A multicenter randomized trial to assess the efficacy of CONvalescent plasma therapy in patients with Invasive COVID-19 and acute respiratory failure treated with mechanical ventilation: the CONFIDENT trial protocol
Ivan
| Updated December 10, 2020
Background: The COVID-19 pandemic reached Europe in early 2020. Convalescent plasma is used with out a constant proof of efficacy. Our speculation is that passive immunization with plasma collected from sufferers having contracted COVID-19 and developed particular neutralizing antibodies could alleviate signs and cut back mortality in sufferers handled with mechanical air flow for extreme respiratory failure through the evolution of SARS-CoV-2 pneumonia.
Strategies: We plan to incorporate 500 grownup sufferers, hospitalized in 16 Belgian intensive care items between September 2020 and 2022, recognized with SARS-CoV-2 pneumonia, below mechanical air flow for lower than 5 days and a medical frailty scale lower than 6. The examine remedy shall be in comparison with commonplace of care and allotted by randomization in a 1 to 1 ratio with out blinding. The primary endpoint shall be mortality at day 28. We’ll carry out an intention to deal with evaluation. The variety of sufferers to incorporate relies on an anticipated mortality charge at day 28 of 40 p.c and an anticipated relative discount with examine intervention of 30 p.c with α threat of 5 p.c and β threat of 20 p.c.
Dialogue: This examine will assess the efficacy of plasma within the inhabitants of mechanically ventilated sufferers. A stratification on the delay from mechanical air flow and inclusion will enable to method the optimum time use. Deciding on convalescent plasmas with a excessive titer of neutralizing antibodies towards SARS-CoV-2 will enable a homogeneous examine remedy. The inclusion within the examine relies on the consent of the affected person or his/her authorized consultant, and the approval of the Investigational Assessment Board of the College hospital of Liège, Belgium. A knowledge security monitoring board (DSMB) has been applied. Interim analyses have been deliberate at 100, 2002, 300 and 400 inclusions with a purpose to resolve whether or not the path ought to be discontinued prematurely for moral points. We plan to publish our leads to a peer-reviewed journal and to current them at nationwide and worldwide conferences.
Cutaneous Rosai – Dorfman illness in a affected person with late syphilis and cervical most cancers – case report and a overview of literature
Background: Cutaneous Rosai – Dorfman illness (CRDD) is extraordinarily uncommon variant of idiopathic histiocytic proliferative dysfunction, which can manifest as a non-specific macules, papules, plaques or nodules ranging in measurement and color from yellow – crimson to crimson -brown.
Case presentation: A 52-year-old feminine offered with three step by step enlarging, reddish – brown nodules on the proper higher extremity lasting six months. The sufferers denied fever, weight reduction, malaise. Medical examination and imaging checks confirmed no signal of lymphadenopathy. A biopsy specimen of a nodule confirmed a dense dermal polymorphic infiltrate with quite a few histiocytes exhibiting emperipolesis phenomenon. Immunohistochemical staining of the histiocytes confirmed S-100 protein (+), CD68(+), however CD1a (-). Aforementioned findings had been in step with CRDD traits. Moreover, a routine serological screening and confirmatory serological checks for syphilis had been constructive. Syphilis of unknown length was recognized. The IgG antibodies titre towards Chlamydia trachomatis was elevated. An remoted sensory impairment over the proper trigeminal nerve was discovered on neurological session. Complete gynaecological evaluation was carried out due to affected person’s complaints of bleeding after sexual activity and led to prognosis of cervical most cancers. The preliminary remedy with methotrexate was discontinued after three months on account of neutropenia. Additional remedy with dapson was ineffective, subsequently full surgical excision was really helpful.
Conclusions: CRDD is a uncommon, benign situation particularly troublesome to diagnose on account of lack of normal signs and lymphadenopathy. Histopathologic examination with immunohistochemical staining, exhibiting attribute and reproducible findings play a key position in establishing an correct prognosis. Within the offered case activated histiocytes demonstrated in a lesional pores and skin may be a response to immune dysregulation associated to power, untreated sexually transmitted infections and most cancers.
A multicenter randomized trial to assess the efficacy of CONvalescent plasma therapy in patients with Invasive COVID-19 and acute respiratory failure treated with mechanical ventilation: the CONFIDENT trial protocol
Pediatric Miller Fisher Syndrome; Attribute Presentation and Comparability with Grownup Miller Fisher Syndrome
Background: We aimed to research the attribute presentation of Miller Fisher syndrome (MFS) in pediatrics and examine it with that in adults.
Strategies: We carried out a retrospective overview of medical data, laboratory findings, and illness course of pediatric MFS. The info had been in contrast with these of grownup MFS, and literature overview was executed. Unpaired and paired comparisons between teams had been made utilizing Wilcoxon rank-sum and signed-rank checks, respectively.
Outcomes: Median age for pediatric MFS was 9.8 ± 6.5 years. There have been 5 (45.5%) male and 6 (54.5%) feminine sufferers. All sufferers had previous an infection. Two sufferers (22.2%) had examined constructive for anti-GQ1b antibody. Ten sufferers (90.1%) had been handled with intravenous immunoglobulin, and a pair of (18.2%) additionally acquired intravenous methylprednisolone. Inside one month, 8 (72.7%) sufferers confirmed restoration, and all 11 (100%) recovered totally inside three months. Additional, the pediatric group had increased frequency of unilateral involvement of ophthalmoplegia, ataxia, and autonomic signs however decrease antiganglioside antibody positivity and manifestations of areflexia than the grownup group.
Description: Description of target: As a result of hemolysis, hemoglobin is found to accumulate in the kidney and is secreted in the urine. Haptoglobin captures, and combines with free plasma hemoglobin to allow hepatic recycling of heme iron and to prevent kidney damage. Haptoglobin also acts as an antioxidant, has antibacterial activity and plays a role in modulating many aspects of the acute phase response. Hemoglobin/haptoglobin complexes are rapidely cleared by the macrophage CD163 scavenger receptor expressed on the surface of liver Kupfer cells through an endocytic lysosomal degradation pathway.;Species reactivity: Cat;Application: ELISA;Assay info: Assay Methodology: Quantitative Sandwich ELISA;Sensitivity: 4.261 ng/ml
Description: A sandwich ELISA for quantitative measurement of Rat Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Rat Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Rat Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Canine Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Canine Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Canine Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Porcine Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Porcine Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Porcine Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Goat Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Goat Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Goat Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Mouse Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Mouse Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Mouse Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Human Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Human Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Human Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Monkey Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Monkey Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Monkey Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Rabbit Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Rabbit Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Rabbit Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Guinea pig Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A sandwich ELISA for quantitative measurement of Guinea pig Haptoglobin Related Protein in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
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Conclusions: Neuro-ophthalmic manifestations and illness course of pediatric MFS had been much like these of grownup MFS as acknowledged within the literature. Nonetheless, the presence of autonomic signs was increased and anti-GQ1b antibody positivity was decrease in pediatric MFS than in grownup MFS.
