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Abstract
PURPOSE OF REVIEW Given the epidemiology and demographic trends of diabetes mellitus and cataracts, ophthalmologists are likely to encounter patients with both comorbidities at an increasing frequency. Patients with diabetes represent a higher risk population than healthy patients for cataract surgery. In this review, we discuss key risks and risk-mitigation practices when performing cataract surgery on these patients. RECENT FINDINGS Patients with diabetes continue to represent a high-risk surgical population: Nagar et al. suggest a dose-dependent relationship may exist between number of intravitreal injections and likelihood of posterior capsular rupture. However, novel treatments are improving outcomes for patients with diabetes. Several studies have reported intracameral phenylephrine/ketorolac may reduce the incidence of post-operative cystoid macular edema while others have discussed the efficacy of pre-treatment and post-treatment with intravitreal bevacizumab on improving cataract surgery outcomes in patients with diabetic retinopathy. Pre-operatively, ophthalmologists should perform an enhanced evaluation, consider timing and lens selection decisions, and complete any appropriate pre-operative treatment. Peri-operatively, surgeons should be aware of pupillary dilation adjustments, combination surgery options, and potential complications. Post-operatively, clinicians should address pseudophakic cystoid macular edema, diabetic macular edema, diabetic retinopathy, and posterior capsular opacification.
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Affiliation(s)
| | - Christina A Mamalis
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX, 77030, USA
| | - Sumitra S Khandelwal
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, 1977 Butler Blvd, Houston, TX, 77030, USA.
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152
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Minuzzi LG, Seelaender M, Silva BSDA, Cunha EDBB, Deus MDC, Vasconcellos FTF, Marqueze LFB, Gadotti AC, Baena CP, Pereira T, Krüger K, Amaral ANM, Pinho RA, Lira FS. COVID-19 Outcome Relates With Circulating BDNF, According to Patient Adiposity and Age. Front Nutr 2021; 8:784429. [PMID: 34957187 PMCID: PMC8704131 DOI: 10.3389/fnut.2021.784429] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/11/2021] [Indexed: 12/28/2022] Open
Abstract
Background and Aims: We evaluated adipose tissue-derived hormones, body composition, serum metabolic profile, levels of brain-derived neurotrophic factor (BDNF), and the association of these parameters with the clinical outcome in patients with COVID-19. We sought to examine whether obesity, sex, and age influence the adipose tissue endocrine response to the disease. Methods: This prospective study investigated 145 hospitalized patients with COVID-19. Patients were categorized based on their body mass index (BMI), sex and age, and were also classified regarding their outcome after hospitalization as: (a) Non-ICU: patients hospitalized who did not receive intensive care; (b) ICU-survivor: patients admitted to the intensive care unit and discharged; (c) ICU-death: patients who died. Blood samples were collected by the hospital staff between the first and third day of hospitalization. Serum leptin, adiponectin and BDNF concentrations, triglycerides, total cholesterol and cholesterol fractions were performed following the manufacturer's guidelines. Results: We demonstrate that BDNF levels predict intensive care (IC) need (p < 0.01). This association was found to be stronger in patients >60y (p = 0.026). Neither leptin nor adiponectin concentration was associated with IC requirement or with patient's outcome, while the BDNF/adiponectin ratio was closely associated with worsened outcomes (p < 0.01). BDNF concentration was similar between sexes, however tended to be lower in male patients (p = 0.023). In older patients, BDNF concentration was lower than that of younger patients (p = 0.020). These age and sex-specific differences should be considered when employing these potential markers for prognosis assessment. While appetite and body composition regulating hormones secreted by the white adipose tissue are not reliable predictors of disease severity, the ratio BDNF/adiponectin was indicative of patient status. Conclusion: Thus, we propose that serum BDNF content and BDNF/adiponectin ratio may serve as tools predicting worsened prognosis in COVID-19, especially for male patients.
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Affiliation(s)
- Luciele Guerra Minuzzi
- Exercise and Immunometabolism Research Group, Postgraduation Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente, Brazil
| | - Marília Seelaender
- Cancer Metabolism Research Group, LIM26-HC, FMUSP, University of São Paulo, São Paulo, Brazil
| | - Bruna Spolador De Alencar Silva
- Exercise and Immunometabolism Research Group, Postgraduation Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente, Brazil
| | | | - Marina De Castro Deus
- Graduate Program in Health Sciences, School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil
| | | | - Luis Felipe Beltrão Marqueze
- Graduate Program in Health Sciences, School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil
| | - Ana Carolina Gadotti
- Graduate Program in Health Sciences, School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil
| | - Cristina Pellegrino Baena
- Graduate Program in Health Sciences, School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil
| | - Telmo Pereira
- Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal.,Laboratory for Applied Health Research (LabinSaúde), Coimbra, Portugal
| | - Karsten Krüger
- Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany
| | - Andréa Novais Moreno Amaral
- Graduate Program in Health Sciences, School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil
| | - Ricardo Aurino Pinho
- Graduate Program in Health Sciences, School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil
| | - Fábio Santos Lira
- Exercise and Immunometabolism Research Group, Postgraduation Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente, Brazil
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153
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Epidemiological Characteristics of Hospitalized Patients with Moderate versus Severe COVID-19 Infection: A Retrospective Cohort Single Centre Study. Diseases 2021; 10:diseases10010001. [PMID: 35076497 PMCID: PMC8788538 DOI: 10.3390/diseases10010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/11/2021] [Accepted: 12/17/2021] [Indexed: 12/15/2022] Open
Abstract
COVID-19 has a devastating impact worldwide. Recognizing factors that cause its progression is important for the utilization of appropriate resources and improving clinical outcomes. In this study, we aimed to identify the epidemiological and clinical characteristics of patients who were hospitalized with moderate versus severe COVID-19 illness. A single-center, retrospective cohort study was conducted between 3 March and 9 September 2020. Following the CDC guidelines, a two-category variable for COVID-19 severity (moderate versus severe) based on length of stay, need for intensive care or mechanical ventilation and mortality was developed. Data including demographic, clinical characteristics, laboratory parameters, therapeutic interventions and clinical outcomes were assessed using descriptive and inferential analysis. A total of 1002 patients were included, the majority were male (n = 646, 64.5%), Omani citizen (n = 770, 76.8%) and with an average age of 54.2 years. At the bivariate level, patients classified as severe were older (Mean = 55.2, SD = 16) than the moderate patients (Mean = 51.5, SD = 15.8). Diabetes mellitus was the only significant comorbidity potential factor that was more prevalent in severe patients than moderate (n = 321, 46.6%; versus n = 178, 42.4%; p < 0.001). Under the laboratory factors; total white cell count (WBC), C-reactive protein (CRP), Lactate dehydrogenase (LDH), D-dimer and corrected calcium were significant. All selected clinical characteristics and therapeutics were significant. At the multivariate level, under demographic factors, only nationality was significant and no significant comorbidity was identified. Three clinical factors were identified, including; sepsis, Acute respiratory disease syndrome (ARDS) and requirement of non-invasive ventilation (NIV). CRP and steroids were also identified under laboratory and therapeutic factors, respectively. Overall, our study identified only five factors from a total of eighteen proposed due to their significant values (p < 0.05) from the bivariate analysis. There are noticeable differences in levels of COVID-19 severity among nationalities. All the selected clinical and therapeutic factors were significant, implying that they should be a key priority when assessing severity in hospitalized COVID-19 patients. An elevated level of CRP may be a valuable early marker in predicting the progression in non-severe patients with COVID-19. Early recognition and intervention of these factors could ease the management of hospitalized COVID-19 patients and reduce case fatalities as well medical expenditure.
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154
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Im H, Ser J, Sim U, Cho H. Promising Expectations for Pneumococcal Vaccination during COVID-19. Vaccines (Basel) 2021; 9:1507. [PMID: 34960253 PMCID: PMC8708837 DOI: 10.3390/vaccines9121507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 02/07/2023] Open
Abstract
The emergence of new viral infections has increased over the decades. The novel virus is one such pathogen liable for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, popularly known as coronavirus disease 2019 (COVID-19). Most fatalities during the past century's influenza pandemics have cooperated with bacterial co/secondary infections. Unfortunately, many reports have claimed that bacterial co-infection is also predominant in COVID-19 patients (COVID-19 associated co/secondary infection prevalence is up to 45.0%). In the COVID-19 pandemic, Streptococcus pneumoniae is the most common coinfecting pathogen. Half of the COVID-19 mortality cases showed co-infection, and pneumonia-related COVID-19 mortality in patients >65 years was 23%. The weakening of immune function caused by COVID-19 remains a high-risk factor for pneumococcal disease. Pneumococcal disease and COVID-19 also have similar risk factors. For example, underlying medical conditions on COVID-19 and pneumococcal diseases increase the risk for severe illness at any age; COVID-19 is now considered a primary risk factor for pneumococcal pneumonia and invasive pneumococcal disease. Thus, pneumococcal vaccination during the COVID-19 pandemic has become more critical than ever. This review presents positive studies of pneumococcal vaccination in patients with COVID-19 and other medical conditions and the correlational effects of pneumococcal disease with COVID-19 to prevent morbidity and mortality from co/secondary infections and superinfections. It also reports the importance and role of pneumococcal vaccination during the current COVID-19 pandemic era to strengthen the global health system.
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Affiliation(s)
- Hyobin Im
- Marketing Department, Pfizer Pharmaceuticals Korea, Pfizer Tower 110, Seoul 04631, Korea;
| | - Jinhui Ser
- Department of School of Materials Science & Engineering, Chonnam National University, Yongbong-ro 77, Gwangju 61186, Korea;
| | - Uk Sim
- Department of School of Materials Science & Engineering, Chonnam National University, Yongbong-ro 77, Gwangju 61186, Korea;
- Research Institute, NEEL Science, Incorporation, Yongbong-ro 77, Gwangju 61186, Korea
| | - Hoonsung Cho
- Department of School of Materials Science & Engineering, Chonnam National University, Yongbong-ro 77, Gwangju 61186, Korea;
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155
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The effect of metformin on body mass index and metabolic parameters in non-diabetic HIV-positive patients: a meta-analysis. J Diabetes Metab Disord 2021; 20:1901-1911. [PMID: 34900832 DOI: 10.1007/s40200-021-00869-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
We sought to evaluate the effetc of metformin on body mass index (BMI) and metabolic parameters in HIV-positive patients. We performed a comprehensive search through five major indexing databases, using keywords ("metformin" OR "dimethylguanylguanidine" OR "biguanide" OR "Glucophage") AND ("HIV" OR "human immunodeficiency virus" OR "AIDS" OR "Acquired immunodeficiency syndrome"), and all possible combinations until January 15, 2021. We measured standardized mean differences (SMD) and 95% confidence intervals (CI) for each outcome. We finally included 12 RCTs (577 participants, 274 in the metformin group and 303 in the comparators). Metformin did not significantly change BMI index compared to various comparators. Metformin generally improve LDL levels (SMD = 0.29, 95% CI: - 1.00 1.57, P = 0.01), HDL levels (SMD = - 0.15, 95% CI: - 0.72 0.41, P = 0.001), triglycerides values (SMD = 0.46, 95% CI: - 0.36 1.27, P < 0.00001), fasting glucose (SMD = - 0.82, 95% CI: - 1.80 0.15, P < 0.00001), insulin 120 min (SMD = - 0.82, 95% CI: - 1.59-0.04, P = 0.02), and glucose 120 min (SMD = - 1.24, 95% CI: - 2.57 0.10, P < 0.0001), but worsened total cholesterol values (SMD = 1.24, 95% CI: - 0.98 3.46, P = 0.0001). Metformin is safe for weight loss in obese people; however, this drug may not be suitable for everyone, especially those who are not overweight. Nevertheless the body of evidences may suggest that metformin had promising impacts on metabolic parameters in patients with both HIV, it is still unknown that such surrogate changes will translate to long-standing clinical advantages. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-021-00869-1.
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156
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Evaluation of Antidiabetic Activity of Sargassum tenerrimum in Streptozotocin-Induced Diabetic Mice. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.4.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Diabetes mellitus has become the most predominant disease in most of the developing and developed countries. Diabetes could occur at any stage of life for which a change in sedentary life style is the possible solution. Despite the introduction of several medications, to curtail the side effects associated with diabetes mellitus, there is no medication or treatment for complete cure. Existing medications and treatments are targeted to mitigate the intensity of the disease which abruptly could result in organ failure. Rather than the available types of treatments, natural medication is reported to produce commendable results. Extracts of many medicinal plants and seaweeds have been documented to possess anti-diabetic properties. A brown alga, S. tenerrimum, found on the west coast of India, is chosen in this study to analyse the anti-diabetic property of its methanolic extract. This extract was used to treat streptozotocin-induced diabetic mice. An experimental design was framed based on acute toxicity studies to determine the change in blood glucose level, body weight, lipid profile, liver enzymes (SGPT and SGOT) and the renal function markers (urea and creatinine). After 15 days of treatment, an increase in body weight and HDL cholesterol was observed while the total cholesterol, VLDL, LDL, serum triglyceride, SGOT, SGPT, creatinine and urea decreased with 250 mg/Kg.bw of S. tenerrimum methanolic extract in Streptozotocin-induced diabetic mice group. This difference is significant (p<0.05) when compared with a healthy non-diabetic mice group and a treated diabetic mice group. This proves that the methanolic extract of S. tenerrimum possess anti-diabetic property. Further research could explore the active compounds that can be used in the formulation of herbal medicine for diabetes mellitus.
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157
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Lotter N, Lahri S, van Hoving D. The burden of diabetic emergencies on the resuscitation area of a district-level public hospital in Cape Town. Afr J Emerg Med 2021; 11:416-421. [PMID: 34703733 PMCID: PMC8524109 DOI: 10.1016/j.afjem.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 02/12/2021] [Accepted: 05/21/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Diabetes and its complications continue to cause a daunting and growing concern on resource-limited environments. There is a paucity of data relating to the care of diabetic emergencies in the emergency centres of entry-level hospitals in Africa. The aim of this study was to describe the burden of diabetic emergencies presenting to the emergency centre of an urban district-level hospital in Cape Town, South Africa. METHODS The Khayelitsha Hospital Emergency Centre database was retrospectively analysed for patients presenting with a diabetic emergency within a 24-week randomly selected period. The database was supplemented by a retrospective chart review to include additional variables for participants with diabetic ketoacidosis (DKA), uncomplicated hyperglycaemia, severe hypoglycaemia and hyperosmolar hyperglycaemic state (HHS). Summary statistics are presented of all variables. RESULTS The prevalence of all diabetic emergencies was 8.1% (197/2424) (DKA n = 96, 48.7%; uncomplicated hyperglycaemia n = 45, 22.8%; severe hypoglycaemia n = 44, 22.3%; HHS n = 12, 6%). The median age was 48 years, with those presenting with DKA being substantially younger (36 years). A likely precipitant was identified in 175 (88%) patients; infection was the most common precipitant (n = 79, 40.1%). Acute kidney injury occurred in 80 (40.6%) cases. The median length of stay in the resuscitation area was 13 h (IQR 7.2-24) and 101 (51.3%) participants represented with a diabetic- related emergency within six months of the study period. The overall mortality rate was 5% (n = 10). CONCLUSION This study highlights the high burden of diabetic emergencies on the provision of acute care at a district-level hospital. The high prevalence of diabetic emergencies (8%) consisted of DKA (48.7%), uncomplicated hyperglycaemia (22.8%), severe hypoglycaemia (22.3%), and HHS (6%). The high infection rate (40%) and the high percentage of patients returning with a diabetic emergency (51%) could be indicative of the need for improved community-based diabetic programmes.
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158
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Fahmy MEA, Abdelaal AA, Hassan SI, Shalaby MA, Ismail MAM, Khairy RA, Badawi MA, Afife AA, Fadl HO. Antiparasitic and immunomodulating effects of nitazoxanide, ivermectin and selenium on Cryptosporidium infection in diabetic mice. REVISTA BRASILEIRA DE PARASITOLOGIA VETERINARIA = BRAZILIAN JOURNAL OF VETERINARY PARASITOLOGY : ORGAO OFICIAL DO COLEGIO BRASILEIRO DE PARASITOLOGIA VETERINARIA 2021; 30:e012121. [PMID: 34852131 DOI: 10.1590/s1984-29612021087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 09/20/2021] [Indexed: 12/12/2022]
Abstract
The present work aims to investigate the antiparasitic and the immunomodulating effects of nitazoxanide (NTZ) and ivermectin (IVC) alone or combined together or combined with selenium (Se), on Cryptosporidium infection in diabetic mice. The results revealed that the combined NTZ and IVC therapy achieved the highest reduction of fecal oocysts (92%), whereas single NTZ showed the lowest reduction (63%). Also, adding Se to either NTZ or IVC resulted in elevation of oocyst reduction from 63% to 71% and from 82% to 84% respectively. All treatment regimens, with the exception of NTZ monotherapy, showed a significant improvement in the intestinal histopathology, the highest score was in combined NTZ and IVC therapy. The unique results of immunohistochemistry in this study showed reversal of the normal CD4/CD8 T cell ratio in the infected untreated mice, however, following therapy it reverts back to a normal balanced ratio. The combined (NTZ+ IVC) treatment demonstrated the highest level of CD4 T cell expression. Taken together, NTZ and IVC combined therapy showed remarkable anti-parasitic and immunostimulatory effects, specifically towards the CD4 population that seem to be promising in controlling cryptosporidiosis in diabetic individuals. Further research is required to explore other effective treatment strategies for those comorbid patients.
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Affiliation(s)
| | - Amany Ahmed Abdelaal
- Medical Parasitology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
- Medical Parasitology Department, Faculty of Medicine, Armed Forces College of Medicine - AFCM, Cairo, Egypt
| | - Soad Ismail Hassan
- Medical Parasitology Department, Theodor Bilharz Research Institute - TBRI, Giza, Egypt
| | - Maisa Ahmed Shalaby
- Medical Parasitology Department, Theodor Bilharz Research Institute - TBRI, Giza, Egypt
| | | | - Rasha Ahmed Khairy
- Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Adam Ashraf Afife
- College of Life Sciences, Faculty of Medicine, Leicester University, United Kingdom
| | - Hanaa Omar Fadl
- Medical Parasitology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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159
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The Sensor Histidine Kinase ArlS Is Necessary for Staphylococcus aureus To Activate ArlR in Response to Nutrient Availability. J Bacteriol 2021; 203:e0042221. [PMID: 34606376 DOI: 10.1128/jb.00422-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Staphylococcus aureus is a versatile opportunistic pathogen whose success is driven by its ability to adapt to diverse environments and host-imposed stresses. Two-component signal transduction systems, such as ArlRS, often mediate these adaptations. Loss of ArlRS or the response regulator ArlR alone impairs the ability of S. aureus to respond to host-imposed manganese starvation and glucose limitation. As sensor histidine kinases and response regulators frequently work as pairs, it has been assumed that ArlS senses and activates ArlR in response to these stimuli. However, recent work suggests that the sensor histidine kinase GraS can also activate ArlR, calling the contribution of ArlS in responding to manganese and glucose availability into question. The results of current studies reveal that ArlS is necessary to activate ArlR in response to manganese sequestration by the host immune effector calprotectin and glucose limitation. Although the loss of ArlS does not completely eliminate ArlR activity, this response regulator is no longer responsive to manganese or glucose availability in the absence of its cognate histidine kinase. Despite the residual activity of ArlR in the absence of ArlS, ArlR phosphorylation by ArlS is required for S. aureus to resist calprotectin-imposed metal starvation. Cumulatively, these findings contribute to the understanding of S. aureus signal transduction in response to nutritional immunity and support the previous observation indicating that ArlRS is activated by a common signal derived from host-imposed manganese and glucose limitation. IMPORTANCE The ability of pathogens, including Staphylococcus aureus, to sense and adapt to diverse environments partially relies on two-component systems, such as ArlRS. Recent work revealed that the response regulator ArlR can be cross-activated by the sensor histidine kinase GraS, rendering the role of its cognate partner, ArlS, in response to manganese and glucose limitation uncertain. The results of this study reveal that ArlS is necessary for the activation of ArlR in response to calprotectin and glucose limitation. Although a low level of ArlR activity remains in the absence of ArlS, ArlS phosphotransfer to ArlR is required for S. aureus to overcome calprotectin-induced nutritional stress. Collectively, this study provides fundamental information to understand how ArlRS mediates staphylococcal adaptation during infection.
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160
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Hegazy WAH, Rajab AAH, Abu Lila AS, Abbas HA. Anti-diabetics and antimicrobials: Harmony of mutual interplay. World J Diabetes 2021; 12:1832-1855. [PMID: 34888011 PMCID: PMC8613656 DOI: 10.4239/wjd.v12.i11.1832] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/26/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetes is one of the four major non-communicable diseases, and appointed by the world health organization as the seventh leading cause of death worldwide. The scientists have turned over every rock in the corners of medical sciences in order to come up with better understanding and hence more effective treatments of diabetes. The continuous research on the subject has elucidated the role of immune disorders and inflammation as definitive factors in the trajectory of diabetes, assuring that blood glucose adjustments would result in a relief in the systemic stress leading to minimizing inflammation. On a parallel basis, microbial infections usually take advantage of immunity disorders and propagate creating a pro-inflammatory environment, all of which can be reversed by antimicrobial treatment. Standing at the crossroads between diabetes, immunity and infection, we aim in this review at projecting the interplay between immunity and diabetes, shedding the light on the overlapping playgrounds for the activity of some antimicrobial and anti-diabetic agents. Furthermore, we focused on the anti-diabetic drugs that can confer antimicrobial or anti-virulence activities.
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Affiliation(s)
- Wael A H Hegazy
- Department of Microbiology and Immunology, Zagazig University, Zagzig 44519, Egypt
| | - Azza A H Rajab
- Department of Microbiology and Immunology, Zagazig University, Zagzig 44519, Egypt
| | - Amr S Abu Lila
- Department of Pharmaceutics, Zagazig University, Faculty of Pharmacy, Zagzig 44519, Egypt
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 81442, Saudi Arabia
| | - Hisham A Abbas
- Department of Microbiology and Immunology, Zagazig University, Zagzig 44519, Egypt
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161
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Andreoni M, Sticchi L, Nozza S, Sarmati L, Gori A, Tavio M. Recommendations of the Italian society for infectious and tropical diseases (SIMIT) for adult vaccinations. Hum Vaccin Immunother 2021; 17:4265-4282. [PMID: 34524945 PMCID: PMC8828129 DOI: 10.1080/21645515.2021.1971473] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/30/2021] [Accepted: 08/18/2021] [Indexed: 12/14/2022] Open
Abstract
Vaccination prevents 2-3 million deaths worldwide every year. Nevertheless, vaccine-preventable diseases (VPDs) still cause a considerable number of deaths especially in subjects belonging to "risk groups." These are represented by older adults, immunocompromised individuals and all subjects with underlying chronic medical conditions (cardiovascular, pulmonary, renal and liver chronic diseases, diabetes, immunodeficiency disorders). They have a weaker immune system and, if infected, are more likely to develop severe complications of their condition or of the preventable-infectious disease. This document summarizes the recommendations for vaccination of the main Global Institutional Organizations and analyses the risks of comorbidities associated with infectious disease and the benefits of vaccination for each specific group. The document provides a clear, practical and authoritative guide to adult vaccination.
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Affiliation(s)
- Massimo Andreoni
- UOC Infectious diseases Tor Vergata Polyclinic, University Hospital Viale, Rome, Italy
| | - Laura Sticchi
- Hygiene Unit, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Silvia Nozza
- Medical Director, San Raffaele Hospital, Milan, Italy
| | - Loredana Sarmati
- UOC Infectious diseases Tor Vergata Polyclinic, University Hospital Viale, Rome, Italy
| | - Andrea Gori
- UOC Infectious Diseases, Irccs Ca’Granda Foundation, Maggiore Policlinico Hospital, Milan, Italy
| | - Marcello Tavio
- UOC Division of Emerging Infectious Diseases and Immunosuppressed, AOU Ospedali Riuniti of Ancona, Ancona, Italy
| | - Society for Infectious and Tropical Diseases (SIMIT)
- UOC Infectious diseases Tor Vergata Polyclinic, University Hospital Viale, Rome, Italy
- Hygiene Unit, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Medical Director, San Raffaele Hospital, Milan, Italy
- UOC Infectious Diseases, Irccs Ca’Granda Foundation, Maggiore Policlinico Hospital, Milan, Italy
- UOC Division of Emerging Infectious Diseases and Immunosuppressed, AOU Ospedali Riuniti of Ancona, Ancona, Italy
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Fang M, Ishigami J, Echouffo-Tcheugui JB, Lutsey PL, Pankow JS, Selvin E. Diabetes and the risk of hospitalisation for infection: the Atherosclerosis Risk in Communities (ARIC) study. Diabetologia 2021; 64:2458-2465. [PMID: 34345973 PMCID: PMC8331324 DOI: 10.1007/s00125-021-05522-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/20/2021] [Indexed: 11/05/2022]
Abstract
AIMS/HYPOTHESIS The aim of this work was to assess the association between diabetes and risk for infection-related hospitalisation and mortality. METHODS We conducted a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study. Diabetes was defined as a fasting glucose ≥7 mmol/l or non-fasting glucose ≥11.1 mmol/l, self-report of a diagnosis of diabetes by a physician, or current diabetes medication use. Hospitalisation for infection was ascertained from hospital discharge records. Participants were followed from 1987-1989 to 2019. RESULTS We included 12,379 participants (mean age 54.5 years; 24.7% Black race; 54.3% female sex). During a median follow-up of 23.8 years, there were 4229 new hospitalisations for infection. After adjusting for potential confounders, people with (vs without) diabetes at baseline had a higher risk for hospitalisation for infection (HR 1.67 [95% CI 1.52, 1.83]). Results were generally consistent across infection type but the association was especially pronounced for foot infection (HR 5.99 [95% CI 4.38, 8.19]). Diabetes was more strongly associated with hospitalisation for infection in younger participants and Black people. Overall infection mortality was low (362 deaths due to infection) but the adjusted risk was increased for people with diabetes (HR 1.72 [95% CI 1.28, 2.31]). CONCLUSIONS/INTERPRETATION Diabetes confers significant risk for infection-related hospitalisation. Enhancing prevention and early treatment of infection in those with diabetes is needed to reduce infection-related morbidity and mortality.
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Affiliation(s)
- Michael Fang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Junichi Ishigami
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Justin B Echouffo-Tcheugui
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Elmajnoun HK, Faris ME, Uday S, Gorman S, Greening JE, Haris PI, Abu-Median AB. Impact of COVID-19 on Children and Young Adults With Type 2 Diabetes: A Narrative Review With Emphasis on the Potential of Intermittent Fasting as a Preventive Strategy. Front Nutr 2021; 8:756413. [PMID: 34778345 PMCID: PMC8581608 DOI: 10.3389/fnut.2021.756413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 09/27/2021] [Indexed: 12/12/2022] Open
Abstract
Background: The world is still struggling to control the COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The level of uncertainty regarding the virus is still significantly high. The virus behaves differently in children and young adults. Most children and adolescents are either asymptomatic or have mild symptoms. They generally have a very good prognosis. However, it is not well-known whether children and young adults with type 2 diabetes are at risk of getting a severe infection of COVID-19. Many Muslim children with type 2 diabetes have been performing dawn to dusk fasting during the month of Ramadan, before and during the COVID-19 pandemic, and the impact of this on their health has not been well investigated. Previous studies in adults have suggested that intermittent fasting may be beneficial in different ways including reversal of type 2 diabetes and prevention of COVID-19 infection. Objective: The primary aim of this narrative review is to summarise the impacts of the COVID-19 pandemic on children and young adults with type 2 diabetes, and to identify the knowledge gaps in the literature. It also explores the potential of intermittent fasting in reversing the pathogenesis of diabetes and highlighting how this approach could prevent these patients from developing chronic complications. Methods: This narrative review has been produced by examining several databases, including Google Scholar, Research Gate, PubMed, Cochrane Library, MEDLINE (EBSCO), and Web of Science. The most common search terms used were "COVID-19 AND Children", "SARS-CoV-2 AND/OR Children", "COVID-19 AND Diabetes" "COVID-19 Epidemiology", "COVID-19 AND Ramadan fasting", "COVID-19 and Intermittent fasting." All the resources used are either peer-reviewed articles/reports and/or official websites of various media, governmental and educational organisations. Results: Having reviewed the currently limited evidence, it has been found that the incidence of COVID-19 among children with type 2 diabetes seems to be not much different from children without diabetes. However, these patients are still vulnerable to any infection. Several studies have reported that prevention programmes such as intermittent fasting are effective to protect these groups of patients from developing any complications. Moreover, observing Ramadan fasting as a type of intermittent fasting could be beneficial for some children with established diabetes, prediabetes and people at risk. Conclusion: Children and young adults with type 2 diabetes are not at risk of severe COVID-19 infection as the case in adults with diabetes. More research is needed to identify the impact of COVID-19 and to investigate the efficacy and safety of intermittent fasting, including Ramadan fasting, among these age groups. Implementing these cost-effective programmes may have a great impact in minimising the incidence of diabetes. Moreover, this could be effective particularly at prediabetes stage by preventing these people from going onto develop type 2 diabetes and taking medications for the rest of their life and protecting people from complications linked to disease and infection.
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Affiliation(s)
- Hala K. Elmajnoun
- Leicester School of Allied Health Sciences, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
- Department of Histology and Medical Genetics, Tripoli University, Tripoli, Libya
| | - MoezAlIslam E. Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Sharjah Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Suma Uday
- Department of Endocrinology and Diabetes, Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
| | - Shaun Gorman
- Department of Paediatrics, St Luke's Hospital, Bradford, United Kingdom
| | - James E. Greening
- University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Parvez I. Haris
- Leicester School of Allied Health Sciences, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Abu-Bakr Abu-Median
- Leicester School of Allied Health Sciences, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
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Asdaq SMB, Rajan A, Damodaran A, Kamath SR, Nair KS, Zachariah SM, Sahu RK, Fattepur S, Sreeharsha N, Nair A, Jacob S, Albahrani HA, Alkhaldi EH, Mohzari Y, Alrashed AA, Imran M. Identifying Mucormycosis Severity in Indian COVID-19 Patients: A Nano-Based Diagnosis and the Necessity for Critical Therapeutic Intervention. Antibiotics (Basel) 2021; 10:1308. [PMID: 34827246 PMCID: PMC8615244 DOI: 10.3390/antibiotics10111308] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 01/01/2023] Open
Abstract
The COVID-19 infection caused by the new SARS-CoV-2 virus has been linked to a broad spectrum of symptoms, from a mild cough to life-threatening pneumonia. As we learn more about this unusual COVID-19 epidemic, new issues are emerging and being reported daily. Mucormycosis, also known as zygomycosis or phycomycosis, causes severe fungal illness to individuals with a weakened immune system. It is a devastating fungal infection, and the most frequent kind is the rhino cerebral type. As a devastating second wave of COVID-19 sweeps India, doctors report several instances involving a strange illness-sometimes known as the "black fungus"-among returning and recovered COVID-19 patients. This paper analyzes the existing statistical data to address the severity of prevalence and further notes the nano-based diagnostic parameters, clinical presentations, its connection with other conditions like diabetes, hypertension, and GI disorders, and the importance of anti-fungal therapy in treating the same. Anti-fungal therapies, as well as surgical interventions, are currently used for the treatment of the disease. Proper and timely diagnosis is necessary, along with the reduction in the spread of COVID-19. From the review, it was found that timely pharmacologic interventions and early diagnosis by using a nano-based diagnostic kit can help control the disease. Additionally, this paper provides novel information about the nanotechnology approaches such as fungal detection biosensors, nucleic acids-based testing, point-of-care tests, and galactomannans detection, in the diagnosis of mucormycosis, and thereby reinforces the need for further research on the topic.
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Affiliation(s)
| | - Arya Rajan
- Amrita School of Pharmacy, AIMS Health Science Campus, Amrita Vishwa Vidyapeetham, Kochi 682041, India; (A.R.); (A.D.); (S.R.K.); (K.S.N.)
| | - Aswin Damodaran
- Amrita School of Pharmacy, AIMS Health Science Campus, Amrita Vishwa Vidyapeetham, Kochi 682041, India; (A.R.); (A.D.); (S.R.K.); (K.S.N.)
| | - Shivali R. Kamath
- Amrita School of Pharmacy, AIMS Health Science Campus, Amrita Vishwa Vidyapeetham, Kochi 682041, India; (A.R.); (A.D.); (S.R.K.); (K.S.N.)
| | - Krishnanjana S. Nair
- Amrita School of Pharmacy, AIMS Health Science Campus, Amrita Vishwa Vidyapeetham, Kochi 682041, India; (A.R.); (A.D.); (S.R.K.); (K.S.N.)
| | - Subin Mary Zachariah
- Amrita School of Pharmacy, AIMS Health Science Campus, Amrita Vishwa Vidyapeetham, Kochi 682041, India; (A.R.); (A.D.); (S.R.K.); (K.S.N.)
| | - Ram Kumar Sahu
- Department of Pharmaceutical Science, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia;
- Department of Pharmaceutical Science, Assam University (A Central University), Silchar 788011, India
| | - Santosh Fattepur
- School of Pharmacy, Management and Science University, Shah Alam 40100, Malaysia;
| | - Nagaraja Sreeharsha
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Hofuf 31982, Saudi Arabia; (N.S.); (A.N.)
- Department of Pharmaceutics, Vidya Siri College of Pharmacy, Bangalore 560035, India
| | - Anroop Nair
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Hofuf 31982, Saudi Arabia; (N.S.); (A.N.)
| | - Shery Jacob
- Department of Pharmaceutical Sciences, College of Pharmacy, Gulf Medical University, Ajman 4184, United Arab Emirates;
| | | | - Eman H. Alkhaldi
- Pharmaceutical Care Services, King Saud Medical City, Riyadh 12746, Saudi Arabia;
| | - Yahya Mohzari
- Clinical Pharmacy Department, King Saud Medical City, Riyadh 12746, Saudi Arabia;
| | - Ahmed A. Alrashed
- Pharmaceutical Services Administration, Inpatient Department, Main Hospital, King Fahad Medical City, Riyadh 11564, Saudi Arabia;
| | - Mohd. Imran
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Northern Border University, Rafha 91911, Saudi Arabia;
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Choo D, Lee K, Yoon H. Fungal balls detected using ultrasonography in the urinary bladder of a dog. Vet Radiol Ultrasound 2021; 63:e1-e4. [PMID: 34637579 DOI: 10.1111/vru.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/22/2021] [Accepted: 08/17/2021] [Indexed: 11/30/2022] Open
Abstract
A 9-year-old dog was presented with hematuria and urinary incontinence. Ultrasonography revealed multiple mobile echogenic ball-shaped structures without distal acoustic shadowing within the lumen. A cystocentesis was performed and a urinalysis of the urine revealed fungus. Candida albicans was identified using an additional urine culture. The patient was finally diagnosed with fungal cystitis with mobile fungal balls and managed with Itraconazole. Follow-up ultrasonography demonstrated the resolution of cystitis without fungal balls. Our findings suggest that fungal balls should be considered as a differential diagnosis when echogenic mobile ball-shaped structures are identified in the urinary bladder of a diabetic or immunocompromised patient.
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Affiliation(s)
- Donghyeok Choo
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Jeollabuk-do, Republic of Korea
| | - Kichang Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Jeollabuk-do, Republic of Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan-si, Jeollabuk-do, Republic of Korea
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166
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Mohsen F, Safieh H, Shibani M, Ismail H, Alzabibi MA, Armashi H, Sawaf B. Assessing diabetes mellitus knowledge among Syrian medical students: A cross-sectional study. Heliyon 2021; 7:e08079. [PMID: 34632146 PMCID: PMC8488477 DOI: 10.1016/j.heliyon.2021.e08079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/13/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022] Open
Abstract
Background Diabetes mellitus is the fastest growing global health emergency of the 21st century. The Middle East and North Africa region have the highest prevalence of diabetes in the world. Since medical students are the pillars of future healthcare systems, their knowledge of the disease must be evaluated, updated, and enhanced appropriately. Methods A cross-sectional study was conducted at the Syrian Private University (SPU) in November 2019 on World Diabetes Day in Damascus, during the Syrian war crisis. Data were collected through self-administered questionnaires and analyzed using the Statistical Package for Social Sciences version 25.0 (SPSS Inc., United States). Results Of the 275 students, 74 (26.9%) were preclinical students and 201 (73%) were clinical students with a mean age of 21.9 (±3.70) years. 67 (25.0%) are overweight, and 26 (9.7%) are obese. Students revealed a good level of knowledge regarding clinical features, risk factors, and complications; however, a lack of knowledge was noticed in the general information and the diagnostic criteria section. Clinical year students (4th, 5th, 6th) demonstrated higher levels of awareness compared to students in pre-clinical years (1st, 2nd, 3rd). Conclusions Knowledge and awareness of medical students about diabetes mellitus were found to have some gaps. Health education efforts are required to reinforce its identification and management at all levels, while also encouraging lifestyle modifications among our students.
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Affiliation(s)
- Fatema Mohsen
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Homam Safieh
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Mosa Shibani
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Hlma Ismail
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | | | - Humam Armashi
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Bisher Sawaf
- Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.,Department of Internal Medicine, Faculty of Medicine, Syrian Private University, Damascus, Syria
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167
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Sen S, Chakraborty R, Kalita P, Pathak MP. Diabetes mellitus and COVID-19: Understanding the association in light of current evidence. World J Clin Cases 2021; 9:8327-8339. [PMID: 34754842 PMCID: PMC8554438 DOI: 10.12998/wjcc.v9.i28.8327] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/12/2021] [Accepted: 07/29/2021] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have posed a problematic healthcare situation worldwide since December 2019. Diabetes mellitus is associated with an increased risk and severity of coronavirus disease 2019 (COVID-19). While interacting with various other risk factors, high blood sugar was found to reduce immunity and increase the replication of SARS-CoV-2. Oxidative stress and the release of pro-inflammatory cytokines are greater in diabetic individuals than in healthy people, worsening the outcome of SARS-CoV-2 infection in diabetics. Increased expression of furin and angiotensin converting enzyme 2 (ACE-2) receptor in the hyperglycemic environment may promote the entry of SARS-CoV-2 in the host cell. COVID-19 infection primarily modulates immune and inflammatory responses, and may cause a cytokine storm, resulting in possible lethal outcomes in diabetics. An experimental report suggests that ACE expressed in the pancreas and the SARS-CoV-2 virus invariably destroy β-cells which contain ACE-2 receptors and results in acute diabetes. Moreover, COVID-19 also causes hyperglycemia in an individual with diabetes which may be related to insulin resistance and destruction of β-cells during SARS-CoV-2 infection. Early observations also suggest a correlation between oral hypoglycemic agents and the risk of COVID-19. This review focused on the possible cause and mechanism involved in SARS-CoV-2 infection in diabetics and the role of antidiabetic drugs in COVID-19.
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Affiliation(s)
- Saikat Sen
- Faculty of Pharmaceutical Science, Assam down town University, Guwahati 781026, Assam, India
| | - Raja Chakraborty
- Department of Pharmaceutical Technology, School of Medical Sciences, ADAMAS University, Kolkata 700 126, West Bengal, India
| | - Pratap Kalita
- Department of Pharmacy, Pratiksha Institute of Pharmaceutical Sciences, Guwahati 781026, Assam, India
| | - Manash Pratim Pathak
- Faculty of Pharmaceutical Science, Assam down town University, Guwahati 781026, Assam, India
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Mostafavi M, Sharifi I, Asadikaram G, Nakhaee N, Kakooei S, Aflatoonian MR, Bamorovat M, Oliaee RT, Karamoozian A. The impact of diabetes on cutaneous leishmaniasis: a case-control field assessment. Parasitol Res 2021; 120:3865-3874. [PMID: 34604933 DOI: 10.1007/s00436-021-07255-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/16/2021] [Indexed: 11/26/2022]
Abstract
This study aimed to assess the associated-risk determinants for cutaneous leishmaniasis (CL) in patients with diabetes mellitus (DM) compared to patients without DM. This case-control study was performed between 2017 and 2019 in southeastern Iran. Overall, 206 participants were selected from patients with DM without CL (11.2%), patients with CL without DM (6.2%), and DM patients concomitance with CL (27.6%) as case groups and healthy individuals as a control group 64 (76%). These cases were compared for parasitological, immunological, biochemical, and hematological parameters. The findings demonstrated that parasitological factors regarding the number, duration, and size of the lesion in CL patients showed a significant difference among patients with and without DM (p < 0.05). Data analysis showed that six major risk factors, including female (odds ratio (OR) = 3.47, confidence interval (CI) = 1.84-6.53, p < 0.001), total protein in CL group (OR = 4.9, CI = 2.3-10.44, p < 0.001), alanine aminotransferase (ALT) concentration in CL group (OR = 0.87, CI = 0.81-0.93, p < 0.001) and DM co-infected with CL group (OR = 0.8, CI = 0.72-0.88, p < 0.001) than healthy group, aspartate aminotransferase (AST) concentration in DM group (OR = 0.86, CI = 0.76-0.98, p = 0.02), transforming growth factor beta)TGF-β( level in the CL group (OR = 1.03, CI = 1.003-1.05, p = 0.02), and presence of diabetes disease (OR = 2.07, CI = 1.16-3.7, p < 0.05), were significantly linked with the induction of CL lesion. The findings demonstrated a significant relationship between DM and CL in distinct risk determinants. Also, the study revealed that DM enhanced the severity of active CL.
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Affiliation(s)
- Mahshid Mostafavi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Area Code 76169-14115, Kerman, Iran
| | - Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Area Code 76169-14115, Kerman, Iran.
| | - Gholamreza Asadikaram
- Department of Clinical Biochemistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Nozar Nakhaee
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sina Kakooei
- Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Aflatoonian
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Bamorovat
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Area Code 76169-14115, Kerman, Iran
| | - Razieh Tavakoli Oliaee
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Area Code 76169-14115, Kerman, Iran
| | - Ali Karamoozian
- Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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169
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Increased Glycated Hemoglobin but Decreased Cholesterol after a Loss of Helicobacter pylori Infection: A Community-Based Longitudinal Metabolic Parameters Follow-Up Study. J Pers Med 2021; 11:jpm11100997. [PMID: 34683138 PMCID: PMC8538159 DOI: 10.3390/jpm11100997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/25/2021] [Accepted: 09/28/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate the impact of Helicobacter pylori (H. pylori) infection on metabolic parameters in a longitudinal follow-up manner. From August 2013 to August 2019, a community-based prospective study of H. pylori and metabolic syndrome (MetS) was performed in the northeastern region of Taiwan. A total of 1865 subjects were divided into four groups according to the serial results of urea breath test (UBT): new H. pylori infection (group 1, n = 41), null H. pylori infection (group 2, n = 897), loss of H. pylori infection (group 3, n = 369), and persistent H. pylori infection (group 4, n = 558). When comparing the subjects between groups 1 and 2, HBA1c was associated with a new H. pylori infection. Body mass index (BMI) was associated with a loss of H. pylori when comparing subjects between groups 3 and 4. Elevated HBA1c and high-density lipoprotein (HDL) levels but lower values of cholesterol and white blood cells (WBCs) were found during serial analyses within group 3. Conclusively, HBA1c was associated with a new H. pylori infection. BMI was associated with H. pylori loss. Increased HBA1c and HDL values but decreased values of cholesterol and WBC were associated with a loss of H. pylori infection.
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170
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Fernández-Grajera M, Pacha-Olivenza MA, Gallardo-Moreno AM, González-Martín ML, Pérez-Giraldo C, Fernández-Calderón MC. Modification of physico-chemical surface properties and growth of Staphylococcus aureus under hyperglycemia and ketoacidosis conditions. Colloids Surf B Biointerfaces 2021; 209:112137. [PMID: 34628126 DOI: 10.1016/j.colsurfb.2021.112137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/24/2021] [Accepted: 09/23/2021] [Indexed: 11/26/2022]
Abstract
Diabetes is a widely spread disease affecting the quality of life of millions of people around the world and is associated to a higher risk of developing infections in different parts of the body. The reasons why diabetes enhances infection episodes are not entirely clear; in this study our aim was to explore the changes that one of the most frequently pathogenic bacteria undergoes when exposed to hyperglycemia and ketoacidosis conditions. Physical surface properties such as hydrophobicity and surface electrical charge are related to bacterial growth behavior and the ability of Staphylococcus aureus to form biofilms. The addition of glucose made bacteria more negatively charged and with moderate-intermediate hydrophobicity. Ketone bodies increased hydrophobicity to approximately 75% and pathological concentrations hindered some of the bacterial surface charge by decreasing the negative zeta potential of cells. When both components were present, the bacterial physical surface changes were more similar to those observed in ketone bodies, suggesting a preferential adsorption of ketone bodies over glucose because of the more favorable solubility of glucose in water. Glucose diabetic concentrations gave the highest number of bacteria in the stationary phase of growth and provoked an increase in the biofilm slime index of around 400% in relation to the control state. Also, this situation is related with an increase of bacterial coverage. The combination of a high concentration of glucose and ketone bodies, which corresponds to a poorly controlled diabetic situation, appears associated with an early infection phase; increased hydrophobic attractive force and reduced electrostatic repulsion between cells results in better packing of cells within the biofilm and more efficient retention to the host surface. Knowledge of bacterial response in high amount of glucose and ketoacidosis environments can serve as a basis for designing strategies to prevent bacterial adhesion, biofilm formation and, consequently, the development of infections.
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Affiliation(s)
- María Fernández-Grajera
- University of Extremadura, Department of Applied Physics, Badajoz, Spain; University Institute of Extremadura Sanity Research (INUBE), Badajoz, Spain
| | - Miguel A Pacha-Olivenza
- University Institute of Extremadura Sanity Research (INUBE), Badajoz, Spain; University of Extremadura, Department of Biomedical Science, Badajoz, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Badajoz, Spain.
| | - Amparo M Gallardo-Moreno
- University of Extremadura, Department of Applied Physics, Badajoz, Spain; University Institute of Extremadura Sanity Research (INUBE), Badajoz, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Badajoz, Spain
| | - M Luisa González-Martín
- University of Extremadura, Department of Applied Physics, Badajoz, Spain; University Institute of Extremadura Sanity Research (INUBE), Badajoz, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Badajoz, Spain
| | - Ciro Pérez-Giraldo
- University Institute of Extremadura Sanity Research (INUBE), Badajoz, Spain; University of Extremadura, Department of Biomedical Science, Badajoz, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Badajoz, Spain
| | - M Coronada Fernández-Calderón
- University Institute of Extremadura Sanity Research (INUBE), Badajoz, Spain; University of Extremadura, Department of Biomedical Science, Badajoz, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Badajoz, Spain
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171
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Risk Factors for Mucormycosis in COVID-19 Patients. Jundishapur J Microbiol 2021. [DOI: 10.5812/jjm.117435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
: Opportunistic infections, such as mucormycosis, in coronavirus disease 2019 (COVID-19) patients has become a new health challenge. Since opportunistic infections can exacerbate COVID-19 patients' status, it is vital to identify the risk factors to prevent, diagnose, and treat them as soon as possible. Viral, fungal, environmental, and host factors may be responsible for this situation. Long hospital stays, impaired host immune system function due to viral infection, and excessive consumption of glucocorticoids in managing COVID-19 patients are the main risk factors for the increased risk of mucormycosis in COVID-19 patients. Educating health care workers and considering the association between mucormycosis of the paranasal sinuses and different strains of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the cause of COVID-19 can help prevent invasive fungal sinusitis in COVID-19 patients.
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172
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Sranujit RP, Noysang C, Tippayawat P, Kooltheat N, Luetragoon T, Usuwanthim K. Phytochemicals and Immunomodulatory Effect of Nelumbo nucifera Flower Extracts on Human Macrophages. PLANTS (BASEL, SWITZERLAND) 2021; 10:2007. [PMID: 34685815 PMCID: PMC8537166 DOI: 10.3390/plants10102007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/12/2021] [Accepted: 09/17/2021] [Indexed: 01/27/2023]
Abstract
This research characterizes phytochemicals inherent in lotus flower and investigates the antioxidant and immunomodulatory activity of ethyl acetate (EA) and ethyl alcohol (ET) lotus petal extracts. In the experiment, human monocytes-derived macrophages were stimulated by lipopoly-saccharide to mimic bacteria-induced inflammation. The results showed that ferulic acid, couma-rin, and chlorogenic acid were three dominant polyphenols. The EA and ET lotus petal extracts also possessed high antioxidant capability. Furthermore, the extracts exhibited immunomodulatory properties by suppressing TNF-α secretion in inflammatory-induced human macrophages by in-hibiting NF-κB-dependent inflammatory response. In essence, the lotus petal extracts possess reme-dial attributes beneficial to individuals afflicted with declined immune functions.
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Affiliation(s)
- Rungnapa Pankla Sranujit
- Faculty of Integrative Medicine, Rajamangala University of Technology Thanyaburi, Pathum Thani 12130, Thailand;
| | - Chanai Noysang
- Faculty of Integrative Medicine, Rajamangala University of Technology Thanyaburi, Pathum Thani 12130, Thailand;
| | - Patcharaporn Tippayawat
- Center for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Science, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Nateelak Kooltheat
- Research Excellence Center for Innovation and Health Products, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80160, Thailand;
| | - Thitiya Luetragoon
- Cellular and Molecular Immunology Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok 65000, Thailand; (T.L.); (K.U.)
| | - Kanchana Usuwanthim
- Cellular and Molecular Immunology Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok 65000, Thailand; (T.L.); (K.U.)
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173
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Llibre A, Dedicoat M, Burel JG, Demangel C, O’Shea MK, Mauro C. Host Immune-Metabolic Adaptations Upon Mycobacterial Infections and Associated Co-Morbidities. Front Immunol 2021; 12:747387. [PMID: 34630426 PMCID: PMC8495197 DOI: 10.3389/fimmu.2021.747387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/08/2021] [Indexed: 12/14/2022] Open
Abstract
Mycobacterial diseases are a major public health challenge. Their causative agents include, in order of impact, members of the Mycobacterium tuberculosis complex (causing tuberculosis), Mycobacterium leprae (causing leprosy), and non-tuberculous mycobacterial pathogens including Mycobacterium ulcerans. Macrophages are mycobacterial targets and they play an essential role in the host immune response to mycobacteria. This review aims to provide a comprehensive understanding of the immune-metabolic adaptations of the macrophage to mycobacterial infections. This metabolic rewiring involves changes in glycolysis and oxidative metabolism, as well as in the use of fatty acids and that of metals such as iron, zinc and copper. The macrophage metabolic adaptations result in changes in intracellular metabolites, which can post-translationally modify proteins including histones, with potential for shaping the epigenetic landscape. This review will also cover how critical tuberculosis co-morbidities such as smoking, diabetes and HIV infection shape host metabolic responses and impact disease outcome. Finally, we will explore how the immune-metabolic knowledge gained in the last decades can be harnessed towards the design of novel diagnostic and therapeutic tools, as well as vaccines.
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Affiliation(s)
- Alba Llibre
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Martin Dedicoat
- Department of Infectious Diseases, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Julie G. Burel
- Division of Vaccine Discovery, La Jolla Institute for Immunology, La Jolla, CA, United States
| | - Caroline Demangel
- Immunobiology of Infection Unit, Institut Pasteur, INSERM U1224, Paris, France
| | - Matthew K. O’Shea
- Department of Infectious Diseases, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Claudio Mauro
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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174
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Gopi P, Anju TR, Pillai VS, Veettil M. SARS-Coronavirus 2, A Metabolic Reprogrammer: A Review in the Context of the Possible Therapeutic Strategies. Curr Drug Targets 2021; 23:770-781. [PMID: 34533443 DOI: 10.2174/1389450122666210917113842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/17/2021] [Accepted: 08/11/2021] [Indexed: 11/22/2022]
Abstract
Novel coronavirus, SARS-CoV-2 is advancing at a staggering pace to devastate the health care system and foster the concerns over public health. In contrast to the past outbreaks, coronaviruses aren't clinging themselves as a strict respiratory virus. Rather, becoming a multifaceted virus, it affects multiple organs by interrupting a number of metabolic pathways leading to significant rates of morbidity and mortality. Following infection they rigorously reprogram multiple metabolic pathways of glucose, lipid, protein, nucleic acid and their metabolites to extract adequate energy and carbon skeletons required for their existence and further molecular constructions inside a host cell. Although the mechanism of these alterations are yet to be known, the impact of these reprogramming is reflected in the hyper inflammatory responses, so called cytokine storm and the hindrance of host immune defence system. The metabolic reprogramming during SARS-CoV-2 infection needs to be considered while devising therapeutic strategies to combat the disease and its further complication. The inhibitors of cholesterol and phospholipids synthesis and cell membrane lipid raft of the host cell can, to a great extent, control the viral load and further infection. Depletion of energy source by inhibiting the activation of glycolytic and hexoseamine biosynthetic pathway can also augment the antiviral therapy. The cross talk between these pathways also necessitates the inhibition of amino acid catabolism and tryptophan metabolism. A combinatorial strategy which can address the cross talks between the metabolic pathways might be more effective than a single approach and the infection stage and timing of therapy will also influence the effectiveness of the antiviral approach. We herein focus on the different metabolic alterations during the course of virus infection that help to exploit the cellular machinery and devise a therapeutic strategy which promotes resistance to viral infection and can augment body's antivirulence mechanisms. This review may cast the light into the possibilities of targeting altered metabolic pathways to defend virus infection in a new perspective.
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Affiliation(s)
- Poornima Gopi
- Department of Biotechnology, Cochin University of Science and Technology, Cochin 682022, Kerala, India
| | - T R Anju
- Department of Biotechnology, Newman College, Thodupuzha 685585, Kerala, India
| | - Vinod Soman Pillai
- Department of Biotechnology, Cochin University of Science and Technology, Cochin 682022, Kerala, India
| | - Mohanan Veettil
- Institute of Advanced Virology, Thonnakkal, Thiruvananthapuram 695317, Kerala, India
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175
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Que Y, Cao M, He J, Zhang Q, Chen Q, Yan C, Lin A, Yang L, Wu Z, Zhu D, Chen F, Chen Z, Xiao C, Hou K, Zhang B. Gut Bacterial Characteristics of Patients With Type 2 Diabetes Mellitus and the Application Potential. Front Immunol 2021; 12:722206. [PMID: 34484230 PMCID: PMC8415158 DOI: 10.3389/fimmu.2021.722206] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/26/2021] [Indexed: 12/13/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a complex disorder comprehensively influenced by genetic and environmental risk, and research increasingly has indicated the role of microbial dysbiosis in T2DM pathogenesis. However, studies comparing the microbiome characteristics between T2DM and healthy controls have reported inconsistent results. To further identify and describe the characteristics of the intestinal flora of T2DM patients, we performed a systematic review and meta-analysis of stool microbial profiles to discern and describe microbial dysbiosis in T2DM and to explore heterogeneity among 7 studies (600 T2DM cases, 543 controls, 1143 samples in total). Using a random effects model and a fixed effects model, we observed significant differences in beta diversity, but not alpha diversity, between individuals with T2DM and controls. We identified various operational taxonomic unit (OTUs) and bacterial genera with significant odds ratios for T2DM. The T2DM signatures derived from a single study by stepwise feature selection could be applied in other studies. By training on multiple studies, we improved the detection accuracy and disease specificity for T2DM. We also discuss the relationship between T2DM-enriched or T2DM-depleted genera and probiotics and provide new ideas for diabetes prevention and improvement.
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Affiliation(s)
- Yanyan Que
- Department of Endocrinology, Zhongshan Hospital Xiamen University, Xiamen, China
| | - Man Cao
- Department of Mathematics and Numerical Simulation and High-Performance Computing Laboratory, School of Sciences, Nanchang University, Nanchang, China
| | - Jianquan He
- Department of Rehabilitation, Zhongshan Hospital Xiamen University, Xiamen, China.,School of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Qiang Zhang
- Department of Gastroenterology, Zhongshan Hospital Xiamen University, Xiamen, China.,School of Medicine, Xiamen University, Xiamen, China
| | - Qiongyun Chen
- Department of Gastroenterology, Zhongshan Hospital Xiamen University, Xiamen, China.,School of Medicine, Xiamen University, Xiamen, China
| | - Changsheng Yan
- Department of Gastroenterology, Zhongshan Hospital Xiamen University, Xiamen, China.,School of Medicine, Xiamen University, Xiamen, China
| | - Aiqiang Lin
- Department of Research and Development, Xiamen Treatgut Biotechnology Co., Ltd., Xiamen, China
| | - Luxi Yang
- School of Medicine, Xiamen University, Xiamen, China
| | - Zezhen Wu
- Department of Endocrine and Metabolic Diseases, Longhu Hospital, The First Affiliated Hospital of Medical College of Shantou University, Shantou, China.,Graduate School, Medical College of Shantou University, Shantou, China
| | - Dan Zhu
- Department of Endocrine and Metabolic Diseases, Longhu Hospital, The First Affiliated Hospital of Medical College of Shantou University, Shantou, China
| | - Fengwu Chen
- Department of Endocrine and Metabolic Diseases, Longhu Hospital, The First Affiliated Hospital of Medical College of Shantou University, Shantou, China
| | - Zhangran Chen
- Department of Gastroenterology, Zhongshan Hospital Xiamen University, Xiamen, China.,School of Medicine, Xiamen University, Xiamen, China
| | - Chuanxing Xiao
- School of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,School of Medicine, Xiamen University, Xiamen, China
| | - Kaijian Hou
- Department of Endocrine and Metabolic Diseases, Longhu Hospital, The First Affiliated Hospital of Medical College of Shantou University, Shantou, China
| | - Bangzhou Zhang
- Department of Gastroenterology, Zhongshan Hospital Xiamen University, Xiamen, China.,School of Medicine, Xiamen University, Xiamen, China
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176
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Phytochemicals and Their Possible Mechanisms in Managing COVID-19 and Diabetes. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11178163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
For the writing of this manuscript, we searched information published from 2000 to 2021, through PubMed, Web of Science, Springer, and Science Direct. Focusing on the effects related to respiratory diseases, in addition to possible direct effects towards SARS-CoV-2, coupled with diabetes. Diabetes is a metabolic disease that is characterized by affecting the function of glucose, in addition to insulin insufficiency. This leads to patients with such pathologies as being at greater risk for developing multiple complications and increase exposure to viruses infections. This is the case of severe acute respiratory disease coronavirus 19 (SARS-CoV-2), which gave rise to coronavirus disease 2019 (COVID-19), declared an international public health emergency in March of 2020 Currently, several strategies have been applied in order to prevent the majority of the consequences of COVID-19, especially in patients with chronic diseases such as diabetes. Among the possible treatment options, we found that the use of phytochemical compounds has exhibited beneficial effects for the prevention and inhibition of infection by SARS-CoV-2, as well as for the improvement of the manifestations of diabetes.
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177
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Uwagbale E, Adeniran OG, Adeniran OA, Onukogu I, Agbroko S, Sonpal N. In-Hospital Outcomes of Inflammatory Bowel Diseases in Patients With Diabetes Mellitus: A Propensity Score Matching Analysis. Cureus 2021; 13:e16566. [PMID: 34430168 PMCID: PMC8380051 DOI: 10.7759/cureus.16566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Inflammatory bowel disease (IBD) is increasingly common among patients with other comorbid chronic conditions, particularly diabetes mellitus (DM). Yet, studies that explored the impact of comorbid diabetes on the outcomes of IBD are scanty. Therefore, this study aims to examine the outcomes of inflammatory bowel disease among hospitalized patients with diabetes mellitus. Methods Using the Nationwide Inpatient Sampling (NIS) database from 2016 to 2018, we identified patients' records with a diagnosis of IBD using the International Classification of Diseases, Tenth Revision codes (ICD-10). The overall study population was further stratified by diabetes mellitus status. We matched patients with IBD and diabetes mellitus (IBD DM) with IBD cohorts using a greedy propensity score matching (PSM) ratio of 1:1 and compared in-hospital outcomes between the two cohorts. Conditional logistic regression was performed to estimate the odds of outcomes. Results Out of the 192,456 hospitalizations for IBD, 34,073 (7.7%) had comorbid IBD DM and 158,383 (92.3%) had no diabetes mellitus (IBD only). Patients with IBD DM are likely to be older. They have higher rates of hypertension, hyperlipidemia, coronary artery disease, obesity, peripheral vascular disease, congestive heart failure, chronic kidney disease, chronic lung disease, chronic liver disease, and stroke than the IBD cohort. After propensity score matching, IBD DM was associated with a lower adverse outcome [odds ratio (OR): 0.96, confidence interval (CI): 0.93 - 0.99, p < 0.01], IBD-related complications (intestinal or rectal fistula, intra-abdominal abscess, toxic colitis, intestinal perforation, intestinal obstruction, toxic megacolon, abscess of the abdomen, and perianal abscess), (OR: 0.76, CI: 0.72 - 0.80, P <0.01), IBD-related surgery (intestinal resections, incision, and excisions of intestine and manipulations of the rectosigmoid, rectal and perianal) (OR: 0.90, CI: 0.85 - 0.95, P <0.01). Furthermore, IBD DM was associated with a higher sepsis complication than the IBD-only cohort (OR: 1.24, CI: 1.19 - 1.30, P <0.01). Conclusion Our results highlight the extent to which diabetes mellitus impacts IBD outcomes and prognosis. Additionally, they emphasize the clinical awareness needed in the management of those with comorbid diseases.
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Affiliation(s)
- Ese Uwagbale
- Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Omolara G Adeniran
- Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Olayemi A Adeniran
- Epidemiology, West Virginia University, Morgantown, USA.,Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | | | - Solomon Agbroko
- Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, USA
| | - Niket Sonpal
- Gastroenterology and Hepatology, Brookdale University Hospital Medical Center, Brooklyn, USA
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178
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Esposito S, Mariotti Zani E, Torelli L, Scavone S, Petraroli M, Patianna V, Predieri B, Iughetti L, Principi N. Childhood Vaccinations and Type 1 Diabetes. Front Immunol 2021; 12:667889. [PMID: 34512622 PMCID: PMC8427438 DOI: 10.3389/fimmu.2021.667889] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/12/2021] [Indexed: 12/17/2022] Open
Abstract
Type 1 diabetes (T1D) is the most common paediatric endocrine disease, and its frequency has been found to increase worldwide. Similar to all conditions associated with poorly regulated glucose metabolism, T1D carries an increased risk of infection. Consequently, careful compliance by T1D children with schedules officially approved for child immunization is strongly recommended. However, because patients with T1D show persistent and profound limitations in immune function, vaccines may evoke a less efficient immune response, with corresponding lower protection. Moreover, T1D is an autoimmune condition that develops in genetically susceptible individuals and some data regarding T1D triggering factors appear to indicate that infections, mainly those due to viruses, play a major role. Accordingly, the use of viral live attenuated vaccines is being debated. In this narrative review, we discussed the most effective and safe use of vaccines in patients at risk of or with overt T1D. Literature analysis showed that several problems related to the use of vaccines in children with T1D have not been completely resolved. There are few studies regarding the immunogenicity and efficacy of vaccines in T1D children, and the need for different immunization schedules has not been precisely established. Fortunately, the previous presumed relationship between vaccine administration and T1D appears to have been debunked, though some doubts regarding rotavirus vaccines remain. Further studies are needed to completely resolve the problems related to vaccine administration in T1D patients. In the meantime, the use of vaccines remains extensively recommended in children with this disease.
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Affiliation(s)
- Susanna Esposito
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
| | - Elena Mariotti Zani
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
| | - Lisa Torelli
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
| | - Sara Scavone
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
| | - Maddalena Petraroli
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
| | - Viviana Patianna
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
| | - Barbara Predieri
- Pediatric Unit, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Nicola Principi
- Paediatric Clinic, Department of Medicine and Surgery, University Hospital, University of Parma, Parma, Italy
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179
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Ninomiya T, Otsubo K, Hoshino T, Shimokawa M, Nakazawa M, Sato Y, Mikumo H, Kawakami S, Mizusaki S, Mori Y, Arimura H, Tsuchiya-Kawano Y, Inoue K, Uchida Y, Nakanishi Y. Risk factors for disease progression in Japanese patients with COVID-19 with no or mild symptoms on admission. BMC Infect Dis 2021; 21:850. [PMID: 34419004 PMCID: PMC8379599 DOI: 10.1186/s12879-021-06574-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/13/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Although the risk factors for coronavirus disease 2019 (COVID-19) mortality have been identified, there is limited information about the risk factors for disease progression after hospitalization among Japanese patients with COVID-19 exhibiting no or mild symptoms. METHODS All 302 consecutive patients who were admitted to our institutions and diagnosed with COVID-19 between March and December 2020 were retrospectively assessed. Ultimately, 210 adult patients exhibiting no or mild symptoms on admission were included in the analysis. They were categorized into the stable (no oxygen needed) and worsened (oxygen needed) groups, and their characteristics and laboratory data were compared. RESULTS Among 210 patients, 49 progressed to a severe disease stage, whereas 161 did not. The mean patient age was 52.14 years, and 126 (60.0%) patients were male. The mean body mass index (BMI) was 23.0 kg/m2, and 71 patients were overweight (BMI ≥ 25 kg/m2). Multivariate logistic analysis showed that old age, overweight, diabetes mellitus (DM), and high serum ferritin levels were independent risk factors for disease progression. CONCLUSIONS Clinicians should closely observe patients with COVID-19, especially those with risk factors such as old age, overweight, DM, and high serum ferritin levels, regardless of whether they have no or mild symptoms.
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Affiliation(s)
- Toshifumi Ninomiya
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan.,Department of General Internal Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Kohei Otsubo
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan.
| | - Teppei Hoshino
- Department of Internal Medicine, Kitakyushu City Yahata Hospital, 2-6-2, Ogura, Yahatahigashi-ku, Kitakyushu, Fukuoka, 805-8534, Japan
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube-shi, Yamaguchi, 755-8505, Japan
| | - Megumi Nakazawa
- Department of General Internal Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Yoriko Sato
- Department of General Internal Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Hironori Mikumo
- Department of General Internal Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Satoru Kawakami
- Department of General Internal Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan.,Department of Respiratory Medicine, JCHO Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu, Fukuoka, 806-8501, Japan
| | - Shun Mizusaki
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan.,Department of General Internal Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Yusuke Mori
- Department of Internal Medicine, Kitakyushu City Yahata Hospital, 2-6-2, Ogura, Yahatahigashi-ku, Kitakyushu, Fukuoka, 805-8534, Japan
| | - Hidenobu Arimura
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Yuko Tsuchiya-Kawano
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Koji Inoue
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Yujiro Uchida
- Department of General Internal Medicine, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Yoichi Nakanishi
- Kitakyushu City Hospital Organization, 1-35 Furusenbamachi, Kokurakita-ku, Kitakyushu, 802-0082, Japan
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Agustin H, Massi MN, Djaharuddin I, Susanto AD, Islam AA, Hatta M, Bukhari A, Tabri NA, Santoso A, Patellongi I. Analysis of CD4 and CD8 expression in multidrug-resistant tuberculosis infection with diabetes mellitus: An experimental study in mice. Ann Med Surg (Lond) 2021; 68:102596. [PMID: 34401121 PMCID: PMC8350178 DOI: 10.1016/j.amsu.2021.102596] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/19/2021] [Accepted: 07/25/2021] [Indexed: 01/19/2023] Open
Abstract
Background Tuberculosis (TB) remains a major global health problem, in the top 10 causes of death. As a regulator of the immune response, T-helper (Th) cells activate other lymphocytes from the immune system, such as B cells, to destroy the TB pathogen by releasing CD4 and CD8 Th cells. Diabetes mellitus (DM) is a known cause of developing active pulmonary TB. Few studies have examined the biomolecular expression affecting Mycobacterium tuberculosis (MTB) and multidrug-resistant (MDR) MTB, which are associated with low immunity represented by TB in diabetes and CD4 and CD8 levels. Materials and methods This animal study used a post-test control group design. We performed an experimental study using 30 BALB/c mice, each weighing 25 g. It included six experimental animal groups, of which three had a diabetes condition induced using intraperitoneal streptozotocin, and all were infected with MTB or MDR TB. We evaluated the CD4 and CD8 levels in each group and analyzed the differences. Results We found a significant difference in CD4 and CD8 levels in MTB and MDR TB conditions. Conclusion This study shows that acute infection in experimental mice with MTB and MDR TB with or without diabetes had the highest levels of both CD4 and CD8 cells, which can be a sign of increased cellular immunity in a mice model. Tuberculosis (TB) is still a major global health problem. TB with comorbid diabetes mellitus (DM) are associated with increased CD4 and CD8. CD4 and CD8 values are increased in animals with DM plus TB infection.
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Affiliation(s)
- Heidy Agustin
- Doctoral Program of Medical Sciences, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.,Departement of Pulmonology and Respiratory Medicine, Faculty of Medicine, Indonesia University, Jakarta, Indonesia.,Departement of Pulmonology and Respiratory Medicine, Persahabatan Hospital, Jakarta, Indonesia
| | - Muhammad Nasrum Massi
- Departement of Microbiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Irawati Djaharuddin
- Departement of Pulmonology and Respiratory Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Agus Dwi Susanto
- Departement of Pulmonology and Respiratory Medicine, Faculty of Medicine, Indonesia University, Jakarta, Indonesia.,Departement of Pulmonology and Respiratory Medicine, Persahabatan Hospital, Jakarta, Indonesia
| | - Andi Asadul Islam
- Department of Neurosurgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Mochammad Hatta
- Clinical Microbiologist Program, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Agussalim Bukhari
- Department of Clinical Nutrition, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Nur Ahmad Tabri
- Departement of Pulmonology and Respiratory Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Arif Santoso
- Departement of Pulmonology and Respiratory Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Ilhamjaya Patellongi
- Department of Biostatistics, Faculty of Public Health, Hasanuddin University, Sulawesi Selatan, Indonesia
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181
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Weng SC, Tsao PN, Shiao SH. Blood glucose promotes dengue virus infection in the mosquito Aedes aegypti. Parasit Vectors 2021; 14:376. [PMID: 34311776 PMCID: PMC8314564 DOI: 10.1186/s13071-021-04877-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/14/2021] [Indexed: 11/30/2022] Open
Abstract
Background Dengue fever is the most rapidly spreading mosquito-borne viral disease globally. More than 2.5 billion people live in dengue-endemic areas. Previous studies suggested an interrelationship between diabetes mellitus (DM) and dengue hemorrhagic fever (DHF). Conversely, glycolysis is a critical metabolic pathway for optimal dengue virus (DENV) replication. However, little is known concerning the effect of glucose on DENV replication in mosquitoes. In this study, we investigated the impact of glucose on DENV replication in mosquitoes Aedes aegypti. Methods Mosquitoes (Ae. aegypti UGAL/Rockefeller strain) were orally infected with DENV (serotype 2, 16681 strain) through infectious blood feeding. The DENV infection and transmission rates were determined by examining mosquito bodies and saliva, respectively, for DENV positivity at different time points after infection. In addition, a reverse genetic approach was applied by introducing double-stranded RNA against genes of interest into the mosquitoes to inhibit gene expression. Results Our data revealed a significant increase of DENV genome levels in mosquitoes consuming an infectious blood meal supplemented with glucose, suggesting that blood glucose is an important factor for viral replication. Interestingly, a significant increase of DENV E protein levels was detected in the saliva 4 days faster in mosquitoes that consumed infectious blood meals supplemented with glucose than in those consuming infectious blood meals alone. Furthermore, we perform RNAi to silence AKT or TOR and investigate the molecular mechanism regulating the glucose-mediated enhancement of viral replication. Silencing of AKT or TOR significantly reduced DENV titers in mosquitoes. Conclusions This study suggested that blood glucose is beneficial to DENV replication and that it facilitates virus transmission in mosquitoes via AKT and TOR signaling. Therefore, our results strengthen our understanding of dengue fever and DM co-morbidity and possibly reveal new targets for specific antiviral therapies. Graphical abstract ![]()
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Affiliation(s)
- Shih-Che Weng
- Department of Tropical Medicine and Parasitology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Po-Nien Tsao
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.,Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan
| | - Shin-Hong Shiao
- Department of Tropical Medicine and Parasitology, College of Medicine, National Taiwan University, Taipei, Taiwan.
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182
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Chen F, Hao L, Zhu S, Yang X, Shi W, Zheng K, Wang T, Chen H. Potential Adverse Effects of Dexamethasone Therapy on COVID-19 Patients: Review and Recommendations. Infect Dis Ther 2021; 10:1907-1931. [PMID: 34296386 PMCID: PMC8298044 DOI: 10.1007/s40121-021-00500-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/06/2021] [Indexed: 12/12/2022] Open
Abstract
In the context of the coronavirus disease 2019 (COVID-19) pandemic, the global healthcare community has raced to find effective therapeutic agents against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To date, dexamethasone is the first and an important therapeutic to significantly reduce the risk of death in COVID-19 patients with severe disease. Due to powerful anti-inflammatory and immunosuppressive effects, dexamethasone could attenuate SARS-CoV-2-induced uncontrolled cytokine storm, severe acute respiratory distress syndrome and lung injury. Nevertheless, dexamethasone treatment is a double-edged sword, as numerous studies have revealed that it has significant adverse impacts later in life. In this article, we reviewed the literature regarding the adverse effects of dexamethasone administration on different organ systems as well as related disease pathogenesis in an attempt to clarify the potential harms that may arise in COVID-19 patients receiving dexamethasone treatment. Overall, taking the threat of COVID19 pandemic into account, we think it is necessary to apply dexamethasone as a pharmaceutical therapy in critical patients. However, its adverse side effects cannot be ignored. Our review will help medical professionals in the prognosis and follow-up of patients treated with dexamethasone. In addition, given that a considerable amount of uncertainty, confusion and even controversy still exist, further studies and more clinical trials are urgently needed to improve our understanding of the parameters and the effects of dexamethasone on patients with SARS-CoV-2 infection.
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Affiliation(s)
- Fei Chen
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China.
| | - Lanting Hao
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Shiheng Zhu
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Xinyuan Yang
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Wenhao Shi
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Kai Zheng
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Tenger Wang
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Huiran Chen
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
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183
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El‐Qushayri AE, Ghozy S, Reda A, Kamel AMA, Abbas AS, Dmytriw AA. The impact of Parkinson's disease on manifestations and outcomes of Covid-19 patients: A systematic review and meta-analysis. Rev Med Virol 2021; 32:e2278. [PMID: 34260773 PMCID: PMC8420424 DOI: 10.1002/rmv.2278] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/20/2022]
Abstract
Parkinson's disease (PD) patients who contracted Coronavirus disease 2019 (Covid‐19) had a decline in motor functions; nevertheless, there is limited evidence on whether PD patients have a higher risk for contracting Covid‐19 or have worse outcomes. This is the first systematic review and meta‐analysis to review the impact of PD on the prognosis of Covid‐19 patients. We performed a systematic search through seven electronic databases under the recommendations of the Preferred Reporting Items for Systematic Review and Meta‐analyses statement (PRISMA) guidelines. The R software version 4.0.2 was used to calculate pooled sample sizes and their associated confidence intervals (95%CI). Finally, we included 13 papers in this study. The pooled prevalence rate of Covid‐19 was 2.12% (95%CI: 0.75–5.98). Fever, cough, fatigue and anorexia were the most common symptoms with a rate of 72.72% (95% CI: 57.3 ‐ 92.29), 66.99% (95% CI: 49.08–91.42), 61.58% (95% CI: 46.69–81.21) and 52.55% (95% CI: 35.09–78.68), respectively. The pooled rates were 39.89% (95% CI: 27.09–58.73) for hospitalisation, 4.7% (95% CI: 1.56–14.16) for ICU admission and 25.1% (95%CI: 16.37–38.49) for mortality. On further comparison of hospitalisation and mortality rates among Covid‐19 patients with and without PD, there were no significant differences. In conclusion, the prevalence and prognosis of Covid‐19 patients seem comparable in patients with PD and those without it. The increased hospitalisation and mortality may be attributed to old age and co‐morbidities.
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Affiliation(s)
| | | | | | | | | | - Adam A. Dmytriw
- Neuroradiology and Neurointervention ServiceBrigham and Women's HospitalBostonMassachusettsUSA
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184
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Muthukrishnan J, Venugopal N, Basavaraj A, Bagga G, Jayakrishnan V, Bharadwaj K, Thoke SV. Management of type 1 diabetes mellitus during the COVID-19 pandemic. Med J Armed Forces India 2021; 77:S393-S397. [PMID: 34334909 PMCID: PMC8313074 DOI: 10.1016/j.mjafi.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/05/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Patients with type 1 diabetes mellitus (DM) require intensive monitoring, which was adversely affected during coronavirus disease 2019 (COVID-19) restrictions. METHODS We evaluated the management of type 1 DM and the role of telephonic consultation and follow-up in 46 patients (10 on insulin pump) with type 1 DM at our centre from 1 February 2020 to 31 January 2021. Patients were telephonically counselled fortnightly. Web-based diabetes education sessions for the patients and parents were conducted. Finally, change in HbA1c during the period of the study, frequency of severe hypoglycaemia, hospital admissions for hyperglycaemic emergencies and degree of satisfaction with care rendered by the treating team were assessed by ratings scored by the patients. RESULTS Five episodes of severe hypoglycaemia were noted in three patients. Two patients had diabetic ketoacidosis. Patients on insulin pump showed a mean baseline HbA1c of 7.8%. Nine of these patients (90%) showed an improvement in Hba1c during the study period compared to 64.3% of patients on conventional regimen. There were no episodes of severe hypoglycaemia or hospitalization with DKA noted in these patients. Only two patients had COVID-19 disease with mild manifestations. Overall satisfaction levels with therapy were high. CONCLUSION This study illustrates the role played by teleconsultation and video conferencing during the period of the COVID-19 pandemic in ensuring optimal healthcare delivery to patients with type 1 DM. Some of these methods can be used even after the pandemic to improve patient convenience and reduce the out-patient burden on the hospitals.
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Affiliation(s)
- J. Muthukrishnan
- Consultant (Medicine) & Endocrinologist, Base Hospital, Delhi Cantt, India
| | | | - A.P. Basavaraj
- Classified Specialist (Medicine), Base Hospital, Delhi Cantt, India
| | - Garvit Bagga
- Classified Specialist (Medicine), Base Hospital, Delhi Cantt, India
| | - V.Y. Jayakrishnan
- Graded Specialist (Paediatrics), INHS Patanjali, Karwar, Karnataka, India
| | - Khushboo Bharadwaj
- Classified Specialist (Medicine), Military Hospital Jaipur, Rajasthan, India
| | - Santosh V. Thoke
- Classified Specialist (Medicine), Command Hospital (Southern Command), Pune, India
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185
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Bykerk VP, Blauvelt A, Curtis JR, Gaujoux-Viala C, Kvien TK, Winthrop K, Tilt N, Popova C, Mariette X, Haraoui B. Associations Between Safety of Certolizumab Pegol, Disease Activity, and Patient Characteristics, Including Corticosteroid Use and Body Mass Index. ACR Open Rheumatol 2021; 3:501-511. [PMID: 34196507 PMCID: PMC8363853 DOI: 10.1002/acr2.11259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 03/17/2021] [Indexed: 12/19/2022] Open
Abstract
Objective To investigate the impact of baseline and time‐varying factors on the risk of serious adverse events (SAEs) in patients during long‐term certolizumab pegol (CZP) treatment. Methods Safety data were pooled across 34 CZP clinical trials in rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), and plaque psoriasis (PSO). Cox proportional hazards modeling was used to investigate the association of baseline patient characteristics with risk of serious infectious events (SIEs), malignancies, and major adverse cardiac events (MACEs). Cox modeling for recurrent events assessed the impact of time‐varying body mass index (BMI), systemic corticosteroid (CS) use, and disease activity on SIE risk in RA and SAE risk in PSO. Results Data were pooled from 8747 CZP‐treated patients across indications. Cox models reported a 44% increase in SIE risk associated with a baseline BMI of 35 kg/m2 or more versus a baseline BMI of 18.5 kg/m2 to less than 25 kg/m2. Baseline systemic CS use, age of 65 years or more, and disease duration of 10 years or longer also increased SIE risk. Older age was the only identified risk factor for malignancies. The risk of MACEs increased 107% for BMI of 35 kg/m2 or more versus BMI of 18.5 kg/m2 to less than 25 kg/m2 and increased 51% for men versus women. Higher disease activity, older age, systemic CS use, BMI of 35 kg/m2 or more, and baseline comorbidities were SIE risk factors in RA. Age and systemic CS use were risk factors for SAEs in PSO. Conclusion Age, BMI, systemic CS use, and disease activity were identified as SIE risk factors in CZP‐treated patients. Risk of malignancies was greater in older patients, whereas obesity and male sex were MACE risk factors.
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Affiliation(s)
| | | | | | - Cécile Gaujoux-Viala
- Nîmes University Hospital, Nîmes, France, and Institut Desbrest d'Epidemiologie et de Sante Publique, IDESP UMR UA11 INSERM, University Montpellier, Montpellier, France
| | | | | | | | | | | | - Boulos Haraoui
- Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, Quebéc, Canada
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186
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Kashyap S, Bala R, Madaan R, Behl T. Uncurtaining the effect of COVID-19 in diabetes mellitus: a complex clinical management approach. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:35429-35436. [PMID: 34021454 PMCID: PMC8139544 DOI: 10.1007/s11356-021-14480-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/14/2021] [Indexed: 04/12/2023]
Abstract
The aim of the present review is to overview the common properties of corona virus and hence proofs well beginning of corona virus in persons with diabetes, and its treatment. Globally, it has been observed that according to the statistics, India has the second largest number of people with diabetes. Literature review has been implemented within the databases using suitable keywords. For persons suffering from diabetic disorder, the COVID-19 infection becomes a dual challenge. Diabetes is a severe metabolic situation which causes the sugar levels in the blood to increase than the normal level. Normally, communicable disease like COVID-19 is more prevailing in patients with diabetes. Diabetic patient has poor immune response to infections. The different bacterial, viral, parasitic, and mycotic infections showed increased probability in diabetic patients as compared to non-diabetic patient. All these conclusions clear out the intention that the diabetic patients are more susceptible to enhanced inflammatory response that may lead to rapid spreading of COVID-19 infection with high rate of mortality. In the present situation of pandemic, managing diabetes seems to be quite challenging and diabetic patient having COVID-19 infection should follow normal course of antihypertensive and antidiabetic drugs prescribed with the exception of sodium glucose co-transpoters-2 inhibitors which would increase the risk of dehydration and ketoacidosis. In view of above discussion, this article highlights the proposed mechanism of COVID-19 infection linking it with diabetes, antidiabetic drugs to be used in COVID-19 infection along with their advantages, and disadvantages and management of COVID-19 infection diabetic patient.
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Affiliation(s)
- Shilpi Kashyap
- Pharmaceutics, Himachal Institute of Pharmacy, Paonta Sahib, India
| | - Rajni Bala
- Chitkara College of Pharmacy, Chitkara University, Punjab, India.
| | - Reecha Madaan
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
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187
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Dallagiacoma G, Allora A, Salvati S, Cocciolo G, Capraro M, Lamberti A, Senatore S, Gentile L, Gianfredi V, Laurenzi A, Molinari C, Caretto A, Faccini M, Signorelli C, Scavini M, Odone A. Type 1 Diabetes Patients' Practice, Knowledge and Attitudes towards Influenza Immunization. Vaccines (Basel) 2021; 9:vaccines9070707. [PMID: 34210044 PMCID: PMC8310009 DOI: 10.3390/vaccines9070707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 12/16/2022] Open
Abstract
Diabetic patients are at higher risk of developing infectious diseases and severe complications, compared to the general population. Almost no data is available in the literature on influenza immunization in people with type 1 diabetes mellitus (T1DM). As part of a broader project on immunization in diabetic patients, we conducted a cross-sectional study to: (i) report on seasonal influenza coverage rates in T1DM patients, (ii) explore knowledge, attitudes, and practices (KAPs) towards seasonal influenza in this population, and (iii) identify factors associated with vaccine uptake, including the role of family doctors and diabetologists. A survey was administered to 251 T1DM patients attending the Diabetes Clinic at San Raffaele Research Hospital in Milan, Italy and individual-level coverage data were retrieved from immunization registries. Self-reported seasonal influenza immunization coverage was 36%, which decreased to 21.7% when considering regional immunization registries, far below coverage target of 75%. More than a third (36.2%) of T1DM patients were classified as pro-vaccine, 30.7% as hesitant, 17.9% as uninformed, and 15.1% as anti-vaccine. Diabetologists resulted to be the most trusted source of information on vaccines’ benefits and risks (85.3%) and should be more actively involved in preventive interventions. Our study highlights the importance of developing tailored vaccination campaigns for people with diabetes, including hospital-based programs involving diabetes specialists.
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Affiliation(s)
- Giulia Dallagiacoma
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.D.); (L.G.)
| | - Agnese Allora
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.A.); (S.S.); (G.C.); (M.C.); (V.G.); (C.S.)
| | - Stefano Salvati
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.A.); (S.S.); (G.C.); (M.C.); (V.G.); (C.S.)
| | - Giulia Cocciolo
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.A.); (S.S.); (G.C.); (M.C.); (V.G.); (C.S.)
| | - Michele Capraro
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.A.); (S.S.); (G.C.); (M.C.); (V.G.); (C.S.)
| | - Anna Lamberti
- Agency for Health Protection of Metropolitan Area of Milan (ATS), 20121 Milan, Italy; (A.L.); (S.S.); (M.F.)
| | - Sabrina Senatore
- Agency for Health Protection of Metropolitan Area of Milan (ATS), 20121 Milan, Italy; (A.L.); (S.S.); (M.F.)
| | - Leandro Gentile
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.D.); (L.G.)
| | - Vincenza Gianfredi
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.A.); (S.S.); (G.C.); (M.C.); (V.G.); (C.S.)
| | - Andrea Laurenzi
- Diabetes Research Institute, San Raffaele Hospital, 20132 Milan, Italy; (A.L.); (C.M.); (A.C.); (M.S.)
| | - Chiara Molinari
- Diabetes Research Institute, San Raffaele Hospital, 20132 Milan, Italy; (A.L.); (C.M.); (A.C.); (M.S.)
| | - Amelia Caretto
- Diabetes Research Institute, San Raffaele Hospital, 20132 Milan, Italy; (A.L.); (C.M.); (A.C.); (M.S.)
| | - Marino Faccini
- Agency for Health Protection of Metropolitan Area of Milan (ATS), 20121 Milan, Italy; (A.L.); (S.S.); (M.F.)
| | - Carlo Signorelli
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.A.); (S.S.); (G.C.); (M.C.); (V.G.); (C.S.)
| | - Marina Scavini
- Diabetes Research Institute, San Raffaele Hospital, 20132 Milan, Italy; (A.L.); (C.M.); (A.C.); (M.S.)
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.D.); (L.G.)
- Correspondence:
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188
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Riba M, Augé E, Tena I, Del Valle J, Molina-Porcel L, Ximelis T, Vilaplana J, Pelegrí C. Corpora Amylacea in the Human Brain Exhibit Neoepitopes of a Carbohydrate Nature. Front Immunol 2021; 12:618193. [PMID: 34262556 PMCID: PMC8273382 DOI: 10.3389/fimmu.2021.618193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 06/10/2021] [Indexed: 11/23/2022] Open
Abstract
Corpora amylacea (CA) in the human brain are polyglucosan bodies that accumulate residual substances originated from aging and both neurodegenerative and infectious processes. These structures, which act as waste containers, are released from the brain to the cerebrospinal fluid, reach the cervical lymph nodes via the meningeal lymphatic system and may be phagocytosed by macrophages. Recent studies indicate that CA present certain neoepitopes (NEs) that can be recognized by natural antibodies of the IgM class, and although evidence of different kinds suggests that these NEs may be formed by carbohydrate structures, their precise nature is unknown. Here, we adapted standard techniques to examine this question. We observed that the preadsorption of IgMs with specific carbohydrates has inhibitory effects on the interaction between IgMs and CA, and found that the digestion of CA proteins had no effect on this interaction. These findings point to the carbohydrate nature of the NEs located in CA. Moreover, the present study indicates that, in vitro, the binding between certain natural IgMs and certain epitopes may be disrupted by certain monosaccharides. We wonder, therefore, whether these inhibitions may also occur in vivo. Further studies should now be carried out to assess the possible in vivo effect of glycemia on the reactivity of natural IgMs and, by extension, on natural immunity.
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Affiliation(s)
- Marta Riba
- Secció de Fisiologia, Departament de Bioquímica i Fisiologia, Universitat de Barcelona, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Centros de Biomedicina en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Elisabet Augé
- Secció de Fisiologia, Departament de Bioquímica i Fisiologia, Universitat de Barcelona, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Centros de Biomedicina en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Iraida Tena
- Secció de Fisiologia, Departament de Bioquímica i Fisiologia, Universitat de Barcelona, Barcelona, Spain
| | - Jaume Del Valle
- Secció de Fisiologia, Departament de Bioquímica i Fisiologia, Universitat de Barcelona, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Centros de Biomedicina en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Laura Molina-Porcel
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Neurological Tissue Bank, Biobanc-Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - Teresa Ximelis
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Neurological Tissue Bank, Biobanc-Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - Jordi Vilaplana
- Secció de Fisiologia, Departament de Bioquímica i Fisiologia, Universitat de Barcelona, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Centros de Biomedicina en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Carme Pelegrí
- Secció de Fisiologia, Departament de Bioquímica i Fisiologia, Universitat de Barcelona, Barcelona, Spain.,Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Centros de Biomedicina en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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189
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Immunomodulatory Properties of Host Defence Peptides in Skin Wound Healing. Biomolecules 2021; 11:biom11070952. [PMID: 34203393 PMCID: PMC8301823 DOI: 10.3390/biom11070952] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/16/2021] [Accepted: 06/19/2021] [Indexed: 02/07/2023] Open
Abstract
Cutaneous wound healing is a vital biological process that aids skin regeneration upon injury. Wound healing failure results from persistent inflammatory conditions observed in diabetes, or autoimmune diseases like psoriasis. Chronic wounds are incurable due to factors like poor oxygenation, aberrant function of peripheral sensory nervature, inadequate nutrients and blood tissue supply. The most significant hallmark of chronic wounds is heavily aberrant immune skin function. The immune response in humans relies on a large network of signalling molecules and their interactions. Research studies have reported on the dual role of host defence peptides (HDPs), which are also often called antimicrobial peptides (AMPs). Their duality reflects their potential for acting as antibacterial peptides, and as immunodulators that assist in modulating several biological signalling pathways related to processes such as wound healing, autoimmune disease, and others. HDPs may differentially control gene regulation and alter the behaviour of epithelial and immune cells, resulting in modulation of immune responses. In this review, we shed light on the understanding and most recent advances related to molecular mechanisms and immune modulatory features of host defence peptides in human skin wound healing. Understanding their functional role in skin immunity may further inspire topical treatments for chronic wounds.
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190
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Zhu J, Yang W, Zhou X, Zöphel D, Soriano-Baguet L, Dolgener D, Carlein C, Hof C, Zhao R, Ye S, Schwarz EC, Brenner D, Prates Roma L, Qu B. High Glucose Enhances Cytotoxic T Lymphocyte-Mediated Cytotoxicity. Front Immunol 2021; 12:689337. [PMID: 34248978 PMCID: PMC8267470 DOI: 10.3389/fimmu.2021.689337] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/10/2021] [Indexed: 12/18/2022] Open
Abstract
Cytotoxic T lymphocytes (CTLs) are key players to eliminate tumorigenic or pathogen-infected cells using lytic granules (LG) and Fas ligand (FasL) pathways. Depletion of glucose leads to severely impaired cytotoxic function of CTLs. However, the impact of excessive glucose on CTL functions still remains largely unknown. Here we used primary human CD8+ T cells, which were stimulated by CD3/CD28 beads and cultured in medium either containing high glucose (HG, 25 mM) or normal glucose (NG, 5.6 mM). We found that in HG-CTLs, glucose uptake and glycolysis were enhanced, whereas proliferation remained unaltered. Furthermore, CTLs cultured in HG exhibited an enhanced CTL killing efficiency compared to their counterparts in NG. Unexpectedly, expression of cytotoxic proteins (perforin, granzyme A, granzyme B and FasL), LG release, cytokine/cytotoxic protein release and CTL migration remained unchanged in HG-cultured CTLs. Interestingly, additional extracellular Ca2+ diminished HG-enhanced CTL killing function. Our findings suggest that in an environment with excessive glucose, CTLs could eliminate target cells more efficiently, at least for a certain period of time, in a Ca2+-dependent manner.
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Affiliation(s)
- Jie Zhu
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Wenjuan Yang
- Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Xiangda Zhou
- Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Dorina Zöphel
- Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Leticia Soriano-Baguet
- Experimental and Molecular Immunology, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Immunology and Genetics, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Belvaux, Luxembourg
- Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Denise Dolgener
- Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Christopher Carlein
- Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Chantal Hof
- Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Renping Zhao
- Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Shandong Ye
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Eva C. Schwarz
- Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Dirk Brenner
- Experimental and Molecular Immunology, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Immunology and Genetics, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Belvaux, Luxembourg
- Odense Research Center for Anaphylaxis, Department of Dermatology and Allergy Center, Odense University Hospital University of Southern Denmark, Odense, Denmark
| | - Leticia Prates Roma
- Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
| | - Bin Qu
- Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany
- INM – Leibniz Institute for New Materials, Saarbrücken, Germany
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191
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Kang CY, Kang EYC, Lai CC, Lo WC, Chen KJ, Wu WC, Liu L, Hwang YS, Lo FS, Huang YC. Nasal Methicillin-Resistant Staphylococcus aureus Colonization in Patients with Type 1 Diabetes in Taiwan. Microorganisms 2021; 9:microorganisms9061296. [PMID: 34203580 PMCID: PMC8232090 DOI: 10.3390/microorganisms9061296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/24/2022] Open
Abstract
Nasal methicillin-resistant Staphylococcus aureus (MRSA) colonies are an essential reservoir of infection, especially for patients with diabetes. However, data on MRSA colonization in patients with type 1 diabetes are limited. We investigated the epidemiology of MRSA colonization in patients with type 1 diabetes. This prospective cross-sectional study was conducted in a medical center (Chang Gung Memorial Hospital) in Taiwan from 1 July to 31 December 2020. Nasal sampling and MRSA detection were performed. The molecular characteristics of MRSA isolates were tested, and factors associated with MRSA colonization were analyzed. We included 245 patients with type 1 diabetes; nasal MRSA colonization was identified in 13 (5.3%) patients. All isolates belonged to community-associated MRSA genetic strains; the most frequent strain was clonal complex 45 (53.8%), followed by ST59 (30.8%) (a local community strain). MRSA colonization was positively associated with age ≤ 10 years, body mass index < 18 kg/m2, and diabetes duration < 10 years; moreover, it was negatively associated with serum low-density lipoprotein cholesterol ≥ 100 mg/dL. No independent factor was reported. The nasal MRSA colonization rate in type 1 diabetes is approximately 5% in Taiwan. Most of these colonizing strains are community strains, namely clonal complex 45 and ST59.
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Affiliation(s)
- Chun-Ya Kang
- School of Medicine, Medical University of Lublin, 20529 Lublin, Poland;
| | - Eugene Yu-Chuan Kang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (E.Y.-C.K.); (C.-C.L.); (K.-J.C.); (W.-C.W.); (L.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
| | - Chi-Chun Lai
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (E.Y.-C.K.); (C.-C.L.); (K.-J.C.); (W.-C.W.); (L.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
- Department of Family Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Wei-Che Lo
- Department of Ophthalmology, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan;
| | - Kun-Jen Chen
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (E.Y.-C.K.); (C.-C.L.); (K.-J.C.); (W.-C.W.); (L.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
| | - Wei-Chi Wu
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (E.Y.-C.K.); (C.-C.L.); (K.-J.C.); (W.-C.W.); (L.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
| | - Laura Liu
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (E.Y.-C.K.); (C.-C.L.); (K.-J.C.); (W.-C.W.); (L.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
| | - Yih-Shiou Hwang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (E.Y.-C.K.); (C.-C.L.); (K.-J.C.); (W.-C.W.); (L.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
| | - Fu-Sung Lo
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (E.Y.-C.K.); (C.-C.L.); (K.-J.C.); (W.-C.W.); (L.L.); (Y.-S.H.)
- Division of Pediatric Endocrinology and Genetics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
- Correspondence: (F.-S.L.); (Y.-C.H.); Tel.: +886-3-3281200 (F.-S.L. & Y.-C.H.)
| | - Yhu-Chering Huang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (E.Y.-C.K.); (C.-C.L.); (K.-J.C.); (W.-C.W.); (L.L.); (Y.-S.H.)
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
- Correspondence: (F.-S.L.); (Y.-C.H.); Tel.: +886-3-3281200 (F.-S.L. & Y.-C.H.)
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192
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Increased insulin and GLUT2 gene expression and elevated glucokinase activity in β-like cells of islets of langerhans differentiated from human haematopoietic stem cells on treatment with Costus igneus leaf extract. Mol Biol Rep 2021; 48:4477-4485. [PMID: 34109498 DOI: 10.1007/s11033-021-06467-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/01/2021] [Indexed: 10/21/2022]
Abstract
In the quest to understand lost β-cells regeneration in the diabetic condition, we have demonstrated successful differentiation of human haematopoietic stem cells (HSCs) to functional β-like cells. Costus igneus (Ci) leaf extract is known to exhibit anti-diabetic properties by lowering the blood glucose level as demonstrated in mice models. To establish the anti-diabetic properties of Ci leaf extract on human subjects, we studied the effect of Ci on these differentiated β-like cells. Ci leaf extract showed its anti-diabetic property through elevated glucokinase activity which catalyzes the rate-limiting step of glucose catabolism in β-like cells and acts as a sensor for insulin production while decreasing the glucose-6-phosphatase activity. Upon increasing the concentrations of Ci leaf extract (25, 65, 105, 145, 185 µg/ml) and glucose concentrations (5.5, 11.1, and 25 mM) Ci leaf extract treated β-like cells showed enhanced glucokinase and decreased glucose-6-phosphatase activities and an exponential rise in gene expressions of INS and GLUT2 was observed. The present study shows enhanced INS and GLUT2 gene expression and elevated glucokinase activity in β-like cells differentiated from HSCs upon treatment with Ci leaf extract explain the anti-diabetic property of Ci leaf extract. This extract can be effectively used in the management of diabetes.
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193
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Torres T, Pereira M, Paiva Lopes MJ, Rebelo C, Andrade P, Henrique M, Oliveira H, Ferreira P, Marques Pinto G, Menezes Brandão F, Rozeira J, Filipe P, Tavares Bello R. Dermatologists' attitude towards psoriasis treatment during the COVID-19 pandemic. Drugs Context 2021; 10:dic-2021-4-4. [PMID: 34178094 PMCID: PMC8195567 DOI: 10.7573/dic.2021-4-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/12/2021] [Indexed: 01/16/2023] Open
Abstract
Background The COVID-19 pandemic introduced new challenges in several dimensions in healthcare services. Herein, we describe the real-life strategies and therapeutic options adopted by dermatologists regarding their patients with psoriasis being treated with or with an indication for systemic therapy during the first COVID-19 lockdown period in Portugal. Methods The study involves a web-based survey on the clinical management of systemic therapy for psoriasis during the COVID-19 pandemic administered to Portuguese dermatologists. The survey consisted of 55 questions (4 open-ended questions; 51 closed-ended questions), grouped into 6 sections. Results A total of 60 dermatologists voluntarily participated in this survey. Nearly 63% of the participants opted for suspending biologics during the COVID-19 lockdown period and 23.3% increased the time between drug administrations. Eighty percent of the participants agreed that biologics did not change the probability of acquiring COVID-19 and 58.4% believed that these drugs decreased or did not change the severity of the disease. Approximately one-third of the participants opted not to prescribe a biological agent in patients despite clinical indication over the duration of the pandemic. Nearly 25% of the participants opted for suspending traditional immunosuppressant administration. Virtual appointments were an option for 93.3% of the participants. Conclusion The COVID-19 pandemic has significantly affected the management of patients with psoriasis being treated with or with an indication for systemic therapy. Some of the decisions made during the first lockdown period were contrary to what we know today. These decisions might have had a significant impact on patients’ quality of life and on future therapeutic success. An adequate interpretation and analysis of the available data will be extremely important to an insightful adaptation of the clinical practice in future confinement or restrictive scenarios.
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Affiliation(s)
- Tiago Torres
- Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | | | - Maria João Paiva Lopes
- Department of Dermatology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.,CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Clarisse Rebelo
- Department of Dermatology, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | - Pedro Andrade
- Department of Dermatology, Hospital de Pedro Hispano, Matosinhos, Portugal
| | - Martinha Henrique
- Department of Dermatology, Centro Hospitalar de Leiria, Leiria, Portugal
| | - Hugo Oliveira
- Department of Dermatology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Paulo Ferreira
- Psoriasis Unit, Hospital CUF Descobertas, Lisbon, Portugal
| | - Gabriela Marques Pinto
- Department of Dermatology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | | | | | - Paulo Filipe
- Department of Dermatology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.,Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Dermatology Research Unit, iMM João Lobo Antunes, University of Lisboa, Lisboa, Portugal
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194
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Palaiodimos L, Chamorro-Pareja N, Karamanis D, Li W, Zavras PD, Chang KM, Mathias P, Kokkinidis DG. Diabetes is associated with increased risk for in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis comprising 18,506 patients. Hormones (Athens) 2021; 20:305-314. [PMID: 33123973 PMCID: PMC7595056 DOI: 10.1007/s42000-020-00246-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/16/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE Infectious diseases are more frequent and can be associated with worse outcomes in patients with diabetes. The aim of this study was to systematically review and conduct a meta-analysis of the available observational studies reporting the effect of diabetes on mortality among hospitalized patients with COVID-19. METHODS The Medline, Embase, Google Scholar, and medRxiv databases were reviewed for identification of eligible studies. A random effects model meta-analysis was used, and I2 was utilized to assess the heterogeneity. In-hospital mortality was defined as the endpoint. Sensitivity, subgroup, and meta-regression analyses were performed. RESULTS A total of 18,506 patients were included in this meta-analysis (3713 diabetics and 14,793 non-diabetics). Patients with diabetes were associated with a higher risk of death compared with patients without diabetes (OR 1.65; 95% CI 1.35-1.96; I2 77.4%). The heterogeneity was high. A study-level meta-regression analysis was performed for all the important covariates, and no significant interactions were found between the covariates and the outcome of mortality. CONCLUSION This meta-analysis shows that that the likelihood of death seems to be higher in diabetic patients hospitalized with COVID-19 compared with non-diabetic patients. Further studies are needed to assess whether this association is independent or not, as well as to investigate the role of adequate glycemic control prior to infection with COVID-19.
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Affiliation(s)
- Leonidas Palaiodimos
- Division of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, NW Building, 8th Floor, 111 East 210th Str., Bronx, NY, 10467, USA.
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA.
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA.
| | - Natalia Chamorro-Pareja
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
| | - Dimitrios Karamanis
- Department of Economics, University of Piraeus, 72 Ellis Str., Piraeus, 18546, Attica, Greece
| | - Weijia Li
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
| | - Phaedon D Zavras
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
| | - Kai Ming Chang
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
- Division of Infectious Disease, Northwell Health, New Hyde Park, NY, USA
| | - Priyanka Mathias
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
- Division of Endocrinology, Montefiore Medical Center, 111 East 210th Str., Bronx, NY, 10467, USA
| | - Damianos G Kokkinidis
- Albert Einstein College of Medicine, 1400 Pelham Parkway South, Bronx, NY, 10461, USA
- Department of Medicine, Jacobi Medical Center, Bronx, NY, USA
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195
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Clinical and surgical factors affecting the prognosis and survival rates in patients with mucormycosis. Eur Arch Otorhinolaryngol 2021; 279:1363-1369. [PMID: 34075487 DOI: 10.1007/s00405-021-06910-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the factors affecting disease specific mortality (DSM) in patients with mucormycosis. METHODS This retrospective study included 24 patients diagnosed with mucormycosis and who had undergone surgical and medical treatment between 2010 and 2020. There were 14 male and 10 female patients whose mean age was 53.70 ± 16.87 years, range 18-83. We reviewed the factors affecting DSM, including the extent of disease (paranasal sinus, palatal, orbital or intracranial involvement) and blood parameters (BP) that are serum glucose level (SGL), white blood cell, neutrophil, lymphocyte counts, C-reactive protein and hemoglobulin levels. Also, the effect of SGL in diabetes mellitus and BP in hematological malignancies on DSM was additionally evaluated. RESULTS Orbital (p = 0.001) and intracranial (p < 0.01) involvement had statistically significant effect on DSM but not the palatal involvement. When Cox regression analysis was employed to analyze the effect of multiple independent factors on DSM, only the extent of disease (p = 0.023) had statistically significant effect. Receiver operating characteristic analysis of SGL for diabetic patients demonstrated that the area under the curve was 0.917 (p = 0.016). A cut-off SGL of 360 mg/dl revealed an 83.3% sensitivity and 83.3% specificity for mortality outcome for diabetic patients having mucormycosis. CONCLUSION Orbital or cerebral involvement is related to a poor prognosis, so early endoscopic nasal examination, diagnosis and treatment are of vital importance for DSM in mucormycosis. Serum glucose level over 360 mg/dl in uncontrolled diabetic patients with fever, ophthalmological findings and facial hypoesthesia should necessitate a consultation to an otolaryngologist and an endoscopic careful nasal examination.
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196
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Lignitz S, Zepp F. Diabetes und Impfen. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1140-1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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197
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Tauseef A, Zafar M, Syyed E, Thirumalareddy J, Sood A, Mirza M. Asymptomatic Bacteriuria (ASB) in diabetic patients: Treat or not to treat: A prospective, observational study conducted at a tertiary care hospital. J Family Med Prim Care 2021; 10:1963-1969. [PMID: 34195132 PMCID: PMC8208176 DOI: 10.4103/jfmpc.jfmpc_1894_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/24/2020] [Accepted: 12/16/2020] [Indexed: 12/02/2022] Open
Abstract
Background: The term asymptomatic bacteriuria (ASB) refers to the isolation of bacteria in a urine specimen of individuals who denied symptoms of urinary tract infection. Diabetes mellitus (DM) is a disease involving multiple organ systems, hallmarked for its chronicity and thus-forth endless complications including asymptomatic bacteriuria. Objectives: This study aimed to determine the characteristics of asymptomatic bacteriuria and antibiotic susceptibility pattern amongst patients with diabetes. Settings and Design: A prospective observational study was conducted at a tertiary care hospital in Karachi, Pakistan. Methods and Material: The study included all those patients with a diagnosis of diabetes with no signs and symptoms of urinary tract infection but showing the growth of an organism in urine culture. Pregnant females and subjects who used antibiotics in last two weeks were excluded. A total of 222 urine cultures were observed prospectively who met the inclusion criteria through non-probability consecutive sampling. Results: Out of 222 urine cultures observed, mean age of subjects were 62.89 ± 13.77 out of which 76% were females, and 61% had a family history of diabetes. The most frequent organisms isolated were Escherichia. Coli (E. Coli), Enterococcus, Klebsiella, Pseudomonas, and Enterobacter species. A total of 20 subjects got dual bacterial growth in their cultures among which 17 subjects had a growth of Enterococcus with any other pathogen causing UTI. Gender, family history of diabetes, levels of HBA1c, and older age groups all were found significantly associated with ASB. Conclusions: Our study is the first to analyze and study the associated risk factors amongst ASB in DM patients, and to identify the pathogens involved along with assessing their antibiotic resistance profiles. Also, due to the increase resistance to antibiotics we would recommend to use antibiotics in ASB patients only if they have any two or more comorbidities.
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Affiliation(s)
- Abubakar Tauseef
- Resident Physician, Department of Internal Medicine, Creighton University Hospital Program, Omaha, NE, USA
| | - Maryam Zafar
- Resident Physician in Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Erum Syyed
- Medical Student at Dow University of Health Sciences, Karachi, Pakistan
| | - Joseph Thirumalareddy
- Hospitalist, Department of Internal Medicine, Creighton University Hospital Program, Omaha, NE, USA
| | - Akshat Sood
- Hospitalist, Department of Internal Medicine, Creighton University Hospital Program, Omaha, NE, USA
| | - Mohsin Mirza
- Associate Program Director, Department of Internal Medicine, Creighton University Hospital Program, Omaha, NE, USA
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198
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Monteiro C, Silvestre S, Duarte AP, Alves G. Assessment of suspected adverse drug reactions in elderly patients with diabetes mellitus based on a Portuguese spontaneous reporting database: analysis of reporting from 2008 to 2018. Expert Opin Drug Saf 2021; 20:845-853. [PMID: 33962523 DOI: 10.1080/14740338.2021.1928072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Age is one of the most important risk factors in the development of diabetes mellitus and certain drug classes indicated for this condition may be associated with clinically important adverse drug reactions (ADRs). The aim of this study was to analyze the suspected ADRs in older patients with diabetes mellitus, reported to the Portuguese Pharmacovigilance System from 2008 to 2018. RESEARCH DESIGN AND METHODS A retrospective analysis of suspected ADRs reports was performed, involving patients aged ≥65 years. RESULTS Of a total of 751 reports collected, 439 were considered serious, 199 led to hospitalization and in 19 of them occurred a fatal outcome. Most of them were observed in females (n = 393) and involved patients belonging mainly to the age group 65-74 years (n = 405). Taking into account a total of 2134 suspected ADRs, the most frequent were hypoglycemia (2.67%) and lactic acidosis (2.62%). The drugs specifically indicated for glycemic control were the most frequently involved in ADRs. CONCLUSIONS Most of the ADRs were reported as serious and were mainly associated to drugs in diabetes mellitus. In addition, the majority of them, such as hypoglycemia, are preventable, highlighting the importance to identify possible factors that determine this occurrence, especially in the elderly.
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Affiliation(s)
- Cristina Monteiro
- UFBI - Pharmacovigilance Unit of Beira Interior, University of Beira Interior, Covilhã, Portugal
| | - Samuel Silvestre
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Ana Paula Duarte
- UFBI - Pharmacovigilance Unit of Beira Interior, University of Beira Interior, Covilhã, Portugal.,CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Gilberto Alves
- UFBI - Pharmacovigilance Unit of Beira Interior, University of Beira Interior, Covilhã, Portugal.,CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.,ESALD-IPCB - Dr. Lopes Dias School of Health, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal
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199
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Potential Pathogenicity of Candida Species Isolated from Oral Cavity of Patients with Diabetes Mellitus. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9982744. [PMID: 34136578 PMCID: PMC8175137 DOI: 10.1155/2021/9982744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/18/2021] [Accepted: 05/12/2021] [Indexed: 01/12/2023]
Abstract
Introduction In the recent decade, the increased immunocompromised population such as diabetic patients makes a high incidence of invasive Candida infections. Diabetes mellitus is the most common endocrine metabolic disorder, and diabetic patients are more susceptible to oral candidiasis infection. Candidiasis is an opportunistic fungal infection caused by many species of Candida. Secretion of exoenzymes plays an important role in the virulence and pathogenesis of Candida species. The aim of this study was to evaluate the potential role of phospholipase, esterase, and hemolytic activity of Candida species isolated from oral cavity lesions of diabetic patients. Methods A total of 108 Candida species including 75 Candida albicans and 33 non-Candida albicans species were recovered from the oral cavity of diabetic patients included in our study. Egg yolk agar, Tween 80 opacity medium, and blood agar plate assays were used for determining phospholipase, esterase, and hemolytic activities, respectively. Results Candida albicans species had the most exoenzyme activity in comparison to non-albicans isolates. Candida albicans isolates showed 97.3%, 100%, and 77.3% phospholipase, hemolysin, and esterase activities, respectively. The difference between Candida albicans and non-Candida albicans was significant in phospholipase (P < 0.001) and hemolytic activity (P = 0.027), but not significant in esterase activity (P = 0.076). Conclusion This study showed that most of the isolates had different enzymatic patterns, and Candida albicans isolates had the most exoenzyme activity. So due to the potential effects of these enzymes in pathogenesis and virulence effects of Candida species, we can conclude that the severity of extracellular enzymes may play a role in the severity of signs and symptoms of Candida oral cavity infections in diabetic patients.
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200
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Adjei P, Afriyie-Mensah J, Ganu VJ, Puplampu P, Opoku-Asare B, Dzefi-Tettey K, Amissah-Arthur MB, Tachi K, Boima V, Dey D, Akamah J, Akpalu A, Akpalu J, Amoo P, Otchi E, Marfoh K, Agyei-Nkansah A. Clinical characteristics of COVID-19 patients admitted at the Korle-Bu Teaching Hospital, Accra, Ghana. Ghana Med J 2021; 54:33-38. [PMID: 33976439 PMCID: PMC8087357 DOI: 10.4314/gmj.v54i4s.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The study examined the clinical characteristics and outcomes of 2019 novel coronavirus disease (COVID-19) infections among hospitalized patients. Design Study design was a retrospective single-center review of hospital data. Setting The study was conducted at the COVID-19 Treatment Center of the Department of Medicine and Therapeutics of the Korle-Bu Teaching hospital in Accra, Ghana. Participants and study tools A total of fifty patients with laboratory (rRT-PCR) confirmed COVID-19 infection were involved in the study. A chart review of the medical records of the patients was conducted and the data obtained was documented using a data extraction form. Results The median age was 53 years and most (36% (18/50)) of the patients were at least 60 years of age. Eighty percent (40/50) of the patients were symptomatic, with cough and difficulty in breathing being the commonest presenting symptoms. The mean duration of hospitalization was 12.3 ± 7.3 days. Hypertension and Diabetes Mellitus were the commonest co-morbidities occurring in 52% (26/50) and 42% (21/50) of patients respectively. Fifty percent of patients developed COVID-19 pneumonia as a complication. The mortality rate was 12% (6/50). Conclusion In this study, SARS-CoV2 infection affected older adults with hypertension and diabetes mellitus being the common comorbidities. Patients with these comorbid conditions should be counselled by their clinicians to strictly observe the COVID-19 prevention protocols to reduce their risk of acquiring the infection. There is a need to pay critical and prompt attention to the management of patients with COVID-19 pneumonia particularly among people with diabetes to improve outcomes. Funding None declared.
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Affiliation(s)
- Patrick Adjei
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana.,Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Jane Afriyie-Mensah
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana.,Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Vincent J Ganu
- Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Peter Puplampu
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana.,Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | | | | | - Maame-Boatemaa Amissah-Arthur
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana.,Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Kenneth Tachi
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana.,Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Vincent Boima
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana.,Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Dzifa Dey
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana.,Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Joseph Akamah
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana.,Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Albert Akpalu
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana.,Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Josephine Akpalu
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana.,Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - Phillip Amoo
- Public Health Unit, Korle Bu Teaching Hospital, Accra, Ghana
| | - Elom Otchi
- Public Health Unit, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - Adwoa Agyei-Nkansah
- Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana.,Department of Medicine, Korle Bu Teaching Hospital, Accra, Ghana
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