Cristian Vergallo
Among haematological parameters of patients seriously ill with the coronavirus infectious disease 2019 (COVID-19), leucocytosis, lymphocytopenia, and the abnormal release of circulating cytokines, termed cytokine storm syndrome (CSS, also known as cytokine release syndrome or CRS), were found associated with disease severity. In particular, according to the serum cytokine profiling, pro-inflammatory interleukin 6 (IL-6) and anti-inflammatory interleukin 10 (IL-10) were observed to be considerably higher in patients experiencing respiratory distress, septic shock and/or multi-organ failure, namely "critical cases" requiring intensive care unit (ICU) admission, very often resulting in death...
October 17, 2020: Electromagnetic Biology and Medicine
Federica Dagradi, Carla Spazzolini, Silvia Castelletti, Matteo Pedrazzini, Maria-Christina Kotta, Lia Crotti, Peter J Schwartz
Background: The diagnosis of long QT syndrome (LQTS) is rather straightforward. We were surprised by realizing that, despite long-standing experience, we were making occasional diagnostic errors by considering as affected subjects that, over time, resulted as not affected. These individuals were all actively practicing sports, an observation which helped to design our study. Methods: We focused on subjects referred to our Center by Sports Medicine doctors with a suspicion of LQTS because of marked repolarization abnormalities on the ECG performed during the mandatory medical visit necessary in Italy to obtain the certificate of eligibility to practice sports...
October 19, 2020: Circulation
Katrin Majari, Hossein Imani, Saeed Hosseini, Ali Amirsavadkouhi, Seyyed Hossein Ardehali, Razieh Khalooeifard
BACKGROUND: There are no data on the validity of the modified Nutrition Risk in the critically ill (m-NUTRIC)-score and Nutritional Risk Screening (NRS)-2002 Score in the Iranian intensive care unit (ICU) patients. The Malnutrition Universal Screening Tool (MUST) is still used in most ICUs of Iran. Our goal was to test the validity of these tools in the Iranian ICU population. METHODS: All adult patients (≥18 years) were included. The association between the nutritional risk scores and outcomes (longer-length of stay, prolonged-mechanical ventilation, and 28-day mortality) was assessed using the Multivariable Logistic regression...
October 18, 2020: JPEN. Journal of Parenteral and Enteral Nutrition
Emelie Lindberger, Inger Sundström Poromaa, Fredrik Ahlsson
Overweight and obesity during pregnancy are risk factors for a large number of perinatal complications, both for the mother and the infant. Risk stratification and early interventions are therefore highly clinically important to minimize future complications. Currently, body mass index (BMI) in early pregnancy is used for risk stratification of pregnant women, but a disadvantage of BMI is that it does not distinguish muscle from fat tissue and central from peripheral adiposity. Maternal fat distribution is suggested to be a better predictor than BMI of obesity-related adverse pregnancy outcomes, with central adiposity posing a greater risk than peripheral subcutaneous fat...
October 2020: European journal of obstetrics & gynecology and reproductive biology: X
William R Hartman, Aaron S Hess, Joseph P Connor
Background: SARS-CoV-2 and its associated disease, COVID-19, has infected over seven million people world-wide, including two million people in the United States. While many people recover from the virus uneventfully, a subset of patients will require hospital admission, some with intensive care needs including intubation, and mechanical ventilation. To date there is no cure and no vaccine is available. Passive immunotherapy by the transfusion of convalescent plasma donated by COVID-19 recovered patients might be an effective option to combat the virus, especially if used early in the course of disease...
2020: Translational medicine communications
Francesco Salton, Paola Confalonieri, G Umberto Meduri, Pierachille Santus, Sergio Harari, Raffaele Scala, Simone Lanini, Valentina Vertui, Tiberio Oggionni, Antonella Caminati, Vincenzo Patruno, Mario Tamburrini, Alessandro Scartabellati, Mara Parati, Massimiliano Villani, Dejan Radovanovic, Sara Tomassetti, Claudia Ravaglia, Venerino Poletti, Andrea Vianello, Anna Talia Gaccione, Luca Guidelli, Rita Raccanelli, Paolo Lucernoni, Donato Lacedonia, Maria Pia Foschino Barbaro, Stefano Centanni, Michele Mondoni, Matteo Davì, Alberto Fantin, Xueyuan Cao, Lucio Torelli, Antonella Zucchetto, Marcella Montico, Annalisa Casarin, Micaela Romagnoli, Stefano Gasparini, Martina Bonifazi, Pierlanfranco D'Agaro, Alessandro Marcello, Danilo Licastro, Barbara Ruaro, Maria Concetta Volpe, Reba Umberger, Marco Confalonieri
Background: In hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia, progression to acute respiratory failure requiring invasive mechanical ventilation (MV) is associated with significant morbidity and mortality. Severe dysregulated systemic inflammation is the putative mechanism. We hypothesize that early prolonged methylprednisolone (MP) treatment could accelerate disease resolution, decreasing the need for intensive care unit (ICU) admission and mortality. Methods: We conducted a multicenter observational study to explore the association between exposure to prolonged, low-dose MP treatment and need for ICU referral, intubation, or death within 28 days (composite primary end point) in patients with severe COVID-19 pneumonia admitted to Italian respiratory high-dependency units...
October 2020: Open Forum Infectious Diseases
Shining Cai, Xiaomin Zhang, Wenyan Pan, Jos M Latour, Jili Zheng, Jun Zhong, Jian Gao, Minzhi Lv, Zhe Luo, Chunsheng Wang, Yuxia Zhang
Objectives: The aim of this study was to investigate the prevalence and explore the predictors and early outcomes of post-operative delirium (POD) in patients with type A aortic dissection (AAD) during intensive care unit (ICU) stays. Methods: We retrospectively reviewed the records of 301 patients with AAD who underwent surgical treatment in our institution from January 2017 to December 2018. Results: Delirium developed in 73 patients (24.25%) during the ICU stay. Patients with lower estimated glomerular filtration rates [odds ratio (OR) 0...
2020: Frontiers in Medicine
Ralphe Bou Chebl, Sarah Jamali, Mohamad Sabra, Rawan Safa, Iskandar Berbari, Ali Shami, Maha Makki, Hani Tamim, Gilbert Abou Dagher
Background: The aim of this study is to evaluate the prognostic value of the Lactate to Albumin (L/A) ratio compared to that of lactate only in predicting morbidity and mortality in sepsis patients. Methods: This was a single-center retrospective cohort study. All adult patients above the age of 18 with a diagnosis of sepsis who presented between January 1, 2014 and June 30, 2019 were included. The primary outcome was in-hospital mortality. Results: A total of 1,381 patients were included, 44% were female. Overall in-hospital mortality was 58...
2020: Frontiers in Medicine
Daniel Wolff, Jelena Bardak, Matthias Edinger, Ursula Klinger-Schindler, Ernst Holler, Anita Lawitschka, Helene Schoemans, Wolfgang Herr, Nikolaus Kröger, Francis Ayuk Ayuketang
The aim of the presented study was to analyze the care expenditure for outpatients after allogeneic hematopoietic stem cell transplantation (alloHSCT) done in accordance with the national, European guidelines and the German Social Law. We performed an analysis of the National and European survivorship care guidelines and in parallel recorded the time expenditure and staff costs separated according to different occupational groups involved in outpatient care at two German transplantation centers [University Hospital Regensburg (UKR) and University Hospital Hamburg-Eppendorf (UKE)]...
2020: Frontiers in Public Health
Yan Zhang, Simiao Xie, Pu Wang, Guixiang Wang, Li Zhang, Xiaochen Cao, Wenzhi Wu, Yueran Bian, Fei Huang, Na Luo, Mingyan Luo, Qiang Xiao
Background: Since the outbreak of COVID-19, physical and psychological harm has been spreading across the global population alongside the spread of the virus. Currently, the novel coronavirus has spread to most countries in the world, and its impact on the public is also increasing. As a high-risk group in direct contact with the virus, medical workers should be monitored, and their mental health deserves extensive attention. The aim of this study was to explore the mental health of medical workers facing the novel coronavirus and the main factors affecting it...
2020: Frontiers in Public Health
Jennifer Hammond, Charlotte Wool, Elvira Parravicini
Background: Perinatal/neonatal palliative care (PNPC) offers a plan of care for improving the quality of life of infants when the prolongation of life is no longer the goal of care. The number of PNPC programs has increased in recent years, but training for clinicians has not kept pace. Therefore, an interdisciplinary team developed a 3-day intensive PNPC training course for physicians, nurses, and other healthcare professionals at Columbia University Irving Medical Center (CUIMC). Objective: The aim of this study was to assess the efficacy of a PNPC training course in improving the self-reported competence of participants...
2020: Frontiers in Pediatrics
Virginia Puyana-Romero, Daniel Núñez-Solano, Ricardo Hernández-Molina, Edgar Jara-Muñoz
The neonatal intensive care unit (NICU) is a very noisy place as compared to the intrauterine environment. To protect the neonate's health, international guidelines suggest avoiding noise levels above 45 dB in NICUs, but this recommendation is not normally met. The incubator acoustic isolation and the acoustic features of the NICU play important roles in determining the noise measured inside the incubator. In this study, the influence of two types of rooms, one with sound-absorbent covering and the other with reverberant surfaces, on the acoustic isolation of a neonatal incubator was evaluated using three acoustic isolation indexes: the level difference, the apparent sound reduction index, and the standardized level difference...
2020: Frontiers in Pediatrics
Omri David Soffer, Angela Kim, Ellen Underwood, Anne Hansen, Laura Cornelissen, Charles Berde
Objective: To evaluate recovery from neuromuscular blockade in infants using Train-of-Four nerve stimulation. Study Design: Ulnar nerve stimulation was used to evoke thumb twitch and reported as Train-of-Four ratio. Thumb twitch was also recorded visually in real-time. Primary outcome was time to near recovery of muscle function (Train-of-Four ratio >70%). Secondary analyses were time to greater degrees of recovery (Train-of-Four ratio >80, 90%), sensitivity of accelerometry vs. visual thumb-twitch and clinical variates to assess safety...
2020: Frontiers in Pediatrics
Shin-Yi Tsai, Chon-Fu Lio, Shou-Chuan Shih, Cheng-Jui Lin, Yu-Tien Chen, Chia-Meng Yu, Fang-Ju Sun, Chien-Feng Kuo, Xiaofeng Jia
Background: Acute kidney injury (AKI) is one of the most severe complications of burn injury. AKI with severe burn injury causes high mortality. This study aims to investigate the incidence of and predisposing factors for AKI in burn patients. Methods: This is a single-center, retrospective, descriptive criterion standard study conducted from June 27, 2015, to March 8, 2016. We used Kidney Disease Improving Global Outcomes criteria to define and select patients with AKI...
2020: PeerJ
Tarang Preet Kaur, Latika Sahu, Asmita M Rathore, Sangeeta Bhasin
Objective: To study the association of seizure disorder with adverse obstetric outcome in terms of maternal and perinatal complications. Materials and Methods: This longitudinal study was conducted at Maulana Azad Medical College, New Delhi over 15 months among women attending the antenatal clinic (ANC) outpatient department. Fifty pregnant women with seizure disorder with their first ANC visit before 28 weeks were recruited as the case group, excluding patients with eclampsia...
September 2020: Turkish Journal of Obstetrics and Gynecology
Niyazi Tug, Murat Yassa, Emre Köle, Önder Sakin, Merve Çakır Köle, Ateş Karateke, Nurettin Yiyit, Emre Yavuz, Pınar Birol, Doğuş Budak, Ömer Kol, Edip Emir
Objective: To investigate pregnancy outcomes and compare the clinical characteristics of coronavirus 2019 (COVID-19) disease in pregnant and agematched non-pregnant women. Materials and Methods: Hospital records of four tertiary care centers were reviewed retrospectively. The subjects comprised 188 pregnant patients and 799 non-pregnant women who were admitted to these hospitals. Results: Pregnancy significantly affected the clinical severity of COVID-19 and this effect was more prominent in pregnant women at >20 weeks gestation (p<0...
September 2020: Turkish Journal of Obstetrics and Gynecology
Désirée Larenas-Linnemann, Noel Rodríguez-Pérez, Alfredo Arias-Cruz, María Virginia Blandón-Vijil, Blanca E Del-Río-Navarro, Alan Estrada-Cardona, José E Gereda, Jorge A Luna-Pech, Elsy Maureen Navarrete-Rodríguez, Ernesto Onuma-Takane, César Fireth Pozo-Beltrán, María Isabel Rojo-Gutiérrez
Introduction: In the light of the current COVID-19 pandemic, during which the world is confronted with a new, highly contagious virus that suppresses innate immunity as one of its initial virulence mechanisms, thus escaping from the first-line human defense mechanisms, enhancing innate immunity seems a good preventive strategy. Methods: Without the intention to write an official systematic review, but more to give an overview of possible strategies, in this review article we discuss several interventions that might stimulate innate immunity and thus our defense against (viral) respiratory tract infections...
October 9, 2020: World Allergy Organization Journal
Nan Zhang, Cheng Wang, Feng Zhu, Hong Mao, Peng Bai, Lu-Lu Chen, Tianshu Zeng, Miao-Miao Peng, Kang Li Qiu, Yixuan Wang, Muqing Yu, Shuyun Xu, Jianping Zhao, Na Li, Min Zhou
Background: Diabetes has been found to increase severity and mortality under the current pandemic of coronavirus disease of 2019 (COVID-19). Up to date, the clinical characteristics of diabetes patients with COVID-19 and the risk factors for poor clinical outcomes are not clearly understood. Methods: The study was retrospectively carried out on enrolled diabetes patients with laboratory confirmed COVID-19 infection from a designated medical center for COVID-19 from January 25th, 2020 to February 14th, 2020 in Wuhan, China...
2020: Frontiers in Endocrinology
Marietou Daou, Irene Telias, Magdy Younes, Laurent Brochard, M Elizabeth Wilcox
Delirium is a syndrome characterized by acute brain failure resulting in neurocognitive disturbances affecting attention, awareness, and cognition. It is highly prevalent among critically ill patients and is associated with increased morbidity and mortality. A core domain of delirium is represented by behavioral disturbances in sleep-wake cycle probably related to circadian rhythm disruption. The relationship between sleep, circadian rhythm and intensive care unit (ICU)-acquired delirium is complex and likely bidirectional...
2020: Frontiers in Neurology
Marco Chiera, Francesco Cerritelli, Alessandro Casini, Nicola Barsotti, Dario Boschiero, Francesco Cavigioli, Carla G Corti, Andrea Manzotti
Neonatal intensive care units (NICUs) greatly expand the use of technology. There is a need to accurately diagnose discomfort, pain, and complications, such as sepsis, mainly before they occur. While specific treatments are possible, they are often time-consuming, invasive, or painful, with detrimental effects for the development of the infant. In the last 40 years, heart rate variability (HRV) has emerged as a non-invasive measurement to monitor newborns and infants, but it still is underused. Hence, the present paper aims to review the utility of HRV in neonatology and the instruments available to assess it, showing how HRV could be an innovative tool in the years to come...
2020: Frontiers in Neuroscience
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