Abstract
The coronavirus is a pathogen that mainly attacks the human respiratory system Previous coronavirus outbreaks (CoV) include severe acute respiratory syndrome (SARS), the clinical spectrum of ...COVID19 is very broad ranging from mild symptoms to ARDS to multiple organ failure and death. A history of DM2, advanced age and other comorbidities are considered predictors of higher morbidity and mortality, it is also known that blood glucose and DM levels are independent predictors of morbidity and mortality in patients with SARS. It should be remembered that patients with DM2 suffer from a chronic low grade inflammation that could facilitate the cytokine storm which in turn would be the cause of severe cases of COVID 19 pneumonia and the eventual death of many patients. Glucocorticoids have a stimulating and inhibitory effect on the immune response according to the moment in which it is administered and its circulating levels insulin therapy has been shown to decrease inflammation. For the control of glycemia the objectives must be individualized. Glycemic and individualized targets for non critical hospitalized patients have been established by different scientific societies such as ADA and AACE and Endocrine Society. In Honduras the protocol for the clinical management of adult patients with COVID 19 was developed to establish and standardize timely treatment in patients with suspected or confirmed COVID 19 which consists of the MAIZ scheme and the MAIZ scheme AAA. A retrospective longitudinal descriptive study was carried out with a review of the data obtained from 32 patients diagnosed with DM2 and COVID19 during the months of June through September 2020 at the CAMI Comprehensive Medical Care Clinic located in the city of Tegucigalpa Honduras collecting epidemiological and clinical data. The results of the research show that of the 32 patients with DM2 and COVID 19, 59% (19) belong to the male gender and 41% (13) to the female gender, with an average age of 60 years. In the COVID19 severity classification the evaluated patients presented in the following condition mild 25% (8), moderate 69% (22) and severe 6% (2). The diagnostic method used was detection of anti SARS CoV2 antibodies 56% (17) and TR-PCR 43% (14). 75% (24) received steroids, 8.69% (2) of the patients who used steroids in their management had hyperglycemia and required management with regular insulin. 100% (32) of the patients who were treated recovered without registering any death. Conclusions: are that the pathophysiological factors of DM2 in relation to the immune system of patients can be a determining factor to present a degree of severity greater than that presented by the general population that falls ill with COVID19. Adequate glycemic control can determine a better prognosis in the evolution of the disease despite its degree of severity.
Ruta chalepensis is an herb used to treat various ailments, and its potential cytotoxic effects on different tumor cell lines have been extensively studied. The present study aimed to evaluate the ...cytotoxic activity of R. chalepensis methanol extract (RCME), sub-partitions obtained from solvents of increasing polarity, and major compounds, as well as their hemolytic, anti-hemolytic, and antioxidant potential. The in vitro cytotoxic activity against the human hepatocarcinoma (HEP-G2) and the murine lymphoma cell line (L5178Y-R) was evaluated using the colorimetric 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction assay, whereas selectivity indices (SIs) were determined by comparing cytotoxicity against normal African green monkey kidney cells (VERO) and human peripheral blood mononuclear cells (PBMC). Hemolytic and anti-hemolytic activities were evaluated on human erythrocytes. The most effective cytotoxic treatment was evaluated for nitric oxide release by J774A.1 macrophages. Antioxidant activity of R. chalepensis material was also determined. Results showed that RCME produced significant (p < 0.05) cytotoxicity in HEP-G2 (ICsub.50 = 1.79 µg/mL) and L5178Y-R (ICsub.50 = 1.60 µg/mL) cells and exhibited high SIs (291.50 and 114.80, respectively). In addition, the n-hexane fraction (RCHF) showed an ICsub.50 of 18.31 µg/mL in HEP-G2 cells and an SI of 9.48 in VERO cells, whereas the chloroform fraction (RCCF) evidenced an ICsub.50 of 1.60 µg/mL in L5178Y-R cells and an SI of 34.27 in PBMC cells. Chalepensin (CHL), rutamarin (RTM), and graveolin (GRV), which are major components of R. chalepensis, showed high activity against L5178Y-R cells, with ICsub.50 of 9.15, 15.13 and SI of 45.08 µg/mL, respectively. In addition, CHL, RTM, and GRV showed SIs of 24.76, 9.98, and 3.52, respectively, when compared with PBMC cells. RCME at concentrations of 125 µg/mL and 250 µg/mL, significantly (p < 0.05) decreased nitrite production in J774A.1 cells, when exposed to lipopolysaccharide. This study demonstrated that RCME showed significant cytotoxic activity against HEP-G2 and L5178Y-R cells, without affecting normal VERO, PBMC, and J774A.1 cells.
Allogeneic hematopoietic stem cell transplantation (alloSCT) is the only curative strategy for relapsed/refractory T cell lymphoma (T-NHL). In the past ten years, there have been several improvements ...in conditioning regimens and graft versus host disease prophylaxis (GVHD), which have contributed to lower transplant-related mortality (TRM). Also, selective and low toxicity therapies, might improve response quality in some T-NHL Recently, haploidentical stem cell transplantation (Haplo) with post-transplant cyclophosphamide is a new option for those patients who do not have an HLA-identical sibling or a suitable unrelated donor, but also it has shortened the time for urgent cases.
This study analyzes overall outcomes of 211 consecutive patients diagnosed with T-NHL who received an alloSCT from 1995 to 2018 in GELTAMO/GETH centers. Previous therapies (chemotherapies and autologous stem cell transplantation) and baseline diagnostic parameters were recorded.
RESULTS
The median age at alloSCT was 47 years (range, 17-69). (see table 1). Forty-nine (23%) had primary extranodal disease. Disease status pre alloSCT was available in 202 patientes: 54% were in complete response (CR), 30% in partial response (PR) and 16% with stable/progressive disease (PD). Since 2013 BV was used as a bridge therapy in ≥ 3rd line in 25 patients with CD30+ tumor expression, it was effective in 20 (CR 68% (n=17), PR 12% (n=3) PD 16% (n=4), not assessed in 1 case). The use of BV was not associated with a better response probability pre alloSCT compared with other regimens used after third line and it did not impact on post alloSCT outcomes. Reduced intensity conditioning (RIC) was the most frequent (76%, n=156). (see table 2) GVHD prophylaxis were Methotrexate + CsaA or Tacrolimus (n=72, 35,8%), sirolimus-tacrolimus (n=37; 18,4%), Cy-post based (n=44, 21,9%; used in Haplo setting n= 29). The median follow-up of all cohort was 22.5 months (range, 0-280). The two year overall survival (OS) and disease free survival (DFS) were 60% (CI95%, 53-67%) and 76.7% (CI95%, 69.3-82.5%) (Figure 1A) We observed a significant improvement in alloSCT outcomes since 2011 (OS <2011 51.4% vs ≥2011 64.8%, p=0,04).(Figure 1B)
Disease status was the only pre alloSCT variable that impacts 2 years - OS: CR 72.8% (CI95%, 63-80.4%), PR 52%(38.7-63.7%), PD 43.8 (26.5-59.8%) (p=0.002) (Figure 1C). Forty-three (21%) cases relapsed after alloSCT.
To analyze the impact of GVHD on OS and DFS we selected landmark time point at day +100 and +1 year after alloSCT for acute (aGVHD) and chronic GVHD (cGVHD) respectively, which allowed us to capture the majority of events that could interfere with the analysis. A landmark analysis (day +100) showed a 2 year OS for grade 3-4 aGVHD was 18% and for 1-2 aGVHD 54,6% (p<0,001). The severity of aGVHD had no impact on DFS. Different grades of cGVHD did not impact OS nor DFS significantly.
Cumulative incidence of acute GVHD at 90 days was 51.6% (CI95%, 43.9-58.2%) being 27% grade 3-4. Chronic GVHD at 6 months was 53.9% (46.1-60.5), 54% of cases were grade 3-4). The 2 years non relapse mortality (NRM) was 30.2% (CI95%, 23.3-36.5%); the main causes contributing to NRM were GVHD (40%) and infections (44%)
Haploidentical (Haplo) alloSCT was introduced in 2012 (29 of 128). With a median follow up of 13 months (range, 0-60) we found that outcomes in terms of 1 year OS (Haplo 60.7% vs. others 67,5%), 1 year DFS (Haplo 74.8% vs. others 83.8%) and 1 year NRM (Haplo 29.7% vs. 26%) are similar to other alloSCT modalities (Figure 1D). Not additional analysis could be estimated due to the low number of population at risk for each category.
CONCLUSION
Overall outcomes of alloSCT for T-NHL have improved over time. Complete response pre alloSCT is the only determinant for OS. Haploidentical alloSCT is not significantly different from other approaches and should be considered as an alternative.
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Sierra:Novartis: Honoraria, Research Funding, Speakers Bureau; Astellas: Honoraria; Pfizer: Honoraria; Daiichi-Sankyo: Honoraria, Speakers Bureau; Abbvie: Honoraria, Speakers Bureau; Roche: Honoraria; Jazz Pharmaceuticals: Honoraria.
Objetivo. Estimar algunos parámetros de estructura poblacional en una población Holstein del departamento de Antioquia. Materiales y métodos. El estudio se realizó con 427 vacas de la raza Holstein ...pertenecientes a 5 municipios del departamento de Antioquia. La genotipificación se llevó a cabo usando la técnica de PCR-PFLPs. La Heterocigocidad observada (Ho) y Heterocigocidad esperada (He), la prueba de Hardy-Weinberg (HW) y la estructura y diferenciación genética entre las poblaciones se calculó mediante los parámetros F de Wright, evaluados mediante el software GENEPOP. Las frecuencias alélicas y genotípicas se evaluaron con el método descrito por Hartl. Resultados. Las frecuencias genotípicas encontradas fueron 0.61, 0.34 y 0.05 para los genotipos AA, AB y BB respectivamente y las frecuencias de los alelos fueron 0.78 y 0.22 para A y B, encontrándose la población en equilibrio de HW. La heterocigocidad fue media entre poblaciones (Ho=0.368). Los valores FIS, FST y FIT de la población total fueron -0.0717, 0.0099 y -0.0611. Conclusiones. No fue posible asumir endogamia, ni exogamia en los municipios analizados, exceptuando el municipio de San Pedro de los Milagros, en cuyo caso se percibe de manera más fuerte el efecto del mejoramiento genético y la disminución de la heterocigocidad.
This study takes a critical look at the challenges and dilemmas of immigration policy and practice in the absence of comprehensive immigration reform. The experiences of children and youth provide a ...prism through which the interwoven dynamics and consequences of immigration policy become apparent. Using a unique sociolegal perspective, authors Zatz and Rodriguez examine the mechanisms by which immigration policies and practices mitigate or exacerbate harm to vulnerable youth. They pay particular attention to prosecutorial discretion, assessing its potential and limitations for resolving issues involving parental detention and deportation, unaccompanied minors, and Dreamers who came to the United States as young children. The book demonstrates how these policies and practices offer a means of prioritizing immigration enforcement in ways that alleviate harm to children, and why they remain controversial and vulnerable to political challenges. References.
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