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1. INTERNATIONAL DIFFERENCES IN FACTORS AFFECTING LABOUR MOBILITY.

Author

International Labour Organisation, Geneva (Switzerland)., SELLIER, F., and ZARKA, C.

Abstract

THE GEOGRAPHICAL, OCCUPATIONAL, AND INTERFIRM MOBILITY, AND THE FACTORS AFFECTING THESE MOVEMENTS FOR WORKERS IN FRANCE, ITALY, GERMANY, AND SWEDEN IN THE PERIOD SINCE THE SECOND WORLD WAR ARE STUDIED. DATA OBTAINED FROM INDUSTRIAL SURVEYS AND GENERAL CENSUSES WERE USED TO COMPARE THE FOUR COUNTRIES WITH EACH OTHER AND WITH THE UNITED STATES. INDUSTRIALIZED WESTERN EUROPE NOW EXPORTS LITTLE MANPOWER TO OTHER CONTINENTS AND, IN FACT, IMPORTS FOREIGN WORKERS FROM AFRICA OR MEDITERRANEAN EUROPE. THE INTERNAL MIGRATIONS IN THE UNITED STATES AND THE FEDERAL REPUBLIC OF GERMANY HAVE BEEN SIMILAR WITH SOMEWHAT LESS MIGRATION IN FRANCE AND ITALY. ALLOWING FOR THE DIFFICULTIES INHERENT IN INTERNATIONAL COMPARISONS, IT APPEARS THAT OCCUPATIONAL MOBILITY IS NO HIGHER IN THE UNITED STATES THAN IN THE EUROPEAN COUNTRIES. THE MOBILITY RATES BETWEEN FIRMS ARE SIMILAR IN GERMANY AND THE UNITED STATES, BUT SWEDEN HAS HIGHER AND ITALY AND FRANCE LOWER RATES THAN THE UNITED STATES AND GERMANY. FACTORS AFFECTING GEOGRAPHICAL MOBILITY WERE REGIONAL WAGE DIFFERENTIALS, REGIONAL DIFFERENCES IN UNEMPLOYMENT, AVAILABILITY OF HOUSING, AND CHANGE IN TRADE UNION ATTITUDES. THE APPENDIX PRESENTS 12 STUDIES OF SPECIFIC CASES OF LABOR MOBILITY IN FIRMS IN FRANCE, WEST GERMANY, AND ITALY. (HC)

Published
1966

2. Intravenous immunoglobulins in patients with COVID-19-associated moderate-to-severe acute respiratory distress syndrome (ICAR): multicentre, double-blind, placebo-controlled, phase 3 trial.

Author

Mazeraud, Aurélien, Jamme, Matthieu, Mancusi, Rossella Letizia, Latroche, Claire, Megarbane, Bruno, Siami, Shidasp, Zarka, Jonathan, Moneger, Guy, Santoli, Francesco, Argaud, Laurent, Chillet, Patrick, Muller, Gregoire, Bruel, Cedric, Asfar, Pierre, Beloncle, Francois, Reignier, Jean, Vinsonneau, Christophe, Schimpf, Caroline, Amour, Julien, and Goulenok, Cyril

Subjects
ADULT respiratory distress syndrome, INTRAVENOUS immunoglobulins, ARTIFICIAL respiration
Abstract

Acute respiratory distress syndrome (ARDS) is a major complication of COVID-19 and is associated with high mortality and morbidity. We aimed to assess whether intravenous immunoglobulins (IVIG) could improve outcomes by reducing inflammation-mediated lung injury. In this multicentre, double-blind, placebo-controlled trial, done at 43 centres in France, we randomly assigned patients (1:1) receiving invasive mechanical ventilation for up to 72 h with PCR confirmed COVID-19 and associated moderate-to-severe ARDS to receive either IVIG (2 g/kg over 4 days) or placebo. Random assignment was done with a web-based system and was stratified according to the participating centre and the duration of invasive mechanical ventilation before inclusion in the trial (<12 h, 12–24 h, and >24–72 h), and treatment was administered within the first 96 h of invasive mechanical ventilation. To minimise the risk of adverse events, the IVIG administration was divided into four perfusions of 0·5 g/kg each administered over at least 8 hours. Patients in the placebo group received an equivalent volume of sodium chloride 0·9% (10 mL/kg) over the same period. The primary outcome was the number of ventilation-free days by day 28, assessed according to the intention-to-treat principle. This trial was registered on ClinicalTrials.gov , NCT04350580. Between April 3, and October 20, 2020, 146 patients (43 [29%] women) were eligible for inclusion and randomly assigned: 69 (47%) patients to the IVIG group and 77 (53%) to the placebo group. The intention-to-treat analysis showed no statistical difference in the median number of ventilation-free days at day 28 between the IVIG group (0·0 [IQR 0·0–8·0]) and the placebo group (0·0 [0·0–6·0]; difference estimate 0·0 [0·0–0·0]; p=0·21). Serious adverse events were more frequent in the IVIG group (78 events in 22 [32%] patients) than in the placebo group (47 events in 15 [20%] patients; p=0·089). In patients with COVID-19 who received invasive mechanical ventilation for moderate-to-severe ARDS, IVIG did not improve clinical outcomes at day 28 and tended to be associated with an increased frequency of serious adverse events, although not significant. The effect of IVIGs on earlier disease stages of COVID-19 should be assessed in future trials. Programme Hospitalier de Recherche Clinique. [ABSTRACT FROM AUTHOR]

Published
2022
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