This study compared the role of octreotide and proton pump inhibitor (PPI) in preventing acute pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). The 320 patients who received ERCP from January 2019 to June 2022 were randomly and evenly divided into octreotide, PPI, combined treatment and control groups. The incidence of post-ERCP acute pancreatitis (PEP) and hyperamylasemia was counted. The incidence of PEP and hyperamylasemia after surgery differed significantly among all groups. For incidence of PEP, it was similar in the control, octreotide and PPI groups (12.50%, 8.75% and 10.00%), all of which were higher than that of the combined treatment group (1.25%). The incidence of hyperamylasemia was similar between the octreotide and PPI groups (12.50% and 13.75%), both decreased compared with the control group (32.50%), and further lowered in the combined treatment group (8.75%), and all differences were statistically significant (p < 0.05). For patients with choledocholithiasis, the incidence of hyperamylasemia in the combined treatment group was lower than that in the other three groups (8.33%, 31.25%, 21.43% and 16.67%) after intervention, while there were no significant differences in the incidence of PEP and hyperamylasemia in patients with cholangiocarcinoma, pancreatic head carcinoma and other lesions. In conclusion, preoperative application of octreotide or PPI alone has a slight effect on preventing PEP and hyperamylasemia after ERCP, and their combination is dramatically effective in preventing PEP.
{"title":"Comparison of octreotide and proton pump inhibitor in the prevention of acute pancreatitis after endoscopic retrograde cholangiopancreatography for different diseases","authors":"","doi":"10.22514/sv.2023.090","DOIUrl":"https://doi.org/10.22514/sv.2023.090","url":null,"abstract":"This study compared the role of octreotide and proton pump inhibitor (PPI) in preventing acute pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). The 320 patients who received ERCP from January 2019 to June 2022 were randomly and evenly divided into octreotide, PPI, combined treatment and control groups. The incidence of post-ERCP acute pancreatitis (PEP) and hyperamylasemia was counted. The incidence of PEP and hyperamylasemia after surgery differed significantly among all groups. For incidence of PEP, it was similar in the control, octreotide and PPI groups (12.50%, 8.75% and 10.00%), all of which were higher than that of the combined treatment group (1.25%). The incidence of hyperamylasemia was similar between the octreotide and PPI groups (12.50% and 13.75%), both decreased compared with the control group (32.50%), and further lowered in the combined treatment group (8.75%), and all differences were statistically significant (p < 0.05). For patients with choledocholithiasis, the incidence of hyperamylasemia in the combined treatment group was lower than that in the other three groups (8.33%, 31.25%, 21.43% and 16.67%) after intervention, while there were no significant differences in the incidence of PEP and hyperamylasemia in patients with cholangiocarcinoma, pancreatic head carcinoma and other lesions. In conclusion, preoperative application of octreotide or PPI alone has a slight effect on preventing PEP and hyperamylasemia after ERCP, and their combination is dramatically effective in preventing PEP.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135358150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Though chest radiography is a first-line diagnostic tool in the emergency department (ED), interpretation has a high error rate. We aimed to evaluate the usability and acceptability of deep learning-based computer-aided detection for chest radiography (DeepCADCR) in an ED environment. We conducted a single-institution survey of emergency physicians (EPs) who had used DeepCADCR (Lunit INSIGHT Chest Xray (CXR), version 3.1.4.1) as part of their ED workflow for at least three months. We developed 22 questions that assessed the subscales of effectiveness, efficiency, safety, satisfaction, and reliability. A seven-point Likert agreement scale was used to rate the responses. A total of 23 EPs who completed the survey was enrolled in the study. When averaged by subscale, satisfaction scores were highest (mean 4.71, standard deviation (SD) 1.43), and safety scores were lowest (mean 4.3, SD 0.72). When scores were converted to acceptability, the total average acceptance of DeepCADCR was 86.0%, with higher scores in ED residents than ED specialists for all subscales. Use of DeepCADCR in the ED workflow was well accepted by EPs.
{"title":"Effect of an artificial-intelligent chest radiographs reporting system in an emergency department","authors":"","doi":"10.22514/sv.2023.108","DOIUrl":"https://doi.org/10.22514/sv.2023.108","url":null,"abstract":"Though chest radiography is a first-line diagnostic tool in the emergency department (ED), interpretation has a high error rate. We aimed to evaluate the usability and acceptability of deep learning-based computer-aided detection for chest radiography (DeepCADCR) in an ED environment. We conducted a single-institution survey of emergency physicians (EPs) who had used DeepCADCR (Lunit INSIGHT Chest Xray (CXR), version 3.1.4.1) as part of their ED workflow for at least three months. We developed 22 questions that assessed the subscales of effectiveness, efficiency, safety, satisfaction, and reliability. A seven-point Likert agreement scale was used to rate the responses. A total of 23 EPs who completed the survey was enrolled in the study. When averaged by subscale, satisfaction scores were highest (mean 4.71, standard deviation (SD) 1.43), and safety scores were lowest (mean 4.3, SD 0.72). When scores were converted to acceptability, the total average acceptance of DeepCADCR was 86.0%, with higher scores in ED residents than ED specialists for all subscales. Use of DeepCADCR in the ED workflow was well accepted by EPs.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135508776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In South Korea, the manner and cause of death are determined by physicians. The present study aimed to investigate the differences in decisions made by physicians when completing death certificates and the factors that lead to these differences in South Korea. Questionnaires were used to survey 210 physicians who routinely complete death certificates, and demographic data along with information on their decisions regarding the manner and cause of death as well as natural and unnatural contributory causes were ascertained for eight representative cases. The study sample comprised 149 (71.0%) and 61 (29.0%) male and female physicians, respectively, and the mean age in this sample was 36.93 ± 4.51 years. We found that 64.7%, 61.4%, 7.6%, 4.3%, 4.3%, 65.7%, 84.3%and 53.3% of the physicians considered cases 1, 2, 3, 4, 5, 6, 7 and 8 as unnatural deaths, respectively, while 27.6%, 32.0%, 91.9%, 95%, 8.5%, 26.6%, 6.7% and 38.1%considered them to be natural deaths, respectively. In Case 5, 81.7% considered death to be due to an indeterminate cause. We found that differences may exist in how physicians select the manner of death when completing a death certificate and that this decision is influenced by several factors.
{"title":"Differences in the determination of manner of death for death certificates by physicians in South Korea: questionnaire survey","authors":"","doi":"10.22514/sv.2023.079","DOIUrl":"https://doi.org/10.22514/sv.2023.079","url":null,"abstract":"In South Korea, the manner and cause of death are determined by physicians. The present study aimed to investigate the differences in decisions made by physicians when completing death certificates and the factors that lead to these differences in South Korea. Questionnaires were used to survey 210 physicians who routinely complete death certificates, and demographic data along with information on their decisions regarding the manner and cause of death as well as natural and unnatural contributory causes were ascertained for eight representative cases. The study sample comprised 149 (71.0%) and 61 (29.0%) male and female physicians, respectively, and the mean age in this sample was 36.93 ± 4.51 years. We found that 64.7%, 61.4%, 7.6%, 4.3%, 4.3%, 65.7%, 84.3%and 53.3% of the physicians considered cases 1, 2, 3, 4, 5, 6, 7 and 8 as unnatural deaths, respectively, while 27.6%, 32.0%, 91.9%, 95%, 8.5%, 26.6%, 6.7% and 38.1%considered them to be natural deaths, respectively. In Case 5, 81.7% considered death to be due to an indeterminate cause. We found that differences may exist in how physicians select the manner of death when completing a death certificate and that this decision is influenced by several factors.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136218163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.22514/10.22514/sv.2023.089
This study aims to explore the clinical significance of C-reactive protein, leukocyte and immunoglobulin in the diagnosis and treatment of infantile pneumonia at acute stage. From January to December 2018, a total of 124 children with pneumonia and healthy children admitted to our hospital were selected as study objects. Among them, 62 children diagnosed with bacterial pneumonia were categorized as the study group, and 62 healthy children who came for physical examination were classified as the control group. The levels of C-reactive protein (CRP), white blood cell (WBC) and immunoglobulin (IgA, IgM and IgG) were observed and compared in the two groups. In this study, higher levels of CRP, IgM, IgG and WBC, along with lower level of IgA were observed in the study group as compared with that in the control group. In the study group, the levels of CRP, IgM, IgG and WBC were lower, but the IgA level was higher in children with mild pneumonia than those with severe pneumonia. After treatment, the levels of CRP, IgM, IgG and WBC were decreased but IgA level was increased after treatment compared with before treatment. In particular, the levels of CRP, WBC, IgA, IgM and IgG in the study group after treatment were restored to comparable levels compared with the control group. Therefore, C-reactive protein, leukocyte and immunoglobulin can be used to determine the diagnosis, condition and outcome of children with pneumonia in the acute stage. This study can provide guidance for clinical diagnosis and treatment of infantile pneumonia based
{"title":"Clinical application of C-reactive protein, leukocyte and immunoglobulin in the diagnosis and treatment of infantile pneumonia at acute stage","authors":"","doi":"10.22514/10.22514/sv.2023.089","DOIUrl":"https://doi.org/10.22514/10.22514/sv.2023.089","url":null,"abstract":"This study aims to explore the clinical significance of C-reactive protein, leukocyte and immunoglobulin in the diagnosis and treatment of infantile pneumonia at acute stage. From January to December 2018, a total of 124 children with pneumonia and healthy children admitted to our hospital were selected as study objects. Among them, 62 children diagnosed with bacterial pneumonia were categorized as the study group, and 62 healthy children who came for physical examination were classified as the control group. The levels of C-reactive protein (CRP), white blood cell (WBC) and immunoglobulin (IgA, IgM and IgG) were observed and compared in the two groups. In this study, higher levels of CRP, IgM, IgG and WBC, along with lower level of IgA were observed in the study group as compared with that in the control group. In the study group, the levels of CRP, IgM, IgG and WBC were lower, but the IgA level was higher in children with mild pneumonia than those with severe pneumonia. After treatment, the levels of CRP, IgM, IgG and WBC were decreased but IgA level was increased after treatment compared with before treatment. In particular, the levels of CRP, WBC, IgA, IgM and IgG in the study group after treatment were restored to comparable levels compared with the control group. Therefore, C-reactive protein, leukocyte and immunoglobulin can be used to determine the diagnosis, condition and outcome of children with pneumonia in the acute stage. This study can provide guidance for clinical diagnosis and treatment of infantile pneumonia based","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"320 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135357794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melatonin is a neurohormone well-known as sleep disorder treatment. A few clinical trials have recently pointed out the biological plausibility of utilising melatonin in the treatment of coronavirus disease 2019 (COVID-19, SARS-CoV-2) patients. Melatonin wide range of activities include anti-inflammatory, antiviral and antioxidant effects. Our meta-analysis aimed to investigate the effect of melatonin on mortality in COVID-19 patients with different disease severity. We searched PubMed, EMBASE, Web of Science with no language restrictions updated on February 2023 for randomized and propensity matched studies, comparing melatonin plus standard COVID-19 therapy vs. standard COVID-19 therapy alone. Patients had to be hospitalised with a confirmed diagnosis of SARS-CoV-2 infection. Primary outcome was mortality at the longest follow-up available. We included 7 randomized and 1 propensity matched studies enrolling 1155 overall patients with a mean age of 61 ± 19.5 years. We found a reduced mortality rate in the overall population (127/575 (22%) vs. 209/580 (36%) Relative Risk: 0.62 (confidence interval (CI): 0.40, 0.96), I2 = 86% p = 0.03, with the results confirmed when pooling the 5 studies which administered melatonin in non-intensive-care-unit patients (26/423 (6.1%) vs. 69/419 (16%) Relative Risk 0.30 (CI: 0.10, 0.86), I2 = 40% p = 0.02). According to recent randomized and propensity matched evidence, melatonin might be a life-saving adjuvant therapy in COVID-19 patients. This effect was mainly driven by non-intensive care unit patients.
褪黑素是一种神经激素，以治疗睡眠障碍而闻名。最近的一些临床试验指出，使用褪黑激素治疗2019冠状病毒病(COVID-19, SARS-CoV-2)患者具有生物学上的合理性。褪黑素具有广泛的抗炎、抗病毒和抗氧化作用。我们的荟萃分析旨在探讨褪黑素对不同疾病严重程度的COVID-19患者死亡率的影响。我们检索了2023年2月更新的PubMed, EMBASE, Web of Science(无语言限制)，以进行随机和倾向匹配研究，比较褪黑素加标准COVID-19治疗与单独标准COVID-19治疗。患者必须在确诊为SARS-CoV-2感染后住院。主要结局是最长随访时的死亡率。我们纳入了7项随机研究和1项倾向匹配研究，共纳入1155例患者，平均年龄为61±19.5岁。我们发现总体死亡率降低(127/575 (22%)vs. 209/580(36%))相对危险度:0.62(置信区间(CI): 0.40, 0.96)， I2 = 86% p = 0.03，合并5项在非重症监护室患者中使用褪黑素的研究(26/423 (6.1%)vs. 69/419(16%)相对危险度0.30 (CI: 0.10, 0.86)， I2 = 40% p = 0.02)时证实了这一结果。根据最近的随机和倾向匹配证据，褪黑素可能是COVID-19患者的救命辅助疗法。这种影响主要由非重症监护病房患者驱动。
{"title":"Melatonin as adjuvant treatment in COVID-19 patients. A meta-analysis of randomized and propensity matched studies","authors":"","doi":"10.22514/sv.2023.076","DOIUrl":"https://doi.org/10.22514/sv.2023.076","url":null,"abstract":"Melatonin is a neurohormone well-known as sleep disorder treatment. A few clinical trials have recently pointed out the biological plausibility of utilising melatonin in the treatment of coronavirus disease 2019 (COVID-19, SARS-CoV-2) patients. Melatonin wide range of activities include anti-inflammatory, antiviral and antioxidant effects. Our meta-analysis aimed to investigate the effect of melatonin on mortality in COVID-19 patients with different disease severity. We searched PubMed, EMBASE, Web of Science with no language restrictions updated on February 2023 for randomized and propensity matched studies, comparing melatonin plus standard COVID-19 therapy vs. standard COVID-19 therapy alone. Patients had to be hospitalised with a confirmed diagnosis of SARS-CoV-2 infection. Primary outcome was mortality at the longest follow-up available. We included 7 randomized and 1 propensity matched studies enrolling 1155 overall patients with a mean age of 61 ± 19.5 years. We found a reduced mortality rate in the overall population (127/575 (22%) vs. 209/580 (36%) Relative Risk: 0.62 (confidence interval (CI): 0.40, 0.96), I2 = 86% p = 0.03, with the results confirmed when pooling the 5 studies which administered melatonin in non-intensive-care-unit patients (26/423 (6.1%) vs. 69/419 (16%) Relative Risk 0.30 (CI: 0.10, 0.86), I2 = 40% p = 0.02). According to recent randomized and propensity matched evidence, melatonin might be a life-saving adjuvant therapy in COVID-19 patients. This effect was mainly driven by non-intensive care unit patients.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"2015 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136137600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The coronavirus disease 2019 (COVID-19) pandemic has been ongoing for more than two years and is likely to continue. Scutellaria barbata (S. barbata) is a traditional Chinese herbal medicine with anti-inflammatory and anti-viral properties and has demonstrated therapeutic effects on patients with COVID-19. Our study aims to shed light on the underlying mechanism and identify possible therapeutic targets. The data on the expression of COVID-19 viremia-associated genes were retrieved from five disease-gene databases. The expression pattern of genes encoding for functional monomer components of S. barbata was retrieved from the Traditional Chinese Medicine Systems Pharmacology platform. To determine the potential mechanism, we used “Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses,” and the protein-protein interaction (PPI) network was constructed using the STRING online tool. CytoNCA, a plug-in for Cytoscape, was used for screening the hub genes. The AutoDocktools and the “PyMOL” software were used for performing molecular docking between active molecules of drugs and disease-target proteins. We identified the S. barbata target and COVID-19 viremia-associated gene sets consisting of 42 genes. GO functional enrichment analysis showed that S. barbata can act by the regulation of cytokine activity and the cytokine-mediated signaling pathway. KEGG pathway enrichment analysis showed that these genes were enriched in several pathways like T helper cell 17 differentiation, the Tumor necrosis factor, and Interleukin-17 signaling pathways. In addition, we identified 17 hub genes, including JUN, RELA, TNF, IL6, etc., using the PPI network and subnetworks. Molecular docking was performed on two highly significant genes: JUN and RELA. The former is a transcription factor, regulating activation-induced cell death, Interferon response post-COVID-19 infection, CD95 ligand promoter activity, and the expression of cytokine genes in T-cells. The five active compounds of S. barbata, including baicalein, wogonin, quercetin, luteolin, and beta-sitosterol, could enter the active pockets of COVID-19 to exert potential therapeutic effects on COVID-19 viremia. JUN and RELA could weaken T cell-mediated immune and cytokine-related inflammatory responses. They could be used as therapeutic targets and could aid in reducing COVID-19 viremia.
2019冠状病毒病(COVID-19)大流行已经持续了两年多，并且可能会持续下去。barbata Scutellaria barbata (S. barbata)是一种具有抗炎和抗病毒特性的传统中草药，对COVID-19患者有治疗作用。我们的研究旨在阐明潜在的机制并确定可能的治疗靶点。从5个疾病基因数据库中检索COVID-19病毒血症相关基因的表达数据。从中药系统药理学平台检索芭芭拉功能单体成分编码基因的表达模式。为了确定潜在的机制，我们使用了“基因本体(GO)和京都基因与基因组百科全书(KEGG)途径富集分析”，并使用STRING在线工具构建了蛋白质-蛋白质相互作用(PPI)网络。利用Cytoscape插件CytoNCA对中心基因进行筛选。AutoDocktools和“PyMOL”软件用于药物活性分子与疾病靶蛋白之间的分子对接。我们确定了S. barbata靶基因和COVID-19病毒血症相关基因集，包括42个基因。氧化石墨烯功能富集分析表明，芭芭拉可通过调节细胞因子活性和细胞因子介导的信号通路发挥作用。KEGG通路富集分析显示，这些基因富集于T辅助细胞17分化、肿瘤坏死因子和白细胞介素-17信号通路等多种通路。此外，我们利用PPI网络和子网络鉴定了17个枢纽基因，包括JUN、RELA、TNF、IL6等。对JUN和RELA两个高度显著的基因进行了分子对接。前者是一种转录因子，调节活化诱导的细胞死亡、covid -19感染后的干扰素应答、CD95配体启动子活性以及t细胞中细胞因子基因的表达。芭芭蕉中黄芩素、枸杞素、槲皮素、木犀草素、谷甾醇等5种活性成分可进入新冠病毒活性口袋，对新冠病毒血症发挥潜在的治疗作用。JUN和RELA可以减弱T细胞介导的免疫和细胞因子相关的炎症反应。它们可以用作治疗靶点，并有助于减少COVID-19病毒血症。
{"title":"Network pharmacology and molecular docking analyses on Scutellaria barbata indicate that JUN and RELA are potential targets to treat and prevent COVID-19 viremia","authors":"","doi":"10.22514/sv.2023.083","DOIUrl":"https://doi.org/10.22514/sv.2023.083","url":null,"abstract":"The coronavirus disease 2019 (COVID-19) pandemic has been ongoing for more than two years and is likely to continue. Scutellaria barbata (S. barbata) is a traditional Chinese herbal medicine with anti-inflammatory and anti-viral properties and has demonstrated therapeutic effects on patients with COVID-19. Our study aims to shed light on the underlying mechanism and identify possible therapeutic targets. The data on the expression of COVID-19 viremia-associated genes were retrieved from five disease-gene databases. The expression pattern of genes encoding for functional monomer components of S. barbata was retrieved from the Traditional Chinese Medicine Systems Pharmacology platform. To determine the potential mechanism, we used “Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses,” and the protein-protein interaction (PPI) network was constructed using the STRING online tool. CytoNCA, a plug-in for Cytoscape, was used for screening the hub genes. The AutoDocktools and the “PyMOL” software were used for performing molecular docking between active molecules of drugs and disease-target proteins. We identified the S. barbata target and COVID-19 viremia-associated gene sets consisting of 42 genes. GO functional enrichment analysis showed that S. barbata can act by the regulation of cytokine activity and the cytokine-mediated signaling pathway. KEGG pathway enrichment analysis showed that these genes were enriched in several pathways like T helper cell 17 differentiation, the Tumor necrosis factor, and Interleukin-17 signaling pathways. In addition, we identified 17 hub genes, including JUN, RELA, TNF, IL6, etc., using the PPI network and subnetworks. Molecular docking was performed on two highly significant genes: JUN and RELA. The former is a transcription factor, regulating activation-induced cell death, Interferon response post-COVID-19 infection, CD95 ligand promoter activity, and the expression of cytokine genes in T-cells. The five active compounds of S. barbata, including baicalein, wogonin, quercetin, luteolin, and beta-sitosterol, could enter the active pockets of COVID-19 to exert potential therapeutic effects on COVID-19 viremia. JUN and RELA could weaken T cell-mediated immune and cytokine-related inflammatory responses. They could be used as therapeutic targets and could aid in reducing COVID-19 viremia.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135358170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the impact of non-invasive sequential ventilation treatment based on the use of an invasive ventilator on the arterial blood gas and inflammatory stress reaction in patients with severe pneumonia with respiratory failure. Ninety patients with severe pneumonia and respiratory failure were equally separated into two groups via a random number table: a conventional treatment group (subjected to invasive mechanical ventilation) and a study group (subjected to invasive mechanical ventilation and non-invasive sequential ventilation treatment). We compared the two groups with respect to several key parameters before and after treatment, including mechanical ventilation time, invasive ventilation time, intensive care unit (ICU) stay, hospital stay, blood gas analysis indicators and the levels of inflammatory factors in the serum. We also compared the two groups with regards to complications. Mechanical ventilation time, invasive ventilation time, ICU stay and hospital stay in the study group were significantly shorter than that in the conventional treatment group (p < 0.05). Arterial Oxygen Saturation (SaO2), Partial Pressure of Oxygen (PaO2) and pH in the study group after intervention were significantly higher than those in the conventional treatment group after intervention (p < 0.05). Following intervention, white blood cell (WBC), serum c-reactive protein (CRP) and serum interleukin-6 (IL-6) were significantly lower than those in the conventional treatment group (p < 0.05). The total incidence of complications in the study group was markedly lower than in the conventional treatment group. Non-invasive sequential ventilation therapy based on an invasive ventilator had a significant treatment impact on patients with severe pneumonia and respiratory failure. This treatment effectively reduced the average treatment time, improved blood gas analysis indicators and reduced inflammatory stress, thus reducing the incidence of complications.
{"title":"The effect of non-invasive sequential ventilation treatment based on the use of an invasive ventilator on the arterial blood gas and inflammatory stress reaction in patients with severe pneumonia with respiratory failure","authors":"","doi":"10.22514/sv.2023.105","DOIUrl":"https://doi.org/10.22514/sv.2023.105","url":null,"abstract":"To investigate the impact of non-invasive sequential ventilation treatment based on the use of an invasive ventilator on the arterial blood gas and inflammatory stress reaction in patients with severe pneumonia with respiratory failure. Ninety patients with severe pneumonia and respiratory failure were equally separated into two groups via a random number table: a conventional treatment group (subjected to invasive mechanical ventilation) and a study group (subjected to invasive mechanical ventilation and non-invasive sequential ventilation treatment). We compared the two groups with respect to several key parameters before and after treatment, including mechanical ventilation time, invasive ventilation time, intensive care unit (ICU) stay, hospital stay, blood gas analysis indicators and the levels of inflammatory factors in the serum. We also compared the two groups with regards to complications. Mechanical ventilation time, invasive ventilation time, ICU stay and hospital stay in the study group were significantly shorter than that in the conventional treatment group (p < 0.05). Arterial Oxygen Saturation (SaO2), Partial Pressure of Oxygen (PaO2) and pH in the study group after intervention were significantly higher than those in the conventional treatment group after intervention (p < 0.05). Following intervention, white blood cell (WBC), serum c-reactive protein (CRP) and serum interleukin-6 (IL-6) were significantly lower than those in the conventional treatment group (p < 0.05). The total incidence of complications in the study group was markedly lower than in the conventional treatment group. Non-invasive sequential ventilation therapy based on an invasive ventilator had a significant treatment impact on patients with severe pneumonia and respiratory failure. This treatment effectively reduced the average treatment time, improved blood gas analysis indicators and reduced inflammatory stress, thus reducing the incidence of complications.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135559616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This retrospective study aimed to investigate the clinical features and treatment of pediatric subglottic hemangioma (SH), identify risk factors for treatment-induced adverse effects, and identify a strategy for timely therapy discontinuation in children diagnosed with SH at the national pediatric center. Medical records of patients presented with stridor from 2010 to 2020 were retrieved and assessed, the diagnosis of SH was established via flexible bronchoscopy, and the patients were treated using propranolol with a subsequent gradual dose increase to 3 mg/kg body weight daily. A two-week oral steroids trial was added for those with circumferential lesions. Early indicators of a good therapeutic response included decreased stridor and primary lesion size on follow-up bronchoscopy performed one week after propranolol commencement. Duration of therapy, tailored individually based on bronchoscopy findings, and at least twelve months of treatment were the two main criteria for deciding therapy termination. Outpatient visits were arranged at least every three months. Our results showed that SH was the third most frequent cause of stridor (15/137 patients), and biphasic stridor was uniformly present as a typical symptom. Both clinical improvement and bronchoscopy findings confirmed the efficacy of the treatment. The mean therapy duration was 17 months. The only significant adverse event observed was hypoglycemic seizures in one infant. Contributory factors were all prematurity, high propranolol dose (3 mg/kg) and poor oral intake. Collectively, defining a safe and timely protocol for therapy cessation and avoidance of risk factors for adverse effects is the mainstay of SH treatment.
{"title":"Subglottic hemangioma—prevalence, clinical presentation and treatment","authors":"","doi":"10.22514/sv.2023.095","DOIUrl":"https://doi.org/10.22514/sv.2023.095","url":null,"abstract":"This retrospective study aimed to investigate the clinical features and treatment of pediatric subglottic hemangioma (SH), identify risk factors for treatment-induced adverse effects, and identify a strategy for timely therapy discontinuation in children diagnosed with SH at the national pediatric center. Medical records of patients presented with stridor from 2010 to 2020 were retrieved and assessed, the diagnosis of SH was established via flexible bronchoscopy, and the patients were treated using propranolol with a subsequent gradual dose increase to 3 mg/kg body weight daily. A two-week oral steroids trial was added for those with circumferential lesions. Early indicators of a good therapeutic response included decreased stridor and primary lesion size on follow-up bronchoscopy performed one week after propranolol commencement. Duration of therapy, tailored individually based on bronchoscopy findings, and at least twelve months of treatment were the two main criteria for deciding therapy termination. Outpatient visits were arranged at least every three months. Our results showed that SH was the third most frequent cause of stridor (15/137 patients), and biphasic stridor was uniformly present as a typical symptom. Both clinical improvement and bronchoscopy findings confirmed the efficacy of the treatment. The mean therapy duration was 17 months. The only significant adverse event observed was hypoglycemic seizures in one infant. Contributory factors were all prematurity, high propranolol dose (3 mg/kg) and poor oral intake. Collectively, defining a safe and timely protocol for therapy cessation and avoidance of risk factors for adverse effects is the mainstay of SH treatment.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135595182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Severe COVID-19 patients can develop a maladaptive immune response with hyper-production of cytokines and chemokines which lead to alveolar damage, endothelial activation, coagulopathy and thromboembolic events. We performed a meta-analysis which included any study performed on COVID-19 patients with respiratory hypoxemic failure who received anakinra versus any comparator. Primary endpoint was mortality. Secondary endpoints were intubation rate, superinfection and thromboembolic events. Subgroups analyses included patients in general ward, with hyperinflammation and/or baseline ratio of arterial oxygen partial pressure (PaO2) to fractional inspired oxygen (FiO2) >200. Twenty-four studies were included. Mortality in anakinra patients was significantly lower than mortality of controls (19% vs. 28%; p < 0.0001). Anakinra patients had significantly lower risk of intubation (16% vs. 33%; p < 0.001). Mortality reduction was confirmed in general ward settings, in patients with hyperinflammation and with PaO2/FiO2 >200, but not when selecting randomized studies only. A trend towards increased mortality in more severe patients was observed.
严重的COVID-19患者可出现适应性不良的免疫反应，产生过多的细胞因子和趋化因子，导致肺泡损伤、内皮细胞激活、凝血功能障碍和血栓栓塞事件。我们进行了一项荟萃分析，其中包括对接受阿那金与任何比较药物的COVID-19呼吸低氧血症衰竭患者进行的任何研究。主要终点是死亡率。次要终点为插管率、重复感染和血栓栓塞事件。亚组分析包括普通病房、高炎症和/或基线动脉氧分压(PaO2)与分次吸入氧(FiO2)之比[gt;200]的患者。纳入了24项研究。阿那金组患者的死亡率显著低于对照组(19% vs. 28%; p <0.0001)。Anakinra患者插管风险显著降低(16% vs. 33%; p <0.001)。在普通病房、高炎症患者和PaO2/FiO2 [gt;200]患者中证实死亡率降低，但仅在选择随机研究时未证实死亡率降低。观察到在较严重的病人中死亡率增加的趋势。
{"title":"Anakinra for patients with COVID-19: an updated systematic review and meta-analysis","authors":"","doi":"10.22514/sv.2023.025","DOIUrl":"https://doi.org/10.22514/sv.2023.025","url":null,"abstract":"Severe COVID-19 patients can develop a maladaptive immune response with hyper-production of cytokines and chemokines which lead to alveolar damage, endothelial activation, coagulopathy and thromboembolic events. We performed a meta-analysis which included any study performed on COVID-19 patients with respiratory hypoxemic failure who received anakinra versus any comparator. Primary endpoint was mortality. Secondary endpoints were intubation rate, superinfection and thromboembolic events. Subgroups analyses included patients in general ward, with hyperinflammation and/or baseline ratio of arterial oxygen partial pressure (PaO2) to fractional inspired oxygen (FiO2) >200. Twenty-four studies were included. Mortality in anakinra patients was significantly lower than mortality of controls (19% vs. 28%; p < 0.0001). Anakinra patients had significantly lower risk of intubation (16% vs. 33%; p < 0.001). Mortality reduction was confirmed in general ward settings, in patients with hyperinflammation and with PaO2/FiO2 >200, but not when selecting randomized studies only. A trend towards increased mortality in more severe patients was observed.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135635916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 7-year-old girl presented with a 2-day history of fever and chest pain that led her to collapse, prompting her father to call the emergency medical services (EMS). Both an EMS ambulance and a physician-staffed ambulance were dispatched to the scene. Upon arrival, the EMS crew discovered that the patient was in cardiac arrest, with ventricular fibrillation (VF) as the initial heart rhythm. Due to the patient’s refractory VF, the physician requested the receiving hospital to prepare for extracorporeal cardiopulmonary resuscitation (ECPR), which was successfully initiated 105 minutes after the patient’s collapse. The patient was admitted to the intensive care unit, where her cardiac function gradually improved. On the eighth day, she was successfully weaned off extracorporeal membrane oxygenation and discharged from the hospital on the thirty-third day without any neurological complications. The presumed cause of the cardiac arrest was fulminant myocarditis, based on the patient’s clinical history and findings from cardiac magnetic resonance imaging. Overall, early mechanical cardiopulmonary support is crucial for patients with fulminant myocarditis. However, cases resulting in out-of-hospital cardiac arrest generally have poor outcomes, even with ECPR. This particular case demonstrated that optimal resuscitation, spanning from the prehospital phase to the intensive care unit, utilizing ECPR, played a vital role in achieving a favorable neurological outcome.
{"title":"A case of pediatric out-of-hospital cardiac arrest due to fulminant myocarditis requiring extracorporeal cardiopulmonary resuscitation","authors":"","doi":"10.22514/sv.2023.075","DOIUrl":"https://doi.org/10.22514/sv.2023.075","url":null,"abstract":"A 7-year-old girl presented with a 2-day history of fever and chest pain that led her to collapse, prompting her father to call the emergency medical services (EMS). Both an EMS ambulance and a physician-staffed ambulance were dispatched to the scene. Upon arrival, the EMS crew discovered that the patient was in cardiac arrest, with ventricular fibrillation (VF) as the initial heart rhythm. Due to the patient’s refractory VF, the physician requested the receiving hospital to prepare for extracorporeal cardiopulmonary resuscitation (ECPR), which was successfully initiated 105 minutes after the patient’s collapse. The patient was admitted to the intensive care unit, where her cardiac function gradually improved. On the eighth day, she was successfully weaned off extracorporeal membrane oxygenation and discharged from the hospital on the thirty-third day without any neurological complications. The presumed cause of the cardiac arrest was fulminant myocarditis, based on the patient’s clinical history and findings from cardiac magnetic resonance imaging. Overall, early mechanical cardiopulmonary support is crucial for patients with fulminant myocarditis. However, cases resulting in out-of-hospital cardiac arrest generally have poor outcomes, even with ECPR. This particular case demonstrated that optimal resuscitation, spanning from the prehospital phase to the intensive care unit, utilizing ECPR, played a vital role in achieving a favorable neurological outcome.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135949781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：