A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia.

BACKGROUND: Convalescent plasma is frequently administered to patients with Covid-19 and has been reported, largely on the basis of observational data, to improve clinical outcomes. Minimal data are available from adequately powered randomized, controlled trials. METHODS: We randomly assigned hospitalized adult patients with severe Covid-19 pneumonia in a 2:1 ratio to receive convalescent plasma or placebo. The primary outcome was the patient's clinical status 30 days after the intervention, as measured on a six-point ordinal scale ranging from total recovery to death. RESULTS: A total of 228 patients were assigned to receive convalescent plasma and 105 to receive placebo. The median time from the onset of symptoms to enrollment in the trial was 8 days (interquartile range, 5 to 10), and hypoxemia was the most frequent severity criterion for enrollment. The infused convalescent plasma had a median titer of 1:3200 of total SARS-CoV-2 antibodies (interquartile range, 1:800 to 1:3200). No patients were lost to follow-up. At day 30 day, no significant difference was noted between the convalescent plasma group and the placebo group in the distribution of clinical outcomes according to the ordinal scale (odds ratio, 0.83; 95% confidence interval [CI], 0.52 to 1.35; P = 0.46). Overall mortality was 10.96% in the convalescent plasma group and 11.43% in the placebo group, for a risk difference of -0.46 percentage points (95% CI, -7.8 to 6.8). Total SARS-CoV-2 antibody titers tended to be higher in the convalescent plasma group at day 2 after the intervention. Adverse events and serious adverse events were similar in the two groups. CONCLUSIONS: No significant differences were observed in clinical status or overall mortality between patients treated with convalescent plasma and those who received placebo. (PlasmAr ClinicalTrials.gov number, NCT04383535.).

Genetic diversity and phylogeographic analysis of human herpesvirus type 8 (HHV-8) in two distant regions of Argentina: Association with the genetic ancestry of the population.

BACKGROUND: The genetic diversity of persistent infectious agents, such as HHV-8, correlates closely with the migration of modern humans out of East Africa which makes them useful to trace human migrations. However, there is scarce data about the evolutionary history of HHV-8 particularly in multiethnic Latin American populations. OBJECTIVES: The aims of this study were to characterize the genetic diversity and the phylogeography of HHV-8 in two distant geographic regions of Argentina, and to establish potential associations with pathogenic conditions and the genetic ancestry of the population. STUDY DESIGN: A total of 101 HIV-1 infected subjects, 93 Kaposi's Sarcoma (KS) patients and 411 blood donors were recruited in the metropolitan (MET) and north-western regions of Argentina (NWA). HHV-8 DNA was detected by ORF-26 PCR in whole blood, saliva and FFPE tissues. Then, ORF-26 and ORF-K1 were analyzed for subtype assignment. Mitochondrial DNA and Y chromosome haplogroups, as well as autosomal ancestry markers were evaluated in samples in which subtypes could be assigned. Phylogeographic analysis was performed in the ORF-K1 sequences from this study combined with 388 GenBank sequences. RESULTS: HHV-8 was detected in 50.7%, 59.2% and 8% of samples from HIV-1 infected subjects, KS patients and blood donors, respectively. ORF-K1 phylogenetic analyses showed that subtypes A (A1-A5), B1, C (C1-C3) and F were present in 46.9%, 6.25%, 43.75% and 3.1% of cases, respectively. Analyses of ORF-26 fragment revealed that 81.95% of strains were subtypes A/C followed by J, B2, R, and K. The prevalence of subtype J was more commonly observed among KS patients when compared to the other groups. Among KS patients, subtype A/C was more commonly detected in MET whereas subtype J was the most frequent in NWA. Subtypes A/C was significantly associated with Native American maternal haplogroups (p = 0.004), whereas subtype J was related to non-Native American haplogroups (p < 0.0001). Sub-Saharan Africa, Europe and Latin America were the most probable locations from where HHV-8 was introduced to Argentina. CONCLUSIONS: These results give evidence of the geographic circulation of HHV-8 in Argentina, suggest the association of ORF-26 subtype J with KS development and provide new insights about its relationship with ancient and modern human migrations and identify the possible origins of this virus in Argentina.

Seroprevalence of human Trypanosoma cruzi infection in the North of Estado de Mexico

Abstract INTRODUCTION: Chagas disease is a neglected public health problem in Mexico; however, detailed studies to determine the seroprevalence in some states have not been performed. METHODS: A total 1,504 human serum from thirteen communities in Estado de Mexico, were analyzed with three diagnostics techniques. RESULTS: The overall seroprevalence was 9.1%, with high prevalence among people aged 51-60 years, while people aged 0-29 years were seronegative against T. cruzi. CONCLUSIONS: Our data demonstrated the seroprevalence of T. cruzi in the North of the Estado de Mexico, an area considered as non-endemic; however, epidemiological conditions necessary for natural transmission were found.

Seroprevalence of human Trypanosoma cruzi infection in the North of Estado de Mexico.

INTRODUCTION: Chagas disease is a neglected public health problem in Mexico; however, detailed studies to determine the seroprevalence in some states have not been performed. METHODS: A total 1,504 human serum from thirteen communities in Estado de Mexico, were analyzed with three diagnostics techniques. RESULTS: The overall seroprevalence was 9.1%, with high prevalence among people aged 51-60 years, while people aged 0-29 years were seronegative against T. cruzi. CONCLUSIONS: Our data demonstrated the seroprevalence of T. cruzi in the North of the Estado de Mexico, an area considered as non-endemic; however, epidemiological conditions necessary for natural transmission were found.

Promoción de la donación de sangre, estudio de las motivaciones con la técnica de grupos focales / Promotion of blood donation, study of motivations in focal groups technique

Dos aspectos podrían resumir las preocupaciones más importantes de todo profesional abocado a la tarea de gestionar un Banco de Sangre: la suficiente provisión, y la seguridad de los hemocomponentes a transfundir. Sin duda, mucho se avanzó en conseguir hoy un producto muy seguro, con bajísimos porcentajes de riesgo en cuanto a la transmisión de enfermedades, pero sigue siendo materia pendiente conseguir una adecuada cantidad de donantes que permitan abastecer la demanda transfusional. Si bien es cierto que bastaría que un 3 al 5 por ciento de la población concurriera como donante de sangre voluntario y habitual para cubrir las necesidades, todavía es bajísimo el porcentaje conseguido, y, por lo tanto muy poco lo que hemos hecho para revertir esta situación. Agreguemos que no basta con llegar a la cifra requerida de donantes sino además, que estos sean habituales, ya que son considerados más seguros, permiten una mejor planificación de los stocks, y terminan con la práctica aberrante de pedir donantes en los momentos de mayor angustia y necesidad, y a veces hasta condicionando prácticas como la cirugía. Últimos datos referidos a Argentina, recopilados por la OPS en 2004 muestran que el porcentaje de donantes voluntarios regulares (o habituales) es de 7 por ciento. El restante 93 por ciento son donantes de reposición y no existen donantes pagos. Siempre resulta difícil para un banco de sangre destinar recursos para la promoción de la donación de sangre, dado que no los tiene, y generarlos a partir del precio de los hemocomponentes no es aceptado por el mercado. Como otras cuestiones vinculadas a la salud, no debe ser el mercado quien establezca las pautas y es necesario un grado mayor de involucramiento del estado para resolver estas cuestiones... (TRUNCADO)

A qualitative research was carried out on focus groups with Gesell dome (one-way mirror). Four groups of twelve people each were studied, divided into two categories, those who have previously donated and those who have not. Characteristics such as age, sex and residence place were taken into account. The evaluation for each group took approximately 1 :30 hr. General objectives of the market research. We asked questions in order to make the members of the group express themselves to achieve the following objectives: To detect donor's motivations. To find out negative values and barriers against blood donation. To detect free association concerning institutions that work as Blood Bank. To detect the degree of knowledge about Donor's Organizations and their positive or negative assumptions. To test some potential advertising concepts.

Evaluación y experiencia local en la utilización de NAT HCV basado en amplificación por NASBA para el tamizaje de donaciones de sangre / Evaluation and local experience using HCV NAT based on NASBA amplification for screening blood donations

Objetivos: Evaluar un nuevo método de NAT HCV basado en amplificación por NASBA (nucleic acid sequence-based amplification) y presentar los datos de nuestra experiencia en aplicar esta metodología para tamizaje de rutina en banco de sangre. Método: La detección de ARN HCV por NASBA (NASBA-HCV) se realizó con un kit comercial (NucliSens Basic Kit, bioMérieux). Para determinar la sensibilidad por análisis de Probit, se probaron diluciones seriadas de un reactivo de referencia para ARN HCV. La especificidad se evaluó con 100 pooles de plasma normal. El tamizaje de rutina se realizó con pooles conteniendo hasta 48 unidades. Resultados: La sensibilidad de NASBA-HCV fue 95 UI/ml de ARN HCV. El límite de detección calculado para una donación individual en pool de 48 fue 4.560 UI/ml. La especificidad preliminar fue de 98 por ciento. Nuestro laboratorio pudo procesar adecuadamente las muestras para NAT HCV y resolver pooles positivos. No encontramos donaciones NAT HCV positivas/anti-HCV negativas en 27.679 muestras evaluadas. El porcentaje de largadas inválidas y pooles falsos positivos fue de 1,9 y 2.7, respectivamente Conclusiones: El límite de detección de NASBA-HCV para pooles de 48 unidades se encuentra dentro de los lineamientos de sensibilidad recomendados por el centro de referencia Paul Ehrlich Institute. Nuestro laboratorio tuvo la capacidad de implementar NAT HCV y obtener resultados en tiempos adecuados para banco de sangre. El tamizaje por NAT mediante NASBA-HCV es una alternativa viable para mejorar el nivel de seguridad en las transfusiones en nuestro país.