221101, Letnik:
28, Številka:
6
Journal Article
Recenzirano
Introduction
Exercise capacity has been established as a protective factor against joint impairment in people with haemophilia (PWH). However, little is known about how exercise capacity is affected ...in PWH.
Aim
To analyse exercise capacity, as assessed by standardised laboratory or field tests in PWH.
Methods
A systematic review was conducted to identify manuscripts investigating physical capacity in PWH. An electronic search of PubMed/MEDLINE, Embase, Web of Science, CENTRAL and CINAHL was conducted from inception to 13 April, 2022. Two independent reviewers performed data extraction and assessed study quality using the critical appraisal tools of the Joanna Briggs Institute.
Results
Nineteen studies with 825 patients were included. Most studies used the six‐min walk test (6MWT) or peak/maximal oxygen consumption (VO2max). In children, the distance walked ranged from 274 ± 36.02 to 680 ± 100 m. In adults, the distance walked ranged from 457.5 ± 96.9 to 650.9 ± 180.3 m. VO2max ranged from 37 ± 8 to 47.42 ± 8.29 ml kg–1 min–1. Most studies reported lower values of exercise capacity compared to standardised values. Overall, the quality of the studies was moderate.
Conclusion
Most of the studies showed that PWH have lower exercise capacity compared to reference values of 6MWT or VO2max. Based on these results, it is necessary to emphasise in both the promotion and the prescription of physical exercise in PWH.
Abstract
Deep near-IR images from the VISTA Variables in the Vía Láctea (VVV) Survey were used to search for RR Lyrae stars within 100 arcmin from the Galactic Center. A large sample of 960 RR Lyrae ...of type ab (RRab) stars were discovered. A catalog is presented featuring the positions, magnitudes, colors, periods, and amplitudes for the sample, in addition to estimated reddenings, distances, and metallicities, and measured individual relative proper motions. We use the reddening-corrected Wesenheit magnitudes, defined as
, in order to isolate bona fide RRL belonging to the Galaxy Center, finding that 30 RRab are foreground/background objects. We measure a range of extinctions from
to 1.75 mag for the RRab in this region, finding that large extinction is the main cause of the sample incompleteness. The mean period is
P
= 0.5446 ± 0.0025 days, yielding a mean metallicity of Fe/H = −1.30 ± 0.01 (
σ
= 0.33) dex for the RRab sample in the Galactic Center region. The median distance for the sample is
D
= 8.05 ± 0.02 kpc. We measure the RRab surface density using the less reddened region sampled here, finding a density of 1000 RRab/sq deg at a projected Galactocentric distance
R
G
= 1.6 deg. Under simple assumptions, this implies a large total mass (
M
> 10
9
M
⊙
) for the old and metal-poor population contained inside
R
G
. We also measure accurate relative proper motions, from which we derive tangential velocity dispersions of
σV
l
= 125.0 and
σV
b
= 124.1 km s
−1
along the Galactic longitude and latitude coordinates, respectively. The fact that these quantities are similar indicate that the bulk rotation of the RRab population is negligible, and implies that this population is supported by velocity dispersion. In summary, there are two main conclusions of this study. First, the population as a whole is no different from the outer bulge RRab, predominantly a metal-poor component that is shifted with respect to the Oosterhoff type I population defined by the globular clusters in the halo. Second, the RRab sample, as representative of the old and metal-poor stellar population in the region, has high velocity dispersions and zero rotation, suggesting a formation via dissipational collapse.
The projected density distribution of type ab RR Lyrae (RRab) stars was characterised from the innermost regions of the Milky Way to the halo, with the aim of placing constraints on the Galaxy’s ...evolution. The compiled sample (
N
RRab
= 64 850) stems from fundamental mode RR Lyrae variables identified by the VVV, OGLE, and
Gaia
surveys. The distribution is well fitted by three power laws over three radial intervals. In the innermost region (
R
< 2.2°) the distribution follows Σ
RRab1
∝
R
−0.94 ± 0.051
, while in the external region the distribution adheres to Σ
RRab2
∝
R
−1.50 ± 0.019
for 2.2° <
R
< 8.0° and Σ
RRab3
∝
R
−2.43 ± 0.043
for 8.0° <
R
< 30.0°. Conversely, the cumulative distribution of red clump (RC) giants exhibits a more concentrated distribution in the mean, but in the central
R
< 2.2° the RRab population is more peaked, whereas globular clusters (GCs) follow a density power law (Σ
GCs
∝
R
−1.59 ± 0.060
for
R
< 30.0°) similar to that of RRab stars, especially when considering a more metal-poor subsample (Fe/H < −1.1 dex). The main conclusion emerging from the analysis is that the RRab distribution favours the star cluster infall and merger scenario for creating an important fraction (> 18%) of the central Galactic region. The radii containing half of the populations (half populations radii) are
R
H RRab
= 6.8° (0.99 kpc),
R
H RC
= 4.2° (0.61 kpc), and
R
H GCs
= 11.9° (1.75 kpc) for the RRab stars, RC giants, and GCs, respectively. Finally, merely ∼1% of the stars have been actually discovered in the innermost region (
R
< 35 pc) out of the expected (based on our considerations) total number of RRab therein:
N
∼ 1562. That deficit will be substantially ameliorated with future space missions like the
Nancy Grace Roman
Space Telescope (formerly WFIRST).
In this work, a pilot plant with two rows of three electrodes in semipermeable electrolyte wells was used to study the electrokinetic treatment of a natural soil polluted with phenanthrene (PHE). The ...electrokinetic pilot plant was an open system, i.e., there was direct contact between the soil and air. To increase the solubility of phenanthrene, thereby enhancing its transport through the soil, an aqueous solution of the anionic surfactant dodecyl sulfate was used as a flushing fluid. The results show that at the pilot scale considered, gravity and evaporation fluxes are more relevant than electrokinetic fluxes. Contrary to observations at the laboratory scale, desorption of PHE promoted by electric heating appears to be a significant removal mechanism at the pilot scale. In addition, PHE is dragged by the electroosmotic flow in the cathodic wells and by electrophoresis after interaction of the surfactant with phenanthrene in the anodic wells. In spite of the long treatment time (corresponding to an energy consumption over 500kWhm(-3)), the average removal attained was only 25%.
Colonoscopy and fecal immunochemical testing (FIT) are accepted strategies for colorectal-cancer screening in the average-risk population.
In this randomized, controlled trial involving asymptomatic ...adults 50 to 69 years of age, we compared one-time colonoscopy in 26,703 subjects with FIT every 2 years in 26,599 subjects. The primary outcome was the rate of death from colorectal cancer at 10 years. This interim report describes rates of participation, diagnostic findings, and occurrence of major complications at completion of the baseline screening. Study outcomes were analyzed in both intention-to-screen and as-screened populations.
The rate of participation was higher in the FIT group than in the colonoscopy group (34.2% vs. 24.6%, P<0.001). Colorectal cancer was found in 30 subjects (0.1%) in the colonoscopy group and 33 subjects (0.1%) in the FIT group (odds ratio, 0.99; 95% confidence interval CI, 0.61 to 1.64; P=0.99). Advanced adenomas were detected in 514 subjects (1.9%) in the colonoscopy group and 231 subjects (0.9%) in the FIT group (odds ratio, 2.30; 95% CI, 1.97 to 2.69; P<0.001), and nonadvanced adenomas were detected in 1109 subjects (4.2%) in the colonoscopy group and 119 subjects (0.4%) in the FIT group (odds ratio, 9.80; 95% CI, 8.10 to 11.85; P<0.001).
Subjects in the FIT group were more likely to participate in screening than were those in the colonoscopy group. On the baseline screening examination, the numbers of subjects in whom colorectal cancer was detected were similar in the two study groups, but more adenomas were identified in the colonoscopy group. (Funded by Instituto de Salud Carlos III and others; ClinicalTrials.gov number, NCT00906997.).
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