scholarly journals #32: Single Center Experience with the Use of Convalescent Plasma Transfusion (CPT) for COVID-19 + Patients in Argentina

2021 ◽  
Vol 10 (Supplement_2) ◽  
pp. S18-S19
Author(s):  
Sergio Miguel Gómez
Keyword(s):  
Side Effects ◽  
Mortality Rate ◽  
Median Time ◽  
Chronic Obstructive Lung Disease ◽  
Categorical Variables ◽  
Chronic Obstructive ◽  
Single Center ◽  
Plasma Therapy ◽  
Single Center Experience ◽  
Day Range

Abstract Background COVID-19 pandemic challenged health sanitary systems worldwide. 1.65 million cases have been reported in Argentina with 43.635 deaths. CPT emerged as a possible and feasible treatment. Transfusion cardiovascular overload (TACO), acute lung injury (TRALI) and anaphylactic reactions (AR) have raised safety concerns; in the other hand, it is still unknown its efficacy but preliminary reports have claimed that if it is delivered early, mortality or morbidity could be decreased. Pediatric use of CPT is emerging from adults’ studies. Objective To review clinical outcomes, laboratory parameters and side effects of CPT in a single center in Argentina and determine the mortality rate. Methods This is a single-center single-arm exploratory-descriptive prospective study, starting on May 1, 2021 until October 31, 2021. A protocol developed for donation of CPT included those individuals with SARS-CoV-2 RT- PCR positive in respiratory secretions and SARS-CoV-2 antibody positive by immunochromatography o chemiluminescence, with a titer by ELISA (Covidar®) > 1:400 and 200 – 250 mL were considered 1 Unit. Recipients weighing <70 kg received 1 unit, and those recipients weighing >70kg received 2 units. CPT was prescribed within 14 days of starting SARS-CoV-2 symptoms. All patients received dexamethasone and standard support measures. We used percentages and frequencies for reporting the results of this study. Categorical variables were compared with Chi2 and numeric Fisher/Mann Whitney. Time dependent survival variables were calculated with Kaplan Meier method. SPPS 20 software was used for data processing. Results The CPT recipients median age (IQR) was 47 years of age (range 43–59 years); 65.5 % were; 12,5% had either hypertension or obesity, 3.1% chronic obstructive lung disease; 30% had diabetes. The median temperature at diagnosed was (IQR) 37.7°C (range 36.6°C - 38.9°C). A total of 39 CPT units were infused in 32 patients. 25 patients (78%) received 1 unit, 6 patients (19%) received 2 units and 1 patient (3%) received 3 units (3%). Donor median (IQR), SARS-CoV-2 antibody titer was 1:400 (range 400–1600); median time (IQR) to transfusion was 1 day (range 1–4). Coverage was 100%. Outcomes 29 patients (91%) survived and 3 (9%) died for COVID-19. Only 3 patients (8%) developed moderate/reversible side effects: allergic reaction (2 pts) and TRALI(1pt) At a median time of 100 days, the median survival was 85% (0.5) and the mortality rate was 19 % (0.6). Laboratory features: Conclusion CPT was feasible to deliver and could be implemented in a less resourced country in a timely fashion. All our patients could afford plasma therapy. No severe adverse events were reported. Pediatric studies can be based on the results of this type of study. Research should focus now on a control case cohort study to determine efficacy of CPT.

scholarly journals The first two months of COVID-19 pandemic in Bosnia and Herzegovina: Single-center experience

2020 ◽  
Author(s):  
Jurica Arapović ◽  
Siniša Skočibušić
Keyword(s):  
Mortality Rate ◽  
Severe Acute Respiratory Syndrome ◽  
Bosnia And Herzegovina ◽  
The Novel ◽  
Single Center ◽  
Single Centre ◽  
Single Center Experience ◽  
Single Centre Experience ◽  
Novel Coronavirus ◽  
The University

The novel coronavirus disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is still progressing and has been recorded in more than 210 countries and territories worldwide. In Bosnia and Herzegovina, the first cases of COVID-19 were detected on 5th of March 2020 in the entity of Republic of Srpska and 9th of March 2020 in the entity of Federation of Bosnia and Herzegovina. Up until the 16th of May 2020, more than 2,200 COVID-19 cases were recorded in both entities, with a mortality rate of 5.8% (131 out of 2231 cases). The aim of this ongoing study is to present the current epidemiological and sociodemographic parameters of 380 COVID-19 patients diagnosed at the University Clinical Hospital Mostar (UCH Mostar) during the first two months of the COVID-19 pandemic. Out of 380 patients, 60 (15.8%) of them required hospitalization. The mortality rate was 5% (19/380). The highest mortality rate of 15.2% (12/79) was recorded in the patients age ≥65 years. In addition to this single-centre experience of the ongoing COVID-19 pandemic, we discuss the epidemiological measures imposed in Bosnia and Herzegovina, with emphasis on the restrictive ones. The COVID-19 pandemic is still ongoing in Bosnia and Herzegovina.

scholarly journals Perceptions of COPD patients of the proposed withdrawal of inhaled corticosteroids prescribed outside guidelines: A qualitative study

2019 ◽  
Vol 16 ◽  
pp. 147997311985588 ◽  
Author(s):  
Gill Gilworth ◽  
Timothy Harries ◽  
Chris Corrigan ◽  
Mike Thomas ◽  
Patrick White
Keyword(s):  
Side Effects ◽  
Inhaled Corticosteroids ◽  
Qualitative Interviews ◽  
Chronic Obstructive Lung Disease ◽  
Airflow Limitation ◽  
Individual Risk ◽  
Chronic Obstructive ◽  
Copd Patients ◽  
Global Initiative ◽  
Long Acting

Global Initiative for Chronic Obstructive Lung Disease guidelines support the prescription of fixed combination inhaled corticosteroids (ICS) and long-acting β-agonists in symptomatic COPD patients with frequent or severe exacerbations, with the aim of preventing them. ICS are frequently also prescribed to COPD patients with mild or moderate airflow limitation, outside guidelines, with the risk of unwanted effects. No investigation to date has addressed the views of these milder COPD patients on ICS withdrawal. The objective is to assess the views of COPD patients with mild or moderate airflow limitation on the staged withdrawal of ICS prescribed outside guidelines. One-to-one semi-structured qualitative interviews exploring COPD patients’ views about ICS use and their attitudes to proposed de-prescription were conducted. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was completed. Seventeen eligible COPD patients were interviewed. Many participants were not aware they were using an ICS. None was aware that prevention of exacerbations was the indication for ICS therapy or the risk of associated side effects. Some were unconcerned by what they perceived as low individual risk. Others expressed fears of worsening symptoms on withdrawal. Most with mild or moderate airflow limitation would have been willing to attempt withdrawal or titration to a lower dosage of ICS if advised by their clinician, particularly if a reasoned explanation were offered. Attitudes in this study to discontinuing ICS use varied. Knowledge of the drug itself, the indications for its prescription in COPD and potential for side effects, was scant. The proposed withdrawal of ICS is likely to be challenging and requires detailed conversations between patients and respiratory healthcare professionals.

Utility of laser-cut covered self-expandable metal stents for unresectable malignant distal biliary obstruction: a single-center experience

Endoscopy ◽  
2020 ◽  
Vol 52 (08) ◽  
pp. 664-668
Author(s):  
Saiko Marui ◽  
Norimitsu Uza ◽  
Hajime Yamazaki ◽  
Sakiko Ota ◽  
Takeharu Nakamura ◽  
...  
Keyword(s):  
Median Time ◽  
Biliary Obstruction ◽  
Metal Stents ◽  
Single Center ◽  
Stent Patency ◽  
Stent Removal ◽  
Single Center Experience

Abstract Background Few reports have evaluated the effectiveness of laser-cut, covered, self-expandable metal stents (LC-CSEMS) for unresectable malignant distal biliary obstruction (MDBO) and whether reintervention is feasible after placement. We describe our experience with LC-CSEMS placement for unresectable MDBO. Methods Patients undergoing LC-CSEMS placement for unresectable MDBO from November 2014 to December 2018 were reviewed. Recurrent biliary obstruction (RBO), median time to RBO (TRBO), and reintervention were analyzed. Results 52 patients who underwent LC-CSEMS placement for unresectable MDBO were included in the analysis. The RBO rate was 15 % and the median TRBO was 445 days. Reintervention was attempted in nine patients and stent removal was successful in eight patients. Conclusions Our experience suggests the effectiveness of LC-CSEMS in patients with unresectable MDBO in terms of stent patency and feasibility of reintervention.

A Double-Blind Parallel Study of Acetylcysteine-Isoproterenol and Saline-Isoproterenol in Patients with Chronic Obstructive Lung Disease

1977 ◽  
Vol 5 (3) ◽  
pp. 175-183 ◽  
Author(s):  
Allen Cato ◽  
Ira Goldstein ◽  
Milton Millman
Keyword(s):  
Side Effects ◽  
Pulmonary Function ◽  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Parallel Study ◽  
Double Blind ◽  
Safety And Efficacy ◽  
Pre Treatment

A double-blind parallel study in patients with asthma compared the safety and efficacy of saline-isoproterenol (SI) and acetylcysteine-isoproterenol (AI), when administered at home as an aerosol, over a one-week period, using a conventional nebulizer compressor. Measurements of pulmonary function revealed statistically significant differences between the two therapies for FEV1 and FVC in favour of AI. In the group treated with AI, the average sputum viscosity after six days of treatment was significantly less than pre-treatment values, or when compared to the results with SI treatment. No serious side-effects were reported during treatment with either therapy. These results indicate that acetylcysteine combined with a bronchodilator, such as isoproterenol, may be safe and of significant value in the treatment of patients with asthma who are also sputum producers.

scholarly journals Surgical management of post-transplant bronchial stenoses: a single-center experience

Surgery Today ◽  
2021 ◽  
Author(s):  
Eleonora Faccioli ◽  
Andrea Dell’Amore ◽  
Pia Ferrigno ◽  
Marco Schiavon ◽  
Marco Mammana ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Lung Transplantation ◽  
Median Time ◽  
Surgical Management ◽  
Endoscopic Treatment ◽  
Endoscopic Management ◽  
Sleeve Resection ◽  
Good Strategy ◽  
Single Center ◽  
Single Center Experience

Abstract Purpose Bronchial stenoses are challenging complications after lung transplantation and are associated with high rates of morbidity and mortality. We report a series of patients who underwent bronchoplasty or sleeve resection for bronchial stenoses that did not resolve with endoscopic treatment after lung transplantation. Methods Between 1995 and 2020, 497 patients underwent lung transplantation at our Institution. 35 patients (7.0%) experienced bronchial stenoses with a median time from transplantation of 3 months. Endoscopic management was effective in 28 cases (5.6%) while 1 patient required re-transplantation. Six patients (1.2%) underwent bronchoplasty or sleeve resection. Results The procedures of the six patients who underwent bronchoplasty or sleeve resection were as follows: lower sleeve bilobectomy (n = 3), wedge bronchoplasty of the bronchus intermedius (n = 1), isolated sleeve resection of the bronchus intermedius (n = 1), and isolated sleeve resection of the bronchus intermedius (n = 1), associated with a middle lobectomy. All patients were discharged after a median time of 11 days. At a median of 12 months from surgery, two patients remain alive with a preserved pulmonary function. Four patients died after a median time of 56 months from bronchoplasty of causes that were not related to surgery. Conclusions Bronchial reconstructions are challenging procedures that can be performed in highly specialized centers. Despite this, they can be considered a good strategy to obtain a definitive resolution of stenosis after lung transplantation.

Long-Term Steroid Side Effects in Renal Transplantation Need a Safe Steroid Withdrawal: A Single-Center Experience

1998 ◽  
Vol 30 (4) ◽  
pp. 1303-1304 ◽  
Author(s):  
E Bertoni ◽  
M Zanazzi ◽  
A Rosati ◽  
L Di Maria ◽  
L Moscarelli ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Side Effects ◽  
Steroid Withdrawal ◽  
Single Center ◽  
Single Center Experience ◽  
Steroid Side Effects

Single-center experience of PD1 inhibition in metastatic uveal melanoma.

2017 ◽  
Vol 35 (7_suppl) ◽  
pp. 87-87
Author(s):  
Tan Xu ◽  
Jung Min Song ◽  
Michael J. McNamara ◽  
Brian Gastman ◽  
Arun D Singh ◽  
...  
Keyword(s):  
Overall Survival ◽  
Median Time ◽  
Median Survival ◽  
Uveal Melanoma ◽  
Metastatic Disease ◽  
Median Overall Survival ◽  
Initial Diagnosis ◽  
Response To Therapy ◽  
Single Center ◽  
Single Center Experience

87 Background: Metastatic uveal melanoma (MUM) is a rare histology with poor prognosis. Therapies used in cutaneous melanoma with success have limited to no efficacy in uveal melanoma. Limited data exists regarding the efficacy of PD-1 inhibition in this disease. Methods: Patients carrying a diagnosis of MUM that had been treated with any PD1 inhibitor at the Cleveland Clinic were analyzed. Median overall survival from the diagnosis of metastatic disease and from the start of PD-1 inhibition were calculated. RECIST 1.1 criteria were used to assess response to therapy. Results: 10 patients with MUM have been treated with a PD1 inhibitor. Mean age at initiation of PD1 inhibition was 74. Five (50%) were female. Median time from initial diagnosis to metastatic disease was 67 months (range, 5-204). All 6 patients with a genetic profiling result available were classified as poor risk either by cytogenetics or gene expression profiling. Median overall survival from diagnosis of metastatic disease was 24 months (range, 9-46). Six patients had also been treated with ipilimumab, 4 had prior treatment, 1 had PD-1 prior to ipilimumab, and one had concurrent treatment with combination ipilimumab/nivolumab. Adjunct local radiation occurred in 6 patients: 5 of the liver (4 embolization, 1 SBRT), one of osseous metastases. Median time on PD1 treatment was 2 months (range, 1-6). Two patients had SD, 6 PD, 3 have not yet been reevaluated. Median survival from initiation of PD1 inhibition was 9 months (range, 7-12). Adverse events were as expected from published experiences with PD-1 inhibition. All patients with median survival from initial diagnosis of metastatic disease over one year received both PD-1 and CTLA-4 inhibition as well as radiation. Conclusions: In this single center experience, no patients had tumor response to PD-1 inhibition. Combination therapies may be worth exploring in the treatment of MUM.

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