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Substance use during COVID-19 pandemic: impact on the underserved communities COVID-19大流行期间的物质使用:对服务不足社区的影响
Pub Date : 2021-12-31 DOI: 10.15190/d.2021.20
Natalia C. Chacon, N. Walia, Abigail Allen, Anthony Sciancalepore, J. Tiong, R. Quick, Sanjana Mada, M. A. Diaz, Ivan Rodriguez
The number of overdose deaths are on the rise all over the world. An estimate of 93,000 drug overdose deaths have been estimated in the United States in 2020. COVID-19 pandemic has exacerbated the drug crisis. Factors, such as existing health disparities among underserved communities, lack of resources for people of color, lack of belief in available resources, social isolation and economic burden, limited access to treatment, regulatory barriers in telehealth, and stress from the on-going COVID-19 pandemic have been identified as some of the key factors behind the acute health effects of people with substance use disorder. These interrelated factors exacerbate the impact of already existing disparities in the underserved communities. Policy and regulatory changes around telehealth and access of treatment for substance use disorder are warranted. Evidence-based strategies and other safer drug practices should be implemented to mitigate the impact on human health. Investment in programs that increase access to treatment, will be useful for potential future pandemics, where increasing mental health services and overall access to healthcare in disadvantaged communities would lessen the disparities in physical and mental ailments. In this review, we are evaluating and summarizing the acute health effects of the ongoing COVID-19 pandemic on individuals with substance use disorder.
世界各地的过量死亡人数都在上升。据估计,2020年美国有9.3万人死于药物过量。COVID-19大流行加剧了毒品危机。服务不足社区之间存在的健康差距、有色人种缺乏资源、对现有资源缺乏信心、社会孤立和经济负担、获得治疗的机会有限、远程医疗的监管障碍以及正在进行的COVID-19大流行带来的压力等因素,已被确定为物质使用障碍患者急性健康影响背后的一些关键因素。这些相互关联的因素加剧了服务不足社区已经存在的差距的影响。有必要对远程保健和获得药物使用障碍治疗的政策和监管进行改革。应实施循证战略和其他更安全的药物做法,以减轻对人类健康的影响。在增加获得治疗机会的项目上进行投资,将有助于应对未来可能出现的流行病,在这些流行病中,增加弱势社区的精神卫生服务和总体获得卫生保健的机会,将缩小身心疾病方面的差距。在这篇综述中,我们正在评估和总结正在进行的COVID-19大流行对物质使用障碍患者的急性健康影响。
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引用次数: 15
Reversal of hypertensive heart disease: a multiple linear regression model 高血压心脏病逆转:一个多元线性回归模型
Pub Date : 2021-12-31 DOI: 10.15190/d.2021.17
S. Ahmed, R. Jhaj, Balakrishnan Sadasivam, R. Joshi
Background: The development of left ventricular hypertrophy in primary hypertension increases cardiovascular mortality and morbidity. Reversal of left ventricular hypertrophy through therapeutic control of blood pressure reduces the risk of adverse cardiovascular incidents. Objective: In our study, we explored for the determinants of left ventricular hypertrophy regression. Methods: A cohort (n=217) of patients with hypertensive left ventricular hypertrophy was identified by screening consecutive patients in medical outpatient unit. The primary inclusion criteria were (i) Blood pressure more than140/90 mm of Hg (ii) Left Ventricular Mass Index more than 115 and 95 gm/m2 for males and females respectively. Left Ventricular Mass Index was determined by echocardiography at the time of recruitment and after 24 weeks of standard pharmacotherapy. The change in Left Ventricular Mass Index was modelled using multiple linear regression with both categorical and continuous explanatory variables. The effect of drug therapy on change in Left Ventricular Mass Index was tested in the model with dummy coded variables for the treatment categories. Results: In simple linear regression, the variables significantly correlating with change in Left Ventricular Mass Index were baseline Left Ventricular Mass Index (r=0.62, p<0.001), change in systolic blood pressure (r=0.22, p=0.001), change in mean blood pressure (r=0.16, p=0.02), baseline systolic blood pressure (r=0.15, p=0.02), age (r=0.12, p=0.09) and diabetes (r=0.12, p=0.09). The best fit model (r2=0.408) retained baseline Left Ventricular Mass Index (β=0.59, p<0.001), change in systolic blood pressure (β=0.14, p=0.01) and diabetes (β=-0.104, p=0.05) as the significant predictors. Introduction of treatment effect into the model non-significantly increased the fit of the model (r2=0.414, p=0.27-0.98). Conclusions: Pre-treatment Left Ventricular Mass Index and reduction in systolic blood pressure were the major determinants of left ventricular hypertrophy regression. We also observed that there is lesser left ventricular hypertrophy regression in diabetic patients, warranting future research to explore glycaemic control as a modifiable factor in left ventricular hypertrophy reversal.
背景:原发性高血压左心室肥厚的发展增加了心血管疾病的死亡率和发病率。通过治疗性控制血压逆转左心室肥厚可降低不良心血管事件的风险。目的:探讨左心室肥厚消退的决定因素。方法:通过门诊连续筛查高血压左室肥厚患者,确定一组217例高血压左室肥厚患者。主要纳入标准是(i)血压大于140/90 mm Hg (ii)左心室质量指数分别大于115和95 gm/m2(男性和女性)。左心室质量指数在招募时和标准药物治疗24周后通过超声心动图测定。左心室质量指数的变化采用多元线性回归模型,包括分类和连续解释变量。药物治疗对左室质量指数变化的影响在治疗类别的虚拟编码变量模型中进行检验。结果:在简单线性回归中,与左室质量指数变化显著相关的变量为基线左室质量指数(r=0.62, p<0.001)、收缩压变化(r=0.22, p=0.001)、平均血压变化(r=0.16, p=0.02)、基线收缩压(r=0.15, p=0.02)、年龄(r=0.12, p=0.09)、糖尿病(r=0.12, p=0.09)。最佳拟合模型(r2=0.408)保留了基线左心室质量指数(β=0.59, p<0.001)、收缩压变化(β=0.14, p=0.01)和糖尿病(β=-0.104, p=0.05)作为显著预测因子。在模型中引入治疗效应后,模型的拟合度无显著提高(r2=0.414, p=0.27-0.98)。结论:治疗前左室质量指数和收缩压降低是左室肥厚消退的主要决定因素。我们还观察到糖尿病患者的左心室肥厚消退较少,这表明未来的研究需要探索血糖控制作为左心室肥厚逆转的可改变因素。
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引用次数: 6
The Pathological Mechanisms and Treatments of Tinnitus 耳鸣的病理机制及治疗
Pub Date : 2021-09-30 DOI: 10.15190/d.2021.16
Sana Saeed, Q. Khan
Tinnitus is defined as the ringing, hissing, clicking or roaring sounds an individual consciously perceives in the absence of an external auditory stimulus. Currently, the literature on the mechanism of tinnitus pathology is multifaceted, ranging from tinnitus generation at the cellular level to its perception at the system level. Cellular level mechanisms include increased neuronal synchrony, neurotransmission changes and maladaptive plasticity. At the system level, the role of auditory structures, non-auditory structures, changes in the functional connectivities in higher regions and tinnitus networks have been investigated. The exploration of all these mechanisms creates a holistic view on understanding the changes the pathophysiology of tinnitus undertakes. Although tinnitus percept may start at the level of cochlear nerve deafferentation, the neuronal changes in the central auditory system to the neuronal and connectivity changes in non-auditory regions, such as the limbic system, become cardinal in chronic tinnitus generation. At the present moment, some tinnitus generation mechanisms are well established (e.g., increased neuronal synchrony) whereas other mechanisms have gained more traction recently (e.g., tinnitus networks, tinnitus-distress networks) and therefore, require additional investigation to solidify their role in tinnitus pathology. The treatments and therapeutics designed for tinnitus are numerous, with varied levels of success. They are generally two-fold: some treatments focus on tinnitus cessation (including cochlear implants, deep brain stimulation, transcranial direct current stimulation and transcranial magnetic stimulation) whereas the other set focuses on tinnitus reduction or masking (including hearing aids, sound therapy, cognitive behavioral therapy, tinnitus retraining therapy, and tailor made notched musical training). Tinnitus management has focused on implementing tinnitus masking/reducing therapies more than tinnitus cessation, since cessation treatments are still lacking in streamlined treatment protocols and long-term sustainability and efficacy of the treatment. This review will focus on concisely exploring the current and most relevant tinnitus pathophysiology mechanisms, treatments and therapeutics.
耳鸣被定义为在没有外部听觉刺激的情况下,个体有意识地感知到的铃声、嘶嘶声、咔哒声或咆哮声。目前,关于耳鸣病理机制的文献是多方面的,从细胞水平的耳鸣产生到系统水平的耳鸣感知。细胞水平的机制包括神经元同步性增加、神经传递改变和适应性不良。在系统水平上,研究了听觉结构、非听觉结构、高级区域功能连接的变化和耳鸣网络的作用。所有这些机制的探索创造了一个整体的观点来理解耳鸣的病理生理变化。虽然耳鸣的感知可能从耳蜗神经失传水平开始,但中枢听觉到非听觉区域(如边缘系统)的神经元变化和连通性变化是慢性耳鸣产生的主要原因。目前,一些耳鸣产生机制已经建立(例如,神经元同步性增加),而其他机制最近获得了更多的关注(例如,耳鸣网络,耳鸣窘迫网络),因此,需要进一步的研究来巩固它们在耳鸣病理中的作用。耳鸣的治疗和治疗方法有很多,成功的程度也各不相同。它们通常是双重的:一些治疗侧重于耳鸣停止(包括耳蜗植入,深部脑刺激,经颅直流电刺激和经颅磁刺激),而另一组治疗侧重于耳鸣减少或掩盖(包括助听器,声音治疗,认知行为治疗,耳鸣再训练治疗,量身定制的凹痕音乐训练)。耳鸣管理的重点是实施耳鸣掩蔽/减少治疗,而不是耳鸣停止,因为停止治疗仍然缺乏简化的治疗方案和长期的可持续性和治疗的有效性。本文就目前国内外最相关的耳鸣病理生理机制、治疗方法和治疗方法进行综述。
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引用次数: 1
Homocysteine as a Predictor Tool in Multiple Sclerosis. 同型半胱氨酸作为多发性硬化症的预测工具。
Pub Date : 2021-09-28 eCollection Date: 2021-07-01 DOI: 10.15190/d.2021.14
Radu Razvan Mititelu, Carmen Valeria Albu, Manuela Violeta Bacanoiu, Vlad Padureanu, Rodica Padureanu, Gabriela Olaru, Ana-Maria Buga, Maria Balasoiu

Multiple sclerosis (MS) is a progressive and irreversible disease which affects the central nervous system (CNS) with still unknown etiology. Our study aimes to establish the homocysteine pattern that can predict the MS diseases progression and to identify a potential disease progression marker that can be easy to perform and non-invasive, in order to predict the diseases outcome. In order to achieve this goal, we included 10 adult RRMS subjects, 10 adult SPMS subjects and 10 age-matched healthy subjects. The homocysteine plasma level was measured using automated latex enhanced immunoassay and the cobalamin and folate measurements were performed using automated chemiluminescence immunoassay (CLIA). HCR was calculated by dividing the homocysteine plasma level by cobalamin plasma level. We found that the homocysteine level in plasma of both RRMS patients and SPMS group are significantly increased compared with the control group. There is a significantly higher concentration of homocysteine in SPMS group compared with the RRMS group. In addition, the HCR is significantly increased in SPMS compared with the RRMS group and is a very good index of disease severity.

多发性硬化症(MS)是一种进行性和不可逆的疾病,影响中枢神经系统(CNS),病因尚不清楚。我们的研究旨在建立可以预测多发性硬化症疾病进展的同型半胱氨酸模式,并确定一种易于执行且无创的潜在疾病进展标志物,以预测疾病结果。为了实现这一目标,我们纳入了10名成人RRMS受试者、10名成人SPMS受试者和10名年龄匹配的健康受试者。使用自动乳胶增强免疫测定法测定同型半胱氨酸血浆水平,使用自动化学发光免疫测定法(CLIA)测定钴胺素和叶酸。通过将同型半胱氨酸血浆水平除以钴胺素血浆水平来计算HCR。我们发现,与对照组相比,RRMS患者和SPMS组的血浆同型半胱氨酸水平均显著升高。SPMS组的同型半胱氨酸浓度明显高于RRMS组。此外,与RRMS组相比,SPMS组的HCR显著增加,是一个非常好的疾病严重程度指标。
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引用次数: 4
Heart function assessment during aging in apolipoprotein E knock-out mice. 载脂蛋白E敲除小鼠衰老过程中心功能的评估。
Pub Date : 2021-09-28 eCollection Date: 2021-07-01 DOI: 10.15190/d.2021.15
Elisa A Liehn, Ana-Mihaela Lupan, Rodica Diaconu, Mihai Ioana, Ioana Streata, Catalin Manole, Alexandrina Burlacu

Background: Apolipoprotein (apo) E isoforms have strong correlations with metabolic and cardiovascular diseases. However, it is not clear if apoE has a role in development of non-ischemic cardiomyopathy. Our study aims to analyze the involvement of apoE in non-ischemic cardiomyopathy.

Methods and results: Serial echo-cardiographic measurements were performed in old wildtype and apoE deficient (apoE-/-) mice. Morphological and functional cardiac parameters were in normal range in both groups at the age of 12 month. At the age of 18 months, both groups had shown ventricular dilation and increased heart rates. However, the apoE-/- mice presented signs of diastolic dysfunction by hypertrophic changes in left ventricle, due probably to arterial hypertension. The right ventricle was not affected by age or genotype.  CONCLUSION: Even in the absence of high fat diet, apoE deficiency in mice induces mild changes in the cardiac function of the left ventricle during aging, by developing diastolic dysfunction, which leads to heart failure with preserved ejection fraction. However, further studies are necessary to conclude over the role of apoE in cardiac physiology and its involvement in development of heart failure.

背景:载脂蛋白(apo) E亚型与代谢和心血管疾病密切相关。然而,apoE是否在非缺血性心肌病的发展中起作用尚不清楚。我们的研究旨在分析apoE在非缺血性心肌病中的作用。方法和结果:对老年野生型和apoE缺陷小鼠(apoE-/-)进行了一系列超声心动图测量。12月龄时,两组心脏形态学和功能参数均在正常范围内。在18个月大的时候,两组都表现出心室扩张和心率增加。然而,apoE-/-小鼠表现出舒张功能障碍的迹象,可能是由于动脉高血压引起的左心室肥厚变化。右心室不受年龄和基因型的影响。结论:即使在没有高脂肪饮食的情况下,apoE缺乏小鼠在衰老过程中也会引起左心室心功能的轻微变化,通过发生舒张功能障碍导致心力衰竭,并保留射血分数。然而,apoE在心脏生理学中的作用及其在心力衰竭发生中的作用还需要进一步的研究。
{"title":"Heart function assessment during aging in apolipoprotein E knock-out mice.","authors":"Elisa A Liehn,&nbsp;Ana-Mihaela Lupan,&nbsp;Rodica Diaconu,&nbsp;Mihai Ioana,&nbsp;Ioana Streata,&nbsp;Catalin Manole,&nbsp;Alexandrina Burlacu","doi":"10.15190/d.2021.15","DOIUrl":"https://doi.org/10.15190/d.2021.15","url":null,"abstract":"<p><strong>Background: </strong>Apolipoprotein (apo) E isoforms have strong correlations with metabolic and cardiovascular diseases. However, it is not clear if apoE has a role in development of non-ischemic cardiomyopathy. Our study aims to analyze the involvement of apoE in non-ischemic cardiomyopathy.</p><p><strong>Methods and results: </strong>Serial echo-cardiographic measurements were performed in old wildtype and apoE deficient (apoE-/-) mice. Morphological and functional cardiac parameters were in normal range in both groups at the age of 12 month. At the age of 18 months, both groups had shown ventricular dilation and increased heart rates. However, the apoE-/- mice presented signs of diastolic dysfunction by hypertrophic changes in left ventricle, due probably to arterial hypertension. The right ventricle was not affected by age or genotype.  CONCLUSION: Even in the absence of high fat diet, apoE deficiency in mice induces mild changes in the cardiac function of the left ventricle during aging, by developing diastolic dysfunction, which leads to heart failure with preserved ejection fraction. However, further studies are necessary to conclude over the role of apoE in cardiac physiology and its involvement in development of heart failure.</p>","PeriodicalId":72829,"journal":{"name":"Discoveries (Craiova, Romania)","volume":"9 3","pages":"e136"},"PeriodicalIF":0.0,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8605688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39765323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Cytologic Categorization with Risk Stratification of Endoscopic Ultrasound-Guided Fine Needle Aspiration from Pancreatic Lesions Based on Guidelines of the Papanicolaou Society of Cytopathology: 12-Year Tertiary Care Experience. 基于Papanicolaou细胞病理学学会指南的内镜下超声引导下胰腺病变细针穿刺的细胞学分类和风险分层:12年三级护理经验。
Pub Date : 2021-08-21 eCollection Date: 2021-07-01 DOI: 10.15190/d.2021.13
Nilay Nishith, Ram Nawal Rao, Praveer Rai

Background and aims: Pancreatic malignancy is an important cause of cancer mortality worldwide. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) plays a crucial role in the pre-operative diagnosis of pancreatic lesions. In this study, we have analyzed the cytological spectrum of pancreatic lesions in the Indian population over 12 years, categorized them according to the Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology (PSCPC), and assessed the risk of malignancy (ROM) for each of the categories.

Methods: A computerized data search from January 2008 to December 2019 revealed 581 pancreatic EUS-FNA samples, among which surgical follow-up was available for 73 cases. All cytological specimens were reviewed and prospectively classified into one of the six diagnostic categories proposed by the PSCPC. Subsequently, a cytohistological correlation was performed and the ROM was calculated for each category.

Results: The cytologic diagnoses included 50 nondiagnostic (category I), 175 negative for malignancy (category II), 19 atypical (category III), 27 neoplastic:benign (category IVA), 30 neoplastic:other (category IVB), 26 suspicious (category V), and 254 malignant (category VI) cases. ROM for non-diagnostic aspirates, nonneoplastic benign specimens, atypical cases, neoplastic:benign, neoplastic:other, suspicious for malignancy, and the malignant category was 16.7%, 7.1%, 33.3%, 0.0%, 20.0%, 100%, and 78.6%, respectively.

Conclusion: We document an increased risk of malignancy from category I to category VI of the PSCPC. The malignancy risk for category VI (malignant) was statistically significant in our study but was lower in comparison to the values reported by other authors. Nonetheless, such an approach would establish transparent communication between the pathologist and the clinician, as well as aid the clinician in decision making, particularly in intermediate categories.

背景与目的:胰腺恶性肿瘤是世界范围内癌症死亡的重要原因。超声内镜引导下细针穿刺(EUS-FNA)在胰腺病变术前诊断中起着至关重要的作用。在这项研究中,我们分析了12年来印度人群胰腺病变的细胞学谱,根据Papanicolaou细胞病理学学会胰胆管细胞学报告系统(PSCPC)对其进行了分类,并评估了每种类别的恶性肿瘤(ROM)风险。方法:计算机检索2008年1月至2019年12月581例胰腺EUS-FNA样本,其中73例可手术随访。对所有细胞学标本进行了审查,并前瞻性地归类为PSCPC提出的六个诊断类别之一。随后,进行细胞组织学相关性,并计算每个类别的ROM。结果:细胞学诊断为非诊断性(I类)50例,恶性(II类)阴性175例,非典型(III类)19例,肿瘤:良性(IVA类)27例,肿瘤:其他(IVB类)30例,可疑(V类)26例,恶性(VI类)254例。非诊断性抽吸、非肿瘤性良性标本、非典型病例、肿瘤性:良性、肿瘤性:其他、可疑恶性、恶性分类的ROM分别为16.7%、7.1%、33.3%、0.0%、20.0%、100%、78.6%。结论:我们记录了从I类到VI类PSCPC恶性肿瘤的风险增加。第六类(恶性)的恶性风险在我们的研究中有统计学意义,但与其他作者报道的值相比要低。尽管如此,这种方法将在病理学家和临床医生之间建立透明的沟通,并有助于临床医生的决策,特别是在中间类别。
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引用次数: 1
Macro Photography with Lightsheet Illumination Enables Whole Expanded Brain Imaging with Single-cell Resolution. 微距摄影与光片照明使整个扩展脑成像单细胞分辨率。
Pub Date : 2021-08-04 eCollection Date: 2021-07-01 DOI: 10.15190/d.2021.12
Chia-Ming Lee, Xuejiao Tian, Chieh Tsao, Peilin Chen, Tzyy-Nan Huang, Yi-Ping Hsueh, Bi-Chang Chen

Macro photography allows direct visualization of the enlarged whole mouse brain by a combination of lightsheet illumination and expansion microscopy with single-cell resolution.  Taking advantage of the long working distance of a camera lens, we imaged a 3.7 cm thick, transparent, fluorescently-labeled expanded brain. In order to improve 3D sectioning capability, we used lightsheet excitation confined as the depth of field of the camera lens. Using 4x sample expansion and 5x optical magnification, macro photography enables imaging of expanded whole mouse brain with an effective resolution of 300 nm, which provides the subcellular structural information at the organ level.

微距摄影允许直接可视化放大的整个老鼠的大脑,通过光片照明和扩展显微镜与单细胞分辨率的组合。利用相机镜头较远的工作距离,我们对3.7厘米厚、透明、荧光标记的扩展大脑进行了成像。为了提高三维切片的能力,我们使用了限制在相机镜头景深范围内的光片激发。利用4倍的样品膨胀和5倍的光学放大倍率,微距摄影能够以300 nm的有效分辨率成像扩展的整个小鼠大脑,从而提供器官水平的亚细胞结构信息。
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引用次数: 1
SARS-CoV-2 effect on male infertility and its possible pathophysiological mechanisms. SARS-CoV-2对男性不育的影响及其可能的病理生理机制
Pub Date : 2021-06-30 eCollection Date: 2021-04-01 DOI: 10.15190/d.2021.10
Arjola Agolli, Zeynep Yukselen, Olsi Agolli, Mehrie H Patel, Kinal Paresh Bhatt, Luis Concepcion, John Halpern, Sabaa Alvi, Rafael Abreu

First case of COVID-19 was reported in Wuhan, China in December 2019. As of now, May 2021, a total of 164,189,004 people were infected, and 3,401,990 deaths have occurred caused by SARS-CoV-2. As SARS-CoV-2 virus cell entry mainly depends on the ACE2 and TMPRSS2 proteins, the presence of high expression levels of both ACE2 and TMPRSS2 in testes highlights the possible vulnerability of men to the virus. Other RNA viruses frequently induce orchitis and result in male infertility. This review evaluates the decline in male fertility and a total of 48 original articles were included for the analysis. We investigated the effects of COVID-19 on male reproductive health and male fertility.  There is a strong association between the high number of ACE2 receptors in the testes and the COVID-19 viral loads. SARS-CoV-2 infection negatively affects the male reproductive tract. Human biological tissues, including body fluids and excretions, tissues, and organs showed positive results tests for SARS-CoV-2. A disruption in the balance of male reproductive system hormones is also observed. Male gonads may be potentially vulnerable to SARS-CoV-2 infection, suggesting caution to follow-up and evaluate infected men that have plans to conceive. Further studies are required to determine if this impairment is temporary or permanent, elucidate SARS-CoV-2's entrance strategies into the testis and how it can affect the semen quality and quantity. We recommend a post-infection follow-up, especially in male patients of reproductive age already having fertility issues.

2019年12月,中国武汉报告了首例COVID-19病例。截至2021年5月,SARS-CoV-2共感染164189004人,死亡3401990人。由于SARS-CoV-2病毒进入细胞主要依赖ACE2和TMPRSS2蛋白,因此ACE2和TMPRSS2在睾丸中的高表达水平突出了男性对该病毒的可能易感性。其他RNA病毒经常引起睾丸炎并导致男性不育。这篇综述评估了男性生育能力的下降,总共纳入了48篇原创文章进行分析。我们调查了COVID-19对男性生殖健康和男性生育能力的影响。睾丸中ACE2受体的高数量与COVID-19病毒载量之间存在很强的相关性。SARS-CoV-2感染对男性生殖道有负面影响。人体体液和排泄物、组织、器官等生物组织的新冠病毒检测呈阳性。男性生殖系统激素平衡的破坏也被观察到。男性性腺可能容易受到SARS-CoV-2感染,建议对计划怀孕的受感染男性进行随访和评估。需要进一步的研究来确定这种损害是暂时的还是永久性的,阐明SARS-CoV-2进入睾丸的策略以及它如何影响精液的质量和数量。我们建议感染后随访,特别是育龄男性患者已经有生育问题。
{"title":"SARS-CoV-2 effect on male infertility and its possible pathophysiological mechanisms.","authors":"Arjola Agolli,&nbsp;Zeynep Yukselen,&nbsp;Olsi Agolli,&nbsp;Mehrie H Patel,&nbsp;Kinal Paresh Bhatt,&nbsp;Luis Concepcion,&nbsp;John Halpern,&nbsp;Sabaa Alvi,&nbsp;Rafael Abreu","doi":"10.15190/d.2021.10","DOIUrl":"https://doi.org/10.15190/d.2021.10","url":null,"abstract":"<p><p>First case of COVID-19 was reported in Wuhan, China in December 2019. As of now, May 2021, a total of 164,189,004 people were infected, and 3,401,990 deaths have occurred caused by SARS-CoV-2. As SARS-CoV-2 virus cell entry mainly depends on the ACE2 and TMPRSS2 proteins, the presence of high expression levels of both ACE2 and TMPRSS2 in testes highlights the possible vulnerability of men to the virus. Other RNA viruses frequently induce orchitis and result in male infertility. This review evaluates the decline in male fertility and a total of 48 original articles were included for the analysis. We investigated the effects of COVID-19 on male reproductive health and male fertility.  There is a strong association between the high number of ACE2 receptors in the testes and the COVID-19 viral loads. SARS-CoV-2 infection negatively affects the male reproductive tract. Human biological tissues, including body fluids and excretions, tissues, and organs showed positive results tests for SARS-CoV-2. A disruption in the balance of male reproductive system hormones is also observed. Male gonads may be potentially vulnerable to SARS-CoV-2 infection, suggesting caution to follow-up and evaluate infected men that have plans to conceive. Further studies are required to determine if this impairment is temporary or permanent, elucidate SARS-CoV-2's entrance strategies into the testis and how it can affect the semen quality and quantity. We recommend a post-infection follow-up, especially in male patients of reproductive age already having fertility issues.</p>","PeriodicalId":72829,"journal":{"name":"Discoveries (Craiova, Romania)","volume":"9 2","pages":"e131"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8605861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39765324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
Information technology-based joint preoperative assessment, risk stratification and its impact on patient management, perioperative outcome, and cost. 基于信息技术的联合术前评估、风险分层及其对患者管理、围手术期结局和成本的影响。
Pub Date : 2021-06-30 eCollection Date: 2021-04-01 DOI: 10.15190/d.2021.9
Habib Md Reazaul Karim, Subrata Kumar Singha, Praveen Kumar Neema, Tridip Dutta Baruah, Rubik Ray, Debajyoti Mohanty, Md Sabah Siddiqui, Rachita Nanda, Narendra Kuber Bodhey

Background:  Despite negative recommendations, routine preoperative testing practice is nearly universal. Our aim is to bring the healthcare providers on one platform by using information-technology based preanaesthetic assessment and evaluate the routine preoperative testing's impact on patient outcome and cost.

Methods: A prospective, non-randomised study was conducted in a teaching hospital during January 2019-August 2020. A locally developed software and cloud-computing were used as a tool to modify preanaesthesia evaluation. The number of investigations ordered, time taken, cost incurred, were compared with the routine practice. Further data were matched as per surgical invasiveness and the patient's physical status. Appropriate tests compared intergroup differences and p-value <0.05 was considered significant.  Results: Data from 114 patients (58 in routine and 56 in patient and surgery specific) were analysed. Patient and surgery specific investigation led to a reduction in the investigations by 80-90%, hospital visit by 50%, and the total cost by 80%, without increasing the day of surgery cancellation or complications.

Conclusion: Information technology-based joint preoperative assessment and risk stratification are feasible through locally developed software with minimal cost. It helps in applying patient and surgery specific investigation, reducing the number of tests, hospital visit, and cost, without adversely affecting the perioperative outcome. The application of the modified method will help in cost-effective, yet quality and safe perioperative healthcare delivery. It will also benefit the public from both service and economic perspective.

背景:尽管有负面建议,常规术前检查实践几乎是普遍的。我们的目标是通过使用基于信息技术的麻醉前评估,将医疗保健提供者整合到一个平台上,并评估常规术前测试对患者预后和成本的影响。方法:2019年1月- 2020年8月在某教学医院进行前瞻性、非随机研究。使用本地开发的软件和云计算作为修改麻醉前评估的工具。将所定的调查次数、所花费的时间、所发生的费用与常规做法进行比较。进一步的数据根据手术侵入性和患者的身体状况进行匹配。结论:基于信息技术的联合术前评估和风险分层是可行的,可以通过本地开发的软件以最小的成本进行。它有助于应用患者和手术特异性调查,减少检查次数,医院就诊和成本,而不会对围手术期结果产生不利影响。改进的方法的应用将有助于成本效益,但质量和安全的围手术期医疗保健服务。从服务和经济的角度来看,这也将使公众受益。
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引用次数: 4
COVID-19 pandemic and antimicrobial resistance in developing countries. COVID-19大流行和发展中国家的抗微生物药物耐药性。
Pub Date : 2021-06-30 eCollection Date: 2021-04-01 DOI: 10.15190/d.2021.6
Abdul Rehman Arshad, Farhat Ijaz, Mishal Shan Siddiqui, Saad Khalid, Abeer Fatima, Rana Khurram Aftab

A wide range of antimicrobial agents were touted as potential remedies during the COVID-19 pandemic. While both developed and developing countries have recorded an increase in the use of antimicrobial drugs, use and misuse have occurred to a far greater degree in developing countries. This can have deleterious consequences on antimicrobial resistance, especially when various developing countries have already reported the emergence of various drug-resistant organisms even before the pandemic. Telemedicine services, societal and cultural pressures, and bacterial co-infections can predispose to overwhelming antimicrobial prescriptions. The emergence of new multidrug resistance species is a major concern for the developing world especially since health services are already overburdened and lack the diagnostic capabilities and basic amenities for infection prevention and control. This can lead to outbreaks and the rampant spread of such microorganisms. Improper waste management and disposal from hospitals and communities establish freshwater runoffs as hubs of various microorganisms that can predispose to the rise of multidrug-resistant species. Microplastics' ability to act as vectors for antibiotic-resistant organisms is also particularly concerning for lower-middle-income countries. In this review, we aim to study the impact of antimicrobial use during the COVID-19 pandemic and antimicrobial resistance in lower middle-income countries, by understanding various determinants of resistance unique to the developing world and exploring solutions to combat the problem.

在COVID-19大流行期间,各种抗菌药物被吹捧为潜在的补救措施。虽然发达国家和发展中国家都记录了抗菌药物使用的增加,但发展中国家使用和滥用的程度要大得多。这可能对抗菌素耐药性产生有害后果,特别是当许多发展中国家甚至在大流行之前就已经报告出现各种耐药生物体时。远程医疗服务、社会和文化压力以及细菌合并感染都可能导致抗生素处方泛滥。新的耐多药物种的出现是发展中世界的一个重大关切,特别是因为卫生服务已经负担过重,缺乏预防和控制感染的诊断能力和基本便利设施。这可能导致此类微生物的爆发和猖獗传播。医院和社区不当的废物管理和处置使淡水径流成为各种微生物的集散地,容易导致耐多药物种的增加。微塑料作为耐抗生素生物载体的能力也特别引起中低收入国家的关注。在这篇综述中,我们的目标是通过了解发展中国家特有的各种耐药性决定因素,并探索应对这一问题的解决方案,研究COVID-19大流行期间抗微生物药物使用的影响和中低收入国家的抗微生物药物耐药性。
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引用次数: 6
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Discoveries (Craiova, Romania)
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