Writing Committee for the REMAP-CAP Investigators IMPORTANCE The evidence for benefit of convalescent plasma for critically ill patients with COVID-19 is inconclusive.OBJECTIVE To determine whether convalescent plasma would improve outcomes for critically ill adults with COVID-19. DESIGN, SETTING, AND PARTICIPANTSThe ongoing Randomized, Embedded, Multifactorial, Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP) enrolled and randomized 4763 adults with suspected or confirmed COVID-19 between March 9, 2020, and January 18, 2021, within at least 1 domain; 2011 critically ill adults were randomized to open-label interventions in the immunoglobulin domain at 129 sites in 4 countries. Follow-up ended on April 19, 2021. INTERVENTIONSThe immunoglobulin domain randomized participants to receive 2 units of high-titer, ABO-compatible convalescent plasma (total volume of 550 mL ± 150 mL) within 48 hours of randomization (n = 1084) or no convalescent plasma (n = 916). MAIN OUTCOMES AND MEASURESThe primary ordinal end point was organ support-free days (days alive and free of intensive care unit-based organ support) up to day 21 (range, −1 to 21 days; patients who died were assigned -1 day). The primary analysis was an adjusted bayesian cumulative logistic model. Superiority was defined as the posterior probability of an odds ratio (OR) greater than 1 (threshold for trial conclusion of superiority >99%). Futility was defined as the posterior probability of an OR less than 1.2 (threshold for trial conclusion of futility >95%). An OR greater than 1 represented improved survival, more organ support-free days, or both. The prespecified secondary outcomes included in-hospital survival; 28-day survival; 90-day survival; respiratory support-free days; cardiovascular support-free days; progression to invasive mechanical ventilation, extracorporeal mechanical oxygenation, or death; intensive care unit length of stay; hospital length of stay; World Health Organization ordinal scale score at day 14; venous thromboembolic events at 90 days; and serious adverse events. RESULTS Among the 2011 participants who were randomized (median age, 61 [IQR, 52 to 70] years and 645/1998 [32.3%] women), 1990 (99%) completed the trial. The convalescent plasma intervention was stopped after the prespecified criterion for futility was met. The median number of organ support-free days was 0 (IQR, -1 to 16) in the convalescent plasma group and 3 (IQR, -1 to 16) in the no convalescent plasma group. The in-hospital mortality rate was 37.3% (401/1075) for the convalescent plasma group and 38.4% (347/904) for the no convalescent plasma group and the median number of days alive and free of organ support was 14 (IQR, 3 to 18) and 14 (IQR, 7 to 18), respectively. The median-adjusted OR was 0.97 (95% credible interval, 0.83 to 1.15) and the posterior probability of futility (OR <1.2) was 99.4% for the convalescent plasma group compared with the no convalescent plasma group. The treatment effects were consistent across the primary outcome and the 11...

These results suggest the HTS is effective for alleviating pain and improving physical performance in women with risk factors for knee OA. However, the HTS does not appear to be superior to low-load resistance training for improving muscle strength, pain relief, or physical function. This clinical trial was registered at clinicaltrials.gov (study ID NCT02802878).

and electromyography, is a proved toxic effect of this drug? The third theme is clinical observation. Surprisingly, the chapter on gout makes no mention of indomethacin (referred to elsewhere in the book) or allopurinol. Debatable points include the statement that the arthritis of ulcerative colitis never precedes bowel symptoms (contradicted elsewhere in the book) and that a full range of passive shoulder movements is retained in polymyalgia rheumatica. However, these are small criticisms of a book that supplies an up-to-date account of research in the arthritides but has little to offer over standard textbooks on management of this group of diseases.

Book Reviews 941 and physicians, especially gastroenterologists and dermatologists, will be very grateful to him.The book is divided into two parts. Part 1 describes alimentary diseases with associated cutaneous manifestations, while Part 2 deals with some systemic diseases involving both the skin and the gut. It is clearly and concisely written and there is a very comprehensive list of references.The black and white photographs are very good indeed but perhaps 7a would have been better labelled 'erythema induratum' rather than 'papulonecrotic tuberculid'. In the section on Kaposi's sarcoma it is stated that the lesions are not tender, but most dermatologists would regard pain as being a prominent feature in this disorder.These are very minor criticisms and should in no way detract from the value of this book, which has been published at a very opportune moment when so much work is being done associating diseases of the skin with those of the gut. * R H MARTENThe Acute Abdomen for the Man on the Spot by J C Angell FRcs ppx+95 20s London: Pitman Medical 1965 This is an entertaining book, written in a conversational style by an informed, experienced, and enthusiastic surgeon. Approval grew as I read for he has a good sense of judgment with a kindly practical attitude to patients, colleagues, and himself. He is aware in emergencies of the influence of persons, environment, and time. The surgeon must keep his head, and always act in the interest of the patient.A chapter covering medical illnesses which mimic the acute abdomen shows knowledge and mature experience. This book is a 'must' for aspirants to the Membership or Fellowship, and for those in active practice.The review of perforations, infections, obstructions, injuries, affections of the biliary and pancreatic tracts, and a miscellany of urgencies is excellent. Acute diverticulitis, ulcerative colitis, and aortic aneurysms are touched on succinctly. The twisted ovarian cyst and rectus hrmatoma, abdominal symptoms arising from the urinary system and pregnancy are honourably mentioned. Eight types of free fluid in the abdomen are considered, and the need for an accurate history is emphasized. Amongst investigations, examination of the urine, vomit, faces, and an X-ray of the chest and abdomen are agreed to be necessary, but caution is advised on further laboratory investigations unless the results will be a deciding factor for or against operation. Treating shock before operation is stressed, and the failure of response in patients with hemorrhage and strangulation is noted. A sign of Crohn's disease is wasting of the muscles of the forearm or hand: why?This fine book, with Zachary Cope's 'Acute Abdomen in Rhyme', merits a place, not on the bookshelf, but on the table or bedside of practising medicos. 'Be widely read, thoroughly instructed, and always cautious' is its message. HAROLD DODD Assessment of Cerebral Palsy I -Muscle Function, Locomotion and Hand Function by K S Holt MD MRCP DCH pp vi+214 illustrated 40s London: Lloyd-Luke 1965Cerebral palsy is a compl...