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Mancilla-Galindo J, Kammar-García A, Mendoza-Gertrudis MDL, García Acosta JM, Nava Serrano YS, Santiago O, Torres Vásquez MB, Martínez Martínez D, Fernández-Urrutia LA, Robledo Pascual JC, Narváez Morales ID, Velasco-Medina AA, Mancilla-Ramírez J, Figueroa-Damián R, Galindo-Sevilla N. Regional moderate hyperthermia for mild-to-moderate COVID-19 (TherMoCoV study): a randomized controlled trial. Front Med (Lausanne) 2023; 10:1256197. [PMID: 38188344 PMCID: PMC10766786 DOI: 10.3389/fmed.2023.1256197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
BackgroundTo prevent COVID-19 progression, low-cost alternatives that are available to all patients are needed. Diverse forms of thermotherapy have been proposed to prevent progression to severe/critical COVID-19.ObjectiveThe aim of this study is to evaluate the efficacy and safety of local thermotherapy to prevent disease progression in hospitalized adult patients with mild-to-moderate COVID-19.MethodsA multicenter, open-label, parallel-group, randomized, adaptive trial is used to evaluate the efficacy and safety of local thermotherapy to prevent disease progression in hospitalized adult patients with mild-to-moderate COVID-19. Eligible hospitalized adult patients with symptoms of COVID-19 with ≤5 days from symptom onset, meeting criteria for mild or moderate COVID-19, were randomly assigned to the intervention consisting of local thermotherapy via an electric heat pad in the thorax (target temperature range 39.5–42°C) continuously for 90 min, twice daily, for 5 days, or standard care. The main outcome was the proportion of patients who progressed to severe-to-critical COVID-19 or death. Patients were randomized in a 1:1 ratio through a centralized computer-generated sequence of minimization with a random component of 20%. Participants and medical staff were not blinded to the intervention.ResultsOne-hundred and five participants (thermotherapy n = 54, control n = 51) with a median age of 53 (IQR: 41–64) years were included for analysis after the early cessation of recruitment due to the closure of all temporal COVID-19 units (target sample size = 274). The primary outcome of disease progression occurred in 31.4% (16/51) of patients in the control group vs. 25.9% (14/54) of those receiving thermotherapy (risk difference = 5.5%; 95%CI: −11.8–22.7, p = 0.54). Thermotherapy was well tolerated with a median total duration of thermotherapy of 900 (IQR: 877.5–900) min. Seven (13.7%) patients in the control group and seven (12.9%) in the thermotherapy group had at least one AE (p = 0.9), none of which were causally attributed to the intervention. No statistically significant differences in serum cytokines (IL-1β, IL-6, IL-8, IL-10, IL-17, and IFN-γ) were observed between day 5 and baseline among groups.ConclusionLocal thermotherapy was safe and well-tolerated. A non-statistically significant lower proportion of patients who experienced disease progression was found in the thermotherapy group compared to standard care. Local thermotherapy could be further studied as a strategy to prevent disease progression in ambulatory settings.Clinical Trial registration: www.clinicaltrials.gov, identifier: NCT04363541.
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Affiliation(s)
- Javier Mancilla-Galindo
- División de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ashuin Kammar-García
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico
| | - María de Lourdes Mendoza-Gertrudis
- Servicio de Alergia e Inmunología Clínica, Hospital General de México, Mexico City, Mexico
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | | | - Yanira Saralee Nava Serrano
- Unidad Temporal COVID-19 Autónomo Hermanos Rodríguez, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Oscar Santiago
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Miriam Berenice Torres Vásquez
- División de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Departamento de Infectología e Inmunología, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Daniela Martínez Martínez
- División de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Departamento de Infectología e Inmunología, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Liliana Aline Fernández-Urrutia
- Departamento de Infectología e Inmunología, Instituto Nacional de Perinatología, Mexico City, Mexico
- St. Luke Medical School of Alliant International University, Mexico City, Mexico
| | | | | | - Andrea Aida Velasco-Medina
- Servicio de Alergia e Inmunología Clínica, Hospital General de México, Mexico City, Mexico
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Javier Mancilla-Ramírez
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
- Hospital de la Mujer, Secretaría de Salud, Mexico City, Mexico
| | - Ricardo Figueroa-Damián
- Departamento de Infectología e Inmunología, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Norma Galindo-Sevilla
- Departamento de Infectología e Inmunología, Instituto Nacional de Perinatología, Mexico City, Mexico
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Harapan H, Johar E, Maroef CN, Sriyani IY, Iqhrammullah M, Kusuma HI, Syukri M, Razali R, Hamdani H, Kurniawan R, Irwansyah I, Sofyan SE, Myint KS, Mahlia TI, Rizal S. Effect of elevated temperature on SARS-CoV-2 viability. F1000Res 2023; 11:403. [PMID: 37745627 PMCID: PMC10517306 DOI: 10.12688/f1000research.110305.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 09/26/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a worldwide disruption of global health putting healthcare workers at high risk. To reduce the transmission of SARS-CoV-2, in particular during treating the patients, our team aims to develop an optimized isolation chamber. The present study was conducted to evaluate the role of temperature elevation against SARS-CoV-2 viability, where the information would be used to build the isolation chamber. 0.6 mL of the Indonesian isolate of SARS-CoV-2 strain 20201012747 (approximately 10 13 PFU/mL) was incubated for one hour with a variation of temperatures: 25, 30, 35, 40, 45, 50, 55, 60, and 65°C in digital block heater as well as at room temperature (21-23°C) before used to infect Vero E6 cells. The viability was determined using a plaque assay. Our data found a significant reduction of the viral viability from 10 13 PFU/mL to 10 9 PFU/mL after the room temperature was increase to 40°C. Further elevation revealed that 55°C and above resulted in the total elimination of the viral viability. Increasing the temperature 40°C to reduce the SARS-CoV-2 survival could create mild hyperthermia conditions in a patient which could act as a thermotherapy. In addition, according to our findings, thermal sterilization of the vacant isolation chamber could be conducted by increasing the temperature to 55°C. In conclusion, elevating the temperature of the isolation chamber could be one of the main variables for developing an optimized isolation chamber for COVID-19 patients.
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Affiliation(s)
- Harapan Harapan
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
| | - Edison Johar
- Eijkman Institute for Molecular Biology, Jakarta, 10430, Indonesia
| | | | - Ida Yus Sriyani
- Eijkman Institute for Molecular Biology, Jakarta, 10430, Indonesia
| | - Muhammad Iqhrammullah
- Graduate School of Mathematics and Applied Sciences, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
| | - Hendrix Indra Kusuma
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
- Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
| | - Maimun Syukri
- Department of Internal Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
| | - Razali Razali
- Department of Mechanical and Industrial Engineering, Faculty of Engineering, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
| | - Hamdani Hamdani
- Department of Mechanical and Industrial Engineering, Faculty of Engineering, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
| | - Rudi Kurniawan
- Department of Mechanical and Industrial Engineering, Faculty of Engineering, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
| | - Irwansyah Irwansyah
- Department of Mechanical and Industrial Engineering, Faculty of Engineering, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
| | - Sarwo Edhy Sofyan
- Department of Mechanical and Industrial Engineering, Faculty of Engineering, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
| | - Khin Saw Myint
- Eijkman Institute for Molecular Biology, Jakarta, 10430, Indonesia
| | - T.M. Indra Mahlia
- School of Civil and Environmental Engineering, University of Technology Sydney, Ultimo, Sydney, NSW 2007, Australia
| | - Samsul Rizal
- Department of Mechanical and Industrial Engineering, Faculty of Engineering, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
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Xue Y, Wang Z, Dutta A, Chen X, Gao P, Li R, Yan J, Niu G, Wang Y, Du S, Cheng H, Yang L. Superhydrophobic, stretchable kirigami pencil-on-paper multifunctional device platform. CHEMICAL ENGINEERING JOURNAL (LAUSANNE, SWITZERLAND : 1996) 2023; 465:142774. [PMID: 37484163 PMCID: PMC10361402 DOI: 10.1016/j.cej.2023.142774] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Wearable electronics with applications in healthcare, human-machine interfaces, and robotics often explore complex manufacturing procedures and are not disposable. Although the use of conductive pencil patterns on cellulose paper provides inexpensive, disposable sensors, they have limited stretchability and are easily affected by variations in the ambient environment. This work presents the combination of pencil-on-paper with the hydrophobic fumed SiO2 (Hf-SiO2) coating and stretchable kirigami structures from laser cutting to prepare a superhydrophobic, stretchable pencil-on-paper multifunctional sensing platform. The resulting sensor exhibits a large response to NO2 gas at elevated temperature from self-heating, which is minimally affected by the variations in the ambient temperature and relative humidity, as well as mechanical deformations such as bending and stretching states. The integrated temperature sensor and electrodes with the sensing platform can accurately detect temperature and electrophysiological signals to alert for adverse thermal effects and cardiopulmonary diseases. The thermal therapy and electrical stimulation provided by the platform can also deliver effective means to battle against inflammation/infection and treat chronic wounds. The superhydrophobic pencil-onpaper multifunctional device platform provides a low-cost, disposable solution to disease diagnostic confirmation and early treatment for personal and population health.
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Affiliation(s)
- Ye Xue
- State Key Laboratory of Reliability and Intelligence of Electrical Equipment, School of Health Sciences and Biomedical Engineering, Hebei University of Technology, Tianjin 300130, China
| | - Zihan Wang
- State Key Laboratory for Reliability and Intelligence of Electrical Equipment, Hebei Key Laboratory of Smart Sensing and Human-Robot Interaction, School of Mechanical Engineering, Hebei University of Technology, Tianjin 300401, China
| | - Ankan Dutta
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, 16802, USA
| | - Xue Chen
- State Key Laboratory of Reliability and Intelligence of Electrical Equipment, Key Laboratory of Bioelectromagnetics and Neuroengineering of Hebei Province, School of Electrical Engineering, Hebei University of Technology, Tianjin 300130, China
| | - Peng Gao
- Department of Electronic Information, Hebei University of Technology, Tianjin, 300130, China
| | - Runze Li
- State Key Laboratory of Reliability and Intelligence of Electrical Equipment, Key Laboratory of Bioelectromagnetics and Neuroengineering of Hebei Province, School of Electrical Engineering, Hebei University of Technology, Tianjin 300130, China
| | - Jiayi Yan
- State Key Laboratory for Reliability and Intelligence of Electrical Equipment, Hebei Key Laboratory of Smart Sensing and Human-Robot Interaction, School of Mechanical Engineering, Hebei University of Technology, Tianjin 300401, China
| | - Guangyu Niu
- Department of Architecture and Art, Hebei University of Technology, Tianjin, 300130, China
| | - Ya Wang
- State Key Laboratory for Reliability and Intelligence of Electrical Equipment, Hebei Key Laboratory of Smart Sensing and Human-Robot Interaction, School of Mechanical Engineering, Hebei University of Technology, Tianjin 300401, China
| | - Shuaijie Du
- State Key Laboratory of Reliability and Intelligence of Electrical Equipment, Key Laboratory of Bioelectromagnetics and Neuroengineering of Hebei Province, School of Electrical Engineering, Hebei University of Technology, Tianjin 300130, China
| | - Huanyu Cheng
- Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, 16802, USA
| | - Li Yang
- State Key Laboratory of Reliability and Intelligence of Electrical Equipment, School of Health Sciences and Biomedical Engineering, Hebei University of Technology, Tianjin 300130, China
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Li Z, Li Q, Wang X, Chen W, Jin X, Liu X, Ye F, Dai Z, Zheng X, Li P, Sun C, Liu X, Zhang Q, Luo H, Liu R. Hyperthermia ablation combined with transarterial chemoembolization versus monotherapy for hepatocellular carcinoma: A systematic review and meta-analysis. Cancer Med 2021; 10:8432-8450. [PMID: 34655179 PMCID: PMC8633247 DOI: 10.1002/cam4.4350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/15/2021] [Accepted: 10/03/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND AIMS The existing evidence has indicated that hyperthermia ablation (HA) and HA combined with transarterial chemoembolization (HATACE) are the optimal alternative to surgical resection for patients with hepatocellular carcinoma (HCC) in the COVID-19 crisis. However, the evidence for decision-making is lacking in terms of comparison between HA and HATACE. Herein, a comprehensive evaluation was performed to compare the efficacy and safety of HATACE with monotherapy. MATERIALS AND METHODS Worldwide studies were collected to evaluate the HATACE regimen for HCC due to the practical need for global extrapolation of applicative population. Meta-analyses were performed using the RevMan 5.3 software (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). RESULTS Thirty-six studies involving a large sample of 5036 patients were included finally. Compared with HA alone, HATACE produced the advantage of 5-year overall survival (OS) rate (OR:1.90; 95%CI:1.46,2.46; p < 0.05) without increasing toxicity (p ≥ 0.05). Compared with TACE alone, HATACE was associated with superior 5-year OS rate (OR:3.54; 95%CI:1.96,6.37; p < 0.05) and significantly reduced the incidences of severe liver damage (OR:0.32; 95%CI:0.11,0.96; p < 0.05) and ascites (OR:0.42; 95%CI:0.20,0.88; p < 0.05). Subgroup analysis results of small (≤3 cm) HCC revealed that there were no significant differences between the HATACE group and HA monotherapy group in regard to the OS rates (p ≥ 0.05). CONCLUSIONS Compared with TACE alone, HATACE was more effective and safe for HCC. Compared with HA alone, HATACE was more effective for non-small-sized (>3 cm) HCC with comparable safety. However, the survival benefit of adjuvant TACE in HATACE regimen was not found for the patients with small (≤3 cm) HCC.
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