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Franchini M, Focosi D, Percivalle E, Beccaria M, Garuti M, Arar O, Pecoriello A, Spreafico F, Greco G, Bertacco S, Ghirardini M, Santini T, Schiavulli M, Stefania M, Gagliardo T, Sammartino JC, Ferrari A, Zani M, Ballotari A, Glingani C, Baldanti F. Variant of Concern-Matched COVID-19 Convalescent Plasma Usage in Seronegative Hospitalized Patients. Viruses 2022; 14:v14071443. [PMID: 35891421 PMCID: PMC9323140 DOI: 10.3390/v14071443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/08/2022] [Accepted: 06/27/2022] [Indexed: 12/24/2022] Open
Abstract
COVID-19 convalescent plasma (CCP) has been the only specific anti-viral therapy against SARS-CoV-2 available for more than one year. Following the negative results from most randomized controlled trials on its efficacy in COVID-19 hospitalized patients and the availability of anti-spike monoclonal antibodies (mAbs), the use of CCP has subsequently rapidly faded. However, the continuous appearance of new variants of concern (VOCs), most of which escape mAbs and vaccine-elicited neutralizing antibodies (nAbs), has renewed the interest towards CCP, at least in seronegative immunocompetent patients, and in immunocompromised patients not able to mount a protective immune response. We report here the experience of a single Italian hospital in collecting and transfusing CCP in immunocompromised patients hospitalized for severe COVID-19 between October 2021 and March 2022. During this 6-month period, we collected CCP from 32 vaccinated and convalescent regular blood donors, and infused high nAb-titer CCP units (titered against the specific VOC affecting the recipient) to 21 hospitalized patients with severe COVID-19, all of them seronegative at the time of CCP transfusion. Patients’ median age was 66 years (IQR 50–74 years) and approximately half of them (47.6%, 10/21) were immunocompromised. Two patients were rescued after previous failure of mAbs. No adverse reactions following CCP transfusion were recorded. A 28-day mortality rate of 14.3 percent (3/21) was reported, with age, advanced disease stage and late CCP transfusion associated with a worse outcome. This real-life experience also supports the use of CCP in seronegative hospitalized COVID-19 patients during the Delta and Omicron waves.
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Affiliation(s)
- Massimo Franchini
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, 46100 Mantua, Italy; (M.Z.); (A.B.); (C.G.)
- Correspondence: ; Tel.: +39-0509-96541; Fax: +39-0376-220144
| | - Daniele Focosi
- North-Western Tuscany Blood Bank, Pisa University Hospital, 56124 Pisa, Italy;
| | - Elena Percivalle
- Microbiology and Virology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (E.P.); (J.C.S.); (A.F.)
| | - Massimiliano Beccaria
- Intensive Care Respiratory Unit, Carlo Poma Hospital, 46100 Mantua, Italy; (M.B.); (M.G.); (O.A.); (A.P.); (F.S.); (G.G.); (S.B.)
| | - Martina Garuti
- Intensive Care Respiratory Unit, Carlo Poma Hospital, 46100 Mantua, Italy; (M.B.); (M.G.); (O.A.); (A.P.); (F.S.); (G.G.); (S.B.)
| | - Omar Arar
- Intensive Care Respiratory Unit, Carlo Poma Hospital, 46100 Mantua, Italy; (M.B.); (M.G.); (O.A.); (A.P.); (F.S.); (G.G.); (S.B.)
| | - Antonietta Pecoriello
- Intensive Care Respiratory Unit, Carlo Poma Hospital, 46100 Mantua, Italy; (M.B.); (M.G.); (O.A.); (A.P.); (F.S.); (G.G.); (S.B.)
| | - Fabio Spreafico
- Intensive Care Respiratory Unit, Carlo Poma Hospital, 46100 Mantua, Italy; (M.B.); (M.G.); (O.A.); (A.P.); (F.S.); (G.G.); (S.B.)
| | - Graziana Greco
- Intensive Care Respiratory Unit, Carlo Poma Hospital, 46100 Mantua, Italy; (M.B.); (M.G.); (O.A.); (A.P.); (F.S.); (G.G.); (S.B.)
| | - Stefano Bertacco
- Intensive Care Respiratory Unit, Carlo Poma Hospital, 46100 Mantua, Italy; (M.B.); (M.G.); (O.A.); (A.P.); (F.S.); (G.G.); (S.B.)
| | - Marco Ghirardini
- Department of Medicine, Carlo Poma Hospital, 46100 Mantua, Italy; (M.G.); (T.S.)
| | - Tiziana Santini
- Department of Medicine, Carlo Poma Hospital, 46100 Mantua, Italy; (M.G.); (T.S.)
| | - Michele Schiavulli
- Regional Reference Center for Coagulation Disorders, Santobono-Pausilipon Children’s Hospital, AORN, 80129 Naples, Italy;
| | - Muzzica Stefania
- Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children’s Hospital, AORN, 80129 Naples, Italy; (M.S.); (T.G.)
| | - Thaililja Gagliardo
- Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children’s Hospital, AORN, 80129 Naples, Italy; (M.S.); (T.G.)
| | - Josè Camilla Sammartino
- Microbiology and Virology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (E.P.); (J.C.S.); (A.F.)
| | - Alessandro Ferrari
- Microbiology and Virology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (E.P.); (J.C.S.); (A.F.)
| | - Matteo Zani
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, 46100 Mantua, Italy; (M.Z.); (A.B.); (C.G.)
| | - Alessia Ballotari
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, 46100 Mantua, Italy; (M.Z.); (A.B.); (C.G.)
| | - Claudia Glingani
- Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, 46100 Mantua, Italy; (M.Z.); (A.B.); (C.G.)
| | - Fausto Baldanti
- Microbiology and Virology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (E.P.); (J.C.S.); (A.F.)
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
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Arar O, Boni F, Meschi T, Tana C. Pulmonary Sarcoidosis Presenting with Miliary Opacities. Curr Med Imaging 2020; 15:81-83. [PMID: 31964332 DOI: 10.2174/1573405614666180806141415] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/02/2018] [Accepted: 07/04/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Lung lesions often appear in patients with sarcoidosis; however, miliary opacities are rare. We present the case of a 55-year-old Indian man who presented with dyspnea and low-grade fever. DISCUSSION Miliary Tuberculosis (TB) was initially suspected, despite the direct microscopic examination from bronchoalveolar lavage was negative for acid-fast bacilli because imaging showed miliary opacities, and transbronchial lung biopsy revealed the presence of typical caseating granulomas. Antitubercular treatment with the classic four-drug regimen was initiated. However, the patient did not improve and cultures were negative for Mycobacterium growth. The diagnosis of sarcoidosis was made only after a negative culture and clinical and histopathological re-evaluation of the case. CONCLUSION Although miliary sarcoidosis is rare, physicians should consider sarcoidosis in the differential diagnosis with conditions like tuberculosis, malignancy, and pneumoconiosis when patients present with miliary opacities who do not respond to the traditional treatment.
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Affiliation(s)
- Omar Arar
- Internal Medicine Unit, Medical Department, Guastalla Hospital, AUSL Reggio Emilia, Reggio Emilia, Italy
| | - Fabrizio Boni
- Internal Medicine Unit, Medical Department, Guastalla Hospital, AUSL Reggio Emilia, Reggio Emilia, Italy
| | - Tiziana Meschi
- Internal Medicine and Critical Subacute Care Unit, Medicine Geriatric-Rehabilitation Department, University-Hospital of Parma, Parma, Italy
| | - Claudio Tana
- Internal Medicine and Critical Subacute Care Unit, Medicine Geriatric-Rehabilitation Department, University-Hospital of Parma, Parma, Italy
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Baida F, Belkhir A, Arar O, Barakat E, Dahdah J, Chemrouk C, Van Labeke D, Diebold C, Perry N, Bernal MP. Enhanced optical transmission by light coaxing: Mechanism of the TEM-mode excitation. Micron 2010; 41:742-5. [DOI: 10.1016/j.micron.2010.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Revised: 06/18/2010] [Accepted: 06/18/2010] [Indexed: 11/26/2022]
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Belkhir A, Arar O, Benabbes SS, Lamrous O, Baida FI. Implementation of dispersion models in the split-field-finite-difference-time-domain algorithm for the study of metallic periodic structures at oblique incidence. Phys Rev E Stat Nonlin Soft Matter Phys 2010; 81:046705. [PMID: 20481858 DOI: 10.1103/physreve.81.046705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 02/22/2010] [Indexed: 05/29/2023]
Abstract
We extend here the finite-difference-time-domain (FDTD) algorithm working in oblique incidence to dispersive media. The split-field method (SFM) is used and adapted for taking into account the metal dispersion. The additional equations to the FDTD algorithm are given. Instead of the 24 field components usually used in the SFM, 38 and 112 field components are needed to implement the cases of Drude and Drude-Lorentz dispersion models, respectively. Some tests are presented to validate our code as long as the angle of incidence is lower than 76 degrees in addition to an application dealing with enhanced transmission and showing original results.
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Affiliation(s)
- A Belkhir
- Laboratoire de Physique et Chimie Quantique, Université Mouloud Mammeri, Tizi-Ouzou, Algeria
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Caramori G, Calia N, Pasquini C, Arar O, Ravenna F, Guzzinati I, Boniotti A, Cavazzini L, Ciaccia A, Cavallesco G, Papi A. Ectopic thymoma simulating a pericardial cyst. Monaldi Arch Chest Dis 2005; 63:230-3. [PMID: 16454223 DOI: 10.4081/monaldi.2005.625] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We present a case of a 53 year old man with a thymoma near the pericardium, a rare ectopic localisation of thymoma. A round radiodensity found at the right cardiophrenic angle was initially suspected at the echocardiography to be a pericardial cyst. The diagnosis of thymoma was made only after histopathological examination of the surgically re-sected lesion.
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Affiliation(s)
- G Caramori
- Dipartimento di Medicina Clinica e Sperimentale, Sezione di Malattie dell'Apparato Respiratorio, University of Ferrara, Italy.
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Caramori G, Fabbri M, Paioli D, Falcone F, Severino C, Felisatti G, Arar O, Adcock IM, Fan Chung K, Barnes PJ, Ciaccia A, Papi A. Asthma is not a common cause of severe chronic respiratory failure in non-smokers: ALOT study. Monaldi Arch Chest Dis 2005; 63:84-7. [PMID: 16128222 DOI: 10.4081/monaldi.2005.643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Little is known about the long-term natural history of asthma and the long-term clinical and functional consequences in non-smoking patients. From a functional point of view, non-smoking asthmatic patients may have a significantly greater decline in forced expiratory volume in one second (FEV1) compared with non-asthmatic subjects and may develop chronic irreversible (fixed) airflow limitation. This has been related to the physiological consequences of chronic airway inflammation causing airway remodeling. However these lesions are all potentially reversible and there is little radiological evidence indicating lung destruction (pulmonary emphysema), which is potentially irreversible, in non-smoking asthmatics. Severe chronic respiratory failure is the major cause of mortality in patients with severe chronic lung diseases. Domiciliary long-term oxygen therapy (LTOT) is an accepted treatment for patients with severe chronic respiratory failure. Our reasoning, therefore, was that if asthma is a cause of severe chronic respiratory failure in non-smokers we should be able to find non-smoking asthmatics within a large population of patients on LTOT. The aim of our study (Asthma and Long-term Oxygen Therapy, "ALOT") was to investigate the prevalence of non-smoking asthmatics in patients on LTOT in a multi-centre, cross-sectional study. METHODS Between June and September 2003 we screened all subjects on long-term domiciliary oxygen therapy in three different hospitals in the North-East area of Italy (within the provinces of Ferrara and Bologna). Taken collectively, we have found one-hundred and eighty-four patients on LTOT. We have reviewed their clinical data (age, sex, smoking, history and physical examination, arterial blood gas analysis, pulmonary function). RESULTS 114 patients (all smokers) fulfilled the diagnostic criteria for COPD. Seventy patients (all smokers) had other diseases. We were unable to find any non-smokers in our screened population of subjects on long-term domiciliary oxygen therapy. Furthermore, there was no past history of asthma and/or acute wheezing episodes in either of the patient groups. CONCLUSIONS This data suggests that asthma is an uncommon cause of severe chronic respiratory failure necessitating long-term domiciliary oxygen therapy in non-smokers and supports the current consensus that asthma and COPD are different diseases with differing stages of severity and the concept that long-term avoidance of active smoking is fundamental for the prevention of severe chronic respiratory failure.
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Affiliation(s)
- G Caramori
- Centro di Ricerca su Asma e BPCO, Università di Ferrara, Italy.
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Abstract
OBJECTIVE To analyze the impact of 2 systematic transition zone (TZ) biopsies in addition to systematic sextant biopsies in an effort to establish the importance of cancer detected in the transition zone. METHODS Between November 1995 and October 1996, TRUS-guided systematic sextant peripheral zone (PZ) and two additional TZ biopsies were performed on 189 consecutive men. Radical retropubic prostatectomy (RRP) was performed to 13 patients with organ-confined prostate cancer. The biopsy results of the 52 patients with cancer and the pathological specimens of the patients who underwent surgery were compared. RESULTS Of the 189 patients, 52 (27.5%) had prostate cancer of whom 20 (38.5%) both in the PZ and TZ, 31 (59.6%) only in the PZ, and 1 (1.9%) in the TZ only. Of the 96 patients with high serum PSA levels despite normal DRE, 14 had prostate cancer. TZ cancer only rate was 7.1% (1 in 14 patients) in this group. RRP was performed to 8 patients who had cancer only in the PZ and 5 patients in both TZ and PZ. The pathological stages of the postoperative specimens and extracapsular extension rates of those with cancer in the PZ and TZ were significantly higher (p = 0.029 and p = 0.008, respectively). CONCLUSIONS Routine TZ biopsy does not substantially increase the prostate cancer detection rate, however it can be useful in selected patient groups. If further studies reveal the relationship of cancer in the transition zone, higher capsular extension rate (pT3 cancer) and higher pathological stage after radical surgery, then TZ biopsies may yield additional information that might influence the therapeutic approach.
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Affiliation(s)
- A U Onder
- Department of Urology, Cerrahpasa School of Medicine, Istanbul University, Turkey
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Kural AR, Demirkesen O, Arar O, Onder AU, Yalçin V, Solok V. Modified "pluck" nephroureterectomy for upper urinary tract disorders: combined endourologic and open approach. J Endourol 1997; 11:131-4. [PMID: 9107587 DOI: 10.1089/end.1997.11.131] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Nephroureterectomy is the standard surgical approach for upper urinary tract transitional-cell carcinoma (TCC) and many other conditions. In 1952, a modification of the conventional method was described in which a transurethral resection of the ureteral meatus and intramural ureter is undertaken until the remaining ureter has no attachment to the bladder. The resected area and the distal tip of the ureter are coagulated, and the ureter is removed in continuity with the kidney through a single flank incision. Since January 1990, we have performed 12 nephroureterectomies with this technique (9 men and 3 women with an average age of 61.8 years, ranging from 35 to 73). Six of them were operated on for a TCC of the upper urinary tract, and the postoperative follow-up of these patients was from 6 to 54 months (mean 18.6). Within the follow-up period, tumor has not recurred either at the resected trigonal area or in the retroperitoneum, and only one patient has had a tumor distant from the site of ureteric resection. One patient with bladder TCC, who had a suspect kidney mass on the left side detected by CT, underwent nephroureterectomy with this technique. Five patients had primary renal disorders and upper tract calculous problems, in which nephroureterectomy was required. After the transurethral resection, an indwelling catheter was left in the bladder for 4 days. We believe that our experience confirms the feasibility of this technique in order to improve and simplify nephroureterectomy. Therefore, we recommend the modified "pluck" technique in all patients who are candidates for an operation requiring nephroureterectomy, as it gives considerable benefit to the patient.
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Affiliation(s)
- A R Kural
- Department of Urology, Cerrahpasa Medical School, University of Istanbul, Turkey
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