We tested several sample pre-treatment protocols for the study of oxygen isotope ratios in the phosphate phase of mammalian enamel of ten different fossil samples. We investigated the effect of different pre-treatment methods and the duration of the hydrogen fluoride treatment on enamel samples from skeletal phosphate with known δ18O values. The samples had been measured previously, so we could compare the ratios measured in our laboratory with the previous values to choose the best chemical preparation procedure. Four pre-soaking methods and two different time intervals of 2 mol dm−3 hydrogen fluoride treatment were compared during our experiments. In our experimental conditions, the distilled water wash and the 6 h of soaking in hydrogen fluoride gave the closest results to the expected δ-values. The steps of the tested preparation processes were repeated at least three times on each sample, so the reproducibility of the process could be also investigated.
Large randomized clinical trials in severe Coronavirus Disease 2019 (COVID-19) patients have proven efficacy of intravenous tocilizumab. Our aim was to describe the laboratory parameters predicting in-hospital mortality of patients with tocilizumab administration in COVID-19 associated cytokine release syndrome (CRS).
We evaluated high-dose (8 mg/kg) intravenous tocilizumab administration in severe and critically ill COVID-19 adult patients fulfilling predefined strict CRS criteria. A single-centre, prospective, observational cohort study was carried out among consecutive adult (≥18 years of age) in-patients with COVID-19 between April 1 and December 31, 2020. The primary endpoint was 28-day all-cause mortality. The changes in laboratory parameters from baseline on day 7 and 14 after administration of tocilizumab were analysed.
In total, 1801 patients were admitted to our centre during the study period. One hundred and six patients received tocilizumab, and among them 62 (58.5%) required intensive care unit admittance while 25 (23.6%) deceased. At day 7 after tocilizumab administration, inflammatory markers (CRP, IL-6, ferritin) and lactate dehydrogenase (LDH) values were significantly lower among survivors. Subsequently, at day 14, differences of IL-6 and LDH levels has become more pronounced between subgroups. Restoration of absolute lymphocyte count (ALC) by day 7 and 14 was insufficient among patients who died.
In our cohort, administration of high-dose tocilizumab for COVID-19 patients with CRS demonstrated clinical and sustained biochemical parameter improvement in 76.4%. In this patient population high and increasing LDH, IL-6, and low ALC levels had a predictive role for mortality.