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The COVID-19 pandemic has caused several millions of deaths and forced the world population to a new normality. This study aims to analyze the air quality variation of several gaseous pollutants (CO, NO2, SO2, O3, PM10, and PM2.5) during the pre-lockdown, lockdown, and unlock period in the city of Monterrey using ground-based measurements. In this research, we proposed to use a control period of previous years to identify parameter variation due to local climate. The results showed a drastic decrease in measured contaminants during the lockdown period as follows: SO2 (−41.9%) > PM10 (−30.5%) > PM2.5 (−25.6%) > NO2 (−14.9%) > CO (−9.8%) compared to the control period (2017–2019). The O3 was the only air pollutant that showed an opposite trend, increasing during lockdown (+15%) and unlock (+2.2%), whereas CO (−16.6%) and NO2 (−30.6%) were further decreased. Moreover, using OMI/AURA satellite data, we detected a NO2 tropospheric column reduction by −1.9% during lockdown concerning the same period in the control interval. Moreover, we found a significant improvement in the Air Quality Index (AQI) due to the lockdown. Our findings indicate an association between air pollutants and economic activity and can be used in future strategies to improve urban air quality. © 2022 by the authors.
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Nanocomposite gels are novel materials mainly used in the medical field for the control drug release and distribution. In this study, the effect of the concentration of galactomannan/zinc oxide nanocomposite in a polymeric Carbopol matrix to obtain a functional nanocomposite gel was studied. The swelling, thermogravimetric, rheological, and antibacterial properties against Escherichia coli and Staphylococcus aureus were evaluated. The results indicate that there is a direct effect between the amount of the employed nanocomposite and the properties studied in the gels. In this regard, we present a formulation that demonstrates that the prepared nanocomposite gel has ideal properties to be used in the medical field as an antibacterial agent.
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Introduction: The aim of the study is based on determine whether the use of empirical antibiotic therapy increases the risk of death in adult patients older than 18 years hospitalized with COVID-19. Material and Methods: A systematic review and meta-analysis were performed, taking into account retrospective and prospective studies. The electronic databases Medline/PubMed, Embase, LILACS, and CINAHL were used for the systematic search in the period from December 2019 to May 2021. Odds Ratio and 95% confidence intervals were calculated using the random effect, depending on whether or not heterogeneity exists, the Funnel Plot graph was elaborated to assess the risk of bias. Results: 528 articles were located, which met the inclusion and exclusion criteria, and the eligibility of the full texts of 90 studies was evaluated, resulting in 10 articles. The Odds Ratio of the 10 studies_ is 1.55 (1.20-2.01), in favor of the non-use of antibiotics, with an I2 of heterogeneity between studies of 50%, and the empirical antibiotic therapy guided with procalcitonin < 0.5 ng/dl the Odds Ratio was 28.99 (10.17-82.64) with an I2 of heterogeneity of 0%. Conclusion: The results indicate that administering antibiotics without evidence of microbiological data increases mortality in these patients and, on the contrary, not using empirical antibiotic therapy reduces mortality in patients infected with severe COVID-19 who arrived at the hospital. © 2022 Publicado por Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo.
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Background: It is essential to identify the epidemiological and clinical characteristics of patients infected with COVID-19 associated with disease progression leading to ICU admission. The objective was to systematically review the models or scores for predicting admission to the intensive care unit (ICU) available to date for patients with COVID-19. Methods: The study is a systematic review. PubMed, Scopus, Web of Science, Ovid-Medline, and Embase were searched until July 13, 2022. We included studies that have developed and validated a model or scoring system to predict ICU admission in patients with COVID-19. The primary outcome was ICU admission. Risk of bias assessment was performed using the PROBAST tool which is based on four domains: participants, predictors, outcome and analysis. Results: Two studies were included for data extraction and critical appraisal. Predictive models of ICU admission and performance were obtained as primary outcomes. Common predictors for both models were associated with pulmonary compromise (respiratory rate or pulmonary ventilation) and systemic inflammation (C-reactive protein). Conclusions: It is feasible to determine predictor variables for ICU admission in patients hospitalized for COVID-19. However, the studies do not determine a clearly defined score and present a high risk of bias, so it is not feasible to recommend the application of any of these models in clinical practice. © 2022 Publicado por Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo.
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Background: The bortezomib, lenalidomide, and dexamethasone (VRd) regimen is a SoC for NDMM. Belamaf, a B-cell maturation antigen (BCMA)-targeting antibody-drug conjugate, demonstrated durable responses in patients with relapsed/refractory multiple myeloma. Preclinical studies of belamaf in combination with bortezomib/ lenalidomide suggest enhanced antimyeloma activity. We report preliminary findings of belamaf + VRd for patients with TI NDMM. Materials and Methods: DREAMM-9 (NCT04091126) is an ongoing Phase I, open label, randomized, dose and schedule evaluation trial. Adults with TI NDMM and ECOG status 0-2 are eligible. VRd is administered Q3W until Cycle 8, followed by lenalidomide + dexamethasone (Rd) Q4W. Belamaf + VRd is administered until Cycle 8, and with Rd thereafter. The currently evaluated belamaf dose cohorts are: Cohort 1 (1.9 mg/kg Q3/4W), Cohort 2 (1.4 mg/kg Q6/8W), Cohort 3 (1.9 mg/ kg Q6/8W), Cohort 4 (1.0 mg/kg Q3/4W), and Cohort 5 (1.4 mg/kg Q3/4W). Primary endpoint is safety. Secondary endpoints include efficacy, tolerability, and pharmacokinetics (PK). Results: Overall 36 patients were treated across the 5 cohorts. The median (range) age was 74.0 (63-80) years;56% patients were male, 17 (47%) had stage 2 disease, 3 (8%) had extramedullary disease, 6 (17%) patients had high risk cytogenetic abnormalities;the median number of belamaf cycles ranged from 1-9. No new safety signals were observed. Across Cohorts 1-5, all patients experienced AEs related to study treatment;1 patient in Cohort 1 died due to COVID-19 infection. The most common AEs leading to dose modification were thrombocytopenia, neutropenia, and corneal events. Patients in Cohort 2 and 3 had the lowest number of Grade ≥3 corneal events (3 and 2 events, respectively). All 12 patients in Cohort 1, all 6 in Cohorts 3 and 5, and 5/6 patients in Cohorts 2 and 4 have responded to the treatment;≥half of patients in each cohort achieved very good partial response or better. As of data cut-off, 3/12 patients in Cohort 1, 2/6 in Cohort 4, and 1/6 patients each in Cohorts 3 and 5 remained in complete response. Belamaf PK profile was similar to that observed in patients with RRMM taking into consideration baseline patients characteristics. Conclusions: Preliminary data suggest addition of belamaf to VRd did not reveal new safety signals and demonstrates high response rates, albeit with short follow-up. The trial is ongoing to confirm safety and evaluate the efficacy of belamaf + VRd. .
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Introduction: The bortezomib, lenalidomide, and dexamethasone (VRd) regimen is an acceptable standard of care (SoC) for both transplant-eligible and transplant-ineligible newly diagnosed multiple myeloma (TI NDMM). Ongoing development of novel therapies and combinations strive to improve survival outcomes beyond what is expected from SoC. Belantamab mafodotin (belamaf) is a B-cell maturation antigen-binding antibody-drug conjugate that eliminates myeloma cells by a multimodal mechanism and has demonstrated durable responses in patients with relapsed/refractory multiple myeloma (RRMM). Preclinical evidence of belamaf in combination with bortezomib or lenalidomide suggests enhanced anti-myeloma activity, providing rationale for this treatment combination. We report the preliminary findings of belamaf + VRd for TI NDMM patients. Methods: DREAMM-9 (NCT04091126) is an ongoing Phase I, open-label, randomized, dose and schedule evaluation study of belamaf + VRd in patients with TI NDMM. Eligible patients include those ≥18 years old with ECOG status 0-2 and adequate organ system functions. The study evaluates safety and tolerability of belamaf + VRd in up to 8 cohorts, up to 144 patients, to establish the recommended phase 3 dose (RP3D). VRd is administered Q3W until cycle 8, followed by lenalidomide + dexamethasone (Rd) Q4W. Belamaf + VRd is administered until cycle 8, and then in combination with Rd thereafter. The belamaf dose cohorts currently being evaluated are: cohort 1 (1.9 mg/kg Q3/4W), cohort 2 (1.4 mg/kg Q6/8W), cohort 3 (1.9 mg/kg Q6/8W), cohort 4 (1.0 mg/kg Q3/4W), and cohort 5 (1.4 mg/kg Q3/4W). After evaluation of safety data for cohort 1, cohorts 2-5 were opened in parallel and enrolled patients were randomized 1:1:1:1. Safety data, clinical activity, and drug concentrations will be assessed, and used to determine the belamaf RP3D. This analysis reports the preliminary results from cohort 1. Primary endpoints include number of patients with adverse events (AEs). Secondary endpoints include establishing relative dose intensity of lenalidomide and bortezomib in combination with belamaf, cumulative dose of belamaf, pharmacokinetics (PK) profile of belamaf when combined with VRd, overall response rate (ORR), complete response (CR), stringent complete response (sCR), complete response rate ([CRR];% of patients with a confirmed CR or better), and rate of very good partial response or better (≥VGPR). Exploratory endpoints include assessing minimal residual disease (MRD) in patients who achieve ≥VGPR, and safety and efficacy exposure-response relationships. Results: Twelve patients in cohort 1 were included in this preliminary analysis. Eight patients (67%) were male;median age (range) was 72.5 years (63-77). Ten patients (83%) were white and 2 (17%) were Asian. Nine patients (75%), were ISS stage II or III, and 4 (33%) patients had high-risk cytogenetics (consisting of one or more of the following: t(4;14), t(14;16), del17p, 17p13del). AEs related to study treatment were experienced by all 12 patients. Dose reductions occurred in 12 (100%) patients, all of whom also experienced a dose delay. Most common AEs leading to dose modification were thrombocytopenia, neutropenia, and corneal events. Grade 3 or 4 AEs related to belamaf occurred in 9 (75%) patients. During the trial, one patient experienced a fatal severe AE due to COVID-19 infection (unrelated to study treatment;Table). All patients, 100% (n=12;95% CI: 73.5-100) achieved ≥VGPR. Early deep responses were observed;2 (17%) patients achieved VGPR as early as 4 weeks. As of data cut-off, 5 (42%) remain in CR and 3 (25%) in sCR. Based on real-time data captured in the clinical database, 7 out of 9 patients achieved MRD-negative status at the first test after VGPR. Belamaf PK profile was similar to that observed in patients with RRMM taking into consideration baseline patients characteristics. Conclusion: Preliminary data suggest addition of belamaf to VRd did not reveal new safety signals and demonstrates high response rates, albeit with short follow up. The study is ongoing to confirm safety and evaluate the efficacy of belamaf + VRd. Updated data for cohort 1 will be reported at the congress. Funding: GSK (Study 209664);belamaf drug linker technology licensed from Seagen;belamaf monoclonal antibody produced using POTELLIGENT Technology licensed from BioWa. [Formula presented] Disclosures: Usmani: Pharmacyclics: Consultancy, Research Funding;Seattle Genetics: Consultancy, Research Funding;Takeda: Consultancy, Research Funding, Speakers Bureau;Merck: Consultancy, Research Funding;SkylineDX: Consultancy, Research Funding;Sanofi: Consultancy, Research Funding, Speakers Bureau;Janssen: Consultancy, Research Funding, Speakers Bureau;Janssen Oncology: Consultancy, Research Funding;Bristol-Myers Squibb: Research Funding;EdoPharma: Consultancy;GSK: Consultancy, Research Funding;Celgene/BMS: Consultancy, Research Funding, Speakers Bureau;Array BioPharma: Consultancy, Research Funding;Abbvie: Consultancy;Amgen: Consultancy, Research Funding, Speakers Bureau. Quach: Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding;Karyopharm: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding;GlaxoSmithKline: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding;Janssen/Cilag: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees;Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding;Sanofi: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding;Bristol Myers Squibb: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding;Antengene: Consultancy, Membership on an entity's Board of Directors or advisory committees;Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees;CSL: Consultancy, Membership on an entity's Board of Directors or advisory committees. Koh: Pfizer: Consultancy;Jassen: Honoraria;AstraZeneca: Honoraria;Novartis: Honoraria;GSK: Honoraria;Roche: Honoraria;Takeda: Honoraria. Guenther: Novartis: Consultancy;Celgene: Consultancy, Honoraria;Roche: Consultancy;Takeda: Consultancy, Honoraria;Amgen: Consultancy, Honoraria;AbbVie: Consultancy;Jazz Pharmaceuticals: Honoraria;Janssen Pharmaceuticals: Consultancy, Honoraria. Zhou: GlaxoSmithKline: Current Employment. Kaisermann: GlaxoSmithKline: Current Employment, Current equity holder in publicly-traded company. Mis: GlaxoSmithKline: Current Employment. Williams: GlaxoSmithKline: Current Employment. Yeakey: GlaxoSmithKline: Current Employment, Current equity holder in publicly-traded company. Ferron-Brady: GlaxoSmithKline: Current Employment, Current equity holder in publicly-traded company. Figueroa: GlaxoSmithKline: Current Employment. Kremer: GlaxoSmithKline: Current Employment. Gupta: Novartis: Current equity holder in publicly-traded company;GlaxoSmithKline: Current Employment, Current equity holder in publicly-traded company. Janowski: Celgene: Consultancy;AstraZeneca: Consultancy, Membership on an entity's Board of Directors or advisory committees;Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees;Amgen: Consultancy, Membership on an entity's Board of Directors or advisory committees;BMS: Membership on an entity's Board of Directors or advisory committees.
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Background: Factors associated with the development of chronic heart failure (CHF) in systemic lupus erythematosus (SLE) have received little attention. On the other hand, recent data from the use of hydroxychloroquine in the treatment of SARS-CoV-2 infection during the COVID19 pandemic have cast some doubts on its cardiological safety. Objectives: To identify factors associated to CHF in SLE. Methods: Retrospective cross-sectional study, including all patients with SLE (≥4 ACR-1997 criteria) recruited in RELESSER registry. The objectives and methodology of the registry have been described previously (1). CHF was defined according to the Charlson index item. Patients with CHF before diagnosis of SLE were excluded. Cumulative damage was measured with the SLICC/ ACR index, excluding cardiovascular (CV) items (mSDI). Multivariate analysis exploring factors associated with CHF was carried out. Results: 117 patients (3% of the entire cohort) with SLE and CHF and 3,506 controls with SLE without CHF were included. 90% were women. Disease duration: mean (SD), 120.2 (87.7) months. CHF appeared after a median (P25-P75) of 9.40 (4.2-18.3) years from SLE diagnosis. Patients with CHF were older (59.8 ± 18.2 vs. 46.2 ± 4.3). In the bivariate analysis, the association of CHF with greater severity [Katz severity index: median (IQR): 4 (3-5) vs. 2 (1-3)], damage [mSDI: 3 (2-4) vs 0 (0-1)], comorbidity [modified Charlson-excluding CV items: 4 (3-6) vs 1(1-3)] and both CV (37.5% vs 6.7%) and overall mortality (43.2% vs 4.7%) (p<0.0001 for all comparisons). Also, CHF patients were more refractory to SLE treatments (33.3% vs 24%, p=0.0377) and were more frequently hospitalised due SLE [median 3 (1-5) vs 1(0-2), p<0.0001]. The results of the multivariable model are depicted in table 1. Conclusion: -CHF is a rather late complication of SLE. -Patients with SLE and CHF have more severe SLE, with greater refractoriness to SLE treatments and higher overall mortality. -Treatment with antimalarials, as routinely used in SLE patients, is not only safe to heart, but even appears to have a cardioprotective effect. (Table Presented).
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This work analyzes the unequal living conditions offered by Mexico City’s housing to deal with the “social distancing” imposed by sars2-Covid-19. In particular, it analyzes the housing precariousness in which the popular sectors live and the difficulties they face in complying with the government mandate to “stay at home” and “wash your hands” as the main protection measures against the spread of the virus. It also considers the actions taken by the three levels of government and some citizen proposals to cope with this health emergency and its serious economic and social effects. © 2021, Revista Mexicana de Sociologia. All Rights Reserved.
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Introduction: The US Department of Agriculture defines food insecurity as a lack of consistent access to enough food for an active, healthy life. Achieving and maintaining food security is crucial for people with cystic fibrosis (CF) because of their increased caloric needs due to lung disease and malabsorption. According to the Greater Philadelphia Hunger Report, 2018 18.3% of Philadelphia is food-insecure which is significantly higher than the national average. Without a standard screening procedure in place, St. Christopher's Hospital for Children's Cystic Fibrosis Center identified 4 patients (5.5%) as being food-insecure in 2019. The CF care team suspected that the number was much higher considering that St. Christopher's serves Philadelphia along with areas outside of the city such as Camden, NJ and Reading, PA who have poverty rates above the national average, according to 2019 US Census. Objective: Our objective was to identify food insecurity and provide sustainable interventions to improve access to food. Methods: The registered dietitian (RD) with input from the CF care team developed a standardized process to screen for and provide appropriate resources for food insecurity. Our goal was to screen 100% of patients with scheduled appointments. The screening tool developed was titled “Food Needs Assessment.” It was a written questionnaire consisting of 5 simple questions which was passed out in clinic from January 2020 to March 2020. Starting in April, patients were seen via telehealth due to COVID-19 and the assessment was given verbally by the RD. A key was developed to assess the degree of food insecurity ranging from low risk to severe food insecurity. An algorithm was created and utilized to help the team determine appropriate interventions. Interventions included referring families to federal nutrition assistance programs such as WIC and SNAP as well as local programs such as Philabundance, Helping Harvest, and Take A Breather. Results: Between January and March, 48 out of 52 patients (92.3%) who came into clinic were screened for food insecurity. Out of the 48 patients screened, 10 patients (20.8%) identified as being food insecure. When telehealth began, it became more challenging to administer the assessment due to more frequent missed appointments and patients' tendency to speak with the physician but not to the rest of the interdisciplinary team. From April to June, 29 out of 43 patients (67.4%) with scheduled telehealth appointments were screened. Out of the 29 patients screened, 9 patients (31.0%) identified as being food-insecure. The team found that resources expanded and evolved to meet the needs of our patients during the pandemic. Conclusion: The rate of food insecurity at St. Christopher's exceeds both Philadelphia and the national average and has increased by 10.2% during the COVID-19 pandemic. This demonstrates the importance of assessing food security on an ongoing basis as resources and finances are constantly fluctuating. Future efforts will focus on ways to increase the administration of the Food Needs Assessment to identify and address all food insecurity within the center.
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During a pandemic in which aerosol and droplet transmission is possible, such as the COVID-19 pandemic of 2020, the demand for face masks that meet medical or workplace standards can prevent most individuals from obtaining suitable protection. Cloth masks are widely believed to impede droplet and aerosol transmission, but most are constructed from materials with unknown filtration efficiency, airflow resistance and water resistance. Here we provide data on a range of common fabrics that might be used to construct masks, complimenting existing studies by largely considering particles in the micron range (a plausible challenge size for human generated aerosols). None of the materials were suitable for N95 masks, but many could provide useful filtration (>90%) of 3 micron particles, with low pressure drop. These were: nonwoven sterile wraps, dried baby wipes and some double-knit cotton materials. Decontamination of N95 masks using isopropyl alcohol produces the expected increase in particle penetration, but for 3 micron particles, filtration efficiency is still well above 95%. Tightly woven thin fabrics, despite having the visual appearance of a good particle barrier, had remarkably low filtration efficiency and high pressure drop. The better material structures expose individual fibers to the flow while the poor materials may have small fundamental fibers but these are in tightly bundled yarns. Despite the complexity of the design of a very good mask, it is clear that for the larger aerosol particles, any mask will provide substantial protection to the wearer and those around them. Copyright © 2020 American Association for Aerosol Research.
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INTRODUCCIÓN: La Organización Mundial de La Salud ha reportado recientemente que el nuevo foco de la pandemia global de la enfermedad Covid-19 es el continente americano. OBJETIVO: Realizar una revisión de la literatura sobre la experiencia internacional de la pandemia Covid 19 y embarazo. MÉTODO: Se realiza una búsqueda de la base de datos PubMed para las palabras clave Pregnancy / Pregnant / Novel Coronavirus / SARS-CoV-2 / Covid-19, desde el 1 de noviembre 2019 hasta el 21 de mayo 2020. RESULTADOS: Un total de 365 artículos fueron inicialmente seleccionados de acuerdo con la estrategia de búsqueda diseñada. El total de artículos revisados de acuerdo con los criterios fueron 42. Las series clínicas seleccionadas acumularon un total de 1098 embarazadas y enfermedad de Covid-19. Las co-morbilidades mas frecuentes fueron hipertensión arterial, diabetes mellitus, obesidad y asma. La mortalidad en relación con el total de pacientes fue de un 1,2 % y la transmisión al recién nacido de 1,7% (15 de 875). CONCLUSIÓN: La información obtenida permite inferir que la presentación clínica de la enfermedad es a lo menos equivalente a la de mujeres de la misma edad no embarazadas. Dada la severidad de la enfermedad por SARS-CoV-2 reportada, las lecciones aprendidas deben ser rápidamente asimiladas y utilizadas en el contexto de la situación nacional epidémica.
INTRODUCTION: The World Health Organization has recently reported that the new focus of the global pandemic of Covid-19 disease is the American continent. OBJECTIVE: To conduct a literature review on the international experience of the Covid 19 pandemic and pregnancy. METHOD: A PubMed database search is performed for the keywords Pregnancy / Pregnant / Novel Coronavirus / SARS-CoV-2 / Covid-19, from November 1, 2019 to May 21, 2020. RESULTS: A total of 365 articles were initially selected according to the designed search strategy. The total of articles reviewed according to the criteria was 42. The selected clinical series accumulated a total of 1098 pregnant women and Covid-19 disease. The most frequent comorbidities were hypertension, diabetes mellitus, obesity, and asthma. Mortality in relation to the total number of patients was 1.2% and transmission to the newborn was 1.7% (15 of 875). CONCLUSION: The information obtained allows us to infer that the clinical presentation of the disease is at least equivalent to that of non-pregnant women of the same age. Given the severity of the reported SARS-CoV-2 disease, the lessons learned must be quickly assimilated and used in the context of the national epidemic situation.