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Nastase F, Nicolescu AC, Busila C, Marin CM, Bogdan Goroftei ER, Bogdan MP, Verenca MC, Barbu RE, Tatu AL. The Influence of the COVID-19 Pandemic on the Addressability to Treatment of Children with Hyperhidrosis-A Retrospective Study and a Short Review. Life (Basel) 2024; 14:995. [PMID: 39202737 PMCID: PMC11355243 DOI: 10.3390/life14080995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 08/01/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
INTRODUCTION This study was carried out to demonstrate the negative influence that the COVID-19 pandemic had on the ability of patients to treat hyperhidrosis with iontophoresis. The purpose of this study is to identify the annual distribution of patients with hyperhidrosis as well as elaborate a curve of cases within the time interval studied. METHODS It is a retrospective study initiated in the Department of Neuropsychomotor Rehabilitation of the "Sf. Ioan" Emergency Clinical Hospital for Children, Galati, Romania, in which we analyzed the electronic database, the treatment, and the consultation files of all the children who presented between January 2013 and December 2023. We found 111 patients who met the inclusion criteria. RESULTS During the 3 years of the pandemic, the number of patients who came to our clinic suddenly dropped to 0. LIMITATIONS This study was conducted on a relatively small number of patients in a Neuropsychomotor Recovery clinic. This study includes only patients with palmar and/or plantar hyperhidrosis who presented to the clinic for iontophoresis. CONCLUSION Although it is a disease that significantly influences the quality of life, patients and their families do not consider hyperhidrosis to be an urgent problem that can be improved by treatment.
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Affiliation(s)
- Florentina Nastase
- Department of Neuropsychomotor Rehabilitation, ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania; (F.N.); (M.C.V.)
| | | | - Camelia Busila
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, 800008 Galati, Romania; (C.M.M.); (R.E.B.); (A.L.T.)
- “Sf. Ioan” Emergency Clinical Paediatric Hospital, 800487 Galati, Romania
| | - Cristina Mihaela Marin
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, 800008 Galati, Romania; (C.M.M.); (R.E.B.); (A.L.T.)
- “Sf. Ioan” Emergency Clinical Paediatric Hospital, 800487 Galati, Romania
| | - Elena Roxana Bogdan Goroftei
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, 800008 Galati, Romania; (C.M.M.); (R.E.B.); (A.L.T.)
- “Sf. Ioan” Emergency Clinical Paediatric Hospital, 800487 Galati, Romania
| | | | - Madalina Codruta Verenca
- Department of Neuropsychomotor Rehabilitation, ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania; (F.N.); (M.C.V.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, 800008 Galati, Romania; (C.M.M.); (R.E.B.); (A.L.T.)
| | - Raisa Eloise Barbu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, 800008 Galati, Romania; (C.M.M.); (R.E.B.); (A.L.T.)
- “Sf. Ioan” Emergency Clinical Paediatric Hospital, 800487 Galati, Romania
| | - Alin Laurentiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, 800008 Galati, Romania; (C.M.M.); (R.E.B.); (A.L.T.)
- Multidisciplinary Integrated Center, Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica—CIM-CID), “Dunărea de Jos” University, 800201 Galati, Romania
- Dermatology Department, “Sfanta Cuvioasa Parascheva” Hospital of Infectious Diseases, 800179 Galati, Romania
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Petrea Cliveți CL, Ciortea DA, Miulescu M, Candussi IL, Chirila SI, Verga Răuță GI, Bergheș SE, Râșcu MC, Berbece SI. A New Case of Paediatric Systemic Lupus Erythematosus with Onset after SARS-CoV-2 and Epstein-Barr Infection-A Case Report and Literature Review. Curr Issues Mol Biol 2024; 46:8642-8657. [PMID: 39194726 DOI: 10.3390/cimb46080509] [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: 06/30/2024] [Revised: 07/28/2024] [Accepted: 07/30/2024] [Indexed: 08/29/2024] Open
Abstract
Viral infections caused by exposure to viruses such as Epstein-Barr, cytomegalovirus, or Parvovirus B19 have always been considered predisposing environmental factors for the onset of autoimmune diseases. More recently, autoimmune mechanisms such as molecular mimicry, T-cell activation, transient immunosuppression and inflammation have also been observed in cases of SARS-CoV-2 infection. Several newly diagnosed autoimmune disorders have been reported post-COVID-19, such as COVID-19-associated multisystemic inflammatory syndrome in children (MIS-C), type 1 diabetes mellitus, systemic lupus erythematosus, or rheumatoid arthritis. In this article, we present a new case of paediatric systemic lupus erythematosus (SLE) with haematological (macrophage activation syndrome), renal (stage 2), cutaneous (urticarial vasculitis) and digestive involvement, onset three and a half months post-COVID-19. In the dynamics, de novo infection generated by Epstein-Barr exposure was associated. The diagnosis was confirmed based on EULAR/ACR 2019 criteria. The aim of the article is to present a possible correlation between SARS-CoV-2 and Epstein-Barr as extrinsic factors in triggering or activating paediatric systemic lupus erythematosus. Keywords: paediatric systemic lupus erythematosus; post-COVID-19; Epstein-Barr; SARS- CoV-2; case report; paediatric patient.
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Affiliation(s)
- Carmen Loredana Petrea Cliveți
- Faculty of Medicine and Pharmacy, University "Dunarea de Jos" of Galati, 800008 Galati, Romania
- Emergency Clinical Hospital for Children "Sf Ioan", 800487 Galati, Romania
| | - Diana-Andreea Ciortea
- Faculty of Medicine and Pharmacy, University "Dunarea de Jos" of Galati, 800008 Galati, Romania
- Emergency Clinical Hospital for Children "Maria Sklodowska Curie", 041451 Bucharest, Romania
| | - Magdalena Miulescu
- Faculty of Medicine and Pharmacy, University "Dunarea de Jos" of Galati, 800008 Galati, Romania
- Emergency Clinical Hospital for Children "Sf Ioan", 800487 Galati, Romania
| | - Iuliana-Laura Candussi
- Faculty of Medicine and Pharmacy, University "Dunarea de Jos" of Galati, 800008 Galati, Romania
- Emergency Clinical Hospital for Children "Sf Ioan", 800487 Galati, Romania
| | | | - Gabriela Isabela Verga Răuță
- Faculty of Medicine and Pharmacy, University "Dunarea de Jos" of Galati, 800008 Galati, Romania
- Emergency Clinical Hospital for Children "Sf Ioan", 800487 Galati, Romania
| | | | - Mihai Ciprian Râșcu
- Faculty of Medicine and Pharmacy, University "Dunarea de Jos" of Galati, 800008 Galati, Romania
| | - Sorin Ion Berbece
- Faculty of Medicine and Pharmacy, University "Dunarea de Jos" of Galati, 800008 Galati, Romania
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3
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Nechita LC, Ignat MD, Balta AAS, Barbu RE, Baroiu L, Voinescu DC, Nechita A, Debita M, Busila C, Stefanopol IA. The Impact of Cardiovascular Antecedents on the Prognosis of COVID-19 Critically Ill Patients. J Clin Med 2024; 13:3518. [PMID: 38930047 PMCID: PMC11205074 DOI: 10.3390/jcm13123518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/17/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Background/Objectives: The objective of the study is to analyze the impact of cardiovascular history on mortality in COVID-19 patients, hospitalized in the intensive care unit with indications for continuous positive airway pressure (CPAP) and subsequently mechanical ventilation, without oncological disease. Methods: A retrospective observational study was carried out on a group of 108 critical COVID-19 patients. We compared demographic data, paraclinical and clinical parameters, days of hospitalization, and mortality rate between two groups of patients, one group with a history of cardiovascular disease (81 patients) and a group without a history of cardiovascular disease (27 patients). Results: Patients with cardiovascular antecedents had a higher mortality rate than those without cardiovascular antecedents, presenting severe forms with shorter survival time in the intensive care unit and increased inflammatory evidence. Compared to patients without a history of cardiovascular illness, those with cardiovascular disease had a lower average age, and developed a severe form of COVID-19. Conclusions: Cardiovascular antecedents can worsen the prognosis of patients with COVID-19, requiring a careful screening and multidisciplinary approach.
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Affiliation(s)
- Luiza Camelia Nechita
- Doctoral School of Biomedical Sciences, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.C.N.); (A.A.S.B.); (R.E.B.)
| | - Mariana Daniela Ignat
- Doctoral School of Biomedical Sciences, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.C.N.); (A.A.S.B.); (R.E.B.)
| | | | - Raisa Eloise Barbu
- Doctoral School of Biomedical Sciences, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.C.N.); (A.A.S.B.); (R.E.B.)
| | - Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (D.C.V.); (A.N.); (C.B.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania;
| | - Doina Carina Voinescu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (D.C.V.); (A.N.); (C.B.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania
| | - Aurel Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (D.C.V.); (A.N.); (C.B.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania;
| | - Mihaela Debita
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania;
- Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Camelia Busila
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (D.C.V.); (A.N.); (C.B.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania;
| | - Ioana Anca Stefanopol
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania;
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
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Salvio AL, Fernandes RA, Ferreira HFA, Duarte LA, Gutman EG, Raposo-Vedovi JV, Filho CHFR, da Costa Nunes Pimentel Coelho WL, Passos GF, Andraus MEC, da Costa Gonçalves JP, Cavalcanti MG, Amaro MP, Kader R, de Andrade Medronho R, Figueiredo CP, Amado-Leon LA, Alves-Leon SV. High Levels of NfL, GFAP, TAU, and UCH-L1 as Potential Predictor Biomarkers of Severity and Lethality in Acute COVID-19. Mol Neurobiol 2024; 61:3545-3558. [PMID: 37996731 PMCID: PMC11087339 DOI: 10.1007/s12035-023-03803-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023]
Abstract
Few studies showed that neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), total tubulin-associated unit (TAU), and ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1) may be related to neurological manifestations and severity during and after SARS-CoV-2 infection. The objective of this work was to investigate the relationship among nervous system biomarkers (NfL, TAU, GFAP, and UCH-L1), biochemical parameters, and viral loads with heterogeneous outcomes in a cohort of severe COVID-19 patients admitted in Intensive Care Unit (ICU) of a university hospital. For that, 108 subjects were recruited within the first 5 days at ICU. In parallel, 16 mild COVID-19 patients were enrolled. Severe COVID-19 group was divided between "deceased" and "survivor." All subjects were positive for SARS-CoV-2 detection. NfL, total TAU, GFAP, and UCH-L1 quantification in plasma was performed using SIMOA SR-X platform. Of 108 severe patients, 36 (33.33%) presented neurological manifestation and 41 (37.96%) died. All four biomarkers - GFAP, NfL, TAU, and UCH-L1 - were significantly higher among deceased patients in comparison to survivors (p < 0.05). Analyzing biochemical biomarkers, higher Peak Serum Ferritin, D-Dimer Peak, Gamma-glutamyltransferase, and C-Reactive Protein levels were related to death (p < 0.0001). In multivariate analysis, GFAP, NfL, TAU, UCH-L1, and Peak Serum Ferritin levels were correlated to death. Regarding SARS-CoV-2 viral load, no statistical difference was observed for any group. Thus, Ferritin, NFL, GFAP, TAU, and UCH-L1 are early biomarkers of severity and lethality of SARS-COV-2 infection and may be important tools for therapeutic decision-making in the acute phase of disease.
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Affiliation(s)
- Andreza Lemos Salvio
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | - Renan Amphilophio Fernandes
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | - Helena França Alcaraz Ferreira
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | - Larissa Araujo Duarte
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | - Elisa Gouvea Gutman
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | - Jessica Vasques Raposo-Vedovi
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | | | | | | | - Maria Emília Cosenza Andraus
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
| | - João Paulo da Costa Gonçalves
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil
| | - Marta Guimarães Cavalcanti
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
- Epidemiology and Evaluation Service, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
| | - Marisa Pimentel Amaro
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
- School of Medicine, Post-Graduate Program in Infectious and Parasitic Diseases, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
| | - Rafael Kader
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
- School of Medicine, Post-Graduate Program in Infectious and Parasitic Diseases, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
| | - Roberto de Andrade Medronho
- Epidemiology and Evaluation Service, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil
| | | | - Luciane Almeida Amado-Leon
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil.
| | - Soniza Vieira Alves-Leon
- Laboratory of Translacional Neurosciences, Biomedical Institute, Federal University of the State of Rio de Janeiro-UNIRIO, Rio de Janeiro, 22290-240, Brazil.
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-901, Brazil.
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5
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Tatu AL. Teledermatology Practice in a Department that Was Relocated Multiple Times during the COVID-19 Pandemic. Clin Cosmet Investig Dermatol 2024; 17:447-449. [PMID: 38375438 PMCID: PMC10875162 DOI: 10.2147/ccid.s452872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/11/2024] [Indexed: 02/21/2024]
Abstract
The COVID pandemic inherently impacts clinical activity in Dermatological practices throughout all sectors. Under these circumstances, our service has implemented teledermatology in order to act both as a filter for reducing in-hospital admittance or face-to-face interactions, and as a straightforward solution to solve the issues faced by patients and family doctors within our area. Live consultations rely on the resident physician's capacity to take a detailed patient history in the limited time allotted, while the subsequent case-discussion with the leading-physician has good didactic value. The establishment of a quality international collaboration through teledermatology would further facilitate a more accurate and faster diagnosis, even for patients traveling for business or tourism.
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Affiliation(s)
- Alin Laurentiu Tatu
- Dermatology Department, “Sfânta Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galati, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, „Dunărea de Jos” University, Galati, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research Center (MIC-DIR), “Dunărea de Jos” University, Galati, Romania
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Manole C, Dediu-Anghel M, Baroiu L, Ștefanopol IA, Nechifor A, Niculet E, Mihailov R, Moroianu LA, Voinescu DC, Firescu D. Efficiency of continuous positive airway pressure and high-flow nasal oxygen therapy in critically ill patients with COVID-19. J Int Med Res 2024; 52:3000605231222151. [PMID: 38194495 PMCID: PMC10777799 DOI: 10.1177/03000605231222151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/06/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVE Critically ill patients with COVID-19 develop acute respiratory distress syndrome characterized by relatively well-preserved pulmonary compliance but severe hypoxemia. The challenge in managing such patients lies in optimizing oxygenation, which can be achieved through either high oxygen flow or noninvasive mechanical ventilation. This study was performed to compare the efficiency of two methods of noninvasive oxygen therapy: continuous positive airway pressure (CPAP) and high-flow nasal oxygen therapy (HFNO). METHODS This retrospective cohort study involved 668 patients hospitalized in the intensive care unit (ICU) of the "Sf. Apostol Andrei" Emergency Clinical Hospital, Galati, Romania from 1 April 2020 to 31 March 2021 (CPAP, n = 108; HFNO, n = 108). RESULTS Mortality was significantly lower in the CPAP and HFNO groups than in the group of patients who underwent intubation and mechanical ventilation after ICU admission. Mortality in the ICU was not significantly different between the CPAP and HFNO groups. CONCLUSIONS HFNO and CPAP represent efficient alternative therapies for patients with severe COVID-19 whose respiratory treatment has failed. Studies involving larger groups of patients are necessary to establish a personalized, more complex management modality for critically ill patients with COVID-19.
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Affiliation(s)
- Corina Manole
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galat,i, Romania
- Intensive Care Department, “Sfantul Apostol Andrei” Emergency Clinical Hospital, Galati, Romania
| | - Mihaela Dediu-Anghel
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galat,i, Romania
- Intensive Care Department, “Sfantul Apostol Andrei” Emergency Clinical Hospital, Galati, Romania
| | - Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galat,i, Romania
- Infectious Diseases Department, “Sf. Cuv. Parascheva” Infectious Diseases Clinical Hospital, Galati, Romania
| | - Ioana Anca Ștefanopol
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galat,i, Romania
- Surgical Department, “Sfantul Ioan” Emergency Clinical Hospital for Children, Galati, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galat,i, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research Center (MIC-DIR), “Dunărea de Jos” University of Galat,i, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galat,i, Romania
- Pathology Department, “Sfantul Apostol Andrei” Emergency Clinical Hospital, Galati, Romania
| | - Raul Mihailov
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galat,i, Romania
- Surgical Department, “Sfantul Apostol Andrei” Emergency Clinical Hospital, Galati, Romania
| | - Lavinia Alexandra Moroianu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galat,i, Romania
- Psychiatry Department, “Elisabeta Doamna” Psychiatric Clinical Hospital, Galati, Romania
| | - Doina Carina Voinescu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galat,i, Romania
- Medical Department, “Sfantul Apostol Andrei” Emergency County Clinical Hospital, Galati, Romania
| | - Dorel Firescu
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galat,i, Romania
- Surgical Department, “Sfantul Apostol Andrei” Emergency Clinical Hospital, Galati, Romania
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Al Nafea HM, Al-Qahtani MT, Al Gahtani FH, Tabassum H. Blood coagulation, risk factors and associated complications in COVID-19 patients in Saudi Arabia: A retrospective cohort study. Medicine (Baltimore) 2023; 102:e35621. [PMID: 37904434 PMCID: PMC10615550 DOI: 10.1097/md.0000000000035621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/21/2023] [Indexed: 11/01/2023] Open
Abstract
A good understanding of the possible risk factors for coronavirus disease 19 (COVID-19) severity could help clinicians in identifying patients who need prioritized treatment to prevent disease progression and adverse outcomes. COVID-19-linked coagulopathy is one of the life-threatening severe acute respiratory syndrome coronavirus 2 infections. Growing evidence indicates a correlation between abnormal coagulation and increased risk of venous thromboembolism; in COVID-19-infected patients, yet a clear understanding of the role of coagulopathy in the severity of COVID-19 illness is still unresolved. This retrospective cohort study was thus undertaken to investigate the role of coagulation dysfunction with COVID-19 mortality/severity. Blood samples from 1000 hospitalized patients with COVID-19 pneumonia were collected. The study participants were both male and female in equal ratios with a mean age of 48.94. Patients were followed-up until discharge either for recovery or death. All biochemical investigations-complete blood count and coagulation profile including D-dimers, prothrombin time, partial prothrombin time, and international normalized ratio was performed in COVID-19 survivors and in non-survivors admitted in intensive care unit. In the survivor group, all coagulation parameters were within normal limits, and 8.7% had a low red blood count. The most common risk factors associated with COVID-19 patients were diabetes mellitus (2.8%), hypertension (10.8%), and heart disease (3%). In the non-survivor group, the coagulation parameters were above the normal range (prothrombin in 31.5%, PTT in 10.5%, international normalized ratio in 26.3%, D-dimer in 36.8%) with thrombocytopenia in 21.04% of patients. Other complications were pulmonary embolism in 21.05% and venous thromboembolism in 15.7% of non-survivors. A significant association was found between increased markers of coagulopathy and the severity of SARS-CoV2 infection. Furthermore, the severity of infection was observed to increase with risk factors such as age, heart disease, hypertension, and DM eventually affecting COVID-19 prognosis and mortality.
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Affiliation(s)
- Haifa Mohammed Al Nafea
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Tahani Al-Qahtani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Farjah Hassan Al Gahtani
- Department of Medicine, Division of Hematology/Oncology (Oncology Center), College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Hajera Tabassum
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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8
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Anghel L, Manole C, Nechita A, Tatu AL, Ștefănescu BI, Nechita L, Bușilă C, Zainea P, Baroiu L, Mușat CL. Calcium, Phosphorus and Magnesium Abnormalities Associated with COVID-19 Infection, and Beyond. Biomedicines 2023; 11:2362. [PMID: 37760804 PMCID: PMC10525362 DOI: 10.3390/biomedicines11092362] [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: 07/19/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023] Open
Abstract
The coronavirus disease (COVID-19) pandemic caused by the novel coronavirus SARS-CoV-2 has had a profound impact on global health, leading to a surge in research to better understand the pathophysiology of the disease. Among the various aspects under investigation, disruptions in mineral homeostasis have emerged as a critical area of interest. This review aims to provide an overview of the current evidence linking calcium, phosphorus and magnesium abnormalities with COVID-19 infection and explores the potential implications beyond the acute phase of the disease. Beyond the acute phase of COVID-19, evidence suggests a potential impact of these mineral abnormalities on long-term health outcomes. Persistent alterations in calcium, phosphorus and magnesium levels have been linked to increased cardiovascular risk, skeletal complications and metabolic disorders, warranting continuous monitoring and management in post-COVID-19 patients.
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Affiliation(s)
- Lucreția Anghel
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (B.I.Ș.); (C.L.M.)
| | - Corina Manole
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (B.I.Ș.); (C.L.M.)
| | - Aurel Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Alin Laurențiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, 800010 Galati, Romania
| | - Bogdan Ioan Ștefănescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (B.I.Ș.); (C.L.M.)
- Clinical Surgery Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Luiza Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (B.I.Ș.); (C.L.M.)
| | - Camelia Bușilă
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Pușica Zainea
- Clinical Emergency County Hospital Braila, 810318 Braila, Romania;
| | - Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
| | - Carmina Liana Mușat
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (B.I.Ș.); (C.L.M.)
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
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9
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Manole C, Baroiu L, Nechita A, Voinescu DC, Ciubara A, Debita M, Tatu AL, Ciubara AB, Stefanopol IA, Anghel L, Nechifor A, Firescu D. Comparative Evaluation of the Clinical Severity of COVID-19 of Vaccinated and Unvaccinated Patients in Southeastern Romania in the First 6 Months of 2022, during the Omicron Wave. Healthcare (Basel) 2023; 11:2184. [PMID: 37570424 PMCID: PMC10418776 DOI: 10.3390/healthcare11152184] [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: 06/24/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Background: The pandemic wave produced by SARS-CoV-2 Omicron was characterized by milder clinical forms and high contagiousness. The vaccination rate against COVID-19 in Romania was approximately 42%. (2) Objectives: Comparison of the clinical severity in vaccinated patients compared to unvaccinated ones. (3) Methods: A retrospective cohort study was conducted on a group of 699 adult patients confirmed with COVID-19 who presented in the "Sf. Cuvioasa Parascheva" Infectious Diseases Clinical Hospital of Galati, Romania, between 1 January 2022 and 30 June 2022. The study compared the need for hospitalization, reinfections, demographic and comorbidity data, clinical and paraclinical parameters from the initial evaluation, and the ratio of unfavorable developments on subgroups chosen according to the vaccination status. (4) Results and Conclusions: Our study reveals that unvaccinated patients required hospitalization in 54.68% of cases, while fully vaccinated patients had a hospitalization rate of 40.72%, which was significantly lower than that of the unvaccinated group (p = 0.01); patients who received a booster dose had a hospitalization rate of 27.84% (p < 0.01, significantly lower than unvaccinated individuals; p = 0.01, significantly lower than fully vaccinated individuals); and among the four patients who received four doses, none required hospitalization. From the analysis of the two subgroups of hospitalized patients, we observed a significantly higher prevalence of radiological lesions, such as pulmonary opacities in the group of unvaccinated patients and a higher average duration of hospitalization, and serum values of D-dimers and blood-sugar at admission were significantly higher in unvaccinated patients. The higher presence of these parameters, which are indicators of severe progression in clinical studies, in the group of unvaccinated patients suggests the need to include them in the initial evaluation of the unvaccinated patients with COVID-19.The cumulative share of deaths and transfers in the ICU was higher in the group of unvaccinated patients, but the difference between the groups had no statistical significance. This study draws attention to the possibility of severe clinical forms among both vaccinated and unvaccinated populations, especially in the elderly and in patients with multiple comorbidities.
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Affiliation(s)
- Corina Manole
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (C.M.); (A.N.); (D.C.V.); (A.C.); (A.L.T.); (L.A.); (A.N.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (A.B.C.); (D.F.)
| | - Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (C.M.); (A.N.); (D.C.V.); (A.C.); (A.L.T.); (L.A.); (A.N.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania;
| | - Aurel Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (C.M.); (A.N.); (D.C.V.); (A.C.); (A.L.T.); (L.A.); (A.N.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania;
| | - Doina Carina Voinescu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (C.M.); (A.N.); (D.C.V.); (A.C.); (A.L.T.); (L.A.); (A.N.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (A.B.C.); (D.F.)
| | - Anamaria Ciubara
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (C.M.); (A.N.); (D.C.V.); (A.C.); (A.L.T.); (L.A.); (A.N.)
- ‘Elisabeta Doamna’ Psychiatric Hospital, 800179 Galati, Romania
| | - Mihaela Debita
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania;
- Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Alin Laurențiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (C.M.); (A.N.); (D.C.V.); (A.C.); (A.L.T.); (L.A.); (A.N.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania;
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, 800010 Galati, Romania
| | - Alexandru Bogdan Ciubara
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (A.B.C.); (D.F.)
- Clinical Surgical Department, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
| | - Ioana Anca Stefanopol
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania;
- Clinical Surgical Department, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
| | - Lucreția Anghel
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (C.M.); (A.N.); (D.C.V.); (A.C.); (A.L.T.); (L.A.); (A.N.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (A.B.C.); (D.F.)
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (C.M.); (A.N.); (D.C.V.); (A.C.); (A.L.T.); (L.A.); (A.N.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (A.B.C.); (D.F.)
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, 800010 Galati, Romania
| | - Dorel Firescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (A.B.C.); (D.F.)
- Clinical Surgical Department, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
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Milić D, Lazarević M, Vuković N, Kamenov A, Perić V, Golubović M, Stošić M, Spasić D, Stojiljković V, Stokanović D. Monitoring the Coagulation Profile of COVID-19 Patients Using Standard and ClotPro ® Hemostasis Tests. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1202. [PMID: 37512014 PMCID: PMC10386453 DOI: 10.3390/medicina59071202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: Coagulation disorders during COVID-19 infection are associated with a poorer prognosis and higher disease severity because thrombosis and inflammation are two processes that interfere with each other. A very important issue for clinicians is timely and adequate hemostasis and inflammation monitoring to prevent and treat potentially lethal consequences. The aim of this study was to identify specific hemostatic parameters that are associated with a higher risk of intrahospital mortality. Materials and Methods: This study was approved by the Ethics Committee of the Clinical Center Nis in Serbia. One hundred and forty-two patients presented with COVID-19 ARDS and were admitted to the ICU in the Clinic for Anesthesiology at the Clinical Center Nis from 14 April 2020 to 25 May 2020. Upon admission, blood was collected for biochemical and coagulation testing. The data obtained were analyzed using the Statistical Package for Social Sciences (SPSS v. 25, Chicago, IL, USA). Results: Among all the parameters assessed, older age; increased levels of fibrinogen, INR, D-dimer, and presepsin; and higher results in the platelet aggregation tests (aggregation induced by adenosine diphosphate based on the ADP test (AU/min), aggregation induced by arachidonic acid based on the ASPI test (AU/min), and aggregation induced by thrombin based on the TRAP test (AU/min)) and some assays of the viscoelastic test (clot amplitude after 5 min in the extrinsic coagulation pathway based on the A5 EX-test (mm), clot amplitude after 10 min in the extrinsic coagulation pathway based on the A10 EX-test (mm), clot amplitude after 5 min regarding functional fibrinogen based on the A5 FIB-test (mm), clot amplitude after 10 min regarding functional fibrinogen based on the A10 FIB-test (mm), and maximum clot firmness based on the MCF FIB-test (mm)); and lower values of viscoelastic clotting time in the extrinsic coagulation pathway based on the CT EX-test (s) were significantly correlated with mortality. In the multivariate analysis, D-dimer levels above 860 ng/mL, higher TRAP test value bins, and values above the normal reference range of the A10 FIB test were found to be independent predictors of mortality. Conclusions: Sophisticated hemostasis parameters can contribute to early risk assessment, which has initially been performed only on the basis of patients' clinical status. Hypercoagulability is the main coagulation disorder in COVID-19 infection.
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Affiliation(s)
- Dragan Milić
- Medical School of Nis, University of Nis, 18000 Nis, Serbia
- Clinic of Cardiovascular Surgery, University Clinical Center Nis, 18000 Nis, Serbia
| | - Milan Lazarević
- Medical School of Nis, University of Nis, 18000 Nis, Serbia
- Clinic of Cardiovascular Surgery, University Clinical Center Nis, 18000 Nis, Serbia
| | - Natalija Vuković
- Clinic for Anesthesiology and Intensive Therapy, University Clinical Center Nis, 18000 Nis, Serbia
| | - Aleksandar Kamenov
- Medical School of Nis, University of Nis, 18000 Nis, Serbia
- Clinic of Cardiovascular Surgery, University Clinical Center Nis, 18000 Nis, Serbia
| | - Velimir Perić
- Medical School of Nis, University of Nis, 18000 Nis, Serbia
- Clinic of Cardiovascular Surgery, University Clinical Center Nis, 18000 Nis, Serbia
| | - Mlađan Golubović
- Medical School of Nis, University of Nis, 18000 Nis, Serbia
- Clinic of Cardiovascular Surgery, University Clinical Center Nis, 18000 Nis, Serbia
| | - Marija Stošić
- Medical School of Nis, University of Nis, 18000 Nis, Serbia
- Clinic of Cardiovascular Surgery, University Clinical Center Nis, 18000 Nis, Serbia
| | - Dimitrije Spasić
- Clinic of Cardiovascular Surgery, University Clinical Center Nis, 18000 Nis, Serbia
| | - Vladimir Stojiljković
- Medical School of Nis, University of Nis, 18000 Nis, Serbia
- Clinic of Cardiovascular Surgery, University Clinical Center Nis, 18000 Nis, Serbia
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11
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Cumhur Cure M, Cure E. Severe acute respiratory syndrome coronavirus 2 may cause liver injury via Na +/H + exchanger. World J Virol 2023; 12:12-21. [PMID: 36743661 PMCID: PMC9896593 DOI: 10.5501/wjv.v12.i1.12] [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: 08/27/2022] [Revised: 10/03/2022] [Accepted: 11/22/2022] [Indexed: 01/18/2023] Open
Abstract
The liver has many significant functions, such as detoxification, the urea cycle, gluconeogenesis, and protein synthesis. Systemic diseases, hypoxia, infections, drugs, and toxins can easily affect the liver, which is extremely sensitive to injury. Systemic infection of severe acute respiratory syndrome coronavirus 2 can cause liver damage. The primary regulator of intracellular pH in the liver is the Na+/H+ exchanger (NHE). Physiologically, NHE protects hepatocytes from apoptosis by making the intracellular pH alkaline. Severe acute respiratory syndrome coronavirus 2 increases local angiotensin II levels by binding to angiotensin-converting enzyme 2. In severe cases of coronavirus disease 2019, high angi-otensin II levels may cause NHE overstimulation and lipid accumulation in the liver. NHE overstimulation can lead to hepatocyte death. NHE overstimulation may trigger a cytokine storm by increasing proinflammatory cytokines in the liver. Since the release of proinflammatory cytokines such as interleukin-6 increases with NHE activation, the virus may indirectly cause an increase in fibrinogen and D-dimer levels. NHE overstimulation may cause thrombotic events and systemic damage by increasing fibrinogen levels and cytokine release. Also, NHE overstimulation causes an increase in the urea cycle while inhibiting vitamin D synthesis and gluconeogenesis in the liver. Increasing NHE3 activity leads to Na+ loading, which impairs the containment and fluidity of bile acid. NHE overstimulation can change the gut microbiota composition by disrupting the structure and fluidity of bile acid, thus triggering systemic damage. Unlike other tissues, tumor necrosis factor-alpha and angiotensin II decrease NHE3 activity in the intestine. Thus, increased luminal Na+ leads to diarrhea and cytokine release. Severe acute respiratory syndrome coronavirus 2-induced local and systemic damage can be improved by preventing virus-induced NHE overstimulation in the liver.
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Affiliation(s)
- Medine Cumhur Cure
- Department of Biochemistry, Private Tanfer Hospital, Istanbul 34394, Turkey
| | - Erkan Cure
- Department of Internal Medicine, Bagcilar Medilife Hospital, Istanbul 34200, Turkey
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12
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Andritoi D, Luca C, Onu I, Corciova C, Fuior R, Salceanu A, Iordan DA. The Use of Modern Technologies in Post-COVID-19 Cardiopulmonary Rehabilitation. APPLIED SCIENCES 2022; 12:7471. [DOI: 10.3390/app12157471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Managing cardiopulmonary rehabilitation in patients with COVID-19 remains a global challenge due to the facets of this virus. The technologies used in the rehabilitation of post-COVID-19 patients fail to keep pace with the global epidemiological developments. The purpose of this article is to review the medical technologies used in post-COVID-19 cardiopulmonary rehabilitation and the innovations that have allowed us to adapt and care for our patients. The pandemic highlighted the need for seismic changes in diagnostic and rehabilitation paradigms. We discuss advances in telemedicine and telemedicine-based rehabilitation, remote patient monitoring and emerging technologies used in cardiopulmonary rehabilitation. The rapid adoption of modern technologies in the practice of post-COVID-19 cardiopulmonary rehabilitation is promising and can improve patients’ access to complex rehabilitation programs with outstanding results.
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13
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Sârbu F, Oprea VD, Tatu AL, Polea Drima E, Bojincă VC, Romila A. Hereditary Hemorrhagic Telangiectasia Associating Neuropsychiatric Manifestations with a Significant Impact on Disease Management-Case Report and Literature Review. Life (Basel) 2022; 12:1059. [PMID: 35888148 PMCID: PMC9320563 DOI: 10.3390/life12071059] [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: 06/23/2022] [Revised: 07/05/2022] [Accepted: 07/12/2022] [Indexed: 11/28/2022] Open
Abstract
(1) Background: Genetic hereditary hemorrhagic telangiectasia (HHT) is clinically diagnosed. The clinical manifestations and lack of curative therapeutic interventions may lead to mental illnesses, mainly from the depression-anxiety spectrum. (2) Methods: We report the case of a 69-year-old patient diagnosed with HHT and associated psychiatric disorders; a comprehensive literature review was performed based on relevant keywords. (3) Results: Curaçao diagnostic criteria based the HHT diagnosis in our patient case at 63 years old around the surgical interventions for a basal cell carcinoma, after multiple episodes of epistaxis beginning in childhood, but with a long symptom-free period between 20 and 45 years of age. The anxiety-depressive disorder associated with nosocomephobia resulted in a delayed diagnosis and low adherence to medical monitoring. A comprehensive literature review revealed the scarcity of publications analyzing the impact of psychiatric disorders linked to this rare condition, frequently associating behavioral disengagement as a coping strategy, psychological distress, anxiety, depression, and hopelessness. (4) Conclusions: As patients with HHT face traumatic experiences from disease-related causes as well as recurring emergency hospital visits, active monitoring for mental illnesses and psychological support should be considered as part of the initial medical approach and throughout the continuum of care.
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Affiliation(s)
- Fabiola Sârbu
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania; (F.S.); (E.P.D.); (A.R.)
- “Elisabeta Doamna” Psychiatric Hospital, 800179 Galati, Romania
| | - Violeta Diana Oprea
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania; (F.S.); (E.P.D.); (A.R.)
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania
| | - Alin Laurențiu Tatu
- Clinical, Medical Department, Dermatology, ReForm UDJ, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania
- Dermatology Department, Clinical Hospital of Infectious Diseases Saint Parascheva, 800179 Galati, Romania
| | - Eduard Polea Drima
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania; (F.S.); (E.P.D.); (A.R.)
- “Elisabeta Doamna” Psychiatric Hospital, 800179 Galati, Romania
| | - Violeta Claudia Bojincă
- Internal Medicine Department, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy in Bucharest, 020021 Bucharest, Romania;
- Department of Internal Medicine and Rheumatology, “Sf. Maria” Hospital, 011172 Bucharest, Romania
| | - Aurelia Romila
- Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University of Galati, 800216 Galati, Romania; (F.S.); (E.P.D.); (A.R.)
- “St. Apostle Andrei” Clinical Emergency County Hospital Galati, 800578 Galati, Romania
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14
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Mocanu GD, Onu I. The influence of specialization and the level of physical activism on leisure options for students of the Faculty of Physical Education and Sports. BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Leisure activities, their dynamics in ontogenesis and the way of managing the time allocated to them are a topic that is frequently researched. Purpose: to investigate students' attitudes, aiming at aspects related to forms of leisure, depending on specialization and level of physical activism, by applying a questionnaire. Material and method: The research took place in the academic year 2019-2020, on a number of 180 students of the Faculty of Physical Education and Sports in Galați. The differences for the pairs of independent specialty variables (PES / physical education and sport and PT / physical therapy), respectively physical activity (HLPA / high level of physical activity, and LLPA / low level of physical activity were analyzed, by applying the techniques of MANOVA and ANOVA calculation. Results: Multivariate analysis indicates significant effects of the physical activity variable on the items of the questionnaire for leisure budget factors, preferred leisure activities, leisure sports activities, and for the specialty variable significant effects are determined only at leisure sports activities, so the level of physical activism will generate more differences between the opinions expressed compared to the specialization of students. Univariate test results indicate significant F values (P <0.05) for a number of items, with weaker values, dominant for PT and LLPA groups. Sports activities and socializing on the internet (defining variant of young people) are at the top, so they do not exclude each other. Conclusion: the students from the PES and HLPA groups stand out through a better organization of free time, high satisfaction of its capitalization, a greater involvement in the variants of active leisure and superior socialization, and those from the PT and LLPA groups allocate more time to watching on TV and using the internet.
Keywords: physical activism, specialization, questionnaire, active and passive leisure options, opinions
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Affiliation(s)
- George-Danut Mocanu
- “Dunărea de Jos” University, Faculty of Physical Education and Sports, 63-65 Gării Street, Galați, România
| | - Ilie Onu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medi-cine and Pharmacy “Grigore T. Popa” Iasi, 700454 Iasi, Romania
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15
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Baroiu L, Lese AC, Stefanopol IA, Iancu A, Dumitru C, Ciubara AB, Bujoreanu FC, Baroiu N, Ciubara A, Nechifor A, Anghel L, Tatu AL. The Role of D-Dimers in the Initial Evaluation of COVID-19 [Response To Letter]. Ther Clin Risk Manag 2022; 18:593-594. [PMID: 35620065 PMCID: PMC9128639 DOI: 10.2147/tcrm.s373236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/14/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Ana Cristina Lese
- Faculty of Visual Arts and Design, “George Enescu” National University of Arts, Iasi, Romania
| | - Ioana Anca Stefanopol
- Departament of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Alina Iancu
- Departament of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research Center (MICDIR), “Dunărea de Jos” University, Galați, Romania
| | - Caterina Dumitru
- Multidisciplinary Integrated Center of Dermatological Interface Research Center (MICDIR), “Dunărea de Jos” University, Galați, Romania
- Pharmaceutical Sciences Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Alexandru Bogdan Ciubara
- Departament of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Florin Ciprian Bujoreanu
- Dermatology Departament, “Sf. Parascheva” Infectious Diseases Clinical Hospital, Galati, Romania
| | - Nicusor Baroiu
- Manufacturing Engineering Department, Faculty of Engineering, “Dunărea de Jos” University, Galati, Romania
| | - Anamaria Ciubara
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research Center (MICDIR), “Dunărea de Jos” University, Galați, Romania
| | - Lucretia Anghel
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
| | - Alin Laurentiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research Center (MICDIR), “Dunărea de Jos” University, Galați, Romania
- Dermatology Departament, “Sf. Parascheva” Infectious Diseases Clinical Hospital, Galati, Romania
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16
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Patel S. Letter to the Editor: The Role of D-Dimers in the Initial Evaluation of COVID-19 [Letter]. Ther Clin Risk Manag 2022; 18:511-512. [PMID: 35510217 PMCID: PMC9059871 DOI: 10.2147/tcrm.s369820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 04/17/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Sachin Patel
- Emergency Department, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK
- Correspondence: Sachin Patel, Emergency Department, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK, Email
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