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Background/ Objectives: Avacopan is a new, promising treatment for ANCA-associated vasculitis (AAV) and can potentially replace steroids. Compared to steroid tapering, avacopan has demonstrated non-inferiority for treatment response at 26 weeks, superiority for sustaining remission at 52 weeks and a reduction of relapses.1 Most recently avacopan was approved for the treatment of AAV by the U.S. Food and ug Administration and approval is pending at the European Medicines Agency (EMA).2 We now report the first clinical experience with avacopan in difficult-to-treat AAV patients in the setting of a compassionate use program. Methods: We collected disease relevant characteristics for the adult AAV patients who were treated with avacopan in the setting of the compassionate use program at the department of Nephrology of the Leiden University Medical Center. Patients were classified by their reason to start avacopan and clinical remission was based on physician’s clinical assessments as reported in the electronic health records. We collected relevant data to assess steroid-related toxicity effects in line with the Glucocorticoid Toxicity Index (GTI) (v2017).3 Results: Eight adult AAV patients were treated within the avacopan compassionate use program at our institute. Indications for avacopan were steroid resistance (n=4), steroid dependence (n=2) and high risk of steroid toxicity (n=2). Most patients had relapsing disease (numbers of flares ranging from 0-3) and received multiple previous remission induction therapies (median 2, range 1-6). All patients achieved clinical remission within six months after avacopan was started. Only one patient experienced a major flare, which coincided with a reduction of avacopan dosing to 20mg bd due to delayed supply during the COVID-19 pandemic. Steroid tapering was successful in all patients, with five patients discontinuing prednisone and three patients continuing low doses of prednisolone (2.5-7.5mg/day). After one year of avacopan use, the GTI improved in four patients. In one patient the GTI worsened due to weight gain. Six patients satisfactorily continue avacopan and are persistently in clinical remission. One patient stopped because of a pregnancy wish. Conclusions: We here provide the first real-life practice observations on the compassionate use of avacopan in difficult-to-treat AAV patients. Avacopan demonstrated added-value in the treatment of our difficult-to-treat AAV cases with respect to improved disease control, reduced steroid dependence and reduced steroid-related toxicity. Disclosures: The work of YKOT was supported by the Dutch Kidney Foundation (17OKG04) and by the Arthritis Research and Collaboration Hub (ARCH) foundation. ARCH is funded by Dutch Arthritis Foundation (ReumaNederland). YKOT received an unrestricted research grant and consultancy fees from Vifor Pharma. References 1. Jayne, D.R.W., et al., Avacopan for the Treatment of ANCA-Associated Vasculitis. N Engl J Med, 2021. 384(7): p. 599-609. 2. ANCA vasculitis News. FDA Approves Tavneos as Add-on Therapy for Severe MPA, GPA. Published October 11, 2021. Accessed October 29, 2021. https://ancavasculitisnews.com/2021/10/11/fda-approves-tavneos-avacopan-add-on-mpa-gpa-therapy/ 3. Miloslavsky, E.M., et al., Development of a Glucocorticoid Toxicity Index (GTI) using multicriteria decision analysis. Ann Rheum Dis, 2017. 76(3): p. 543-546.

examination of pharmacy students

El espectro clínico de la infección por Dengue y el COVID-19 presenta gran similitud en relación a los eventos fisiopatológicos. Por ello el presente trabajo tiene por finalidad conocer las características clínicas y de laboratorio en pacientes pediátricos con coinfección por dengue y COVID-19, Hospital EsSalud III – Iquitos, 2020. Se realizó un estudio de tipo descriptivo en 57 pacientes atendidos. Concluyendo que los síntomas más frecuentes fueron la fiebre (100 %), cefalea (70,2 %), astenia (68,4 %), náuseas (66,7 %) y vómitos (64,9 %). En menor proporción se observa que los pacientes presentaron escalofríos (52,6 %) y dolor abdominal (42,1 %). La pérdida de olfato y de gusto presentaron menor frecuencia. El 64,9 % presentaron leucocitos < 4000 / mm3, mientras que solo el 1,8 % presentaron leucocitos > 10 000 / mm3. Respecto a los linfocitos se observa que el 64,9 % presentaron linfocitos < 1500 / mm3 y 1,8 % presentaron linfocitos > 4000 / mm3. Respecto a neutrófilos se observa que 64,9 % de pacientes presentaron neutrófilos < 2000 / mm3. El 29,8 % presentaron eosinófilos < 40 / mm3 y el resto valores de 40 a 500 / mm3. En cuanto a monocitos el 21 % presentó un valor < 200 / mm3, el 3,5 % presentaron un valor > 800 / mm3. El 17,5 % de los pacientes presentaron basófilos < 10 / mm3, el 63,2 % 10 a 100 / mm3 y el 19,3 % > 100 / mm3. Respecto al hematocrito, se observa que el 71,9 % de pacientes presentaron hematocrito de 35 a 48 % y el 28,1 % un hematocrito menor a 35 %, el 41 % presentaron hemoglobina <12 g/dL y solo el 10,3 % un valor > 14 g/dL. La mayoría de pacientes presentaron plaquetas < 150000 / mm3. Palabras clave: COVID-19, dengue

Although the types of coronaviruses seen in animals differ, recent studies have also shown that they are affected by COVID-19, known as SARS-CoV-2. The impact of COVID-19 on animals is a factor that should be followed carefully, especially since different variants appear in humans every day and this disease is transmitted from human to animal. Thanks to vaccination, animals are less affected by different types of coronaviruses. Cats and ferrets are especially affected much more in COVID-19, causing damage to the lungs and other organs. Recently, it has been shown that the use of monoclonal antibodies, especially in the early stages of COVID-19, by people with chronic diseases, positively affects the course of the disease, reduces the frequency of hospitalization and the possibility of falling into intensive care. Sotrovimab is a pan-sarbecovirus monoclonal antibody, and 12-13 studies to date have shown that individuals with chronic disease are less affected when given in the early stages of the disease when the symptoms are mild. We also think that if especially old cats and ferrets are treated with Sotrovimab in the early stages of the disease when they contract COVID-19, it will positively affect the prognosis of the disease.

Purpose and scope of the deliverable: This is a framework report on Policies, Practices and Strategies. All partners have contributed material used in the production of the report which is described in the Work Programme as D2.1. This report seeks to establish a benchmark. With so much in flux, a starting point for identifying sig-nificant policy change is necessary. The benchmark is set at the outset of the project, approximately Q1 (January to March 2020), before the impact of COVID-19 and before the onset/impact of the new Programming Period. As a benchmark, the report seeks to be descriptive; there is no attempt at this stage to introduce any evaluation into the document; nor is there an intention to ’cluster’ case studies or countries – each case stands on its own merit. The attention to policy detail at Case Study level is relatively light. Here we are describing the Policy Framework. Detailed work on the Case Studies will take place later in the project when we have access to survey data and can view the emerging policies following the current hiatus in tourism. This is the first stage of the policy theme running through the three years of SPOT - the Social and Innovative Platform on Cultural Tourism and its Potential towards Deepening Europeanisation. This Framework Paper consists of four parts: Part One: The Executive Summary Part Two: The report on Policies, Practices and Strategies for each of the 15 partners (= Appendix A – Exploration of the Policy Framework) Part Three: A spreadsheet showing broad themes for each of the partners (= Appendix B) Part Four: A list of the sources used in preparing the report

Data 5 for the manuscript. Refer to Data 1 for the full description and links to the remaining datasets: https://doi.org/10.5281/zenodo.6887186

Schaeden durch eine SARS-CoV-2-Infektion - Long-Covid v4 ist eine Zusammenfassung von möglichen Schäden, die Covid-19 bei Kindern und Erwachsenen verursachen kann, welche mitunter erst Wochen oder Monate später in der Form des sog. Long Covid wahrnehmbar werden. Der Text besteht daneben größtenteils aus Überschriften oder Zitaten mit Links zu den entsprechenden Aussagen. Er trifft auch Aussagen zur aktuell grassierenden Omikron-Variante und zum aktuellen Wissensstand zum Impfschutz gegen Omikron und allgemein gegen Long Covid.

Background: Pre-clinical giant cell arteritis (GCA) mouse models have demonstrated effective suppression of arterial wall lesional T-cells through inhibition of Janus kinase 3 (JAK3) and JAK1. However, JAK inhibition in patients with GCA has not been formerly investigated. Methods: We performed a prospective, open-label, pilot study of baricitinib (4mg/day) in patients with relapsing GCA. The primary outcome was the frequency of adverse events and serious adverse events at week 52. Secondary outcomes included relapse at week 24 and week 52, change in pre-enrollment erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) to week 24 and week 52, and comparison of glucocorticoid dose at enrollment to week 24 and week 52. The study schema is outlined in Figure 1. Results: 15 patients were enrolled in the study (11, 73% female) with a mean(SD) age at entry 72.4(7.2) years, median(IQR) duration of GCA of 9 (7, 21) months, and median of 1 (1, 2) prior relapse. Treatments prior to study entry included: glucocorticoids (15, 100%); methotrexate (2, 13%); cyclophosphamide (1, 7%); sirukumab (1, 7%). Characteristics at GCA diagnosis and at relapse prior to study entry are listed in Table 1. Four (27%) patients entered the study on prednisone 30mg/day, 6 (40%) at 20 mg/day, and 5 (33%) at 10mg/day. One patient with baseline chronic kidney disease had a decline in renal function below study threshold for continuation and was withdrawn at week 8. The remaining 14 patients completed 52 weeks of baricitinib. At week 52, 14/15 (93%) patients had at least one adverse event recorded with the most frequent events including: infection not requiring antibiotics (n=8), infection requiring antibiotics (n=5), nausea (n=6), leg swelling (n=2), fatigue (n=2), diarrhea (n=1), abdominal pain (n=1). Two patients contracted COVID-19 during the study, both with mild symptoms, neither hospitalized. One patient had a serious adverse event during the study (transient thrombocytopenia attributed to concomitant use of antimicrobial therapy). Study outcomes are listed in Table 2. ESR and CRP were significantly lower at week 24 and week 52 compared to pre-enrollment values. Patient global assessment at week 0 was also significantly improved at both week 24 and week 52. Only 1 of 14 (7%) patients relapsed during the study (same patient at week 24 and week 52). The remaining 13 patients achieved steroid discontinuation and remained in disease remission during the duration of the 52-week study. Among patients completing the study, 4/14 (29%) flared during the 12-week follow up period after baricitinib discontinuation. Conclusion: In this proof of concept study, baricitinib at a dose of 4mg/day appeared both safe and effective in the management of patients with relapsing GCA. Larger randomized clinical trials are needed to determine the utility of JAK inhibition in GCA. Disclosures: KW received funds from Eli Lilly and Company to assist in the completion of the clinical trial. MK, CS, RG, JJ, EM, AD-G, CW report no financial disclosures of interest related to this study.

Atividade interativa sobre Saúde Planetária e Covid-19, desenvolvida com fins didáticos pedagógicos para adolescentes de escola pública. A educação é uma aliada no combate a pandemia da Covid-19. Espaços formais como as escolas deveriam ser utilizadas com o objetivo de combater fake news, proporcionar conhecimento acadêmico sobre doenças infecciosas entres adolescentes. A aprendizagem precisa ser significativa e contextualizada, estimular os jovens a assumirem papel de protagonismo juvenil. Para isso, utilizar tecnologias visando a construção de espaços para abordar temas complexos e necessários.

Synthèse des commentaires de l'Enquête sur les usages documentaires pendant l'année 2020 (Covid19) des usagers de la bibliothèque de Sciences Po