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1.
Sci Rep ; 11(1): 9927, 2021 05 11.
Article in English | MEDLINE | ID: mdl-33976287

ABSTRACT

Convalescent plasma (CP) therapy in COVID-19 disease may improve clinical outcome in severe disease. This pilot study was undertaken to inform feasibility and safety of further definitive studies. This was a prospective, interventional and randomized open label pilot trial in patients with severe COVID-19. Twenty COVID-19 patients received two 200 ml transfusions of convalescent patient CP over 24-h compared with 20 who received standard of care. The primary outcome was the requirement for ventilation (non-invasive or mechanical ventilation). The secondary outcomes were biochemical parameters and mortality at 28 days. The CP group were a higher risk group with higher ferritin levels (p < 0.05) though respiratory indices did not differ. The primary outcome measure was required in 6 controls and 4 patients on CP (risk ratio 0.67, 95% CI 0.22-2.0, p = 0.72); mean time on ventilation (NIV or MV) did not differ. There were no differences in secondary measures at the end of the study. Two patients died in the control and one patient in the CP arm. There were no significant differences in the primary or secondary outcome measures between CP and standard therapy, although a larger definitive study is needed for confirmation. However, the study did show that CP therapy appears to be safe in hospitalized COVID-19 patients with hypoxia.Clinical trials registration NCT04356534: 22/04/2020.


Subject(s)
COVID-19/therapy , Adult , Aged , COVID-19/mortality , COVID-19/pathology , COVID-19/virology , Female , Ferritins/metabolism , Humans , Immunization, Passive , Male , Middle Aged , Pilot Projects , Prospective Studies , Respiration, Artificial/statistics & numerical data , SARS-CoV-2/isolation & purification , Severity of Illness Index , Survival Rate , Treatment Outcome , COVID-19 Serotherapy
2.
Tex Heart Inst J ; 46(2): 124-127, 2019 Apr.
Article in English | MEDLINE | ID: mdl-31236077

ABSTRACT

Pheochromocytoma, a rare catecholamine-secreting tumor, typically manifests itself with paroxysmal hypertension, tachycardia, headache, and diaphoresis. Less often, symptoms related to substantial hemodynamic compromise and cardiogenic shock occur. We report the case of a 66-year-old woman who presented with abdominal pain. Examination revealed a large right adrenal mass, cardiogenic shock, and severe heart failure in the presence of normal coronary arteries. Within days, the patient's hemodynamic status and left ventricular ejection fraction improved markedly. Results of imaging and biochemical tests confirmed the diagnosis of pheochromocytoma-induced takotsubo cardiomyopathy. Medical therapy and right adrenalectomy resolved the patient's heart failure, and she was asymptomatic postoperatively. We recommend awareness of the link between pheochromocytoma and takotsubo cardiomyopathy, and we discuss relevant diagnostic and management principles.


Subject(s)
Adrenal Gland Neoplasms/complications , Pheochromocytoma/complications , Takotsubo Cardiomyopathy/etiology , Adrenal Gland Neoplasms/diagnosis , Adrenal Gland Neoplasms/surgery , Adrenalectomy , Aged , Diagnosis, Differential , Electrocardiography , Female , Humans , Magnetic Resonance Imaging, Cine/methods , Pheochromocytoma/diagnosis , Pheochromocytoma/surgery , Takotsubo Cardiomyopathy/diagnosis , Tomography, X-Ray Computed/methods
3.
Clin Case Rep ; 7(5): 1053-1056, 2019 May.
Article in English | MEDLINE | ID: mdl-31110744

ABSTRACT

Transformation of lymphoma is an infrequent phenomenon, and involvement of the eye as such is even uncommon. Histological transformation in patients with follicular lymphoma who were previously treated with immune-chemotherapy carry a poor outcome. Here, we illustrate such a case with aggressive histological transformation from a low-grade lymphoma.

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