Abstract Individuals with malignancies and COVID-19 have a lower survival compared with the general population. However, the information about the impact of COVID-19 on the whole hematological population is scarce. We aimed to describe the 30th day overall survival (OS) after COVID-19 infection in pa tients with a hematological disease in Argentina. A completely anonymous survey from the Argentine Society of Hematology was delivered to all the hematologists in Argentina; it started in April 2020. A cut-off to analyze the data was performed in December 2020 and, finally, 419 patients were reported and suitable for the analysis (average age: 58 years, 90% with malignant diseases). After the COVID-19 diagnosis, the 30-day OS for the whole population was 80.2%. From the entire group (419), 101 (24.1%) individuals required intensive care unit admission, where the 30-day OS was 46.6%. Among allogeneic stem cell transplant recipients, the 30-day OS was 70.3%. Factors associated with a low OS were two or more comorbidities, an active hematological disease and history of chemotherapy. In individuals with the three factors, the 30-day OS was 49.6% while the 30-day OS in those without those factors was 100%. Patients with hematological diseases have a higher mortality than the general population. This group represents a challenge and requires careful decision-making of the treatment in order not to compromise the chances of cure.

Resumen El presente estudio tuvo por objetivo primario conocer la mortalidad de pacientes con enfermedad hematológica que presentaron infección por COVID-19 en Argentina. Para ello se difundió una encuesta desde la Sociedad Argentina de Hematología (SAH) entre los hematológos para informar sobre los pacientes con enfermedades hematológicas y diagnóstico de infección por SARS- CoV-2, entre el 19/4/2020, y el 7/12/2020. Se incluyeron individuos de todas las edades con diagnóstico de enfermedad hematológica benigna o maligna e infección por SARS-CoV-2 confirmada por técnica de RT-PCR. Se analizaron 419 pacientes (mediana 58 años; 90% enfermedades malignas). La supervivencia al día 30 fue de 80.2%. La supervivencia fue menor en aquellos que requirieron internación (74.2%), cuidados intensivos (46.6%) y asistencia respiratoria mecánica (36.8%). Entre los trasplantados alogénicos la supervivencia fue 70.3%. Los factores vinculados a la supervivencia global fueron las comorbilidades, el estado de la enfermedad al momento de la infección y el antecedente de quimioterapia. Se pudo establecer un score en el que aquellos que tuvieron un puntaje de 4 alcanzaron una supervivencia del 49.6% al día 30, mientras que la de los pacientes con score 0 fue del 100% a 30 días. En comparación con la población general, los pacientes con enfermedades hematológicas presentan una mayor mortalidad vinculada al COVID-19, motivo por el cual es primordial definir pautas destinadas a disminuir la exposición de los mismos sin comprometer las posibilidades de beneficiarse del tratamiento de la enfermedad de base.

Abstract Background: Antiphospholipid syndrome (APS) is characterized by episodes of thrombosis, obstetric morbidity or both, associated with persistently positive antiphospholipid antibodies (aPL). Studying the profile of a rare disease in an admixed population is important as it can provide new insights for understanding an autoimmune disease. In this sense of miscegenation, Brazil is characterized by one of the most heterogeneous populations in the world, which is the result of five centuries of interethnic crosses of people from three continents. The objective of this study was to compare the clinical and laboratory characteristics of Brazilian vs. non-Brazilian primary antiphospholipid syndrome (PAPS) patients. Methods: We classified PAPS patients into 2 groups: Brazilian PAPS patients (BPAPS) and PAPS patients from other countries (non-BPAPS). They were compared regarding demographic characteristics, criteria and non-criteria APS manifestations, antiphospholipid antibody (aPL) profile, and the adjusted Global Antiphospholipid Syndrome Score (aGAPSS). Results: We included 415 PAPS patients (88 [21%] BPAPS and 327 [79%] non-BPAPS). Brazilian patients were significantly younger, more frequently female, sedentary, obese, non-white, and had a higher frequency of livedo (25% vs. 10%, p < 0.001), cognitive dysfunction (21% vs. 8%, p = 0.001) and seizures (16% vs. 7%, p = 0.007), and a lower frequency of thrombocytopenia (9% vs. 18%, p = 0.037). Additionally, they were more frequently positive for lupus anticoagulant (87.5% vs. 74.6%, p = 0.01), and less frequently positive to anticardiolipin (46.6% vs. 73.7%, p < 0.001) and anti-ß2-glycoprotein-I (13.6% vs. 62.7%, p < 0.001) antibodies. Triple aPL positivity was also less frequent (8% vs. 41.6%, p < 0.001) in Brazilian patients. Median aGAPSS was lower in the Brazilian group (8 vs. 10, p < 0.0001). In the multivariate analysis, BPAPS patients still presented more frequently with livedo, cognitive dysfunction and sedentary lifestyle, and less frequently with thrombocytopenia and triple positivity to aPL. They were also less often white. Conclusions: Our study suggests a specific profile of PAPS in Brazil with higher frequency of selected non-criteria manifestations and lupus anticoagulant positivity. Lupus anticoagulant (not triple positivity) was the major aPL predictor of a classification criteria event.

ABSTRACT Introduction: The fight against coronavirus infection requires knowledge about how to cope with this disease, as well as awareness of its main characteristics and the leading role played by basic hygiene actions. Objective: Determine the factors associated to patient empowerment in the context of coronavirus infection. Methods: A multicenter analytical cross-sectional study based on a self-applied survey was conducted in Peru from March to May 2020. The "empowered patient" was defined by a 10-question survey (Cronbach's alpha: 0.83); four: basic knowledge about severity and contagion; two: who are the most harshly affected, and four: protection measures. Total scores were added together and compared with four socioeducational variables. Results: Most of the 4 167 respondents were aware of the measures required to prevent contagion: hand and respiratory hygiene (both with 65% respondents very much in agreement). Multivariate analysis revealed that people with a technical educational level were less empowered about the disease (coefficient: 0.39; CI95%: 0.15-0.98; p=0.046). Comparison between respondents under no risk for complications, the health personnel (coefficient: 1.77; CI 95%: 1.01-3.09; p=0.045) and the health personnel under some sort of risk (coefficient: 4.73; CI 95%: 1.46-15.31; p=0.010) showed that the latter were the most empowered about the disease. These comparisons were adjusted for respondent sex, age and location. Conclusions: The health personnel were found to be the most highly empowered about COVID-19, due to the job they do, and showed to have the broadest knowledge about transmission and prevention topics.

RESUMEN Introducción: Para combatir al Coronavirus se requiere saber cómo afrontarlo, saber sus características más importantes y reconocer que lo más sustancial es generar medidas higiénicas básicas. Objetivo: Determinar los factores asociados al paciente empoderado en el tema de coronavirus. Métodos: Estudio transversal-analítico, con encuesta autoaplicada de carácter multicéntrico realizado en Perú entre marzo y mayo de 2020. El “paciente empoderado” se definió mediante encuesta de diez preguntas (alpha de Cronbach: 0,83); cuatro: conocimiento básico, de la gravedad y del contagio; dos: en quienes genera más daño y cuatro: medidas de protección. Se hizo la sumatoria del total de los puntajes y se cruzó versus cuatro variables socio-educativas. Resultados: De los 4167 encuestados; la mayoría sabía las medidas para evitar el contagio: el lavado de manos y estornudar adecuadamente (ambas con 65 % de personas muy de acuerdo). En el análisis multivariado, los del nivel técnico tenían un menor empoderamiento con respecto a la enfermedad (coeficiente: 0,39; IC95%: 0,15-0,98; p=0,046); además, en comparación con los encuestados que no tenían riesgo de complicaciones, los que eran del personal de salud sin riesgo (coeficiente: 1,77; IC95%: 1,01-3,09; p= 0,045) y los del personal de salud que tenían algún riesgo (coeficiente: 4,73; IC95%: 1,46-15,31; p= 0,010), fueron los más empoderados con respecto a la enfermedad; todas estas comparaciones se ajustaron por el sexo, la edad y el lugar de encuestado. Conclusiones: El personal de salud, debido a su actividad laboral, son lo más empoderados con respecto a COVID-19 y tienen mejor conocimiento en los temas de transmisión y prevención.

ABSTRACT Introduction: The COVID-19 pandemic has generated diverse reactions, but these have not yet been measured in the Latin American population. Objective: To determine the factors associated with the perception of fatalism in the face of COVID-19 infection in inhabitants of 20 cities in Peru. Material and Methods: A cross-sectional, multicenter study with a sample size of 2 466 people from 20 cities of Peru that measured fatalism during the COVID-19 pandemic was conducted through a validated survey (Cronbach´s alpha: 0,78) consisting of 7 items. Statistical analysis was conducted in terms of each city, and p < 0,05 was considered significant. Results: Of the 2 466 respondents, 36 % were depressed, 26 % thought that they might die, 17 % say that this was evidence of the end of the world, and 9 % could make a fatal decision. Women were more likely to engage in three of the fatalistic behaviors (becoming infected, p = 0,020; infecting others, p = 0,004, and becoming depressed, p = 0,020). At an older age there were 5 perceptions (infecting others, p = 0,007; becoming complicated, p < 0,001; becoming depressed, p < 0,001, thinking they would die, p < 0,001; or committing suicide, p = 0,014). Those at risk of complications of COVID-19 had 4 perceptions (infecting others, p = 0,024; becoming complicated, p = 0,002; thinking they would die, p < 0,001; and thinking that this is a sign of the end of the world, p = 0,039). Respondents who were agnostic exhibited a lower frequency in 5 perceptions, while atheist respondents showed a lower frequency in 2 perceptions. Conclusion: Many fatalistic ideas are found among the population in the face of the coronavirus pandemic.

RESUMEN Introducción: la pandemia del COVID-19 ha generado reacciones diversas, pero estas aún no han sido medidas en la población latinoamericana. Objetivo: determinar los factores asociados a la percepción de fatalismo ante la infección del COVID-19 en pobladores de 20 departamentos del Perú. Material y Métodos: estudio transversal analítico, de tipo multicéntrico que con una muestra de 2466 personas en 20 departamentos del Perú midió el fatalismo ante la pandemia del COVID - 19 a través de una encuesta validada (Alpha Crombach: 0,78) que consistía en 7 ítems. El análisis estadístico fue realizado en función de cada ciudad y se consideró significativos p < 0,05. Resultados: de los 2466 encuestados, el 36 % se deprimirían, el 26 % piensa que podrían fallecer, el 17 % dice que esto es evidencia del fin del mundo y el 9 % podrían tomar una decisión fatal. Las mujeres tuvieron mayor frecuencia de 3 de las conductas fatalistas (contagiarse p=0,020; contagiar a otros p=0,004 y deprimirse p=0,020). A mayor edad hubo 5 percepciones (contagiar a otros p=0,007; complicarse p<0,001; deprimirse p<0,001, pensar que morirían p<0,001 o suicidarse p=0,014). Los que tenían un riesgo para complicación por COVID-19 tuvieron 4 percepciones (contagiar a otros p=0,024; complicarse p=0,002; pensar que morirían p<0,001 y que esto es señal del fin del mundo p=0,039). El ser agnóstico tuvo menor frecuencia de 5 percepciones, el ser ateo en 2. Conclusión: Se halló muchas ideas fatalistas entre la población ante la pandemia de coronavirus.

ABSTRACT Meclofenamic acid is a nonsteroidal anti-inflammatory drug that has shown therapeutic potential for different types of cancers, including androgen-independent prostate neoplasms. The antitumor effect of diverse nonsteroidal anti-inflammatory drugs has been shown to be accompanied by histological and molecular changes that are responsible for this beneficial effect. The objective of the present work was to analyze the histological changes caused by meclofenamic acid in androgen-independent prostate cancer. Tumors were created in a nude mouse model using PC3 cancerous human cells. Meclofenamic acid (10 mg/kg/day; experimental group, n=5) or saline solution (control group, n=5) was administered intraperitoneally for twenty days. Histological analysis was then carried out on the tumors, describing changes in the cellular architecture, fibrosis, and quantification of cellular proliferation and tumor vasculature. Meclofenamic acid causes histological changes that indicate less tumor aggression (less hypercellularity, fewer atypical mitoses, and fewer nuclear polymorphisms), an increase in fibrosis, and reduced cellular proliferation and tumor vascularity. Further studies are needed to evaluate the molecular changes that cause the beneficial and therapeutic effects of meclofenamic acid in androgen-independent prostate cancer.

The sedimentary sequences exposed in cutbanks of the middle course of the Luján river preserve important paleoenvironmental information on the late Quaternary climatic evolution of the north-eastern Pampean region. The objective of this paper is to define depositional units and infer the paleoenvironmental conditions from the analysis of the sedimentary facies and the paleobiological content (mollusks, phytoliths and diatoms) of the sequences dated between ca. 70,000 and 11,000 yr BP, Oxygen Isotopic States (OIS) 4 to 2, of the middle region of the Luján river basin. This paper follows on from previous studies about the reconstructions of the paleoenvironmental and climatic changes in the northern region of the Buenos Aires Province presented by Dangavs and Blasi (1995), Prieto et al. (2004) Fucks et al. (2005), Fucks and Deschamps (2008) and Blasi et al. (2008, 2009a, b). A late Pleistocene-Holocene cutbank (PT-H) is preserved along the banks of the Luján river where three sections were analyzed (Table 1). The lower exposures, found from the present river level to halfway up the bank show late Pleistocene materials, while the upper portion shows Holocene fluvio-lacustrine and aeolian deposits. The Holocene deposits overlie paraconformably and start with a high organic matter concentration level which was deposited ca. 11,000 14C yr BP in a lentic environment of meso-eutrophical characteristic (Prieto et al., 2004). Between the Jáuregui and Manzanares cities the PT-H cut bank is not continuous but alternates with deposits from a previous sedimentary cycle that we informally named "Pampeano" (Ameghino, 1884; Dangavs and Blasi, 1995). This last unit constitutes the present fluvial channel floor and interfluvial deposits of this region. The development of the cutbanks studied here is likely to be related to a late Holocene fluvial incision of the late Pleistocene-Holocene sediments and aeolian, fluvial and lacustrine deposits that infill blowout depressions (Ameghino, 1880-1881, 1884; Frenguelli, 1925; Dangavs and Blasi, 1995). Three sections along the middle course of the Luján river were selected for the production of seven detailed stratigraphic profiles (Table 1), for collecting samples for sedimentological and paleobiological analyses (Table 2), and for radiocarbon and IRSL dating (Table 3). The late Pleistocene sedimentary record (ca. <70,000 - <11,000 14C yr BP) between the localities of Jáuregui and Manzanares allowed recognition of five facies: F1, F2, F3, F4 and F5 (Table 2), which are either totally or partially present in the studied sequences. The facies were correlated to the units described by other authors (Table 4). The studied sequence starts with silty gravel and gravelly silt of lacustrine and fluvial nature (facies F1), that grade upward or laterally to sandy silt to silty sand of facies F2 that represent dunes of pellets (Figs. 4 and 5). Facies F2 presents an irregular based and low angle cross-bedding, and is composed of fine sedimentary lithoclasts, quartz and feldspar grains. The biological indicators are represented almost exclusively by phytoliths. This facies would have been produced because of seasonal wind storms that deflated sediments of the marginal platform of the lentic bodies that had been exposed by the retraction of the water body during temperate sub-humid dry to seasonal conditions. Facies F1 and F2 are unconformably covered by sandy gravel, gravelly sand and sand within a sandy silt matrix, included in the facies F3. It forms a massive lenticular stratum with commonly carbonatic clasts ("tosca"), reworked fragments of bones, siliciclastic grains and fine sedimentary intraclasts (Figs. 4-6). Remains of ostracods, diatoms, extinct mollusks and phytoliths are also abundant in facies F3 (Table 5). These deposits were accumulated after successive ephemeral fluvial episodes, because of heavy and concentrated rains of different frequency and caudal from channeled flow in gullies. During each fluvial event, temporary lentic water bodies would have originated because of either damming or overflow, thus producing the accumulation of fine material which, in part, was infiltrated as the matrix of the coarse deposits. The paleobiological records, frequently monospecific, suggest conditions of environmental stress due to abrupt salinity changes, caudal and temperature. These environments were very changeable because of water overflow produced during storms, and with low water levels after high evaporation periods. During facies F3 deposition, distal and local aeolian inputs would have continuously taken place with low sedimentation rates and without aeolian landforms; instead the aeolian materials would have been amalgamated to the alluvial ones. Sedimentation under temperate to cold conditions with alternant sub-humid/humid facies and dry or highly seasonal facies is interpreted here. Subsequently, the sediments included in facies F4 are vitroclastic sandy silt and silt (Figs. 4-6) with higher abundance and diversity of diatoms and phytoliths of Poaceae, Cyperaceae and woody dicots. This facies would correspond to loess deposits that accumulated in flooded lowlands, lentic shallow water bodies, and under temperate to cold and sub-humid to highly seasonal conditions. The succession ends with sandy silt of the facies F5 (Fig. 6), with very scarce biological content. These deposits represent the degradation of the lentic water bodies due to clastic infilling under temperate sub-humid/dry conditions that formed alkaline swamps. The depositional paleoenvironments for the lapse ca. <70,000 - <11,000 14C yr BP were interpreted as ephemeral lake-fluvial and aeolian settings in dry-subhumid and semiarid basins. Three major erosion discontinuities were recognized (Fig. 8). The first discontinuity would have occurred during late Pleistocene times, the second one corresponds to the late Pleistocene-Holocene transition and the third discontinuity would have taken place during historical times. Two other discontinuities were observed and are marked by indicators of stability like the presence of a duricrust on the top of the facies F3 and a paleosoil on the top of the late Holocene lake-fluvial deposits (Prieto et al., 2004). These discontinuities allowed recognition of five depositional units (DU) or aggradation events in the middle basin of the Luján river within the late Pleistocene-Holocene sub-cycle (Zárate, 2005). The DU 1 consists of facies F1 and F2, with ephemeral lacustrine-fluvial and aeolian deposits, respectively. It represents sedimentation in lowlands interconnected by ephemeral streams, which were active during instantaneous current episodes, derived from storms, with the generation of ephemeral lakes and formation of aeolian lunettes towards the end of the flooding cycle. The minimal depositational age of DU 1 was inferred as being ca. 60,000 yr BP. The DU 2 includes the facies F3 of ephemeral fluvial to ephemeral lacustrine deposits (the later of eutrophic to distrophic characteristics). This sedimentation took place in lowlands interconnected by ephemeral streams during instantaneous current episodes derived from storms and the formation of temporary lakes. Different from the previous DU 1, this multiepisodic accumulation was produced under cold, dry conditions. The inferred depositional lapse was estimated to be between ca. 50,000 yr BP and 32,500 yr BP. The DU 3 is formed by facies F4 and F5. Its accumulation started with settling in permanent lakes or ponds with variable inputs of aeolian sand and dust, due to wind storms, under temperate and sub-humid climatic conditions (facies F4). Subsequently, these lentic water bodies were degraded by dystrophy (facies F5). The temporal interval of DU 3 accumulation was dated between 37,700 yr BP and 11,000 yr BP. The DU 4 includes lake-fluvial to marsh deposits of eutrophic to distrophic characteristics, analyzed by Prieto et al. (2004). According to these authors this deposition took place in lowlands interconnected by permanent streams, under humid to sub-humid/dry conditions after 7,000 yr BP. The deposition lapse was dated between ca. 11,000 and 3000 yr BP. The DU 5 consists of sandy-silty facies corresponding to reworked aeolian deposits that buried a paleosoil of ca. 3,000 yr BP (Prieto et al., 2004). They interpreted this unit as deposited under climatic conditions similar to the present ones since 3000 yr BP and until the incision of the present channel in historical times. Two aeolian episodes of large magnitude were recognized, presented in the facies F2 (=56,400 ± 6,500 yr BP) and facies F4-F5 (=32,500 ± 4,700 to =11,000 yr BP). The deposition of distal or local aeolian material could have been continuous, but, during some stages of lower deposition rate, aeolian deposits might have been integrated in the alluvial deposits. During the late Pleistocene, the seasonal regime of these environments would have influenced the aeolian and ephemeral-fluvial deposition processes, with differing degrees of participation in the sedimentation. The present day middle reaches of Luján river may have constituted, at that time, the head of the basin with low order ephemeral or temporary streams, so the influence eustacy is considered negligible (Blasi et al., 2009a). The succession studied here shows that the environmental variability during the OIS 4 to 2 in the northern Buenos Aires province would have been higher than previously interpreted. Episodic alluvial events probably took place under sub-humid climatic conditions during the OIS3, as shown by the paleobiologic records, and aeolian deposition was predominant during most of the OSI2 and, at least, part of the OIS4, evidencing sub-humid/dry climatic conditions. Sedimentological and paleobiological records of the middle course of Luján river allowed the inference that climate was the main driving force for sedimentation.

El objetivo de este trabajo es definir unidades depositacionales y realizar inferencias paleoambientales a partir del análisis de facies y del contenido paleobiológico (moluscos, fitolitos y diatomeas) de depósitos acotados cronológicamente entre ca. <70.000 años y 11.000 años AP., Estadios Isotópicos de Oxígeno (EIO) 4 a 2, para la cuenca media del río Luján. Se seleccionaron tres secciones en las cuales se realizaron un total de siete perfiles estratigráficos de detalle y donde se extrajeron las muestras para los análisis sedimentológico, del contenido paleobiológico y para dataciones. Los depósitos estudiados fueron agrupados en cinco facies sedimentarias (F1, F2, F3, F4 y F5), ubicados cronológicamente y correlacionados con unidades semejantes descriptas por otros autores. Se reconocieron varias discontinuidades erosivas y de estabilidad para el lapso Pleistoceno tardío-Holoceno, las que permitieron definir cinco unidades depositacionales (UD). La presencia en el río Luján de una barranca, donde se exponen depósitos de edad Pleistoceno tardío-Holoceno, está estrechamente asociada a la incisión de los depósitos de relleno de antiguas depresiones interconectadas, ocurrida durante el Holoceno. Esto permitió inferir que la paleotopografía de esta área ha ejercido un control determinante en la existencia de barrancas con afloramientos del Pleistoceno tardío-Holoceno. Aún cuando las sucesiones son incompletas y las dataciones no permiten ajustar el inicio y la finalización de las UD para el lapso EIO 4 a 2, el análisis facial sugiere la existencia de una marcada variabilidad ambiental durante ese lapso, para el noreste de la provincia de Buenos Aires. En función del análisis facial se interpretó que el ambiente de depositación correspondió a sistemas fluvio-lacustres efímeros y eólicos, con sedimentación para el lapso ca. <70.000 años - <11.000 14C años AP, bajo condiciones áridas, principalmente climas seco-subhúmedo y semiárido. Durante al menos una parte del EIO4 y durante el EIO2 habría ocurrido depositación eólica predominante, durante intervalos climáticos sub-húmedos secos. En tanto durante el EIO3 habrían tenido lugar eventos aluvionales episódicos bajo condiciones climáticas subhúmedas a subhúmedas secas o fuertemente estacionales y con alternancia de fases sub-húmedas-húmedas. Esto indicaría que las acumulaciones habrían tenido lugar mayormente en ambientes depositacionales con déficit hídrico aunque de variado grado. Las características geomorfológicas y las evidencias sedimentológicas y paleobiológicas permitieron inferir que el clima fue el forzante principal en el desarrollo de la sucesión sedimentaria.