Pub Date : 2022-01-01DOI: 10.4103/jtccm-d-22-00010
S. Patil, Abhijit Mugalikar, Deepak Patil, G. Gondhali
{"title":"Remdesivir Use and Controversies in COVID-19 Pneumonia: Myths and Reality!","authors":"S. Patil, Abhijit Mugalikar, Deepak Patil, G. Gondhali","doi":"10.4103/jtccm-d-22-00010","DOIUrl":"https://doi.org/10.4103/jtccm-d-22-00010","url":null,"abstract":"","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80054820","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}
Pub Date : 2021-11-16DOI: 10.4103/2665-9190.330535
Jiahao Zhang, X. Rao, Liangdong Chen, Xiaofang Jiang, Cheng Yang, Fengqin Wang, Sanying Shen, L. Su, Z. Peng
ABSTRACT Objective: The objective of the study is to describe the clinical characteristics, risk factors, and prognosis for acute kidney injury (AKI) among patients with coronavirus disease (COVID-19). Methods: Retrospective study of 456 consecutive patients with confirmed COVID-19 infection at the whole hospital from January 1 to March 1, 2020 was enrolled. Demographic, clinical characteristics, the risk factors, and prognosis were collected and analyzed. Results: Of 456 patients with COVID-19, 38 patients developed AKI. Patients with AKI were older and predominantly male sex and were more likely to have comorbidities such as hypertension, cardiovascular, and cerebrovascular diseases. Among patients with AKI, the white blood cell count, neutrophil count, neutrophil-to-lymphocyte ratio, alanine aminotransferase, and C-reaction protein were increased, and lymphocyte and platelet count were decreased. Multivariate analysis showed that age, hypertension, and lymphocyte count were independent risk factors for AKI. The overall mortality rate of 456 patients was 9.9%, and the mortality rate of patients with AKI was 23.7%. In particular, increasing AKI severity was associated with increased risk. Conclusions: The risk of AKI was high in patients with COVID-19. Older age, hypertension, and lower lymphocyte count were independent risk factors for AKI. COVID-19-associated AKI was associated with higher risk of death in patients with COVID-19.
{"title":"Clinical Characteristics and Risk Factors for Acute Kidney Injury in COVID-19","authors":"Jiahao Zhang, X. Rao, Liangdong Chen, Xiaofang Jiang, Cheng Yang, Fengqin Wang, Sanying Shen, L. Su, Z. Peng","doi":"10.4103/2665-9190.330535","DOIUrl":"https://doi.org/10.4103/2665-9190.330535","url":null,"abstract":"ABSTRACT Objective: The objective of the study is to describe the clinical characteristics, risk factors, and prognosis for acute kidney injury (AKI) among patients with coronavirus disease (COVID-19). Methods: Retrospective study of 456 consecutive patients with confirmed COVID-19 infection at the whole hospital from January 1 to March 1, 2020 was enrolled. Demographic, clinical characteristics, the risk factors, and prognosis were collected and analyzed. Results: Of 456 patients with COVID-19, 38 patients developed AKI. Patients with AKI were older and predominantly male sex and were more likely to have comorbidities such as hypertension, cardiovascular, and cerebrovascular diseases. Among patients with AKI, the white blood cell count, neutrophil count, neutrophil-to-lymphocyte ratio, alanine aminotransferase, and C-reaction protein were increased, and lymphocyte and platelet count were decreased. Multivariate analysis showed that age, hypertension, and lymphocyte count were independent risk factors for AKI. The overall mortality rate of 456 patients was 9.9%, and the mortality rate of patients with AKI was 23.7%. In particular, increasing AKI severity was associated with increased risk. Conclusions: The risk of AKI was high in patients with COVID-19. Older age, hypertension, and lower lymphocyte count were independent risk factors for AKI. COVID-19-associated AKI was associated with higher risk of death in patients with COVID-19.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"76 1","pages":"1 - 5"},"PeriodicalIF":0.0,"publicationDate":"2021-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86026855","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}
Pub Date : 2021-09-28DOI: 10.4103/2665-9190.326914
Xiaofang Jiang, Jiahao Zhang, Cheng Yang, Qin-jing Xie, G. Xiao, Fengqin Wang, Sanying Shen, L. Su, Z. Peng
ABSTRACT Background: COVID-19 outbreak has spread around the world. Liver dysfunction (LD) was related with high mortality in COVID-19. Methods: Retrospective, single-center study case series of 425 consecutive hospitalized COVID-19 patients were enrolled. Demographic, clinical, laboratory, and treatment data were collected. Results: A total of 425 patients were included in this study, 145 of whom had LD. The overall mortality rate was 8.9%, while 17.9% in the LD group and 4.3% in the nonliver dysfunction (NLD) group. Age, sex, and hypertension were the independent risk factors of LD. LD was an independent risk factor for incidence of severe illness, acute respiratory distress syndrome, and death. The survival rate of patients in LD group was lower than that in NLD group (P < 0.001). A similar trend was observed by the multivariate regression analysis (adjusted hazard ratio, 3.52; 95% confidence interval [CI], 1.69–7.33; P = 0.001). Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers had effect to reduce LD (odds ratio of 0.48 [95% CI, 0.232–0.989; P = 0.045]). Conclusions: LD is one of the main features of hospitalized patients of COVID-19, with a worse prognosis. Patients of COVID-19 with LD on admission should be more cautions.
{"title":"Clinical Characteristics and Risk Factors of Liver Dysfunction in COVID-19 Patients","authors":"Xiaofang Jiang, Jiahao Zhang, Cheng Yang, Qin-jing Xie, G. Xiao, Fengqin Wang, Sanying Shen, L. Su, Z. Peng","doi":"10.4103/2665-9190.326914","DOIUrl":"https://doi.org/10.4103/2665-9190.326914","url":null,"abstract":"ABSTRACT Background: COVID-19 outbreak has spread around the world. Liver dysfunction (LD) was related with high mortality in COVID-19. Methods: Retrospective, single-center study case series of 425 consecutive hospitalized COVID-19 patients were enrolled. Demographic, clinical, laboratory, and treatment data were collected. Results: A total of 425 patients were included in this study, 145 of whom had LD. The overall mortality rate was 8.9%, while 17.9% in the LD group and 4.3% in the nonliver dysfunction (NLD) group. Age, sex, and hypertension were the independent risk factors of LD. LD was an independent risk factor for incidence of severe illness, acute respiratory distress syndrome, and death. The survival rate of patients in LD group was lower than that in NLD group (P < 0.001). A similar trend was observed by the multivariate regression analysis (adjusted hazard ratio, 3.52; 95% confidence interval [CI], 1.69–7.33; P = 0.001). Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers had effect to reduce LD (odds ratio of 0.48 [95% CI, 0.232–0.989; P = 0.045]). Conclusions: LD is one of the main features of hospitalized patients of COVID-19, with a worse prognosis. Patients of COVID-19 with LD on admission should be more cautions.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"6 1","pages":"1 - 6"},"PeriodicalIF":0.0,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89492312","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}
Pub Date : 2021-09-28DOI: 10.4103/jtccm.jtccm_20_21
Tuo Li, Xian-liang Zhang, Wei Tang, Liangliang Sun, J. Zou, Yong-Quan Shi
ABSTRACT Background and Objectives: To explore the superiority of flipping-classroom lended learning in which the stay-home e-learning and traditional internship complements each other in resident training of endcorinology during coronavirus disease 2019 restriction period. Materials and Methods: A total of 44 residents were randomized as the study population. In the endocrine-rotation training, we reformed the clinical learning by unified online-teaching led by teachers' combination with individual guidance by residents. Moreover, the final implementation assessment was conducted by standard double-blind examinations. Results: After 4–8 weeks training, the 44 residents were assessed for clinical skills from six dimensions, including medical history collection, physical examination, history report and inpatient record writing, case analysis, and overviewing capability. Compared with the mean scores of 68 residents rotated in internal medicine in 2019, the mean scores on physical examination, inpatient record writing, and overviewing capability in 2020 group were higher with significance ([85.72 ± 8.33] vs.[79.22 ± 10.12], P = 0.0006), ([90.28 ± 10.70] vs. [81.82 ± 8.03], P < 0.0001), ([80.31 ± 8.70] vs. [73.04 ± 12.74], P = 0.0012), whereas scores on skills of medical history collection and history report were slightly lower ([82.11 ± 9.02] vs. [85.06 ± 7.23], P = 0.0586), ([79.30 ± 8.17] vs. [83.21 ± 5.01], P = 0.0022), while scores on case analysis did not show huge gap but with polarized performance in 2020 group ([74.38 ± 10.29] vs. [78.13 ± 8.53], P = 0.0386). Conclusions: Providing the novel pattern of unified online-teaching combined with individual-guidance at the bedside to the front-line residents can reduce the risk of cluster epidemics and effectively ensure the training effect on them but still with shortcomings. The future online teaching reform is better for focus more on how to make up for or reduce the actual problem of disconnection between theory and practice in the process of online clinical skills training for residents and teachers.
{"title":"Exploration and Thinking in Mixed Flipping-Classroom Teaching Approach on Clinical Endocrinolgy during the Coronavirus Disease 2019 Period","authors":"Tuo Li, Xian-liang Zhang, Wei Tang, Liangliang Sun, J. Zou, Yong-Quan Shi","doi":"10.4103/jtccm.jtccm_20_21","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_20_21","url":null,"abstract":"ABSTRACT Background and Objectives: To explore the superiority of flipping-classroom lended learning in which the stay-home e-learning and traditional internship complements each other in resident training of endcorinology during coronavirus disease 2019 restriction period. Materials and Methods: A total of 44 residents were randomized as the study population. In the endocrine-rotation training, we reformed the clinical learning by unified online-teaching led by teachers' combination with individual guidance by residents. Moreover, the final implementation assessment was conducted by standard double-blind examinations. Results: After 4–8 weeks training, the 44 residents were assessed for clinical skills from six dimensions, including medical history collection, physical examination, history report and inpatient record writing, case analysis, and overviewing capability. Compared with the mean scores of 68 residents rotated in internal medicine in 2019, the mean scores on physical examination, inpatient record writing, and overviewing capability in 2020 group were higher with significance ([85.72 ± 8.33] vs.[79.22 ± 10.12], P = 0.0006), ([90.28 ± 10.70] vs. [81.82 ± 8.03], P < 0.0001), ([80.31 ± 8.70] vs. [73.04 ± 12.74], P = 0.0012), whereas scores on skills of medical history collection and history report were slightly lower ([82.11 ± 9.02] vs. [85.06 ± 7.23], P = 0.0586), ([79.30 ± 8.17] vs. [83.21 ± 5.01], P = 0.0022), while scores on case analysis did not show huge gap but with polarized performance in 2020 group ([74.38 ± 10.29] vs. [78.13 ± 8.53], P = 0.0386). Conclusions: Providing the novel pattern of unified online-teaching combined with individual-guidance at the bedside to the front-line residents can reduce the risk of cluster epidemics and effectively ensure the training effect on them but still with shortcomings. The future online teaching reform is better for focus more on how to make up for or reduce the actual problem of disconnection between theory and practice in the process of online clinical skills training for residents and teachers.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"30 1","pages":"1 - 4"},"PeriodicalIF":0.0,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84652630","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}
Pub Date : 2021-01-01DOI: 10.4103/jtccm.jtccm_14_21
Xuehao Lu, Feng Zhang, Longzhu Li, Meilian Li, Haifeng Hu, Z. Qu, Chuiyan Qiu, Zhigang Wang, Haiyan Yin, Hui Liu
Sepsis is one of the most common severe diseases in clinic. With the progression of the disease, it is very likely to occur acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). Despite years of research, the mortality rate from sepsis-associated lung injury remains high. MicroRNAs (miRNAs) are a class of non-coding small RNAs with the function of regulating gene expression. In recent years, miRNAs have become a research hotspot in the field of biomedicine. Therefore, this review summarizes a large body of evidence implicating miRNAs and their target molecules in ALI/ARDS originating largely from studies using animal and cell culture model systems of ALI/ARDS. First, the pathophysiology and potential molecular mechanism of sepsis-associated ALI were briefly discussed at the cellular level, and the regulatory effect of miRNA on sepsis-associated ALI was summarized from the molecular mechanism so as to provide the possibility to find new targets for the treatment of sepsis-associated lung injury. Finally, some promising methods and some shortcomings of existing research are introduced.
{"title":"Recent Advances of MicroRNA in Sepsis-associated Acute Lung Injury","authors":"Xuehao Lu, Feng Zhang, Longzhu Li, Meilian Li, Haifeng Hu, Z. Qu, Chuiyan Qiu, Zhigang Wang, Haiyan Yin, Hui Liu","doi":"10.4103/jtccm.jtccm_14_21","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_14_21","url":null,"abstract":"Sepsis is one of the most common severe diseases in clinic. With the progression of the disease, it is very likely to occur acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). Despite years of research, the mortality rate from sepsis-associated lung injury remains high. MicroRNAs (miRNAs) are a class of non-coding small RNAs with the function of regulating gene expression. In recent years, miRNAs have become a research hotspot in the field of biomedicine. Therefore, this review summarizes a large body of evidence implicating miRNAs and their target molecules in ALI/ARDS originating largely from studies using animal and cell culture model systems of ALI/ARDS. First, the pathophysiology and potential molecular mechanism of sepsis-associated ALI were briefly discussed at the cellular level, and the regulatory effect of miRNA on sepsis-associated ALI was summarized from the molecular mechanism so as to provide the possibility to find new targets for the treatment of sepsis-associated lung injury. Finally, some promising methods and some shortcomings of existing research are introduced.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"13 1","pages":"1 - 1"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89140260","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}
Pub Date : 2021-01-01DOI: 10.4103/jtccm.jtccm_11_21
Ke Wang, Zhidan zhang
This review discusses the clinical beneficial effects of peptide-based enteral nutrition (EN) for critically ill patients, especially those with gastrointestinal (GI) dysfunction. The GI dysfunction is very common in critically ill patients and always leads to intolerance of enteral feeding. Experimental and clinical studies suggest that peptide-based EN can be easily digested and absorbed by the GI tract which improving the feeding intolerance and provide better nutritional effects for critically ill patients. In addition, peptide-based EN may also have anti-inflammation, anti-oxidation, and immune-modulation effects and can facilitate muscle protein synthesis to improve muscle weakness which is commonly seen in critically ill patients. Peptide-based EN may have both nutritional and nonnutritional beneficial effects for critically ill patients. Further, large prospective randomized clinical trials should to be done to make the definite results.
{"title":"Peptide-Based Enteral Nutrition for Critically Ill Patients","authors":"Ke Wang, Zhidan zhang","doi":"10.4103/jtccm.jtccm_11_21","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_11_21","url":null,"abstract":"This review discusses the clinical beneficial effects of peptide-based enteral nutrition (EN) for critically ill patients, especially those with gastrointestinal (GI) dysfunction. The GI dysfunction is very common in critically ill patients and always leads to intolerance of enteral feeding. Experimental and clinical studies suggest that peptide-based EN can be easily digested and absorbed by the GI tract which improving the feeding intolerance and provide better nutritional effects for critically ill patients. In addition, peptide-based EN may also have anti-inflammation, anti-oxidation, and immune-modulation effects and can facilitate muscle protein synthesis to improve muscle weakness which is commonly seen in critically ill patients. Peptide-based EN may have both nutritional and nonnutritional beneficial effects for critically ill patients. Further, large prospective randomized clinical trials should to be done to make the definite results.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"31 1","pages":"2 - 2"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89654514","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}
Pub Date : 2021-01-01DOI: 10.4103/jtccm.jtccm_31_21
Jianxin Zhou, Xiumei Sun, Lu Chen
{"title":"Complete Airway Closure","authors":"Jianxin Zhou, Xiumei Sun, Lu Chen","doi":"10.4103/jtccm.jtccm_31_21","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_31_21","url":null,"abstract":"","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86956091","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}
Pub Date : 2021-01-01DOI: 10.4103/jtccm.jtccm_12_21
William Camargo-Martínez, I. Lozada‐Martínez, A. Osorio, L. Moscote-Salazar, Tariq Janjua
It has been described that COVID-19 is a dynamic behavior and systemic affectation entity, so it is essential to develop the diagnostic and prognostic tools which allows to specifically identify target organ damage. The electrocardiographic finding of an inverse T-wave suggests transient apical dysfunction of the left ventricle, generating confusion among different heart diseases. However, despite the lack of troponin elevation and other myocardial injury signs, this finding is unspecific, especially in the patient with COVID-19. The aim of this manuscript is to present the case of a patient with COVID-19 without a previous diagnosis of heart disease, which manifests an isolated inverse T-wave.
{"title":"Giant Inverse T-wave in a Patient with COVID-19","authors":"William Camargo-Martínez, I. Lozada‐Martínez, A. Osorio, L. Moscote-Salazar, Tariq Janjua","doi":"10.4103/jtccm.jtccm_12_21","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_12_21","url":null,"abstract":"It has been described that COVID-19 is a dynamic behavior and systemic affectation entity, so it is essential to develop the diagnostic and prognostic tools which allows to specifically identify target organ damage. The electrocardiographic finding of an inverse T-wave suggests transient apical dysfunction of the left ventricle, generating confusion among different heart diseases. However, despite the lack of troponin elevation and other myocardial injury signs, this finding is unspecific, especially in the patient with COVID-19. The aim of this manuscript is to present the case of a patient with COVID-19 without a previous diagnosis of heart disease, which manifests an isolated inverse T-wave.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"44 1","pages":"1 - 4"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86832402","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}
Pub Date : 2021-01-01DOI: 10.4103/jtccm.jtccm_8_21
Xiao-juan Zhang, Xin Li, Wang Liang, Liang Yingjian, Lu Li, Xiaotong Li, Zhidan zhang
{"title":"TEG Parameters Maximum Amplitude, Reaction Time Predicts Sepsis-Induced Coagulopathy and Mortality: A Prospective, Observational Study","authors":"Xiao-juan Zhang, Xin Li, Wang Liang, Liang Yingjian, Lu Li, Xiaotong Li, Zhidan zhang","doi":"10.4103/jtccm.jtccm_8_21","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_8_21","url":null,"abstract":"","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75389236","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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