COVID-19 Severity and Survival over Time in Patients with Hematologic Malignancies: A Population-Based Registry Study.

Mortality rates for COVID-19 have declined over time in the general population, but data in patients with hematologic malignancies are contradictory. We identified independent prognostic factors for COVID-19 severity and survival in unvaccinated patients with hematologic malignancies, compared mortality rates over time and versus non-cancer inpatients, and investigated post COVID-19 condition. Data were analyzed from 1166 consecutive, eligible patients with hematologic malignancies from the population-based HEMATO-MADRID registry, Spain, with COVID-19 prior to vaccination roll-out, stratified into early (February-June 2020; n = 769 (66%)) and later (July 2020-February 2021; n = 397 (34%)) cohorts. Propensity-score matched non-cancer patients were identified from the SEMI-COVID registry. A lower proportion of patients were hospitalized in the later waves (54.2%) compared to the earlier (88.6%), OR 0.15, 95%CI 0.11-0.20. The proportion of hospitalized patients admitted to the ICU was higher in the later cohort (103/215, 47.9%) compared with the early cohort (170/681, 25.0%, 2.77; 2.01-3.82). The reduced 30-day mortality between early and later cohorts of non-cancer inpatients (29.6% vs. 12.6%, OR 0.34; 0.22-0.53) was not paralleled in inpatients with hematologic malignancies (32.3% vs. 34.8%, OR 1.12; 0.81-1.5). Among evaluable patients, 27.3% had post COVID-19 condition. These findings will help inform evidence-based preventive and therapeutic strategies for patients with hematologic malignancies and COVID-19 diagnosis.

Higher mortality of hospitalized haematologic patients with COVID-19 compared to non-haematologic is driven by thrombotic complications and development of ARDS: An age-matched cohorts study.

BACKGROUND AND OBJECTIVES: The characteristics of COVID-19 in haematologic patients compared to non-haematologic patients have seldom been analyzed. Our aim was to analyze whether there are differences in clinical characteristics and outcome of haematologic patients with COVID-19 as compared to non-haematologic. PATIENTS AND METHODS: Retrospective cohort study in 2 University hospitals of patients admitted with laboratory-confirmed COVID-19 included in the SEMICOVID19 database. The cohort with underlying haematologic disease was compared to a cohort of age and date-of-COVID-19-matched controls without haematologic disease (1:2). RESULTS: 71 cases and 142 controls were included from March-May 2020.Twenty (28.1%) had received recent chemotherapy. Twelve (16.9%) were stem cell transplant recipients (SCT). Eleven (15.5%) were neutropenic concurrently with COVID-19 diagnosis.Haematologic patients presented ARDS (58.5 vs 20.7%, p = 0.0001), thrombotic complications (15.7 vs 2.1%, p = 0.002), DIC (5.7 vs 0.0%, p = 0.011), heart failure (14.3 vs 4.9%, p = 0.029) and required ICU admission (15.5 vs 2.8%, p = 0.001), MV (14.1% vs 2.1%, p 0.001), steroid (64.8 vs 33.1%, p = 0.0001), tocilizumab (33.8 vs 8.5%, p = 0.0001) or anakinra treatment (9.9% vs 0%, p = 0.0001) more often. In-hospital mortality was significantly higher (38.0% vs 18.3%, p = 0.002). CONCLUSIONS: Our results suggest COVID-19 has worse outcomes in haematologic patients than in non-haematologic, independently of age, and that the development of ARDS and thrombotic complications drive the higher in-hospital mortality.

Gastrointestinal stromal tumour and second tumours: A literature review. / El tumor del estroma gastrointestinal y la aparición de segundos tumores: revisión de la bibliografía.

There are several tumours associated with gastrointestinal stromal tumour (GIST), most of them without an apparent family relationship; only 5% of them occur within the context of a family syndrome. In this article the corresponding literature about the former has been reviewed. A search in Pubmed was carried out, the methodology of which is described in detail in the body of the article. A total of 88 articles have been chosen for the review, next to the application of limits as well as a manual review. GIST patients have a twofold risk of developing a second tumour than the general population (4-33% of them develop a second neoplasm, either synchronic or metachronic). Most incident tumours associated with GIST are gastrointestinal and genitourinary tumours. In addition, patients with second tumours have a worse survival rate than those without second tumours.

A portal dosimetry dose prediction method based on collapsed cone algorithm using the clinical beam model.

PURPOSE: Amorphous silicon electronical portal imaging devices (EPIDs) are widely used for dosimetric measurements in Radiation Therapy. The purpose of this work was to determine if a portal dose prediction method can be utilized for dose map calculations based on the linear accelerator model within a commercial treatment planning system (Pinnacle3 v8.0 m). METHODS: The method was developed for a 6 MV photon beam on the Varian Clinac 21-EX, at a nominal dose rate of 400 MU/min. The Varian aS1000 EPID was unmounted from the linear accelerator and scanned to acquire CT images of the EPID. The CT images were imported into Pinnacle3 and were used as a quality assurance phantom to calculate dose on the EPID setup at a source to detector distance of 105 cm. The best match of the dose distributions was obtained considering the image plane located at 106 cm from the source to detector plane. The EPID was calibrated according to the manufacturer procedure and corrections were made for output factors. Arm-backscattering effect, based on profile correction curves, has been introduced. Five low-modulated and three high-modulated clinical planned treatments were predicted and measured with the method presented here and with MatriXX (IBA Dosimetry, Schwarzenbruck, Germany). RESULTS: A portal dose prediction method based on Pinnacle3 was developed without modifying the commissioned parameters of the model in use in the clinic. CT images of the EPID were acquired and used as a quality assurance phantom. The CT images indicated a mean density of 1.16 g/cm3 for the sensitive area of the EPID. Output factor measured with the EPID were lower for small fields and larger for larger fields (beyond 10 × 10 cm2 ). Arm-backscatter correction showed a better agreement at the target side of the EPID. Analysis of Gamma index comparison (3%, 3 mm) indicated a minimum of 97.4% pass rate for low modulated and 98.3% for high modulated treatments. Pass rates were similar for MatriXX measurements. CONCLUSIONS: The method developed here can be easily implemented into clinic, as neither additional modeling of the clinical energy nor an independent image prediction algorithm are necessary. The main advantage of this method is that portal dose prediction is calculated with the same algorithm and beam model used for patient dose distribution calculation. This method was independently validated with an ionization chamber matrix.

Lesiones talámicas: un desafío semiológico / Thalamic lesions

RESUMEN: El tálamo es un núcleo gris de la base que sirve como punto de entrecruzamiento de múltiples vías neuronales. Las manifestaciones clínicas producidas por lesiones talámicas son muy diversas, poco sistematizables y relativamente poco conocidas por el médico clínico. A su vez, dichas lesiones responden a variadas etiologías, dentro de las cuales predomina la vascular. En el presente artículo se describen dos casos clínicos de lesiones talámicas que difieren en su presentación y naturaleza: el primero se manifestó con una sintomatología de la esfera neurológica muy variada y correspondía a una lesión de origen vascular, mientras que el segundo se presentó como el clásico síndrome sensitivo de Déjerine-Roussy correspondiendo a una lesión de origen infeccioso.

ABSTRACT: The thalamus is a basal grey nuclei which serves as a cross-linking point for multiple neural networks. Clinical manifestations of thalamic lesions are varied, non-systematized and relatively not familiar to physicians. Moreover, these lesions are associated with numerous disorders, among which vascular lesions are by far the more frequent. Two cases of thalamic lesions that differ in their presentation and nature are described in this article: the first one showed varied neurologic symptoms and was caused by a vascular disease, while the second one presented itself as the classic Déjerine-Roussy sensitive syndrome and was caused by an infectious disease

Síndrome de dress.: A propósito de tres casos clínicos y revisión de la literatura / The DRESS Syndrome.: On three clinical cases and literature review

El síndrome de DRESS (drug reaction with eosinophilia and systemic symptoms) constituye una farmacodermia grave, potencialmente fatal, caracterizada por fiebre, exantema cutáneo, adenopatías, alteraciones hematológicas y afección visceral, siendo el hígado el más comúnmente afectado. Es producido por más de 50 fármacos, siendo los anticonvulsivantes los más frecuentes. Presentamos tres casos clínicos de pacientes que recibieron Allopurinol y que desarrollaron como complicación un síndrome de DRESS. Los tres pacientes se presentaron con fiebre, erupción cutánea y alteraciones hematológicas (leucocitosis con eosinofilia). En dos de ellos el órgano interno afectado fue el hígado presentándose en forma de hepatitis. En el restante se constató una agravación de su enfermedad renal previa. En los tres casos el tratamiento se basó en la suspensión del fármaco, corticoides y reposición hidroelectrolítica, siendo necesario en uno de ellos el ingreso a unidad de quemados (CENAQUE) así como el uso de inmunoglobulinas i/v. Todos presentaron una excelente evolución.

The DRESS syndrom (drug reaction with eosinophilia and systemic symptoms) is a potencially life-threatening adverse drug reaction with fever, cutaneous eruption, lymphadenopathy, hematologic alterations and internal organ involment. Liver is the most affected organ. It is produced by over 50 types of drugs; anticonvulsant are the most common offending agents. We present three cases with patients that taked Allopurinol and then present a Dress Syndrome as a complication. The three patients presented with fever, cutaneous eruption and hematologic alterations (leukocytosis with eosinophilia). In two of them the liver was the internal organ affected and produce an hepatitis. In the other one, the kidney was affected by renal faileure. The treatment was based on suspending drug reponsable, systemic corticosteroid and electrolitical reposition. One patient required admission in a burning unit care and treatment with intravenous immunoglobulin (IVIG) was necessary. All of patiens present an excellente evolution.

El espectáculo de la intimidad. raíces históricas de la comunicación centrada en el yo / The privacy show: historical roots of communication focused on the ego

El presente artículo presenta los resultados de una investigación que gira en torno a la sociedad de la información hoy, las fuertes tensiones a las que está sometida, al tradicional consenso social sobre la modestia y el pudor. La comunicación se centra en el yo íntimo, en los sentimientos, mientras se hace cada vez más frecuente la exhibición descarada de la propia interioridad y una curiosidad morbosa, libre de culpa y castigo. Los medios de comunicación social [=MCS] explotan sin reparos el filón de la intimidad, pisoteando con frecuencia el derecho a la privacidad. Los programas de telerrealidad (reality shows) figuran entre los preferidos por la audiencia.

This article presents the results of a research that revolves around the Information Society today, the strong tensions to which it is subject, the traditional social consensus on modesty and decency. Communication focuses on the intimate ego and feelings, while it is much more often the blatant exhibition of the own interiority and a morbid curiosity, free of guilt and punishment. The social media [SM] exploit without objection, the gold mine of privacy, often trampling on the right of privacy. Reality T.V. programs (reality shows) are among the preferred by the audience.

The importance of controversies in the epistemic progress of ecology

La ecología, como disciplina científica, ha sido analizada por la filosofía de la ciencia en menor medida que otros campos de la ciencia. En general sus cambios epistémicos han sido presentados de forma de progreso acumulativo, acorde a la propuesta de la filosofía clásica de la ciencia; o como rupturas sucesivas, siguiendo la interpretación kuhniana de cambio científico. En este trabajo se busca mostrar que, como en otros campos de la ciencia, la trayectoria de cambio de la ecología es diferente a estas dinámicas. Para ello se centra el análisis en las controversias con carácter permanente de la ecología, una de las principales fuentes de autocrítica disciplinar. La subsistencia de las controversias ha sido interpretada como signo de inmadurez o debilidad de la ecología. En este trabajo no se supone que la persistencia de las controversias sea problemática. Aun cuando las controversias no arriben a una síntesis, pueden ser progresivas desde un punto de vista epistémico. En este estudio se analizan dos de los más prominentes debates en la historia de la ecología: el debate sobre la sucesión vegetal y el debate sobre el rol de la competencia en la estructuración de comunidades. En estos casos se encontró que, en oposición a la percepción usual de las controversias como problema a resolver, las mismas pueden producir crecimiento epistémico a través de la incorporación de nuevos interrogantes e incrementar la rigurosidad en la evaluación de hipótesis.

Evaluación por competencias de la dimensión ética en la formación de psicólogos en Colombia / Evaluation by competences of the ethical dimension in the formation of psychologists in Colombia

Este artículo presenta los resultados de una investigación interinstitucional Universidad de La Sabana - Universidad Santo Tomás. Se construyó un instrumento para evaluar el nivel de desarrollo de cinco competencias éticas; y, a partir de una muestra, no aleatoria, de 100 estudiantes de cinco facultades de psicología de Bogotá, se compararon estudiantes de primer año y de último año. Se encontró en el instrumento diseñado un 95% de confiabilidad, y un 69.51% de validez factorial. Igualmente, se concluyó que el 80% de los estudiantes evaluados se encuentra en un nivel de desarrollo entre deficiente y aceptable de las competencias, y el 20% se encuentra en un nivel de desarrollo satisfactorio de dichas competencias; en este rango se inscriben los estudiantes de último año.

This article presents the results of an interinstitutional investigation La Sabana University - Santo Tomás University . An instrument was constructed to evaluate the level of development of five ethical competences, and, from a sample, nonrandom, of 100 students of five faculties of psychology of Bogotá, students of first year and last year were compared. The reliability found was 95% and a 69.51% of factorial validity. Also, that 80% of the evaluated students, are in a level of development between deficient and acceptable of the competitions, and 20% is in a level of satisfactory development of these competitions, within this percentage the students of last year are.

[Ascorbic acid in the plasma and blood cells of women with breast cancer. The effect of the consumption of food with an elevated content of this vitamin]. / Estudio del ácido ascórbico en plasma y células sanguíneas en mujeres con cáncer de mama. Influencia del consumo de alimentos con elevado contenido en dicha vitamina.

The levels of ascorbic acid in plasma and in blood cells (erythrocytes, neutrophils, and platelets) was studied in a group of 30 women with recent onset of breast cancer, and they were compared with a group of 30 healthy women, thus establishing the possible correlations between them. At the same time, these levels were related to the frequency of consumption of foods with a high content of this vitamin (fruits, potatoes, and vegetables). The women with breast cancer present plasma levels of ascorbic acid which are significantly lower (p < 0.01), and platelet levels which are significantly higher (p < 0.05). There are no differences with respect to the levels in erythrocytes or neutrophils. The frequency of consumption of vegetables, which is higher in the controls (p < 0.001), is significantly related to higher levels of ascorbic acid in plasma (r = 0.458), and erythrocytes (r = 0.444) in this group, but we did not find any correlation in the group of the patients. The frequency of fruit or potatoes consumption, which is very similar in both groups, does not appear to lead to significant differences in the ascorbic acid contents.

[Serum levels of vitamin A (retinol), vitamin E (alpha-tocopherol), cholesterol and triglycerides in women with breast cancer. The relationship to some food habits]. / Niveles séricos de vitamina A (retinol), vitamina E (alfa-tocoferol) colesterol y triglicéridos en mujeres con cáncer de mama. Relación con algunos hábitos alimentarios.

The serum levels of vitamin A (retinol), vitamin E (alpha-tocopherol), cholesterol and triglycerides were studied in a group of 40 women who had been diagnosed as having breast cancer, and they were compared to the levels found in a group of 30 healthy women. Our results indicate that the only statistically significant differences found were those involving retinol, with the cancer group showing significantly lower levels (p < 0.05). These parameters have been examined in the context of the frequency of consumption of foods rich in these vitamins and lipids. A higher frequency of consumption of foods rich in the studied vitamins does not appear to cause significant differences in their blood levels. The differences in specific dietary habits have also been analyzed, with both groups showing a high percentage of people who consume skimmed milk and a majority who use olive oil. Nevertheless, the consumption of fruits and vegetables is lower in the cancer group than in the control group.

Obesidad y lípidos / Obesity and lipids

Se realizó un estudio en 30 pacientes obesos de ambos sexos entre 16 y 50 años de edad que no presentan endocrinopatías evidentes por la clínica ni por los exámenes de laboratorio. El período comprendido fue: enero de 1986 a marzo de 1987, en consulta externa del Hospital Clinicoquirúrgico "Hermanos Ameijeiras". Se estableció la evaluación del grado de obesidad mediante las mediciones del peso corporal y la talla, y se calculó el sobrepeso por el porcentaje que el mismo representa del peso considerado como ideal, el que fue tomado de la diferencia entre la talla en centímetros y 100. Se hizo un estudio inicial que constituyó el control para cada paciente y se inició un tratamiento con dietas y ejercicios. Posteriormente se repitió el estudio de triglicéridos, colesterol, LDL, HDL, VLDL cuando se logró una reducción del 30 % del sobrepeso y del 60 %, comparándolos con el estudio inicial. Se demostró la importancia de la dieta y el ejercicio en la reducción del sobrepeso, así como los efectos beneficiosos sobre las lipoproteínas plasmáticas