Background: Recent studies have highlighted the relationship between EDs and COVID-19 and have shown how the change in daily dynamics and lifestyle together with the forced isolation regime have worked as psychopathological risk factors. Prolonged isolation, as an effect of the lockdown, has generated anxieties and fears related to the loss of control, increasing food restrictions. Aim: The aim of this study was to evaluate the impact of COVID-19 on symptoms, body image and the relationship between the onset of symptoms and the second block of the pandemic period. Methods: A total of 14 female patients (mean age = 18.71; SD = 5.59) with anorexia nervosa in treatment before the COVID-19 outbreak contributed to this study. The evaluation included the EDI-3, BUT and Disgust Scale-R questionnaires for general psychopathology, personality and ED severity indexes. Results: A total of 30% of patients reported increased symptoms during lockdown, and 88.2% passed the clinical cut-off on the general psychological maladaptation scale (EDI-3–GPMC > 26p), showing widespread dissatisfaction with body image and increased diet-related stress. Conclusions: Preliminary data on these specific vulnerability factors combined with stressful situations—in our case, the isolation due to the COVID-19 pandemic—can help in the design of personalized preventive and therapeutic approaches.
{"title":"Eating Disorders (EDs) and the COVID-19 Pandemic: A Pilot Study on the Impact of Phase II of the Lockdown","authors":"G. Savarese, W. Milano, L. Carpinelli","doi":"10.3390/biomed2010012","DOIUrl":"https://doi.org/10.3390/biomed2010012","url":null,"abstract":"Background: Recent studies have highlighted the relationship between EDs and COVID-19 and have shown how the change in daily dynamics and lifestyle together with the forced isolation regime have worked as psychopathological risk factors. Prolonged isolation, as an effect of the lockdown, has generated anxieties and fears related to the loss of control, increasing food restrictions. Aim: The aim of this study was to evaluate the impact of COVID-19 on symptoms, body image and the relationship between the onset of symptoms and the second block of the pandemic period. Methods: A total of 14 female patients (mean age = 18.71; SD = 5.59) with anorexia nervosa in treatment before the COVID-19 outbreak contributed to this study. The evaluation included the EDI-3, BUT and Disgust Scale-R questionnaires for general psychopathology, personality and ED severity indexes. Results: A total of 30% of patients reported increased symptoms during lockdown, and 88.2% passed the clinical cut-off on the general psychological maladaptation scale (EDI-3–GPMC > 26p), showing widespread dissatisfaction with body image and increased diet-related stress. Conclusions: Preliminary data on these specific vulnerability factors combined with stressful situations—in our case, the isolation due to the COVID-19 pandemic—can help in the design of personalized preventive and therapeutic approaches.","PeriodicalId":93816,"journal":{"name":"SPG biomed","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73465524","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}
The definition of the word “pain” has recently been changed by the International agency for the studies of pain (IASP), to include also non-verbal and pre-verbal people. During the COVID pandemic, we have seen a new category of people who cannot speak: in many countries, anxiety and isolation and the cuts to home-assistance and to many hospital services, have brought to de-crease the explicit request for healthcare. This is a problem to be solved and an important alert about what is still an unsatisfactory response given by the national healthcare systems: the care of those who are most frail and voiceless. In this article, this scenario is described, and proposals for a future improvement of pain treatment for those who cannot speak are described. The first is to create a “Medicine of Abundance”: it is possible to avoid wastes in healthcare, and with these funds, a better welcoming of people in hospitals, a better stay, and more motivated personnel can be provided. Abundance is a right of the poorest and sickest even more than the general population; when people are at their ease, they can express better their wishes and their sufferings. The hospital should become a place of hospitality, its walls should be the first care for the sick: now in too many cases it is a cold hub/container of services. The second proposal is having caregivers always measure the pain level in hospitalized patients before taking decisions on implementing or withdrawing medical treatments, in particular those that can accelerate their end-of-life; this is called the “pain principle”.
{"title":"The COVID Era Unveils Flaws in Pain Treatment","authors":"C. Bellieni","doi":"10.3390/biomed2010011","DOIUrl":"https://doi.org/10.3390/biomed2010011","url":null,"abstract":"The definition of the word “pain” has recently been changed by the International agency for the studies of pain (IASP), to include also non-verbal and pre-verbal people. During the COVID pandemic, we have seen a new category of people who cannot speak: in many countries, anxiety and isolation and the cuts to home-assistance and to many hospital services, have brought to de-crease the explicit request for healthcare. This is a problem to be solved and an important alert about what is still an unsatisfactory response given by the national healthcare systems: the care of those who are most frail and voiceless. In this article, this scenario is described, and proposals for a future improvement of pain treatment for those who cannot speak are described. The first is to create a “Medicine of Abundance”: it is possible to avoid wastes in healthcare, and with these funds, a better welcoming of people in hospitals, a better stay, and more motivated personnel can be provided. Abundance is a right of the poorest and sickest even more than the general population; when people are at their ease, they can express better their wishes and their sufferings. The hospital should become a place of hospitality, its walls should be the first care for the sick: now in too many cases it is a cold hub/container of services. The second proposal is having caregivers always measure the pain level in hospitalized patients before taking decisions on implementing or withdrawing medical treatments, in particular those that can accelerate their end-of-life; this is called the “pain principle”.","PeriodicalId":93816,"journal":{"name":"SPG biomed","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85058134","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}
Multimorbid patients represent a special population of vulnerable individuals who suffer from two or more long-term conditions. They are a very prevalent group with an increased risk of death from COVID-19. The present study aimed to identify the sociodemographic and clinical determinants of multimorbidity of underlying conditions that increase the risk of severe COVID-19 in chronic adult individuals by analyzing data from the Portuguese National Health Survey 2019. The inclusion sample consisted of 7859 adult residents in Portugal who had at least one chronic condition. The health conditions considered for multimorbidity were CKD, COPD, heart conditions, diabetes mellitus, obesity, and smoking. In Portugal, approximately 6 out of every 10 individuals with chronic diseases suffer from one or more conditions that are on the list of those at increased risk of severe COVID-19 disease, and approximately 2 out of every 10 individuals have multimorbidity. Obesity and diabetes are the most frequent risk factors. Timely interventions (e.g., regular medical follow-up for preventive health services and health information) targeting multimorbidity in males and individuals with low educational levels, a poor health status, and low functionality may help to reduce the risk of severe COVID-19 and post-COVID-19 sequelae, and to improve health in a large proportion of the population.
{"title":"Sociodemographic and Clinical Determinants of Multimorbidity of Underlying Conditions That Increase the Risk of Severe Illness from COVID-19 in Chronic Adult Individuals","authors":"Filipe Prazeres, Luísa Castro, A. Teixeira","doi":"10.3390/biomed2010010","DOIUrl":"https://doi.org/10.3390/biomed2010010","url":null,"abstract":"Multimorbid patients represent a special population of vulnerable individuals who suffer from two or more long-term conditions. They are a very prevalent group with an increased risk of death from COVID-19. The present study aimed to identify the sociodemographic and clinical determinants of multimorbidity of underlying conditions that increase the risk of severe COVID-19 in chronic adult individuals by analyzing data from the Portuguese National Health Survey 2019. The inclusion sample consisted of 7859 adult residents in Portugal who had at least one chronic condition. The health conditions considered for multimorbidity were CKD, COPD, heart conditions, diabetes mellitus, obesity, and smoking. In Portugal, approximately 6 out of every 10 individuals with chronic diseases suffer from one or more conditions that are on the list of those at increased risk of severe COVID-19 disease, and approximately 2 out of every 10 individuals have multimorbidity. Obesity and diabetes are the most frequent risk factors. Timely interventions (e.g., regular medical follow-up for preventive health services and health information) targeting multimorbidity in males and individuals with low educational levels, a poor health status, and low functionality may help to reduce the risk of severe COVID-19 and post-COVID-19 sequelae, and to improve health in a large proportion of the population.","PeriodicalId":93816,"journal":{"name":"SPG biomed","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73089975","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 COVID-19 smoker’s paradox was identified during the early days of the COVID-19 pandemic—many studies reported that smokers appeared to be protected against SARS-CoV-2 infections. Conversely, other studies added to the smoker’s paradox controversy with findings of increased risk for COVID-19 in heavy smokers. Ciliary beat frequency (CBF) within the ciliated epithelium of the nasal tract can be stimulated to a higher frequency and provide increased protection against transient exposure to airway irritants. Smokers as well as non-smokers exposed to secondhand tobacco smoke were found to have higher CBFs. However, with extended exposure to irritants, persistent upregulated CBF can damage and remodel the epithelial layer with fewer protective cilia. Additionally, mucociliary clearance (MCC), the innate defense mechanism of the respiratory system, traps particles and pathogens within the mucous layer of the epithelium and propels them out of the airways through ciliary activity. However, this mechanism becomes defective as disease progresses, increasing susceptibility to viral respiratory infections. This paper proposes that a smoker’s paradox associated with SARS-CoV-2 infection in COVID-19 patients may be mediated by upregulated ciliary beating frequency and mucociliary clearance with transient exposure to tobacco smoke, and downregulated CBF and MCC with extended exposure to tobacco smoke.
{"title":"SARS-CoV-2 and Smoker’s Paradox: Mediation by Ciliary Beat Frequency and Mucociliary Clearance?","authors":"Ronald B. Brown","doi":"10.3390/biomed2010009","DOIUrl":"https://doi.org/10.3390/biomed2010009","url":null,"abstract":"A COVID-19 smoker’s paradox was identified during the early days of the COVID-19 pandemic—many studies reported that smokers appeared to be protected against SARS-CoV-2 infections. Conversely, other studies added to the smoker’s paradox controversy with findings of increased risk for COVID-19 in heavy smokers. Ciliary beat frequency (CBF) within the ciliated epithelium of the nasal tract can be stimulated to a higher frequency and provide increased protection against transient exposure to airway irritants. Smokers as well as non-smokers exposed to secondhand tobacco smoke were found to have higher CBFs. However, with extended exposure to irritants, persistent upregulated CBF can damage and remodel the epithelial layer with fewer protective cilia. Additionally, mucociliary clearance (MCC), the innate defense mechanism of the respiratory system, traps particles and pathogens within the mucous layer of the epithelium and propels them out of the airways through ciliary activity. However, this mechanism becomes defective as disease progresses, increasing susceptibility to viral respiratory infections. This paper proposes that a smoker’s paradox associated with SARS-CoV-2 infection in COVID-19 patients may be mediated by upregulated ciliary beating frequency and mucociliary clearance with transient exposure to tobacco smoke, and downregulated CBF and MCC with extended exposure to tobacco smoke.","PeriodicalId":93816,"journal":{"name":"SPG biomed","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75990303","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}
F. Martino, Giulia Fanton, Fiammetta Zanetti, M. Pascarella, G. Novara
COVID-19 remains a major world health problem, and its clinical manifestations can vary from an oligosymptomatic form to severe pulmonary infection, which can require invasive ventilation and is strictly related to death. Identifying risk factors for adverse outcomes is essential for performing adequate care and contrasting high mortality. Chronic kidney disease (CKD) is a widespread comorbidity and is a known risk factor for death during SARS-CoV-2 infection. The present study evaluates the death risk assessment during the COVID-19 pandemic in (CKD) patients, considering the baseline value of an estimated glomerular filtration rate (eGFR) and other possible risk factors. We retrospectively assessed the mortality risk in 150 patients with COVID-19 between 1 October and 31 December 2020. We evaluated eGFR, haemoglobin, albumin, uric acid, cholesterol, triglycerides, and significant risk factors, such as diabetes mellitus and cardiovascular disease in every patient. We had 53 deaths (35.3%) during the observational period, significantly related to age, eGFR, albumin, and baseline nephropathy. In the multivariable analysis, only baseline eGFR and age were independent predictors of death during SARS-CoV-2 infection, with an OR equal to 0.96 and 1.067, respectively. In conclusion, by our analysis, age, and the baseline eGFR were the only reliable predictors of death during COVID-19 in CKD patients.
{"title":"Is Previous eGFR a Reliable Risk Factor for COVID-19 Death? Single Centre Analysis in Chronic Kidney Disease Patients in Northern Italy","authors":"F. Martino, Giulia Fanton, Fiammetta Zanetti, M. Pascarella, G. Novara","doi":"10.3390/biomed2010008","DOIUrl":"https://doi.org/10.3390/biomed2010008","url":null,"abstract":"COVID-19 remains a major world health problem, and its clinical manifestations can vary from an oligosymptomatic form to severe pulmonary infection, which can require invasive ventilation and is strictly related to death. Identifying risk factors for adverse outcomes is essential for performing adequate care and contrasting high mortality. Chronic kidney disease (CKD) is a widespread comorbidity and is a known risk factor for death during SARS-CoV-2 infection. The present study evaluates the death risk assessment during the COVID-19 pandemic in (CKD) patients, considering the baseline value of an estimated glomerular filtration rate (eGFR) and other possible risk factors. We retrospectively assessed the mortality risk in 150 patients with COVID-19 between 1 October and 31 December 2020. We evaluated eGFR, haemoglobin, albumin, uric acid, cholesterol, triglycerides, and significant risk factors, such as diabetes mellitus and cardiovascular disease in every patient. We had 53 deaths (35.3%) during the observational period, significantly related to age, eGFR, albumin, and baseline nephropathy. In the multivariable analysis, only baseline eGFR and age were independent predictors of death during SARS-CoV-2 infection, with an OR equal to 0.96 and 1.067, respectively. In conclusion, by our analysis, age, and the baseline eGFR were the only reliable predictors of death during COVID-19 in CKD patients.","PeriodicalId":93816,"journal":{"name":"SPG biomed","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85653312","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}
The outbreak of the COVID-19 epidemic has focused enormous attention on the genetics of viral infection and related disease. Since the beginning of the pandemic, we focused on the collection and integration of SARS-CoV-2 databases, which contain information on the structure of the virus and on its ability to spread, mutate, and evolve; data are made available from several open-source databases. In the past, we gathered experience on human genomics data by building models and integrated databases of genomic datasets (representing, e.g., mutations, gene expression profiles, epigenetic signals). We also coordinated the development of a data dictionary describing the clinical phenotype of the COVID19 disease, in the context of a very large consortium. The main objective of this paper is to describe the content of the data dictionary and the process of data collection and organization. We also argue that—in the context of the COVID-19 disease—interoperability between the three domains of viral genomics, clinical phenotype, and human host genomics is essential for empowering important analysis processes and results. We call for actions that could be performed to link these data.
{"title":"Interoperability of COVID-19 Clinical Phenotype Data with Host and Viral Genetics Data","authors":"Anna Bernasconi, S. Ceri","doi":"10.3390/biomed2010007","DOIUrl":"https://doi.org/10.3390/biomed2010007","url":null,"abstract":"The outbreak of the COVID-19 epidemic has focused enormous attention on the genetics of viral infection and related disease. Since the beginning of the pandemic, we focused on the collection and integration of SARS-CoV-2 databases, which contain information on the structure of the virus and on its ability to spread, mutate, and evolve; data are made available from several open-source databases. In the past, we gathered experience on human genomics data by building models and integrated databases of genomic datasets (representing, e.g., mutations, gene expression profiles, epigenetic signals). We also coordinated the development of a data dictionary describing the clinical phenotype of the COVID19 disease, in the context of a very large consortium. The main objective of this paper is to describe the content of the data dictionary and the process of data collection and organization. We also argue that—in the context of the COVID-19 disease—interoperability between the three domains of viral genomics, clinical phenotype, and human host genomics is essential for empowering important analysis processes and results. We call for actions that could be performed to link these data.","PeriodicalId":93816,"journal":{"name":"SPG biomed","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82537004","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}
SARS-CoV-2 is one more virus that can affect the brain in one way or another. Now, we are only beginning to understand some mechanisms and the degree to which it can impact the nervous system. Considering the rapid accumulation of knowledge about multiple neurological and cognitive symptoms in COVID-19 patients, it seems useful to encourage the development of systematic approaches for the diagnosis, management and treatment of the cognitive aspects of COVID-19. From what is known at this time about the impact of COVID-19 on the brain, the presentation of long-term cognitive sequelae can be expected to be heterogeneous in nature and will depend at least in part on the severity of the disease at the stage acute COVID-19. The long-term essential characteristics of these sequelae will probably be related to a combination of causes and different neuropathological processes in the acute phase. The scope and severity of the current COVID-19 pandemic are unparalleled in modern society. The later implications for neurological function can be just as serious. Although the current focus is on the management of acute diseases, in the near future the focus should be on the long-term consequences of COVID-19 infection and its mitigation, hence the need for the development of systematic approaches for the management of the cognitive and neuropsychiatric aspects of COVID-19.
{"title":"Cognitive Function and Neuropsychiatric Disorders after COVID-19: A Long Term Social and Clinical Problem?","authors":"J. Ramírez-Moreno, A. Muñoz-Sanz, F. Vaz-Leal","doi":"10.3390/biomed2010005","DOIUrl":"https://doi.org/10.3390/biomed2010005","url":null,"abstract":"SARS-CoV-2 is one more virus that can affect the brain in one way or another. Now, we are only beginning to understand some mechanisms and the degree to which it can impact the nervous system. Considering the rapid accumulation of knowledge about multiple neurological and cognitive symptoms in COVID-19 patients, it seems useful to encourage the development of systematic approaches for the diagnosis, management and treatment of the cognitive aspects of COVID-19. From what is known at this time about the impact of COVID-19 on the brain, the presentation of long-term cognitive sequelae can be expected to be heterogeneous in nature and will depend at least in part on the severity of the disease at the stage acute COVID-19. The long-term essential characteristics of these sequelae will probably be related to a combination of causes and different neuropathological processes in the acute phase. The scope and severity of the current COVID-19 pandemic are unparalleled in modern society. The later implications for neurological function can be just as serious. Although the current focus is on the management of acute diseases, in the near future the focus should be on the long-term consequences of COVID-19 infection and its mitigation, hence the need for the development of systematic approaches for the management of the cognitive and neuropsychiatric aspects of COVID-19.","PeriodicalId":93816,"journal":{"name":"SPG biomed","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91131627","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}
The pandemic caused by the new coronavirus in 2019, now called SARS-CoV-2 or COVID-19 disease, has become a major public health problem worldwide. The main method of diagnosing SARS-CoV-2 infection is RT-PCR, but medical imaging brings important quantitative and qualitative information that complements the data for diagnosis and prediction of the clinical course of the disease, even if chest X-rays and CT scans are not routinely recommended for screening and diagnosis of COVID-19 infections. Identifying characteristics of medical images, such as GGO, crazy paving, and consolidation as those of COVID-19 can guide the diagnosis, and can help clinicians in decisions in patient treatment if an RT-PCR result is not available rapidly. Chest radiographs and CT also bring information about the severity and unfavorable evolution potential of the disease. Radiomics, a new research subdomain of A.I. based on the extraction and analysis of shape and texture characteristics from medical images, along with deep learning, another A.I. method that uses neural networks, can offer new horizons in the development of models with diagnostic and predictive value for COVID-19 disease management. Standardizing the methods and creating multivariable models that include etiological, biological, and clinical data may increase the value and impact of using radiomics in routine COVID-19 evaluation. Recently, proposed complex models that may include radiological features or clinical variables have appeared to add value to the accuracy of CT diagnosis by radiomix and are likely to underlie the routine use of radiomic in COVID-19 management.
{"title":"Radiomics in COVID-19: The Time for (R)evolution Has Came","authors":"R. Iancu, A. Zară, C. Mireștean, D. Iancu","doi":"10.3390/biomed2010006","DOIUrl":"https://doi.org/10.3390/biomed2010006","url":null,"abstract":"The pandemic caused by the new coronavirus in 2019, now called SARS-CoV-2 or COVID-19 disease, has become a major public health problem worldwide. The main method of diagnosing SARS-CoV-2 infection is RT-PCR, but medical imaging brings important quantitative and qualitative information that complements the data for diagnosis and prediction of the clinical course of the disease, even if chest X-rays and CT scans are not routinely recommended for screening and diagnosis of COVID-19 infections. Identifying characteristics of medical images, such as GGO, crazy paving, and consolidation as those of COVID-19 can guide the diagnosis, and can help clinicians in decisions in patient treatment if an RT-PCR result is not available rapidly. Chest radiographs and CT also bring information about the severity and unfavorable evolution potential of the disease. Radiomics, a new research subdomain of A.I. based on the extraction and analysis of shape and texture characteristics from medical images, along with deep learning, another A.I. method that uses neural networks, can offer new horizons in the development of models with diagnostic and predictive value for COVID-19 disease management. Standardizing the methods and creating multivariable models that include etiological, biological, and clinical data may increase the value and impact of using radiomics in routine COVID-19 evaluation. Recently, proposed complex models that may include radiological features or clinical variables have appeared to add value to the accuracy of CT diagnosis by radiomix and are likely to underlie the routine use of radiomic in COVID-19 management.","PeriodicalId":93816,"journal":{"name":"SPG biomed","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76945426","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}
D. Mačáková, Markéta Plchová, L. Cibičková, O. Krystyník, D. Karásek, J. Zadražil
Introduction: One of the most common chronic complications of diabetes mellitus is diabetic neuropathy. The aim of the study was to elucidate the association between selected markers of oxidative stress and markers of vascular stiffness and to contribute to the understanding of the pathophysiological links between oxidative stress and micro- and macrovascular complications of diabetes. Methods: We enrolled patients with type 2 DM (n = 49), with moderate to severe diabetic polyneuropathy of lower extremities, and a control group without microvascular complications (n = 29). The neuropathy group received alpha-lipoic acid infusion therapy. Sampling was performed before and after treatment to determine the level of oxidative markers (advanced glycation end-products—AGEs, glycation products of AOPP proteins, MDA malondialdehyde and oxidized LDL), parameters of metabolic control and parameters of vascular wall stiffness were measured by sphygmomanometry. Results: After the administration of alpha-lipoic acid, we demonstrated a significant reduction in the level of three selected oxidation markers (AOPP: p < 0.001, AGE: p < 0.001, oxLDL: p < 0.05). In contrast, the level of MDA did not change significantly (p = 0.83). Throughout the group, oxLDL was significantly correlated with central BP (SBP and DBP in the aorta, p < 0.05 and <0.01) and with the augmentation index (AiX/75 bpm, p < 0.01). AOPP significantly correlated with systolic BP in the aorta (p < 0.05). We did not find significant associations in the remaining oxidation markers. Conclusion: In our study, we demonstrated a reduction in the level of oxidative markers after alpha-lipoic acid administration and also an association between markers of oxidative damage to lipids and proteins (oxLDL and AOPP) and some parameters of vascular stiffness.
糖尿病性神经病变是糖尿病最常见的慢性并发症之一。该研究的目的是阐明氧化应激标记物与血管僵硬标记物之间的关联，并有助于理解氧化应激与糖尿病微血管和大血管并发症之间的病理生理联系。方法:我们招募了49例伴有中重度糖尿病下肢多发性神经病变的2型糖尿病患者和29例无微血管并发症的对照组。神经病变组给予硫辛酸输注治疗。治疗前后取样测定氧化标志物(晚期糖基化终产物- ages、AOPP蛋白糖基化产物、MDA丙二醛和氧化LDL)水平，通过血压计测定代谢控制参数和血管壁刚度参数。结果:α -硫辛酸给药后，我们发现三种选定的氧化标志物水平显著降低(AOPP: p < 0.001, AGE: p < 0.001, oxLDL: p < 0.05)。相比之下，MDA水平无明显变化(p = 0.83)。在整个组中，oxLDL与中心血压(主动脉收缩压和舒张压，p < 0.05和<0.01)和增强指数(AiX/75 bpm, p <0.01)显著相关。AOPP与主动脉收缩压有显著相关性(p < 0.05)。我们在剩余的氧化标记物中没有发现显著的关联。结论:在我们的研究中，我们证明了α -硫辛酸给药后氧化标志物水平的降低，并且脂质和蛋白质氧化损伤标志物(oxLDL和AOPP)与血管硬度的一些参数之间存在关联。
{"title":"Association of Oxidative Stress Markers with Vascular Stiffness Parameters in Patients with Diabetic Neuropathy","authors":"D. Mačáková, Markéta Plchová, L. Cibičková, O. Krystyník, D. Karásek, J. Zadražil","doi":"10.3390/biomed2010001","DOIUrl":"https://doi.org/10.3390/biomed2010001","url":null,"abstract":"Introduction: One of the most common chronic complications of diabetes mellitus is diabetic neuropathy. The aim of the study was to elucidate the association between selected markers of oxidative stress and markers of vascular stiffness and to contribute to the understanding of the pathophysiological links between oxidative stress and micro- and macrovascular complications of diabetes. Methods: We enrolled patients with type 2 DM (n = 49), with moderate to severe diabetic polyneuropathy of lower extremities, and a control group without microvascular complications (n = 29). The neuropathy group received alpha-lipoic acid infusion therapy. Sampling was performed before and after treatment to determine the level of oxidative markers (advanced glycation end-products—AGEs, glycation products of AOPP proteins, MDA malondialdehyde and oxidized LDL), parameters of metabolic control and parameters of vascular wall stiffness were measured by sphygmomanometry. Results: After the administration of alpha-lipoic acid, we demonstrated a significant reduction in the level of three selected oxidation markers (AOPP: p < 0.001, AGE: p < 0.001, oxLDL: p < 0.05). In contrast, the level of MDA did not change significantly (p = 0.83). Throughout the group, oxLDL was significantly correlated with central BP (SBP and DBP in the aorta, p < 0.05 and <0.01) and with the augmentation index (AiX/75 bpm, p < 0.01). AOPP significantly correlated with systolic BP in the aorta (p < 0.05). We did not find significant associations in the remaining oxidation markers. Conclusion: In our study, we demonstrated a reduction in the level of oxidative markers after alpha-lipoic acid administration and also an association between markers of oxidative damage to lipids and proteins (oxLDL and AOPP) and some parameters of vascular stiffness.","PeriodicalId":93816,"journal":{"name":"SPG biomed","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73829959","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}
S. Jimeno, M. Gomez, P. Ventura, Ángeles Calle, Elena Núñez, J. Castellano, Alejandro López-Escobar
Background: The worldwide COVID-19 pandemic has created a shortage of ICU beds and ventilators. The objective was to assess whether administration of high-flow nasal cannula (HFNC) in patients with acute hypoxic respiratory failure due to COVID-19 averted mechanical ventilation (MV). Methods: Prospective observational study performed at Hospital Universitario HM Puerta del Sur (Madrid). The protocol included early administration of HFNC in clinically suspected COVID-19 patients with progressive desaturation. Results: Twenty patients were started on respiratory support with HFNC. Hospital admission took place after a median of 7 days since symptom onset and clinical deterioration was apparent at 9 days after symptom onset. Anti-inflammatory treatment with methylprednisolone and tocilizumab was initiated at 9 days (6.5–12), followed by HFNC at 9.5 days (7–12). HFNC was maintained for an average of 4.5 days (2.8–6.3), was successful in eighteen patients (90%), as defined by not needing invasive MV, and failed in two cases (10%) resulting in death. Since HFNC was implemented, there has been a decrease in the number of patients admitted to the ICU and treated with MV for acute hypoxic respiratory failure. Conclusions: HFNC administration may represent a viable therapeutic option for patients in the early stages of severe respiratory failure due to clinically suspected COVID-19.
{"title":"High Flow in the Storm. Early Administration of High-Flow Nasal Cannula in Patients with Severe Acute Hypoxic Respiratory Failure Due to Clinically Suspected COVID-19","authors":"S. Jimeno, M. Gomez, P. Ventura, Ángeles Calle, Elena Núñez, J. Castellano, Alejandro López-Escobar","doi":"10.3390/biomed1020012","DOIUrl":"https://doi.org/10.3390/biomed1020012","url":null,"abstract":"Background: The worldwide COVID-19 pandemic has created a shortage of ICU beds and ventilators. The objective was to assess whether administration of high-flow nasal cannula (HFNC) in patients with acute hypoxic respiratory failure due to COVID-19 averted mechanical ventilation (MV). Methods: Prospective observational study performed at Hospital Universitario HM Puerta del Sur (Madrid). The protocol included early administration of HFNC in clinically suspected COVID-19 patients with progressive desaturation. Results: Twenty patients were started on respiratory support with HFNC. Hospital admission took place after a median of 7 days since symptom onset and clinical deterioration was apparent at 9 days after symptom onset. Anti-inflammatory treatment with methylprednisolone and tocilizumab was initiated at 9 days (6.5–12), followed by HFNC at 9.5 days (7–12). HFNC was maintained for an average of 4.5 days (2.8–6.3), was successful in eighteen patients (90%), as defined by not needing invasive MV, and failed in two cases (10%) resulting in death. Since HFNC was implemented, there has been a decrease in the number of patients admitted to the ICU and treated with MV for acute hypoxic respiratory failure. Conclusions: HFNC administration may represent a viable therapeutic option for patients in the early stages of severe respiratory failure due to clinically suspected COVID-19.","PeriodicalId":93816,"journal":{"name":"SPG biomed","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86359895","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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