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Objectives: To describe the clinical characteristics and predictors of major outcomes in patients treated with tocilizumab (TCZ) for severe COVID-19 pneumonia., Patients and Methods: Case series of all sequential patients with severe COVID-19 pneumonia treated with TCZ at an Academic Spanish hospital (March 12 - May 2, 2020). Clinical outcomes: death, length of hospital stay. An early clinical response to TCZ (48-72 h after the administration) was assessed by variations in respiratory function markers, Brescia COVID Respiratory Severity Scale (BCRSS), inflammatory parameters, and patients' and physicians' opinion. Associations were tested by multiple logistic regression., Results: From a cohort of 236 patients, 77 patients treated with TCZ were included (median age 62 years (IQR 53.0-72.0), 64.9% were males), 42.9% had Charlson index ≥3; hypertension (41.6%), obesity (34.7%), and diabetes (20.8%). Median follow-up was 83.0 days (78.0-86.5), no patient was readmitted. ICU admission was required for 42 (54.5%), invasive mechanical ventilation in 38 (49.4%) and 10 patients died (12.9% global, 23.8% at ICU admitted). After multivariate adjustment, TCZ response by BCRSS (OR 0.03 (0.01-0.68), p = 0.028), and Charlson index (OR 3.54 (1.20-10.44), p = 0.022) has been identified as independent factors associated with mortality. Median of hospital stay was 16.0 days (11.0-23.0); BCRSS, physician subjective and D-dimer response were associated with shorter hospitalization stay., Conclusions: In a Mediterranean cohort, use of tocilizumab for severe COVID-19 show 12.9% of mortality. Early TCZ-response by BCRSS and low comorbidity were associated with increased survival. Early TCZ-response was related to shorter median hospital stay., (Published by Elsevier Ltd.)

Introduction: Antiphospholipid antibodies (aPL) have been associated with organ damage and certain features in systemic lupus erythematosus(SLE) patients. Our aim was to investigate the differences between SLE patients according to the presence of aPL and/or clinical antiphospholipid syndrome (APS)., Materials and Methods: Patients from the RELESSER-T registry were included. RELESSER-T is a Spanish multicenter, hospital-based, retrospective, SLE registry., Results: We included 2398 SLE patients, 1372 of whom were positive for aPL. Overall 1026 patients were classified as SLE, 555 as SLE-APS and817 as SLE-aPL. Regarding cardiovascular risk factors, SLE-APS patients had higher rates of hypertension, dyslipidemia and diabetes than those with SLE-aPL and SLE ( p  < 0.001). SLE-APS patients showed higher rates of neuropsychiatric, cardiac, pulmonary, renal and ophthalmological manifestations than the other groups ( p  < 0.001). SLE-APS patients presented greater damage accrual with higher SLICC values (1.9 ± 2.2 in SLE-APS, 0.9 ± 1.4 in SLE-aPL and 1.1 ± 1.6 in SLE, p  < 0.001) and more severe disease as defined by the Katz index (3 ± 1.8 in SLE-APS, 2.7 ± 1.7 in SLE-aPL and 2.6 ± 1.6 in SLE, p  < 0.001). SLE-APS patients showed higher mortality rates ( p  < 0.001)., Conclusions: SLE-APS patients exhibited more severe clinical profiles with higher frequencies of major organ involvement, greater damage accrual and higher mortality than SLE-aPL and SLE patients.

Recess is a frequent target in school-based physical activity (PA) promotion research but there are challenges in assessing PA during this time period. The purpose of this study was to evaluate the reliability and validity of a recess PA recall (RPAR) instrument designed to assess total PA and time spent in moderate to vigorous PA (MVPA) during recess. One hundred twenty-five 7th and 8th-grade students (59 females), age 12-14 years, participated in the study. Activity levels were objectively monitored on Mondays using different activity monitors (Yamax Digiwalker, Biotrainer and ActiGraph). On Tuesdays, 2 RPAR self-reports were administered within 1-hr. Test-retest reliability showed ICC = 0.87 and 0.88 for total PA and time spent in MVPA, respectively. The RPAR was correlated against Yamax (r = .35), Biotrainer (r = .40 and 0.54) and ActiGraph (r = .42) to assess total PA during recess. The RPAR was also correlated against ActiGraph (r = .54) to assess time spent in MVPA during recess. Mean difference between the RPAR and ActiGraph to assess time spent in MVPA during recess was no significant (2.15 +/- 3.67 min, p = .313). The RPAR showed an adequate reliability and a reasonable validity for assessing PA during the school recess in youth.

A retrospective observational study was performed on shoulder pain cases seen in a community general practice. Two hundred and one patients were treated with acupuncture (on distant points plus local shoulder points), moxibustion and auriculotherapy. Data was retrieved from records over a three-year period to assess the effect of acupuncture and moxibustion on pain, mobility and disability, and to compare perceived efficacy rates with published reports from Chinese acupuncturists. Using a four-point outcome scale in this series of 201 patients the study found: one patient (0.5%) reported no improvement, 12 (6%) simple improvement, 68 (33.8%) remarkable improvement, and 120 (59.7%) clinical resolution. Only two patients left the programme. In conclusion, treatment of soft tissue shoulder disorders with acupuncture and moxibustion in this series seems to have good clinical results in diminishing symptoms, shortening disease duration time and improving functional ability, even in long-lasting disease (up to 10 years). A combination of distant points plus local points, moxibustion and auriculotherapy seems to increase effectiveness, reduce the number of sessions per patient, and increase the time between sessions, suiting the needs of patients and those of a busy National Health Service clinic. The authors report results similar to those reported by Chinese acupuncturists when using similar diagnostic procedures, techniques, outcome measures and patients. This case series is the first step towards conducting a randomised controlled trial (RCT) of acupuncture efficacy in shoulder pain. Such trials are needed to confirm the perceived efficacy of acupuncture from observational studies.