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Trandafir LM, Moisa SM, Vlaiculescu MV, Butnariu LI, Boca LO, Constantin MML, Lupu PM, Brinza C, Temneanu OR, Burlacu A. Insulin Pump Therapy Efficacy and Key Factors Influencing Adherence in Pediatric Population-A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1671. [PMID: 36422210 PMCID: PMC9699426 DOI: 10.3390/medicina58111671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 08/27/2023]
Abstract
Objective: we aimed to highlight the state of the art in terms of pediatric population adherence to insulin pumps. This study intends to underline the significance of identifying and minimizing, to the greatest extent feasible, the factors that adversely affect the juvenile population's adherence to insulin pump therapy. Materials and methods: articles from PubMed, Embase, and Science Direct databases were evaluated using the following search terms: adherence, pump insulin therapy, children, pediatric population, and type 1 diabetes, in combination with several synonyms such as compliance, treatment adherence, pump adherence, patient dropouts, and treatment refusal. Results: A better glycemic control is connected to a better adherence to diabetes management. We identify, enumerate, and discuss a number of variables which make it difficult to follow an insulin pump therapy regimen. Several key factors might improve adherence to insulin pump therapy: efficient communication between care provider and patients (including home-based video-visits), continuous diabetes education, family support and parental involvement, as well as informational, practical assistance, and emotional support from the society. Conclusions: every cause and obstacle that prevents young patients from adhering to insulin pumps optimally is an opportunity for intervention to improve glycemic control and, as a result, their quality of life.
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Affiliation(s)
- Laura Mihaela Trandafir
- Pediatrics Department, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- “Sfanta Maria” Clinical Emergency Hospital, 700309 Iasi, Romania
| | - Stefana Maria Moisa
- Pediatrics Department, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- “Sfanta Maria” Clinical Emergency Hospital, 700309 Iasi, Romania
| | | | - Lacramioara Ionela Butnariu
- “Sfanta Maria” Clinical Emergency Hospital, 700309 Iasi, Romania
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, Romania
| | | | - Maria Magdalena Leon Constantin
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, Romania
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Paula Madalina Lupu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, Romania
| | - Crischentian Brinza
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, Romania
- Institute of Cardiovascular Diseases “Prof. Dr. George I.M. Georgescu”, 700503 Iasi, Romania
| | - Oana Raluca Temneanu
- Department of Mother and Child Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Alexandru Burlacu
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, Romania
- Institute of Cardiovascular Diseases “Prof. Dr. George I.M. Georgescu”, 700503 Iasi, Romania
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202
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Calcaterra V, Verduci E, Vandoni M, Rossi V, Fiore G, Massini G, Berardo C, Gatti A, Baldassarre P, Bianchi A, Cordaro E, Cavallo C, Cereda C, Bosetti A, Zuccotti G. The Effect of Healthy Lifestyle Strategies on the Management of Insulin Resistance in Children and Adolescents with Obesity: A Narrative Review. Nutrients 2022; 14:4692. [PMID: 36364954 PMCID: PMC9657567 DOI: 10.3390/nu14214692] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 10/29/2022] [Accepted: 11/04/2022] [Indexed: 11/07/2023] Open
Abstract
Childhood obesity is characterized by an increased risk of several metabolic derangements including insulin resistance (IR). The strongest recommendations to prevent obesity and related complications are a balanced and adequate diet and practicing physical activity from early childhood. In this review, we propose to present the effects of healthy lifestyle strategies, including physical exercise and dietary approaches, on the management of IR and related metabolic derangements. All types of exercise (aerobic, resistance and combined training) effectively reduce IR in pediatric patients with obesity; it seems that aerobic and combined training stimulate greater improvements in IR compared to resistance training. Balanced normocaloric or hypocaloric dietary approaches are also valid strategies to address IR; it is not possible to assess the long-term impact of varying macronutrients on cardiometabolic risk. The glycemic index/load evaluation is a useful dietary approach to glucose metabolism control. Similarly, they should adopt the principle of the Mediterranean diet. Randomized studies with longer monitoring are needed to define the benefits of nutritional supplementation on IR. Considering that healthy style acquisition could track to later ages, programs of healthy lifestyle starting with children offer a better preventive strategy to preserve metabolic control and children's health.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Elvira Verduci
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
- Department of Health Sciences, University of Milano, 20142 Milan, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Virginia Rossi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Giulia Fiore
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Giulia Massini
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Clarissa Berardo
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milan, Italy
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Paola Baldassarre
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Alice Bianchi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Erika Cordaro
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Caterina Cavallo
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- LUNEX International University of Health, Exercise and Sports, 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg
| | - Cristina Cereda
- Neonatal Screening and Metabolic Disorders Unit, V. Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Alessandra Bosetti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milan, Italy
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203
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Romeyke T. A Multimodal Approach in the Treatment of Persistent Post-COVID. Diseases 2022; 10:diseases10040097. [PMID: 36412591 PMCID: PMC9680432 DOI: 10.3390/diseases10040097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/10/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Many patients suffer from the consequences of a COVID infection. The so-called long or post-COVID syndrome affects the quality of life of patients and can lead to severe physical impairments. There are currently no suitable therapies for the treatment of long/post-COVID. CASE PRESENTATION A 49-year-old patient with post-COVID was admitted to a specialized clinic to carry out a multimodal therapy approach in the event of a therapy-resistant course. In addition to pronounced fatigue, sleep disorders, inner restlessness, and depression were seen in the patients' high levels of suffering. A naturopathic complex therapy including systemic whole-body hyperthermia was carried out. Well-being and physical well-being were recorded using the visual analog scale, and depression was recorded using the Patient Health Questionnaire Depression (PHQ-D). There was close monitoring of the vital parameters, and an evaluation of the therapy result was performed. DISCUSSION AND CONCLUSION The implementation of a naturopathic complex therapy including systemic whole-body hyperthermia was able to significantly improve the mental state, physical well-being, and mood of the patient. Since there are still no evidence-based therapy recommendations for the treatment of long/post-COVID, clinical research is called upon to intensively deal with this topic and to examine treatment concepts.
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Affiliation(s)
- Tobias Romeyke
- Medical Informatics and Technology, Institute for Management and Economics in Health Care, UMIT—University of Health Sciences, 6060 Hall in Tirol, Austria;
- Waldhausklinik Deuringen, Acute Hospital for Internal Medicine, Pain Therapy, Complementary and Individualized Patient Centered Medicine, 86391 Deuringen, Germany
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204
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Impact of an exercise program in children with inflammatory bowel disease in remission. Pediatr Res 2022:10.1038/s41390-022-02362-8. [PMID: 36319697 PMCID: PMC9628325 DOI: 10.1038/s41390-022-02362-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/20/2022] [Accepted: 10/17/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND The aim of our study was to investigate the impact of a structured exercise program on bone mineral density (BMD) and body composition parameters in children and adolescents with IBD in remission. METHODS Patients were recruited to participate in a 6-month exercise program. Total body less head (TLBH) dual energy X-ray absorptiometry (DXA) was used to measure BMD. The same method was used to assess fat mass (FM) and lean body mass (LBM) at baseline and at the completion of the program. RESULTS Based on the baseline and endpoint TBLH DXA measurements, a total of 42 study participants (25 boys; aged 15.3 ± 2.08 years) experienced an increase in BMD (from 0.959 ± 0.023 g/cm2 to 0.988 ± 0.025 g/cm2, p < 0.001) and LBM (from 37.12 ± 1.43 kg to 38.75 ± 1.61 kg, p = 0.012). Age- and sex-based BMD Z-score increased significantly (from -0.35 ± 0.15 to -0.28 ± 0.17, p = 0.020), whilst LBM Z-score did not significantly change (from -1.78 ± 0.23 to -1.71 ± 1.49, p = 0.908). CONCLUSIONS There was a significant improvement in BMD, age- and sex-based BMD Z-score, and LBM amongst study participants. Subgroup analysis showed that patients with CD and male study participants experienced significant improvement in all parameters, whilst patients with UC and IBD-U and female patients experienced improvement solely in BMD. IMPACT STATEMENT Children and adolescents with IBD, regardless of disease activity, are under increased risk of secondary osteoporosis and lean body mass deficits. A 6-month home-based structured exercise program leads to a significant improvement in bone mineral density and lean body mass. Exercise therapy should be explored as a potentially adjacent to standard treatment modalities.
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205
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Ying-hao P, Yuan-yuan G, Hai-dong Z, Qiu-hua C, Xue-ran G, Hai-qi Z, Hua J. Clinical characteristics and analysis of risk factors for disease progression of patients with SARS-CoV-2 Omicron variant infection: A retrospective study of 25207 cases in a Fangcang hospital. Front Cell Infect Microbiol 2022; 12:1009894. [PMID: 36389157 PMCID: PMC9659624 DOI: 10.3389/fcimb.2022.1009894] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/17/2022] [Indexed: 08/01/2023] Open
Abstract
OBJECTIVES To summarize the clinical characteristics of patients infected by SARS-CoV-2 omicron variant and explore the risk factors affecting the progression in a Fangcang hospital, Shanghai, China. METHODS A total of 25,207 patients were retrospectively enrolled. We described the clinical characteristics and performed univariate and multivariate logistic regression analysis to identify the risk factors for non-severe to severe COVID-19 or death. RESULTS According to the outcomes, there were 39 severe patients (including 1 death) and 25,168 non-severe patients enrolled in this study. Among the 25,207 cases, the median age was 45 years (IQR 33-54), and 65% patients were male. Cough (44.5%) and expectoration (38.4%) were the most two common symptoms. Hypertension (10.4%) and diabetes (3.5%) were most two common comorbidities. Most patients (81.1%) were fully vaccinated. The unvaccinated and partially vaccinated patients were 15.1% and 3.9%, respectively. The length of viral shedding time was six days (IQR 4-9) in non-severe patients. Multivariate logistic regression analysis suggested that age (OR=1.062, 95%CI 1.034-1.090, p<0.001), fever (OR=2.603, 95%CI 1.061-6.384, p=0.037), cough (OR=0.276, 95%CI 0.119-0.637, p=0.003), fatigue (OR=4.677, 95%CI 1.976-11.068, p<0.001), taste disorders (OR=14.917, 95%CI 1.884-118.095, p=0.010), and comorbidity (OR=2.134, 95%CI 1.059-4.302, p=0.034) were predictive factors for deterioration of SARS-CoV-2 omicron variant infection. CONCLUSIONS Non-critical patients have different clinical characteristics from critical patients. Age, fever, cough, fatigue, taste disorders, and comorbidity are predictors for the deterioration of SARS-CoV-2 omicron variant infection.
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Affiliation(s)
- Pei Ying-hao
- Department of Intensive Care Unit, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Gu Yuan-yuan
- Department of Intensive Care Unit, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Zhang Hai-dong
- Department of Intensive Care Unit, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Chen Qiu-hua
- Department of Intensive Care Unit, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Gu Xue-ran
- Department of Medical Affairs, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Zhou Hai-qi
- Department of Intensive Care Unit, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jiang Hua
- Department of Intensive Care Unit, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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206
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Sunada N, Honda H, Nakano Y, Yamamoto K, Tokumasu K, Sakurada Y, Matsuda Y, Hasegawa T, Otsuka Y, Obika M, Hanayama Y, Hagiya H, Ueda K, Kataoka H, Otsuka F. Hormonal trends in patients suffering from long COVID symptoms. Endocr J 2022; 69:1173-1181. [PMID: 35491089 DOI: 10.1507/endocrj.ej22-0093] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Symptoms of long COVID are complex and long-lasting, and endocrine dysfunction might be involved in the underlying mechanisms. In this study, to clarify the hormonal characteristics of long COVID patients, laboratory data for patients who visited the outpatient clinic for long COVID were evaluated. A retrospective analysis was performed for patients who visited Okayama University Hospital during the period from Feb 2021 to Dec 2021 with focus on the interrelationships between major symptoms and endocrine data. Information and laboratory data were obtained from medical records for 186 patients. The patients had various symptoms, and the most frequent symptoms were general malaise, dysosmia/dysgeusia, hair loss, headache, dyspnea, and sleeplessness. Patients who were suffering from fatigue and dysosmia/dysgeusia were younger, while hair loss was more frequent in older and female patients. As for the characteristics of patients suffering from general fatigue, the scores of depression and fatigue were positively correlated with serum levels of cortisol and free thyroxin (FT4), respectively. Also, patients suffering from general fatigue had lower levels of serum growth hormone and higher levels of serum FT4, while patients with dysosmia/dysgeusia had a significantly lower level of serum cortisol. Serum thyrotropin (TSH) levels were higher and the ratios of FT4/TSH were lower in the initially severe cases, suggesting occult hypothyroidism. In addition, the ratios of plasma adrenocorticotropin to serum cortisol were decreased in patients with relatively high titers of serum SARS-CoV-2 antibody. Thus, hormonal changes seem to be, at least in part, involved in the persistent symptoms of long COVID.
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Affiliation(s)
- Naruhiko Sunada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Hiroyuki Honda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yasuhiro Nakano
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Koichiro Yamamoto
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Kazuki Tokumasu
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yasue Sakurada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yui Matsuda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Toru Hasegawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yuki Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Mikako Obika
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yoshihisa Hanayama
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Hideharu Hagiya
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Keigo Ueda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Hitomi Kataoka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
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207
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Lopes S, Fontes T, Tavares RG, Rodrigues LM, Ferreira-Pêgo C. Bioimpedance and Dual-Energy X-ray Absorptiometry Are Not Equivalent Technologies: Comparing Fat Mass and Fat-Free Mass. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13940. [PMID: 36360820 PMCID: PMC9657485 DOI: 10.3390/ijerph192113940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Bioimpedance (BIA) is the most frequently used technology for body composition assessment at a daily clinical level, mostly due to its low price and user-friendly operation. However, many doubts persist regarding its physiological meaning and applicability. The present study aimed to compare one BIA system and the Dual-Energy X-ray Absorptiometry (DXA) for the characterization of body composition in a previously selected cohort of healthy adult participants. A descriptive observational cross-sectional study included a final sample of 121 participants, 93 women and 28 men, with a mean age of 28.26 ± 9.72 years old and a mean body mass index (BMI) of 22.68 ± 3.13 kg/m2. Statistics involved paired t-tests and agreement analysis by the Bland-Altman method. BIA underestimated the percent body fat (%BF) by 5.56% and overestimated Fat-Free Mass (FFM) by 2.90 kg. A strong positive correlation between both technologies was found for FFM (r = 0.980) and the %BF (r = 0.932), but the disagreement was statistically significant (p < 0.001). Although DXA and BIA seem to correlate, these technologies are not congruent. Therefore, the risk of (mis)interpretation and bias is clear with BIA, potentially impacting the nutritional planning of clinical dietitians and the further results of its patients.
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208
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Armbruster CR, Li K, Kiedrowski MR, Zemke AC, Melvin JA, Moore J, Atteih S, Fitch AC, DuPont M, Manko CD, Weaver ML, Gaston JR, Alcorn JF, Morris A, Methé BA, Lee SE, Bomberger JM. Low Diversity and Instability of the Sinus Microbiota over Time in Adults with Cystic Fibrosis. Microbiol Spectr 2022; 10:e0125122. [PMID: 36094193 PMCID: PMC9603634 DOI: 10.1128/spectrum.01251-22] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 08/10/2022] [Indexed: 12/30/2022] Open
Abstract
Chronic rhinosinusitis (CRS) is a common, yet underreported and understudied manifestation of upper respiratory disease in people with cystic fibrosis (CF). Recently developed standard of care guidelines for the management of CF CRS suggest treatment of upper airway disease may ameliorate lower airway disease. We sought to determine whether changes to sinus microbial community diversity and specific taxa known to cause CF lung disease are associated with increased respiratory disease and inflammation. We performed 16S rRNA gene sequencing, supplemented with cytokine analyses, microscopy, and bacterial culturing, on samples from the sinuses of 27 adults with CF CRS. At each study visit, participants underwent endoscopic paranasal sinus sampling and clinical evaluation. We identified key drivers of microbial community composition and evaluated relationships between diversity and taxa with disease outcomes and inflammation. Sinus community diversity was low, and the composition was unstable, with many participants exhibiting alternating dominance between Pseudomonas aeruginosa and staphylococci over time. Despite a tendency for dominance by these two taxa, communities were highly individualized and shifted composition during exacerbation of sinus disease symptoms. Exacerbations were also associated with communities dominated by Staphylococcus spp. Reduced microbial community diversity was linked to worse sinus disease and the inflammatory status of the sinuses (including increased interleukin-1β [IL-1β]). Increased IL-1β was also linked to worse sinus endoscopic appearance, and other cytokines were linked to microbial community dynamics. Our work revealed previously unknown instability of sinus microbial communities and a link between inflammation, lack of microbial community diversity, and worse sinus disease. IMPORTANCE Together with prior sinus microbiota studies of adults with CF chronic rhinosinusitis, our study underscores similarities between sinus and lower respiratory tract microbial community structures in CF. We show how community structure tracks with inflammation and several disease measures. This work strongly suggests that clinical management of CRS could be leveraged to improve overall respiratory health in CF. Our work implicates elevated IL-1β in reduced microbiota diversity and worse sinus disease in CF CRS, suggesting applications for existing therapies targeting IL-1β. Finally, the widespread use of highly effective cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy has led to less frequent availability of spontaneous expectorated sputum for microbiological surveillance of lung infections. A better understanding of CF sinus microbiology could provide a much-needed alternative site for monitoring respiratory infection status by important CF pathogens.
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Affiliation(s)
- Catherine R. Armbruster
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kelvin Li
- Center for Medicine and the Microbiome, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Megan R. Kiedrowski
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Anna C. Zemke
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jeffrey A. Melvin
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - John Moore
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Samar Atteih
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Adam C. Fitch
- Center for Medicine and the Microbiome, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Matthew DuPont
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Christopher D. Manko
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Madison L. Weaver
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jordon R. Gaston
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - John F. Alcorn
- Department of Pediatrics, Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alison Morris
- Center for Medicine and the Microbiome, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Barbara A. Methé
- Center for Medicine and the Microbiome, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Stella E. Lee
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jennifer M. Bomberger
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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209
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Serum kisspeptin and proopiomelanocortin in cystic fibrosis: a single study. Sci Rep 2022; 12:17669. [PMID: 36271282 PMCID: PMC9586927 DOI: 10.1038/s41598-022-21851-8] [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: 06/29/2022] [Accepted: 10/04/2022] [Indexed: 01/18/2023] Open
Abstract
The determination of hormonal biomarkers is of increasing interest in many diseases, including cystic fibrosis (CF). Hormones that have not been estimated and described so far in CF include kisspeptin (KISS) and proopiomelanocortin (POMC), which are involved in the regulation of many processes, including appetite and fertility. Therefore, the aim of our study was to estimate the level of KISS and POMC in sera from CF patients and to determine the correlation between these hormones and clinical parameters. For this purpose, we estimated the levels of KISS and POMC in 38 CF patients and 16 healthy participants with enzyme-linked immunosorbent assay. We found significantly reduced levels of KISS and POMC in people with CF compared to healthy subjects (1.76 ± 0.46 vs. 2.27 ± 0.56 ng/mL, p < 0.05 and 6.25 ± 4.36 vs. 14.74 ± 6.24 ng/mL, p < 0.001, respectively). Furthermore, the level of both hormones was negatively correlated with age. The hormones studied did not correlate with the results of spirometry and each other. Thus, decreased KISS and POMC levels may be associated with lower body weight and delayed puberty in patients with CF.
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210
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Colnago M, Benvenuto GA, Casaca W, Negri RG, Fernandes EG, Cuminato JA. Risk Factors Associated with Mortality in Hospitalized Patients with COVID-19 during the Omicron Wave in Brazil. Bioengineering (Basel) 2022; 9:584. [PMID: 36290552 PMCID: PMC9598428 DOI: 10.3390/bioengineering9100584] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Considering the imminence of new SARS-CoV-2 variants and COVID-19 vaccine availability, it is essential to understand the impact of the disease on the most vulnerable groups and those at risk of death from the disease. To this end, the odds ratio (OR) for mortality and hospitalization was calculated for different groups of patients by applying an adjusted logistic regression model based on the following variables of interest: gender, booster vaccination, age group, and comorbidity occurrence. A massive number of data were extracted and compiled from official Brazilian government resources, which include all reported cases of hospitalizations and deaths associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Brazil during the "wave" of the Omicron variant (BA.1 substrain). Males (1.242; 95% CI 1.196-1.290) aged 60-79 (3.348; 95% CI 3.050-3.674) and 80 years or older (5.453; 95% CI 4.966-5.989), and hospitalized patients with comorbidities (1.418; 95% CI 1.355-1.483), were more likely to die. There was a reduction in the risk of death (0.907; 95% CI 0.866-0.951) among patients who had received the third dose of the anti-SARS-CoV-2 vaccine (booster). Additionally, this big data investigation has found statistical evidence that vaccination can support mitigation plans concerning the current scenario of COVID-19 in Brazil since the Omicron variant and its substrains are now prevalent across the entire country.
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Affiliation(s)
- Marilaine Colnago
- Institute of Chemistry, São Paulo State University (UNESP), Araraquara 14800-060, Brazil
| | - Giovana A. Benvenuto
- Faculty of Science and Technology (FCT), São Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil
| | - Wallace Casaca
- Institute of Biosciences, Letters and Exact Sciences, São Paulo State University (UNESP), São José do Rio Preto 15054-000, Brazil
| | - Rogério G. Negri
- Science and Technology Institute, São Paulo State University (UNESP), São José dos Campos 12247-004, Brazil
| | - Eder G. Fernandes
- Immunization Division—Centre of Epidemiology Surveillance of the São Paulo State Health Department, São Paulo 01246-000, Brazil
| | - José A. Cuminato
- Institute of Mathematics and Computer Science, São Paulo University (USP), São Carlos 13566-590, Brazil
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211
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Brown RB. Hypertension, Anxiety and Obstructive Sleep Apnea in Cardiovascular Disease and COVID-19: Mediation by Dietary Salt. Diseases 2022; 10:diseases10040089. [PMID: 36278588 PMCID: PMC9590013 DOI: 10.3390/diseases10040089] [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: 09/05/2022] [Revised: 10/07/2022] [Accepted: 10/14/2022] [Indexed: 12/02/2022] Open
Abstract
This perspective paper used a grounded theory method to synthesize evidence proposing that sodium toxicity from excessive dietary salt intake is a potential common pathophysiological mechanism that mediates the association of hypertension, obstructive sleep apnea, and anxiety with cardiovascular disease and COVID-19. Increased anxiety in these conditions may be linked to a high-salt diet through stimulation of the sympathetic nervous system, which increases blood pressure while releasing catecholamines, causing a "fight or flight" response. A rostral shift of fluid overload from the lower to the upper body occurs in obstructive sleep apnea associated with COVID-19 and cardiovascular disease, and may be related to sodium and fluid retention triggered by hypertonic dehydration. Chronic activation of the renin-angiotensin-aldosterone system responds to salt-induced dehydration by increasing reabsorption of sodium and fluid, potentially exacerbating fluid overload. Anxiety may also be related to angiotensin II that stimulates the sympathetic nervous system to release catecholamines. More research is needed to investigate these proposed interrelated mechanisms mediated by dietary salt. Furthermore, dietary interventions should use a whole-food plant-based diet that eliminates foods processed with salt to test the effect of very low sodium intake levels on hypertension, anxiety, and obstructive sleep apnea in cardiovascular disease and COVID-19.
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Affiliation(s)
- Ronald B Brown
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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212
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Tito K, Gebremariam GT, Beyene K, Sander B, Gebretekle GB. Health-related quality of life and treatment satisfaction of patients with cardiovascular disease in Ethiopia. Front Public Health 2022; 10:972378. [PMID: 36299740 PMCID: PMC9589146 DOI: 10.3389/fpubh.2022.972378] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/13/2022] [Indexed: 01/25/2023] Open
Abstract
Purpose Cardiovascular disease is the most prevalent health problem associated with poorer health-related quality of life (HRQoL). We aimed to assess HRQoL and treatment satisfaction of cardiovascular disease patients in Ethiopia. Methods A cross-sectional survey was conducted among adults attending the outpatient cardiac clinic at Tikur Anbessa Specialized Hospital from July to September 2021. Patients were recruited consecutively during follow-up visits. Treatment Satisfaction Questionnaire for Medication and European Quality of life questionnaires were used to evaluate treatment satisfaction and HRQoL, respectively. Kruskal-Wallis and Mann-Whitney U-tests were used to compare utility weights between patient subgroups. Utility values were computed using disutility weights of the Ethiopian general population derived using a hybrid regression model. Tobit regression modeling was used to explore factors associated with poor HRQoL. Statistical significance was determined at p < 0.05. Results A total of 357 patients participated in the study with a mean age of 49.3 ± 17.8 years. The most frequently reported health problems were pain/discomfort (75.4%), followed by mobility (73.4%). The median (interquartile range) European Quality questionnaires five dimensions with five levels utility (EQ-5D-5L) and European Quality of life Visual Analog Scale scores were 0.84 (0.55-0.92) and 70.0 (50.0-85.0), respectively. The highest and lowest mean (standard deviation) treatment satisfaction scores were for the convenience and safety satisfaction dimensions: 87.7 (17.9) and 53.1 (33.5), respectively. Unemployment, older age, previous hospital admission, non-adherence to lifestyle modification, and presence of three or more cardiovascular disease factors were significantly negatively associated with HRQoL. Conclusions Overall, the study found that cardiovascular disease had a profound negative effect on HRQoL and patient treatment satisfaction. We suggest that interventions to enhance HRQoL and treatment satisfactions should focus on modifiable associated factors including lifestyle changes and controlling disease progression.
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Affiliation(s)
- Kebron Tito
- School of Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girma Tekle Gebremariam
- School of Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia,*Correspondence: Girma Tekle Gebremariam
| | - Kebede Beyene
- Department of Pharmaceutical and Administrative Sciences, University of Health Sciences and Pharmacy in St. Louis, St. Louis, MO, United States
| | - Beate Sander
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada,Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, ON, Canada,Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada,Public Health Ontario, Toronto, ON, Canada
| | - Gebremedhin Beedemariam Gebretekle
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada,Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, ON, Canada
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213
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Hendson L, Church PT, Banihani R. Follow-up care of the extremely preterm infant after discharge from the neonatal intensive care unit. Paediatr Child Health 2022; 27:359-371. [PMID: 36200103 PMCID: PMC9528778 DOI: 10.1093/pch/pxac058] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 10/13/2021] [Indexed: 11/07/2022] Open
Abstract
The survival of babies born extremely preterm (EP, <28 weeks gestation) has improved over time, and many have good outcomes and quality of life. They remain at risk for health issues, including neurosensory and neurodevelopmental difficulties requiring monitoring by primary physicians, paediatricians, and specialty clinics. This statement reviews potential medical and neurodevelopmental consequences for EP infants in the first 2 years after discharge and provides strategies for counselling, early detection, and intervention. EP-related conditions to assess for early include bronchopulmonary dysplasia or respiratory morbidity, feeding and growth concerns, neurosensory development (vision and hearing), cerebral palsy, and autism spectrum disorder. Correction for gestational age should be used for growth and development until 36 months of age. Integral to quality care of the child born EP is attention to the emotional well-being of parents and caregivers.
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Affiliation(s)
- Leonora Hendson
- Canadian Paediatric Society Fetus and Newborn Committee, Ottawa, Ontario, Canada
| | - Paige T Church
- Canadian Paediatric Society Fetus and Newborn Committee, Ottawa, Ontario, Canada
| | - Rudaina Banihani
- Canadian Paediatric Society Fetus and Newborn Committee, Ottawa, Ontario, Canada
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214
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Koul A, Bawa RK, Kumar Y. Artificial Intelligence Techniques to Predict the Airway Disorders Illness: A Systematic Review. ARCHIVES OF COMPUTATIONAL METHODS IN ENGINEERING : STATE OF THE ART REVIEWS 2022; 30:831-864. [PMID: 36189431 PMCID: PMC9516534 DOI: 10.1007/s11831-022-09818-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
Airway disease is a major healthcare issue that causes at least 3 million fatalities every year. It is also considered one of the foremost causes of death all around the globe by 2030. Numerous studies have been undertaken to demonstrate the latest advances in artificial intelligence algorithms to assist in identifying and classifying these diseases. This comprehensive review aims to summarise the state-of-the-art machine and deep learning-based systems for detecting airway disorders, envisage the trends of the recent work in this domain, and analyze the difficulties and potential future paths. This systematic literature review includes the study of one hundred fifty-five articles on airway diseases such as cystic fibrosis, emphysema, lung cancer, Mesothelioma, covid-19, pneumoconiosis, asthma, pulmonary edema, tuberculosis, pulmonary embolism as well as highlights the automated learning techniques to predict them. The study concludes with a discussion and challenges about expanding the efficiency and machine and deep learning-assisted airway disease detection applications.
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Affiliation(s)
- Apeksha Koul
- Department of Computer Science and Engineering, Punjabi University, Patiala, Punjab India
| | - Rajesh K. Bawa
- Department of Computer Science, Punjabi University, Patiala, Punjab India
| | - Yogesh Kumar
- Department of Computer Science and Engineering, School of Technology, Pandit Deendayal Energy University, Gandhinagar, Gujarat India
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215
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Mhesin D, Nazzal H, Amerah J, Azamtta M, Ismail Y, Daralammouri Y, Abdalla MA, Jaber MM, Koni AA, Zyoud SH. Prevalence of pain and its association with quality of life of patients with heart failure in a developing country: findings from a multicenter cross-sectional study. BMC Cardiovasc Disord 2022; 22:426. [PMID: 36171539 PMCID: PMC9516499 DOI: 10.1186/s12872-022-02864-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 09/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Heart failure (HF) is considered one of the main causes of morbidity and death among chronic diseases worldwide. Patients have increasingly reported chronic pain in long-standing heart failure as a disturbing symptom. Its unknown etiology and mechanism, in addition to its insidious progressive nature, made both the doctor and the patient not notice it until it affects the quality of life (QoL) and general health status. The primary objective of this study is to find the prevalence of pain in chronic heart failure patients and its impact on their QoL. The secondary objective is to determine the predictors of QoL in HF patients. METHODS A multicenter cross-sectional design was used. The European Quality of Life scale five dimensions scale and the Brief Pain Inventory were adopted to evaluate QoL and pain, respectively. The Statistical Package for the Social Sciences version 25 was applied to present the data. The Mann-Whitney U, Kruskal-Wallis, and Cronbach alpha tests were used. RESULTS The final study had a total of 142 individuals. The prevalence of pain among HF patients was 84.5%. Knee pain was the main complaint among patients. Our patients' median pain severity score was 18 [5.00-25.00], while the median pain interference score was 39 [24.75-53.00]. They had a median EQ-5D score of 0.34 [0.0-0.6] and an EQ-VAS score of 50 [30-70]. Pain severity (p = 0.004 and p < 0.001, respectively) and pain interference (p < 0.001 and p = 0.001, respectively) were found to significantly associated with both QoL scores; the visual analogue scale (EQ-VAS) and EQ-5D-5L. In multivariate analysis, monthly income was the only variable significantly correlated with EQ-VAS and EQ-5D-5L, along with pain variables. CONCLUSIONS Pain is a common symptom among patients with HF and is significantly associated with their QoL. Low income is also highly associated with poor QoL. Definitive guidelines should be achieved to increase awareness and understanding of the importance of pain management, reaching a higher QoL level, less pain, and good adherence to HF medications.
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Affiliation(s)
- Deema Mhesin
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Hadeel Nazzal
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Jalilah Amerah
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Murad Azamtta
- grid.11942.3f0000 0004 0631 5695Department of Cardiology, An-Najah National University Hospital, Nablus, 44839 Palestine
| | - Yahia Ismail
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Department of Cardiology, An-Najah National University Hospital, Nablus, 44839 Palestine
| | - Yunis Daralammouri
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Department of Cardiology, An-Najah National University Hospital, Nablus, 44839 Palestine
| | - Mazen A. Abdalla
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Department of Orthopedics, An-Najah National University Hospital, Nablus, 44839 Palestine
| | - Mohammad M. Jaber
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Department of Orthopedics, An-Najah National University Hospital, Nablus, 44839 Palestine
| | - Amer A. Koni
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Clinical Research Center, An-Najah National University Hospital, Nablus, 44839 Palestine
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Clarence DD, Paudel KR, Manandhar B, Singh SK, Devkota HP, Panneerselvam J, Gupta V, Chitranshi N, Verma N, Saad S, Gupta G, Hansbro PM, Oliver BG, Madheswaran T, Dua K, Chellappan DK. Unravelling the Therapeutic Potential of Nano-Delivered Functional Foods in Chronic Respiratory Diseases. Nutrients 2022; 14:3828. [PMID: 36145202 PMCID: PMC9503475 DOI: 10.3390/nu14183828] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/04/2022] [Accepted: 09/11/2022] [Indexed: 12/12/2022] Open
Abstract
Chronic inflammation of the respiratory tract is one of the most concerning public health issues, as it can lead to chronic respiratory diseases (CRDs), some of which are more detrimental than others. Chronic respiratory diseases include chronic obstructive pulmonary disease (COPD), asthma, lung cancer, and pulmonary fibrosis. The conventional drug therapies for the management and treatment of CRDs only address the symptoms and fail to reverse or recover the chronic-inflammation-mediated structural and functional damage of the respiratory tract. In addition, the low efficacy and adverse effects of these drugs have directed the attention of researchers towards nutraceuticals in search of potential treatment strategies that can not only ameliorate CRD symptoms but also can repair and reverse inflammatory damage. Hence, there is a growing interest toward investigating the medicinal benefits of nutraceuticals, such as rutin, curcumin, zerumbone, and others. Nutraceuticals carry many nutritional and therapeutic properties, including anti-inflammatory, antioxidant, anticancer, antidiabetic, and anti-obesity properties, and usually do not have as many adverse effects, as they are naturally sourced. Recently, the use of nanoparticles has also been increasingly studied for the nano drug delivery of these nutraceuticals. The discrete size of nanoparticles holds great potential for the level of permeability that can be achieved when transporting these nutraceutical compounds. This review is aimed to provide an understanding of the use of nutraceuticals in combination with nanoparticles against CRDs and their mechanisms involved in slowing down or reversing the progression of CRDs by inhibiting pro-inflammatory signaling pathways.
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Affiliation(s)
- Dvya Delilaa Clarence
- School of Postgraduate Studies, International Medical University (IMU), Kuala Lumpur 57000, Malaysia
| | - Keshav Raj Paudel
- Centre for Inflammation, Centenary Institute and University of Technology Sydney, Faculty of Science, School of Life Sciences, Sydney, NSW 2007, Australia
| | - Bikash Manandhar
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW 2007, Australia
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Sachin Kumar Singh
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, NSW 2007, Australia
- School of Pharmaceutical Sciences, Lovely Professional University, Jalandhar-Delhi G.T. Road, Phagwara 144411, India
| | - Hari Prasad Devkota
- Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto 862-0973, Japan
- Pharmacy Program, Gandaki University, Pokhara 33700, Nepal
| | - Jithendra Panneerselvam
- Department of Pharmaceutical Technology, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Vivek Gupta
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, Sydney, NSW 2109, Australia
| | - Nitin Chitranshi
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, Sydney, NSW 2109, Australia
| | - Nitin Verma
- Chitkara School of Pharmacy, Chitkara University, Atal Nagar 174103, India
| | - Sonia Saad
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Gaurav Gupta
- School of Pharmacy, Suresh Gyan Vihar University, Jaipur 302017, India
- Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India
- Uttaranchal Institute of Pharmaceutical Sciences, Uttaranchal University, Dehradun 248007, India
| | - Philip Michael Hansbro
- Centre for Inflammation, Centenary Institute and University of Technology Sydney, Faculty of Science, School of Life Sciences, Sydney, NSW 2007, Australia
| | - Brian Gregory Oliver
- Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW 2006, Australia
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Thiagarajan Madheswaran
- Department of Pharmaceutical Technology, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW 2007, Australia
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Dinesh Kumar Chellappan
- Department of Life Sciences, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia
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Podgórska B, Wielogórska-Partyka M, Godzień J, Siemińska J, Ciborowski M, Szelachowska M, Krętowski A, Siewko K. Applications of Metabolomics in Calcium Metabolism Disorders in Humans. Int J Mol Sci 2022; 23:ijms231810407. [PMID: 36142318 PMCID: PMC9499180 DOI: 10.3390/ijms231810407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/26/2022] [Accepted: 09/05/2022] [Indexed: 12/13/2022] Open
Abstract
The pathogenesis of the disorders of calcium metabolism is not fully understood. This review discusses the studies in which metabolomics was applied in this area. Indeed, metabolomics could play an essential role in discovering biomarkers and elucidating pathological mechanisms. Despite the limited bibliography, the present review highlights the potential of metabolomics in identifying the biomarkers of some of the most common endocrine disorders, such as primary hyperparathyroidism (PHPT), secondary hyperparathyroidism (SHPT), calcium deficiency, osteoporosis and vitamin D supplementation. Metabolites related to above-mentioned diseorders were grouped into specific classes and mapped into metabolic pathways. Furthermore, disturbed metabolic pathways can open up new directions for the in-depth exploration of the basic mechanisms of these diseases at the molecular level.
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Affiliation(s)
- Beata Podgórska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland
- Correspondence: ; Tel.: +48-85-831-83-12
| | - Marta Wielogórska-Partyka
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Joanna Godzień
- Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Julia Siemińska
- Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Michał Ciborowski
- Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Małgorzata Szelachowska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Adam Krętowski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland
- Clinical Research Centre, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Katarzyna Siewko
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland
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Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, Adrián TM, Allen LR, Azul D, Bagga H, Başar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, Capitán L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D'Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim AI, Seal LJ, Sehoole TJ, Spencer K, St Amand C, Steensma TD, Strang JF, Taylor GB, Tilleman K, T'Sjoen GG, Vala LN, Van Mello NM, Veale JF, Vencill JA, Vincent B, Wesp LM, West MA, Arcelus J. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2022; 23:S1-S259. [PMID: 36238954 PMCID: PMC9553112 DOI: 10.1080/26895269.2022.2100644] [Citation(s) in RCA: 674] [Impact Index Per Article: 337.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.
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Affiliation(s)
- E Coleman
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A E Radix
- Callen-Lorde Community Health Center, New York, NY, USA
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - W P Bouman
- Nottingham Centre for Transgender Health, Nottingham, UK
- School of Medicine, University of Nottingham, Nottingham, UK
| | - G R Brown
- James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
- James H. Quillen VAMC, Johnson City, TN, USA
| | - A L C de Vries
- Department of Child and Adolescent Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M B Deutsch
- Department of Family & Community Medicine, University of California-San Francisco, San Francisco, CA, USA
- UCSF Gender Affirming Health Program, San Francisco, CA, USA
| | - R Ettner
- New Health Foundation Worldwide, Evanston, IL, USA
- Weiss Memorial Hospital, Chicago, IL, USA
| | - L Fraser
- Independent Practice, San Francisco, CA, USA
| | - M Goodman
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - J Green
- Independent Scholar, Vancouver, WA, USA
| | - A B Hancock
- The George Washington University, Washington, DC, USA
| | - T W Johnson
- Department of Anthropology, California State University, Chico, CA, USA
| | - D H Karasic
- University of California San Francisco, San Francisco, CA, USA
- Independent Practice at dankarasic.com
| | - G A Knudson
- University of British Columbia, Vancouver, Canada
- Vancouver Coastal Health, Vancouver, Canada
| | - S F Leibowitz
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - H F L Meyer-Bahlburg
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - J Motmans
- Transgender Infopunt, Ghent University Hospital, Gent, Belgium
- Centre for Research on Culture and Gender, Ghent University, Gent, Belgium
| | - L Nahata
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Endocrinology and Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - T O Nieder
- University Medical Center Hamburg-Eppendorf, Interdisciplinary Transgender Health Care Center Hamburg, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, Hamburg, Germany
| | - S L Reisner
- Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - C Richards
- Regents University London, UK
- Tavistock and Portman NHS Foundation Trust, London, UK
| | | | - V Tangpricha
- Division of Endocrinology, Metabolism & Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Decatur, GA, USA
| | - A C Tishelman
- Boston College, Department of Psychology and Neuroscience, Chestnut Hill, MA, USA
| | - M A A Van Trotsenburg
- Bureau GenderPRO, Vienna, Austria
- University Hospital Lilienfeld-St. Pölten, St. Pölten, Austria
| | - S Winter
- School of Population Health, Curtin University, Perth, WA, Australia
| | - K Ducheny
- Howard Brown Health, Chicago, IL, USA
| | - N J Adams
- University of Toronto, Ontario Institute for Studies in Education, Toronto, Canada
- Transgender Professional Association for Transgender Health (TPATH)
| | - T M Adrián
- Asamblea Nacional de Venezuela, Caracas, Venezuela
- Diverlex Diversidad e Igualdad a Través de la Ley, Caracas, Venezuela
| | - L R Allen
- University of Nevada, Las Vegas, NV, USA
| | - D Azul
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - H Bagga
- Monash Health Gender Clinic, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - K Başar
- Department of Psychiatry, Hacettepe University, Ankara, Turkey
| | - D S Bathory
- Independent Practice at Bathory International PLLC, Winston-Salem, NC, USA
| | - J J Belinky
- Durand Hospital, Guemes Clinic and Urological Center, Buenos Aires, Argentina
| | - D R Berg
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J U Berli
- Oregon Health & Science University, Portland, OR, USA
| | - R O Bluebond-Langner
- NYU Langone Health, New York, NY, USA
- Hansjörg Wyss Department of Plastic Surgery, New York, NY, USA
| | - M-B Bouman
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Plastic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - M L Bowers
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mills-Peninsula Medical Center, Burlingame, CA, USA
| | - P J Brassard
- GrS Montreal, Complexe CMC, Montreal, Quebec, Canada
- Université de Montreal, Quebec, Canada
| | - J Byrne
- University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - L Capitán
- The Facialteam Group, Marbella International Hospital, Marbella, Spain
| | | | - J M Carswell
- Harvard Medical School, Boston, MA, USA
- Boston's Children's Hospital, Boston, MA, USA
| | - S C Chang
- Independent Practice, Oakland, CA, USA
| | - G Chelvakumar
- Nationwide Children's Hospital, Columbus, OH, USA
- The Ohio State University, College of Medicine, Columbus, OH, USA
| | - T Corneil
- School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
| | - K B Dalke
- Penn State Health, PA, USA
- Penn State College of Medicine, Hershey, PA, USA
| | - G De Cuypere
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
| | - E de Vries
- Nelson Mandela University, Gqeberha, South Africa
- University of Cape Town, Cape Town, South Africa
| | - M Den Heijer
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Endocrinology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - A H Devor
- University of Victoria, Victoria, BC, Canada
| | - C Dhejne
- ANOVA, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - A D'Marco
- UCTRANS-United Caribbean Trans Network, Nassau, The Bahamas
- D M A R C O Organization, Nassau, The Bahamas
| | - E K Edmiston
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L Edwards-Leeper
- Pacific University, Hillsboro, OR, USA
- Independent Practice, Beaverton, OR, USA
| | - R Ehrbar
- Whitman Walker Health, Washington, DC, USA
- Independent Practice, Maryland, USA
| | - D Ehrensaft
- University of California San Francisco, San Francisco, CA, USA
| | - J Eisfeld
- Transvisie, Utrecht, The Netherlands
| | - E Elaut
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Clinical Experimental and Health Psychology, Ghent University, Gent, Belgium
| | - L Erickson-Schroth
- The Jed Foundation, New York, NY, USA
- Hetrick-Martin Institute, New York, NY, USA
| | - J L Feldman
- Institute for Sexual and Gender Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - A D Fisher
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | - M M Garcia
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Departments of Urology and Anatomy, University of California San Francisco, San Francisco, CA, USA
| | - L Gijs
- Institute of Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - B P Hall
- Duke University Medical Center, Durham, NC, USA
- Duke Adult Gender Medicine Clinic, Durham, NC, USA
| | - T L D Hardy
- Alberta Health Services, Edmonton, Alberta, Canada
- MacEwan University, Edmonton, Alberta, Canada
| | - M S Irwig
- Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - A C Janssen
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - K Johnson
- RMIT University, Melbourne, Australia
- University of Brighton, Brighton, UK
| | - D T Klink
- Department of Pediatrics, Division of Pediatric Endocrinology, Ghent University Hospital, Gent, Belgium
- Division of Pediatric Endocrinology and Diabetes, ZNA Queen Paola Children's Hospital, Antwerp, Belgium
| | - B P C Kreukels
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - L E Kuper
- Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, USA
- Department of Endocrinology, Children's Health, Dallas, TX, USA
| | - E J Kvach
- Denver Health, Denver, CO, USA
- University of Colorado School of Medicine, Aurora, CO, USA
| | - M A Malouf
- Malouf Counseling and Consulting, Baltimore, MD, USA
| | - R Massey
- WPATH Global Education Institute
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - T Mazur
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- John R. Oishei Children's Hospital, Buffalo, NY, USA
| | - C McLachlan
- Professional Association for Transgender Health, South Africa
- Gender DynamiX, Cape Town, South Africa
| | - S D Morrison
- Division of Plastic Surgery, Seattle Children's Hospital, Seattle, WA, USA
- Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA
| | - S W Mosser
- Gender Confirmation Center, San Francisco, CA, USA
- Saint Francis Memorial Hospital, San Francisco, CA, USA
| | - P M Neira
- Johns Hopkins Center for Transgender Health, Baltimore, MD, USA
- Johns Hopkins Medicine Office of Diversity, Inclusion and Health Equity, Baltimore, MD, USA
| | - U Nygren
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - J M Oates
- La Trobe University, Melbourne, Australia
- Melbourne Voice Analysis Centre, East Melbourne, Australia
| | - J Obedin-Maliver
- Stanford University School of Medicine, Department of Obstetrics and Gynecology, Palo Alto, CA, USA
- Department of Epidemiology and Population Health, Stanford, CA, USA
| | - G Pagkalos
- Independent PracticeThessaloniki, Greece
- Military Community Mental Health Center, 424 General Military Training Hospital, Thessaloniki, Greece
| | - J Patton
- Talkspace, New York, NY, USA
- CytiPsychological LLC, San Diego, CA, USA
| | - N Phanuphak
- Institute of HIV Research and Innovation, Bangkok, Thailand
| | - K Rachlin
- Independent Practice, New York, NY, USA
| | - T Reed
- Gender Identity Research and Education Society, Leatherhead, UK
| | - G N Rider
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J Ristori
- Andrology, Women Endocrinology and Gender Incongruence, Careggi University Hospital, Florence, Italy
| | | | - S A Roberts
- Harvard Medical School, Boston, MA, USA
- Division of Endocrinology, Boston's Children's Hospital, Boston, MA, USA
| | - K A Rodriguez-Wallberg
- Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
| | - S M Rosenthal
- Division of Pediatric Endocrinology, UCSF, San Francisco, CA, USA
- UCSF Child and Adolescent Gender Center
| | - K Sabir
- FtM Phoenix Group, Krasnodar Krai, Russia
| | - J D Safer
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Center for Transgender Medicine and Surgery, New York, NY, USA
| | - A I Scheim
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - L J Seal
- Tavistock and Portman NHS Foundation Trust, London, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - K Spencer
- National Center for Gender Spectrum Health, Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - C St Amand
- University of Houston, Houston, TX, USA
- Mayo Clinic, Rochester, MN, USA
| | - T D Steensma
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit Amsterdam, , Amsterdam, Netherlands
| | - J F Strang
- Children's National Hospital, Washington, DC, USA
- George Washington University School of Medicine, Washington, DC, USA
| | - G B Taylor
- Atrium Health Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Charlotte, NC, USA
| | - K Tilleman
- Department for Reproductive Medicine, Ghent University Hospital, Gent, Belgium
| | - G G T'Sjoen
- Center for Sexology and Gender, Ghent University Hospital, Gent, Belgium
- Department of Endocrinology, Ghent University Hospital, Gent, Belgium
| | - L N Vala
- Independent Practice, Campbell, CA, USA
| | - N M Van Mello
- Center of Expertise on Gender Dysphoria, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Obstetrics and Gynaecology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - J F Veale
- School of Psychology, University of Waikato/Te Whare Wānanga o Waikato, Hamilton/Kirikiriroa, New Zealand/Aotearoa
| | - J A Vencill
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - B Vincent
- Trans Learning Partnership at https://spectra-london.org.uk/trans-learning-partnership, UK
| | - L M Wesp
- College of Nursing, University of Wisconsin MilwaukeeMilwaukee, WI, USA
- Health Connections Inc., Glendale, WI, USA
| | - M A West
- North Memorial Health Hospital, Robbinsdale, MN, USA
- University of Minnesota, Minneapolis, MN, USA
| | - J Arcelus
- School of Medicine, University of Nottingham, Nottingham, UK
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
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Risk Factors for Hypertension in Hospitalised Patient Mortality with Laboratory-Confirmed SARS-CoV-2: A Population-Based Study in Limpopo Province, South Africa. JOURNAL OF RESPIRATION 2022. [DOI: 10.3390/jor2030013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease (COVID-19) pandemic has recently impacted and destabilised the global community. The healthcare systems of many countries have been reported to be partially or entirely interrupted. More than half of the countries surveyed (53%) have partially or completely disrupted hypertension treatment services. A population-based retrospective cohort study approach was used to determine the prevalence of hypertension and related risk factors for mortality in COVID-19 hospitalised patients in the Limpopo Province, South Africa. Hierarchical logistic regression was applied to determine the determinants of hypertension. Sixty-nine percent (69%) of mortality among individuals with laboratory-confirmed SARS-CoV-2 were elderly persons aged 60 years and above admitted to a person under investigation (PUI) ward (52%), and 66% had hypertension. Among the hospitalised COVID-19 patients who died, prominent risk factors for hypertension were advanced age, the presence of co-morbidities, such as diabetes and HIV/AIDS. There was no evidence to establish a link between hypertension and COVID-19 case severity. More cohort and systematic studies are needed to determine whether there is a link between hypertension and COVID-19 case severity.
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220
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Huang S, Hong X, Zhao M, Liu N, Liu H, Zhao J, Shao L, Xue W, Zhang H, Zhu P, Guo R. Nanocomposite hydrogels for biomedical applications. Bioeng Transl Med 2022; 7:e10315. [PMID: 36176618 PMCID: PMC9471997 DOI: 10.1002/btm2.10315] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 12/12/2022] Open
Abstract
Nanomaterials' unique structures at the nanometer level determine their incredible functions, and based on this, they can be widely used in the field of nanomedicine. However, nanomaterials do possess disadvantages that cannot be ignored, such as burst release, rapid elimination, and poor bioadhesion. Hydrogels are scaffolds with three-dimensional structures, and they exhibit good biocompatibility and drug release capacity. Hydrogels are also associated with disadvantages for biomedical applications such as poor anti-tumor capability, weak bioimaging capability, limited responsiveness, and so on. Incorporating nanomaterials into the 3D hydrogel network through physical or chemical covalent action may be an effective method to avoid their disadvantages. In nanocomposite hydrogel systems, multifunctional nanomaterials often work as the function core, giving the hydrogels a variety of properties (such as photo-thermal conversion, magnetothermal conversion, conductivity, targeting tumor, etc.). While, hydrogels can effectively improve the retention effect of nanomaterials and make the nanoparticles have good plasticity to adapt to various biomedical applications (such as various biosensors). Nanocomposite hydrogel systems have broad application prospects in biomedicine. In this review, we comprehensively summarize and discuss the most recent advances of nanomaterials composite hydrogels in biomedicine, including drug and cell delivery, cancer treatment, tissue regeneration, biosensing, and bioimaging, and we also briefly discussed the current situation of their commoditization in biomedicine.
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Affiliation(s)
- Shanghui Huang
- Key Laboratory of Biomaterials of Guangdong Higher Education Institutes, Guangdong Provincial Engineering and Technological Research Centre for Drug Carrier Development, Department of Biomedical EngineeringJinan UniversityGuangzhouChina
| | - Xiangqian Hong
- Institute of Microscale Optoelectronics, Collaborative Innovation Centre for Optoelectronic Science & Technology, International Collaborative Laboratory of 2D Materials for Optoelectronics Science and Technology of Ministry of Education, Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong Province, Shenzhen Key Laboratory of Micro‐Nano Photonic Information Technology, Guangdong Laboratory of Artificial Intelligence and Digital Economy (SZ)College of Physics and Optoelectronic Engineering, Shenzhen UniversityShenzhenChina
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, School of Optometry, Shenzhen UniversityShenzhenChina
| | - Mingyi Zhao
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouChina
| | - Nanbo Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouChina
| | - Huiling Liu
- Key Laboratory of Biomaterials of Guangdong Higher Education Institutes, Guangdong Provincial Engineering and Technological Research Centre for Drug Carrier Development, Department of Biomedical EngineeringJinan UniversityGuangzhouChina
| | - Jun Zhao
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, School of Optometry, Shenzhen UniversityShenzhenChina
- Department of OphthalmologyShenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology)ShenzhenChina
| | - Longquan Shao
- Stomatological Hospital, Southern Medical UniversityGuangzhouChina
| | - Wei Xue
- Key Laboratory of Biomaterials of Guangdong Higher Education Institutes, Guangdong Provincial Engineering and Technological Research Centre for Drug Carrier Development, Department of Biomedical EngineeringJinan UniversityGuangzhouChina
| | - Han Zhang
- Institute of Microscale Optoelectronics, Collaborative Innovation Centre for Optoelectronic Science & Technology, International Collaborative Laboratory of 2D Materials for Optoelectronics Science and Technology of Ministry of Education, Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong Province, Shenzhen Key Laboratory of Micro‐Nano Photonic Information Technology, Guangdong Laboratory of Artificial Intelligence and Digital Economy (SZ)College of Physics and Optoelectronic Engineering, Shenzhen UniversityShenzhenChina
| | - Ping Zhu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesGuangzhouChina
| | - Rui Guo
- Key Laboratory of Biomaterials of Guangdong Higher Education Institutes, Guangdong Provincial Engineering and Technological Research Centre for Drug Carrier Development, Department of Biomedical EngineeringJinan UniversityGuangzhouChina
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Chandrashekhar Joshi S, Pozzilli P. COVID-19 induced Diabetes: A novel presentation. Diabetes Res Clin Pract 2022; 191:110034. [PMID: 35940303 PMCID: PMC9355745 DOI: 10.1016/j.diabres.2022.110034] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The COVID-19 pandemic disproportionately affected patients who had comorbid diabetes mellitus. COVID-19 patients with diabetes experience significantly higher rates of complications and mortality. COVID-induced diabetes is a novel phenomenon observed in critically ill patients. The aims of this review were to explore the literature about COVID-induced diabetes and the pathophysiological mechanisms that could lead to this novel presentation. METHODS A literature search was performed using PUBMED, Google Scholar, MEDLINE and Embase for original studies (meta-analyses, cross-sectional studies, case series, case reports) about new-onset diabetes following COVID infection, and the proposed biochemical pathways behind this presentation. It was assumed that the authors of the studies used the current diagnostic criteria for diagnosis of type 1 and type 2 diabetes. RESULTS COVID-19 causes dysregulation of glucose homeostasis leading to new-onset diabetes and hyperglycaemia. This is also seen in patients with no previous risk factors for diabetes mellitus. The atypical glycaemic parameters and increased rates of DKA suggest that COVID-induced diabetes is a novel form of diabetes. A spectrum of COVID-induced diabetes has also been noted. COVID-induced diabetes is associated with remarkably higher mortality rates and worse outcomes compared to COVID-19 patients with pre-existing diabetes. The novel presentation of COVID-induced diabetes could be due to beta cell damage and insulin resistance caused by SARS-CoV-2. CONCLUSION COVID-induced diabetes is essential to detect early, owing to its implications on prognosis. Further studies must include follow-up of these patients to better understand the trajectory of COVID-induced diabetes and the best management plan. It is also important to assess the beta cell function and insulin resistance of COVID-induced diabetes patients over time to better understand the underlying biochemical mechanisms.
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Affiliation(s)
| | - Paolo Pozzilli
- The Blizard Institute, Centre of Immunobiology, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, UK; Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Italy.
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Becsei D, Kiss E, Szatmári I, Arató A, Reusz G, Szabó AJ, Bókay J, Zsidegh P. A retrospective analysis of metabolic control in children with PKU in the COVID-19 era. Mol Genet Metab Rep 2022; 32:100897. [PMID: 35845719 PMCID: PMC9284369 DOI: 10.1016/j.ymgmr.2022.100897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022] Open
Abstract
Background Patients with phenylketonuria (PKU) must maintain a lifelong natural protein-restricted diet to prevent neuro-cognitive damage. Early diagnosis is established with newborn screening, with diet subsequently controlled by regular phenylalanine (Phe) monitoring. During the COVID-19 pandemic, significant lockdown measures were introduced that may have influenced the above. Aim of our study To establish whether the diagnosis was delayed in neonates during the pandemic. In addition, metabolic control was further assessed during the COVID-19 pandemic era (CE) compared to the same period a year prior (non-COVID-19 era, NCE). The lockdown periods (LD) were also compared with unrestricted periods (URP). Patients, methods Six neonates born during the CE and eight neonates born during NCE were included in the newborn screening analysis. Seventy-two classical PKU patients aged 2–18 years and categorized as children (2–12 years; 51 patients) and adolescents (>13 years; 21 patients) were included in the metabolic control analysis. The frequency of dried blood spot (DBS) sampling and Phe levels were assessed according to the different periods. Results There was no diagnostic or therapeutic delay in reaching the recommended Phe range in neonates born during CE compared to those born in NCE (median [interquartile range, IQR]: 23.5 [22.5–24] vs. 22 [18.0–27] days, p = NS). The cumulative DBS sampling frequency in children increased by 9.9% in the CE while no change was noted in the adolescent group. The median Phe level increased significantly in both age groups in the CE, but remained within the recommended target range. During CE, changes in Phe levels differed in the two age groups: children had the highest median Phe in the second lockdown period (LD2), while the adolescents had an increased Phe in URP. There were significant negative correlations between DBS sampling frequencies and Phe levels in both age groups in NCE (children: r − 0.43, p = 0.002; adolescents r = −0.37, p = 0.012), and in adolescents in CE (r = −0.62, p = 0.006). Conclusion The pandemic did not impact newborn metabolic screening. The increased frequency of DBS sampling in CE and good target Phe levels suggest a better compliance in a very sensitive period. Since many factors may impact metabolic control in the different age groups, further studies are needed to analyse their respective role.
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Key Words
- CE, COVID-19 era
- CLD1, control to lockdown period 1
- CLD2, control to lockdown period 2
- COVID, coronavirus disease
- COVID-19 pandemic
- CURP, control to unrestricted period
- DBS, dried blood spot
- IQR, interquartile range
- LD, lockdown
- Lockdown
- MS/MS, tandem mass spectrometry
- Metabolic control
- NCE, non-COVID-19 era
- Phenylketonuria
- SARS, Severe Acute Respiratory Syndrome,
- URP, unrestricted period
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Affiliation(s)
- Dóra Becsei
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
| | - Erika Kiss
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
| | - Ildikó Szatmári
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
| | - András Arató
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
| | - György Reusz
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
| | - Attila J Szabó
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary.,ELKH-SE Pediatrics and Nephrology Research Group, Budapest, Hungary
| | - János Bókay
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
| | - Petra Zsidegh
- 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, Budapest 1083, Hungary
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Nayyar D, Pendrith C, Kishimoto V, Chu C, Fujioka J, Rios P, Sacha Bhatia R, Lyons OD, Harvey P, O'Brien T, Martin D, Agarwal P, Mukerji G. Quality of virtual care for ambulatory care sensitive conditions: Patient and provider experiences. Int J Med Inform 2022; 165:104812. [PMID: 35691260 PMCID: PMC9366328 DOI: 10.1016/j.ijmedinf.2022.104812] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/28/2022] [Accepted: 06/05/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND The COVID-19 pandemic and the need for physical distancing has led to rapid uptake of virtual visits to deliver ambulatory health care. Despite widespread adoption, there has been limited evaluation of the quality of care being delivered through virtual modalities for ambulatory care sensitive conditions (ACSCs). OBJECTIVE To characterize patients' and providers' experiences with the quality and sustainability of virtual care for ACSCs. DESIGN This was a multi-method study utilizing quantitative and qualitative data from patient surveys, provider surveys, and provider focus groups at a large academic ambulatory care hospital between May 2020 and June 2021. We included patients and providers utilizing telephone or video visits for the following ACSCs: hypertension, angina, heart failure, atrial fibrillation, diabetes, chronic obstructive pulmonary disease, or asthma. MAIN MEASURES Quantitative and qualitative patient and provider survey responses were mapped to the Six Domains of Healthcare Quality framework. Provider focus groups were coded to identify themes within each quality domain. KEY RESULTS Surveys were completed by 110/352 (31%) consenting patients and 20/61 (33%) providers. 5 provider focus groups were held with 14 participants. Patients found virtual visits to be generally more convenient than in-person visits for ACSCs. The perceived effectiveness of virtual visits was dependent on the clinical and social complexity of individual encounters. Respondents reported difficulty forming effective patient-provider relationships in the virtual environment. Patients and providers felt that virtual care has potential to both alleviate and exacerbate structural barriers to equitable access to care. CONCLUSIONS In a large academic ambulatory care hospital, patients and providers experienced the quality of virtual visits for the management of ACSCs to be variable depending on the biopsychosocial complexity of the individual encounter. Our findings in each quality domain highlight key considerations for patients, providers and institutions to uphold the quality of virtual care for ACSCs.
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Affiliation(s)
- Dhruv Nayyar
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ciara Pendrith
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Vanessa Kishimoto
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada
| | - Cherry Chu
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada
| | - Jamie Fujioka
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada
| | - Patricia Rios
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada
| | - R Sacha Bhatia
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada; Department of Medicine, Women's College Hospital, Toronto, ON, Canada
| | - Owen D Lyons
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada; Department of Medicine, Women's College Hospital, Toronto, ON, Canada
| | - Paula Harvey
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada; Department of Medicine, Women's College Hospital, Toronto, ON, Canada
| | - Tara O'Brien
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada; Department of Medicine, Women's College Hospital, Toronto, ON, Canada
| | - Danielle Martin
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Payal Agarwal
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Geetha Mukerji
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada; Department of Medicine, Women's College Hospital, Toronto, ON, Canada.
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Valero M, Pola P, Falaiye O, Ingram KH, Zhao L, Shahriar H, Ahamed SI. Development of a Noninvasive Blood Glucose Monitoring System Prototype: Pilot Study. JMIR Form Res 2022; 6:e38664. [PMID: 36018623 PMCID: PMC9463623 DOI: 10.2196/38664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/06/2022] [Accepted: 07/09/2022] [Indexed: 11/26/2022] Open
Abstract
Background Diabetes mellitus is a severe disease characterized by high blood glucose levels resulting from dysregulation of the hormone insulin. Diabetes is managed through physical activity and dietary modification and requires careful monitoring of blood glucose concentration. Blood glucose concentration is typically monitored throughout the day by analyzing a sample of blood drawn from a finger prick using a commercially available glucometer. However, this process is invasive and painful, and leads to a risk of infection. Therefore, there is an urgent need for noninvasive, inexpensive, novel platforms for continuous blood sugar monitoring. Objective Our study aimed to describe a pilot test to test the accuracy of a noninvasive glucose monitoring prototype that uses laser technology based on near-infrared spectroscopy. Methods Our system is based on Raspberry Pi, a portable camera (Raspberry Pi camera), and a visible light laser. The Raspberry Pi camera captures a set of images when a visible light laser passes through skin tissue. The glucose concentration is estimated by an artificial neural network model using the absorption and scattering of light in the skin tissue. This prototype was developed using TensorFlow, Keras, and Python code. A pilot study was run with 8 volunteers that used the prototype on their fingers and ears. Blood glucose values obtained by the prototype were compared with commercially available glucometers to estimate accuracy. Results When using images from the finger, the accuracy of the prototype is 79%. Taken from the ear, the accuracy is attenuated to 62%. Though the current data set is limited, these results are encouraging. However, three main limitations need to be addressed in future studies of the prototype: (1) increase the size of the database to improve the robustness of the artificial neural network model; (2) analyze the impact of external factors such as skin color, skin thickness, and ambient temperature in the current prototype; and (3) improve the prototype enclosure to make it suitable for easy finger and ear placement. Conclusions Our pilot study demonstrates that blood glucose concentration can be estimated using a small hardware prototype that uses infrared images of human tissue. Although more studies need to be conducted to overcome limitations, this pilot study shows that an affordable device can be used to avoid the use of blood and multiple finger pricks for blood glucose monitoring in the diabetic population.
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Affiliation(s)
- Maria Valero
- Department of Information Technology, Kennesaw State University, Marietta, GA, United States
| | - Priyanka Pola
- Department of Information Technology, Kennesaw State University, Marietta, GA, United States
| | - Oluwaseyi Falaiye
- Department of Software Engineering and Game Development, Kennesaw State University, Marietta, GA, United States
| | - Katherine H Ingram
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, United States
| | - Liang Zhao
- Department of Information Technology, Kennesaw State University, Marietta, GA, United States
| | - Hossain Shahriar
- Department of Information Technology, Kennesaw State University, Marietta, GA, United States
| | - Sheikh Iqbal Ahamed
- Department of Computer Science, Marquette University, Milwaukee, WI, United States
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Müller P, Leow MKS, Dietrich JW. Minor perturbations of thyroid homeostasis and major cardiovascular endpoints—Physiological mechanisms and clinical evidence. Front Cardiovasc Med 2022; 9:942971. [PMID: 36046184 PMCID: PMC9420854 DOI: 10.3389/fcvm.2022.942971] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
It is well established that thyroid dysfunction is linked to an increased risk of cardiovascular morbidity and mortality. The pleiotropic action of thyroid hormones strongly impacts the cardiovascular system and affects both the generation of the normal heart rhythm and arrhythmia. A meta-analysis of published evidence suggests a positive association of FT4 concentration with major adverse cardiovascular end points (MACE), but this association only partially extends to TSH. The risk for cardiovascular death is increased in both subclinical hypothyroidism and subclinical thyrotoxicosis. Several published studies found associations of TSH and FT4 concentrations, respectively, with major cardiovascular endpoints. Both reduced and elevated TSH concentrations predict the cardiovascular risk, and this association extends to TSH gradients within the reference range. Likewise, increased FT4 concentrations, but high-normal FT4 within its reference range as well, herald a poor outcome. These observations translate to a monotonic and sensitive effect of FT4 and a U-shaped relationship between TSH and cardiovascular risk. Up to now, the pathophysiological mechanism of this complex pattern of association is poorly understood. Integrating the available evidence suggests a dual etiology of elevated FT4 concentration, comprising both ensuing primary hypothyroidism and a raised set point of thyroid function, e. g. in the context of psychiatric disease, chronic stress and type 2 allostatic load. Addressing the association between thyroid homeostasis and cardiovascular diseases from a systems perspective could pave the way to new directions of research and a more personalized approach to the treatment of patients with cardiovascular risk.
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Affiliation(s)
- Patrick Müller
- Department for Electrophysiology, Medical Hospital I, Klinikum Vest, Recklinghausen, NRW, Germany
| | - Melvin Khee-Shing Leow
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore
- Metabolic Disorders Research Programme, Lee Kong Chian School of Medicine, Singapore, Singapore
- Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore, Singapore
| | - Johannes W. Dietrich
- Diabetes, Endocrinology and Metabolism Section, Department of Internal Medicine I, St. Josef Hospital, Ruhr University Bochum, Bochum, NRW, Germany
- Diabetes Centre Bochum/Hattingen, St. Elisabeth-Hospital Blankenstein, Hattingen, NRW, Germany
- Centre for Rare Endocrine Diseases, Ruhr Centre for Rare Diseases (CeSER), Ruhr University Bochum and Witten/Herdecke University, Bochum, NRW, Germany
- Centre for Diabetes Technology, Catholic Hospitals Bochum, Ruhr University Bochum, Bochum, NRW, Germany
- *Correspondence: Johannes W. Dietrich
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226
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Montesinos-Vázquez T, Pérez-Silva I, Galán-Vidal CA, Ibarra IS, Rodríguez JA, Páez-Hernández ME. Solution blow spinning polysulfone-Aliquat 336 nanofibers: synthesis, characterization, and application for the extraction and preconcentration of losartan from aqueous solutions. JOURNAL OF POLYMER ENGINEERING 2022. [DOI: 10.1515/polyeng-2022-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Nanofibers are materials used in a wide range of applications due to their unique physicochemical properties. As an alternative to the most common method of its manufacturing (electrospinning) blow spinning has been used since it has greater production efficiency and simplicity. A wide variety of polymers is used for its preparation and can be modified to improve the interaction and selectivity toward specific analytes. Thereby nanofibers have been used for the extraction or removal of organic compounds such as drugs but there are still few reports of drug extractions like losartan. In this work polysulfone-Aliquat 336 nanofibers were prepared using the blow spinning method to extract and preconcentrate losartan. The studies showed that Aliquat 336 incorporation significantly improve the extraction of losartan with polysulfone fibers. Adsorption process was thermodynamically favorable with an adsorption capacity of 15.45 mg·g−1. Thus, it was possible to extract more than 92% of initial losartan using 10 mg of polysulfone-Aliquat 336 fibers (9 and 3.5% (w/v)), at pH 6 from deionized water and synthetic wastewater. Finally, losartan preconcentration was evaluated to facilitate its quantification using ultraviolet–visible spectrometry (UV-Vis), which allowed the determination of this drug at concentrations below the detection limit.
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Affiliation(s)
- Tanese Montesinos-Vázquez
- Laboratorio 2, Área Académica de Química , Universidad Autónoma del Estado de Hidalgo , Carretera Pachuca-Tulancingo Km. 4.5 , 42184 Mineral de la Reforma , Hidalgo , Mexico
| | - Irma Pérez-Silva
- Laboratorio 2, Área Académica de Química , Universidad Autónoma del Estado de Hidalgo , Carretera Pachuca-Tulancingo Km. 4.5 , 42184 Mineral de la Reforma , Hidalgo , Mexico
| | - Carlos A. Galán-Vidal
- Laboratorio 2, Área Académica de Química , Universidad Autónoma del Estado de Hidalgo , Carretera Pachuca-Tulancingo Km. 4.5 , 42184 Mineral de la Reforma , Hidalgo , Mexico
| | - Israel S. Ibarra
- Laboratorio 2, Área Académica de Química , Universidad Autónoma del Estado de Hidalgo , Carretera Pachuca-Tulancingo Km. 4.5 , 42184 Mineral de la Reforma , Hidalgo , Mexico
| | - José A. Rodríguez
- Laboratorio 2, Área Académica de Química , Universidad Autónoma del Estado de Hidalgo , Carretera Pachuca-Tulancingo Km. 4.5 , 42184 Mineral de la Reforma , Hidalgo , Mexico
| | - M. Elena Páez-Hernández
- Laboratorio 2, Área Académica de Química , Universidad Autónoma del Estado de Hidalgo , Carretera Pachuca-Tulancingo Km. 4.5 , 42184 Mineral de la Reforma , Hidalgo , Mexico
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227
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Magdy R, Elmazny A, Soliman SH, Elsebaie EH, Ali SH, Abdel Fattah AM, Hassan M, Yassien A, Mahfouz NA, Elsayed RM, Fathy W, Abdel-Hamid HM, Mohamed J, Hussein M. Post-COVID-19 neuropsychiatric manifestations among COVID-19 survivors suffering from migraine: a case-control study. J Headache Pain 2022; 23:101. [PMID: 35962348 PMCID: PMC9372973 DOI: 10.1186/s10194-022-01468-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/20/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The burden of post-coronavirus disease (COVID)-19 symptoms has been increasing and is of great concern in patients with pre-existing chronic medical conditions.This study aimed to delineate the post-COVID-19 neuropsychiatric symptoms among migraine patients compared to the non-migraine control group. METHODS Two groups, each of 204 COVID-19 survivors, were enrolled in the study after 3 months of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, one group fulfilling the episodic migraine criteria and the other serving as a matching control group. Subjects were evaluated through an in-person interview for post-COVID-19 neuropsychiatric symptoms, including detailed headache patterns and severity, using the visual analogue scale. RESULTS The Frequency of headache during the acute phase of COVID-19 was more frequent in migraine patients (OR = 1.60, 95%CI = 1.04-2.45, P-value = 0.031). The reported significant post-COVID-19 neuropsychiatric symptoms in migraine patients compared to controls were fatigue (OR = 1.662, 95%CI = 1.064-2.596, P-value = 0.025), anosmia/hyposmia (OR = 2.06, 95%CI = 1.164- 3.645, P-value = 0.012), cacosmia (OR = 2.663, 95%CI = 1.145-6.195, P-value = 0.019), depression (OR = 2.259, 95%CI = 1.284- 3.975, P-value = 0.004), anxiety (OR = 3.267, 95%CI = 1.747- 6.108, P-value ≤ 0.001), insomnia (OR = 2.203, 95%CI = 1.298- 3.739, P-value = 0.003), and headache (OR = 3.148, 95%CI = 1.616-6.136, P-value = ≤ 0.001).While there was no statistically significant difference between migraine patients and controls regarding the post-COVID-19 functional status score (P-value = 0.102). The pattern of post-COVID-19 headache was reported as chronic headache transformation in 17.6% of the migraine group, with the median intensity rate being 5.5 and IQR (3-7). In the control group, 14% experienced chronic headache attributed to systemic viral infection with a median intensity rate of 2 and IQR (2-5), while 12% experienced a new daily persistent headache with a median intensity of 5 and IQR (1-6). CONCLUSION The study highlighted the importance of follow-up migraine patients upon recovery from COVID-19 infection, being more vulnerable to post-COVID-19 symptoms.
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Affiliation(s)
- Rehab Magdy
- Neurology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Alaa Elmazny
- Neurology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
- Internal Medicine Department, Arabian Gulf University, Manama, Bahrain
| | - Shaimaa H Soliman
- Neurology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Eman H Elsebaie
- Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sara H Ali
- Department of Otolaryngology, Faculty of Medicine, Beni-Suef University, Beni- Suef, Egypt
| | - Ali M Abdel Fattah
- Department of Gastroenterology, Hepatology, and Endemic Medicine, Faculty of Medicine, Beni-Suef University, Beni- Suef, Egypt
| | - Mahmoud Hassan
- Department of Internal Medicine, Faculty of Medicine, Beni-Suef University, Beni- Suef, Egypt
| | - Ahmed Yassien
- Department of Critical Care Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Noha A Mahfouz
- Department of Psychiatry Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Radwa M Elsayed
- Department of Family Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Wael Fathy
- Department of Anaesthesia, Surgical ICU and Pain Management, Beni-Suef University, Beni-Suef, Egypt
| | - Hoda M Abdel-Hamid
- Department of Chest Diseases, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Jehan Mohamed
- Department of Anaesthesia, Surgical ICU and Pain Management, Beni-Suef University, Beni-Suef, Egypt
| | - Mona Hussein
- Neurology department, Beni-Suef University, Beni-Suef, Egypt
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Lopes KG, Rodrigues EL, da Silva Lopes MR, do Nascimento VA, Pott A, Guimarães RDCA, Pegolo GE, Freitas KDC. Adiposity Metabolic Consequences for Adolescent Bone Health. Nutrients 2022; 14:3260. [PMID: 36014768 PMCID: PMC9414751 DOI: 10.3390/nu14163260] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 12/20/2022] Open
Abstract
Infancy and adolescence are crucial periods for bone health, since they are characterized by intense physical growth and bone development. The unsatisfactory acquisition of bone mass in this phase has consequences in adult life and increases the risk of developing bone diseases at more advanced ages. Nutrient deficiencies, especially calcium and vitamin D, associated with a sedentary lifestyle; lack of sun exposure; and epigenetic aspects represent some of the main risk factors for poor bone quality. In addition, recent studies relate childhood obesity to impaired bone health; however, studies on the adiposity effects on bone health are scarce and inconclusive. Another gap concerns the implications of obesity on child sexual maturity, which can jeopardize their genetic potential bone mass and increase fracture risk. Therefore, we reviewed the analyzed factors related to bone health and their association with obesity and metabolic syndrome in adolescents. We concluded that obesity (specifically, accumulated visceral fat) harms bones in the infant-juvenile phase, thereby increasing osteopenia/osteoporosis in adults and the elderly. Thus, it becomes evident that forming and maintaining healthy eating habits is necessary during infancy and adolescence to reduce the risk of fractures caused by bone-metabolic diseases in adulthood and to promote healthy ageing.
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Affiliation(s)
- Kátia Gianlupi Lopes
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Elisana Lima Rodrigues
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Mariana Rodrigues da Silva Lopes
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Valter Aragão do Nascimento
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Arnildo Pott
- Institute of Biosciences, Federal University of Mato Grosso do Sul-UFMS, Campo Grande 79079-900, Brazil
| | - Rita de Cássia Avellaneda Guimarães
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Giovana Eliza Pegolo
- Faculty of Pharmaceutical Sciences, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Karine de Cássia Freitas
- Post-Graduate Program in Health and Development in the Mid-West Region, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
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Roth GA, Vaduganathan M, Mensah GA. Impact of the COVID-19 Pandemic on Cardiovascular Health in 2020: JACC State-of-the-Art Review. J Am Coll Cardiol 2022; 80:631-640. [PMID: 35926937 PMCID: PMC9341480 DOI: 10.1016/j.jacc.2022.06.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 10/31/2022]
Abstract
The impact of COVID-19 on the burden of cardiovascular diseases (CVD) during the early pandemic remains unclear. COVID-19 has become one of the leading causes of global mortality, with a disproportionate impact on persons with CVD. Studies of health facility admissions for CVD found significant decreases during the pandemic. Studies of hospital mortality for CVD were more variable. Studies of population-level CVD mortality differed across countries, with most showing decreases, although some revealed increases in deaths. In some countries where large increases in CVD deaths were reported in vital registration systems, misclassification of COVID-19 as CVD may have occurred. Taken together, studies suggest heterogeneous effects of the COVID-19 pandemic on CVD without large increases in CVD mortality in 2020 for a number of countries. Clinical and population science research is needed to examine the ways in which the pandemic has affected CVD burden.
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Affiliation(s)
- Gregory A Roth
- Division of Cardiology, Department of Medicine, and Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.
| | - Muthiah Vaduganathan
- Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - George A Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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He W, Deng Y, Luo X. Bibliometric analysis of the global research status and trends of the association between Vitamin D and infections from 2001 to 2021. Front Public Health 2022; 10:934106. [PMID: 35991038 PMCID: PMC9386288 DOI: 10.3389/fpubh.2022.934106] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/07/2022] [Indexed: 12/11/2022] Open
Abstract
Objective The objective of this study was the visualization of hot spots and evolving trends in research on the association between vitamin D and infections through the use of bibliometric analysis. Methods Based on 3046 relevant articles collected in the Web of Science Core Collection for the period of 2001–2021, the data were processed using CiteSpace software. GraphPad software was used for some of the graphics. Results A total of 3,046 literature were retrieved, with an average citation frequency of 27.89 times. The number of published papers in the direction of “Immunology” (453 articles, 14.9%) and “Infectious diseases” (312 articles, 10.2%) is much higher. The United States presents the highest publication count (890, 29.2%) and shows a strong leadership in this field. Country burst shows that since 2015, many developing countries and low-income countries have carried out enthusiastic research in this regard, including China, Pakistan, and Iran. As for institutions, the League of European Research Universities produces a larger proportion of articles (220, 7.2%). In terms of authors, Martineau AR and Camargo CA have the highest number of published articles, contributing 30 (0.99%) and 28 articles (0.92%), respectively. Major studies are supported by the United States Department of Health Human Services funding (394, 12.9%). According to the keyword co-occurrence diagram, the 10 most frequent keywords from 2001 to 2021 are “vitamin D”, “infection”, “d deficiency”, “risk”, “association”, “expression”, “disease”, “d supplementation”, “vitamin d deficiency”, and “children”. The top 10 cited articles in 2021 are all related to COVID-19, suggesting it is a hotspot in recent times. Conclusion Research on the association between vitamin D and infection has grown rapidly since 2012 and is generally developing well. While developed Western countries continue to be leading roles in this field, research trends in developing countries are also very promising. It is demonstrated that the relationship between vitamin D and respiratory infections, especially respiratory viruses and the more recently COVID-19, has received a lot of attention in the last two decades, suggesting that this is the hotspot and frontier of research issue.
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Affiliation(s)
- Wenfang He
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yali Deng
- Department of Obstetrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xuemei Luo
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Xuemei Luo
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231
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Effects of an Online Supervised Exercise Training in Children with Obesity during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159421. [PMID: 35954777 PMCID: PMC9368250 DOI: 10.3390/ijerph19159421] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/28/2022] [Accepted: 07/28/2022] [Indexed: 02/01/2023]
Abstract
COVID-19 restrictions have dramatically reduced the active lifestyle and physical activity (PA) levels in the whole population, a situation that can contribute to weight gain and to develop obesity. To improve physical fitness (PF) in children with obesity during COVID-19 restrictions, sport specialists started to deliver physical training through tele-exercise. For these reasons, the aim of this study was to evaluate the effects of a 12-week online supervised training program in children with obesity on different PF components and PA levels. We enrolled a total of 40 Caucasian children (9 F/31 M; aged 11 ± 1.9 years) with obesity. The data collection consisted of a series of anthropometric measures, the PAQ-C questionnaire, and PF tests, valid and reliable tools to assess PF in children. We used a Wilcoxon’s t-test and a Student’s t-test, as appropriate, to assess the differences before and after the training protocol. A total of 37 patients completed the training protocol and were considered in the analysis. Our results show an improvement in all the PF tests, a reduction in the BMI z-score, the waist circumference, and in the waist-to-height ratio, and an increased PA level. In conclusion, the results of our study show that an online supervised training program is effective to promote PA, improving PF and reducing the BMI z-score in children with obesity.
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232
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Krithika MV, Balakrishnan U, Amboiram P, Shaik MSJ, Chandrasekaran A, Ninan B. Early calcium and phosphorus supplementation in VLBW infants to reduce metabolic bone disease of prematurity: a quality improvement initiative. BMJ Open Qual 2022; 11:bmjoq-2022-001841. [PMID: 35995540 PMCID: PMC9403146 DOI: 10.1136/bmjoq-2022-001841] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/08/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To reduce the incidence of metabolic bone disease (MBD) among very low birthweight (VLBW) infants admitted to neonatal intensive care unit from baseline of 35% by 50% over 2 years by implementing a quality improvement (QI) initiative. Methods A multidisciplinary QI team used evidence-based interventions and the healthcare improvement model to reduce MBD rate in VLBW infants. The specific interventions included routine enteral supplementation of calcium and phosphorus using Human Milk Fortifier (HMF) to expressed breast milk by day 14 of life (Plan/Do/Study/Act (PDSA) cycle 1), parenteral and early enteral supplementation of calcium and phosphorus (PDSA cycles 2 and 3). We included VLBW infants admitted within the study period at birth and excluded babies with congenital malformations, skeletal disorders and those who died before 2 weeks of age. Compliance with adding HMF by day 14, compliance with adding calcium and phosphorus in total parenteral nutrition (TPN) from day 1 of life and compliance with starting HMF when the baby reached 100 mL/kg/day of feeds were used as process indicators. The incidence of MBD was used as an outcome indicator during the study. The incidence of MBD was tracked using the Statistical Process Control methodology. Results The baseline MBD rate in 2015 was 35%. After the first PDSA cycle, 20% developed MBD (p=0.02). The same was sustained for a period of 1 year with the rate of 22%. After the second and third PDSA cycles, there was a drop in the MBD rate to 17%, and sustained for 3 months with 21%. Conclusion Implementation of QI initiatives decreased the MBD rate from 35% to <20%. Early parenteral calcium and phosphorus supplementation in TPN and optimising enteral supplementation with multicomponent fortifiers appear to have significant reduction in the incidence of MBD.
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Affiliation(s)
- M V Krithika
- Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
- Neonatology, MS Ramaiah Medical College, Bangalore, Karnataka, India
| | | | - Prakash Amboiram
- Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Mohammed Shafi Jan Shaik
- Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Ashok Chandrasekaran
- Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
- Neonatology, SRM Medical College Hospital and Resrearch Centre, Kattankulathur, Tamilnadu, India
| | - Binu Ninan
- Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
- Pediatrics and Neonatology, MGM Healthcare, Chennai, Tamilnadu, India
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233
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Abdraimova A, Besançon S, Portocarrero J, Ramaiya K, Dunganova A, Ewen M, Hogerzeil H, Lazo‐Porras M, Laing R, Lepeska M, Nchimbi H, Sidibé A, Swai A, Tenorio‐Mucha J, Yudkin JS, Zafra‐Tanaka JH, Zurdinova A, Beran D. Management of type 1 diabetes in low- and middle-income countries: Comparative health system assessments in Kyrgyzstan, Mali, Peru and Tanzania. Diabet Med 2022; 39:e14891. [PMID: 35621029 PMCID: PMC9543552 DOI: 10.1111/dme.14891] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/12/2022] [Accepted: 05/22/2022] [Indexed: 11/26/2022]
Abstract
AIMS To describe and compare the health system responses for type 1 diabetes in Kyrgyzstan, Mali, Peru and Tanzania. METHODS The Rapid Assessment Protocol for Insulin Access, a multi-level assessment of the health system, was implemented in Kyrgyzstan, Mali, Peru and Tanzania using document reviews, site visits and interviews to assess the delivery of care and access to insulin. RESULTS Despite the existence of noncommunicable or diabetes strategies and Universal Health Coverage policies including diabetes-related supplies, this has not necessarily translated into access to insulin or diabetes care for all. Insulin and related supplies were often unavailable and unaffordable. Across the four countries test strips and insulin, when paid for by the individual, represented respectively 48-82% and 25-36% of total costs. Care was mainly delivered at tertiary-level hospitals by specialists. Only Kyrgyzstan had data collection systems integrated into the Ministry of Health structure. In addition, issues with healthcare worker training and education and empowerment of people with diabetes were present in these health systems. CONCLUSIONS People with type 1 diabetes in these countries face different barriers, including the cost of insulin and care. Given the renewed attention to diabetes on the global health agenda tailored health system responses for type 1 diabetes are needed. Insulin should be prioritized as it is the foundation of type 1 diabetes care, but other elements of care and support need to be fostered by different actors.
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Affiliation(s)
| | | | - Jill Portocarrero
- CRONICAS Centre of Excellence in Chronic DiseasesUniversidad Peruana Cayetano HerediaLimaPeru
| | - Kaushik Ramaiya
- Hindu Mandal HospitalDar es SalaamTanzania
- Tanzanian Diabetes AssociationDar es SalaamTanzania
| | | | | | | | - Maria Lazo‐Porras
- CRONICAS Centre of Excellence in Chronic DiseasesUniversidad Peruana Cayetano HerediaLimaPeru
- Division of Tropical and Humanitarian MedicineUniversity of Geneva and Geneva University HospitalsGenevaSwitzerland
| | - Richard Laing
- Boston University School of Public HealthBostonUSA
- School of Public HealthUniversity of Western CapeSouth Africa
| | | | | | | | - Andrew Swai
- Tanzanian Diabetes AssociationDar es SalaamTanzania
| | - Janeth Tenorio‐Mucha
- CRONICAS Centre of Excellence in Chronic DiseasesUniversidad Peruana Cayetano HerediaLimaPeru
| | | | - Jessica H. Zafra‐Tanaka
- CRONICAS Centre of Excellence in Chronic DiseasesUniversidad Peruana Cayetano HerediaLimaPeru
| | | | - David Beran
- Division of Tropical and Humanitarian MedicineUniversity of Geneva and Geneva University HospitalsGenevaSwitzerland
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Stafie CS, Solomon SM, Sufaru IG, Manaila M, Stafie II, Melinte G, Simionescu B, Leustean L. Pathogenic Connections in Post-COVID Conditions: What Do We Know in the Large Unknown? A Narrative Review. Viruses 2022; 14:1686. [PMID: 36016309 PMCID: PMC9413998 DOI: 10.3390/v14081686] [Citation(s) in RCA: 4] [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: 07/10/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022] Open
Abstract
The coronavirus 2019 (COVID-19) disease has long-term effects, known as post-COVID conditions (PCC) or long-COVID. Post-COVID-19 syndrome is defined by signs and symptoms that occur during or after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection which persist for more than 12 weeks and cannot be supported by an alternative diagnosis. The cardiovascular damage caused by COVID-19 in the severe forms of the disease is induced by severe systemic inflammation, considered to be one of the causes of myocardial lesions, with increased levels of circulating cytokines and toxic response mediators. We have focused on conditions that can induce long-COVID-19, or multisystem inflammatory syndrome in adults or children (MIS-C/MIS-A), with an emphasis on endocrinological and metabolic disorders. Although described less frequently in children than in adults, long-COVID syndrome should not be confused with MIS-C, which is an acute condition characterized by multisystem involvement and paraclinical evidence of inflammation in a pediatric patient who tested positive for SARS-CoV-2. At the same time, we mention that the MIS-A symptoms remit within a few weeks, while the duration of long-COVID is measured in months. Long-COVID syndrome, along with its complications, MIS-A and MIS-C, represents an important challenge in the medical community. Underlying comorbidities can expose both COVID-19 adult and pediatric patients to a higher risk of negative outcomes not only during, but in the aftermath of the SARS-CoV-2 infection as well.
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Affiliation(s)
- Celina Silvia Stafie
- Department of Preventive Medicine and Interdisciplinarity—Family Medicine Discipline, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania;
| | - Sorina Mihaela Solomon
- Department of Periodontology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700111 Iasi, Romania
| | - Irina-Georgeta Sufaru
- Department of Periodontology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700111 Iasi, Romania
| | - Maria Manaila
- Endocrinology Residency Program, Sf. Spiridon Clinical Emergency Hospital, Independentei, 1, 700111 Iasi, Romania; (M.M.); (I.I.S.); (G.M.)
| | - Ingrid Ioana Stafie
- Endocrinology Residency Program, Sf. Spiridon Clinical Emergency Hospital, Independentei, 1, 700111 Iasi, Romania; (M.M.); (I.I.S.); (G.M.)
| | - Gabriela Melinte
- Endocrinology Residency Program, Sf. Spiridon Clinical Emergency Hospital, Independentei, 1, 700111 Iasi, Romania; (M.M.); (I.I.S.); (G.M.)
| | - Bianca Simionescu
- Pediatric Clinic No. 2, Mother and Child Department, Iuliu Hatieganu University of Medicine and Pharmacy, 8 Victor Babes, 400347 Cluj-Napoca, Romania;
| | - Letitia Leustean
- Department of Endocrinology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania;
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235
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Agathis NT, Womack LS, Webber BJ, Choudhary R, Wanga V, Ko JY, Dupont H, Imperatore G, Koumans EH, Saydah S, Kimball AA, Siegel DA. Children, adolescents, and young adults hospitalized with COVID-19 and diabetes in summer 2021. Pediatr Diabetes 2022; 23:961-967. [PMID: 35876454 PMCID: PMC9349842 DOI: 10.1111/pedi.13396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/18/2022] [Accepted: 07/20/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION More information is needed to understand the clinical epidemiology of children and young adults hospitalized with diabetes and COVID-19. We describe the demographic and clinical characteristics of patients <21 years old hospitalized with COVID-19 and either Type 1 or Type 2 Diabetes Mellitus (T1DM or T2DM) during peak incidence of SARS-CoV-2 infection with the B.1.617.2 (Delta) variant. METHODS This is a descriptive sub-analysis of a retrospective chart review of patients aged <21 years hospitalized with COVID-19 in six US children's hospitals during July-August 2021. Patients with COVID-19 and either newly diagnosed or known T1DM or T2DM were described using originally collected data and diabetes-related data specifically collected on these patients. RESULTS Of the 58 patients hospitalized with COVID-19 and diabetes, 34 had T1DM and 24 had T2DM. Of those with T1DM and T2DM, 26% (9/34) and 33% (8/24), respectively, were newly diagnosed. Among those >12 years old and eligible for COVID-19 vaccination, 93% were unvaccinated (42/45). Among patients with T1DM, 88% had diabetic ketoacidosis (DKA) and 6% had COVID-19 pneumonia; of those with T2DM, 46% had DKA and 58% had COVID-19 pneumonia. Of those with T1DM or T2DM, 59% and 46%, respectively, required ICU admission. CONCLUSION Our findings highlight the importance of considering diabetes in the evaluation of children and young adults presenting with COVID-19; the challenges of managing young patients who present with both COVID-19 and diabetes, particularly T2DM; and the importance of preventive actions like COVID-19 vaccination to prevent severe illness among those eligible with both COVID-19 and diabetes.
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Affiliation(s)
- Nickolas T. Agathis
- Epidemic Intelligence Service, Centers for Disease Control and PreventionAtlantaGA,COVID‐19 Response, Centers for Disease Control and PreventionAtlantaGA
| | - Lindsay S. Womack
- COVID‐19 Response, Centers for Disease Control and PreventionAtlantaGA,United States Public Health Service, Commissioned CorpsRockvilleMaryland
| | - Bryant J. Webber
- Epidemic Intelligence Service, Centers for Disease Control and PreventionAtlantaGA,COVID‐19 Response, Centers for Disease Control and PreventionAtlantaGA
| | - Rewa Choudhary
- Epidemic Intelligence Service, Centers for Disease Control and PreventionAtlantaGA,COVID‐19 Response, Centers for Disease Control and PreventionAtlantaGA
| | - Valentine Wanga
- Epidemic Intelligence Service, Centers for Disease Control and PreventionAtlantaGA,COVID‐19 Response, Centers for Disease Control and PreventionAtlantaGA
| | - Jean Y. Ko
- COVID‐19 Response, Centers for Disease Control and PreventionAtlantaGA,United States Public Health Service, Commissioned CorpsRockvilleMaryland
| | - Hannah Dupont
- COVID‐19 Response, Centers for Disease Control and PreventionAtlantaGA,United States Public Health Service, Commissioned CorpsRockvilleMaryland
| | - Giuseppina Imperatore
- Division of Diabetes TranslationNational Center for Chronic Disease Prevention and Health Promotion
| | - Emilia H. Koumans
- COVID‐19 Response, Centers for Disease Control and PreventionAtlantaGA,United States Public Health Service, Commissioned CorpsRockvilleMaryland
| | - Sharon Saydah
- COVID‐19 Response, Centers for Disease Control and PreventionAtlantaGA,United States Public Health Service, Commissioned CorpsRockvilleMaryland
| | - Anne A. Kimball
- COVID‐19 Response, Centers for Disease Control and PreventionAtlantaGA
| | - David A. Siegel
- COVID‐19 Response, Centers for Disease Control and PreventionAtlantaGA,United States Public Health Service, Commissioned CorpsRockvilleMaryland
| | - the Pediatric COVID‐19 Hospital Investigation TeamGerdesMegan E.MPHShiDallas S.MD, PhDDulskiTheresa M.MD, MPHHsuSophiaMSN, MPHIduborOsatohamwen I.MDWendelArthur M.MDAndersonKristiMDBoylesTriciaMHAChiuSophia K.MDClickEleanor S.MD, PhDDa SilvaJulianaMDEvansMaryMDGoldJeremy A. W.MD, MSHastonJuliaMDLoganPamelaMD, MPH, MAMaloneySusan A.MDMartinezMarisolPharmDNatarajanPavithraBMBSSpicerKevin B.MD, PhDSwancuttMarkMDStevensValerie A.BrownJessicaPhDChandraGyanMBALightMeganMPHSchweitzerBethMSMorrisSapna BamrahMDBarrFrederick E.MDSnowdenJessicaMDKociolekLarry K.MDMcHughMatthewMPHWesselDavid L.MDSimpsonJoelle N.MDGormanKathleen C.MSNBreslinKristen A.MD, MPHDeBiasiRoberta L.MD, MSThompsonAaronMDKlineMark W.MDBoomJulie A.MDSinghIla R.MD, PhDDowlinMichaelWietechaMarkMS, MBA
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236
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张 娜, 刘 建, 褚 亚, 帅 金, 黄 坤. [Clinical and gene mutation features of cystic fibrosis: an analysis of 8 cases]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:771-777. [PMID: 35894192 PMCID: PMC9336621 DOI: 10.7499/j.issn.1008-8830.2203015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To study the clinical features and gene mutation sites of children with cystic fibrosis (CF), in order to improve the understanding of CF to reduce misdiagnosis and missed diagnosis. METHODS A retrospective analysis was performed on the medical records of 8 children with CF who were diagnosed in Hebei Children's Hospital from 2018 to 2021. RESULTS Among the 8 children with CF, there were 5 boys and 3 girls, with an age of 3-48 months (median 8 months) at diagnosis, and the age of onset ranged from 0 to 24 months (median 2.5 months). Clinical manifestations included recurrent respiratory infection in 7 children, sinusitis in 3 children, bronchiectasis in 4 children, diarrhea in 8 children, fatty diarrhea in 3 children, suspected pancreatic insufficiency in 6 children, pancreatic cystic fibrosis in 1 child, malnutrition in 5 children, and pseudo-Bartter syndrome in 4 children. The most common respiratory pathogens were Pseudomonas aeruginosa (4 children). A total of 16 mutation sites were identified by high-throughput sequencing, multiplex ligation-dependent probe amplification, and Sanger sequencing, including 5 frameshift mutations, 4 nonsense mutations, 4 missense mutations, 2 exon deletions, and 1 splice mutation. CFTR mutations were found in all 8 children. p.G970D was the most common mutation (3 children), and F508del mutation was observed in one child. Four novel mutations were noted: deletion exon15, c.3796_3797dupGA(p.I1267Kfs*12), c.2328dupA(p.V777Sfs*2), and c.2950G>A(p.D984N). CONCLUSIONS p.G970D is the most common mutation type in children with CF. CF should be considered for children who have recurrent respiratory infection or test positive for Pseudomonas aeruginosa, with or without digestive manifestations or pseudo-Bartter syndrome.
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237
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Santos-Sánchez G, Cruz-Chamorro I, Álvarez-Ríos AI, Álvarez-Sánchez N, Rodríguez-Ortiz B, Álvarez-López AI, Fernández-Pachón MS, Pedroche J, Millán F, Millán-Linares MDC, Lardone PJ, Bejarano I, Carrillo-Vico A. Bioactive Peptides from Lupin ( Lupinus angustifolius) Prevent the Early Stages of Atherosclerosis in Western Diet-Fed ApoE -/- Mice. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:8243-8253. [PMID: 35767743 PMCID: PMC9284549 DOI: 10.1021/acs.jafc.2c00809] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
We have previously reported the in vitro hypocholesterolemic, anti-inflammatory, and antioxidant effects of Alcalase-generated lupin protein hydrolysate (LPH). Given that lipoprotein deposition, oxidative stress, and inflammation are the main components of atherogenesis, we characterized the LPH composition, in silico identified LPH-peptides with activities related to atherosclerosis, and evaluated the in vivo LPH effects on atherosclerosis risk factors in a mouse model of atherosclerosis. After 15 min of Alcalase hydrolysis, peptides smaller than 8 kDa were obtained, and 259 peptides out of 278 peptides found showed biological activities related to atherosclerosis risk factors. Furthermore, LPH administration for 12 weeks reduced the plasma lipids, as well as the cardiovascular and atherogenic risk indexes. LPH also increased the total antioxidant capacity, decreased endothelial permeability, inflammatory response, and atherogenic markers. Therefore, this study describes for the first time that LPH prevents the early stages of atherosclerosis.
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Affiliation(s)
- Guillermo Santos-Sánchez
- Instituto
de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta
de Andalucía, CSIC), 41013 Seville, Spain
- Departamento
de Bioquímica Médica y Biología Molecular e Inmunología, Universidad de Sevilla, 41009 Seville, Spain
| | - Ivan Cruz-Chamorro
- Instituto
de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta
de Andalucía, CSIC), 41013 Seville, Spain
- Departamento
de Bioquímica Médica y Biología Molecular e Inmunología, Universidad de Sevilla, 41009 Seville, Spain
- .
Phone: +34955923106
| | - Ana Isabel Álvarez-Ríos
- Instituto
de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta
de Andalucía, CSIC), 41013 Seville, Spain
- Departamento
de Bioquímica Clínica, Unidad de Gestión de Laboratorios, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
| | - Nuria Álvarez-Sánchez
- Instituto
de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta
de Andalucía, CSIC), 41013 Seville, Spain
| | - Beatriz Rodríguez-Ortiz
- Instituto
de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta
de Andalucía, CSIC), 41013 Seville, Spain
- Departamento
de Bioquímica Médica y Biología Molecular e Inmunología, Universidad de Sevilla, 41009 Seville, Spain
| | - Ana Isabel Álvarez-López
- Instituto
de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta
de Andalucía, CSIC), 41013 Seville, Spain
| | - María-Soledad Fernández-Pachón
- Área
de Nutrición y Bromatología, Departamento de Biología
Molecular e Ingeniería Bioquímica, Universidad Pablo de Olavide, Ctra Utrera Km 1, 41013 Seville, Spain
| | - Justo Pedroche
- Department
of Food & Health, Instituto de la grasa,
CSIC, Ctra Utrera Km
1, 41013 Seville, Spain
| | - Francisco Millán
- Department
of Food & Health, Instituto de la grasa,
CSIC, Ctra Utrera Km
1, 41013 Seville, Spain
| | - María del Carmen Millán-Linares
- Departamento
de Bioquímica Médica y Biología Molecular e Inmunología, Universidad de Sevilla, 41009 Seville, Spain
- Department
of Food & Health, Instituto de la grasa,
CSIC, Ctra Utrera Km
1, 41013 Seville, Spain
| | - Patricia Judith Lardone
- Instituto
de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta
de Andalucía, CSIC), 41013 Seville, Spain
- Departamento
de Bioquímica Médica y Biología Molecular e Inmunología, Universidad de Sevilla, 41009 Seville, Spain
| | - Ignacio Bejarano
- Instituto
de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta
de Andalucía, CSIC), 41013 Seville, Spain
- Departamento
de Bioquímica Médica y Biología Molecular e Inmunología, Universidad de Sevilla, 41009 Seville, Spain
| | - Antonio Carrillo-Vico
- Instituto
de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta
de Andalucía, CSIC), 41013 Seville, Spain
- Departamento
de Bioquímica Médica y Biología Molecular e Inmunología, Universidad de Sevilla, 41009 Seville, Spain
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Kostev K, Smith L, Koyanagi A, Jacob L. Prevalence of and factors associated with post-COVID-19 condition in the 12 months following the diagnosis of COVID-19 in adults followed in general practices in Germany. Open Forum Infect Dis 2022; 9:ofac333. [PMID: 35891693 PMCID: PMC9278235 DOI: 10.1093/ofid/ofac333] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/30/2022] [Indexed: 11/15/2022] Open
Abstract
Background Little is known about the epidemiology of post-coronavirus disease 2019 (COVID-19) condition (PCC) in primary care practices. Therefore, this study aimed to investigate the prevalence of and the factors associated with PCC in the 12 months after the diagnosis of COVID-19 in patients followed in general practices in Germany. Methods This retrospective cohort study included adults aged ≥18 years who were diagnosed for the first time with COVID-19 (index date) in 1 of 855 general practices in Germany between October 2020 and August 2021 (Disease Analyzer database; IQVIA). The outcome was the occurrence of PCC 91 to 365 days after the index date. Covariates included age, sex, and comorbidities documented in the 12 months before the index date. The association between covariates and PCC was assessed using a multivariable logistic regression model. Results We included 51 630 patients in this study (mean age, 47.1 [standard deviation, 19.8] years; 54.3% women). The prevalence of PCC was 8.3%. Age >30 years (odds ratios [ORs] ranging from 1.40 for 31–45 years to 2.10 for 46–60 years) and female sex (OR = 1.23) were positively and significantly associated with PCC compared with age 18–30 years and male sex, respectively. There was also a significant relationship of PCC with asthma (OR = 1.38), reaction to severe stress, and adjustment disorders (OR = 1.24), and somatoform disorders (OR = 1.23). Conclusions Post-COVID-19 condition was found in the 12 months after the diagnosis of COVID-19 in approximately 8% of adults from general practices in Germany. More data from other settings are warranted to confirm these findings.
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Affiliation(s)
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University , Cambridge , UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu , CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona , Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA) , Pg. Lluis Companys 23, Barcelona , Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu , CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona , Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines , Montigny-le-Bretonneux , France
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Abstract
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, is a global pandemic impacting 254 million people in 190 countries. Comorbidities, particularly cardiovascular disease, diabetes, and hypertension, increase the risk of infection and poor outcomes. SARS-CoV-2 enters host cells through the angiotensin-converting enzyme-2 receptor, generating inflammation and cytokine storm, often resulting in multiorgan failure. The mechanisms and effects of COVID-19 on patients with high-risk diabetes are not yet completely understood. In this review, we discuss the variety of coronaviruses, structure of SARS-CoV-2, mutations in SARS-CoV-2 spike proteins, receptors associated with viral host entry, and disease progression. Furthermore, we focus on possible mechanisms of SARS-CoV-2 in diabetes, leading to inflammation and heart failure. Finally, we discuss existing therapeutic approaches, unanswered questions, and future directions.
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Affiliation(s)
- Chandrakala Aluganti Narasimhulu
- Division of Metabolic and Cardiovascular Sciences, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, United States
| | - Dinender K Singla
- Division of Metabolic and Cardiovascular Sciences, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, Florida, United States
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240
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Laštovičková L, Kopčil M, Kanďár R. Dried blood spot as an alternative sample for screening of fatty acids, amino acids, and keto acids metabolism in humans. Biomed Chromatogr 2022; 36:e5431. [PMID: 35732590 DOI: 10.1002/bmc.5431] [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: 03/14/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/07/2022]
Abstract
The dried blood spot is a simple and non-invasive sample collection technique allowing self-collection at home. It can be used as an alternative sample for the screening of metabolism in humans since changes in the levels of some fatty acids, amino acids, and keto acids can be associated with metabolic disorders (for example diabetes mellitus). In this study we optimized three different methods that are sensitive enough for the determination of above-mentioned analytes from a small volume of a biological material in dried blood spot. In total 20 amino acids, 5 keto acids, and 24 fatty acids were determined. This sample technique was applied to prepare samples from 60 individuals by a finger prick. Samples were analysed with chromatographic methods and acquired data were statistically evaluated. Even though most analytes were higher in men, only 5 amino acids, 3 keto acids and 8 fatty acids showed significant gender-dependency (α = 0.05). Asparagine, serine, α- and γ-linolenic acids showed significant age-dependency (α = 0.05). The most of statistically significant correlations were positive and were found within one category. This work shows that because of many benefits, the dried blood spot sample could be a good alternative to whole blood sample collection for the screening of metabolism in humans in general or in individualised medicine. The chromatographic methods can be used in the next research, for example to set reference range or plasma-correction factors (various aspects as age or gender should be considered).
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Affiliation(s)
- Lenka Laštovičková
- Department of Biological and Biochemical Sciences, Faculty of Chemical Technology, University of Pardubice, Pardubice, Czech Republic
| | - Michal Kopčil
- Department of Biological and Biochemical Sciences, Faculty of Chemical Technology, University of Pardubice, Pardubice, Czech Republic
| | - Roman Kanďár
- Department of Biological and Biochemical Sciences, Faculty of Chemical Technology, University of Pardubice, Pardubice, Czech Republic
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241
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Messina A, Amati R, Albanese E, Fiordelli M. Help-Seeking in Informal Family Caregivers of People with Dementia: A Qualitative Study with iSupport as a Case in Point. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7504. [PMID: 35742751 PMCID: PMC9224309 DOI: 10.3390/ijerph19127504] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/08/2022] [Accepted: 06/17/2022] [Indexed: 01/27/2023]
Abstract
Supportive measures and training interventions can improve the care of people with dementia and reduce the burden on informal caregivers, whose needs remain largely unmet. iSupport is an evidence-based online intervention developed by the World Health Organization to provide support and self-guided education to informal family caregivers of people with dementia. This qualitative study explored barriers and facilitators in the access and use of supportive measures for family caregivers of people with dementia living in Southern Switzerland (Ticino). We conducted five focus groups and explored experiences, beliefs, and attitudes toward seeking help (SH), and used thematic analysis to identify key themes. Participants (N = 13) reported a general reluctance to SH. We identified four main barriers to SH: high level of burden; sense of duty; fear of being misunderstood by others; and difficulty in reaching information. We also identified facilitators of help seeking behaviors and unveiled the need of caregivers to be assisted by a dementia case manager to facilitate access to support resources. Local services and interventions should be adapted to caregivers' needs and expectations, with the aim of facilitating the acceptance of, access to, and service integration of existing and future support measures, including iSupport.
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Affiliation(s)
- Anna Messina
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland; (R.A.); (E.A.); (M.F.)
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Petropoulou A, Bakounaki G, Grammatikopoulou MG, Bogdanos DP, Goulis DG, Vassilakou T. Eating Disorders and Disordered Eating Behaviors in Cystic Fibrosis: A Neglected Issue. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9060915. [PMID: 35740852 PMCID: PMC9221629 DOI: 10.3390/children9060915] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/06/2022] [Accepted: 06/16/2022] [Indexed: 05/28/2023]
Abstract
As with the majority of chronic diseases having specific nutrition recommendations, in cystic fibrosis (CF), the emphasis placed on patients regarding their diet and ideal body weight status often increases the risk of developing disordered eating behaviors and by inference, eating disorders (EDs). Body weight appears to be an important concern for patients with CF, with many patients struggling to lose weight. Between sexes, women appear more preoccupied with dieting compared to men, but exhibit a better body image, mainly due to their preference for a lower weight. Several comorbidities appear to change these dynamics, and visibly apparent factors, including scars, ports, and tubes, and the need for supplementary oxygen supply, may also influence body image perception. Disordered eating is usually initiated during a bout of pulmonary infection, with the patient feeling unwell to eat. Regarding the prevalence of EDs, research appears conflicting on whether it is higher among individuals with a CF diagnosis or not. As for comorbidities, anxiety and depression consist of the most common psychiatric diagnoses in CF, also greatly prevalent in EDs. Despite the plethora of studies, non-specific CF tools, small samples, and lack of data regarding important outcomes, including lung health, indicate the need for more research.
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Affiliation(s)
- Anastasia Petropoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, 57400 Thessaloniki, Greece; (A.P.); (G.B.)
| | - Georgia Bakounaki
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, 57400 Thessaloniki, Greece; (A.P.); (G.B.)
| | - Maria G. Grammatikopoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, 57400 Thessaloniki, Greece; (A.P.); (G.B.)
- Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 40500 Larissa, Greece;
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, Agiou Pavlou 76, 56429 Thessaloniki, Greece;
| | - Dimitrios P. Bogdanos
- Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 40500 Larissa, Greece;
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, Agiou Pavlou 76, 56429 Thessaloniki, Greece;
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, Athens University Campus, 196 Alexandra’s Avenue, 11521 Athens, Greece
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243
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Dietary interventions for managing glucose abnormalities in people with cystic fibrosis. Hippokratia 2022. [DOI: 10.1002/14651858.cd014708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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244
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Karimova MV, Gvazava IG, Vorotelyak EA. Overcoming the Limitations of Stem Cell-Derived Beta Cells. Biomolecules 2022; 12:biom12060810. [PMID: 35740935 PMCID: PMC9221417 DOI: 10.3390/biom12060810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 12/13/2022] Open
Abstract
Great advances in type 1 diabetes (T1D) and type 2 diabetes (T2D) treatment have been made to this day. However, modern diabetes therapy based on insulin injections and cadaveric islets transplantation has many disadvantages. That is why researchers are developing new methods to regenerate the pancreatic hormone-producing cells in vitro. The most promising approach is the generation of stem cell-derived beta cells that could provide an unlimited source of insulin-secreting cells. Recent studies provide methods to produce beta-like cell clusters that display glucose-stimulated insulin secretion—one of the key characteristics of the beta cell. However, in comparison with native beta cells, stem cell-derived beta cells do not undergo full functional maturation. In this paper we review the development and current state of various protocols, consider advantages, and propose ways to improve them. We examine molecular pathways, epigenetic modifications, intracellular components, and the microenvironment as a possible leverage to promote beta cell functional maturation. A possibility to create islet organoids from stem cell-derived components, as well as their encapsulation and further transplantation, is also examined. We try to combine modern research on beta cells and their crosstalk to create a holistic overview of developing insulin-secreting systems.
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Affiliation(s)
- Mariana V. Karimova
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, 119334 Moscow, Russia; (M.V.K.); (I.G.G.)
| | - Inessa G. Gvazava
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, 119334 Moscow, Russia; (M.V.K.); (I.G.G.)
| | - Ekaterina A. Vorotelyak
- Koltzov Institute of Developmental Biology of Russian Academy of Sciences, 119334 Moscow, Russia; (M.V.K.); (I.G.G.)
- Department of Biology, Lomonosov Moscow State University, 119991 Moscow, Russia
- Correspondence:
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245
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Flume PA, Saiman L, Marshall B. The Impact of COVID-19 in Cystic Fibrosis. Arch Bronconeumol 2022; 58:466-468. [PMID: 34934258 PMCID: PMC8679495 DOI: 10.1016/j.arbres.2021.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 02/06/2023]
Affiliation(s)
| | - Lisa Saiman
- Columbia University Irving Medical Center, New York, NY, USA
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246
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Shafiee A, Teymouri Athar MM, Nassar M, Seighali N, Aminzade D, Fattahi P, Rahmannia M, Ahmadi Z. Comparison of COVID-19 outcomes in patients with Type 1 and Type 2 diabetes: A systematic review and meta-analysis. Diabetes Metab Syndr 2022; 16:102512. [PMID: 35660932 PMCID: PMC9135641 DOI: 10.1016/j.dsx.2022.102512] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/07/2022] [Accepted: 05/17/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS This systematic review and meta-analysis aimed to evaluate the current evidence available to investigate clinical outcomes between patients with type 1 and type 2 diabetes. METHODS MEDLINE (Pubmed), Scopus, Web of Science, Cochrane library, Google scholar and Clinicaltrials.gov were searched. Randomized controlled trials (RCTs), non-randomized trials, and observational studies were eligible for inclusion. National Institutes of Health Quality Assessment Tool was used to assess the quality. Data were pooled by the Restricted-maximum-likelihood random-effects approach. RESULTS Total 11 studies comprising 7690415 individuals were included in this study. The log OR for the pooled data for all-cause mortality rate was -0.71 (95% CI: -1.38 to -0.03). Based on the pooled results, type 1 diabetic COVID-19 patients may have a better prognosis for mortality. There were no significant differences between groups in term of ICU-admission log OR -0.22 (95% CI: -0.81 to 0.37), and hospitalization log OR -0.48 (95% CI: -1.23 to 0.27). Based on our descriptives analyses after adjusting for age and comorbidities, the high-risk group in three studies was type 2 diabetes, and in five studies was type 1. Two studies reported no significant difference between these groups in relevant outcomes. CONCLUSION There were no significant differences in disease severity between type 1 and type 2 diabetes. Based on the unadjusted data available, the mortality rate for people with type 1 diabetes was shown to be lower than that for people with type 2. As data on these subjects is scarce, and the results obtained from studies are heterogeneous, further research with adequate sample sizes is needed to precisely compare the outcomes of COVID-19 between type 1 and type 2 diabetes.
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Affiliation(s)
- Arman Shafiee
- School of Medicine, Alborz University of Medical Sciences, Karaj, Iran; Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran.
| | | | - Mahmoud Nassar
- Medicine Department, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals / Queens, New York, USA
| | - Niloofar Seighali
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Dlnya Aminzade
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Payam Fattahi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rahmannia
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Ahmadi
- Department of Basic Sciences and New Technologies, Electronical Branch, Islamic Azad University, Tehran, Iran
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247
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Cohen O, Ronen O, Khafif A, Rodrigo JP, Simo R, Pace-Asciak P, Randolph G, Mikkelsen LH, Kowalski LP, Olsen KD, Sanabria A, Tufano RP, Babighian S, Shaha AR, Zafereo M, Ferlito A. Revisiting the role of surgery in the treatment of Graves' disease. Clin Endocrinol (Oxf) 2022; 96:747-757. [PMID: 34954838 DOI: 10.1111/cen.14653] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/22/2021] [Accepted: 11/22/2021] [Indexed: 01/06/2023]
Abstract
Graves' disease (GD) can be managed by antithyroid drugs (ATD), radioactive iodine (RAI) and surgery. Thyroidectomy offers the highest success rates for both primary and persistent disease, yet it is the least recommended or utilized option reaching <1% for primary disease and <25% for persistent disease. Several surveys have found surgery to be the least recommended by endocrinologists worldwide. With the development of remote access thyroidectomies and intraoperative nerve monitoring of the recurrent laryngeal nerve, combined with current knowledge of possible risks associated with RAI or failure of ATDs, revaluation of the benefit to harm ratio of surgery in the treatment of GD is warranted. The aim of this review is to discuss possible reasons for the low proportion of surgery in the treatment of GD, emphasizing an evidence-based approach to the clinicians' preferences for surgical referrals, surgical indications and confronting traditional reasons and concerns relating to the low referral rate with up-to-date data.
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Affiliation(s)
- Oded Cohen
- Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Ohad Ronen
- Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Avi Khafif
- A.R.M. Center of Otolaryngology-Head and Neck Surgery, Assuta Medical Center, Affiliated with Ben-Gurion University of the Negev, Tel Aviv, Israel
| | - Juan P Rodrigo
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, Oviedo, Spain
| | - Ricard Simo
- Department of Otorhinolaryngology, Head and Neck Surgery, Head and Neck and Thyroid Oncology Unit, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, UK
| | - Pia Pace-Asciak
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Gregory Randolph
- Division of Otolaryngology-Endocrine Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard University, Boston, Massachusetts, USA
| | - Lauge H Mikkelsen
- Department of Pathology, Eye Pathology Section, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Luiz P Kowalski
- Department of Head and Neck Surgery, University of Sao Paulo Medical School, AC Camargo Cancer Center, Sao Paulo, Brazil
- Department of Head and Neck Surgery and Otorhinolaryngology, AC Camargo Cancer Center, Sao Paulo, Brazil
| | - Kerry D Olsen
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia-Ips Universitaria, Medellín, Colombia
- CEXCA Centro de Excelencia en Enfermedades de Cabeza y Cuello-Clínica Las Vegas-Quirón, Medellín, Colombia
| | - Ralph P Tufano
- Multidisciplinary Thyroid and Parathyroid Center, Head and Neck Endocrine Surgery, Sarasota Memorial Health Care System, Sarasota, Florida, USA
- Division of Otolaryngology-Endocrine Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Madison, USA
| | - Silvia Babighian
- Department of Ophthalmology, Ospedale Sant'Antonio, Azienda Ospedaliera, Padova, Italy
| | - Ashok R Shaha
- Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Mark Zafereo
- Department of Head & Neck Surgery, Anderson Cancer Center, Houston, Texas, USA
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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248
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Abstract
Die Weltgesundheitsorganisation (WHO) definiert Post-COVID-19(„coronavirus disease 2019“) als Zustand, der bei Personen mit einer anamnestisch wahrscheinlichen oder bestätigten SARS-CoV-2(„severe acute respiratory syndrome coronavirus type 2“)-Infektion 3 Monate nach Beginn der COVID-19-Symptome und mindestens 2 Monate andauernd vorhanden ist und durch eine alternative Diagnose nicht erklärbar ist. Kernsymptome des Post-COVID-Syndroms umfassen Atemnot, Fatigue und kognitive Dysfunktion, welche das alltägliche Funktionsniveau beeinflussen. Neuropsychiatrische Spätfolgen sind bei COVID-19-Patienten mit Inzidenzraten von über 30 % häufig. Neben den genannten Kernsymptomen zeigen Schlafstörungen, Depression und Angsterkrankungen erhöhte Inzidenzen. Nach gegenwärtiger Meinung werden assoziierte neuropsychiatrische Symptome sowohl unter dem Begriff Post-COVID-Syndrom subsumiert, aber auch als Komorbiditäten interpretiert, welche die Manifestation eines Post-COVID-Syndroms begünstigen können. So zeigt das Kernsymptom Fatigue Symptomüberlappung und Komorbidität mit psychischen Erkrankungen. Bildgebungsstudien deuten auf ein organisches Korrelat der Fatigue bei Post-COVID-Patienten hin, darüber hinaus wurden psychosoziale Aspekte und psychiatrische Komorbiditäten wie Depression und Angsterkrankungen als modulierende und damit potenziell behandelbare Faktoren identifiziert. Die Therapie der Fatigue umfasst neben dem pharmakologischen Management mit u. a. Stimulanzien und Antidepressiva auch nichtpharmakologische Strategien, hier vor allem die kognitive Verhaltenstherapie sowie körper- und bewegungsfokussierte Interventionen. Die Evidenz hierfür erwächst aus Metaanalysen bei tumorassoziierter oder postviraler Fatigue.
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249
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Pan X. The Roles of Fatty Acids and Apolipoproteins in the Kidneys. Metabolites 2022; 12:metabo12050462. [PMID: 35629966 PMCID: PMC9145954 DOI: 10.3390/metabo12050462] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 12/10/2022] Open
Abstract
The kidneys are organs that require energy from the metabolism of fatty acids and glucose; several studies have shown that the kidneys are metabolically active tissues with an estimated energy requirement similar to that of the heart. The kidneys may regulate the normal and pathological function of circulating lipids in the body, and their glomerular filtration barrier prevents large molecules or large lipoprotein particles from being filtered into pre-urine. Given the permeable nature of the kidneys, renal lipid metabolism plays an important role in affecting the rest of the body and the kidneys. Lipid metabolism in the kidneys is important because of the exchange of free fatty acids and apolipoproteins from the peripheral circulation. Apolipoproteins have important roles in the transport and metabolism of lipids within the glomeruli and renal tubules. Indeed, evidence indicates that apolipoproteins have multiple functions in regulating lipid import, transport, synthesis, storage, oxidation and export, and they are important for normal physiological function. Apolipoproteins are also risk factors for several renal diseases; for example, apolipoprotein L polymorphisms induce kidney diseases. Furthermore, renal apolipoprotein gene expression is substantially regulated under various physiological and disease conditions. This review is aimed at describing recent clinical and basic studies on the major roles and functions of apolipoproteins in the kidneys.
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Affiliation(s)
- Xiaoyue Pan
- Department of Foundations of Medicine, New York University Long Island School of Medicine, Mineola, New York, NY 11501, USA;
- Diabetes and Obesity Research Center, NYU Langone Hospital—Long Island, Mineola, New York, NY 11501, USA
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250
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D'hoore L, T'Sjoen G. Gender-affirming hormone therapy: An updated literature review with an eye on the future. J Intern Med 2022; 291:574-592. [PMID: 34982475 DOI: 10.1111/joim.13441] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In line with increasing numbers of transgender (trans) and gender nonbinary people requesting hormone treatment, the body of available research is expanding. More clinical research groups are presenting data, and the numbers of participants in these studies are rising. Many previous review papers have focused on all available data, as these were scarce, but a more recent literature review is timely. Hormonal regimens have changed over time, and older data may be less relevant for today's practice. In recent literature, we have found that even though mental health problems are more prevalent in trans people compared to cisgender people, less psychological difficulties occur, and life satisfaction increases with gender-affirming hormone treatment (GAHT) for those who feel this is a necessity. With GAHT, body composition and contours change towards the affirmed sex. Studies in bone health are reassuring, but special attention is needed for adolescent and adult trans women, aiming at adequate dosage of hormonal supplementation and stimulating therapy compliance. Existing epidemiological data suggest that the use of (certain) estrogens in trans women induces an increased risk of myocardial infarction and stroke, the reason that lifestyle management can be an integral part of trans health care. The observed cancer risk in trans people does not exceed the known cancer-risk differences between men and women. Now it is time to integrate the mostly reassuring data, to leave the overly cautious approach behind, to not copy the same research questions repeatedly, and to focus on longer follow-up data with larger cohorts.
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Affiliation(s)
- Laurens D'hoore
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Guy T'Sjoen
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium.,Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium
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