1
|
Dhuiege L, De Backer D, Kalisz S, Cavallotto F, Rousseaux C, Van Overstraeten C, Lambert P. [Relationship between the lung ultrasound and the clinical severity of the patient with seasonal flu]. Rev Med Liege 2024; 79:152-160. [PMID: 38487909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
INTRODUCTION The seasonal flu is a very important reason for consultation every winter. Symptoms can quickly progress to severe pneumonia. Currently, few tools exist to assess the clinical severity of patients. The aim of this study is to demonstrate the role of lung ultrasound as a marker of severity in patients with influenza. METHODS 79 patients who arrived at the emergency department with flu-like symptoms were included. A pulmonary ultrasound looking for an interstitial syndrome or consolidation was performed. The qSOFA, the SOFA, the saturation, the PaO2/FiO2 ratio, the oxygen needs, the destination of the patient made it possible to establish the seriousness of the pathology of the patient. Ultrasound was then compared to these different tools. RESULTS The more the ultrasound became pathological, the more we observed a proportion of qSOFA (p = 0.001) and pathological SOFA (p = 0.009). Most patients with acute respiratory distress syndrome have pathological ultrasound (p < 0.001). The average admission saturation is 89.2 % in the "pathological ultrasound" group compared to 95.8 % in the "normal ultrasound" group (p < 0.001). Patients who required invasive therapies had pathological ultrasound (p < 0.001). Of the 28 patients with pathological ultrasound, 24 required hospitalization (p < 0.001). CONCLUSION Lung ultrasound is a major asset for assessing the severity of the patient with seasonal flu. In addition, ultrasound allows better monitoring of the patient by being able to influence the destination of the latter towards a return home or monitoring in intensive care.
Collapse
Affiliation(s)
- Lucile Dhuiege
- Service des Urgences HELORA, site Kennedy, Mons, Belgique
| | | | | | | | | | | | | |
Collapse
|
2
|
Kim G, Lee S, Lee Y, Kim JH, Lee J. The molecular epidemiology and clinical implication of methicillin-resistant Staphylococcus aureus (MRSA) sequence types in pediatric bacteremia: a restrospective observational study, 2016-2021. BMC Infect Dis 2024; 24:259. [PMID: 38402154 PMCID: PMC10894466 DOI: 10.1186/s12879-023-08914-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/14/2023] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND While there is a high burden of methicillin-resistant Staphylococcus aureus (MRSA) infections among pediatric patients, studies on the molecular epidemiology of MRSA infections in Korean children since the 2010s are lacking. This study aimed to investigate the molecular genotypes and clinical characteristics of MRSA isolates from children with MRSA bacteremia at Asan Medical Center Children's Hospital from 2016 to 2021. METHODS Clinical data were retrospectively reviewed, and the molecular types of MRSA were determined using multilocus sequence typing (MLST) and Staphylococcal cassette chromosome mec (SCCmec) typing. RESULTS The overall methicillin resistance rate of S. aureus bacteremia was 44.8% (77/172); 49.5% in the period 2016-2018 (period 1) and 37.3% in the period 2019-2021 (period 2) (P = 0.116). Community-acquired infections accounted for only 3.9% of cases. The predominant ST group was ST72 group (67.6%), followed by ST5 group (18.9%) and ST1 group (5.4%). The proportion of ST5 was significantly lower in period 2 compared to period 1 (P = 0.02). Compared to the ST5 and ST1 groups, the ST72 group exhibited lower overall antibiotic resistance and multidrug-resistant (MDR) rates (12.0% [6/50] in ST72 group vs. 100.0% [14/14] in ST5 group vs. 50.0% [2/4] in ST1 group; P < 0.001). In the multivariate analysis, the ST1 group was an independent risk factor for 30-day all-cause mortality (aOR, 44.12; 95% CI, 3.46-562.19). CONCLUSION The ST72-MRSA strain remained the most frequently isolated genotype in Korean children, while the ST1 group emerged as an independent risk factor for 30-day all-cause mortality in pediatric MRSA bacteremia. Ongoing efforts to uncover the evolving epidemiology of MRSA are essential for developing effective strategies for prevention and treatment.
Collapse
Affiliation(s)
- Gahee Kim
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Department of Pediatrics, Chosun University hospital, Gwangju, Republic of Korea
| | - Sanghoon Lee
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yonghee Lee
- Department of Pediatrics, Gangwon National University hospital, Chunchen, Gangwon-do, Republic of Korea
| | - Jung Hwa Kim
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jina Lee
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
3
|
Bou Khalil R, Kassab A, Richa S, Seneque M, Lefebvre P, Sultan A, Avignon A, Maimoun L, Renard E, Courtet P, Guillaume S. Weight suppression at lowest weight as an indicator of eating disorder clinical severity: A retrospective cohort study. Eat Behav 2024; 53:101853. [PMID: 38382309 DOI: 10.1016/j.eatbeh.2024.101853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVES Weight suppression (WS) defines the difference between the highest weight in adulthood and the current weight. WS at lowest weight is the difference between the highest and the lowest ever weight. Weight rebound is the difference between the past lowest weight and current weight. The distinction in the capacities of WS, weight rebound, and WS at the lowest weight remains unclear regarding their efficacy in forecasting clinical endpoints. This study assessed the relationship between WS, WS at lowest weight and/or weight rebound and eating disorder (ED) clinical severity. METHODS In this retrospective cohort study, adult participants were selected at the Outpatient Unit for multidisciplinary assessment of ED, Montpellier, France, between February 2012 and October 2014 and May 2017 and January 2020. ED clinical severity was evaluated using the Eating Disorder Examination Questionnaire (EDE-Q). RESULTS The sample included 303 patients: 204 with anorexia nervosa (AN) and 99 with bulimia nervosa (BN). The EDE-Q total score was positively correlated with WS at lowest weight in patients with AN (Spearman's rho = 0.181, p = 0.015) and with BN (Spearman's rho = 0.377; p < 0.001). It was also positively correlated with weight rebound (Spearman's rho = 0.319; p = 0.003) in patients with BN. In the multivariate analysis, EDE-Q total score was associated with WS at lowest weight only in patients with BN (β = 0.265; p = 0.03). CONCLUSION WS at lowest weight seems to be a good measure of ED clinical severity. More research is needed for better understanding WS at lowest weight in assessment and treatment of patients with ED.
Collapse
Affiliation(s)
- Rami Bou Khalil
- Saint Joseph University-Hôtel Dieu de France Hospital, Department of Psychiatry, Beirut, Lebanon; Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France; Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295 Montpellier, France.
| | - Anthony Kassab
- Saint Joseph University-Hôtel Dieu de France Hospital, Department of Psychiatry, Beirut, Lebanon
| | - Sami Richa
- Saint Joseph University-Hôtel Dieu de France Hospital, Department of Psychiatry, Beirut, Lebanon
| | - Maude Seneque
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France; Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295 Montpellier, France
| | - Patrick Lefebvre
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | - Ariane Sultan
- University of Montpellier, PhyMedExp, INSERM, CNRS UMR, CHRU Montpellier, France
| | - Antoine Avignon
- Desbrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, CHU, Montpellier, France
| | - Laurent Maimoun
- University of Montpellier, PhyMedExp, INSERM, CNRS UMR, CHRU Montpellier, France; Department of Nuclear Medicine, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
| | - Eric Renard
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Philippe Courtet
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France; Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295 Montpellier, France
| | - Sebastien Guillaume
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France; Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295 Montpellier, France
| |
Collapse
|
4
|
Hao Q, Gong Z, Song Y, Wang Y, Meng W, Wu W, Li Y, Zhang Y. Amyloid and Tau as cerebrospinal fluid biomarkers in anti-N-Methyl-D-aspartate receptor encephalitis. Neurol Sci 2024:10.1007/s10072-024-07341-x. [PMID: 38280087 DOI: 10.1007/s10072-024-07341-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/19/2024] [Indexed: 01/29/2024]
Abstract
INTRODUCTION Neuroinfection is associated with the deposition of amyloid-beta (Aβ) peptides, and subsequent decrease in cerebrospinal fluid (CSF) amyloid levels. However, whether autoimmune encephalitis involves extracellular deposition of Aβ peptides in the brain is unreported. METHODS We examined CSF amyloid and tau values in adults with anti-N-methyl-D-aspartate receptor encephalitis (NMDAR-E). Forty-two patients with NMDAR-E, 35 patients with viral and bacterial neuroinfections, and 16 controls were included. We measured CSF Aβ1-42 (cAβ1-42), Aβ1-40 (cAβ1-40), t-Tau (ct-Tau), and p-Tau181 (cp-Tau181) levels and assessed their efficacies regarding differential diagnosis and predicting prognosis. RESULTS NMDAR-E patients had lower cAβ1-42 levels; however, they were higher than those of patients with bacterial meningitis. ct-Tau levels in NMDAR-E patients were lower than those in patients with neuroinfections. No changes were observed in controls. cAβ1-42 and ct-Tau were combined as an excellent marker to distinguish NMDAR-E from neuroinfections. cAβ1-42 levels in NMDAR-E patients were positively correlated with Montreal Cognitive Assessment scores. We observed an inverse relationship between cAβ1-42 levels and modified Rankin Scale scores. Patients with poor outcomes exhibited low cAβ1-42 levels and high levels of several blood parameters. cAβ1-42 was the highest quality biomarker for assessing NMDAR-E prognosis. Correlations were found between cAβ1-42 and some inflammatory indicators. CONCLUSION cAβ1-42 was decreased in NMDAR-E patients. cAβ1-42 levels indicated NMDAR-E severity and acted as a biomarker for its prognosis. Combining cAβ1-42 and ct-Tau levels could serve as a novel differential diagnostic marker for NMDAR-E.
Collapse
Affiliation(s)
- Qianmeng Hao
- Department of Blood Transfusion, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450053, Henan, China
| | - Zhe Gong
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yajun Song
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yali Wang
- Department of Blood Transfusion, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450053, Henan, China
| | - Weiwei Meng
- Department of Blood Transfusion, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450053, Henan, China
| | - Wei Wu
- Department of Blood Transfusion, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450053, Henan, China
| | - Yanfei Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yulin Zhang
- Department of Blood Transfusion, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450053, Henan, China.
| |
Collapse
|
5
|
Calvet J, Berenguer-Llergo A, Orellana C, García-Manrique M, Rusiñol M, Garcia-Cirera S, Llop M, Arévalo M, Garcia-Pinilla A, Galisteo C, Aymerich C, Gómez R, Serrano A, Carreras A, Gratacós J. Specific-cytokine associations with outcomes in knee osteoarthritis subgroups: breaking down disease heterogeneity with phenotyping. Arthritis Res Ther 2024; 26:19. [PMID: 38212829 PMCID: PMC10782658 DOI: 10.1186/s13075-023-03244-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Despite existing extensive literature, a comprehensive and clinically relevant classification system for osteoarthritis (OA) has yet to be established. In this study, we aimed to further characterize four knee OA (KOA) inflammatory phenotypes (KOIP) recently proposed by our group, by identifying the inflammatory factors associated with KOA severity and progression in a phenotype-specific manner. METHODS We performed an analysis within each of the previously defined four KOIP groups, to assess the association between KOA severity and progression and a panel of 13 cytokines evaluated in the plasma and synovial fluid of our cohort's patients. The cohort included 168 symptomatic female KOA patients with persistent joint effusion. RESULTS Overall, our analyses showed that associations with KOA outcomes were of higher magnitude within the KOIP groups than for the overall patient series (all p-values < 1.30e-16) and that several of the cytokines showed a KOIP-specific behaviour regarding their associations with KOA outcomes. CONCLUSION Our study adds further evidence supporting KOA as a multifaceted syndrome composed of multiple phenotypes with differing pathophysiological pathways, providing an explanation for inconsistencies between previous studies focussed on the role of cytokines in OA and the lack of translational results to date. Our findings also highlight the potential clinical benefits of accurately phenotyping KOA patients, including improved patient stratification, tailored therapies, and the discovery of novel treatments.
Collapse
Affiliation(s)
- Joan Calvet
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain.
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
| | - Antoni Berenguer-Llergo
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
| | - Cristóbal Orellana
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
| | - María García-Manrique
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Menna Rusiñol
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
| | - Silvia Garcia-Cirera
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
| | - Maria Llop
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
| | - Marta Arévalo
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
| | - Alba Garcia-Pinilla
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
| | - Carlos Galisteo
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
| | - Cristina Aymerich
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
| | - Rafael Gómez
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
| | - Alejandra Serrano
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
| | - Anna Carreras
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
| | - Jordi Gratacós
- Department of Rheumatology, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, c/Parc Taulí s/n, edifici VII Centenari, 08208, Sabadell, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| |
Collapse
|
6
|
Cáceres C, Castillo M, Carrillo K, Tapia CV, Valderrama G, Maquilón C, Toro-Ascuy D, Zorondo-Rodríguez F, Fuenzalida LF. Overnutrition as a risk factor for more serious respiratory viral infections in children: A retrospective study in hospitalized patients. ENDOCRINOL DIAB NUTR 2023; 70:476-483. [PMID: 37527958 DOI: 10.1016/j.endien.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/03/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND The prevalence of obesity has increased dramatically in children worldwide. Obesity has been recognized as a risk factor for more serious viral respiratory infections, mainly in adults. OBJECTIVE To study the relationship between overnutrition (obesity and overweight) and clinical severity in children hospitalized with acute respiratory infections of viral origin. METHODS One hundred and forty-three clinical records of children between 2 and 18 years old hospitalized for acute respiratory infection at Clínica Dávila (2014-2018) were analyzed, recording the respiratory viruses detected at the time of hospitalization, weight, and height. Nutritional status was estimated using Z score or body mass index, according to age. RESULTS Eighty-tree3 children (58%) were positive for more than one respiratory virus. The main virus detected in monoinfection was adenovirus (9.8%), followed by respiratory syncytial virus (7.7%) and parainfluenza virus (7.7%). There were no deaths. Patients with obesity presented more days of hospitalization (P = .04), oxygen therapy (P = .03) and mechanical ventilation (P < .001), as well as a higher probability of requiring mechanical ventilation (P = .001) and of ICU admission (P = .003) compared with children with normal weight. Patients with overweight presented more days of mechanical ventilation (P < .001) than patients with normal weight. No significant differences were found between the presence of viral coinfection and nutritional status. CONCLUSION Overnutrition is associated with greater severity of viral respiratory infection in hospitalized children.
Collapse
Affiliation(s)
- Camila Cáceres
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | - Macarena Castillo
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | - Karin Carrillo
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | | | | | - César Maquilón
- Unidad Broncopulmonar Adulto, Clínica Dávila, Santiago, Chile
| | - Daniela Toro-Ascuy
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | | | - Loreto F Fuenzalida
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile.
| |
Collapse
|
7
|
Roldán-Bretón NR, Capuchino-Suárez AG, Mejía-León ME, Olvera-Sandoval C, Lima-Sánchez DN. Selenium serum levels in patients with SARS-CoV-2 infection: a systematic review and meta-analysis. J Nutr Sci 2023; 12:e86. [PMID: 37528833 PMCID: PMC10388439 DOI: 10.1017/jns.2023.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/28/2023] [Accepted: 07/01/2023] [Indexed: 08/03/2023] Open
Abstract
The nutritional status is a determinant of the immune response that promotes a cellular homeostasis. In particular, adequate selenium levels lead to a better antioxidant and immune response. The aim of this work is to assess whether blood selenium levels, at time of SARS-CoV-2 infection, have an impact on the development and severity of COVID-19. A systematic review and meta-analysis of comparative and descriptive studies using MeSH terms, selenium and COVID-19 was performed. We searched bibliographic databases up to 17 July 2022 in PubMed and ScienceDirect. Studies that reported data on blood selenium levels were considered. A total of 629 articles were examined by abstract and title, of which 595 abstracts were read, of which 38 were included in the systematic review and 11 in the meta-analysis. Meta-analysis was conducted to mean difference (MD) with a 95 % confidence interval (CI), and heterogeneity was tested by I2 with random factors with a MD between selenium levels, mortality, morbidity and healthy subjects with a P-value of 0⋅05. Selenium levels were higher in healthy people compared to those in patients with COVID-19 disease (six studies, random effects MD: test for overall effect Z = 3⋅28 (P = 0⋅001), 97 % CI 28⋅36 (11⋅41-45⋅31), P < 0⋅00001), but without difference when compared with the degree of severity in mild, moderate or severe cases. In conclusion, the patients with active SARS-CoV-2 infection had lower selenium levels than the healthy population. More studies are needed to evaluate its impact on clinical severity through randomised clinical trials.
Collapse
Affiliation(s)
| | | | - María Esther Mejía-León
- Facultad de Medicina, Universidad Autónoma de Baja California, Mexicali, Baja California, Mexico
| | - Carlos Olvera-Sandoval
- Facultad de Medicina, Universidad Autónoma de Baja California, Mexicali, Baja California, Mexico
| | - Dania Nimbe Lima-Sánchez
- Department of Biomedical Informatics, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, Mexico
| |
Collapse
|
8
|
Santos JX, Sampaio P, Rasga C, Martiniano H, Faria C, Café C, Oliveira A, Duque F, Oliveira G, Sousa L, Nunes A, Vicente AM. Evidence for an association of prenatal exposure to particulate matter with clinical severity of Autism Spectrum Disorder. Environ Res 2023; 228:115795. [PMID: 37028534 DOI: 10.1016/j.envres.2023.115795] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 03/06/2023] [Accepted: 03/28/2023] [Indexed: 05/16/2023]
Abstract
Early-life exposure to air pollutants, including ozone (O3), particulate matter (PM2.5 or PM10, depending on diameter of particles), nitrogen dioxide (NO2) and sulfur dioxide (SO2) has been suggested to contribute to the etiology of Autism Spectrum Disorder (ASD). In this study, we used air quality monitoring data to examine whether mothers of children with ASD were exposed to high levels of air pollutants during critical periods of pregnancy, and if higher exposure levels may lead to a higher clinical severity in their offspring. We used public data from the Portuguese Environment Agency to estimate exposure to these pollutants during the first, second and third trimesters of pregnancy, full pregnancy and first year of life of the child, for 217 subjects with ASD born between 2003 and 2016. These subjects were stratified in two subgroups according to clinical severity, as defined by the Autism Diagnostic Observational Schedule (ADOS). For all time periods, the average levels of PM2.5, PM10 and NO2 to which the subjects were exposed were within the admissible levels defined by the European Union. However, a fraction of these subjects showed exposure to levels of PM2.5 and PM10 above the admissible threshold. A higher clinical severity was associated with higher exposure to PM2.5 (p = 0.001), NO2 (p = 0.011) and PM10 (p = 0.041) during the first trimester of pregnancy, when compared with milder clinical severity. After logistic regression, associations with higher clinical severity were identified for PM2.5 exposure during the first trimester (p = 0.002; OR = 1.14, 95%CI: 1.05-1.23) and full pregnancy (p = 0.04; OR = 1.07, 95%CI: 1.00-1.15) and for PM10 (p = 0.02; OR = 1.07, 95%CI: 1.01-1.14) exposure during the third trimester. Exposure to PM is known to elicit neuropathological mechanisms associated with ASD, including neuroinflammation, mitochondrial disruptions, oxidative stress and epigenetic changes. These results offer new insights on the impact of early-life exposure to PM in ASD clinical severity.
Collapse
Affiliation(s)
- João Xavier Santos
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Avenida Padre Cruz, 1649-016, Lisboa, Portugal; BioISI - Biosystems & Integrative Sciences Institute, University of Lisboa, Faculty of Sciences, Campo Grande, C8, 1749-016, Lisboa, Portugal.
| | - Pedro Sampaio
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Avenida Padre Cruz, 1649-016, Lisboa, Portugal; BioISI - Biosystems & Integrative Sciences Institute, University of Lisboa, Faculty of Sciences, Campo Grande, C8, 1749-016, Lisboa, Portugal.
| | - Célia Rasga
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Avenida Padre Cruz, 1649-016, Lisboa, Portugal; BioISI - Biosystems & Integrative Sciences Institute, University of Lisboa, Faculty of Sciences, Campo Grande, C8, 1749-016, Lisboa, Portugal.
| | - Hugo Martiniano
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Avenida Padre Cruz, 1649-016, Lisboa, Portugal; BioISI - Biosystems & Integrative Sciences Institute, University of Lisboa, Faculty of Sciences, Campo Grande, C8, 1749-016, Lisboa, Portugal.
| | - Clarissa Faria
- Unidade de Neurodesenvolvimento e Autismo, Serviço Do Centro de Desenvolvimento da Criança, Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - Cátia Café
- Unidade de Neurodesenvolvimento e Autismo, Serviço Do Centro de Desenvolvimento da Criança, Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University Clinic of Pediatrics and Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal
| | - Alexandra Oliveira
- Unidade de Neurodesenvolvimento e Autismo, Serviço Do Centro de Desenvolvimento da Criança, Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University Clinic of Pediatrics and Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.
| | - Frederico Duque
- Unidade de Neurodesenvolvimento e Autismo, Serviço Do Centro de Desenvolvimento da Criança, Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University Clinic of Pediatrics and Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.
| | - Guiomar Oliveira
- Unidade de Neurodesenvolvimento e Autismo, Serviço Do Centro de Desenvolvimento da Criança, Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University Clinic of Pediatrics and Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.
| | - Lisete Sousa
- Departamento de Estatística e Investigação Operacional e Centro de Estatística e Aplicações, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal.
| | - Ana Nunes
- BioISI - Biosystems & Integrative Sciences Institute, University of Lisboa, Faculty of Sciences, Campo Grande, C8, 1749-016, Lisboa, Portugal; Departamento de Física, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal.
| | - Astrid Moura Vicente
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Avenida Padre Cruz, 1649-016, Lisboa, Portugal; BioISI - Biosystems & Integrative Sciences Institute, University of Lisboa, Faculty of Sciences, Campo Grande, C8, 1749-016, Lisboa, Portugal.
| |
Collapse
|
9
|
Lu J, Ma X, Zhang H, Xiao Z, Li M, Wu J, Ju Z, Chen L, Zheng L, Ge J, Liang X, Bao W, Wu P, Ding D, Yen TC, Guan Y, Zuo C, Zhao Q. Head-to-head comparison of plasma and PET imaging ATN markers in subjects with cognitive complaints. Transl Neurodegener 2023; 12:34. [PMID: 37381042 PMCID: PMC10308642 DOI: 10.1186/s40035-023-00365-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 06/02/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Gaining more information about the reciprocal associations between different biomarkers within the ATN (Amyloid/Tau/Neurodegeneration) framework across the Alzheimer's disease (AD) spectrum is clinically relevant. We aimed to conduct a comprehensive head-to-head comparison of plasma and positron emission tomography (PET) ATN biomarkers in subjects with cognitive complaints. METHODS A hospital-based cohort of subjects with cognitive complaints with a concurrent blood draw and ATN PET imaging (18F-florbetapir for A, 18F-Florzolotau for T, and 18F-fluorodeoxyglucose [18F-FDG] for N) was enrolled (n = 137). The β-amyloid (Aβ) status (positive versus negative) and the severity of cognitive impairment served as the main outcome measures for assessing biomarker performances. RESULTS Plasma phosphorylated tau 181 (p-tau181) level was found to be associated with PET imaging of ATN biomarkers in the entire cohort. Plasma p-tau181 level and PET standardized uptake value ratios of AT biomarkers showed a similarly excellent diagnostic performance for distinguishing between Aβ+ and Aβ- subjects. An increased tau burden and glucose hypometabolism were significantly associated with the severity of cognitive impairment in Aβ+ subjects. Additionally, glucose hypometabolism - along with elevated plasma neurofilament light chain level - was related to more severe cognitive impairment in Aβ- subjects. CONCLUSION Plasma p-tau181, as well as 18F-florbetapir and 18F-Florzolotau PET imaging can be considered as interchangeable biomarkers in the assessment of Aβ status in symptomatic stages of AD. 18F-Florzolotau and 18F-FDG PET imaging could serve as biomarkers for the severity of cognitive impairment. Our findings have implications for establishing a roadmap to identifying the most suitable ATN biomarkers for clinical use.
Collapse
Affiliation(s)
- Jiaying Lu
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoxi Ma
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Huiwei Zhang
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenxu Xiao
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ming Li
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jie Wu
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zizhao Ju
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Chen
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Li Zheng
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jingjie Ge
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoniu Liang
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Weiqi Bao
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Ping Wu
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Ding Ding
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | | | - Yihui Guan
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China.
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China.
| | - Chuantao Zuo
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, China.
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China.
- Human Phenome Institute, Fudan University, Shanghai, China.
| | - Qianhua Zhao
- National Clinical Research Center for Aging and Medicine and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China.
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
| |
Collapse
|
10
|
Wani SA, Gulzar B, Khan MS, Majid S, Bhat IA. Impact of Age and Clinico-Biochemical Parameters on Clinical Severity of SARS-CoV-2 Infection. Intervirology 2023; 66:88-96. [PMID: 37263256 PMCID: PMC10353304 DOI: 10.1159/000530906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/13/2023] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION The surge in novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leading to coronavirus disease-2019 (COVID-19) has overwhelmed the health system. To help health-care workers and policy makers prioritize treatment and to decrease the burden on health systems caused by COVID-19, clinical severity along with various clinico-biochemical parameters was evaluated by designing a cross-sectional study comprising 236 SARS-CoV-2-infected individuals from Kashmir Valley, India. METHODS Briefly, real-time polymerase chain reaction (RT-PCR) was used for the confirmation of SARS-CoV-2 infection. The principles of spectrophotometry and chemiluminescent microparticle immunoassay (CMIA) were employed to estimate the levels of glucose, TSH, and 25-hydroxy vitamin D levels in serum of infected patients. RESULTS A total of 236 patients infected with SARS-CoV-2 were taken for this cross-sectional study. Patients with COVID-19 had a male predominance (72.9 vs. 27.1%) and a higher prevalence of 25-hydroxy vitamin D deficiency (72.0 vs. 28.0%) with a mean 25-hydroxy vitamin D levels of 24.0 ± 13.9 in ng/mL. We observed a varied clinical spectrum of SARS-CoV-2 infection with 36.4%, 23.7%, and 29.7% patients having mild, moderate, and severe disease, respectively. We observed that severity of SARS-CoV-2 infection was significantly associated with older age group, hypertension, low TSH levels, and 25-hydroxy vitamin D deficiency. CONCLUSION We conclude that not only old age but also hypertension and low levels of TSH and 25-hydroxy vitamin D levels could significantly lead to clinical severity of SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Shariq Ahmad Wani
- Department of Medicine, Government Medical College Srinagar and Associated Hospitals, Jammu and Kashmir, India
| | - Babar Gulzar
- Department of Medicine, Government Medical College Srinagar and Associated Hospitals, Jammu and Kashmir, India
| | - Mosin Saleem Khan
- Department of Biochemistry, Government Medical College Baramulla and Associated Hospitals, Jammu and Kashmir, India
| | - Sabhiya Majid
- Department of Biochemistry, Government Medical College Baramulla and Associated Hospitals, Jammu and Kashmir, India
| | - Irfan Ahmad Bhat
- Department of Medicine, Government Medical College Srinagar and Associated Hospitals, Jammu and Kashmir, India
| |
Collapse
|
11
|
Kerget B, Özkan HB, Afşin DE, Koçak AO, Laloglu E, Uçar EY, Sağlam L. Evaluation of serum YKL-40 level among clinical risk scores for early mortality in acute pulmonary thromboembolism. Clin Biochem 2022; 108:20-26. [PMID: 35853494 DOI: 10.1016/j.clinbiochem.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Pulmonary embolism (PE) often occurs secondary to deep vein thrombosis and is an important cause of mortality and morbidity. This study aimed to evaluate the relationship between YKL-40 level and clinical risk score in patients with PE. METHODS The study included a total of 100 patients, 80 patients diagnosed with PE in the emergency department and 20 healthy controls. Patients with PE were divided into four groups: high-risk patients (n = 20), high-intermediate-risk patients (n = 20), low-intermediate-risk patients (n = 20), and low-risk patients (n = 20). Serum YKL-40 levels were measured by enzyme-linked immunosorbent assay. Pulmonary artery obstruction index (PAOI) was calculated from computed tomography angiography images. RESULTS PAOI increased in correlation with PE risk and differed significantly between all patient groups (p < 0.001). Troponin-I levels were significantly higher in the high-risk and high-intermediate-risk groups compared to the other groups (p < 0.001), but did not differ significantly between high-risk and high-intermediate-risk patients (p = 0.09). YKL-40 level was significantly higher in the high-risk PE group than the high-intermediate-risk group (p < 0.001). In receiving operator characteristic curve analysis assessing the discriminatory value of YKL-40 for high-risk PE patients, a cut-off value of 227.2 ng/mL had sensitivity of 85 % and specificity of 70 %. DISCUSSION YKL-40 may be an important biomarker in decisions regarding early thrombolytic treatment in patients with high-intermediate-risk PE. In addition, medical treatments targeting YKL-40 may also reduce thrombotic tendency in high-risk patient groups.
Collapse
Affiliation(s)
- Buğra Kerget
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Yakutiye, Erzurum, Turkey.
| | - Hatice Beyza Özkan
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Yakutiye, Erzurum, Turkey
| | - Dursun Erol Afşin
- Depertmant of Pulmonary Diseases, Health Sciences University Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Abdullah Osman Koçak
- Department of Emergency Medicine, Ataturk University School of Medicine, 25240, Yakutiye, Erzurum, Turkey
| | - Esra Laloglu
- Department of Biochemistry, Ataturk University School of Medicine, 25240, Yakutiye, Erzurum, Turkey
| | - Elif Yılmazel Uçar
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Yakutiye, Erzurum, Turkey
| | - Leyla Sağlam
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Yakutiye, Erzurum, Turkey
| |
Collapse
|
12
|
Zhang W, Liu W, Lin J, Jin J, Zhao K, Zhu L, Wang X, Wang L, Tang R, Zhu Y, Zhou W, You E, Zhang L, Liu X, Wu J, Chen L, Wang W, Zhang Q, Gao R. Highly Prevalent SARS-CoV-2 Antigenemia in COVID-19 Patients. Infect Dis Immun 2022; 2:193-199. [PMID: 37520106 PMCID: PMC9295937 DOI: 10.1097/id9.0000000000000057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Indexed: 01/08/2023]
Abstract
Background Many issues, such as severity assessment and antibody responses, remain to be answered eagerly for evaluation and understanding of COVID-19. Immune lesion is one of key pathogenesis of the disease. It would be helpful to understand the disease if an investigation on antigenemia and association was conducted in the patients with SARS-CoV-2 infection. Methods A total of 156 patients admitted to the First People's Hospital of Hefei or Anhui Provincial Hospital on January to February 2020 were involved in this study. SARS-CoV-2 nucleocapsid (NP) antigen, specific IgM/IgG antibodies, and RNA were detected in sequential sera from three COVID-19 patients, and additional 153 COVID-19 patients by means of NP-antigen capture enzyme-linked immunosorbent assay, colloidal gold quick diagnosis, and real-time RT-PCR, respectively. The clinical types of COVID-19 patients were classified into asymptomatic, mild, moderate, severe, and critical, following on the Chinese guideline of COVID-19 diagnosis and treatment. The demographic and clinical data of patients were obtained for comparable analysis. Results NP antigen was detected in 5 of 20 sequential sera collected from three COVID-19 patients with typically clinical symptoms, and 60.13% (92/153) expanded samples collected within 17 days after illness onset. No SARS-CoV-2 RNA segment was detected in these sera. The NP positive proportion reached a peak (84.85%, 28/33) on 6 to 8 days after illness onset. Both NP concentration and positive proportion were increased with the increase of clinical severity of COVID-19. Compared to NP negative patients, NP positive patients had older age [years, medians (interquartile ranges (IQR)), 49 (6) vs. 31 (11)], lower positive proportion of NP specific IgM [27.17% (25/92) vs. 59.02% (36/61)], and IgG [21.74% (20/92) vs. 59.02% (36/61)] antibodies, and longer duration [days, medians (IQR), 24 (10) vs. 21 (13)] from illness to recovery. Conclusions SARS-CoV-2 NP antigenemia occurred in COVID-19, and presented highly prevalent at early stage of the disease. The antigenemia was related to clinical severity of the disease, and may be responsible for the delay of detectable SARS-Cov-2 IgM.
Collapse
Affiliation(s)
- Wenyan Zhang
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Wei Liu
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Jiawang Lin
- BIOHIT Healthcare (Hefei) Co., Hefei, Anhui Province 230000, China
| | - Jing Jin
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Kefu Zhao
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Liwei Zhu
- The First People's Hospital of Hefei, Hefei, Anhui Province 230091, China
| | - Xiuzhen Wang
- Anhui Provincial Hospital, Hefei, Anhui Province 231501, China
| | - Lijie Wang
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Renshu Tang
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Yindi Zhu
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Wei Zhou
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Enqing You
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Lei Zhang
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Xuxiang Liu
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Jinju Wu
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Lili Chen
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Wenjing Wang
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Qiang Zhang
- Hefei Center for Disease Control and Prevention, Hefei, Anhui Province 230061, China
| | - Rongbao Gao
- NHC Key Laboratory of Biosafety, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| |
Collapse
|
13
|
Fimognari FL, Corsonello A, Rizzo M, Bambara V, Fabbietti P, Arone A, Cuccurullo O, Pilotto A, Ferrari A; PIACE Study Group. Contribution of clinical severity and geriatric risk factors in predicting short-term mortality of older hospitalized pneumonia patients: the Pneumonia in Italian Acute Care for Elderly units (PIACE) study. Aging Clin Exp Res 2022; 34:1419-27. [PMID: 35195875 DOI: 10.1007/s40520-021-02063-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 12/27/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Clinical severity of pneumonia in older persons increases the risk for short-term mortality. Comprehensive geriatric assessment (CGA) may provide further insight in prognostic stratification. AIMS To investigate whether CGA may improve prognostic stratification among older patients with pneumonia admitted to hospital. METHODS Our series consisted of 318 consecutive patients hospitalized for pneumonia in a multicenter observational study. Disease severity was assessed by Sequential Organ Failure Assessment (SOFA) and Pneumonia Severity Index (PSI). CGA included the occurrence of delirium, Basic Activities of Daily Living (BADL) disability, cognitive impairment at Short Portable Mental Status Questionnaire (SPMSQ) and overall comorbidity assessed by Cumulative Illness Rating Scale (CIRS). The outcomes were in-hospital and post-discharge 3 month mortality. Statistical analysis was carried out by Cox regression, area under receiver operating curve (AUC) and net reclassification index (NRI). RESULTS Overall, 53 patients died during hospitalization and 52 after discharge. Delirium, SOFA score and admission BADL disability were significant predictors of in-hospital mortality. SOFA score, CIRS, previous long-term oxygen therapy and discharge BADL dependency significantly predicted post-discharge mortality. The accuracy of SOFA in predicting in-hospital and post-discharge mortality was fair (AUC = 0.685, 95% CI = 0.610-0.761 and AUC = 0.663, 95% CI = 0.593-0.734, respectively). BADL dependency and delirium improved predictive accuracy for in-hospital mortality (ΔAUC = 0.144, 95% CI = 0.062-0.227, p < 0.001), while pre-admission oxygen therapy, CIRS and BADL dependency improved predictivity for 3 month mortality (ΔAUC = 0.177, 95% CI = 0.102-0.252, p < 0.001). DISCUSSION Among older pneumonia patients, prognostic stratification obtained by clinical severity indexes is significantly improved by CGA risk factors. CONCLUSIONS CGA provides important information for prognostic stratification and clinical management of older pneumonia patients.
Collapse
|
14
|
Yang L, Liu B, Dong X, Wu J, Sun C, Xi L, Cheng R, Wu B, Wang H, Tong S, Wang D, Luo F. Clinical severity prediction in children with osteogenesis imperfecta caused by COL1A1/2 defects. Osteoporos Int 2022; 33:1373-1384. [PMID: 35044492 PMCID: PMC9106613 DOI: 10.1007/s00198-021-06263-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/03/2021] [Indexed: 12/03/2022]
Abstract
UNLABELLED Osteogenesis imperfecta (OI) is a genetic disease with an estimated prevalence of 1 in 13,500 and 1 in 9700. The classification into subtypes of OI is important for prognosis and management. In this study, we established a clinical severity prediction model depending on multiple features of variants in COL1A1/2 genes. INTRODUCTION Ninety percent of OI cases are caused by pathogenic variants in the COL1A1/COL1A2 gene. The Sillence classification describes four OI types with variable clinical features ranging from mild symptoms to lethal and progressively deforming symptoms. METHODS We established a prediction model of the clinical severity of OI based on the random forest model with a training set obtained from the Human Gene Mutation Database, including 790 records of the COL1A1/COL1A2 genes. The features used in the prediction model were respectively based on variant-type features only, and the optimized features. RESULTS With the training set, the prediction results showed that the area under the receiver operating characteristic curve (AUC) for predicting lethal to severe OI or mild/moderate OI was 0.767 and 0.902, respectively, when using variant-type features only and optimized features for COL1A1 defects, 0.545 and 0.731, respectively, for COL1A2 defects. For the 17 patients from our hospital, prediction accuracy for the patient with the COL1A1 and COL1A2 defects was 76.5% (95% CI: 50.1-93.2%) and 88.2% (95% CI: 63.6-98.5%), respectively. CONCLUSION We established an OI severity prediction model depending on multiple features of the specific variants in COL1A1/2 genes, with a prediction accuracy of 76-88%. This prediction algorithm is a promising alternative that could prove to be valuable in clinical practice.
Collapse
Affiliation(s)
- Lin Yang
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Bo Liu
- Key Laboratory of Birth Defects, Children's Hospital of Fudan University, Shanghai, 201102, China
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Xinran Dong
- Key Laboratory of Birth Defects, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Jing Wu
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Chengjun Sun
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Li Xi
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Ruoqian Cheng
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China
| | - Bingbing Wu
- Key Laboratory of Birth Defects, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Huijun Wang
- Key Laboratory of Birth Defects, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Shiyuan Tong
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, 201102, China
| | - Dahui Wang
- Division of Orthopedics, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai, 201102, China.
| | - Feihong Luo
- Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, China.
| |
Collapse
|
15
|
Yang JE, Zhao KH, Qu Y, Zou YC. Increased serum CXCL10 levels are associated with clinical severity and radiographic progression in patients with lumbar disc degeneration. Clin Chim Acta 2021; 525:15-22. [PMID: 34902344 DOI: 10.1016/j.cca.2021.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/16/2021] [Accepted: 12/07/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Lumbar intervertebral degenerative disc disease (IDD) is a multifaceted progressive condition that commonly occurs in conjunction with lumbar disc herniation (LDH). CXCL10 mRNA appears to be increased in both IDD and LHD. OBJECTIVE This study was performed to identify the relationship between serum CXCL10 levels and disease severity in patients with IDD. METHODS 136 IDD patients with low back pain, 127 asymptomatic volunteers and 120 healthy controls were enrolled. Serum CXCL10 protein concentrations were detected using commercial human CXCL10 ELISA Kits. Serum CXCL10 mRNA were examined using qRT-PCR. Clinical severity was assessed using the visual analog scale (VAS) and Oswestry Disability Index(ODI) scores. Radiographic severity was defined using the MRI-based Pfirrmann classification of disc degeneration. Receiver operating characteristic (ROC) curve analysis was used in estimating the correlation between CXCL10 and Pfirrmann grade. The cross-sectional area (CSA) of the lumbar multifidus muscle (LMM) and psoas major (PM) were calculated, and fat infiltration was evaluated by Ropponen-Kjaer criteria. RESULTS Serum CXCL10 concentrations were markedly raised in IDD patients with low back pain in contrast to asymptomatic individuals and healthy controls. Serum CXCL10 levels were positively associated with Pfirrmann grade. ROC curve analysis indicated that serum CXCL10 correlated well with Pfirrmann grade. In addition, serum CXCL10 concentrations were significantly higher in IDD patients with LMM and PM degeneration compared with IDD patients without degeneration. Increased CXCL10 levels positively correlated with VAS and ODI scores, as well as decreased CSA and fat filtration of the LMM and PM. CONCLUSION Increased serum CXCL10 levels correspond to clinical severity and radiographic progression in IDD patients.
Collapse
Affiliation(s)
- Jia-En Yang
- Department of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; College of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Sichuan Provincial Key Laboratory of Rehabilitation Medicine, Sichuan University, Chengdu 610041, Sichuan, China; Department of Rehabilitation Medicine, Affiliated Foshan Gaoming Hospital of Guangdong Medical University, Foshan 528000, Guangdong, China
| | - Ke-Hong Zhao
- Department of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; College of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Sichuan Provincial Key Laboratory of Rehabilitation Medicine, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yun Qu
- Department of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; College of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Sichuan Provincial Key Laboratory of Rehabilitation Medicine, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Yu-Cong Zou
- Department of Rehabilitation,The third Affiliated Hospital,Southern Medical University ,Guangzhou 510630, GuangDong, China.
| |
Collapse
|
16
|
Zhang ZJ, Che TL, Wang T, Zhao H, Hong J, Su Q, Zhang HY, Zhou SX, Teng AY, Zhang YY, Yang Y, Fang LQ, Liu W. Epidemiological features of COVID-19 patients with prolonged incubation period and its implications for controlling the epidemics in China. BMC Public Health 2021; 21:2239. [PMID: 34886835 DOI: 10.1186/s12889-021-12337-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/29/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND COVID-19 patients with long incubation period were reported in clinical practice and tracing of close contacts, but their epidemiological or clinical features remained vague. METHODS We analyzed 11,425 COVID-19 cases reported between January-August, 2020 in China. The accelerated failure time model, Logistic and modified Poisson regression models were used to investigate the determinants of prolonged incubation period, as well as their association with clinical severity and transmissibility, respectively. RESULT Among local cases, 268 (10.2%) had a prolonged incubation period of > 14 days, which was more frequently seen among elderly patients, those residing in South China, with disease onset after Level I response measures administration, or being exposed in public places. Patients with prolonged incubation period had lower risk of severe illness (ORadjusted = 0.386, 95% CI: 0.203-0.677). A reduced transmissibility was observed for the primary patients with prolonged incubation period (50.4, 95% CI: 32.3-78.6%) than those with an incubation period of ≤14 days. CONCLUSIONS The study provides evidence supporting a prolonged incubation period that exceeded 2 weeks in over 10% for COVID-19. Longer monitoring periods than 14 days for quarantine or persons potentially exposed to SARS-CoV-2 should be justified in extreme cases, especially for those elderly.
Collapse
|
17
|
D'Souza NS, Nebel MB, Crocetti D, Robinson J, Wymbs N, Mostofsky SH, Venkataraman A. Deep sr-DDL: Deep structurally regularized dynamic dictionary learning to integrate multimodal and dynamic functional connectomics data for multidimensional clinical characterizations. Neuroimage 2021; 241:118388. [PMID: 34271159 PMCID: PMC8528511 DOI: 10.1016/j.neuroimage.2021.118388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/05/2021] [Accepted: 07/10/2021] [Indexed: 11/27/2022] Open
Abstract
We propose a novel integrated framework that jointly models complementary information from resting-state functional MRI (rs-fMRI) connectivity and diffusion tensor imaging (DTI) tractography to extract biomarkers of brain connectivity predictive of behavior. Our framework couples a generative model of the connectomics data with a deep network that predicts behavioral scores. The generative component is a structurally-regularized Dynamic Dictionary Learning (sr-DDL) model that decomposes the dynamic rs-fMRI correlation matrices into a collection of shared basis networks and time varying subject-specific loadings. We use the DTI tractography to regularize this matrix factorization and learn anatomically informed functional connectivity profiles. The deep component of our framework is an LSTM-ANN block, which uses the temporal evolution of the subject-specific sr-DDL loadings to predict multidimensional clinical characterizations. Our joint optimization strategy collectively estimates the basis networks, the subject-specific time-varying loadings, and the neural network weights. We validate our framework on a dataset of neurotypical individuals from the Human Connectome Project (HCP) database to map to cognition and on a separate multi-score prediction task on individuals diagnosed with Autism Spectrum Disorder (ASD) in a five-fold cross validation setting. Our hybrid model outperforms several state-of-the-art approaches at clinical outcome prediction and learns interpretable multimodal neural signatures of brain organization.
Collapse
Affiliation(s)
- N S D'Souza
- Department of Electrical and Computer Engineering, Johns Hopkins University, USA.
| | - M B Nebel
- Center for Neurodevelopmental & Imaging Research, Kennedy Krieger Institute, USA; Department of Neurology, Johns Hopkins School of Medicine, USA
| | - D Crocetti
- Center for Neurodevelopmental & Imaging Research, Kennedy Krieger Institute, USA
| | - J Robinson
- Center for Neurodevelopmental & Imaging Research, Kennedy Krieger Institute, USA
| | - N Wymbs
- Center for Neurodevelopmental & Imaging Research, Kennedy Krieger Institute, USA; Department of Neurology, Johns Hopkins School of Medicine, USA
| | - S H Mostofsky
- Center for Neurodevelopmental & Imaging Research, Kennedy Krieger Institute, USA; Department of Neurology, Johns Hopkins School of Medicine, USA; Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, USA
| | - A Venkataraman
- Department of Electrical and Computer Engineering, Johns Hopkins University, USA
| |
Collapse
|
18
|
Halacli SO. The effect of mutatio-type on proteo-phenotype and clinico-phenotype in selected primary immunodeficiencies. Immunol Res 2021; 70:56-66. [PMID: 34622368 DOI: 10.1007/s12026-021-09239-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/25/2021] [Indexed: 11/29/2022]
Abstract
In the diagnosis of primary immunodeficiencies which are heterogeneous groups of genetic disorders, next-generation sequencing strategies take an important place. Protein expression analyses and some functional studies which are fundamental to determine the pathogenicity of the mutation are also performed to accelerate the diagnosis of PIDs before sequencing. However, protein expressions and functions do not always reflect the genetic and clinical background of the disease even the existence of a pathogenic variant or vice versa. In this study, it was aimed to understand genotype-proteophenotype-clinicophenotype correlation by investigating the effect of mutation types on protein expression, function, and clinical severity in X-linked, autosomal dominant, and autosomal recessive forms of PIDs. It was searched in PubMed and Web of Science without any restrictions on study design and publication time. Totally, 1178 patients with PIDs who have 553 different mutations were investigated from 174 eligible full-text articles. For all mutations, the effect of mutation type on protein expressions and protein functions was analyzed. Furthermore, the most frequent missense and nonsense mutations that were identified in patients with PIDs were evaluated to determine the genotype-clinicophenotype correlation. Protein expressions and functions were changed depending on the mutation type and the affected domain. A significant relationship was observed between protein expression level and clinical severity among all investigated patients. There was also a positive correlation between clinical severity and the affected domains. Mutation types and affected domains should be carefully evaluated with respect to protein expression levels and functional changes during the evaluation of clinico-phenotype.
Collapse
Affiliation(s)
- Sevil Oskay Halacli
- Division of Pediatric Immunology, Department of Basic Sciences of Pediatrics, Institute of Child's Health, Hacettepe University, Ankara, Turkey.
| |
Collapse
|
19
|
Liu Q, Yu Y, Lin J, Wang Y, Ai L, Li Q, Wu W, Jin H, Li S, Liu M, Yu S, Liu T. Treatment strategy for myocarditis in patients using immune checkpoint inhibitors or combined anti-vascular endothelial growth factor therapy by clinical severity. Eur J Cancer 2021; 157:10-20. [PMID: 34464781 DOI: 10.1016/j.ejca.2021.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/01/2021] [Accepted: 07/22/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Combination of immune checkpoint inhibitor (ICI) and anti-vascular endothelial growth factor (VEGF) therapy has increasingly become a promising strategy in various tumors. However, the combination might be associated with increased cardiotoxicities. Myocarditis is a potentially fatal complication in cancer patients treated with ICI. Currently, there are no clear guidelines for the management of this disease nor data characterizing the clinical course of myocarditis patients due to the combination of ICI and anti-VEGF therapy. PATIENTS AND METHODS This study included all patients consecutively admitted to Shanghai Zhongshan Hospital, Fudan University for the diagnosis of ICI-associated myocarditis according to Bonaca's criteria. The clinical presentation and outcome of myocarditis patients were collected receiving ICI and anti-VEGF combined therapy. RESULTS A total of 48 patients were included (23 received combined treatment of ICI and anti-VEGF while 25 received ICI only). No differences in baseline characteristics, clinical course, and outcomes were observed among patients receiving ICI with or without anti-VEGF treatment. The patients were subdivided into 3 groups including 8 fulminant cases, 25 clinically significant cases, and 15 subclinical cases based on clinical severity. The fulminant group was associated with a higher rate of cardiovascular deaths (CVDs) compared with clinically significant and subclinical groups (87.5% versus 4.0% versus 0.0%, p < 0.01). When stratified by the dose of corticosteroids used, cases with high-dose usage were more likely to have a CVD when compared to low dose or no use and intermediate dose groups (0.0% versus 4.0% versus 57.1%, p < 0.01). CONCLUSIONS No significant differences between myocarditis patients receiving ICI or combined anti-VEGF therapy in terms of clinical presentation and outcome were observed. Treatment strategy for myocarditis in patients using ICI or combined anti-VEGF therapy should be based on clinical severity. Specifically, immunosuppressive therapy besides high-dose corticosteroids is needed for fulminant cases.
Collapse
Affiliation(s)
- Qing Liu
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Cancer Center, Zhongshan Hospital, 180 Fenglin Road, Shanghai, 200032, China
| | - Yiyi Yu
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Cancer Center, Zhongshan Hospital, 180 Fenglin Road, Shanghai, 200032, China
| | - Jinyi Lin
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yan Wang
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Cancer Center, Zhongshan Hospital, 180 Fenglin Road, Shanghai, 200032, China
| | - Luoyan Ai
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Cancer Center, Zhongshan Hospital, 180 Fenglin Road, Shanghai, 200032, China
| | - Qian Li
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Cancer Center, Zhongshan Hospital, 180 Fenglin Road, Shanghai, 200032, China
| | - Wei Wu
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Hang Jin
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Suyao Li
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Mengling Liu
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Shan Yu
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Cancer Center, Zhongshan Hospital, 180 Fenglin Road, Shanghai, 200032, China
| | - Tianshu Liu
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China; Cancer Center, Zhongshan Hospital, 180 Fenglin Road, Shanghai, 200032, China.
| |
Collapse
|
20
|
Nimavat N, Singh S, Singh P, Singh SK, Sinha N. Vitamin D deficiency and COVID-19: A case-control study at a tertiary care hospital in India. Ann Med Surg (Lond) 2021; 68:102661. [PMID: 34377451 PMCID: PMC8339450 DOI: 10.1016/j.amsu.2021.102661] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/31/2021] [Accepted: 08/03/2021] [Indexed: 12/20/2022] Open
Abstract
Background As the pandemic COVID-19 affected developing and developed countries, there is no proven treatment options available yet. The anti-inflammatory, antiviral and immune modulator effect of Vitamin D could be beneficial to COVID-19. Aim To find out the possible association between Vitamin D and COVID-19. Methods The present case-control study was conducted at tertiary care hospital, AIIMS, Patna, Bihar, India. Total 156 cases and 204 controls were enrolled in the study after obtaining informed consent. Categorization of the patients were done based on clinical severity and level of Vitamin D. The association between these categories with different variables were analyzed using regression analysis and other statistical tests. Results The status of Vitamin D (optimal, mild to moderate deficiency and severe deficiency) differed significantly among cases and controls. Diabetes and hypertension were most prevalent comorbidities among cases. On regression analysis, the difference in Vitamin D level was significant (aOR, 3.295; 95%CI, 1.25-8.685). The association between Vitamin D status and clinical severity group was statistically significant among cases. Among all variables, age, diabetes, hypertension and clinical severity were associated with worst outcome. Conclusion Vitamin D status appears to be strongly associated with COVID-19 clinical severity. After COVID-19 confirmation, Vitamin D level should be measured in all patients and curative plus preventive therapy should be initiated.
Collapse
Affiliation(s)
- Nirav Nimavat
- Department of Community Medicine, SBKS MIRC, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
| | - Shruti Singh
- Department of Pharmacology, AIIMS, Patna, Bihar, India
| | - Pratibha Singh
- Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Nishi Sinha
- Department of Pharmacology, AIIMS, Patna, Bihar, India
| |
Collapse
|
21
|
I Y, Karakelle S G, Aydın G T, R M, T O, Iu A. The relationship between clinical severity and outcome measures in patients with chronic venous insufficiency with or without leg ulcer. J Tissue Viability 2021; 30:310-316. [PMID: 34140210 DOI: 10.1016/j.jtv.2021.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 03/28/2021] [Accepted: 06/04/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the relationship between clinical severity and functionality, sleep quality, depression, and quality of life (QoL) in patients with CVI with or without leg ulcers. METHODS A total of sixty patients with CVI were enrolled in the study. The patients were C2-6 according to the CEAP classification. All the patients were assessed with Venous Clinical Severity Score (VCSS) for clinical severity, Visual Analog Scale (VAS) for pain, right and left lower limb (RLL and LLL) circumference measurements for edema, 6-min-walk test (6-MWT) for functional capacity, Lower Extremity Functional Scale (LEFS) for functionality, Pittsburg Sleep Quality Index (PSQI) for sleep quality, Beck Depression Inventory version I (BDI-I) for depression, and The Quality of Life Questionnaire for Chronic Venous Diseases-20 (CIVIQ-20) for QoL. RESULTS The mean age of the patients was 45.83 ± 13.25 years, and the mean duration of disease was 8.30 ± 7.42 years. There was a significant association between VCSS and VAS-rest/activity, edema-RLL/LLL, PSQI, BDI-I, LEFS, and CIVIQ-20 in patients without leg ulcers. In addition, a significant association was found between VCSS and VAS-rest/activity and CIVIQ-20 in patients with leg ulcers. CONCLUSION The current study showed that an association has been found between clinical severity and pain at rest and during activity, edema, sleep quality, depression, lower extremity function, and QoL in patients without ulcers. However, clinical severity has been correlated with only pain at rest and during activity, and QoL in patients with leg ulcers.
Collapse
Affiliation(s)
- Yeldan I
- Department of Physiotherapy and Rehabilitation, Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gürdal Karakelle S
- Department of Physiotherapy and Rehabilitation, Institute of Postgraduate Education, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Tosun Aydın G
- Department of Physiotherapy and Rehabilitation, Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Okan University, Istanbul, Turkey
| | - Mustafaoğlu R
- Department of Physiotherapy and Rehabilitation, Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Ozalhas T
- Department of Cardiovascular Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alpagut Iu
- Department of Cardiovascular Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
22
|
Ötiken Arıkan K, Şahinkaya Ş, Böncüoğlu E, Kıymet E, Cem E, Akaslan Kara A, Bayram N, Devrim İ. Can Hematological Findings of COVID-19 in Pediatric Patients Guide Physicians Regarding Clinical Severity? Turk J Haematol 2021; 38:243-245. [PMID: 33906331 PMCID: PMC8386318 DOI: 10.4274/tjh.galenos.2021.2021.0157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Kamile Ötiken Arıkan
- University of Health Sciences Turkey, İzmir Dr. Behçet Uz Children Hospital, Clinic of Pediatric Infectious Disease, İzmir, Turkey
| | - Şahika Şahinkaya
- University of Health Sciences Turkey, İzmir Dr. Behçet Uz Children Hospital, Clinic of Pediatric Infectious Disease, İzmir, Turkey
| | - Elif Böncüoğlu
- University of Health Sciences Turkey, İzmir Dr. Behçet Uz Children Hospital, Clinic of Pediatric Infectious Disease, İzmir, Turkey
| | - Elif Kıymet
- University of Health Sciences Turkey, İzmir Dr. Behçet Uz Children Hospital, Clinic of Pediatric Infectious Disease, İzmir, Turkey
| | - Ela Cem
- University of Health Sciences Turkey, İzmir Dr. Behçet Uz Children Hospital, Clinic of Pediatric Infectious Disease, İzmir, Turkey
| | - Aybüke Akaslan Kara
- University of Health Sciences Turkey, İzmir Dr. Behçet Uz Children Hospital, Clinic of Pediatric Infectious Disease, İzmir, Turkey
| | - Nuri Bayram
- University of Health Sciences Turkey, İzmir Dr. Behçet Uz Children Hospital, Clinic of Pediatric Infectious Disease, İzmir, Turkey
| | - İlker Devrim
- University of Health Sciences Turkey, İzmir Dr. Behçet Uz Children Hospital, Clinic of Pediatric Infectious Disease, İzmir, Turkey
| |
Collapse
|
23
|
Kalem AK, Kayaaslan B, Neselioglu S, Eser F, Hasanoglu İ, Aypak A, Akinci E, Akca HN, Erel O, Guner R. A useful and sensitive marker in the prediction of COVID-19 and disease severity: Thiol. Free Radic Biol Med 2021; 166:11-17. [PMID: 33588050 PMCID: PMC7880846 DOI: 10.1016/j.freeradbiomed.2021.02.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 12/11/2022]
Abstract
Thiol-disulphide homeostasis (TDH) is a new parameter indicating oxidative stress that plays a role in the pathogenesis of various clinical disorders. Our study planned to investigate TDH in COVID-19 patients. Age and gender-matched healthy subjects (n = 70) and COVID-19 patients (n = 144) were included in the study. In addition to the routine laboratory parameters of the groups, their native thiol (NT), total thiol (TT) and disulphide levels were measured. Primarily, we compared COVID-19 patients to the healthy control group for inflammatory parameters, NT, TT and disulphide levels. Then, COVID-19 patients were divided into two groups according to the severity of the disease as mild to moderate and severe COVID-19, and the three groups were compared with each other. Predictive value of thiol parameters in the diagnosis of COVID-19 and in the determining its severity, and its correlation with presence and duration of symptoms were investigated. Severe COVID-19 patients had lower NT and TT levels compared with healthy controls and mild to moderate patients (P < 0.001 for both). The results of ROC analysis show that the greatest AUC was IL-6 and NT (AUC = 0.97, AUC = 0.96, respectively) between control and COVID-19 patients, while it was CRP and NT (AUC = 0.85, AUC = 0.83) between mild to moderate and severe patients. A negative correlation was found between duration of symptoms of dyspnoea, cough, fever, and sore throat and NT (r = -0.45, P = 0.017, r = -0.418, P < 0.001, r = -0.131, P = 0.084, r = -0.452, P = 0.040, respectively). NT and TT levels have a strong predictive value in the diagnosis of COVID-19 and in determining disease severity. Our results support that changing TDH parameters appears to have an important role in disease pathogenesis and it can be used in clinical management of patients.
Collapse
Affiliation(s)
- Ayse Kaya Kalem
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
| | - Bircan Kayaaslan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Salim Neselioglu
- Department of Biochemistry, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Fatma Eser
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - İmran Hasanoglu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Adalet Aypak
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Esragul Akinci
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - H Nisa Akca
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Ozcan Erel
- Department of Biochemistry, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Guner
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| |
Collapse
|
24
|
Grover A, Oberoi M. A systematic review and meta-analysis to evaluate the clinical outcomes in COVID-19 patients on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Eur Heart J Cardiovasc Pharmacother 2021; 7:148-157. [PMID: 32542337 PMCID: PMC7314072 DOI: 10.1093/ehjcvp/pvaa064] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/28/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Abstract
Introduction Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) share their target receptor site with the SARS-CoV-2 virus, that may cause ACE2 receptor up-regulation which raised concerns regarding ACEI and ARB use in COVID-19 patients. However, many medical professional societies recommended their continued use given the paucity of clinical evidence, but there is a need for an updated systematic review and meta-analysis of the latest clinical studies. Methods and results A search was conducted on PubMed, Google Scholar, EMBASE, and various preprint servers for studies comparing clinical outcomes and mortality in COVID-19 patients on ACEIs and/or ARBs, and a meta-analysis was performed. A total of 16 studies were included for the review and meta-analysis. There were conflicting findings reported in the rates of severity and mortality in several studies. In a pooled analysis of four studies, there was a statistically non-significant association of ACEI/ARB use with lower odds of developing severe disease vs. non-users [odds ratio (OR) = 0.81, 95% confidence interval (CI): 0.41–1.58, I2=50.52, P-value = 0.53). In a pooled analysis of six studies, there was a statistically non-significant association of ACEI/ARB use with lower odds of mortality as compared with non-users (OR = 0.86, 95% CI = 0.53–1.41, I2 = 79.12, P-value = 0.55). Conclusion It is concluded that ACEIs and ARBs should be continued in COVID-19 patients, reinforcing the recommendations made by several medical societies. Additionally, the individual patient factors such as ACE2 polymorphisms which might confer higher risk of adverse outcomes need to be evaluated further.
Collapse
Affiliation(s)
- Abhinav Grover
- Internal Medicine, University of California, Irvine, School of Medicine, Irvine, CA, USA
| | - Mansi Oberoi
- Internal Medicine, University of South Dakota, Sanford School of Medicine, Sioux Falls, SD, USA
| |
Collapse
|
25
|
Sampedro F, Farrés CCI, Soler J, Elices M, Schmidt C, Corripio I, Domínguez-Clavé E, Pomarol-Clotet E, Salvador R, Pascual JC. Structural brain abnormalities in borderline personality disorder correlate with clinical severity and predict psychotherapy response. Brain Imaging Behav 2021; 15:2502-2512. [PMID: 33634348 DOI: 10.1007/s11682-021-00451-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2021] [Indexed: 11/24/2022]
Abstract
Although previous imaging studies in borderline personality disorder (BPD) have found brain abnormalities, the results have been inconsistent. This study aimed to investigate structural brain abnormalities using voxel-based morphometry (VBM) and cortical thickness (Cth) analyses in a large sample of patients with BPD. Additionally, we aimed to determine the correlation between structural abnormalities and clinical severity and to assess its potential value at predicting psychotherapeutic response. Sixty-one individuals with BPD and 19 healthy controls underwent magnetic resonance imaging. Participants with BPD completed several self-report clinical scales, received dialectical-behavioral therapy skills training and post-therapy changes in clinical scores were also recorded. Gray matter volume (GMV) and Cth differences between groups were compared. Within the BPD group, we further characterized the structural brain correlates of clinical severity and investigated the relationship between pre-therapy structural abnormalities and therapeutic response. As potential confounders we included age, sex, educational level, and total intracranial volume (the latter only in VBM analyses). Compared to controls, the BPD group showed a reduced GMV/Cth in prefrontal areas but increased GMV in the limbic structures (amygdala and parahippocampal regions). Prefrontal abnormalities correlated with higher baseline scores on impulsivity and general BPD severity. Increased GMV in the parahippocampal area correlated with a greater emotion dysregulation. Importantly, several baseline structural abnormalities correlated with worse response to psychotherapy. Patients with BPD showed a reduced GMV in the prefrontal areas but a greater GMV in the limbic structures. Several structural abnormalities (i.e. middle and inferior prefrontal areas, anterior insula, or parahippocampal area) correlated with clinical severity and could potentially be used as imaging biological correlates biomarkers to predict psychotherapy response.
Collapse
Affiliation(s)
- Frederic Sampedro
- Movement Disorders Unit Neurology Department Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Cristina Carmona I Farrés
- Department of Psychiatry Hospital de la Santa Creu i Sant Pau, C/ Sant Antoni Mª Claret, 167.08025, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
| | - Joaquim Soler
- Department of Psychiatry Hospital de la Santa Creu i Sant Pau, C/ Sant Antoni Mª Claret, 167.08025, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain. .,Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, UAB, Barcelona, Spain.
| | - Matilde Elices
- Department of Psychiatry Hospital de la Santa Creu i Sant Pau, C/ Sant Antoni Mª Claret, 167.08025, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
| | - Carlos Schmidt
- Department of Psychiatry Hospital de la Santa Creu i Sant Pau, C/ Sant Antoni Mª Claret, 167.08025, Barcelona, Spain
| | - Iluminada Corripio
- Department of Psychiatry Hospital de la Santa Creu i Sant Pau, C/ Sant Antoni Mª Claret, 167.08025, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, UAB, Barcelona, Spain
| | - Elisabet Domínguez-Clavé
- Department of Psychiatry Hospital de la Santa Creu i Sant Pau, C/ Sant Antoni Mª Claret, 167.08025, Barcelona, Spain
| | - Edith Pomarol-Clotet
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Raymond Salvador
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Juan C Pascual
- Department of Psychiatry Hospital de la Santa Creu i Sant Pau, C/ Sant Antoni Mª Claret, 167.08025, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain.,Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, UAB, Barcelona, Spain
| |
Collapse
|
26
|
Park KS. Carrier frequency and predicted genetic prevalence of Pompe disease based on a general population database. Mol Genet Metab Rep 2021; 27:100734. [PMID: 33717985 PMCID: PMC7933537 DOI: 10.1016/j.ymgmr.2021.100734] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 02/15/2021] [Accepted: 02/15/2021] [Indexed: 12/15/2022] Open
Abstract
Background The genetic prevalence of Pompe disease was estimated based on the proportion of individuals who have a causative genotype in a general population database. In addition, clinical severity for causative genotypes was assessed based on currently available locus-specific databases (LSDBs), which contain information on both genotype and clinical severity. Methods Genetic variants in the GAA gene in the Genome Aggregation Database (gnomAD) (v2.1.1) were analyzed in combination with LSDBs of ClinVar, ClinGen Evidence Repository, Pompe disease GAA variant database, and the Pompe Registry. Carrier frequency (CF) and predicted genetic prevalence (pGP) were estimated. Results Of 7 populations, East Asian and African showed higher proportions of pathogenic or likely pathogenic variants (PLPVs) associated with classic infantile-onset Pompe disease. Total CF and pGP in the overall population were 1.3% (1 in 77) and 1:23,232, respectively. The highest pGP was observed in the East Asian population at 1:12,125, followed by Non-Finnish European (1:13,756), Ashkenazi Jewish (1:22,851), African/African-American (1:26,560), Latino/Admixed American (1:57,620), South Asian (1:93,087), and Finnish (1:1,056,444). Conclusions Pompe disease has a higher pGP (1:23,232) than earlier accepted (1:40,000). The pGP for Pompe disease was expectedly wide by population and consistent with previous reports based on newborn screening programs (approximately 1:10,000-1:30,000).
Collapse
Affiliation(s)
- Kyung Sun Park
- Department of Laboratory Medicine, Kyung Hee University School of Medicine and Kyung Hee University Medical Center, Seoul, Republic of Korea
| |
Collapse
|
27
|
Spitz MA, Severac F, Obringer C, Baer S, Le May N, Calmels N, Laugel V. Diagnostic and severity scores for Cockayne syndrome. Orphanet J Rare Dis 2021; 16:63. [PMID: 33536051 PMCID: PMC7860636 DOI: 10.1186/s13023-021-01686-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/06/2021] [Indexed: 11/23/2022] Open
Abstract
Background Cockayne syndrome is a progressive multisystem genetic disorder linked to defective DNA repair and transcription. This rare condition encompasses a very wide spectrum of clinical severity levels ranging from severe prenatal onset to mild adult-onset subtypes. The rarity, complexity and variability of the disease make early diagnosis and severity assessment difficult. Based on similar approaches in other neurodegenerative disorders, we propose to validate diagnostic and severity scores for Cockayne syndrome. Methods Clinical, imaging and genetic data were retrospectively collected from 69 molecularly confirmed CS patients. A clinical diagnostic score and a clinical-radiological diagnostic score for CS were built using a multivariable logistic regression model with a stepwise variable selection procedure. A severity score for CS was designed on five items (head circumference, growth failure, neurosensorial signs, motor autonomy, communication skills) and validated by comparison with classical predefined severity subtypes of CS. Results Short stature, enophtalmos, hearing loss, cataracts, cutaneous photosensitivity, frequent dental caries, enamel hypoplasia, morphological abnormalities of the teeth, areflexia and spasticity were included in the clinical diagnostic score as being the most statistically relevant criteria. Appropriate weights and thresholds were assigned to obtain optimal sensitivity and specificity (95.7% and 86.4% respectively). The severity score was shown to be able to quantitatively differentiate classical predefined subtypes of CS and confirmed the continuous distribution of the clinical presentations in CS. Longitudinal follow-up of the severity score was able to reflect the natural course of the disease. Conclusion The diagnostic and severity scores for CS will facilitate early diagnosis and longitudinal evaluation of future therapeutic interventions. Prospective studies will be needed to confirm these findings.
Collapse
Affiliation(s)
- M A Spitz
- Service de Pédiatrie Spécialisée et Générale, Unité de Neurologie Pédiatrique, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - F Severac
- Groupe Méthode en Recherche Clinique, Service de Santé Publique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Laboratoire de Biostatistique et d'Informatique Médicale, ICube, UMR 7357, Faculté de Médecine, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - C Obringer
- Laboratoire de Génétique Médicale, Institut de Génétique Médicale d'Alsace, Faculté de Médecine de Strasbourg, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - S Baer
- Service de Pédiatrie Spécialisée et Générale, Unité de Neurologie Pédiatrique, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - N Le May
- Laboratoire de Génétique Médicale, Institut de Génétique Médicale d'Alsace, Faculté de Médecine de Strasbourg, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - N Calmels
- Laboratoire de Diagnostic Génétique, Institut de Génétique Médicale d'Alsace, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - V Laugel
- Service de Pédiatrie Spécialisée et Générale, Unité de Neurologie Pédiatrique, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. .,Laboratoire de Génétique Médicale, Institut de Génétique Médicale d'Alsace, Faculté de Médecine de Strasbourg, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
| |
Collapse
|
28
|
Nair AV, Kumar D, Yadav SK, Nepal P, Jacob B, Al-Heidous M. Utility of visual coronary artery calcification on non-cardiac gated thoracic CT in predicting clinical severity and outcome in COVID-19. Clin Imaging 2021; 74:123-130. [PMID: 33485116 PMCID: PMC7834505 DOI: 10.1016/j.clinimag.2021.01.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/28/2020] [Accepted: 01/15/2021] [Indexed: 12/12/2022]
Abstract
Background Assessment of visual-coronary artery calcification on non-cardiac gated CT in COVID-19 patients could provide an objective approach to rapidly identify and triage clinically severe patients for early hospital admission to avert worse prognosis. Purpose To ascertain the role of semi-quantitative scoring in visual-coronary artery calcification score (V-CACS) for predicting the clinical severity and outcome in patients with COVID-19. Materials and methods With institutional review board approval this study included 67 COVID-19 confirmed patients who underwent non-cardiac gated CT chest in an inpatient setting. Two blinded radiologist (Radiologist-1 &2) assessed the V-CACS, CT Chest severity score (CT-SS). The clinical data including the requirement for oxygen support, assisted ventilation, ICU admission and outcome was assessed, and patients were clinically subdivided depending on clinical severity. Logistic regression analyses were performed to identify independent predictors. ROC curves analysis is performed for the assessment of performance and Pearson correlation were performed to looks for the associations. Results V-CACS cut off value of 3 (82.67% sensitivity and 54.55% specificity; AUC 0.75) and CT-SS with a cut off value of 21.5 (95.7% sensitivity and 63.6% specificity; AUC 0.87) are independent predictors for clinical severity and also the need for ICU admission or assisted ventilation. The pooling of both CT-SS and V-CACS (82.67% sensitivity and 86.4% specificity; AUC 0.92) are more reliable in terms of predicting the primary outcome of COVID-19 patients. On regression analysis, V-CACS and CT-SS are individual independent predictors of clinical severity in COVID-19 (Odds ratio, 1.72; 95% CI, 0.99–2.98; p = 0.05 and Odds ratio, 1.22; 95% CI, 1.08–1.39; p = 0.001 respectively). The area under the curve (AUC) for pooled V-CACS and CT-SS was 0.96 (95% CI 0.84–0.98) which correctly predicted 82.1% cases. Conclusion Logistic regression model using pooled Visual-Coronary artery calcification score and CT Chest severity score in non-cardiac gated CT can predict clinical severity and outcome in patients with COVID-19.
Collapse
Affiliation(s)
| | | | | | - Pankaj Nepal
- Frank H Netter School Of Medicine, Quinnipac University, CT, USA.
| | - Bamil Jacob
- Al Wakra Hospital, Hamad Medical Corporation, Qatar.
| | | |
Collapse
|
29
|
Hashemi-Madani N, Emami Z, Janani L, Khamseh ME. Typical chest CT features can determine the severity of COVID-19: A systematic review and meta-analysis of the observational studies. Clin Imaging. 2021;74:67-75. [PMID: 33444992 PMCID: PMC7837254 DOI: 10.1016/j.clinimag.2020.12.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 12/03/2020] [Accepted: 12/30/2020] [Indexed: 01/08/2023]
Abstract
Background It remains unclear whether a specific chest CT characteristic is associated with the clinical severity of COVID-19. This meta-analysis was performed to assess the relationship between different chest CT features and severity of clinical presentation in COVID-19. Methods PubMed, Embase, Scopus, web of science databases (WOS), Cochrane library, and Google scholar were searched up to May 19, 2020 for observational studies that assessed the relationship of different chest CT manifestations and the severity of clinical presentation in COVID-19 infection. Risk of bias assessment was evaluated applying the Newcastle-Ottawa Scale. A random-effects model or fixed-effects model, as appropriately, were used to pool results. Heterogeneity was assessed using Forest plot, Cochran's Q test, and I2. Publication bias was assessed applying Egger's test. Results A total of 18 studies involving 3323 patients were included. Bronchial wall thickening (OR 11.64, 95% CI 1.81–74.66) was more likely to be associated with severe cases of COVID-19 infection, followed by crazy paving (OR 7.60, 95% CI 3.82–15.14), linear opacity (OR 3.27, 95% CI 1.10–9.70), and GGO (OR 1.37, 95% CI 1.08–1.73). However, there was no significant association between the presence of consolidation and severity of clinical presentation (OR 2.33, 95% CI 0.85–6.36). Considering the lesion distribution bilateral lung involvement was more frequently associated with severe clinical presentation (OR 3.44, 95% CI 1.74–6.79). Conclusions Our meta-analysis of observational studies indicates some specific chest CT features are associated with clinical severity of COVID-19.
Collapse
|
30
|
McGuire JF, Piacentini J, Storch EA, Ricketts EJ, Woods DW, Peterson AL, Walkup JT, Wilhelm S, Ramsey K, Essoe JKY, Himle MB, Lewin AB, Chang S, Murphy TK, McCracken JT, Scahill L. Defining tic severity and tic impairment in Tourette Disorder. J Psychiatr Res 2021; 133:93-100. [PMID: 33338735 PMCID: PMC7867408 DOI: 10.1016/j.jpsychires.2020.12.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Treatment guidelines for Tourette's Disorder (TD) are based on patients' degree of tic severity and impairment. However, clear benchmarks for determining tic severity and impairment have not been established. This study examined benchmarks of tic severity and tic impairment using the Yale Global Tic Severity Scale (YGTSS) and the Clinical Global Impression of Severity (CGI-S). METHOD Individuals with TD or another Tic Disorder (N = 519) recruited across nine sites were administered a diagnostic interview, the YGTSS, and the CGI-S. Correlations and trend analyses contrasted YGTSS scores across CGI-S ratings. A logistic regression model examined predictive benchmarks for tic severity, tic impairment, and global severity. Model classifications were compared against CGI-S ratings, and agreement was examined using kappa. RESULTS Spearman correlations between the CGI-S and YGTSS scores ranged from 0.54 to 0.63 (p < 0.001). Greater CGI-S ratings were associated with a linear stepwise increase in YGTSS Total Tic scores, Impairment scores, and Global Severity scores. Despite moderate-to-strong associations (ρ = 0.45-0.56, p < 0.001) between the CGI-S and predictive logistical regression models, only fair agreement was achieved when applying classification benchmarks (κ = 0.21-0.32, p < 0.001). CONCLUSIONS CGI-S ratings are useful to characterize benchmarks for tic severity, tic impairment, and global severity on the YGTSS. Logistic regression model benchmarks had only fair agreement with the CGI-S and underscore the heterogeneity of TD symptoms. Collectively, findings offer guidance on the delineation of tic severity categorizations to apply evidence-based treatment recommendations.
Collapse
Affiliation(s)
- Joseph F McGuire
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA; Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, USA.
| | - John Piacentini
- Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, USA
| | - Eric A Storch
- Department of Psychiatry, Baylor College of Medicine, USA
| | - Emily J Ricketts
- Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, USA
| | | | - Alan L Peterson
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, USA; Research and Development Service, South Texas Veterans Health Care System, USA; Department of Psychology, University of Texas at San Antonio, USA
| | - John T Walkup
- Ann and Robert H. Lurie Children's Hospital of Chicago, USA
| | - Sabine Wilhelm
- Massachusetts General Hospital and Harvard Medical School, USA
| | - Kesley Ramsey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - Joey K-Y Essoe
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | | | - Adam B Lewin
- Departments of Pediatrics, Psychiatry and Behavioral Neuroscience, University of South Florida, USA
| | - Susanna Chang
- Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, USA
| | - Tanya K Murphy
- Departments of Pediatrics, Psychiatry and Behavioral Neuroscience, University of South Florida, USA; All Children's Hospital, Johns Hopkins Medicine, USA
| | - James T McCracken
- Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, USA
| | | |
Collapse
|
31
|
Vassallo M, Manni S, Pini P, Blanchouin E, Ticchioni M, Seitz-Polski B, Puchois A, Sindt A, Lotte L, Fauque P, Durant J. Patients with Covid-19 exhibit different immunological profiles according to their clinical presentation. Int J Infect Dis 2020; 101:174-179. [PMID: 33002623 PMCID: PMC7521203 DOI: 10.1016/j.ijid.2020.09.1438] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES A novel beta coronavirus has been identified as responsible for the 2019 coronavirus infection (Covid-19). Clinical presentations range from asymptomatic cases to acute respiratory distress syndrome with fatal outcome. Such a broad spectrum of disease expression calls for an investigation of immune response characteristics. METHODS We identified subjects admitted for Covid-19 in whom a large panel of immunological markers were measured, including B- and T- and NK-lymphocyte phenotypes, T-lymphocyte subpopulation cells and plasma cytokines. Patients were divided according to symptom severity during hospitalisation, in those with uncomplicated and complicated infection. Differences between groups were analyzed. RESULTS Seventeen patients were included (mean age: 83 years; 9 women; mean delay of symptoms onset: 4 days). Six had uncomplicated infection, while 11 developed complicated forms during hospitalization. CD10 + B lymphocyte levels were inversely correlated with clinical severity (5.8% vs 2.0%, p = 0.04) and CD10+ levels above 3% were independently associated with uncomplicated forms [Odds Ratio 0.04 (CI 0.002-0.795, p = 0.034)]. TNF-alpha, IL-1, Il-6 and Il-8 measurements upon admission differed between patients who died and those who survived (p < 0.01 for all comparisons). CONCLUSIONS In a population of elderly patients recently infected with Covid-19, CD10 + B cell levels were inversely correlated with clinical severity. Cytokine values upon admission were highly predictive of fatal outcome during hospitalisation. These findings could explain differences in the clinical presentation and allow rapid identification of patients at risk for complications.
Collapse
Affiliation(s)
- M Vassallo
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France.
| | - S Manni
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France
| | - P Pini
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France
| | - E Blanchouin
- Department of Internal Medicine/Infectious Diseases, Cannes General Hospital, Cannes, France
| | - M Ticchioni
- Laboratory of Immunology, Nice University Hospital, Université Côte d'Azur, Nice, France
| | - B Seitz-Polski
- Laboratory of Immunology, Nice University Hospital, Université Côte d'Azur, Nice, France
| | - A Puchois
- Multipurpose Laboratory, Bacteriology and Virology Unit, Cannes General Hospital, Cannes, France
| | - A Sindt
- Multipurpose Laboratory, Bacteriology and Virology Unit, Cannes General Hospital, Cannes, France
| | - L Lotte
- Multipurpose Laboratory, Bacteriology and Virology Unit, Cannes General Hospital, Cannes, France
| | - P Fauque
- Institut Polyclinique de Cannes (IPOCA), Cannes, France
| | - J Durant
- Infectious Diseases Department, Nive University Hospital, Université Côte d'Azur, Nice, France
| |
Collapse
|
32
|
Song C, Li Y, Zhou Y, Liang L, Turtle L, Wang F, Wu P, Qiu Q, Yang J, Wang K, Cui P, Cheng Y, Zhang T, Guo C, Zeng M, Long L, Peiris M, Zhou C, Cowling BJ, Yu H. Enterovirus genomic load and disease severity among children hospitalised with hand, foot and mouth disease. EBioMedicine 2020; 62:103078. [PMID: 33161231 PMCID: PMC7653080 DOI: 10.1016/j.ebiom.2020.103078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/24/2020] [Accepted: 10/06/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Examining associations between viral genomic loads of enteroviruses and clinical severity is important for promoting and improving development of antiviral drugs related to hand, foot and mouth disease (HFMD). METHODS Throat swabs were collected from HFMD cases at acute phase of illness using a standardized technique in a prospective study. The viral genomic load was categorized into low, medium, and high groups using parameters of real-time reverse transcription-polymerase chain reaction. The clinical severities were assessed with four indicators, respectively. FINDINGS We analysed 1109 HFMD cases, including 538 children with CV-A6, 231 with CV-A16, 156 with EV-A71, 78 with CV-A10, 59 with CV-A4, and 47 with CV-A2. EV-A71 genomic load categories were associated with risks of diagnoses of CNS complications (p = 0.016), requiring systemic corticosteroids or IVIG (p = 0.011), intensive care unit admission (p = 0.002) and length of hospital stay over 5 days (p = 0.048). In the multivariate analyses, point estimates of adjusted odds ratio (OR) tended to increase with viral genomic loads for all four severe outcomes and ORs of highest viral genomic load were all significantly larger than one for EV-A71. INTERPRETATION HFMD clinical severities positively associate with viral genomic loads of EV-A71 in throat swabs. Specific antiviral drugs should be developed to reduce enterovirus load and to alleviate the clinical severities for HFMD cases. FUNDING National Science Fund for Distinguished Young Scholars.
Collapse
Affiliation(s)
- Chunlan Song
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
| | - Yu Li
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yonghong Zhou
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Lu Liang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Lance Turtle
- NIHR Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom; Tropical & Infectious Disease Unit, Royal Liverpool University Hospital (member of Liverpool Health Partners), Liverpool, United Kingdom
| | - Fang Wang
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
| | - Peng Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Qi Qiu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jianli Yang
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
| | - Kai Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Peng Cui
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Yibing Cheng
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
| | - Tianchen Zhang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chun Guo
- School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Mengyao Zeng
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; NHC key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Medical School, Fudan University, Shanghai, China
| | - Lu Long
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Malik Peiris
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Chongchen Zhou
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China.
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
| |
Collapse
|
33
|
Ma X, Wang XH, Li L. Identifying individuals with autism spectrum disorder based on the principal components of whole-brain phase synchrony. Neurosci Lett 2020; 742:135519. [PMID: 33246027 DOI: 10.1016/j.neulet.2020.135519] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/03/2020] [Accepted: 11/19/2020] [Indexed: 11/29/2022]
Abstract
Autism spectrum disorder (ASD) is a brain disorder that develops during an early stage of childhood. Previous neuroimaging-based diagnostic models for ASD were based on static functional connectivity (FC). The nonlinear complexity of brain connectivity remains unexplored for ASD diagnosis. This study aimed to build intelligent discriminative models for ASD based on phase synchrony (PS). To this end, data from 49 patients with ASD and 41 healthy controls were obtained from the Autism Brain Imaging Data Exchange (ABIDE) project. PS between brain regions was determined using Hilbert transform. Principal component analysis (PCA) and support vector machines (SVMs) were used to build the discriminative models. PS-based models (AUC = 0.81) outperformed static FC-based models (AUC = 0.71). Furthermore, embedded functional biomarkers were discovered. Moreover, significant correlations were found between PCA-PS and the clinical severity of ASD. Together, intelligent discriminative models based on PS were established for ASD identification. The performance of the diagnostic models suggested the potential benefits of PS for clinical applications. The discriminative patterns indicated that PCA-PS features could be additional biomarkers for ASD research. Furthermore, the significant relationships between the PCA-PS features and clinical scores implied their potential use for personalized medication strategies.
Collapse
Affiliation(s)
- Xueke Ma
- Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Xun-Heng Wang
- Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Lihua Li
- Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, Hangzhou, 310018, China.
| |
Collapse
|
34
|
Raesi A, Saedi Dezaki E, Moosapour H, Saeidifard F, Habibi Z, Rahmani F, Kheiri S, Taheri E. Hypocalcemia in Covid-19: A Prognostic Marker for Severe Disease. Iran J Pathol 2020; 16:144-153. [PMID: 33936225 PMCID: PMC8085287 DOI: 10.30699/ijp.2020.130491.2442] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/25/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND & OBJECTIVE Previous studies have addressed the electrolyte abnormalities such as hypocalcemia in COVID-19 patients. We aimed to compare the laboratory findings especially the electrolyte levels among COVID-19 patients and healthy controls and evaluate their prognostic values. METHODS This case-control study included 91 COVID-19 patients and 169 healthy individuals. Their laboratory parameters including electrolytes, albumin, liver enzymes, complete blood count, vitamin D, and parathyroid hormone (PTH) were compared. We also analyzed the association between these markers and the major outcomes including severity, mortality and hospitalization. RESULTS Among patients with COVID-19, 59.3% of the patients had hypocalcemia on admission while in control group only 32.5% had low calcium level (OR=3.02, 95% CI: 1.79-5.13, P<0.001). The rates of death and ICU admission were significantly higher among the patients in hypocalcemic group than those of eucalcemic group (85.7% vs 14.3% and 33.3% Vs 9.1%, respectively). However, there was no significant difference in the mean PTH and vitamin D levels between the two groups. In terms of the severity of the infection, 74.1% of patients in hypocalcemic group had a severe infection while 24.3% of the patients in eucalcemic group were diagnosed with severe infection (OR=8.89, 95% CI: 3.38-23.37, P<0.001). CONCLUSION Patients with COVID-19 may present with considerable laboratory abnormalities including hypocalcemia. The hypocalcemia would be also associated with worse major clinical outcome and higher mortality risk.
Collapse
Affiliation(s)
- Ahmad Raesi
- Department of Internal Medicine, Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Ebrahim Saedi Dezaki
- Department of Parasitology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Hamideh Moosapour
- Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzane Saeidifard
- Department of Medicine, Northwell Health-Lenox Hill Hospital, Zucker School of Medicine at Hofstra/Northwell, New York, United States of America (USA)
- Division of Preventive Cardiology, Department of Cardiovascular Disease, Mayo Clinic, Rochester, United States of America (USA)
| | - Zahra Habibi
- Department of Internal Medicine, Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Fereidoun Rahmani
- Department of Infectious Disease, Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Soleiman Kheiri
- Department of Epidemiology and Biostatistics, School of Health, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Elham Taheri
- Molecular Pathology and Cytogenetic Ward, Pathology Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
35
|
Tedla K, Medhin G, Berhe G, Mulugeta A, Berhe N. Delay in treatment initiation and its association with clinical severity and infectiousness among new adult pulmonary tuberculosis patients in Tigray, northern Ethiopia. BMC Infect Dis 2020; 20:456. [PMID: 32600284 PMCID: PMC7325053 DOI: 10.1186/s12879-020-05191-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/22/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Delayed treatment initiation of tuberculosis (TB) increases disease progression and development of complications which may lead to a higher level of infectiousness, clinical severity and increased mortality. But published evidences that investigated the effect of delayed initiation of treatment on clinical severity and level of infectiousness of pulmonary tuberculosis patients is scarce in Tigray, Northern Ethiopia. OBJECTIVE To investigate the association of delayed treatment initiation of new adult Pulmonary Tuberculosis patients with clinical severity and level of infectiousness. METHODS In this cross-sectional study design, a total of 875 newly diagnosed adult pulmonary tuberculosis patients were recruited from 21 health facilities from October 2018 to October 2019. Health facilities and study participants were selected by a simple random sampling method. Data were collected using questionnaires through face-to-face interviews of patients within the first 2 weeks of treatment initiation. Clinical severity was assessed by Bandim tuberculosis score and level of infectiousness was assessed by smear positivity or lung cavitations. Data were analyzed using SPSS version 21 software program. Logistic regression analysis was used to ascertain the association of delay with clinical severity and level of infectiousness. P-BMC Public Health of less than 0.05 was reported as being statistically significant. RESULTS Those who had initiated treatment without delay and those who have initiated treatment after a medium delay of 31 to 60 days were significantly associated with decreased clinical score compared to those who initiated treatment after a delay of more than two months. Compared with patients who have initiated treatment within one month, the level of infectiousness was greater for delay of 30-60 days and above 60 days. Patients having more than 3 family members have higher level of infectiousness as compared to those who have a maximum of 3 family members. Whereas, patients having at least two rooms and being HIV negative had lower levels of infectiousness compared to their counter patients. CONCLUSION Narrowing the gap between their initial occurrence of TB symptoms and treatment initiation is the way forward to improve clinical courses of TB patients and to reduce the level of infectiousness of TB to other people from these patients.
Collapse
Affiliation(s)
- Kiros Tedla
- Institute of Biomedical Science, College of Health Science, Mekelle University, Mekelle, Ethiopia.
| | - Girmay Medhin
- Aklillu Lema Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gebretsadik Berhe
- School of Public Health, College of Health Science, Mekelle University, Mekelle, Ethiopia
| | - Afework Mulugeta
- School of Public Health, College of Health Science, Mekelle University, Mekelle, Ethiopia
| | - Nega Berhe
- Aklillu Lema Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
36
|
Díaz-Fernández S, Frías-Ortiz DF, Fernández-Miranda JJ. Suicide attempts in people with schizophrenia before and after participating in an intensive case managed community program: A 20-year follow-up. Psychiatry Res 2020; 287:112479. [PMID: 31377009 DOI: 10.1016/j.psychres.2019.112479] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 07/09/2019] [Accepted: 07/09/2019] [Indexed: 01/22/2023]
Abstract
Lack of treatment compliance in patients with schizophrenia is a risk factor that leads to illness-relapse, hospitalization and potentially strengthens suicidal behavior. The purpose of this investigation was to assess treatment adherence, reasons for treatment discharge, suicidal behaviour and impact of route of antipsychotics administration in a group of patients with schizophrenia treated in a comprehensive, community-based, intensive case managed program for people with severe mental illness. And to compare it to previous standard treatment received in mental health units (MHU). An observational, longitudinal, mirror-image study of patients with severe schizophrenia (N = 344) was carried out: ten years of follow-up (Program) and ten years retrospective (MHU). Reasons for treatment discharge, suicide attempts and antipsychotic (AP) medication were recorded. Treatment adherence during the Program was higher than in MHU (abandonment of treatment: 12.2% vs. 84.3% of patients). Forty patients died during follow-up, five of them due to suicide. Suicidal attempts significantly decreased during Program treatment compared to the standard one (7.6% vs. 38.9% of patients). Long-acting injectable (LAI) AP medication was significantly related to this outcome. A combination of intensive case-managed and LAIAP treatment helped to improve compliance and to reduce suicidal behavior compared to standard treatment in patients with severe schizophrenia.
Collapse
Affiliation(s)
- Sylvia Díaz-Fernández
- Centro de Tratamiento Integral-AGC SM-HUCAB-SESPAsturian Mental Health Service, Gijón, Spain; Health Sciences Dt. Camilo J Cela University, Madrid, Spain
| | - Danny F Frías-Ortiz
- Centro de Tratamiento Integral-AGC SM-HUCAB-SESPAsturian Mental Health Service, Gijón, Spain; Health Sciences Dt. Camilo J Cela University, Madrid, Spain
| | - Juan J Fernández-Miranda
- Centro de Tratamiento Integral-AGC SM-HUCAB-SESPAsturian Mental Health Service, Gijón, Spain; Health Sciences Dt. Camilo J Cela University, Madrid, Spain.
| |
Collapse
|
37
|
Chen J, Zhu H, Horby PW, Wang Q, Zhou J, Jiang H, Liu L, Zhang T, Zhang Y, Chen X, Deng X, Nikolay B, Wang W, Cauchemez S, Guan Y, Uyeki TM, Yu H. Specificity, kinetics and longevity of antibody responses to avian influenza A(H7N9) virus infection in humans. J Infect 2020; 80:310-319. [PMID: 31954742 PMCID: PMC7112568 DOI: 10.1016/j.jinf.2019.11.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/26/2019] [Accepted: 11/08/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The long-term dynamics of antibody responses in patients with influenza A(H7N9) virus infection are not well understood. METHODS We conducted a longitudinal serological follow-up study in patients who were hospitalized with A(H7N9) virus infection, during 2013-2018. A(H7N9) virus-specific antibody responses were assessed by hemagglutination inhibition (HAI) and neutralization (NT) assays. A random intercept model was used to fit a curve to HAI antibody responses over time. HAI antibody responses were compared by clinical severity. RESULTS Of 67 patients with A(H7N9) virus infection, HAI antibody titers reached 40 on average 11 days after illness onset and peaked at a titer of 290 after three months, and average titers of ≥80 and ≥40 were present until 11 months and 22 months respectively. HAI antibody responses were significantly higher in patients who experienced severe disease, including respiratory failure and acute respiratory distress syndrome, compared with patients who experienced less severe illness. CONCLUSIONS Patients with A(H7N9) virus infection who survived severe disease mounted higher antibody responses that persisted for longer periods compared with those that experienced moderate disease. Studies of convalescent plasma treatment for A(H7N9) patients should consider collection of donor plasma from survivors of severe disease between 1 and 11 months after illness onset.
Collapse
Affiliation(s)
- Junbo Chen
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - Huachen Zhu
- Joint Institute of Virology (STU-HKU), Shantou University, Shantou 515041, China; State Key Laboratory of Emerging Infectious Diseases, School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Peter W Horby
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Qianli Wang
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - Jiaxin Zhou
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - Hui Jiang
- Beijing Chest Hospital, Capital Medical University, Beijing 101149, China; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
| | - Liwei Liu
- Joint Institute of Virology (STU-HKU), Shantou University, Shantou 515041, China
| | - Tianchen Zhang
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang 330000, China
| | - Yongli Zhang
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xinhua Chen
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - Xiaowei Deng
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - Birgit Nikolay
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, 75015 Paris, France
| | - Wei Wang
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, Institut Pasteur, UMR2000, CNRS, 75015 Paris, France
| | - Yi Guan
- Joint Institute of Virology (STU-HKU), Shantou University, Shantou 515041, China; State Key Laboratory of Emerging Infectious Diseases, School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Hongjie Yu
- School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Building 8, 130 Dong'an Road, Xuhui District, Shanghai 200032, China.
| |
Collapse
|
38
|
D'Souza NS, Nebel MB, Wymbs N, Mostofsky SH, Venkataraman A. A joint network optimization framework to predict clinical severity from resting state functional MRI data. Neuroimage 2020; 206:116314. [PMID: 31678501 PMCID: PMC7985860 DOI: 10.1016/j.neuroimage.2019.116314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/23/2019] [Accepted: 10/24/2019] [Indexed: 01/24/2023] Open
Abstract
We propose a novel optimization framework to predict clinical severity from resting state fMRI (rs-fMRI) data. Our model consists of two coupled terms. The first term decomposes the correlation matrices into a sparse set of representative subnetworks that define a network manifold. These subnetworks are modeled as rank-one outer-products which correspond to the elemental patterns of co-activation across the brain; the subnetworks are combined via patient-specific non-negative coefficients. The second term is a linear regression model that uses the patient-specific coefficients to predict a measure of clinical severity. We validate our framework on two separate datasets in a ten fold cross validation setting. The first is a cohort of fifty-eight patients diagnosed with Autism Spectrum Disorder (ASD). The second dataset consists of sixty three patients from a publicly available ASD database. Our method outperforms standard semi-supervised frameworks, which employ conventional graph theoretic and statistical representation learning techniques to relate the rs-fMRI correlations to behavior. In contrast, our joint network optimization framework exploits the structure of the rs-fMRI correlation matrices to simultaneously capture group level effects and patient heterogeneity. Finally, we demonstrate that our proposed framework robustly identifies clinically relevant networks characteristic of ASD.
Collapse
Affiliation(s)
- N S D'Souza
- Department of Electrical and Computer Engineering, Johns Hopkins University, USA.
| | - M B Nebel
- Center for Neurodevelopmental & Imaging Research, Kennedy Krieger Institute, USA
| | - N Wymbs
- Center for Neurodevelopmental & Imaging Research, Kennedy Krieger Institute, USA
| | - S H Mostofsky
- Center for Neurodevelopmental & Imaging Research, Kennedy Krieger Institute, USA; Department of Neurology, Johns Hopkins School of Medicine, USA; Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, USA
| | - A Venkataraman
- Department of Electrical and Computer Engineering, Johns Hopkins University, USA
| |
Collapse
|
39
|
Thomas P, He F, Mazumdar S, Wood J, Bhatia T, Gur RC, Gur RE, Buysse D, Nimgaonkar VL, Deshpande SN. Joint analysis of cognitive and circadian variation in Schizophrenia and Bipolar I Disorder. Asian J Psychiatr 2018; 38:96-101. [PMID: 29158147 PMCID: PMC5938152 DOI: 10.1016/j.ajp.2017.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 10/20/2017] [Accepted: 11/06/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Impairment in cognitive variables and alterations in circadian function have been documented among patients with schizophrenia (SZ) and bipolar I disorder (BP1), but it is not known whether joint analysis of these variables can define clinically relevant sub-groups in either disorder. OBJECTIVES To evaluate the pattern and relationship of cognitive and circadian function in SZ and BP1 patients with respect to diagnosis and indices of clinical severity. METHODS Among patients with SZ and BP1, cognitive function was evaluated using the Penn Computerized Neurocognitive Battery and circadian function was assessed using the Composite Scale of Morningness/ Eveningness (CSM). Clinical severity was estimated using the Global Assessment of Function (GAF) scale, and age at onset of illness (AAO). The patients were compared with community based non-psychotic control individuals and non-psychotic first degree relatives of the SZ patients. The cluster distributions of cognitive function, circadian function and clinical severity were investigated and identified clusters compared across diagnostic groups. RESULTS Across participants, the cognitive domains could be separated into two clusters. Cluster 1 included the majority of control individuals and non-psychotic relatives, while SZ patients predominated in Cluster 2. BP1 patients were distributed across both clusters. The clusters could be differentiated by GAF scores, but not AAO. CSM scores were not significantly correlated with individual cognitive domains or with the clusters. CONCLUSIONS Clusters based on levels of cognitive function can discriminate SZ patients from control individuals, but not BP1 patients. CSM scores do not contribute to such discrimination.
Collapse
Affiliation(s)
- Pramod Thomas
- Department of Community medicine, Believers Church Medical College, Thiruvalla, Kerala, India.
| | - Fanyin He
- Department of Biostatistics and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sati Mazumdar
- Department of Biostatistics and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joel Wood
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Triptish Bhatia
- Indo-US Projects, Department of Psychiatry, Centre of Excellence in Mental Health, Post Graduate Institute of Medical Education and Research-Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel Buysse
- Sleep and Chronobiology Center, Department of Psychiatry, Western Psychiatric Institute and Clinic, 3811 O'Hara St. University of Pittsburgh, School of Medicine, Pittsburgh PA, USA
| | - Vishwajit L Nimgaonkar
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA; Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Smita N Deshpande
- Department of Psychiatry, Centre of Excellence in Mental Health, Post Graduate Institute of Medical Education and Research- Dr. Ram Manohar Lohia Hospital, New Delhi, India
| |
Collapse
|
40
|
Zhang B, Wang Y, Zhong Y, Liao S, Lu Z. Serum 25-hydroxyvitamin D deficiency predicts poor outcome among acute ischemic stroke patients without hypertension. Neurochem Int 2018; 118:91-95. [PMID: 29729873 DOI: 10.1016/j.neuint.2018.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 04/15/2018] [Accepted: 05/02/2018] [Indexed: 10/17/2022]
Abstract
25-Hydroxyvitamin D (25(OH)D) deficiency is a frequent condition in patients who suffer acute ischemic stroke (AIS), and several studies suggested that it may be associated with a poorer prognosis. Whether this association is affected by hypertension is unclear. Our aim was to investigate the association between 25(OH)D levels and both clinical severity and outcome after 3 months in AIS patients stratified by the history of hypertension. Consecutive first-ever AIS patients admitted to the Third Affiliated Hospital of Sun Yat-sen University, China were identified. Clinical information was collected. Serum 25(OH)D levels were measured at baseline. Stroke severity was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS) score. Functional outcome was evaluated after 3 months of onset using the modified Rankin Scale (mRS). Multivariate analyses were performed using logistic regression models. During the study period, 377 patients were diagnosed as AIS and were included in the analysis. 25(OH)D deficiency was not associated with the risk of NIHSS at admission and 3 months mRS both in total patients and the hypertension subgroup. Among AIS without hypertension, 25(OH)D deficiency subjects had a significantly higher of NIHSS at admission and 3 months mRS compared with those with 25(OH)D ≥ 50 nmol/L. The odds ratios (95% confidence interval) were 5.51(1.83-16.60) and 4.63(1.53-14.05) in the multivariable adjusted model (P for linear trend < 0.05). Serum lower 25(OH)D levels can be seen as an independent prognostic factor of functional outcome in AIS without hypertension. Additional studies about improving prognosis of AIS by vitamin D supplementation could be first applied to these patients.
Collapse
Affiliation(s)
- Bingjun Zhang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuge Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yi Zhong
- Department of Dermatology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Siyuan Liao
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhengqi Lu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
| |
Collapse
|
41
|
Oggiano R, Solinas G, Forte G, Bocca B, Farace C, Pisano A, Sotgiu MA, Clemente S, Malaguarnera M, Fois AG, Pirina P, Montella A, Madeddu R. Trace elements in ALS patients and their relationships with clinical severity. Chemosphere 2018; 197:457-466. [PMID: 29366958 DOI: 10.1016/j.chemosphere.2018.01.076] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 01/06/2018] [Accepted: 01/15/2018] [Indexed: 06/07/2023]
Abstract
An exploratory study of trace elements in ALS and their relationships with clinical severity was detected. Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder that causes irreversible damage in humans, with the consequent loss of function of motoneurons (MNs), with a prognosis up to 5 years after diagnosis. Except to genetic rare cases it is not known the etiology of the disorder. Aim of our research is to investigate the possible role of heavy metals in the severity of the disease. In this study, by the use of plasma mass (ICP-MS), we have analyzed the content of essential and heavy metals such: Pb, Cd, Al, Hg, Mn, Fe, Cu, Zn, Se, Mg, and Ca, in blood, urine and hair of ALS patients and controls; moreover we divided the patients in two groups for disease severity and analyzed the difference among the groups, in order to study a possible involvement of metals in the severity of the damage. Our results suggest a protective role of Selenium, involved in protective antioxidant mechanisms, and a risk factor in the case of presence of Lead in blood. The levels of the other metals are not easy to interpret, because these may be due to life style and for essential metals a consequence of the disease condition, not a cause.
Collapse
Affiliation(s)
- Riccardo Oggiano
- Department of Biomedical Sciences - Histology, University of Sassari, Sassari, Italy
| | - Giuliana Solinas
- Department of Biomedical Sciences - Hygiene, University of Sassari, Sassari, Italy
| | - Giovanni Forte
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Beatrice Bocca
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Cristiano Farace
- Department of Biomedical Sciences - Histology, University of Sassari, Sassari, Italy
| | - Andrea Pisano
- Department of Biomedical Sciences - Histology, University of Sassari, Sassari, Italy
| | | | | | - Michele Malaguarnera
- Department of Medical and Pediatric Science, Research Centre "The Great Senescence", University of Catania, Catania, Italy
| | - Alessandro Giuseppe Fois
- Department of Clinical and Experimental Medicine - Institute of Respiratory Diseases, University of Sassari, Sassari, Italy
| | - Pietro Pirina
- Department of Clinical and Experimental Medicine - Institute of Respiratory Diseases, University of Sassari, Sassari, Italy
| | - Andrea Montella
- Department of Biomedical Sciences- Human Anatomy, University of Sassari, Sassari, Italy
| | - Roberto Madeddu
- Department of Biomedical Sciences - Histology, University of Sassari, Sassari, Italy; National Institute of Biostructures and Biosystems, Rome, Italy.
| |
Collapse
|
42
|
Kaneko K, Arakawa R, Urano M, Aoki R, Saito K. Relationships between long-term observations of motor milestones and genotype analysis results in childhood-onset Japanese spinal muscular atrophy patients. Brain Dev 2017; 39:763-773. [PMID: 28601407 DOI: 10.1016/j.braindev.2017.04.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 04/28/2017] [Accepted: 04/28/2017] [Indexed: 12/11/2022]
Abstract
AIM To clarify the long-term natural history of SMA in Japanese patients by investigating the peak motor milestones of cases 7months through 57years of age, in efforts to contribute to evaluating outcomes of new therapeutic interventions. METHODS We sub-classified 112 SMA type I-III cases into type Ia, type Ib, type IIa, type IIb, type IIIa and type IIIb, according to peak motor milestone achieved, and analyzed the SMN1, SMN2 and NAIP genes in relation to clinical subtypes. RESULTS In type I cases, there was a significant difference (p<0.0001), depending on whether or not head control was obtained, in the time of ventilation support being required. In type II cases as well, the time at which the ability to maintain the sitting position independently was lost also differed significantly (p<0.01) between those acquiring the ability to sit unaided within eight months after birth and those acquiring this ability after eight months of age. In type III cases, being able versus unable to climb stairs was associated with a significant difference (p=0.02) in the median time until loss of walking independently. Positive correlations were also seen between copy numbers and the clinical severity of SMA. CONCLUSION Our long-term results show peak motor milestone evaluations distinguishing between subtypes to be useful not only as outcome measures for assessing treatment efficacy in clinical trials but also for predicting the clinical courses of Japanese SMA patients.
Collapse
Affiliation(s)
- Kaori Kaneko
- Affiliated Field of Medical Genetics, Division of Biomedical Engineering and Science, Graduate Course of Medicine, Graduate School of Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Reiko Arakawa
- Institute of Medical Genetics, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Mari Urano
- Institute of Medical Genetics, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Ryoko Aoki
- Institute of Medical Genetics, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Kayoko Saito
- Affiliated Field of Medical Genetics, Division of Biomedical Engineering and Science, Graduate Course of Medicine, Graduate School of Tokyo Women's Medical University, Shinjuku, Tokyo, Japan; Institute of Medical Genetics, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
| |
Collapse
|
43
|
Yeh YC, Wang PW, Huang MF, Lin PC, Chen CS, Ko CH. The procrastination of Internet gaming disorder in young adults: The clinical severity. Psychiatry Res 2017; 254:258-262. [PMID: 28482194 DOI: 10.1016/j.psychres.2017.04.055] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 04/22/2017] [Accepted: 04/23/2017] [Indexed: 02/07/2023]
Abstract
Young adults with Internet gaming disorder (IGD) usually postpone the tasks of their daily lives to engage in Internet gaming. This study evaluates the association between procrastination and IGD and the association between the negative consequences of IGD and procrastination. We recruited 87 individuals with IGD and 87 controls without a history of IGD. All participants underwent a diagnostic interview based on the DSM-5 IGD criteria to assess the clinical global score. They also completed questionnaires regarding IGD, procrastination, impulsivity, depression, and hostility. Young adults with IGD had higher levels of procrastination. Procrastination was positively associated with depression, hostility, and impulsivity. After controlling for depression, hostility, and impulsivity, procrastination was still found to be associated with IGD. Further, procrastination was positively associated with the clinical global impressions score among young adults with IGD. Procrastination is associated with IGD independent of depression, hostility, and impulsivity. Procrastination is also associated with the clinical severity of IGD. The results suggest that procrastination should be carefully evaluated and intervention should be taken with young adults with IGD. This intervention might attenuate the negative consequences of IGD.
Collapse
Affiliation(s)
- Yi-Chun Yeh
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807 Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City 807, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
| | - Peng-Wei Wang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807 Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City 807, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
| | - Mei-Feng Huang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807 Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City 807, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
| | - Pai-Cheng Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City 807, Taiwan; Department of psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Cheng-Sheng Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City 807, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City 807, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan; Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung City 812, Taiwan.
| |
Collapse
|
44
|
Chang L, Zhang J, Liu L, Huang Z, Han Y, Zhu Y. Fatty acid binding protein 4 is associated with stroke risk and severity in patients with acute ischemic stroke. J Neuroimmunol 2017; 311:29-34. [PMID: 28781090 DOI: 10.1016/j.jneuroim.2017.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 07/13/2017] [Accepted: 07/18/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The role of fatty acid-binding proteins (FABPs) in atherosclerosis has been investigated. The aim of this study was to verify the hypothesis that higher levels of serum FABP4 could be a biomarker for stroke and associated with stroke severity in Chinese patients with ischemic stroke. METHODS All consecutive patients with first-ever acute ischemic stroke from September 2015 to August 2016 were recruited to participate in the study. Serum FABP4 levels and routine tests were examined at admission. The National Institutes of Health Stroke Scale (NIHSS) score was assessed on admission blinded to FABP4 levels. RESULTS We recorded 277 stroke patients. There was a significant difference in median serum FABP4 levels between stroke patients and control cases (P<0.001). Serum FABP4 levels increased with increasing severity of stroke as defined by the NIHSS score. The result illustrates the time course of serum FABP4, showing significant changes with day of sampling, with peak levels on day 1, falling to a plateau by days 2 to 5. At admission, 129 patients (46.6%) had a minor stroke (NIHSS≤5). In these patients, the median serum FABP4 level was lower than that observed in patients with moderate-to-sever clinical severity (P<0.001). In multivariate models comparing the second, third, and fourth quartiles against the first quartile of the FABP4, levels of FABP4 were associated with stroke risk and severity. CONCLUSION High levels of FABP4 are significantly related to stroke risk and severity, independent from other traditional and emerging risk factors, suggesting that they may play a role in stroke pathogenesis.
Collapse
Affiliation(s)
- Li Chang
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
| | - Jianlong Zhang
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Li Liu
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Zhen Huang
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Yingbo Han
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Yanyan Zhu
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| |
Collapse
|
45
|
Scudeller L, Bassetti M, Concia E, Corrao S, Cristini F, De Rosa FG, Del Bono V, Durante-Mangoni E, Falcone M, Menichetti F, Tascini C, Tumbarello M, Venditti M, Viale P, Viscoli C, Mazzone A. MEDical wards Invasive Candidiasis ALgorithms (MEDICAL):Consensus proposal for management. Eur J Intern Med 2016; 34:45-53. [PMID: 27495949 DOI: 10.1016/j.ejim.2016.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 07/06/2016] [Accepted: 07/08/2016] [Indexed: 01/27/2023]
Abstract
INTRODUCTION A majority of invasive Candida infections occur in medical wards; however, evidence for management in this setting is scarce and based primarily on the intensive care or surgical setting. On behalf of the Italian Society for Anti-Infective Therapy (SITA) and the Italian Federation of Associations of Hospital Doctors on Internal Medicine (FADOI), the MEDICAL group produced practical management algorithms for patients in internal medicine wards. METHODS The MEDICAL group panel, composed of 30 members from internal medicine, infectious disease, clinical pharmacology, clinical microbiology and clinical epidemiology, provided expert opinion through the RAND/UCLA method. RESULTS Seven clinical scenarios were constructed based on clinical severity and probability of invasive candidiasis. For each scenario, the appropriateness of 63 different diagnostic, imaging, management, or therapeutic procedures was determined in two Delphi rounds. The necessity for performing each appropriate procedure, was then determined in a third Delphi round. Results were summarized in algorithms. DISCUSSION The proposed algorithms provide internal medicine physicians and managers with an easy to interpret tool that is exhaustive, clear and suitable for adaption to individual local settings. Attention was paid to individual patient management and resource allocation.
Collapse
Affiliation(s)
- Luigia Scudeller
- Clinical Epidemiology Unit, Scientific Direction, IRCCS, Policlinico San Matteo Foundation, Pavia, Italy.
| | - Matteo Bassetti
- Infectious Diseases Division, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Ercole Concia
- Section of Infectious Diseases, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata, Policlinico G B Rossi, Verona, Italy
| | - Salvatore Corrao
- Department of Internal Medicine, National Relevance Hospital Trust, ARNAS Civico, Di Cristina e Benfratelli, Palermo, Di.Bi.M.I.S., University of Palermo, Italy
| | - Francesco Cristini
- Infectious Diseases Unit, Teaching Hospital Policlinico S. Orsola-Malpighi Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Valerio Del Bono
- Clinic of Infectious Diseases, IRCCS San Martino-IST, University of Genova, Genova, Italy
| | - Emanuele Durante-Mangoni
- Internal Medicine Section, Department of Cardiothoracic Sciences, and Division of Infectious and Transplant Medicine, Second University of Naples at Monaldi Hospital, Napoli, Italy
| | - Marco Falcone
- Department of Public Health and Infectious Diseases, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | | | - Carlo Tascini
- Infectious Disease Department, Cisanello Hospital, Pisa, Italy
| | - Mario Tumbarello
- Infectious Diseases Institute, Policlinico Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Pierluigi Viale
- Infectious Diseases Unit, Teaching Hospital Policlinico S. Orsola-Malpighi Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Claudio Viscoli
- Clinic of Infectious Diseases, IRCCS San Martino-IST, University of Genova, Genova, Italy
| | - Antonino Mazzone
- Internal Medicine Department, Hospital of Legnano, Legnano, Italy
| |
Collapse
|
46
|
Calvet J, Orellana C, Gratacós J, Berenguer-Llergo A, Caixàs A, Chillarón JJ, Pedro-Botet J, García-Manrique M, Navarro N, Larrosa M. Synovial fluid adipokines are associated with clinical severity in knee osteoarthritis: a cross-sectional study in female patients with joint effusion. Arthritis Res Ther 2016; 18:207. [PMID: 27629533 PMCID: PMC5024464 DOI: 10.1186/s13075-016-1103-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/26/2016] [Indexed: 12/20/2022] Open
Abstract
Background Adipokines are related to knee osteoarthritis, but their exact role is not well known. The aim of this study was to evaluate the association between adipokines in synovial fluid and clinical severity in patients with knee osteoarthritis with joint effusion. Methods Cross-sectional study with systematic inclusion of female patients with symptomatic primary knee osteoarthritis with ultrasound-confirmed joint effusion. Age, physical exercise, knee osteoarthritis symptoms duration, classical cardiovascular risk factors and different anthropometric measurements were collected. Metabolic syndrome was defined in accordance to National Cholesterol Education Program-Adult Treatment Panel III. Radiographic severity was evaluated according to Kellgren-Lawrence scale and Lequesne index was used to assess clinical severity. Seven adipokines (leptin, adiponectin, resistin, visfatin, osteopontin, omentin and chemerin) and three inflammatory markers (tumor necrosis factor α, interleukin 6 and high sensitivity C-reactive protein) were measured by enzyme-linked immunosorbent assay in synovial fluid. Results Kellgren-Lawrence grade, physical exercise, all anthropometric measurements (especially waist circumference), tumor necrosis factor α, and high levels of leptin, resistin, and ostepontin were related to knee osteoarthritis severity. After adjustment for clinical confounders (age, symptom duration, and radiology), anthropometric measurements, inflammatory markers, and all evaluated adipokines, there were independent associations with clinical severity for resistin (directly associated) and visfatin (inversely associated). No other adipokines or inflammatory markers were independently associated with Lequesne index. The association of radiological parameters, physical exercise, and waist circumference with Lequesne index remained after adjustment. Conclusions Resistin was directly associated, and visfatin was inversely associated, with clinical severity in female patients with knee osteoarthritis with joint effusion. These associations were more important after adjustment for confounders, especially when all adipokines were evaluated. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-1103-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Joan Calvet
- Rheumatology Department, Parc Tauli Sabadell University Hospital, Institute for Research and Innovation Parc Tauli (I3PT), Universitat Autónoma de Barcelona (UAB), 08208, Sabadell, Spain. .,Departament de Medicina, Universitat Autónoma de Barcelona (UAB), 08003, Barcelona, Spain.
| | - Cristóbal Orellana
- Rheumatology Department, Parc Tauli Sabadell University Hospital, Institute for Research and Innovation Parc Tauli (I3PT), Universitat Autónoma de Barcelona (UAB), 08208, Sabadell, Spain
| | - Jordi Gratacós
- Rheumatology Department, Parc Tauli Sabadell University Hospital, Institute for Research and Innovation Parc Tauli (I3PT), Universitat Autónoma de Barcelona (UAB), 08208, Sabadell, Spain.,Departament de Medicina, Universitat Autónoma de Barcelona (UAB), 08003, Barcelona, Spain
| | - Antoni Berenguer-Llergo
- Biostatistics and Bioinformatics Unit, Institute for Research in Biomedicine Barcelona (IRB Barcelona), 08028, Barcelona, Spain
| | - Assumpta Caixàs
- Endocrinology and Nutrition Department, Parc Tauli Sabadell University Hospital, Institute for Research and Innovation Parc Tauli (I3PT), Universitat Autónoma de Barcelona (UAB), 08208, Sabadell, Spain
| | - Juan José Chillarón
- Departament de Medicina, Universitat Autónoma de Barcelona (UAB), 08003, Barcelona, Spain.,Endocrinology and Nutrition Department, Hospital del Mar, 08003, Barcelona, Spain
| | - Juan Pedro-Botet
- Departament de Medicina, Universitat Autónoma de Barcelona (UAB), 08003, Barcelona, Spain.,Endocrinology and Nutrition Department, Hospital del Mar, 08003, Barcelona, Spain
| | - María García-Manrique
- Rheumatology Department, Parc Tauli Sabadell University Hospital, Institute for Research and Innovation Parc Tauli (I3PT), Universitat Autónoma de Barcelona (UAB), 08208, Sabadell, Spain
| | - Noemí Navarro
- Rheumatology Department, Parc Tauli Sabadell University Hospital, Institute for Research and Innovation Parc Tauli (I3PT), Universitat Autónoma de Barcelona (UAB), 08208, Sabadell, Spain
| | - Marta Larrosa
- Rheumatology Department, Parc Tauli Sabadell University Hospital, Institute for Research and Innovation Parc Tauli (I3PT), Universitat Autónoma de Barcelona (UAB), 08208, Sabadell, Spain
| |
Collapse
|
47
|
Lasure N, Gopalkrishna V. Clinico-epidemiology and genetic diversity of Salivirus in acute gastroenteritis cases from Pune, Western India: 2007-2011. Infect Genet Evol 2016; 44:425-430. [PMID: 27491456 DOI: 10.1016/j.meegid.2016.07.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/29/2016] [Accepted: 07/31/2016] [Indexed: 12/21/2022]
Abstract
Acute gastroenteritis is a leading cause of mortality in children from developing countries. Recently, Salivirus has been frequently detected in acute gastroenteritis patients, suggesting its possible aetiological role. Conflicting reports available on disease association of Salivirus have made it difficult to ascertain their causative role. The overall epidemiology and clinical features of Salivirus infections are poorly understood. The present five year study was undertaken to investigate the presence and genetic diversity of Salivirus in acute gastroenteritis cases from Pune, Western India and to determine the clinico-epidemiological features of Salivirus infections. A total of 985 faecal samples (778 acute gastroenteritis and 207 asymptomatic controls), collected from three local hospitals (Jan2007-Dec2011) were examined for the presence of Salivirus by RT-PCR. Molecular characterization was performed by PCR amplification of the 3D and VP regions. Frequency of Salivirus detection in cases (2.6%) and controls (1.93%) was not significantly different (p = 0.57). Co-infection with other enteric viruses was seen in 50% of the cases. Comparison of clinical features between Salivirus mono and mixed infections revealed that Salivirus alone did not exacerbate gastroenteritis. The frequency of diarrhoea and overall clinical severity of mixed infections was significantly greater than mono infections (p = 0.02). Based on clinical findings, our study suggests that Salivirus does not cause severe gastroenteritis. Phylogenetic analysis indicated that study strains belonged to Salivirus A1 and formed 2 distinct clusters which shared nucleotide identities of 94.1-96.2% and 88.9-93.8% between themselves in 3D and VP regions, respectively. Interestingly, the more divergent Cluster2 strains shared a low nucleotide identity with the closest reference strain in both regions (~95% in 3D and ~92% in VP) suggesting that they could represent a variant type of Salivirus A1. The genetic diversity in strains detected from study region, emphasizes the need for Salivirus surveillance from other regions of India.
Collapse
Affiliation(s)
- N Lasure
- Enteric Viruses Group, National Institute of Virology, 20-A. Dr. Ambedkar Road, Pune 411001, India
| | - V Gopalkrishna
- Enteric Viruses Group, National Institute of Virology, 20-A. Dr. Ambedkar Road, Pune 411001, India.
| |
Collapse
|
48
|
Kim H, Lee SA, Kim BJ. X region mutations of hepatitis B virus related to clinical severity. World J Gastroenterol 2016; 22:5467-5478. [PMID: 27350725 PMCID: PMC4917607 DOI: 10.3748/wjg.v22.i24.5467] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/17/2016] [Accepted: 06/02/2016] [Indexed: 02/06/2023] Open
Abstract
Chronic hepatitis B virus (HBV) infection remains a major health problem, with more than 240 million people chronically infected worldwide and potentially 650000 deaths per year due to advanced liver diseases including liver cirrhosis and hepatocellular carcinoma (HCC). HBV-X protein (HBx) contributes to the biology and pathogenesis of HBV via stimulating virus replication or altering host gene expression related to HCC. The HBV X region contains only 465 bp encoding the 16.5 kDa HBx protein, which also contains several critical cis-elements such as enhancer II, the core promoter and the microRNA-binding region. Thus, mutations in this region may affect not only the HBx open reading frame but also the overlapped cis-elements. Recently, several types of HBx mutations significantly associated with clinical severity have been described, although the functional mechanism in most of these cases remains unsolved. This review article will mainly focus on the HBx mutations proven to be significantly related to clinical severity via epidemiological studies.
Collapse
|
49
|
Shim JO, Chang JY, Shin S, Moon JS, Ko JS. Changing distribution of age, clinical severity, and genotypes of rotavirus gastroenteritis in hospitalized children after the introduction of vaccination: a single center study in Seoul between 2011 and 2014. BMC Infect Dis 2016; 16:287. [PMID: 27296987 DOI: 10.1186/s12879-016-1623-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 06/04/2016] [Indexed: 01/07/2023] Open
Abstract
Background This study aimed to explore changes in clinical epidemiology and genotype distribution and their association among hospitalized children with rotavirus gastroenteritis after the introduction of vaccines. Methods Between November 2010 and October 2014, hospitalized children with acute gastroenteritis were enrolled. Rotavirus genotypes were confirmed through reverse transcription-polymerase chain reaction (RT-PCR), semi-nested PCR, and sequencing. Clinical information including vaccination status and the modified Vesikari scores were collected. Results Among 179 children with rotavirus infection, nineteen (10.6 %) were completely vaccinated. During the study period, the number of children between three and 23 months of age decreased significantly compared to the number of children older than 24 months of age (P = 0.010), who showed lower diarrhea severity (duration, P = 0.042; frequency, P = 0.021) but higher vomiting severity (P = 0.007, 0.036) compared to the former. Vaccination status was also significantly associated with lower vomiting severity after adjustment for age (frequency only, P = 0.018). The predominant genotypes were G2P[4] (18.4 %), G1P[8] (14.5 %), and G1P[4]P[8] (12.8 %), and the prevalence of genotypes with uncommon and mixed combinations was more than 50 %. Children infected with G2P[4] strains tended to be older (P = 0.005) and had more severe vomiting (P = 0.018, 0.006) than those with G1P[8]. Conclusions Increase in age of infected, hospitalized children was accompanied by change in clinical severity during 2011–2014 after the introduction of vaccines in Seoul. Clinical severity was also associated with vaccination status and genotype. Long-term large scale studies are needed to document the significance of the increase in genotypes of uncommon and mixed combinations. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1623-y) contains supplementary material, which is available to authorized users.
Collapse
|
50
|
Achakzai H, Shah H, Zahid SB, Zuhaid M. Hypovitaminosis-D: Frequency and association of clinical disease with biochemical levels in adult patients of RMI Medical OPD. Pak J Med Sci 2016; 32:394-8. [PMID: 27182247 PMCID: PMC4859030 DOI: 10.12669/pjms.322.9172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background and Objective: Vitamin D is steroid hormone essential for maintaining many important functions in the body. Hypovitaminosis D has become worldwide problem affecting all age groups and both genders, but its prevalence is very high in South Asia. Therefore this study was aimed to determine frequency of hypovitaminosis D in adult patients of RMI Medical Out Patients Department (OPD) and find association of clinical disease with biochemical levels. Methods: It was a cross sectional study carried out on all patients visiting RMI Medical OPD from 1st Jan, 2015 to 30th April, 2015 with clinical indications using universal sampling technique involving 400 subjects. Data was analyzed using SPSS 16. Results: Out of 400 subjects 85(21.3%) were males, 315(78.8%) were females, biochemical hydroxyvitamin-D3 deficiency was present in 320 (80%) subjects with 86(21.5%) having severe deficiency, 176(44%) having moderate deficiency and 58(14.5%) having mild deficiency. There was statistically significant association between biochemical deficiency and severity of clinical disease manifestation, calculated using chi square test. (p < 0.001). Conclusion: Most of the patient with musculoskeletal symptoms had vitamin D deficiency affecting all age groups and mostly female gender. There is a statistically significant association between low biochemical hydroxyvitamin-D3 levels and severity of clinical signs and symptoms which can provide evidence for replacement therapies in rural and far flung areas where biochemical assays are not available. Early recognition and replacement can prevent the massive complications, which deficiency of vitamin D makes us prone to develop.
Collapse
Affiliation(s)
- Humaira Achakzai
- Humaira Achakzai, MBBS, FCPS, Assistant Professor, Department of Medicine, Rehman Medical Institute, Peshawar, Pakistan
| | - Hammad Shah
- Hammad Shah, MBBS, Resident Trainee FCPS, Department of Medicine, Rehman Medical Institute, Peshawar, Pakistan
| | - Shahzada Bakhtyar Zahid
- Shahzada Bakhtyar Zahid, MBBS, MRCPCH (UK), Associate Professor, Department of Pediatrics, Rehman Medical Institute, Peshawar, Pakistan
| | - Muhammad Zuhaid
- Muhammad Zuhaid, MBBS, Resident Trainee, Department of Medicine, Rehman Medical Institute, Peshawar, Pakistan
| |
Collapse
|