ABSTRACT
Acquired somatic mutations in hematopoietic stem and progenitor cells (clonal hematopoiesis or CH) are associated with advanced age, increased risk of cardiovascular and malignant diseases, and decreased overall survival.1-4 These adverse sequelae may be mediated by altered inflammatory profiles observed in patients with CH.2,5,6 A pro-inflammatory immunologic profile is also associated with worse outcomes of certain infections, including SARS-CoV-2 and its associated disease Covid-19.7,8 Whether CH predisposes to severe Covid-19 or other infections is unknown. Among 515 individuals with Covid-19 from Memorial Sloan Kettering (MSK) and the Korean Clonal Hematopoiesis (KoCH) consortia, we found that CH was associated with severe Covid-19 outcomes (OR=1.9, 95%=1.2-2.9, p=0.01). We further explored the relationship between CH and risk of other infections in 14,211 solid tumor patients at MSK. CH was significantly associated with risk of Clostridium Difficile (HR=2.0, 95% CI: 1.2-3.3, p=6x10-3) and Streptococcus/Enterococcus infections (HR=1.5, 95% CI=1.1-2.1, p=5x10-3). These findings suggest a relationship between CH and risk of severe infections that warrants further investigation.
ABSTRACT
There is an urgent need to identify therapies to prevent and treat SARS-CoV-2 infection. We performed a statistical evaluation of in vitro gene expression profiles reflecting exposure to 1,835 drugs, and found topoisomerase inhibitors and PI3K/mTOR pathway inhibitors among the strongest candidates for reduced expression of ACE2, a host gene associated with SARS-CoV-2 infection. Retrospective clinical data suggest that patients on these agents may be less likely to test positive for SARS-CoV-2.
ABSTRACT
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Subject(s)
Humans , Male , Adult , Mental Disorders/complications , Mental Disorders/diagnosis , Mental Disorders/psychology , Parasomnias/complications , Parasomnias/diagnosis , Imagery, Psychotherapy/methods , Imagery, Psychotherapy/standards , Plethysmography/instrumentation , Plethysmography/methods , Parasomnias/psychology , Parasomnias , REM Sleep Parasomnias/complications , REM Sleep ParasomniasABSTRACT
El status cataplecticus es una situación excepcional, consistente en ataques continuados de cataplejía. Presentamos un caso clínico de una mujer de 42 años diagnosticada de síndrome de narcolepsia con cataplejía, bien controlada con modafinil y paroxetina, que presentó status cataplecticus tras la auto-retirada brusca de la medicación antidepresiva (AU)
Status cataplecticus is an exceptional situation, described as continuous cataplexy attacks. We report a 42-year-old woman with narcolepsy-cataplexy syndrome, well controled with modafinil and paroxetine, who developed status cataplecticus after abrupt self-withdrawal of the antidepressant medication (AU)
Subject(s)
Humans , Female , Adult , Paroxetine/administration & dosage , Paroxetine/therapeutic use , Narcolepsy/complications , Narcolepsy/diagnosis , Antidepressive Agents/adverse effects , Disorders of Excessive Somnolence/complications , Disorders of Excessive Somnolence/diagnosis , Sleep-Wake Transition Disorders/complications , Clomipramine/therapeutic use , Paroxetine/adverse effects , Paroxetine/metabolism , Paroxetine/pharmacokinetics , Narcolepsy/drug therapy , Disorders of Excessive Somnolence/drug therapy , Polysomnography/instrumentation , Polysomnography/methodsABSTRACT
Evaluamos los trastornos de sueño en ocho pacientes con distrofia miotónica tipo 1 confirmada genéticamente, con edades comprendidas entre 38 y 58 años. Los pacientes fueron estudiados mediante polisomnografía y test de latencias múltiples de sueño. Encontramos excesiva somnolencia diurna en el 75% de los pacientes, no justificable por los eventos respiratorios durante el sueño. El modafinil mejoró este síntoma en todos ellos (AU)
We investigated the sleep disorders in eight patients with genetically confirmed myotonic dystrophy type 1, aged from 38 to 58 years. Patients were studied with nocturnal polysomnogram and multiple sleep latency tests. We found excessive daytime sleepiness in 75% of them, not accountable for respiratory events during sleep. Modafinil improved this symptom in all of them (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Myotonic Dystrophy/complications , Myotonic Dystrophy/diagnosis , Myotonic Dystrophy/drug therapy , Disorders of Excessive Somnolence/complications , Disorders of Excessive Somnolence/diagnosis , Neuroprotective Agents/therapeutic use , Myotonic Dystrophy/classification , Disorders of Excessive Somnolence/drug therapy , Disorders of Excessive Somnolence/physiopathology , Polysomnography/instrumentation , Polysomnography/methods , Biofeedback, Psychology/physiology , ElectromyographyABSTRACT
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Subject(s)
Bioethics , Family Practice , Spain , Preventive Medicine , Education, MedicalABSTRACT
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Subject(s)
Middle Aged , Child , Adult , Male , Female , Humans , Bioethics , Family Practice , Risk Factors , Controlled Clinical Trials as Topic , Postmenopause , Alendronate , Physician-Patient Relations , Patient Advocacy , Osteoporosis , Placebos , Quality of Life , Child Advocacy , Child Abuse , Cost-Benefit Analysis , Hip Fractures , Randomized Controlled Trials as TopicABSTRACT
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Subject(s)
Humans , Bioethics , Family Practice , Spain , Societies, Medical , Models, Theoretical , Quality of Health Care , Primary Health Care , Community Medicine , Ethics, MedicalABSTRACT
Se tomaron muestras de placa dental bacteriana a 61 sujetos con actividad cariogénica variada y se sembraron en mitis-salivarius-agar. El estudio de las colonias nos permitió conocer una variada gama de morfologías, describiéndose las mismas. Se identificó el streptococus salivarius, que sin ser predominante en la placa, aparece con regularidad en sus dos variantes típicas, de colonias lisas y mucoides y de colonias rugosas y duras. Se identificaron el Estreptococcus mutans y el sanguis, aunque se requieren estudios ulteriores para su confirmación. Se halló una correlación positiva entre la presencia de los tipos 7 y 8 (supuestos mutans) y la actividad cariogénica actual de los sujetos estudiados; se falló en encontrar alguna correlación positiva con otros tipos, así como con el índice COPI y con el volúmen de placa sobre la superficie de las piezas dentales en el momento de la muestra(AU)