scholarly journals Convalescent Plasma as a Treatment for Severe Patients with SARS-CoV-2 Infection: A Case Report

2020 ◽  
Author(s):  
Chaoying Yong ◽  
Xinyu Deng ◽  
Yuyan Song ◽  
Wenguang Tian ◽  
Di Qi ◽  
...  
Keyword(s):  
Adverse Reactions ◽  
Small Samples ◽  
Plasma Therapy ◽  
Case Presentation ◽  
Randomized Controlled ◽  
Failure Treatment ◽  
Global Pandemic ◽  
Clinical Conditions ◽  
Antibody Levels ◽  
Severe Adverse Reactions

Abstract Background: Coronavirus disease 2019 (COVID-19) has become a global pandemic, affecting the lives of millions of people around the world.Although research including hydroxychloroquine, antiviral drugs and vaccines is under way, there is still no effective therapy applied for COVID-19.Case presentation: Here, we reported five cases of severe COVID-19 patients with respiratory failure treatment with supportable care and ABO-compatible convalescent plasma (CP).All the patients’ clinical conditions, laboratory results, viral nucleic acid results, and chest CT images, were improved. Meanwhile, all the patients recovered and no severe adverse reactions were found. We also followed up the antibody levels of some patients within 2 months after onset, but our study did not show the inherent relationship between CP treatment and changes in antibody levels due to small samples.Conclusions: Although short of evidence of randomized controlled trials, convalescent plasma therapy probably was a potentially safe and effective treatment for COVID-19.

scholarly journals Convalescent Plasma as a Treatment for Severe Patients With SARS-CoV-2 Infection: A Case Report

2020 ◽  
Author(s):  
Chaoying Yong ◽  
Xinyu Deng ◽  
Yuyan Song ◽  
Wenguang Tian ◽  
Di Qi ◽  
...  
Keyword(s):  
Adverse Reactions ◽  
Virus Disease ◽  
Plasma Therapy ◽  
Case Presentation ◽  
Randomized Controlled ◽  
Failure Treatment ◽  
Global Pandemic ◽  
Laboratory Results ◽  
Antibody Levels ◽  
Severe Adverse Reactions

Abstract Background: Corona virus disease 2019 (COVID-19) has become a global pandemic, affecting the lives of millions of people around the world.Although research including hydroxychloroquine, antiviral drugs and vaccines is under way, there is still no effective therapy applied for COVID-19.Case presentation: Here, we reported five cases of severe COVID-19 patients with respiratory failure treatment with supportable care and ABO-compatible convalescent plasma(CP).All the patients’clinical conditions, laboratory results, viral nucleic acid results, and chest CT images, were improved. Meanwhile, all the patients recovered and no severe adverse reactions were found. We also followed up the antibody levels of some patients within 2 months after onset, but our study did not show the inherent relationship between CP treatment and changes in antibody levels due to small samples.Conclusions: Although short of evidence of randomized controlled trials, convalescent plasma therapy probably was a potentially safe and effective treatment for COVID-19.

Intravenous versus Oral iron for Iron-Deficiency Anemia in Pregnancy (IVIDA): A Randomized Controlled Trial

2021 ◽  
Author(s):  
Adam K. Lewkowitz ◽  
Molly J. Stout ◽  
Emily Cooke ◽  
Seon C. Deoni ◽  
Viren D'Sa ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Adverse Reactions ◽  
Controlled Trial ◽  
Oral Iron ◽  
Deficiency Anemia ◽  
Randomized Controlled ◽  
Iv Iron ◽  
Severe Adverse Reactions

Objective Iron-deficiency anemia (IDA) can have serious consequences for mothers and babies. Iron supplementation is recommended, but the administration route is controversial. We sought to conduct a randomized controlled trial (RCT) testing the effectiveness and safety of intravenous (IV) iron compared with oral iron on perinatal outcomes in pregnant women with IDA. Study Design This open-label RCT randomized patients with IDA (hemoglobin [hgb] <10 g/dL and ferritin <30 ng/mL) at 24 to 34 weeks' to oral iron or single 1,000-mg dose of IV low-molecular weight iron dextran over one hour. The primary outcome was maternal anemia at delivery (hgb < 11 g/dL). Secondary outcomes were mild/moderate or severe adverse reactions, maternal hgb and ferritin at delivery, blood transfusion, gestational age at delivery, birth weight, neonatal hgb and ferritin, and composite neonatal morbidity. Analysis was as per protocol. Results The trial was stopped early for logistical reasons, and the data analyzed as preliminary data to inform a larger, potentially externally funded, definitive trial. Of 55 patients approached, 38 consented. Of these, 15 were withdrawn: 5 received IV iron from their primary obstetrician after being randomized to oral iron and 10 declined to receive IV iron. Of the remaining 23 patients, who were included in the analytic population, 13 received oral iron and 10 received IV iron. The rate of maternal anemia at delivery (hgb < 11 g/dL) was high overall but significantly reduced with IV iron (40 vs. 85%, p = 0.039). Rates of maternal hgb < 10 g/dL were significantly lower in the IV iron group (10 vs. 54%, p = 0.029). There were no severe adverse reactions and similar rates of mild/moderate reactions between groups. Conclusion IV iron reduces rates of anemia at the time of admission for delivery, supporting a larger RCT comparing IV versus oral iron for the treatment of IDA of pregnancy powered for definitive clinical outcomes. However, issues uncovered in this RCT suggest that patient, clinician, and systems-level barriers associated with different IDA treatment modalities must be considered prior to conducting a larger RCT. This study is registered with clinicaltrials.gov with identifier no.: NCT03438227. Key Points

scholarly journals A comparison between the Disposcope endoscope and fiberoptic bronchoscope for nasotracheal intubation-A randomized controlled trial

2019 ◽  
Author(s):  
Junma Yu ◽  
Rui Hu ◽  
Lining Wu ◽  
Peng Sun ◽  
Zhi Zhang
Keyword(s):  
Adverse Reactions ◽  
Controlled Trial ◽  
Nasotracheal Intubation ◽  
Fiberoptic Bronchoscopy ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Severe Epistaxis ◽  
Nasal Bleeding ◽  
Severe Adverse Reactions ◽  
Time Point

Abstract Background Nasotracheal intubation (NTI) is frequently performed in oral and maxillofacial surgeries. This study evaluated whether NTI is easier when guided by Disposcope endoscopy or fiberoptic bronchoscopy. Methods Sixty patients (30 per group) requiring NTI were randomly assigned to undergo fiberoptic bronchoscopy-guided (fibreoptic group) or Disposcope endoscope-guided (Disposcope group) NTI. Then, the NTI time were recorded. Epistaxis was recorded using direct laryngoscopy five minutes after completing NTI. Results The time to complete NTI was significantly longer in the fiberoptic group than the Disposcope group (38.4 sec vs 24.1 sec; mean difference, 14.2 sec; 95% CI, 10.4 to 18.1). In addition, Mild epistaxis (nasal bleeding) was observed in 8 patients in the fiberoptic group and 7 patients in the Disposcope group (26.7% vs 23.3%, respectively; relative risk, 1.2; 95% CI, 0.4 to 3.9). No moderate or severe epistaxis occurred in either group. Furthermore, there was no obvious nasal pain at any time point after extubation in the Disposcope group, and there was no significant difference between the two groups. Conclusion NTI can be completed successfully using either fiberoptic bronchoscopy or a Disposcope endoscope as a guide without any severe adverse reactions. However, compared to fiberoptic bronchoscopy, the Disposcope endoscope requires less transaction time.

Randomized Controlled Trials in Psychiatry. Part II: Their Relationship to Clinical Practice

2003 ◽  
Vol 37 (3) ◽  
pp. 265-269 ◽  
Author(s):  
Roger T. Mulder ◽  
Chris Frampton ◽  
Peter R. Joyce ◽  
Richard Porter
Keyword(s):  
Clinical Practice ◽  
Randomized Controlled Trials ◽  
External Validity ◽  
Internal Validity ◽  
Small Samples ◽  
Controlled Trials ◽  
Treatment Protocols ◽  
Randomized Controlled ◽  
Clinical Conditions ◽  
Internal And External Validity

Objective: To discuss the extent to which the results of randomized controlled trials (RCTs) in psychiatry can be generalized to clinical practice. Method: Threats to internal and external validity in psychiatric RCTs are reviewed. Results: Threats to internal validity increase the possibility of bias. Psychiatric RCTs have problems with small samples, arbitrary definitions of caseness, disparate definitions of outcome and high spontaneous recovery rates. Particular issues arise in psychotherapy RCTs. Threats to external validity reduce the extent to which the results of a RCT produce a correct basis for generalization to other circumstances. These include high rates of comorbidity and sub syndromal pathology in normal clinical practice, manual-based treatment protocols and varying definitions of successful treatment. Conclusions: Randomized controlled trials remain the most robust design to investigate the effectiveness of treatments. They should be applied to important clinical questions; and carried out, as far as possible, with typical patients in the clinical conditions in which the treatment is likely to be used.

ОЦЕНКА ЭФФЕКТИВНОСТИ И БЕЗОПАСНОСТИ 10% ВНУТРИВЕННОГО ИММУНОГЛОБУЛИНА ПРИВИДЖЕН В РЕАЛЬНОЙ КЛИНИЧЕСКОЙ ПРАКТИКЕ

2019 ◽  
Author(s):  
L.G. Khludova ◽  
I.A. Manto ◽  
E.A. Latysheva ◽  
T.V. Latysheva ◽  
M.R. Khaitov
Keyword(s):  
Replacement Therapy ◽  
Primary Immunodeficiency ◽  
Adverse Reactions ◽  
Efficacy And Safety ◽  
High Efficacy ◽  
Antibody Synthesis ◽  
Human Immunoglobulins ◽  
Severe Adverse Reactions ◽  
Common Variable ◽  
Real Clinical Practice

Актуальность. Заместительная терапия иммуноглобулинами человека является ведущим патогенетическим методом лечения первичных иммунодефицитов с нарушением синтеза антител. В настоящее время в России доступно несколько препаратов иммуноглобулинов человека нормальных для внутривенного введения. Цель. Оценить эффективность и безопасность препарата Привиджен (10 раствор иммуноглобулина для внутривенного введения) в реальной клинической практике в течение 12 клинических месяцев. Материалы и методы. 20 взрослых с диагнозом общая вариабельная иммунная недостаточности и Х-сцепленная агаммаглобулинемия получали внутривенный иммуноглобулин Привиджен к интервалом 243 дня в течение 12 мес. Первичными критериями оценки была частота инфекционных осложнений и нежелательных явлений. Результаты. У большинства пациентов в ходе исследования достигнут удовлетворительный претранс-фузионный уровень IgG. Тяжелых нежелательных явлений, связанных с введением препарата, не зарегистрировано. Заключение. В ходе исследования препарат продемонстрировал высокую эффективность и безопасность у пациентов, нуждающихся в ежемесячной заместительной терапииRelevance. Replacement therapy with human immunoglobulins is the leading pathogenetic method of treatment of primary immunodeficiency with impaired antibody synthesis. Currently, several preparations of human immunoglobulins for intravenous administration are available in Russia. Purposes. Evaluation of the efficacy and safety of Privigen immunoglobulin intravenous 10 liquid in real clinical practice within 12 clinical months. Methods. Twenty adults diagnosed with common variable immunodeficiency or X-linked agammaglobulinemia received intravenous Privigen infusions (0.2-0.4 mg/kg) at 243 intervals over a 12-month period. The primary endpoint was the annual rate of infections and adverse events. Results. Sufficient level of IgG was achieved in most patients during the study. Severe adverse reactions during the treatment were not registered. Conclusions. High efficacy and safety of monthly replacement therapy in patients with primary immunodeficiency with impaired antibody synthesis has been demonstrated.

A Brief outlook on possible available solutions, therapies and suggestions for COVID-19

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Rashmi Saxena Pal ◽  
Yogendra Pal ◽  
Pranay Wal ◽  
Ankita Wal ◽  
Nikita Saraswat
Keyword(s):  
United States ◽  
Plasma Therapy ◽  
Social Distancing ◽  
The Past ◽  
Antiviral Compounds ◽  
Global Pandemic ◽  
Case Count ◽  
Current Scenario ◽  
Hiv Drugs

Background: WHO declared COVID-19 a global pandemic. New cases are being added every day, as the case count in United States are to the maximum. No drugs or biologics are yet found to be effective for the prevention or treatment of COVID-19. Objective: To discuss the possibilities of available treatments available. Materials & Methods: Brief out-look is undertaken over the past issues available over the similar situations occurred with respect to the current scenario and prospectives. Results: There can be various possibilities in form of convalescent plasma therapy. The known drugs as HIV drugs, antimalarial medicines and antiviral compounds can serve as suggestive option. Conclusion: Till a confirm medicine or vaccine is sorted out for Covid-19, we need to take natural immune-boosters, along with precautionary steps, social distancing and other preventions as instructed for the benefit of everyone with an optimistic mind and attitude.

scholarly journals Convalescent plasma therapy for COVID-19 patients: a protocol of a prospective meta-analysis of randomized controlled trials

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lajos Szakó ◽  
Nelli Farkas ◽  
Szabolcs Kiss ◽  
Szilárd Váncsa ◽  
Noémi Zádori ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Organ Failure ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Plasma Therapy ◽  
Monthly Basis ◽  
Randomized Controlled

Abstract Background Coronavirus disease 2019 (COVID-19) is an infection with possible serious consequences. The plasma of recovered patients might serve as treatment, which we aim to assess in the form of a prospective meta-analysis focusing on mortality, multi-organ failure, duration of intensive care unit stay, and adverse events. Methods A systematic search was conducted to find relevant registered randomized controlled trials in five trial registries. A comprehensive search will be done continuously on a monthly basis in MEDLINE (via PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science to find the results of previously registered randomized controlled trials. The selection will be done by two independent authors. Data extraction will be carried out by two other independent reviewers. Disagreements will be resolved by a third investigator. An update of the search of the registries and the first search of the databases will be done on the 21st of July. Data synthesis will be performed following the recommendations of the Cochrane Collaboration. In the case of dichotomous outcomes (mortality and organ failure), we will calculate pooled risk ratios with a 95% confidence interval (CI) from two-by-two tables (treatment Y/N, outcome Y/N). Data from models with multivariate adjustment (hazard ratios, odds ratio, risk ratio) will be preferred for the analysis. P less than 0.05 will be considered statistically significant. In the case of ICU stay, weighted mean difference with a 95% confidence interval will be calculated. Heterogeneity will be tested with I2, and χ2 tests. Meta-analysis will be performed if at least 3 studies report on the same outcome and population. Discussion Convalescent plasma therapy is a considerable alternative in COVID-19, which we aim to investigate in a prospective meta-analysis.

scholarly journals COVID-19 related mortality in post-operative cardiac surgical patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Azhar Hussain ◽  
Amina Khalil ◽  
Priyanka Kolvekar ◽  
Prity Gupta ◽  
Shyamsunder Kolvekar
Keyword(s):  
Cardiac Surgery ◽  
Long Term Outcomes ◽  
Case Presentation ◽  
Elective Cardiac Surgery ◽  
The United Kingdom ◽  
Global Pandemic ◽  
Cardiac Operations ◽  
Related Mortality

Abstract Background COVID-19 has caused a global pandemic of unprecedented proportions. Elective cardiac surgery has been universally postponed with only urgent and emergency cardiac operations being performed. The National Health Service in the United Kingdom introduced national measures to conserve intensive care beds and significantly limit elective activity shortly after lockdown. Case presentation We report two cases of early post-operative mortality secondary to COVID-19 infection immediately prior to the implementation of these widespread measures. Conclusion The role of cardiac surgery in the presence of COVID-19 is still very unpredictable and further studies on both short term and long term outcomes are warranted.

scholarly journals Granisetron plus dexamethasone for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery: A meta-analysis

2017 ◽  
Vol 45 (3) ◽  
pp. 904-911 ◽  
Author(s):  
Min Zhu ◽  
Chengmao Zhou ◽  
Bing Huang ◽  
Lin Ruan ◽  
Rui Liang
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Nausea ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Cochrane Library ◽  
Randomized Controlled ◽  
Laparoscopy Surgery ◽  
The Cochrane Library

Objective This study was designed to compare the effectiveness of granisetron plus dexamethasone for preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic surgery. Methods We searched the literature in the Cochrane Library, PubMed, EMBASE, and CNKI. Results In total, 11 randomized controlled trials were enrolled in this analysis. The meta-analysis showed that granisetron in combination with dexamethasone was significantly more effective than granisetron alone in preventing PONV in patients undergoing laparoscopy surgery. No significant differences in adverse reactions (dizziness and headache) were found in association with dexamethasone. Conclusion Granisetron in combination with dexamethasone was significantly more effective than granisetron alone in preventing PONV in patients undergoing laparoscopic surgery, with no difference in adverse reactions between the two groups. Granisetron alone or granisetron plus dexamethasone can be used to prevent PONV in patients undergoing laparoscopic surgery.

scholarly journals Risk of Severe Adverse Reactions Related to Allopurinol and Febuxostat in Asians

2018 ◽  
Vol 21 ◽  
pp. S106
Author(s):  
C Chen ◽  
W Chung ◽  
YJ Lin ◽  
C Chang ◽  
S Chang
Keyword(s):  
Adverse Reactions ◽  
Severe Adverse Reactions
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