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Ahluwalia M, Gaur P, Vaibhav K. Brain Injury and Neurodegeneration: Molecular, Functional, and Translational Approach. Biomedicines 2023; 11:1947. [PMID: 37509586 PMCID: PMC10377691 DOI: 10.3390/biomedicines11071947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Recently, we have achieved substantial progress in our understanding of brain injury and neurodegeneration [...].
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Affiliation(s)
- Meenakshi Ahluwalia
- Department of Pathology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
- Georgia Cancer Center, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Department of Neurosurgery, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Pankaj Gaur
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA;
| | - Kumar Vaibhav
- Department of Neurosurgery, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Department of Oral Biology and Diagnostic Sciences, Center for Excellence in Research, Scholarship and Innovation, Dental College of Georgia, Augusta University, Augusta, GA 30912, USA
- Transdisciplinary Research Initiative in Inflammaging and Brain Aging (TRIBA), Augusta University, Augusta, GA 30912, USA
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De Freitas VM, Chiloff DM, Bosso GG, Teixeira JOP, Hernandes ICDG, Padilha MDP, Moura GC, De Andrade LGM, Mancuso F, Finamor FE, Serodio AMDB, Arakaki JSO, Sartori MGF, Ferreira PRA, Rangel ÉB. A Machine Learning Model for Predicting Hospitalization in Patients with Respiratory Symptoms during the COVID-19 Pandemic. J Clin Med 2022; 11:jcm11154574. [PMID: 35956189 PMCID: PMC9369854 DOI: 10.3390/jcm11154574] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 12/28/2022] Open
Abstract
A machine learning approach is a useful tool for risk-stratifying patients with respiratory symptoms during the COVID-19 pandemic, as it is still evolving. We aimed to verify the predictive capacity of a gradient boosting decision trees (XGboost) algorithm to select the most important predictors including clinical and demographic parameters in patients who sought medical support due to respiratory signs and symptoms (RAPID RISK COVID-19). A total of 7336 patients were enrolled in the study, including 6596 patients that did not require hospitalization and 740 that required hospitalization. We identified that patients with respiratory signs and symptoms, in particular, lower oxyhemoglobin saturation by pulse oximetry (SpO2) and higher respiratory rate, fever, higher heart rate, and lower levels of blood pressure, associated with age, male sex, and the underlying conditions of diabetes mellitus and hypertension, required hospitalization more often. The predictive model yielded a ROC curve with an area under the curve (AUC) of 0.9181 (95% CI, 0.9001 to 0.9361). In conclusion, our model had a high discriminatory value which enabled the identification of a clinical and demographic profile predictive, preventive, and personalized of COVID-19 severity symptoms.
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Affiliation(s)
- Victor Muniz De Freitas
- Paulista School of Medicine, Hospital São Paulo, Federal University of São Paulo, São Paulo 04038-901, Brazil
| | - Daniela Mendes Chiloff
- Paulista School of Medicine, Hospital São Paulo, Federal University of São Paulo, São Paulo 04038-901, Brazil
| | - Giulia Gabriella Bosso
- Paulista School of Medicine, Hospital São Paulo, Federal University of São Paulo, São Paulo 04038-901, Brazil
| | | | | | - Maira do Patrocínio Padilha
- Paulista School of Medicine, Hospital São Paulo, Federal University of São Paulo, São Paulo 04038-901, Brazil
| | - Giovanna Corrêa Moura
- Paulista School of Medicine, Hospital São Paulo, Federal University of São Paulo, São Paulo 04038-901, Brazil
| | | | - Frederico Mancuso
- Discipline of Emergency Medicine, Department of Medicine, Paulista School of Medicine, Hospital São Paulo, Federal University of São Paulo, São Paulo 04038-901, Brazil
| | - Francisco Estivallet Finamor
- Discipline of Emergency Medicine, Department of Medicine, Paulista School of Medicine, Hospital São Paulo, Federal University of São Paulo, São Paulo 04038-901, Brazil
| | - Aluísio Marçal de Barros Serodio
- Sector of Bioethics, Department of Surgery, Paulista School of Medicine, Hospital São Paulo, Federal University of São Paulo, São Paulo 04038-901, Brazil
| | - Jaquelina Sonoe Ota Arakaki
- Pneumology Division, Department of Medicine, Paulista School of Medicine, Hospital São Paulo, Federal University of São Paulo, São Paulo 04038-901, Brazil
| | - Marair Gracio Ferreira Sartori
- Department of Obstetrics, Paulista School of Medicine, Hospital São Paulo, Federal University of São Paulo, São Paulo 04038-901, Brazil
| | - Paulo Roberto Abrão Ferreira
- Infectious Disease Division, Department of Medicine, Paulista School of Medicine, Hospital São Paulo, Federal University of São Paulo, São Paulo 04038-901, Brazil
| | - Érika Bevilaqua Rangel
- Nephrology Division, Department of Medicine, Paulista School of Medicine, Hospital São Paulo, Federal University of São Paulo, São Paulo 04038-901, Brazil
- Correspondence:
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Chawla S, Chawla S. Comparative Analysis of Susceptibility and Severity of COVID-19 in Countries from the Eastern and the Western World Till March '21. Microbiol Insights 2021; 14:11786361211041367. [PMID: 34483666 PMCID: PMC8411631 DOI: 10.1177/11786361211041367] [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: 12/19/2020] [Accepted: 07/27/2021] [Indexed: 11/24/2022] Open
Abstract
Majority of the world’s human population today is affected by Covid-19. The
disease has not only exhibited differences in susceptibility among people of
different countries, but also the mortality rate. In general, Western world has
been reporting a greater number of infected cases than eastern countries. Even
the mortality rates are quite high there. The aim of this study was to analyse
the data available on the infectivity and mortality rates of Covid-19 in
different countries till March’21 and then reviewed the literature to find
reasons for the differences in susceptibility and severity in eastern and
western countries. The reasons for the observed differences may be: (i) Eastern
countries followed stricter modalities and got grace period to create better
healthcare facilities to tackle COVID-19. This probably also slowed the
transmission of virus and its evolution, (ii) Vaccination policies in the east
may have provided some immunity due to cross reactivity, (iii) Frequent exposure
to infections at young age in eastern countries might be helping in better
immunity, (iv) Mutations in viral genome may be geography based and (v) Genetic
differences in the immune system of the hosts with respect to ACE receptors and
MHC may be playing an important role. In this article, an attempt has been made
to put forth and discuss these plausible reasons along with suitable evidences.
These findings may help in future research on the diagnosis, treatment and
prevention of Covid-19.
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Affiliation(s)
- Shashi Chawla
- Department of Microbiology, Gargi College, New Delhi, India
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Liskova A, Koklesova L, Samec M, Abdellatif B, Zhai K, Siddiqui M, Šudomová M, Hassan ST, Kudela E, Biringer K, Giordano FA, Büsselberg D, Golubnitschaja O, Kubatka P. Targeting phytoprotection in the COVID-19-induced lung damage and associated systemic effects-the evidence-based 3PM proposition to mitigate individual risks. EPMA J 2021; 12:325-347. [PMID: 34367380 PMCID: PMC8329620 DOI: 10.1007/s13167-021-00249-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/03/2021] [Indexed: 02/06/2023]
Abstract
The risks related to the COVID-19 are multi-faceted including but by far not restricted to the following: direct health risks by poorly understood effects of COVID-19 infection, overloaded capacities of healthcare units, restricted and slowed down care of patients with non-communicable disorders such as cancer, neurologic and cardiovascular pathologies, among others; social risks-restricted and broken social contacts, isolation, professional disruption, explosion of aggression in the society, violence in the familial environment; mental risks-loneliness, helplessness, defenceless, depressions; and economic risks-slowed down industrial productivity, broken delivery chains, unemployment, bankrupted SMEs, inflation, decreased capacity of the state to perform socially important programs and to support socio-economically weak subgroups in the population. Directly or indirectly, the above listed risks will get reflected in a healthcare occupation and workload which is a tremendous long-term challenge for the healthcare capacity and robustness. The article does not pretend to provide solutions for all kind of health risks. However, it aims to present the scientific evidence of great clinical utility for primary, secondary, and tertiary care to protect affected individuals in a cost-effective manner. To this end, due to pronounced antimicrobial, antioxidant, anti-inflammatory, and antiviral properties, naturally occurring plant substances are capable to protect affected individuals against COVID-19-associated life-threatening complications such as lung damage. Furthermore, they can be highly effective, if being applied to secondary and tertiary care of noncommunicable diseases under pandemic condition. Thus, the stratification of patients evaluating specific health conditions such as sleep quality, periodontitis, smoking, chronic inflammation and diseases, metabolic disorders and obesity, vascular dysfunction, and cancers would enable effective managemenet of COVID-19-associated complications in primary, secondary, and tertiary care in the context of predictive, preventive, and personalized medicine (3PM).
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Affiliation(s)
- Alena Liskova
- Department of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Lenka Koklesova
- Department of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Marek Samec
- Department of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Basma Abdellatif
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, 24144 Qatar
| | - Kevin Zhai
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, 24144 Qatar
| | - Manaal Siddiqui
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, 24144 Qatar
| | - Miroslava Šudomová
- Museum of Literature in Moravia, Klášter 1, 66461, Rajhrad, Czech Republic
| | - Sherif T.S. Hassan
- Department of Applied Ecology, Faculty of Environmental Sciences, Czech University of Life Sciences Prague, Kamýcká 129, 16500 Prague, Czech Republic
| | - Erik Kudela
- Department of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Kamil Biringer
- Department of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia
| | - Frank A. Giordano
- Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - Dietrich Büsselberg
- Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, 24144 Qatar
| | - Olga Golubnitschaja
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 03601 Martin, Slovakia
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Complex analysis of the personalized pharmacotherapy in the management of COVID-19 patients and suggestions for applications of predictive, preventive, and personalized medicine attitude. EPMA J 2021; 12:307-324. [PMID: 34306260 PMCID: PMC8283099 DOI: 10.1007/s13167-021-00247-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/08/2021] [Indexed: 02/07/2023]
Abstract
Aims Coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide. Drug therapy is one of the major treatments, but contradictory results of clinical trials have been reported among different individuals. Furthermore, comprehensive analysis of personalized pharmacotherapy is still lacking. In this study, analyses were performed on 47 well-characterized COVID-19 drugs used in the personalized treatment of COVID-19. Methods Clinical trials with published results of drugs use for COVID-19 treatment were collected to evaluate drug efficacy. Drug-to-Drug Interactions (DDIs) were summarized and classified. Functional variations in actionable pharmacogenes were collected and systematically analysed. “Gene Score” and “Drug Score” were defined and calculated to systematically analyse ethnicity-based genetic differences, which are important for the safer use of COVID-19 drugs. Results Our results indicated that four antiviral agents (ritonavir, darunavir, daclatasvir and sofosbuvir) and three immune regulators (budesonide, colchicine and prednisone) as well as heparin and enalapril could generate the highest number of DDIs with common concomitantly utilized drugs. Eight drugs (ritonavir, daclatasvir, sofosbuvir, ribavirin, interferon alpha-2b, chloroquine, hydroxychloroquine (HCQ) and ceftriaxone had actionable pharmacogenomics (PGx) biomarkers among all ethnic groups. Fourteen drugs (ritonavir, daclatasvir, prednisone, dexamethasone, ribavirin, HCQ, ceftriaxone, zinc, interferon beta-1a, remdesivir, levofloxacin, lopinavir, human immunoglobulin G and losartan) showed significantly different pharmacogenomic characteristics in relation to the ethnic origin of the patient. Conclusion We recommend that particularly for patients with comorbidities to avoid serious DDIs, the predictive, preventive, and personalized medicine (PPPM, 3 PM) strategies have to be applied for COVID-19 treatment, and genetic tests should be performed for drugs with actionable pharmacogenes, especially in some ethnic groups with a higher frequency of functional variations, as our analysis showed. We also suggest that drugs associated with higher ethnic genetic differences should be given priority in future pharmacogenetic studies for COVID-19 management. To facilitate translation of our results into clinical practice, an approach conform with PPPM/3 PM principles was suggested. In summary, the proposed PPPM/3 PM attitude should be obligatory considered for the overall COVID-19 management. Supplementary Information The online version contains supplementary material available at 10.1007/s13167-021-00247-0.
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Richter K, Kellner S, Hillemacher T, Golubnitschaja O. Sleep quality and COVID-19 outcomes: the evidence-based lessons in the framework of predictive, preventive and personalised (3P) medicine. EPMA J 2021; 12:221-241. [PMID: 34122671 PMCID: PMC8185312 DOI: 10.1007/s13167-021-00245-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 01/08/2023]
Abstract
Sleep quality and duration play a pivotal role in maintaining physical and mental health. In turn, sleep shortage, deprivation and disorders are per evidence the risk factors and facilitators of a broad spectrum of disorders, amongst others including depression, stroke, chronic inflammation, cancers, immune defence insufficiency and individual predisposition to infection diseases with poor outcomes, for example, related to the COVID-19 pandemic. Keeping in mind that COVID-19-related global infection distribution is neither the first nor the last pandemic severely affecting societies around the globe to the costs of human lives accompanied with enormous economic burden, lessons by predictive, preventive and personalised (3P) medical approach are essential to learn and to follow being better prepared to defend against global pandemics. To this end, under extreme conditions such as the current COVID-19 pandemic, the reciprocal interrelationship between the sleep quality and individual outcomes becomes evident, namely, at the levels of disease predisposition, severe versus mild disease progression, development of disease complications, poor outcomes and related mortality for both - population and healthcare givers. The latter is the prominent example clearly demonstrating the causality of severe outcomes, when the long-lasting work overload and shift work rhythm evidently lead to the sleep shortage and/or deprivation that in turn causes immune response insufficiency and strong predisposition to the acute infection with complications. This article highlights and provides an in-depth analysis of the concerted risk factors related to the sleep disturbances under the COVID-19 pandemic followed by the evidence-based recommendations in the framework of predictive, preventive and personalised medical approach.
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Affiliation(s)
- Kneginja Richter
- Outpatient Clinic for Sleep Disorders, University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, 90419 Nuremberg, Germany
- Faculty for Social Work, Technical University of Applied Sciences Nuremberg Georg Simon Ohm, 90489 Nuremberg, Germany
- Faculty for Medical Sciences, University Goce Delcev Stip, 2000 Stip, North Macedonia
| | - Stefanie Kellner
- Faculty for Social Work, Technical University of Applied Sciences Nuremberg Georg Simon Ohm, 90489 Nuremberg, Germany
| | - Thomas Hillemacher
- Outpatient Clinic for Sleep Disorders, University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, 90419 Nuremberg, Germany
| | - Olga Golubnitschaja
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
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Ahluwalia P, Vaibhav K, Ahluwalia M, Mondal AK, Sahajpal N, Rojiani AM, Kolhe R. Infection and Immune Memory: Variables in Robust Protection by Vaccines Against SARS-CoV-2. Front Immunol 2021; 12:660019. [PMID: 34046033 PMCID: PMC8144450 DOI: 10.3389/fimmu.2021.660019] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/27/2021] [Indexed: 12/24/2022] Open
Abstract
SARS-CoV-2 is the cause of a recent pandemic that has led to more than 3 million deaths worldwide. Most individuals are asymptomatic or display mild symptoms, which raises an inherent question as to how does the immune response differs from patients manifesting severe disease? During the initial phase of infection, dysregulated effector immune cells such as neutrophils, macrophages, monocytes, megakaryocytes, basophils, eosinophils, erythroid progenitor cells, and Th17 cells can alter the trajectory of an infected patient to severe disease. On the other hand, properly functioning CD4+, CD8+ cells, NK cells, and DCs reduce the disease severity. Detailed understanding of the immune response of convalescent individuals transitioning from the effector phase to the immunogenic memory phase can provide vital clues to understanding essential variables to assess vaccine-induced protection. Although neutralizing antibodies can wane over time, long-lasting B and T memory cells can persist in recovered individuals. The natural immunological memory captures the diverse repertoire of SARS-CoV-2 epitopes after natural infection whereas, currently approved vaccines are based on a single epitope, spike protein. It is essential to understand the nature of the immune response to natural infection to better identify ‘correlates of protection’ against this disease. This article discusses recent findings regarding immune response against natural infection to SARS-CoV-2 and the nature of immunogenic memory. More precise knowledge of the acute phase of immune response and its transition to immunological memory will contribute to the future design of vaccines and the identification of variables essential to maintain immune protection across diverse populations.
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Affiliation(s)
- Pankaj Ahluwalia
- Department of Pathology, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Kumar Vaibhav
- Department of Neurosurgery, Augusta University, Augusta, GA, United States
| | | | - Ashis K Mondal
- Department of Pathology, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Nikhil Sahajpal
- Department of Pathology, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Amyn M Rojiani
- Department of Pathology, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Ravindra Kolhe
- Department of Pathology, Medical College of Georgia, Augusta University, Augusta, GA, United States
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Tachalov VV, Orekhova LY, Kudryavtseva TV, Loboda ES, Pachkoriia MG, Berezkina IV, Golubnitschaja O. Making a complex dental care tailored to the person: population health in focus of predictive, preventive and personalised (3P) medical approach. EPMA J 2021; 12:129-140. [PMID: 33897916 PMCID: PMC8053896 DOI: 10.1007/s13167-021-00240-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 02/06/2023]
Abstract
An evident underestimation of the targeted prevention of dental diseases is strongly supported by alarming epidemiologic statistics globally. For example, epidemiologists demonstrated 100% prevalence of dental caries in the Russian population followed by clinical manifestation of periodontal diseases. Inadequately provided oral health services in populations are caused by multi-factorial deficits including but not limited to low socio-economic status of affected individuals, lack of insurance in sub-populations, insufficient density of dedicated medical units. Another important aspect is the “participatory” medicine based on the active participation of population in maintaining oral health: healthcare will remain insufficient as long as the patient is not motivated and does not feel responsible for their oral health. To this end, nearly half of chronically diseased people do not comply with adequate medical services suffering from severely progressing pathologies. Noteworthy, the prominent risk factors and comorbidities linked to the severe disease course and poor outcomes in COVID-19-infected individuals, such as elderly, diabetes mellitus, hypertension and cardiovascular disease, are frequently associated with significantly altered oral microbiome profiles, systemic inflammatory processes and poor oral health. Suggested pathomechanisms consider potential preferences in the interaction between the viral particles and the host microbiota including oral cavity, the respiratory and gastrointestinal tracts. Since an aspiration of periodontopathic bacteria induces the expression of angiotensin-converting enzyme 2, the receptor for SARS-CoV-2, and production of inflammatory cytokines in the lower respiratory tract, poor oral hygiene and periodontal disease have been proposed as leading to COVID-19 aggravation. Consequently, the issue-dedicated expert recommendations are focused on the optimal oral hygiene as being crucial for improved individual outcomes and reduced morbidity under the COVID-19 pandemic condition. Current study demonstrated that age, gender, socio-economic status, quality of environment and life-style, oral hygiene quality, regularity of dental services requested, level of motivation and responsibility for own health status and corresponding behavioural patterns are the key parameters for the patient stratification considering person-tailored approach in a complex dental care in the population. Consequently, innovative screening programmes and adapted treatment schemes are crucial for the complex person-tailored dental care to improve individual outcomes and healthcare provided to the population.
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Affiliation(s)
- V. V. Tachalov
- Therapeutic Dentistry and Periodontology Department, Pavlov First Saint Petersburg State Medical University, 6/8 Lva Tolstogo Street, St. Petersburg, Russia
| | - L. Y. Orekhova
- Therapeutic Dentistry and Periodontology Department, Pavlov First Saint Petersburg State Medical University, 6/8 Lva Tolstogo Street, St. Petersburg, Russia
- City Periodontology Centre, “PAKS”, Dobrolubova prospect, 27, St. Petersburg, Russia
| | - T. V. Kudryavtseva
- Therapeutic Dentistry and Periodontology Department, Pavlov First Saint Petersburg State Medical University, 6/8 Lva Tolstogo Street, St. Petersburg, Russia
| | - E. S. Loboda
- City Periodontology Centre, “PAKS”, Dobrolubova prospect, 27, St. Petersburg, Russia
| | - M. G. Pachkoriia
- Therapeutic Dentistry and Periodontology Department, Pavlov First Saint Petersburg State Medical University, 6/8 Lva Tolstogo Street, St. Petersburg, Russia
| | - I. V. Berezkina
- Therapeutic Dentistry and Periodontology Department, Pavlov First Saint Petersburg State Medical University, 6/8 Lva Tolstogo Street, St. Petersburg, Russia
| | - O. Golubnitschaja
- Predictive, Preventive, Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
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ABG Assistant-Towards an Understanding of Complex Acid-Base Disorders. J Clin Med 2021; 10:jcm10071516. [PMID: 33916476 PMCID: PMC8038584 DOI: 10.3390/jcm10071516] [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: 02/06/2021] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 11/30/2022] Open
Abstract
The ability to diagnose acid-base imbalances correctly is essential for physicians and other healthcare workers. Despite its importance, it is often considered too complex and confusing. Although most people dealing with arterial blood gases (ABGs) do not usually have problems with acid-base disorder assessment, such an analysis is also carried out by other healthcare workers for whom this can be a challenging task. Many aspects may be problematic, partly due to multiple data analysis methods and no definitive statement on which one is better. According to our survey, the correctness of arterial blood gas analysis is unsatisfactory, especially in mixed disorders, which do not always manifest an obvious set of symptoms. Therefore, ABG parameters can be used as an established biomarker panel, which is considered to be a powerful tool for personalized medicine. Moreover, using different approaches to analyze acid-base disorders can lead to varying diagnoses in some cases. Because of these problems, we developed a mobile application that can spot diagnostic differences by taking into account physiological and chemical approaches, including their variants, with a corrected anion gap. The proposed application is characterized by a high percentage of correct analyses and can be an essential aid for diagnosing acid-base disturbances.
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Skladany L, Koller T, Adamcova Selcanova S, Vnencakova J, Jancekova D, Durajova V, Laffers L, Svac J, Janickova K, Palkovič M, Kohout P, Golubnitschaja O. Challenging management of severe chronic disorders in acute pandemic situation: Chronic liver disease under COVID-19 pandemic as the proof-of-principle model to orchestrate the measures in 3PM context. EPMA J 2021; 12:1-14. [PMID: 33680218 PMCID: PMC7926196 DOI: 10.1007/s13167-021-00231-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/11/2021] [Indexed: 02/06/2023]
Abstract
Chronic liver disease management is a comprehensive approach requiring multi-professional expertise and well-orchestrated healthcare measures thoroughly organized by responsible medical units. Contextually, the corresponding multi-faceted chain of healthcare events is likely to be severely disturbed or even temporarily broken under the force majeure conditions such as global pandemics. Consequently, the chronic liver disease is highly representative for the management of any severe chronic disorder under lasting pandemics with unprecedented numbers of acutely diseased persons who, together with the chronically sick patient cohorts, have to be treated using the given capacity of healthcare systems with their limited resources. Current study aimed at exploring potentially negative impacts of the SARS CoV-2 outbreak on the quality of the advanced chronic liver disease (ACLD) management considering two well-classified parameters, namely, (1) the continuity of the patient registrations and (2) the level of mortality rates, comparing pre-COVID-19 statistics with these under the current pandemic in Slovak Republic. Altogether 1091 registrations to cirrhosis registry (with 60.8% versus 39.2% males to females ratio) were included with a median age of 57 years for patients under consideration. Already within the very first 3 months of the pandemic outbreak in Slovakia (lockdown declared from March 16, 2020, until May 20, 2020), the continuity of the patient registrations has been broken followed by significantly increased ACLD-related death rates. During this period of time, the total number of new registrations decreased by about 60% (15 registrations in 2020 versus 38 in 2018 and 38 in 2019). Corresponding mortality increased by about 52% (23 deaths in 2020 versus 10 in 2018 and 12 in 2019). Based on these results and in line with the framework of 3PM guidelines, the pandemic priority pathways (PPP) are strongly recommended for maintaining tertiary care uninterrupted. For the evidence-based implementation of PPP, creation of predictive algorithms and individualized care strategy tailored to the patient is essential. Resulting classification of measures is summarized as follows:The Green PPP Line is reserved for prioritized (urgent and comprehensive) treatment of patients at highest risk to die from ACLD (tertiary care) as compared to the risk from possible COVID-19 infection. The Orange PPP Line considers patients at middle risk of adverse outcomes from ACLD with re-addressing them to the secondary care. As further deterioration of ACLD is still probable, pro-active management is ascertained with tertiary center serving as the 24/7 telemedicine consultation hub for a secondary facility (on a physician-physician level). The Red PPP Line is related to the patients at low risk to die from ACLD, re-addressing them to the primary care. Since patients with stable chronic liver diseases without advanced fibrosis are at trivial inherent risk, they should be kept out of the healthcare setting as far as possible by the telemedical (patient-nurse or patient- physician) measurements.
The assigned priority has to be monitored and re-evaluated individually—in intervals based on the baseline prognostic score such as MELD. The approach is conform with principles of predictive, preventive and personalized medicine (PPPM / 3PM) and demonstrates a potential of great clinical utility for an optimal management of any severe chronic disorder (cardiovascular, neurological and cancer) under lasting pandemics.
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Affiliation(s)
- Lubomir Skladany
- HEGITO (Div. Hepatology, Gastroenterology, and Liver Transplantation) of the Department of Internal Medicine II, Faculty of Medicine, Slovak Medical University, F. D. Roosevelt Teaching Hospital, Banska Bystrica, Slovakia
| | - Tomas Koller
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital Bratislava Ruzinov, Bratislava, Slovakia
| | - Svetlana Adamcova Selcanova
- HEGITO (Div. Hepatology, Gastroenterology, and Liver Transplantation) of the Department of Internal Medicine II, Faculty of Medicine, Slovak Medical University, F. D. Roosevelt Teaching Hospital, Banska Bystrica, Slovakia
| | - Janka Vnencakova
- HEGITO (Div. Hepatology, Gastroenterology, and Liver Transplantation) of the Department of Internal Medicine II, Faculty of Medicine, Slovak Medical University, F. D. Roosevelt Teaching Hospital, Banska Bystrica, Slovakia
| | - Daniela Jancekova
- HEGITO (Div. Hepatology, Gastroenterology, and Liver Transplantation) of the Department of Internal Medicine II, Faculty of Medicine, Slovak Medical University, F. D. Roosevelt Teaching Hospital, Banska Bystrica, Slovakia
| | - Viktoria Durajova
- Department of Science and Research, F.D. Roosevelt Teaching Hospital, Banska Bystrica, Slovakia
| | - Lukas Laffers
- Department of Mathematics, Faculty of Natural Sciences, Matej Bel University, Banska Bystrica, Slovakia
| | - Juraj Svac
- HEGITO (Div. Hepatology, Gastroenterology, and Liver Transplantation) of the Department of Internal Medicine II, Faculty of Medicine, Slovak Medical University, F. D. Roosevelt Teaching Hospital, Banska Bystrica, Slovakia
| | - Katarina Janickova
- Central Evidence Department, Health Care Surveillance Authority (HCSA), Bratislava, Slovakia
| | - Michal Palkovič
- Forensic Medicine and Pathological Anatomy Department, Health Care Surveillance Authority (HCSA), Bratislava, Slovakia
| | - Pavel Kohout
- Department of Internal Medicine, 3Rd Medical Faculty Charles University, Thomayer Hospital Prague, Prague, Czech Republic
| | - Olga Golubnitschaja
- Predictive, Preventive Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany.,3PM Research Unit, Department of Radiation Oncology, University Hospital, Medical Faculty, Rheinische Friedrich-Wilhelms-Universität Bonn, 53107 Bonn, Germany
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11
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Mathew S, Faheem M, Hassain NA, Benslimane FM, Al Thani AA, Zaraket H, Yassine HM. Platforms Exploited for SARS-CoV-2 Vaccine Development. Vaccines (Basel) 2020; 9:11. [PMID: 33375677 PMCID: PMC7824029 DOI: 10.3390/vaccines9010011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 12/18/2022] Open
Abstract
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the only zoonotic-origin coronavirus (CoV) that has reached the pandemic stage. The virus uses its spike (S) glycoprotein to attach to the host cells and initiate a cascade of events that leads to infection. It has sternly affected public health, economy, education, and social behavior around the world. Several scientific and medical communities have mounted concerted efforts to limit this pandemic and the subsequent wave of viral spread by developing preventative and potential vaccines. So far, no medicine or vaccine has been approved to prevent or treat coronavirus disease 2019 (COVID-19). This review describes the latest advances in the development of SARS-CoV-2 vaccines for humans, mainly focusing on the lead candidates in clinical trials. Moreover, we seek to provide both the advantages and the disadvantages of the leading platforms used in current vaccine development, based on past vaccine delivery efforts for non-SARS CoV-2 infections. We also highlight the population groups who should receive a vaccine against COVID-19 in a timely manner to eradicate the pandemic rapidly.
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Affiliation(s)
- Shilu Mathew
- Biomedical Research Center, Qatar University, Doha 2173, Qatar; (S.M.); (F.M.B.); (A.A.A.T.)
| | - Muhammed Faheem
- Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada;
| | - Neeraja A. Hassain
- Department of Biotechnology, Jamal Mohamed College, Tamil Nadu 620020, India;
| | - Fatiha M. Benslimane
- Biomedical Research Center, Qatar University, Doha 2173, Qatar; (S.M.); (F.M.B.); (A.A.A.T.)
| | - Asmaa A. Al Thani
- Biomedical Research Center, Qatar University, Doha 2173, Qatar; (S.M.); (F.M.B.); (A.A.A.T.)
- Department of Public Health, College of Health Sciences, Qatar University, Doha 2173, Qatar
| | - Hassan Zaraket
- Department of Experimental Pathology, Immunology, and Microbiology, Faculty of Medicine, American University of Beirut, Beirut 11-0236, Lebanon;
- Center for Infectious Diseases Research, American University of Beirut, Beirut 11-0236, Lebanon
| | - Hadi M. Yassine
- Biomedical Research Center, Qatar University, Doha 2173, Qatar; (S.M.); (F.M.B.); (A.A.A.T.)
- Department of Public Health, College of Health Sciences, Qatar University, Doha 2173, Qatar
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