Rationale and design of the PRAETORIAN-COVID trial:A double-blind, placebo-controlled randomized clinical trial with valsartan for PRevention of Acute rEspiraTORy dIstress syndrome in hospitAlized patieNts with SARS-COV-2 Infection Disease

There is much debate on the use of angiotensin receptor blockers (ARBs) in severe acute respiratory syndrome–coronavirus-2 (SARS-CoV-2)–infected patients. Although it has been suggested that ARBs might lead to a higher susceptibility and severity of SARS-CoV-2 infection, experimental data suggest that ARBs may reduce acute lung injury via blocking angiotensin-II–mediated pulmonary permeability, inflammation, and fibrosis. However, despite these hypotheses, specific studies on ARBs in SARS-CoV-2 patients are lacking. Methods: The PRAETORIAN-COVID trial is a multicenter, double-blind, placebo-controlled 1:1 randomized clinical trial in adult hospitalized SARS-CoV-2–infected patients (n = 651). The primary aim is to investigate the effect of the ARB valsartan compared to placebo on the composite end point of admission to an intensive care unit, mechanical ventilation, or death within 14 days of randomization. The active-treatment arm will receive valsartan in a dosage titrated to blood pressure up to a maximum of 160 mg bid, and the placebo arm will receive matching placebo. Treatment duration will be 14 days, or until the occurrence of the primary end point or until hospital discharge, if either of these occurs within 14 days. The trial is registered at clinicaltrials.gov (NCT04335786, 2020). The PRAETORIAN-COVID trial is a double-blind, placebo-controlled 1:1 randomized trial to assess the effect of valsartan compared to placebo on the occurrence of ICU admission, mechanical ventilation, and death in hospitalized SARS-CoV-2–infected patients. The results of this study might impact the treatment of SARS-CoV-2 patients globally

Oxidative Modifications of Rat Liver Cell Components During Fasciola hepatica Infection

The aim of this paper was to assess the influence of Fasciola hepatica infection on oxidative modifications of rat liver cell components such as proteins and lipids. Wistar rats were infected per os with 30 metacercariae of F. hepatica. Activities and concentrations of liver damage markers were determined in the 4th, 7th, and 10th week postinfection (wpi). A decrease in antioxidant capacity of the host liver, manifested by a decrease in total antioxidant status (TAS), was observed. Diminution of antioxidant abilities resulted in enhanced oxidative modifications of lipids and proteins. F. hepatica infection enhanced lipid peroxidation, which was visible in the statistically significant increase in the level of different lipid peroxidation products such as conjugated dienes (CDs), lipid hydroperoxides (LOOHs), malondialdehyde (MDA) and 4-hydroxynonenal (4-HNE). The level of protein modification markers in the rat liver was also significantly changed and the most intensified changes were observed at seventh week postinfection. Concentration of carbonyl groups and dityrosine was significantly increased, whereas the level of tryptophan and sulfhydryl and amino groups was decreased. Changes in the antioxidant abilities of the liver and in the lipid and protein structure of the cell components resulted in destruction of the function of the liver. F. hepatica infection was accompanied by raising serum activities of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) as markers of liver damage. A significant decrease in lysosomal as well as in the total activity of cathepsin B during fasciolosis was also observed

Analysis of injuries and causes of death in fatal farm-related incidents in Lower Silesia, Poland

Introduction. Workers in the agriculture sector are among the groups at the highest risk of fatal occupational injuries. The aim of study is to show the most common causes of farm-related deaths in Poland, with the circumstances, injuries sustained and mechanisms of death. Materials and methods. There were 109 (90.8%) males aged 19–81 and 11 females aged 19–73. 18.3% were over 60 years of age. There were 6 children (boys) aged between 2–6. A retrospective review was undertaken of 16,140 medico-legal autopsy reports by the Department of Forensic Medicine in Wroclaw between 1991–2011, which included 120 fatal farm-related incidents. The study protocol included gender, age, date and cause of death, all injuries found, circumstances and mechanism of death, place of death and blood alcohol concentration. Results. The most common (33/120; 27.5%) causes of death, both in men and women, were traffic accidents, the second being hit, crushed or buried by materials and falling objects. The most common injury was multi-organ damage (27/120; 22.5%), less common were cranio-cerebral injury (17/120; 14.2%) and thoracic blunt trauma (11/120; 9.2%). In multi-organ and thoracic traumas the mechanism of death was almost always exsanguinations. 85.3% of victims died at the place found. 37.2% of victims were drunk. Conclusion. In Poland, fatal injuries occurring in agriculture are mostly related to the misuse of transport and machinery. The main efforts to prevent accidents are engineering improvements, use of personal protective equipment, alcohol intake prevention and appropriate education of the workforce. Special prevention programmes should take gender and age differences into account