N. Hakami, Nouf I. Almohammadi, Raghad A. Alqahtani, Nouf A. Alsayel, Raed I. Felimban, S. Hindawi, Y. Elmosaad, Hala Elsir Khair, A. Hjazi, H. Waggiallah, Elturabi Elsayed Elkhider, M. Eltayeb
Patient blood management (PBM) is a comprehensive approach to optimizing the care of patients who might need a transfusion. It involves the use of evidence-based strategies to reduce or avoid the need for allogeneic blood transfusions while ensuring that patients receive safe and appropriate care. PBM includes strategies such as preoperative autologous donation, intraoperative cell salvage, and minimally invasive techniques to reduce bleeding. The purpose of this study is to assess the medical staff’s awareness of preoperative PBM in Saudi Arabia. Between April 2022 and July 2022, data was collected using a 10-minute online (Google Forms) self-administered, anonymous, researcherstructured questionnaire adapted from previous studies and translated into both English and Arabic. The questionnaire was divided into three sections. The first section contained sociodemographic data, while the second section was used to estimate physicians’ and nurses’ knowledge of preoperative PBM. Two questions in Part 3 of the questionnaire were used to assess doctors’ and nurses’ preoperative PBM attitudes and practices. The average relationship between patients’ blood management attitudes and levels of awareness. It was revealed that there was a positive attitude (P≤0.005) as well as a high level of awareness (P≤0.002). The effect of job, gender, or geographical distribution on PBM awareness, attitude, and practice was not significant. Despite the fact that the majority of participants have a positive attitude and good awareness of PBM, more efforts should be implemented to improve PBM awareness, which was linked to increased transfusion practices and lower product costs.
{"title":"Appraisal of awareness of medical staff about preoperative patient blood management in Saudi Arabia: a questionnaire-based study","authors":"N. Hakami, Nouf I. Almohammadi, Raghad A. Alqahtani, Nouf A. Alsayel, Raed I. Felimban, S. Hindawi, Y. Elmosaad, Hala Elsir Khair, A. Hjazi, H. Waggiallah, Elturabi Elsayed Elkhider, M. Eltayeb","doi":"10.4081/itjm.2023.1638","DOIUrl":"https://doi.org/10.4081/itjm.2023.1638","url":null,"abstract":"Patient blood management (PBM) is a comprehensive approach to optimizing the care of patients who might need a transfusion. It involves the use of evidence-based strategies to reduce or avoid the need for allogeneic blood transfusions while ensuring that patients receive safe and appropriate care. PBM includes strategies such as preoperative autologous donation, intraoperative cell salvage, and minimally invasive techniques to reduce bleeding. The purpose of this study is to assess the medical staff’s awareness of preoperative PBM in Saudi Arabia. Between April 2022 and July 2022, data was collected using a 10-minute online (Google Forms) self-administered, anonymous, researcherstructured questionnaire adapted from previous studies and translated into both English and Arabic. The questionnaire was divided into three sections. The first section contained sociodemographic data, while the second section was used to estimate physicians’ and nurses’ knowledge of preoperative PBM. Two questions in Part 3 of the questionnaire were used to assess doctors’ and nurses’ preoperative PBM attitudes and practices. The average relationship between patients’ blood management attitudes and levels of awareness. It was revealed that there was a positive attitude (P≤0.005) as well as a high level of awareness (P≤0.002). The effect of job, gender, or geographical distribution on PBM awareness, attitude, and practice was not significant. Despite the fact that the majority of participants have a positive attitude and good awareness of PBM, more efforts should be implemented to improve PBM awareness, which was linked to increased transfusion practices and lower product costs.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70231419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Ahmann, P. Kanizsai, A. Kónyi, I. Al-Sadoon, A. Pakai, T. Csákvári, Z. Verzár
The aim of our study was to investigate short- and medium-term survival in patients with sudden cardiac death (SCD) after resuscitation. We continued a retrospective study at the University of Pécs from April 2018 to December 2019. 192 patients with SCD were selected. Exclusion criteria were incomplete documentation and unstable rhythm, after which we continued the study with 181 patients. Our data were obtained from documents recorded by the Emergency Department. The study population was divided into two groups, with proven shockable (I) and non-shockable (II) initial rhythm, and their data were compared at hospital discharge, at 1 month, and at 3 months. The main endpoint was the mortality between the two groups. Our results already showed that hospital survival was significantly higher in the shockable rhythm group than in the non-shockable group (62% vs. 38%, P=0.002). We also obtained similar results for 1-month survival (54% vs. 16%, P=0.004). When risk factors were examined, there was a significant difference in the survival of diabetic (P=0.001) and hypertensive patients (P=0.001). Patients with shockable rhythm have significantly better survival rates.
{"title":"Estimation of short-term and medium-term survival from sudden cardiac death based on the initial rhythm","authors":"M. Ahmann, P. Kanizsai, A. Kónyi, I. Al-Sadoon, A. Pakai, T. Csákvári, Z. Verzár","doi":"10.4081/itjm.2023.1634","DOIUrl":"https://doi.org/10.4081/itjm.2023.1634","url":null,"abstract":"The aim of our study was to investigate short- and medium-term survival in patients with sudden cardiac death (SCD) after resuscitation. We continued a retrospective study at the University of Pécs from April 2018 to December 2019. 192 patients with SCD were selected. Exclusion criteria were incomplete documentation and unstable rhythm, after which we continued the study with 181 patients. Our data were obtained from documents recorded by the Emergency Department. The study population was divided into two groups, with proven shockable (I) and non-shockable (II) initial rhythm, and their data were compared at hospital discharge, at 1 month, and at 3 months. The main endpoint was the mortality between the two groups. Our results already showed that hospital survival was significantly higher in the shockable rhythm group than in the non-shockable group (62% vs. 38%, P=0.002). We also obtained similar results for 1-month survival (54% vs. 16%, P=0.004). When risk factors were examined, there was a significant difference in the survival of diabetic (P=0.001) and hypertensive patients (P=0.001). Patients with shockable rhythm have significantly better survival rates.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44903834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Mahfouz, Ahmad Y. Alqassim, Abdullah A. Alharbi, A. A. Najmi, M. Abualgasem, Albaraa Y. Abbas, Mazin A. Sabi, Abdulaziz A. Kaal, Huda H. Hakami, Mohammed A. Muaddi, R. Al-Sanosi
Background and Objectives. Healthcare professionals (HCPs) have had to deal with large numbers of confirmed or suspected cases of COVID-19 and were at a high risk of burnout and dissatisfaction regarding their work-life integration. This article aims to assess burnout, the work-life balance (WLB), and quality of life (QoL) among healthcare workers and the relationship between these aspects in Saudi Arabia. Methods. An analytical cross-sectional study was conducted among 491 HCPs from five secondary hospitals in Jazan, Saudi Arabia. Three standardized questionnaires were used to gather data, including WLB, burnout, and the WHO Quality of Life-BREF. Results. Healthcare professionals struggled to balance their work and personal lives during COVID-19 and reported many burnout symptoms and a low level of QoL. Two-thirds (68.8%) of HCPs arrived home late from work and (56.6%) skipped a meal. HCPs who worked through a shift without any breaks were found in 57.8%. It was reported that 39.3% of HCPs felt frustrated by technology while being exhausted from their work (60.5%). The correlation coefficients between the WLB and health-related QoL (HRQoL) showed a significant negative correlation for all items, which ranged from (-.099 to -.403, P<0.05). The WLB and burnout scores were successful predictors of low levels of HRQoL (P<0.001 for both explanatory variables). Conclusions. Work-life imbalances, high levels of burnout, and low QoL levels are common among healthcare professionals in Saudi Arabia during COVID-19. Hospital administration should address the WLB and reduce burnout symptoms among HCPs to increase satisfaction and improve the quality of care.
{"title":"Burnout and quality of life among healthcare professionals during the COVID-19 pandemic in Saudi Arabia","authors":"M. Mahfouz, Ahmad Y. Alqassim, Abdullah A. Alharbi, A. A. Najmi, M. Abualgasem, Albaraa Y. Abbas, Mazin A. Sabi, Abdulaziz A. Kaal, Huda H. Hakami, Mohammed A. Muaddi, R. Al-Sanosi","doi":"10.4081/itjm.2023.1623","DOIUrl":"https://doi.org/10.4081/itjm.2023.1623","url":null,"abstract":"Background and Objectives. Healthcare professionals (HCPs) have had to deal with large numbers of confirmed or suspected cases of COVID-19 and were at a high risk of burnout and dissatisfaction regarding their work-life integration. This article aims to assess burnout, the work-life balance (WLB), and quality of life (QoL) among healthcare workers and the relationship between these aspects in Saudi Arabia. Methods. An analytical cross-sectional study was conducted among 491 HCPs from five secondary hospitals in Jazan, Saudi Arabia. Three standardized questionnaires were used to gather data, including WLB, burnout, and the WHO Quality of Life-BREF. Results. Healthcare professionals struggled to balance their work and personal lives during COVID-19 and reported many burnout symptoms and a low level of QoL. Two-thirds (68.8%) of HCPs arrived home late from work and (56.6%) skipped a meal. HCPs who worked through a shift without any breaks were found in 57.8%. It was reported that 39.3% of HCPs felt frustrated by technology while being exhausted from their work (60.5%). The correlation coefficients between the WLB and health-related QoL (HRQoL) showed a significant negative correlation for all items, which ranged from (-.099 to -.403, P<0.05). The WLB and burnout scores were successful predictors of low levels of HRQoL (P<0.001 for both explanatory variables). Conclusions. Work-life imbalances, high levels of burnout, and low QoL levels are common among healthcare professionals in Saudi Arabia during COVID-19. Hospital administration should address the WLB and reduce burnout symptoms among HCPs to increase satisfaction and improve the quality of care.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43378189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Mumoli, Francesca Zuretti, D. Mastroiacovo, F. Dentali, F. Cipollini
Sonography – similar to what happened almost two centuries ago with the introduction of stethoscopes – has completely changed patients’ clinical management in Internal Medicine. The availability of performant, sometimes even small-sized and cost-effective machines, has allowed doctors in Internal-Medicine units to perform bedside-ultrasound examinations alongside regular clinical ones. [...]
{"title":"A new series on diagnostic echographic cases and living brief reviews: a potentially useful tool for clinicians edited by FADOI","authors":"N. Mumoli, Francesca Zuretti, D. Mastroiacovo, F. Dentali, F. Cipollini","doi":"10.4081/itjm.2023.1625","DOIUrl":"https://doi.org/10.4081/itjm.2023.1625","url":null,"abstract":"Sonography – similar to what happened almost two centuries ago with the introduction of stethoscopes – has completely changed patients’ clinical management in Internal Medicine. The availability of performant, sometimes even small-sized and cost-effective machines, has allowed doctors in Internal-Medicine units to perform bedside-ultrasound examinations alongside regular clinical ones. [...]","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"12 7","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41251109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Coppola, G. Cardillo, M. Lugará, S. Tamburrini, F. Bizzarri, Gianmaria Chicone, F. Scotto di Uccio, Maria Flavia Coppola, M. Piccirillo, C. Liguori, C. D’Amore, A. Tuccillo, P. Madonna, G. Noschese, E. Pone, P. Di Micco
Background. Since the European Society of Cardiology (ESC) published guidelines to stratify the risk of pulmonary embolism (PE), the main goal of several physicians has been to find a biomarker able to identify patients with venous thromboembolism at high risk to die. Increased levels of pro-B-type natriuretic peptide (BNP) were suggested as useful biomarkers in the guidelines of ESC (i.e., 2014) to identify patients with PE at high risk of death, but its role was not confirmed in other guidelines. Lung Ultrasound Scan (LUS) has been suggested as a diagnostic and prognostic test to identify patients with a high risk of mortality for lung failure. The aim of this study is to evaluate the prognostic role of pro- BNP together with the LUS evaluation in patients with COVID-19 and PE in particular regarding mortality for pulmonary embolism and overall death. Patients and Methods. We retrospectively analyzed records from 178 patients with confirmed COVID-19, admitted to our ward (i.e., COVID Medicine Unit at Ospedale del Mare in the town of Napoli) between March 2020 and May 2021. For this study, we analyzed the LUS data of all 178 patients and the available data on the pro-BNP of 120 patients. For all selected patients, mortality for PE and overall deaths were recorded. Results. The Propensity Score Matching was used to minimize and erase confounding factors. Data showed that an association between serum levels of pro-BNP and pulmonary thrombotic events was neither present before nor after matching an association with adverse outcomes and was found for increased values of LUS. Discussion. During the first waves of the pandemic, patients with confirmed COVID-19 with severe lung failure frequently showed pulmonary embolism as a clinical acute complication inducing life-threatening evolution. Conclusions. An association between LUS score and severe PE and/or overall mortality in hospitalized patients with COVID-19 was found while a similar association was not confirmed for pro-BNP.
背景自从欧洲心脏病学会（ESC）发布了对肺栓塞（PE）风险进行分层的指南以来，几位医生的主要目标是找到一种能够识别高死亡风险静脉血栓栓塞患者的生物标志物。在ESC指南（即2014年）中，B型钠尿肽原（BNP）水平的升高被认为是有用的生物标志物，用于识别PE患者的高死亡风险，但其作用在其他指南中未得到证实。肺部超声扫描（LUS）已被建议作为一种诊断和预后测试，以识别肺衰竭死亡率高的患者。本研究的目的是评估BNP原与LUS评估在新冠肺炎和PE患者中的预后作用，特别是在肺栓塞死亡率和总体死亡方面。患者和方法。我们回顾性分析了2020年3月至2021年5月期间入住我们病房（即那不勒斯镇Ospedale del Mare的COVID医学室）的178名确诊新冠肺炎患者的记录。在本研究中，我们分析了所有178名患者的LUS数据和120名患者的前BNP可用数据。对于所有选定的患者，记录PE的死亡率和总死亡人数。后果倾向评分匹配用于最小化和消除混杂因素。数据显示，血清前BNP水平与肺血栓形成事件之间的相关性在与不良结果匹配之前和之后都不存在，并且发现LUS值增加。讨论在第一波疫情期间，确诊患有严重肺衰竭的新冠肺炎患者经常表现出肺栓塞，这是一种导致危及生命的临床急性并发症。结论。在新冠肺炎住院患者中，发现LUS评分与严重PE和/或总体死亡率之间的相关性，而pro-BNP未证实类似的相关性。
{"title":"Lung ultrasound scan score can identify pulmonary embolism high risk in patients with COVID-19: a retrospective analysis from a single center","authors":"M. Coppola, G. Cardillo, M. Lugará, S. Tamburrini, F. Bizzarri, Gianmaria Chicone, F. Scotto di Uccio, Maria Flavia Coppola, M. Piccirillo, C. Liguori, C. D’Amore, A. Tuccillo, P. Madonna, G. Noschese, E. Pone, P. Di Micco","doi":"10.4081/itjm.2023.1617","DOIUrl":"https://doi.org/10.4081/itjm.2023.1617","url":null,"abstract":"Background. Since the European Society of Cardiology (ESC) published guidelines to stratify the risk of pulmonary embolism (PE), the main goal of several physicians has been to find a biomarker able to identify patients with venous thromboembolism at high risk to die. Increased levels of pro-B-type natriuretic peptide (BNP) were suggested as useful biomarkers in the guidelines of ESC (i.e., 2014) to identify patients with PE at high risk of death, but its role was not confirmed in other guidelines. Lung Ultrasound Scan (LUS) has been suggested as a diagnostic and prognostic test to identify patients with a high risk of mortality for lung failure. The aim of this study is to evaluate the prognostic role of pro- BNP together with the LUS evaluation in patients with COVID-19 and PE in particular regarding mortality for pulmonary embolism and overall death. Patients and Methods. We retrospectively analyzed records from 178 patients with confirmed COVID-19, admitted to our ward (i.e., COVID Medicine Unit at Ospedale del Mare in the town of Napoli) between March 2020 and May 2021. For this study, we analyzed the LUS data of all 178 patients and the available data on the pro-BNP of 120 patients. For all selected patients, mortality for PE and overall deaths were recorded. Results. The Propensity Score Matching was used to minimize and erase confounding factors. Data showed that an association between serum levels of pro-BNP and pulmonary thrombotic events was neither present before nor after matching an association with adverse outcomes and was found for increased values of LUS. Discussion. During the first waves of the pandemic, patients with confirmed COVID-19 with severe lung failure frequently showed pulmonary embolism as a clinical acute complication inducing life-threatening evolution. Conclusions. An association between LUS score and severe PE and/or overall mortality in hospitalized patients with COVID-19 was found while a similar association was not confirmed for pro-BNP.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49508858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Methicillin-resistant Staphylococcus Aureus (MRSA) bacteremia is a complex and lethal condition. We reported the clinical case of a 58-year-old woman who developed MRSA bacteremia after a 3-month hospitalization for trauma and sepsis. Delay in diagnosis of aortic and mitral endocarditis in the setting of new-onset regurgitations, as the application of suboptimal therapy with linezolid and vancomycin, led to widespread disease with embolic dissemination and development of septic infarctions. Clinicians must be aware of the necessity to consider as high risk of endocarditis new onset valvular regurgitations and of the evidence about the need for daptomycin in treating high-risk MRSA bacteremia.
{"title":"MRSA bacteremia and new-onset aortic and mitral regurgitation: a pernicious and tricky association","authors":"M. Cinquegrani, F. Cei, M. Pistoia, N. Mumoli","doi":"10.4081/itjm.2023.1618","DOIUrl":"https://doi.org/10.4081/itjm.2023.1618","url":null,"abstract":"Methicillin-resistant Staphylococcus Aureus (MRSA) bacteremia is a complex and lethal condition. We reported the clinical case of a 58-year-old woman who developed MRSA bacteremia after a 3-month hospitalization for trauma and sepsis. Delay in diagnosis of aortic and mitral endocarditis in the setting of new-onset regurgitations, as the application of suboptimal therapy with linezolid and vancomycin, led to widespread disease with embolic dissemination and development of septic infarctions. Clinicians must be aware of the necessity to consider as high risk of endocarditis new onset valvular regurgitations and of the evidence about the need for daptomycin in treating high-risk MRSA bacteremia.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70231360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mudathir Abdelshafea Abdelkareem Abakar, Ashwag Ali Hussein Ali, Eman Damra Ahmed Elhassan, Esra Ali Hamuda Altaher, Nosaiba Hussein Abdalbasit Musa, S. Kafi, Amira Eltom Fawzi Osman, H. Waggiallah
Cytokines have a crucial part in the pathogenesis, persistence of infection, and prognosis of hepatitis B virus (HBV) infection as HBV does not cause direct liver destruction; rather, disease-related complications and prognosis are more associated with immune system action, specifically cytokines such as TNF-α, IFN-γ, IL-6, IL-10, and other cytokines. This study sought to link TNF-, IFN-, IL-6, and IL-10 to various clinical manifestations of HBV infection. Ninety sera were taken from HBV-infected patients, 30 (33.3%) of whom had liver cirrhosis, 30 (33.3%) were HBV carriers, 19 (21.2%) were acute HBV patients, and 11 (12.2%) were recently HBV infected. ELISA was used to determine the serum levels of TNF-α, IFN-γ, IL-6, and IL-10. HBV-infected patients with liver cirrhosis had considerably higher mean serum levels of IFN-γ (P=0.005) and IL-10 (P=0.003), but TNF-α and IL-6 were significantly higher in recent HBV-infected patients (P values 0.034 and 0.004, respectively). There were substantial changes in mean serum levels of TNF-α, IFN-γ, IL-6, and IL-10 at different phases of HBV infection, implying a role for cytokines in HBV etiology, chronicity, and consequences.
{"title":"Association of TNF-α, IFN-γ, IL-6, and IL-10 with different clinical manifestations of hepatitis B infection","authors":"Mudathir Abdelshafea Abdelkareem Abakar, Ashwag Ali Hussein Ali, Eman Damra Ahmed Elhassan, Esra Ali Hamuda Altaher, Nosaiba Hussein Abdalbasit Musa, S. Kafi, Amira Eltom Fawzi Osman, H. Waggiallah","doi":"10.4081/itjm.2023.1627","DOIUrl":"https://doi.org/10.4081/itjm.2023.1627","url":null,"abstract":"Cytokines have a crucial part in the pathogenesis, persistence of infection, and prognosis of hepatitis B virus (HBV) infection as HBV does not cause direct liver destruction; rather, disease-related complications and prognosis are more associated with immune system action, specifically cytokines such as TNF-α, IFN-γ, IL-6, IL-10, and other cytokines. This study sought to link TNF-, IFN-, IL-6, and IL-10 to various clinical manifestations of HBV infection. Ninety sera were taken from HBV-infected patients, 30 (33.3%) of whom had liver cirrhosis, 30 (33.3%) were HBV carriers, 19 (21.2%) were acute HBV patients, and 11 (12.2%) were recently HBV infected. ELISA was used to determine the serum levels of TNF-α, IFN-γ, IL-6, and IL-10. HBV-infected patients with liver cirrhosis had considerably higher mean serum levels of IFN-γ (P=0.005) and IL-10 (P=0.003), but TNF-α and IL-6 were significantly higher in recent HBV-infected patients (P values 0.034 and 0.004, respectively). There were substantial changes in mean serum levels of TNF-α, IFN-γ, IL-6, and IL-10 at different phases of HBV infection, implying a role for cytokines in HBV etiology, chronicity, and consequences.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43597733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Palmiero, M. Maiello, F. Amati, M. Ciccone, T. Paul
Background. Chronic depression (CD) is common among postmenopausal women and is associated with an increased risk of cardiovascular disease (CVD). The diagnosis of CD is a challenging problem in clinical practice which is vastly underdiagnosed. CD detection in postmenopausal women with metabolic syndrome (MetS) or hypertension is necessary for CVD prevention. Our study aims to assess the prevalence of CD in postmenopausal women and the relationship between CD and MetS or hypertension. Results. The rate of CD was significantly higher among postmenopausal women with MetS compared with the control group [18% versus 8%; Odds ratio (OR) 2.2, P<0.007]. The CD rate was significantly higher among women with MetS and hypertension (21% versus 8%; OR 2.7, P<0.0000). The rate of CD was similar between women with MetS and women with hypertension, 18% versus 21%; OR 0.8, P<0.44) and between women with metabolic cardiomyopathy and hypertensive cardiomyopathy (10% versus 8%; OR 1.1, P<0.65). Conclusions. There is a relationship between MetS and CD, which is stronger when compared to women with hypertension. There is a need to improve the diagnosis of CD in postmenopausal women with MetS or hypertension as unrecognized and untreated CD is associated with a poor outcome.
{"title":"Association between metabolic syndrome, hypertension, and chronic depression: a postmenopausal women prevention study","authors":"P. Palmiero, M. Maiello, F. Amati, M. Ciccone, T. Paul","doi":"10.4081/itjm.2023.1624","DOIUrl":"https://doi.org/10.4081/itjm.2023.1624","url":null,"abstract":"Background. Chronic depression (CD) is common among postmenopausal women and is associated with an increased risk of cardiovascular disease (CVD). The diagnosis of CD is a challenging problem in clinical practice which is vastly underdiagnosed. CD detection in postmenopausal women with metabolic syndrome (MetS) or hypertension is necessary for CVD prevention. Our study aims to assess the prevalence of CD in postmenopausal women and the relationship between CD and MetS or hypertension. Results. The rate of CD was significantly higher among postmenopausal women with MetS compared with the control group [18% versus 8%; Odds ratio (OR) 2.2, P<0.007]. The CD rate was significantly higher among women with MetS and hypertension (21% versus 8%; OR 2.7, P<0.0000). The rate of CD was similar between women with MetS and women with hypertension, 18% versus 21%; OR 0.8, P<0.44) and between women with metabolic cardiomyopathy and hypertensive cardiomyopathy (10% versus 8%; OR 1.1, P<0.65). Conclusions. There is a relationship between MetS and CD, which is stronger when compared to women with hypertension. There is a need to improve the diagnosis of CD in postmenopausal women with MetS or hypertension as unrecognized and untreated CD is associated with a poor outcome.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48392540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Presciuttini, Dario Benazzi, Massimo Amato, M. Pagani
Patients hospitalized with COVID-19 pneumonia are at risk for thrombotic complications. At the same time, they need respiratory support, and they frequently require nursing in a prone position. From March to May 2020, 57 patients with acute respiratory distress syndrome were admitted to our departments. Our therapeutic protocol included anticoagulant treatment and prone positioning. We have treated three obese women affected by severe pneumonia and pectoral hematoma with post-hemorrhagic anemia. We have already described two of these cases in our previous publication; in this new article, we describe a third similar case and review clinical reports from 2020 to 2022 about hemorrhagic complications during COVID-19. Reports confirm that pectoral hematomas and bleeding in unusual sites are a complication of COVID-19. Pectoral hematomas are likely to be related to COVID-19 severity, heparin dosage, and traumatism due to cough and pronosupination.
{"title":"Hemorrhagic complications in COVID-19: three women with pectoral hematoma and a review","authors":"B. Presciuttini, Dario Benazzi, Massimo Amato, M. Pagani","doi":"10.4081/itjm.2023.1590","DOIUrl":"https://doi.org/10.4081/itjm.2023.1590","url":null,"abstract":"Patients hospitalized with COVID-19 pneumonia are at risk for thrombotic complications. At the same time, they need respiratory support, and they frequently require nursing in a prone position. From March to May 2020, 57 patients with acute respiratory distress syndrome were admitted to our departments. Our therapeutic protocol included anticoagulant treatment and prone positioning. We have treated three obese women affected by severe pneumonia and pectoral hematoma with post-hemorrhagic anemia. We have already described two of these cases in our previous publication; in this new article, we describe a third similar case and review clinical reports from 2020 to 2022 about hemorrhagic complications during COVID-19. Reports confirm that pectoral hematomas and bleeding in unusual sites are a complication of COVID-19. Pectoral hematomas are likely to be related to COVID-19 severity, heparin dosage, and traumatism due to cough and pronosupination.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44249933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. Urotensin II (U II) is a kind of active peptide with a variety of biological effects, such as promoting cell proliferation and endocrine effects. The aim of this study is to investigate the effect of urotensin II on the proliferation and secretion of vascular endothelial growth factor (VEGF) in cultured rat dermal papilla cells (DPCs), and to explore its molecular mechanism. Materials and Methods. We used the DPCs isolated from the thoracic aortas of Wistar-Kyoto rats to run the CCK8 and ELISA assay, RC-PCR and Western blotting techniques to identify the effect of Urotensin II on the proliferation and secretion of VEGF in DPCs, data were analyzed by one-way ANOVA or t-test. Results. U II can increase the mRNA expression of proliferation markers Ki67 and PCNA. In addition, the Wnt/β-catenin pathway was activated by U II, but Wnt inhibitor DKK1 reversed the effect of U II. Conclusions. U II promoted the proliferation and secretion of VEGF in rat DPCs through activation of the Wnt-β-catenin signaling pathway.
{"title":"Urotensin II promotes the proliferation and secretion of vascular endothelial growth factor in rat dermal papilla cells by activating the Wnt-β-catenin signaling pathway","authors":"Congjuan Liao, Zhen Huang, Liuting Chen, Xiao-guang Fan, J. Peng, Xiaoqing Tan, Jian-Bin Yang, Xusheng Zhang","doi":"10.4081/itjm.2023.1607","DOIUrl":"https://doi.org/10.4081/itjm.2023.1607","url":null,"abstract":"Introduction. Urotensin II (U II) is a kind of active peptide with a variety of biological effects, such as promoting cell proliferation and endocrine effects. The aim of this study is to investigate the effect of urotensin II on the proliferation and secretion of vascular endothelial growth factor (VEGF) in cultured rat dermal papilla cells (DPCs), and to explore its molecular mechanism. Materials and Methods. We used the DPCs isolated from the thoracic aortas of Wistar-Kyoto rats to run the CCK8 and ELISA assay, RC-PCR and Western blotting techniques to identify the effect of Urotensin II on the proliferation and secretion of VEGF in DPCs, data were analyzed by one-way ANOVA or t-test. Results. U II can increase the mRNA expression of proliferation markers Ki67 and PCNA. In addition, the Wnt/β-catenin pathway was activated by U II, but Wnt inhibitor DKK1 reversed the effect of U II. Conclusions. U II promoted the proliferation and secretion of VEGF in rat DPCs through activation of the Wnt-β-catenin signaling pathway.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47163052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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