Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

The Functions of an Amputation Clinic

In an effort towards a more positive approach to the treatment and rehabilitation of the amputee, an Amputation Clinic was commenced at Groote Schuur Hospital in 1968. During this period 301 new amputees were seen and assisted in rehabilitation. The importance of psychological trauma and readjustment is emphasized and the necessity of getting these patients to feel themselves to be productive, and therefore useful, members of the community is stressed. In order for such a programme to be successful it is essential that co-ordination exist between the various services involved in the rehabilitation of the amputee. It is suggested that such a co-ordinated programme be instituted at all hospitals where appreciable numbers of amputations are carried out

Degradation of millimolar concentration of the herbicide dalapon (2,2-Dichloropropionic Acid) by rhizobium Sp isolated from soil

The herbicide Dalapon is widely used in agricultural areas and is persistent in ground water. A Rhizobium sp. was able to grow at 0.2 mM 2,2-dichloropropionic acid (2,2DCP), which was 100-fold lower than the concentration of the substrate routinely used. Apparently, no new dehalogenases are required to allow growth on this low concentration of 2,2DCP as judged by electrophoretic mobility of dehalogenase proteins in native-PAGE analysis and protein separation by anion-exchange column chromatography. The kinetic analysis suggested that the known dehalogenases were able to act efficiently on low concentrations of haloalkanoic acids. The amount of each dehalogenase, from cells grown on low substrate concentration was different compared to that seen at 20 mM 2,2DCP due to complex regulatory controls, which respond to the growth environment

Serum lactate and base deficit as predictors of mortality after ruptured abdominal aortic aneurysm repair.

OBJECTIVE Whole body hypoperfusion and lower torso ischaemia-reperfusion contribute to post-operative organ dysfunction in patients undergoing repair of ruptured abdominal aortic aneurysm (AAA). Serum lactate and base deficit are markers of tissue ischaemia and are used to assess the adequacy of resuscitation. This study examines the prognostic value of immediate post-operative levels of serum lactate and base deficit in ruptured AAA. METHODS Thirty patients (24 men and 6 women of median age 74, range 51-85, years) who survived to at least 12h after ruptured AAA repair were studied retrospectively. The relationship between immediate post-operative lactate, base deficit and mortality was determined. RESULTS Fifteen patients (50%) died, all from organ failure. An elevated lactate (>2.1 mmol/l) and base deficit ( or =4.0 mmol/l was 13 of 15 (87%) and 12 of 15 (80%), respectively, and base deficit or =4.0 mmol/l and base deficit or =-7 mmol/l were associated with a 4% probability of death. CONCLUSION These data demonstrate that an immediate post-operative serum lactate > or =4.0 mmol/l and base deficit < or =-7 mmol/l are good predictors of outcome after ruptured AAA repair. The prognostic value of these simple and inexpensive tests require corroboration in a larger prospective study