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Ferguson LT, Rashied AA, Liang Z, Yumoto T, Anyalebechi JC, Swift DA, Hernandes MS, Krafty RT, Coopersmith CM, Lee VK. A Novel Scoring System for Humane Endpoints in Mice with Cecal Ligation and Puncture-Induced Sepsis. Comp Med 2023; 73:446-460. [PMID: 38217069 PMCID: PMC10752367 DOI: 10.30802/aalas-cm-22-000124] [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: 12/02/2022] [Revised: 01/26/2023] [Accepted: 03/14/2023] [Indexed: 01/14/2024]
Abstract
Animal-based research is essential to the study of sepsis pathophysiology, diagnostics, and therapeutics. However, animal models of sepsis are often associated with high mortality because of the difficulty in predicting imminent death based on premortem assessment of the animals. The use of validated visual scoring would allow researchers to systematically identify humane endpoints but visual approaches require high interobserver agreement for accurate results. The objective of this study was to establish a scoring system for mice undergoing cecal ligation and puncture (CLP)-induced sepsis based on 3 visual parameters: respiratory status, activity and response to stimulus (ASR), and eye appearance, with scores ranging from 0 to 3. In the first study, we evaluated interobserver agreement. Veterinary and investigative staff assessed 283 mice with CLP and had substantial to near-perfect agreement for all 3 parameters as evaluated using weighted Cohen κ statistic. The second study assessed the ability of the scoring system and temperature to predict death. The scoring system and subcutaneous transpond- ers were used to monitor C57BL/6J mice (n = 80, male and female) until death or for 7 days after CLP. Results showed that the scoring system discriminates between surviving (n = 26) and nonsurviving (n = 54) septic mice. The scoring system was accurate in predicting death, with an AUC of 0.8997. The sensitivity and specificity of the ASR parameter were 96% and 92%, respectively, and for the eye parameter were 94% and 73%. A sum of the ASR and eye scores that was 5 or more was also predictive of death. Temperature was a quantitative predictor, with sensitivity and specificity of 93% and 92%, respectively. This scoring system refines the CLP model by allowing identification of humane endpoints and avoidance of spontaneous death.
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Affiliation(s)
| | - Ammar A Rashied
- Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia; and
| | - Zhe Liang
- Department of Surgery and Emory Critical Care Center, Emory University School of Medicine and Emory Healthcare, Atlanta, Georgia
| | - Tetsuya Yumoto
- Department of Surgery and Emory Critical Care Center, Emory University School of Medicine and Emory Healthcare, Atlanta, Georgia
- Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Kita-ku, Okayama, Japan
| | - Jerome C Anyalebechi
- Department of Surgery and Emory Critical Care Center, Emory University School of Medicine and Emory Healthcare, Atlanta, Georgia
| | - David A Swift
- Department of Surgery and Emory Critical Care Center, Emory University School of Medicine and Emory Healthcare, Atlanta, Georgia
| | - Marina S Hernandes
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Robert T Krafty
- Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia; and
| | - Craig M Coopersmith
- Department of Surgery and Emory Critical Care Center, Emory University School of Medicine and Emory Healthcare, Atlanta, Georgia
| | - Vanessa K Lee
- Division of Animal Resources, Emory University, Atlanta, Georgia
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Taylor LA, Saleh MN, Kneese EC, Vemulapalli TH, Verocai GG. Comparison of 3 Diagnostic Tests for the Detection of Giardia and Cryptosporidium spp. in Asymptomatic Dogs ( Canis lupis familiaris). J Am Assoc Lab Anim Sci 2023; 62:139-146. [PMID: 36878482 PMCID: PMC10078926 DOI: 10.30802/aalas-jaalas-22-000108] [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] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/13/2022] [Accepted: 01/17/2023] [Indexed: 03/08/2023]
Abstract
After detecting Giardia and Cryptosporidium infections and coinfections in 2 litters of puppies in our vivarium, our team realized that we needed a simple, quick, and economical point-of-care test for concurrent screening of asymptomatic dogs for both organisms. Periodic screening of colony dogs and of all dogs introduced into a colony can prevent the spread of Giardia and Cryptosporidium to immunologically naïve animals and help keep staff safe from these zoonotic organisms. To compare methods for diagnosing Giardia and Cryptosporidium spp. in dogs, we used a convenience sampling of feces from 2 popula- tions of dogs; samples were tested with a lateral-flow assay (QC), a commercially-available direct fluorescent assay (DFA), and an inhouse PCR test using established primers. QC results were analyzed in 2 ways: 1) relative to a reference standard that permitted comparative interpretation of DFA and PCR results; and 2) using Bayesian analysis for comparison independent of a reference standard. The QC test showed good specificity for the detection of Giardia according to both the reference standard (95%) and the Bayesian analysis (98%). Similarly, specificity of the QC for the detection of Cryptosporidium was 95% according to the reference standard and 97% according to Bayesian analysis. However, the sensitivity of the QC test was much lower for both Giardia (reference standard, 38%; Bayesian analysis, 48%) and Cryptosporidium (25% and 40%, respectively). This study demonstrates that the QC test can be used to detect both Giardia and Cryptosporidium in dogs and that positive results can be accepted with confidence, whereas negative tests should be confirmed through secondary testing methods.
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Affiliation(s)
- Loni A Taylor
- Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas; Comparative Medicine Program, Texas A&M University, College Station, Texas;,
| | - Meriam N Saleh
- Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas
| | - Eric C Kneese
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Tracy H Vemulapalli
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Guilherme G Verocai
- Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas
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Aysun Tekin, Shahraz Qamar, Mayank Sharma, Romil Singh, Michael Malinchoc, Vikas Bansal, Neha Deo, Marija Bogojevic, Diana J. Valencia-Morales, Simon Zec, Nika Zorko-Garbajs, Nikhil Sharma, Amos Lal, Devang K. Sanghavi, Rodrigo Cartin-Ceba, Syed A. Khan, Abigail T. La Nou, Anusha Cherian, Igor Borisovich-Zabolotskikh, Vishakha K. Kumar, Rahul Kashyap, Allan J. Walkey, Juan P. Domecq, Hemang Yadav, Ognjen Gajic, Yewande E. Odeyemi, Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group$. Development and Validation of an Acute Respiratory Distress Syndrome Prediction Model in Coronavirus Disease-2019: Updated Lung Injury Prediction Score. Mayo Clin Proc 2022. [PMID: 37028977 PMCID: PMC9800809 DOI: 10.1016/j.mayocp.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/05/2022] [Accepted: 11/22/2022] [Indexed: 01/01/2023]
Abstract
Objective To develop and validate an updated lung injury prediction score (c-LIPS) tailored for predicting acute respiratory distress syndrome (ARDS) in coronavirus disease-2019. Patients and Methods This was a registry-based cohort study using the Viral Infection and Respiratory Illness Universal Study. Hospitalized adult patients between January 2020 and January 2022 were screened. Patients who qualified for ARDS within the first day of admission were excluded. Development cohort consisted of patients enrolled from participating Mayo Clinic sites. The validation analyses were carried out on remaining patients enrolled from more than 120 hospitals in 15 countries. The original LIPS was calculated and enhanced using reported COVID-19 specific laboratory risk factors, constituting c-LIPS. The main outcome was ARDS development and secondary outcomes included hospital mortality, invasive mechanical ventilation, progression in World Health Organization ordinal scale. Results The derivation cohort consisted of 3710 patients, of whom 28% developed ARDS. The c-LIPS discriminated COVID-19 patients who developed ARDS with an AUC of 0.79 compared to original LIPS (AUC 0.74, P<.001) with good calibration accuracy (Hosmer-Lemeshow P=.50). Despite different characteristics of the two cohorts, the c-LIPS’s performance was comparable in the validation cohort of 5426 patients (16% ARDS), with an AUC of 0.74; and its discriminatory performance was significantly higher than the LIPS (AUC 0.68, P<.001). The c-LIPS’s performance in predicting the requirement for invasive mechanical ventilation in derivation and validation cohorts had an AUC of 0.74 and 0.72, respectively. Conclusion In this large patient sample c-LIPS was successfully tailored to predict ARDS in COVID-19 patients.
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Key Words
- ards, acute respiratory distress syndrome
- arf, acute respiratory failure
- ast, aspartate aminotransferase
- auc, area under the curve
- c-lips, lung injury prediction score for covid-19 patients
- covid-19, coronavirus disease 2019
- crp, c-reactive protein
- hfnc, high flow nasal cannula
- iqr, interquartile range
- lips, lung injury prediction score
- pao2/fio2, partial pressure of arterial oxygen to fractional inspired oxygen ratio
- roc, receiver operating characteristic
- sccm, society of critical care medicine
- spo2, oxygen saturation
- virus, viral infection and respiratory illness universal study
- who, world health organization
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Gupta A, Kachur SM, Tafur JD, Patel HK, Timme DO, Shariati F, Rogers KD, Morin DP, Lavie CJ. Development and Validation of a Multivariable Risk Prediction Model for COVID-19 Mortality in the Southern United States. Mayo Clin Proc 2021; 96:3030-3041. [PMID: 34863394 PMCID: PMC8445799 DOI: 10.1016/j.mayocp.2021.09.002] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/06/2021] [Accepted: 09/10/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate clinical characteristics of patients admitted to the hospital with coronavirus disease 2019 (COVID-19) in Southern United States and development as well as validation of a mortality risk prediction model. PATIENTS AND METHODS Southern Louisiana was an early hotspot during the pandemic, which provided a large collection of clinical data on inpatients with COVID-19. We designed a risk stratification model to assess the mortality risk for patients admitted to the hospital with COVID-19. Data from 1673 consecutive patients diagnosed with COVID-19 infection and hospitalized between March 1, 2020, and April 30, 2020, was used to create an 11-factor mortality risk model based on baseline comorbidity, organ injury, and laboratory results. The risk model was validated using a subsequent cohort of 2067 consecutive hospitalized patients admitted between June 1, 2020, and December 31, 2020. RESULTS The resultant model has an area under the curve of 0.783 (95% CI, 0.76 to 0.81), with an optimal sensitivity of 0.74 and specificity of 0.69 for predicting mortality. Validation of this model in a subsequent cohort of 2067 consecutively hospitalized patients yielded comparable prognostic performance. CONCLUSION We have developed an easy-to-use, robust model for systematically evaluating patients presenting to acute care settings with COVID-19 infection.
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Affiliation(s)
- Aashish Gupta
- John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA; University of Queensland School of Medicine, Brisbane, Australia.
| | - Sergey M Kachur
- John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA; University of Queensland School of Medicine, Brisbane, Australia; Department of Medicine, University of Central Florida School of Medicine, Orlando, FL
| | - Jose D Tafur
- John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA; University of Queensland School of Medicine, Brisbane, Australia
| | - Harsh K Patel
- Department of Medicine, Ochsner Clinic Foundation, New Orleans, LA
| | - Divina O Timme
- Department of Medicine, Ochsner Clinic Foundation, New Orleans, LA
| | | | - Kristen D Rogers
- Department of Medicine, Ochsner Clinic Foundation, New Orleans, LA
| | - Daniel P Morin
- John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA; University of Queensland School of Medicine, Brisbane, Australia
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA; University of Queensland School of Medicine, Brisbane, Australia
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de Gonzalo-Calvo D, Benítez ID, Pinilla L, Carratalá A, Moncusí-Moix A, Gort-Paniello C, Molinero M, González J, Torres G, Bernal M, Pico S, Almansa R, Jorge N, Ortega A, Bustamante-Munguira E, Gómez JM, González-Rivera M, Micheloud D, Ryan P, Martinez A, Tamayo L, Aldecoa C, Ferrer R, Ceccato A, Fernández-Barat L, Motos A, Riera J, Menéndez R, Garcia-Gasulla D, Peñuelas O, Torres A, Bermejo-Martin JF, Barbé F. Circulating microRNA profiles predict the severity of COVID-19 in hospitalized patients. Transl Res 2021; 236:147-159. [PMID: 34048985 PMCID: PMC8149473 DOI: 10.1016/j.trsl.2021.05.004] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/04/2021] [Accepted: 05/20/2021] [Indexed: 12/13/2022]
Abstract
We aimed to examine the circulating microRNA (miRNA) profile of hospitalized COVID-19 patients and evaluate its potential as a source of biomarkers for the management of the disease. This was an observational and multicenter study that included 84 patients with a positive nasopharyngeal swab Polymerase chain reaction (PCR) test for SARS-CoV-2 recruited during the first pandemic wave in Spain (March-June 2020). Patients were stratified according to disease severity: hospitalized patients admitted to the clinical wards without requiring critical care and patients admitted to the intensive care unit (ICU). An additional study was completed including ICU nonsurvivors and survivors. Plasma miRNA profiling was performed using reverse transcription polymerase quantitative chain reaction (RT-qPCR). Predictive models were constructed using least absolute shrinkage and selection operator (LASSO) regression. Ten circulating miRNAs were dysregulated in ICU patients compared to ward patients. LASSO analysis identified a signature of three miRNAs (miR-148a-3p, miR-451a and miR-486-5p) that distinguishes between ICU and ward patients [AUC (95% CI) = 0.89 (0.81-0.97)]. Among critically ill patients, six miRNAs were downregulated between nonsurvivors and survivors. A signature based on two miRNAs (miR-192-5p and miR-323a-3p) differentiated ICU nonsurvivors from survivors [AUC (95% CI) = 0.80 (0.64-0.96)]. The discriminatory potential of the signature was higher than that observed for laboratory parameters such as leukocyte counts, C-reactive protein (CRP) or D-dimer [maximum AUC (95% CI) for these variables = 0.73 (0.55-0.92)]. miRNA levels were correlated with the duration of ICU stay. Specific circulating miRNA profiles are associated with the severity of COVID-19. Plasma miRNA signatures emerge as a novel tool to assist in the early prediction of vital status deterioration among ICU patients.
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Key Words
- auc, area under the roc curve
- crp, c-reactive protein
- cq, quantification cycle
- icu, intensive care unit
- lasso, least absolute shrinkage and selection operator
- ldh, lactate dehydrogenase
- mirna, microrna
- mse, mean square error
- ncrna, noncoding rna
- pca, principal component analysis
- roc, receiver operating characteristic
- rt, reverse transcription
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Affiliation(s)
- David de Gonzalo-Calvo
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Iván D Benítez
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Lucía Pinilla
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Amara Carratalá
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Anna Moncusí-Moix
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Clara Gort-Paniello
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Marta Molinero
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Jessica González
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain
| | - Gerard Torres
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - María Bernal
- Laboratory Medicine Department, University Hospital Arnau de Vilanova, Lleida, Spain
| | - Silvia Pico
- Laboratory Medicine Department, University Hospital Arnau de Vilanova, Lleida, Spain
| | - Raquel Almansa
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Noelia Jorge
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Alicia Ortega
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | | | | | | | | | - Pablo Ryan
- Hospital Universitario Infanta Leonor, Madrid, Spain
| | | | - Luis Tamayo
- Hospital Universitario Río Hortega, Valladolid, Spain
| | - César Aldecoa
- Hospital Universitario Río Hortega, Valladolid, Spain
| | - Ricard Ferrer
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Intensive Care Department, Vall d'Hebron Hospital Universitari. SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Spain
| | - Adrián Ceccato
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain
| | - Laia Fernández-Barat
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Servei de Pneumologia, Hospital Clinic. Universitat de Barcelona. IDIBAPS, Barcelona, Spain
| | - Ana Motos
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Servei de Pneumologia, Hospital Clinic. Universitat de Barcelona. IDIBAPS, Barcelona, Spain
| | - Jordi Riera
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Intensive Care Department, Vall d'Hebron Hospital Universitari. SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Spain
| | - Rosario Menéndez
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Pulmonology Service, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | - Oscar Peñuelas
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Hospital Universitario de Getafe, Madrid, Spain
| | - Antoni Torres
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Servei de Pneumologia, Hospital Clinic. Universitat de Barcelona. IDIBAPS, Barcelona, Spain
| | - Jesús F Bermejo-Martin
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain; Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain; Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Ferran Barbé
- Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, Lleida, Spain; CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, Madrid, Spain.
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Benotmane I, Gautier-Vargas G, Wendling MJ, Perrin P, Velay A, Bassand X, Bedo D, Baldacini C, Sagnard M, Bozman DF, Della-Chiesa M, Solis M, Gallais F, Cognard N, Olagne J, Delagrèverie H, Gontard L, Panaget B, Marx D, Heibel F, Braun-Parvez L, Moulin B, Caillard S, Fafi-Kremer S. In-depth virological assessment of kidney transplant recipients with COVID-19. Am J Transplant 2020; 20:3162-3172. [PMID: 32777130 PMCID: PMC7436721 DOI: 10.1111/ajt.16251] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [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] [Received: 06/18/2020] [Revised: 07/23/2020] [Accepted: 07/29/2020] [Indexed: 01/25/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread widely, causing coronavirus disease 2019 (COVID-19) and significant mortality. However, data on viral loads and antibody kinetics in immunocompromised populations are lacking. We aimed to determine nasopharyngeal and plasma viral loads via reverse transcription-polymerase chain reaction and SARS-CoV-2 serology via enzyme-linked immunosorbent assay and study their association with severe forms of COVID-19 and death in kidney transplant recipients. In this study, we examined hospitalized kidney transplant recipients with nonsevere (n = 21) and severe (n = 19) COVID-19. SARS-CoV-2 nasopharyngeal and plasma viral load and serological response were evaluated based on outcomes and disease severity. Ten recipients (25%) displayed persistent viral shedding 30 days after symptom onset. The SARS-CoV-2 viral load of the upper respiratory tract was not associated with severe COVID-19, whereas the plasma viral load was associated with COVID-19 severity (P = .010) and mortality (P = .010). All patients harbored antibodies during the second week after symptom onset that persisted for 2 months. We conclude that plasma viral load is associated with COVID-19 morbidity and mortality, whereas nasopharyngeal viral load is not. SARS-CoV-2 shedding is prolonged in kidney transplant recipients and the humoral response to SARS-CoV-2 does not show significant impairment in this series of transplant recipients.
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Key Words
- clinical research/practice
- complication: infectious
- immune deficiency
- infection and infectious agents – viral
- infectious disease
- kidney transplantation/nephrology
- cni, calcineurin inhibitor
- covid-19, coronavirus disease 2019
- ct, computed tomography
- d, day after symptom onset
- icu, intensive care unit
- ig, immunoglobulin
- il, interleukin
- ktr, kidney transplant recipients
- mpa, mycophenolic acid
- roc, receiver operating characteristic
- rt-pcr, reverse transcription-polymerase chain reaction
- sars-cov-2, severe acute respiratory syndrome coronavirus 2
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Affiliation(s)
- Ilies Benotmane
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France,Department of Virology, Strasbourg University Hospital, Strasbourg, France,INSERM U1109, LabEx TRANSPLANTEX, Strasbourg, France
| | - Gabriela Gautier-Vargas
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | | | - Peggy Perrin
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France,INSERM U1109, LabEx TRANSPLANTEX, Strasbourg, France
| | - Aurélie Velay
- Department of Virology, Strasbourg University Hospital, Strasbourg, France,INSERM U1109, LabEx TRANSPLANTEX, Strasbourg, France
| | - Xavier Bassand
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Dimitri Bedo
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Clément Baldacini
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Mylène Sagnard
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Dogan-Firat Bozman
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Margaux Della-Chiesa
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Morgane Solis
- Department of Virology, Strasbourg University Hospital, Strasbourg, France,INSERM U1109, LabEx TRANSPLANTEX, Strasbourg, France
| | - Floriane Gallais
- Department of Virology, Strasbourg University Hospital, Strasbourg, France,INSERM U1109, LabEx TRANSPLANTEX, Strasbourg, France
| | - Noëlle Cognard
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Jérôme Olagne
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | | | - Louise Gontard
- Department of Virology, Strasbourg University Hospital, Strasbourg, France
| | - Baptiste Panaget
- Department of Virology, Strasbourg University Hospital, Strasbourg, France
| | - David Marx
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Françoise Heibel
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Laura Braun-Parvez
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Bruno Moulin
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France,INSERM U1109, LabEx TRANSPLANTEX, Strasbourg, France
| | - Sophie Caillard
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France,INSERM U1109, LabEx TRANSPLANTEX, Strasbourg, France
| | - Samira Fafi-Kremer
- Department of Virology, Strasbourg University Hospital, Strasbourg, France,INSERM U1109, LabEx TRANSPLANTEX, Strasbourg, France,Correspondence Samira Fafi-Kremer
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R Williams A, Ueda Y, A Stern J, Christe KL. Vertebral Heart Score in Rhesus Macaques (Macaca mulatta): Generating Normal Reference Intervals and Assessing its Validity for Identifying Cardiac Disease. J Am Assoc Lab Anim Sci 2020; 59. [PMID: 32317049 PMCID: PMC7338866 DOI: 10.30802/aalas-jaalas-19-000143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/06/2019] [Accepted: 12/10/2019] [Indexed: 02/02/2023]
Abstract
Vertebral heart scoring (VHS) is a semiquantitative method to assess the presence and severity of cardiomegaly by using thoracic radiographs. VHS in rhesus macaques (Macaca mulatta) has not been validated or used routinely in the clinical or research setting. We hypothesized that rhesus macaques with cardiac disease diagnosed by using echocardiography would have higher VHS than animals without cardiac disease. A total of 150 rhesus macaques were enrolled in this study. All animals underwent echocardiography and thoracic radiography (right lateral [RL], dorsoventral [DV], and ventrodorsal [VD] views).According to echocardiography, 121 rhesus macaques had no cardiac disease and were used to establish reference intervals for VHS. The remaining 29 macaques had hypertrophic cardiomyopathy (n = 20) or other cardiac disease (n = 9). Results showed that VHS of RL and VD views were significantly higher in macaques with any of the identified cardiac diseases and in the cardiac disease group that excluded hypertrophic cardiomyopathy. VHS of animals with HCM was not significantly different than that of control animals. In the RL view, VHS was moderately accurate for predicting the presence of cardiac disease, with an AUC of 0.71 and an optimal cut-off value of 10.25 (sensitivity: 62%, specificity: 77%). In the VD view, VHS was a mildly accurate test for cardiac disease, with an AUC of 0.654 and an optimal cut-off value of 10.65 (sensitivity, 66%;specificity, 63%). Study results indicated that VHS could be a useful screening tool for clinically identifying rhesus macaques with cardiac disease. However, VHS is unlikely to replace echocardiographic examination for determining the presence, type,and severity of cardiac disease in this species.
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Affiliation(s)
- Amber R Williams
- Department of Primate Medicine, California National Primate Research Center, and
| | - Yu Ueda
- Department of Medicine and Epidemiology, University of California–Davis, Davis, California
| | - Joshua A Stern
- Department of Primate Medicine, California National Primate Research Center, and
- Department of Medicine and Epidemiology, University of California–Davis, Davis, California
| | - Kari L Christe
- Department of Primate Medicine, California National Primate Research Center, and
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Jaber SM, Sullivan S, Hankenson FC, Kilbaugh TJ, Margulies SS. Comparison of Heart Rate and Blood Pressure with Toe Pinch and Bispectral Index for Monitoring the Depth of Anesthesia in Piglets. J Am Assoc Lab Anim Sci 2015; 54:536-544. [PMID: 26424252 PMCID: PMC4587622] [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] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 10/17/2014] [Accepted: 01/26/2015] [Indexed: 06/05/2023]
Abstract
Determining depth of anesthesia (DOA) is a clinical challenge in veterinary medicine, yet it is critical for the appropriate oversight of animals involved in potentially painful experimental procedures. Here, we investigated various parameters used to monitor conscious awareness during surgical procedures and refined the application of noxious stimuli to anesthetized animals. Specifically we used a common stimulus, a compressive toe pinch (TP), to determine physiologic changes that accompanied a positive or negative motion response in isoflurane-anesthetized piglets. A positive response was defined as any reflexive withdrawal, whereas a negative response was defined as the absence of motion after stimulation. We also assessed the utility of the bispectral index (BIS) for its ability to predict a motion response to TP. The average of BIS values over 1 min (BISmean) was recorded before and after TP. In piglets with a positive response to TP, heart rate (HR), but not blood pressure (BP), increased significantly, but receiver operating characteristic (ROC) analysis revealed that HR was not a sensitive, specific predictor of TP motion response. Both before and after TP, BISmean was a strong predictor of a positive motion response. We conclude that HR and noninvasive BP changes are not clinically reliable indicators of anesthetic depth when assessed immediately after a peripherally applied compressive force as an indicator stimulus; however, BISmean and response TP are acceptable for assessing DOA in piglets maintained under isoflurane anesthesia.
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Affiliation(s)
- Samer M Jaber
- University Laboratory Animal Resources and Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Animal Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Sarah Sullivan
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - F Claire Hankenson
- University Laboratory Animal Resources and Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, USA; Pennsylvania, Campus Animal Resources, Michigan State University, East Lansing, MI, USA
| | - Todd J Kilbaugh
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Susan S Margulies
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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Albaba M, Cha SS, Takahashi PY. The Elders Risk Assessment Index, an electronic administrative database-derived frailty index, can identify risk of hip fracture in a cohort of community-dwelling adults. Mayo Clin Proc 2012; 87:652-8. [PMID: 22766085 PMCID: PMC3538479 DOI: 10.1016/j.mayocp.2012.01.020] [Citation(s) in RCA: 20] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 12/20/2011] [Accepted: 01/06/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine whether an Elders Risk Assessment (ERA) index can predict incident hip fractures without the need for physician-patient encounter or bone mineral density testing. PATIENTS AND METHODS A retrospective cohort study was conducted in a community-based cohort of 12,650 patients aged 60 years and older. An ERA score was computed for each subject at index time (January 1, 2005). Incidents of hip fracture from January 1, 2005, through December 31, 2006, were obtained from electronic medical records. We divided the cohort into 5 groups, with the lowest ERA scores forming group A (<15%); 15% to 49%, group B; 50% to 74%, group C; 75% to 89%, group D; and the top 11%, group E. With group A as a reference group, we used logistic regression to compute odds ratios of sustaining hip fracture during a 2-year period (January 1, 2005, through December 31, 2006) for groups B, C, D, and E. Sensitivity and specificity of each possible ERA score were calculated, and a receiver operating characteristic curve was created. RESULTS Two hundred sixty-five patients (2.1%) sustained at least 1 hip fracture from January 1, 2005, through December 31, 2006. Odds ratios (95% confidence intervals) for groups B, C, D, and E were 1.6 (0.7-3.4), 4.5 (2.2-9.4), 6.9 (3.3-14.3), and 18.4 (8.9-37.9), respectively. The area under the receiver operating characteristic curve was 74.5%. CONCLUSION An electronic medical record-based, easily derived ERA index might be useful in hip fracture risk stratification.
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Key Words
- ci, confidence interval
- emr, electronic medical record
- era, elders risk assessment
- fnbmd, femoral neck bone mineral density
- framo, fracture and mortality
- frax, fracture risk assessment
- gdms, generic disease management system
- icd-9, international classification of diseases, ninth revision
- or, odds ratio
- pcim, primary care internal medicine
- roc, receiver operating characteristic
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Affiliation(s)
- Mohammad Albaba
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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Barreira TV, Staiano AE, Harrington DM, Heymsfield SB, Smith SR, Bouchard C, Katzmarzyk PT. Anthropometric correlates of total body fat, abdominal adiposity, and cardiovascular disease risk factors in a biracial sample of men and women. Mayo Clin Proc 2012; 87:452-60. [PMID: 22560524 PMCID: PMC3498102 DOI: 10.1016/j.mayocp.2011.12.017] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [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: 10/14/2011] [Revised: 11/30/2011] [Accepted: 12/07/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To investigate associations between anthropometric measurements and total body fat, abdominal adipose tissue, and cardiovascular disease risk factors in a large biracial sample. PATIENTS AND METHODS This study is limited to cross-sectional analyses of data from participants attending a baseline visit between January 26, 1996, and February 1, 2011. The sample included 2037 individuals aged 18 to 69 years: 488 African American women (24%), 686 white women (34%), 196 African American men (9%), and 667 white men (33%). Anthropometry included weight; hip circumference; waist circumference; waist-hip, waist-height, and weight-height ratios; body adiposity index; and body mass index. Body fat and percentage of fat were measured by dual-energy x-ray absorptiometry, and abdominal visceral and subcutaneous adipose tissue were measured by computed tomography. Bivariate correlations, logistic regression models, and receiver operator characteristic curves were used, and analyses were stratified by sex and race. RESULTS In each sex-by-race group, all anthropometric measures were highly correlated with percentage of fat, fat mass, and subcutaneous adipose tissue and moderately correlated with visceral adipose tissue, with the exception of the waist-hip ratio. The odds of having an elevated cardiometabolic risk were increased more than 2-fold per SD increase for most anthropometric variables, and the areas under the curve for each anthropometric measure were significantly greater than 0.5. CONCLUSION Several common anthropometric measures were moderately to highly correlated with total body fat, abdominal fat, and cardiovascular disease risk factors in a biracial sample of women and men. This comprehensive analysis provides evidence of the linkage between simple anthropometric measurements and the purported pathways between adiposity and health.
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Key Words
- auc, area under the curve
- bai, body adiposity index
- bmi, body mass index
- ct, computed tomography
- cvd, cardiovascular disease
- dxa, dual-energy x-ray absorptiometry
- hc, hip circumference
- hdl-c, high-density lipoprotein cholesterol
- ldl-c, low-density lipoprotein cholesterol
- pcls, pennington center longitudinal study
- roc, receiver operating characteristic
- sat, subcutaneous adipose tissue
- vat, visceral adipose tissue
- wc, waist circumference
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Affiliation(s)
| | | | | | | | - Steven R. Smith
- Translational Research Institute for Metabolism and Diabetes, Sanford Burnham Medical Research Institute, Winter Park, FL
| | | | - Peter T. Katzmarzyk
- Pennington Biomedical Research Center, Baton Rouge, LA
- Correspondence: Address to Peter T. Katzmarzyk, PhD, FACSM, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808-4124
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McBrier NM, Neuberger T, Denegar CR, Sharkey NA, Webb AG. Magnetic resonance imaging of acute injury in rats and the effects of buprenorphine on limb volume. J Am Assoc Lab Anim Sci 2009; 48:147-151. [PMID: 19383210 PMCID: PMC2679659] [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] [Received: 04/03/2008] [Revised: 05/05/2008] [Accepted: 07/10/2008] [Indexed: 05/27/2023]
Abstract
The purposes of this study were to determine 1) whether magnetic resonance imaging (MRI)-based T2 mapping and measurements of limb volume can differentiate injured and uninjured tissue after blunt trauma to rat hindlimbs and 2) whether administration of buprenorphine influences these assessments. Male Wistar rats (age, 3 to 4 mo) underwent blunt contusion injury to the posterior aspect of the hindlimb; MRI was conducted at 6, 12, 24, 48, 72, and 96 h after injury. The imaging results showed that administration of buprenorphine had no effect on the T2 value {area under the receiver operating characteristic [ROC] curve: with drug, 0.869 [95% confidence interval (CI), 0.78 to 0.96]; without drug, 0.809 [95% CI, 0.72 to 0.90]} but did influence limb volume [area under the ROC curve; without drug, 0.954 (95% CI, 0.92 to 0.99); with drug, 0.713 (95% CI, 0.61 to 0.82)]. When using MRI to determine the extent of injury or to track injury over time, calculated limb volumes may lose sensitivity to detect injury, due to the intrinsic increase in volume from morphine-derived drugs. During administration of morphine derivatives, T2 maps may provide more accurate assessments of muscle tissue injury both initially after injury and over time.
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Affiliation(s)
- Nicole M McBrier
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA.
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