RESUMEN
BACKGROUND: It is unknown whether convalescent immunoglobulins (cIgGs) are better than convalescent plasma (CP) for patients with coronavirus 2019 (COVID-19). METHODS: In this randomized controlled trial, we assigned high risk COVID-19 patients with ≤10 days of symptoms, to receive cIgGs or CP. The primary endpoint was improvement on day 14 according to the World Health Organization scale. Secondary endpoints were survival on day 14, and improvement, survival, and percent of ventilated patients on day 28, and treatment response in unvaccinated and vaccinated patients. RESULTS: A total of 319 patients were included: 166 received cIgGs and 153 CP. Median age was 64 to 66 years. A total of 112 patients (67.5%) in the cIgG group and 103 patients (67.3%) in the CP group reached the primary endpoint. Difference between groups was 0.1 (95% confidence interval, -10.1 to 10.4; P = .026), failing to reach noninferiority. More patients receiving cIgG improved by day 28 (136 patients [81.9%] and 108 patients [70.6%], respectively; 95% confidence interval, 1.9-20.7; P < .001; for superiority P = .018). Seventeen patients in the cIgG group (10.2%) and 25 patients (16.3%) in the CP group required mechanical ventilation (P = .136). Sixteen (9.6%) and 23 (15%) patients, respectively, died (P = .172). More unvaccinated patients improved by day 28 in the cIgG group (84.1% vs 66.1%; P = .024), and survival was better in the cIgG group (89.9% vs 77.4%; P = .066). CONCLUSIONS: cIgGs failed to reach the primary noninferiority endpoint on day 14 but was superior to CP on day 28. Survival and improvement by day 28 in unvaccinated patients treated with cIgGs were better. In the face of new variants, cIgGs are a viable option for treating COVID-19. TRIAL REGISTRATION NUMBER: My Trials MOH_2021-01-14_009667.
Asunto(s)
COVID-19 , Humanos , Persona de Mediana Edad , Anciano , COVID-19/terapia , SARS-CoV-2 , Inmunización Pasiva/efectos adversos , Resultado del Tratamiento , Sueroterapia para COVID-19 , InmunoglobulinasRESUMEN
Objetivo:Determinar los factores asociados al estrés laboral en las enfermeras de dos hospitales de la ciudad de Cartagena. Metodología: Se realizó un estudio analítico de corte transversal.La población correspondió a 156 enfermeras y enfermeros de los servicios de Urgencia, Hospitalización, UCI Adulto, Cirugía, Consulta Externa de dos hospitales de la ciudad de Cartagena. Para la recolección de información se utilizó la versión española del instrumento"TheNursing Stress Scale" (NSS), que valora siete factores relacionados con el ambiente físico, el ambiente psicológico y dos relacionados con el ambiente social en el hospital. Para el análisis de los datos se aplicó estadística descriptiva, se realizó análisis bivariado utilizando la probabilidad Kruskall Wallis y U Mann Whitney para estimar diferencias significativas de promedios entre variables. Resultados: Participaron en el estudio 156 enfermerasy enfermeros de dos hospitales de la ciudad de Cartagena, con promedio de edad de 33.2 años, el 94,2% (147) pertenecen al género femenino. La prevalencia de nivel alto de estrés correspondió a 33.9% (53) de los encuestados.Son variables asociadas al estrés ser menor de 30 años, tener pareja, tener más de un hijo, laborar en la consulta externa, tener un contrato a término fijo, estar vinculado a la empresa por más de dos años y tener más de cinco años de experiencia en el cargo. Conclusión: La presencia de estrés en los profesionales se asocia principalmente a factores personales y laborales como los servicios en que se trabaja y el tipo de contratación.
Objective: To determine the factors associated with work stress in nurses at two hospitals in the city of Cartagena. Methods: We performed across-sectional analytical study. The population fell to 156 nurses Emergency Services, Hospital, Adult ICU, Surgery, Outpatient, two hospitals in the city of Cartagena. For data collect on we used the Spanish version of the instrument "The Nursing Stress Scale" (NSS), which assesses seven factors related to the physical environment, the psychological environment and two related to the social environmentin the hospital. For the analysis of the data using descriptive statistics, we conducted bivariate analyzes using probability Kruskal Wallis and Mann Whitney U to estimate significant differences between variables averages. Results:The study involved 156 nursesat two hospitals inthe city of Cartagena, with a mean age of 33.2 years, 94.2% (147) are female. Thehighprevalence of stress corresponded to 33.9% (53) of respondents. Variables are associated with stress, age less than 30 years, having a partner, having more than one childin the outpatient work, have afixed term contract, be linked to the company for more than two years and have more than five years of experience in office.> Conclusion: The presence of stress in professionals is mainly associated with personal and work factors such as services in which they work and the type of contract.
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Stem cell-based therapy holds great potential for future treatment of multiple sclerosis (MS). Bone marrow mesenchymal stem cells (MSCs) were previously reported to ameliorate symptoms in mouse MS models (experimental autoimmune encephalomyelitis, EAE). In this study, we induced MSCs to differentiate in vitro into neurotrophic factor-producing cells (NTFCs). Our main goal was to examine the clinical use of NTFCs on EAE symptoms. The NTFCs and MSCs were transplanted intracerebroventricularly (ICV) to EAE mice. We found that NTFCs transplantations resulted in a delay of symptom onset and increased animal survival. Transplantation of MSCs also exerted a positive effect but to a lesser extent. In vitro analysis demonstrated the NTFCs' capacity to suppress mice immune cells and protect neuronal cells from oxidative insult. Our results indicate that NTFCs-transplanted ICV delay disease symptoms of EAE mice, possibly via neuroprotection and immunomodulation, and may serve as a possible treatment to MS.
