Pub Date : 2022-12-01Epub Date: 2022-10-09DOI: 10.3390/reports5040041
Amanda Blair Spence, Sameer Desale, Jennifer Lee, Princy Kumar, Xu Huang, Stanley Evan Cooper, Stephen Fernandez, Seble G Kassaye
Reported coronavirus disease 2019 (COVID-19) outcomes in persons living with HIV (PLWH) vary across cohorts. We examined clinical characteristics and outcomes of PLWH with COVID-19 compared with a matched HIV-seronegative cohort in a mid-Atlantic US healthcare system. Multivariate logistic regression was used to explore factors associated with hospitalization and death/mechanical ventilation among PLWH. Among 281 PLWH with COVID-19, the mean age was 51.5 (SD 12.74) years, 63% were male, 86% were Black, and 87% had a HIV viral load <200 copies/mL. Overall, 47% of PLWH versus 24% (p < 0.001) of matched HIV-seronegative individuals were hospitalized. Rates of COVID-19 associated cardiovascular and thrombotic events, AKI, and infections were similar between PLWH and HIV-seronegative individuals. Overall mortality was 6% (n = 18/281) in PLWH versus 3% (n = 33/1124) HIV-seronegative, p < 0.0001. Among admitted patients, mortality was 14% (n = 18/132) for PLWH and 13% (n = 33/269) for HIV-seronegative, p = 0.75. Among PLWH, hospitalization associated with older age aOR 1.04 (95% CI 1.01, 1.06), Medicaid insurance aOR 2.61 (95% CI 1.39, 4.97) and multimorbidity aOR 2.98 (95% CI 1.72, 5.23). Death/mechanical ventilation associated with older age aOR 1.06 (95% CI 1.01, 1.11), Medicaid insurance aOR 3.6 (95% CI 1.36, 9.74), and multimorbidity aOR 4.4 (95% CI 1.55, 15.9) in adjusted analyses. PLWH were hospitalized more frequently than the HIV-seronegative group and had a higher overall mortality rate, but once hospitalized had similar mortality rates. Older age, multimorbidity and insurance status associated with more severe outcomes among PLWH suggesting the importance of targeted interventions to mitigate the effects of modifiable inequities.
不同队列中报告的艾滋病毒感染者（PLWH）2019 年冠状病毒病（COVID-19）结果各不相同。我们研究了美国大西洋中部医疗系统中感染 COVID-19 的艾滋病病毒感染者与匹配的艾滋病病毒阴性者队列相比的临床特征和结局。我们采用多变量逻辑回归来探讨与感染 COVID-19 的 PLWH 住院和死亡/机械通气相关的因素。在 281 名患有 COVID-19 的 PLWH 中，平均年龄为 51.5（SD 12.74）岁，63% 为男性，86% 为黑人，87% 的匹配 HIV 阴性患者住院治疗。与 COVID-19 相关的心血管和血栓事件、AKI 和感染的发生率在 PLWH 和 HIV 阴性患者之间相似。PLWH 患者的总死亡率为 6%（n = 18/281），而 HIV 阴性患者的总死亡率为 3%（n = 33/1124），P < 0.0001。在住院患者中，PLWH 患者的死亡率为 14%（n = 18/132），HIV 阴性患者的死亡率为 13%（n = 33/269），p = 0.75。在 PLWH 患者中，住院与年龄较大 aOR 1.04 (95% CI 1.01, 1.06)、医疗补助保险 aOR 2.61 (95% CI 1.39, 4.97)和多病相关 aOR 2.98 (95% CI 1.72, 5.23)。在调整分析中，死亡/机械通气与年龄较大 aOR 1.06（95% CI 1.01，1.11）、医疗补助保险 aOR 3.6（95% CI 1.36，9.74）和多病症 aOR 4.4（95% CI 1.55，15.9）相关。与艾滋病毒阴性组相比，艾滋病毒携带者住院的频率更高，总死亡率也更高，但一旦住院，死亡率却相差无几。高龄、多病和保险状况与艾滋病毒感染者更严重的结果有关，这表明采取有针对性的干预措施以减轻可改变的不平等的影响非常重要。
{"title":"COVID-19 Outcomes in a US Cohort of Persons Living with HIV (PLWH).","authors":"Amanda Blair Spence, Sameer Desale, Jennifer Lee, Princy Kumar, Xu Huang, Stanley Evan Cooper, Stephen Fernandez, Seble G Kassaye","doi":"10.3390/reports5040041","DOIUrl":"10.3390/reports5040041","url":null,"abstract":"<p><p>Reported coronavirus disease 2019 (COVID-19) outcomes in persons living with HIV (PLWH) vary across cohorts. We examined clinical characteristics and outcomes of PLWH with COVID-19 compared with a matched HIV-seronegative cohort in a mid-Atlantic US healthcare system. Multivariate logistic regression was used to explore factors associated with hospitalization and death/mechanical ventilation among PLWH. Among 281 PLWH with COVID-19, the mean age was 51.5 (SD 12.74) years, 63% were male, 86% were Black, and 87% had a HIV viral load <200 copies/mL. Overall, 47% of PLWH versus 24% (<i>p</i> < 0.001) of matched HIV-seronegative individuals were hospitalized. Rates of COVID-19 associated cardiovascular and thrombotic events, AKI, and infections were similar between PLWH and HIV-seronegative individuals. Overall mortality was 6% (<i>n</i> = 18/281) in PLWH versus 3% (<i>n</i> = 33/1124) HIV-seronegative, <i>p</i> < 0.0001. Among admitted patients, mortality was 14% (<i>n</i> = 18/132) for PLWH and 13% (<i>n</i> = 33/269) for HIV-seronegative, <i>p</i> = 0.75. Among PLWH, hospitalization associated with older age aOR 1.04 (95% CI 1.01, 1.06), Medicaid insurance aOR 2.61 (95% CI 1.39, 4.97) and multimorbidity aOR 2.98 (95% CI 1.72, 5.23). Death/mechanical ventilation associated with older age aOR 1.06 (95% CI 1.01, 1.11), Medicaid insurance aOR 3.6 (95% CI 1.36, 9.74), and multimorbidity aOR 4.4 (95% CI 1.55, 15.9) in adjusted analyses. PLWH were hospitalized more frequently than the HIV-seronegative group and had a higher overall mortality rate, but once hospitalized had similar mortality rates. Older age, multimorbidity and insurance status associated with more severe outcomes among PLWH suggesting the importance of targeted interventions to mitigate the effects of modifiable inequities.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10104440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9316682","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}
M. Colosimo, M. Caroleo, A. Caruso, F. Luciani, E. Cione, G. Talarico, Virginia Vescio, G. De Sarro, P. Minchella, S. Nisticò
Strongyloides stercoralis is an intestinal nematode that can induce disseminated infection in immunocompromised patients. It is most commonly acquired in tropical and subtropical countries; however, foci of the infection have also been reported in temperate geographic areas. In non-endemic areas, the diagnosis of an S. stercoralis infection is challenging due to the variety of clinical symptoms. Herein, we report the case of a patient, born and raised in the Calabria region of Southern Italy, who presented with melanoma and S. stercoralis hyperinfection, which is characterized by dyspnea, productive cough, inappetence, marked asthenia, weight loss, and Klebsiella pneumoniae bacteremia. He worked as a farmer and never traveled to another country known to be endemic for S. stercoralis. Despite the prompt identification of the parasite with sputum microscopy and the initiation of therapy with ivermectin and piperacillin–tazobactam, the patient later died. This case underscores the continued risk for S. stercoralis infection even in geographic areas that were previously considered non-endemic for the nematode and indicates that the geographic distribution of S. stercoralis may be expanding in Italy.
{"title":"Fatal Case of Autochthonous Strongyloides stercoralis Hyperinfection in an Immunosuppressed Calabrian Patient","authors":"M. Colosimo, M. Caroleo, A. Caruso, F. Luciani, E. Cione, G. Talarico, Virginia Vescio, G. De Sarro, P. Minchella, S. Nisticò","doi":"10.3390/reports5040047","DOIUrl":"https://doi.org/10.3390/reports5040047","url":null,"abstract":"Strongyloides stercoralis is an intestinal nematode that can induce disseminated infection in immunocompromised patients. It is most commonly acquired in tropical and subtropical countries; however, foci of the infection have also been reported in temperate geographic areas. In non-endemic areas, the diagnosis of an S. stercoralis infection is challenging due to the variety of clinical symptoms. Herein, we report the case of a patient, born and raised in the Calabria region of Southern Italy, who presented with melanoma and S. stercoralis hyperinfection, which is characterized by dyspnea, productive cough, inappetence, marked asthenia, weight loss, and Klebsiella pneumoniae bacteremia. He worked as a farmer and never traveled to another country known to be endemic for S. stercoralis. Despite the prompt identification of the parasite with sputum microscopy and the initiation of therapy with ivermectin and piperacillin–tazobactam, the patient later died. This case underscores the continued risk for S. stercoralis infection even in geographic areas that were previously considered non-endemic for the nematode and indicates that the geographic distribution of S. stercoralis may be expanding in Italy.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45644332","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}
A. Pană, V. Neculicioiu, Dan-Alexandru Toc, Gheorghe Dan Sprinjan, Mara Cristina Rusu, C. Costache
Actinomyces odontolyticus is a strictly anaerobic species, a member of the Actinomyces genus and of the commensal flora, especially oral flora, which can trigger severe infections through breaches in healthy tissue or necrotic tissue that are often hard to diagnose clinically and microbiologically. Most infections with this species are pulmonary or pleural, which might hint at a connection with poor dental hygiene, but other locations have been documented. We present a case of a tubo-ovarian abscess with a difficult identification of the etiological agent in a woman with multiple admissions, no significant comorbidities, and a longstanding use of an IUD (intrauterine device). To our knowledge, no previous case of tubo-ovarian abscess with an accurate A. odontolyticus microbiological species identification has been reported so far. This case also highlights the importance of considering an anaerobic species as an etiologic agent in an infectious process concerning a previously damaged tissue and the importance of appropriate harvesting and culturing in the accurate diagnosis of such species.
{"title":"Tubo-Ovarian Abscess with Actinomyces odontolyticus: Case Report and Brief Review of Literature","authors":"A. Pană, V. Neculicioiu, Dan-Alexandru Toc, Gheorghe Dan Sprinjan, Mara Cristina Rusu, C. Costache","doi":"10.3390/reports5040046","DOIUrl":"https://doi.org/10.3390/reports5040046","url":null,"abstract":"Actinomyces odontolyticus is a strictly anaerobic species, a member of the Actinomyces genus and of the commensal flora, especially oral flora, which can trigger severe infections through breaches in healthy tissue or necrotic tissue that are often hard to diagnose clinically and microbiologically. Most infections with this species are pulmonary or pleural, which might hint at a connection with poor dental hygiene, but other locations have been documented. We present a case of a tubo-ovarian abscess with a difficult identification of the etiological agent in a woman with multiple admissions, no significant comorbidities, and a longstanding use of an IUD (intrauterine device). To our knowledge, no previous case of tubo-ovarian abscess with an accurate A. odontolyticus microbiological species identification has been reported so far. This case also highlights the importance of considering an anaerobic species as an etiologic agent in an infectious process concerning a previously damaged tissue and the importance of appropriate harvesting and culturing in the accurate diagnosis of such species.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47200076","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}
Adopting a vegan diet as a long-term diet has recently become a new global trend among healthy and physically active adult populations. Unfortunately, scarce scientific data are available on the nutritional and health status and lifestyle patterns of long-term highly physically active vegan populations. In the present case study, we present the results of the nutritional, health and lifestyle status of a highly physically active and health-conscious long-term vegan man. The following research methods were used to assess overall health and lifestyle status: (i) analysis of blood serum (selected cardiovascular risk factors (e.g., lipoproteins, triglycerides, glucose, glycosylated haemoglobin, and homocysteine), safety markers (e.g., insulin-like growth factor 1, total testosterone, high-sensitivity C-reactive protein, uric acid, and creatinine), and micronutrients (e.g., vitamin B12, 25-hydroxyvitamin D, iron and ferritin); (ii) erythrocyte membranes analysis (omega-3 index); (iii) urine sample analysis (creatinine and iodine); (iv) blood pressure measurement; (v) bioimpedance and densitometry measurement (initial and current anthropometric variables and body composition); (vi) seven-day weighted dietary records (energy and nutrient intake from regular foods only were compared with the recommended daily intake); and (vii) standardized questionnaires (sociodemographic status, economic status and lifestyle status). The most remarkable results related to dietary intake were high energy (4420 kcal/d) and fibre intake (143 g/d) and nutritional sufficiency from foods only compared with dietary recommendations, with the exception of eicosapentaenoic omega-3 fatty acids and docosahexaenoic omega-3 fatty acids, vitamin B12 and vitamin D. Overall dietary acid load (DAL) scores, calculated from the potential renal acid load (PRAL) and net endogenous acid production (NEAPF), were rated as lower compared to those of other dietary patterns. In addition, we found that the overall health and lifestyle status of the subject was satisfactory, with some minor deviations that we interpreted.
{"title":"Nutritional, Health and Lifestyle Status of a Highly Physically Active and Health-Conscious Long-Term Vegan Man: A Case Report from Slovenia","authors":"Boštjan Jakše, S. Pinter","doi":"10.3390/reports5040045","DOIUrl":"https://doi.org/10.3390/reports5040045","url":null,"abstract":"Adopting a vegan diet as a long-term diet has recently become a new global trend among healthy and physically active adult populations. Unfortunately, scarce scientific data are available on the nutritional and health status and lifestyle patterns of long-term highly physically active vegan populations. In the present case study, we present the results of the nutritional, health and lifestyle status of a highly physically active and health-conscious long-term vegan man. The following research methods were used to assess overall health and lifestyle status: (i) analysis of blood serum (selected cardiovascular risk factors (e.g., lipoproteins, triglycerides, glucose, glycosylated haemoglobin, and homocysteine), safety markers (e.g., insulin-like growth factor 1, total testosterone, high-sensitivity C-reactive protein, uric acid, and creatinine), and micronutrients (e.g., vitamin B12, 25-hydroxyvitamin D, iron and ferritin); (ii) erythrocyte membranes analysis (omega-3 index); (iii) urine sample analysis (creatinine and iodine); (iv) blood pressure measurement; (v) bioimpedance and densitometry measurement (initial and current anthropometric variables and body composition); (vi) seven-day weighted dietary records (energy and nutrient intake from regular foods only were compared with the recommended daily intake); and (vii) standardized questionnaires (sociodemographic status, economic status and lifestyle status). The most remarkable results related to dietary intake were high energy (4420 kcal/d) and fibre intake (143 g/d) and nutritional sufficiency from foods only compared with dietary recommendations, with the exception of eicosapentaenoic omega-3 fatty acids and docosahexaenoic omega-3 fatty acids, vitamin B12 and vitamin D. Overall dietary acid load (DAL) scores, calculated from the potential renal acid load (PRAL) and net endogenous acid production (NEAPF), were rated as lower compared to those of other dietary patterns. In addition, we found that the overall health and lifestyle status of the subject was satisfactory, with some minor deviations that we interpreted.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45848992","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}
Background: Patients with heart failure (HF) may benefit greatly from cardiopulmonary rehabilitation (CR), which is provided by a team of healthcare professionals that often includes nurses. There has been no research on how nurses perceive providing CR or the hurdles that may affect referrals. Methods: All registered nurses in Saudi Arabia’s Eastern Province were given access to a cross-sectional online survey consisting of nine multiple-choice questions that address attitudes, beliefs, and barriers to CR for HF patients in Saudi Arabia. Descriptive statistics were used to characterize the respondents. Results: Altogether, 439 registered nurses participated in the online survey, with men making up 194 (44%) and women 245 (56%). The mean and SD of years of clinical experience in caring for patients with HF were 6 ± 5 years. Out of 439 nurses, 107 (24%) strongly agree, and 255 (58%) agree that CR will enhance the physical fitness of patients. However, 94 (21.1%) strongly agree, and 248 (56.4%) agree that CR might alleviate dyspnea in HF patients. The vast majority of the nurses either strongly agree (90 (20.5%)) or agree (240 (55%)), that CR would help reduce palpitations and fatigue in HF patients. Indeed, 87 (19.81%) strongly agree, and 262 (59.68%) agree that CR would help improve HF patients’ ability to perform daily activities, while 51 (11.6%) strongly agree and 223 (51%) agree that CR would help in reducing hospital readmission. It was shown that 360 (82%) of the 439 nurses favored the delivery of CR programs in hospital-supervised programs, while 368 (83.8%) ranked information on HF disease as the most important aspect of the CR program, followed by information about medications at 305 (69.4%). The availability of CR facilities (36%), the cost of therapy (35%), and the absence of an established standardized referring strategy (34%) were identified as the most significant barriers affecting the referral of patients with HF for CR by nurses. Conclusion: Generally, nurses believed CR helped improve desired clinical outcomes in HF patients. Although a hospital-based program with close supervision is optimal for administering CR, few such options exist. Referrals of patients with HF were hampered by the lack of CR facilities, the cost of intervention, and the lack of a systematic approach to referrals.
{"title":"Nurses’ Beliefs and Barriers of Delivering Cardiopulmonary Rehabilitation for Heart Failure Patients in Saudi Arabia: A Cross-Sectional Study","authors":"Eidan M Alzahrani","doi":"10.3390/reports5040044","DOIUrl":"https://doi.org/10.3390/reports5040044","url":null,"abstract":"Background: Patients with heart failure (HF) may benefit greatly from cardiopulmonary rehabilitation (CR), which is provided by a team of healthcare professionals that often includes nurses. There has been no research on how nurses perceive providing CR or the hurdles that may affect referrals. Methods: All registered nurses in Saudi Arabia’s Eastern Province were given access to a cross-sectional online survey consisting of nine multiple-choice questions that address attitudes, beliefs, and barriers to CR for HF patients in Saudi Arabia. Descriptive statistics were used to characterize the respondents. Results: Altogether, 439 registered nurses participated in the online survey, with men making up 194 (44%) and women 245 (56%). The mean and SD of years of clinical experience in caring for patients with HF were 6 ± 5 years. Out of 439 nurses, 107 (24%) strongly agree, and 255 (58%) agree that CR will enhance the physical fitness of patients. However, 94 (21.1%) strongly agree, and 248 (56.4%) agree that CR might alleviate dyspnea in HF patients. The vast majority of the nurses either strongly agree (90 (20.5%)) or agree (240 (55%)), that CR would help reduce palpitations and fatigue in HF patients. Indeed, 87 (19.81%) strongly agree, and 262 (59.68%) agree that CR would help improve HF patients’ ability to perform daily activities, while 51 (11.6%) strongly agree and 223 (51%) agree that CR would help in reducing hospital readmission. It was shown that 360 (82%) of the 439 nurses favored the delivery of CR programs in hospital-supervised programs, while 368 (83.8%) ranked information on HF disease as the most important aspect of the CR program, followed by information about medications at 305 (69.4%). The availability of CR facilities (36%), the cost of therapy (35%), and the absence of an established standardized referring strategy (34%) were identified as the most significant barriers affecting the referral of patients with HF for CR by nurses. Conclusion: Generally, nurses believed CR helped improve desired clinical outcomes in HF patients. Although a hospital-based program with close supervision is optimal for administering CR, few such options exist. Referrals of patients with HF were hampered by the lack of CR facilities, the cost of intervention, and the lack of a systematic approach to referrals.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49215165","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. Zurita, C. Bonilla, C. Aguayo, C. Fernández-Mateos, P. Martínez, Silvia De La Calle, Nieves Repollés, Esther Moñivas
Background aims: The possibility of permanent neurological sequels after surgery of benign lesions affecting the spinal cord is well known. Frequently, they are irreversible, with no effective treatment other than rehabilitation. However, in recent years, intrathecal cell therapy with autologous bone marrow stromal cells (MSCs) in patients with incomplete paraplegia has shown benefits for diverse sequels of spinal cord injury (SCI). Methods: We present two patients with chronic spinal cord sequels after a surgery, who underwent cell therapy treatment with NC1 medicament (repeated intrathecal administrations of MSCs). Results: In both cases, cell therapy achieved a clear improvement in neurological sequels, such as recovery of gait disturbances, bowel dysfunction, or neuropathic pain. Conclusion: Intrathecal cell therapy with autologous MSCs offers a new approach for neurological sequels after spinal cord surgery.
{"title":"Intrathecal Cell Therapy with Autologous Bone Marrow Stromal Cells as a New Tool for Neurologic Sequels after Spinal Cord Surgery: A Report of Two Cases","authors":"M. Zurita, C. Bonilla, C. Aguayo, C. Fernández-Mateos, P. Martínez, Silvia De La Calle, Nieves Repollés, Esther Moñivas","doi":"10.3390/reports5040043","DOIUrl":"https://doi.org/10.3390/reports5040043","url":null,"abstract":"Background aims: The possibility of permanent neurological sequels after surgery of benign lesions affecting the spinal cord is well known. Frequently, they are irreversible, with no effective treatment other than rehabilitation. However, in recent years, intrathecal cell therapy with autologous bone marrow stromal cells (MSCs) in patients with incomplete paraplegia has shown benefits for diverse sequels of spinal cord injury (SCI). Methods: We present two patients with chronic spinal cord sequels after a surgery, who underwent cell therapy treatment with NC1 medicament (repeated intrathecal administrations of MSCs). Results: In both cases, cell therapy achieved a clear improvement in neurological sequels, such as recovery of gait disturbances, bowel dysfunction, or neuropathic pain. Conclusion: Intrathecal cell therapy with autologous MSCs offers a new approach for neurological sequels after spinal cord surgery.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48492832","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}
Marian-Sorin Popescu, A. Drocaș, Andrei Osman, D. Firu, V. Pădureanu, C. Marginean, Daniel-Cristian Pîrvu, R. Mitrut, D. Mărgăritescu, A. Radu, D. Calina, A. Docea, P. Mitruț
A high risk of developing insulin resistance (IR) and, eventually, type 2 diabetes mellitus (T2DM) is associated with chronic hepatitis C virus (HCV). Multiple mechanisms can account for the development of IR in chronic HCV patients, steatosis or fatty liver that can lead to metabolic syndrome, and the inflammatory process associated with the presence of HCV infection. In this article, we analyze the reported values of homoeostasis model assessment (HOMA-IR) before and after successful direct-acting agents (DAAs) treatment in the literature (23 studies) at certain intervals, respectively 12, 24, and 52 weeks depending on the presence of T2DM among patients. The meta-analysis showed improvement of IR in most cases except for three studies that presented a minimal increase in HOMA-IR value for the non-T2DM group at the 12- and 24-week check-ups possibly hinting at a prediabetes group. All other studies showed an important decrease in HOMA-IR post-DAA treatment specifically for the T2DM group. The most significant change in HOMA-IR values was noticed after 24 weeks in all categories. Our meta-analysis showed that clearance of HCV leads to improvement of IR, especially in the case of patients with T2DM.
{"title":"The Extent of Insulin Resistance in Patients That Cleared Viral Hepatitis C Infection and the Role of Pre-Existent Type 2 Diabetes Mellitus: A Meta-Analysis","authors":"Marian-Sorin Popescu, A. Drocaș, Andrei Osman, D. Firu, V. Pădureanu, C. Marginean, Daniel-Cristian Pîrvu, R. Mitrut, D. Mărgăritescu, A. Radu, D. Calina, A. Docea, P. Mitruț","doi":"10.3390/reports5040042","DOIUrl":"https://doi.org/10.3390/reports5040042","url":null,"abstract":"A high risk of developing insulin resistance (IR) and, eventually, type 2 diabetes mellitus (T2DM) is associated with chronic hepatitis C virus (HCV). Multiple mechanisms can account for the development of IR in chronic HCV patients, steatosis or fatty liver that can lead to metabolic syndrome, and the inflammatory process associated with the presence of HCV infection. In this article, we analyze the reported values of homoeostasis model assessment (HOMA-IR) before and after successful direct-acting agents (DAAs) treatment in the literature (23 studies) at certain intervals, respectively 12, 24, and 52 weeks depending on the presence of T2DM among patients. The meta-analysis showed improvement of IR in most cases except for three studies that presented a minimal increase in HOMA-IR value for the non-T2DM group at the 12- and 24-week check-ups possibly hinting at a prediabetes group. All other studies showed an important decrease in HOMA-IR post-DAA treatment specifically for the T2DM group. The most significant change in HOMA-IR values was noticed after 24 weeks in all categories. Our meta-analysis showed that clearance of HCV leads to improvement of IR, especially in the case of patients with T2DM.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41696500","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}
Consumer rhythm-monitoring devices, such as the Apple Watch, are becoming more readily available. Irregular pulses can be detected using an optical sensor that is built into the wearable device. The Apple Watch (Apple Inc., Cupertino, CA, USA) is a class II medical device with pulse rate and electrocardiography (ECG) monitoring capabilities. Here, we report a case in which an arrhythmia that was conventionally perceived but undiagnosed was identified as an atrial fibrillation by the self-acquisition of the ECG data using an Apple Watch.
{"title":"Apple Watch for Pulse Rate Assessment Detects Unidentified Paroxysmal Atrial Fibrillation","authors":"Kiichi Hirota, Maretoshi Hirai","doi":"10.3390/reports5040040","DOIUrl":"https://doi.org/10.3390/reports5040040","url":null,"abstract":"Consumer rhythm-monitoring devices, such as the Apple Watch, are becoming more readily available. Irregular pulses can be detected using an optical sensor that is built into the wearable device. The Apple Watch (Apple Inc., Cupertino, CA, USA) is a class II medical device with pulse rate and electrocardiography (ECG) monitoring capabilities. Here, we report a case in which an arrhythmia that was conventionally perceived but undiagnosed was identified as an atrial fibrillation by the self-acquisition of the ECG data using an Apple Watch.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42665761","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}
In patients undergoing cardiac-device implantation, pneumothorax incidence occurs in 1–6%, and is more common in women over 80 years of age with chronic obstructive pulmonary disease (COPD). The aim of this study was to do a service review to identify ways to improve care delivery. Caldicott approval was gained. Those complicated by a pneumothorax were further analysed regarding basic demographics and pleural interventions and outcomes. Continuous variables are presented as mean (range) or median (with interquartile ranges) and categorical variables are presented as percentages where appropriate. A total of 2056 implantation episodes from January 2010 to December 2020 occurred with 70 pneumothoraxes (3.4%), which were all related to pacemaker insertion. The mean age was 68.1 years (17–97), 39 were female, and 31 were male. A total of 36 pneumothoraxes were small and were 34 large according to British Thoracic Society (BTS) criteria. We initially observed 56 patients with minimal or no symptoms (30 were large pneumothoraxes), with five requiring intercostal drainage (ICD). A total of 14 pneumothoraxes were treated with ICD as a first-line treatment: the mean age was 78 years (69–89) and eight patients had COPD. Five pneumothoraxes were large. All had significant symptoms. All pneumothoraxes resolved within six weeks with no associated mortality.
{"title":"Cardiac-Device Implantation and Pneumothorax—A Symptom-Based Approach: Experience from a District General Hospital","authors":"G. George, A. Aujayeb","doi":"10.3390/reports5040039","DOIUrl":"https://doi.org/10.3390/reports5040039","url":null,"abstract":"In patients undergoing cardiac-device implantation, pneumothorax incidence occurs in 1–6%, and is more common in women over 80 years of age with chronic obstructive pulmonary disease (COPD). The aim of this study was to do a service review to identify ways to improve care delivery. Caldicott approval was gained. Those complicated by a pneumothorax were further analysed regarding basic demographics and pleural interventions and outcomes. Continuous variables are presented as mean (range) or median (with interquartile ranges) and categorical variables are presented as percentages where appropriate. A total of 2056 implantation episodes from January 2010 to December 2020 occurred with 70 pneumothoraxes (3.4%), which were all related to pacemaker insertion. The mean age was 68.1 years (17–97), 39 were female, and 31 were male. A total of 36 pneumothoraxes were small and were 34 large according to British Thoracic Society (BTS) criteria. We initially observed 56 patients with minimal or no symptoms (30 were large pneumothoraxes), with five requiring intercostal drainage (ICD). A total of 14 pneumothoraxes were treated with ICD as a first-line treatment: the mean age was 78 years (69–89) and eight patients had COPD. Five pneumothoraxes were large. All had significant symptoms. All pneumothoraxes resolved within six weeks with no associated mortality.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45211261","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}
A. d’Amati, M. Mariano, Francesca Addante, Giovanna Giliberti, G. Tomasicchio, M. Mastropasqua
The presence of stromal osteoclast-like giant cells is a distinctive feature of some rare breast tumors, accounting for less than 1% of all breast cancer cases. Although the presence of stromal osteoclast-like giant cells may be encountered in different breast tumors, some authors still describe them as a specific tumor type. Usually, a histological diagnosis of breast carcinoma is made by a pathologist through a biopsy, which is then confirmed through a surgical specimen: it is rare for the two to differ, particularly when there are pathognomonic morphological markers, such as osteoclast-like giant cells. Herein, we report a case of a 45-year-old pre-menopausal woman, who was found to have a single solid mass in her right breast on screening mammogram. She underwent a core biopsy, which showed a malignant epithelial lesion arranged in tubules, glands, and papillae, intermingled with numerous stromal osteoclast-like giant cells. Therefore, a diagnosis of breast cancer with osteoclast-like giant cells was rendered. Curiously, these cells were no longer detectable in the surgical specimen.
{"title":"When Histological Tumor Type Diagnosed on Core Biopsy Changes Its Face after Surgery: Report of a Deceptive Case of Breast Carcinoma","authors":"A. d’Amati, M. Mariano, Francesca Addante, Giovanna Giliberti, G. Tomasicchio, M. Mastropasqua","doi":"10.3390/reports5040038","DOIUrl":"https://doi.org/10.3390/reports5040038","url":null,"abstract":"The presence of stromal osteoclast-like giant cells is a distinctive feature of some rare breast tumors, accounting for less than 1% of all breast cancer cases. Although the presence of stromal osteoclast-like giant cells may be encountered in different breast tumors, some authors still describe them as a specific tumor type. Usually, a histological diagnosis of breast carcinoma is made by a pathologist through a biopsy, which is then confirmed through a surgical specimen: it is rare for the two to differ, particularly when there are pathognomonic morphological markers, such as osteoclast-like giant cells. Herein, we report a case of a 45-year-old pre-menopausal woman, who was found to have a single solid mass in her right breast on screening mammogram. She underwent a core biopsy, which showed a malignant epithelial lesion arranged in tubules, glands, and papillae, intermingled with numerous stromal osteoclast-like giant cells. Therefore, a diagnosis of breast cancer with osteoclast-like giant cells was rendered. Curiously, these cells were no longer detectable in the surgical specimen.","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49648275","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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