INFLAMMATORY STATE AS A CAUSE OF STEMI IN A PATIENT PRESENTATION WITH DKA

Coronavirus disease 19 is a global pandemic which infects over millions of people worldwide in a limited time and changes the lifestyle, clinical spectrum lies from asymptomatic infection to pneumonitis with cardiorespiratory failure and finally death. Higher mortality occurs in senior and who are suffering from co-morbidities like chronic kidney disease, (HTN) hypertension, (DM TYPE II) diabetes mellitus or (CVD) cardiovascular diseases. However, rather than normal individuals, patients with chronic kidney disease (CKD) are under higher risk for infections. The chronic systemic inflammatory state is a significant cause for morbidity and mortality in CKD patients. The objective of this review is to discuss the pathogenesis of COVID-19 in CKD, changes observed in the immune system of CKD patients, COVID-19 infections risk in CKD and therapeutic approach of COVID-19 in CKD patients. From the standpoint of frequent renal co-morbidities in covid19 patients, renal complications were explored in covid19 patients received at level 2 tertiary care Santosh Hospital, Ghaziabad, U.P. Delhi-NCR India during March to August 2020 as per the protocol of Nephrology Society of India. Relevant clinical trials were reviewed in support. Meta-analysis and clinical trials are covered in this review study. Duplicate studies are not taken into account. The outcome of the studies shows that CKD patients are more prone to COVID-19. CKD patients are more likely infected with COVID-19 virus. Whereas in intensive care, CKD occurs more frequent than DM type II and CVD. So,COVID-19 pathogenesis in CKD patients, risk of COVID-19, immunologic changes and therapy COVID-19 in CKD can add support in the effective management of COVID-19.

Download Full-text

Inflammatory Biomarkers in Atrial Fibrillation

Current Medicinal Chemistry ◽

10.2174/0929867324666170727103357 ◽

2019 ◽

Vol 26 (5) ◽

pp. 837-854 ◽

Cited By ~ 7

Author(s):

Effimia Zacharia ◽

Nikolaos Papageorgiou ◽

Adam Ioannou ◽

Gerasimos Siasos ◽

Spyridon Papaioannou ◽

...

Keyword(s):

Atrial Fibrillation ◽

Plasma Levels ◽

Large Scale ◽

Inflammatory Biomarkers ◽

Inflammatory Pathways ◽

Inflammatory State ◽

Anti Inflammatory ◽

Underlying Mechanisms

During the last few years, a significant number of studies have attempted to clarify the underlying mechanisms that lead to the presentation of atrial fibrillation (AF). Inflammation is a key component of the pathophysiological processes that lead to the development of AF; the amplification of inflammatory pathways triggers AF, and, in tandem, AF increases the inflammatory state. Indeed, the plasma levels of several inflammatory biomarkers are elevated in patients with AF. In addition, the levels of specific inflammatory biomarkers may provide information regarding to the AF duration. Several small studies have assessed the role of anti-inflammatory treatment in atrial fibrillation but the results have been contradictory. Large-scale studies are needed to evaluate the role of inflammation in AF and whether anti-inflammatory medications should be routinely administered to patients with AF.

Download Full-text

Evidences of Brain Plasticity and Motor Control Modulation after Hemodialysis Session by Helixone Membrane: BOLD-fMRI Study

CNS & Neurological Disorders - Drug Targets ◽

10.2174/1871527319666200902133343 ◽

2020 ◽

Vol 19 (6) ◽

pp. 466-477

Author(s):

Saïd Boujraf ◽

Rachida Belaïch ◽

Abdelkhalek Housni ◽

Badreeddine Alami ◽

Tariq Skalli ◽

...

Keyword(s):

Oxidative Stress ◽

Functional Activity ◽

Brain Plasticity ◽

Biological Assessment ◽

Bold Fmri ◽

Before And After ◽

Total Antioxidant ◽

Inflammatory State ◽

Functional Control ◽

The Impact

Objective: The aim of this paper is to demonstrate the impact of hemodialysis (HD) using synthetic Helixone membrane on brain functional control reorganization and plasticity in the cortical area generated while Oxidative Stress (OS) would be the main impacting agent. Methods: Indeed, 9 chronic HD patients underwent identical brain BOLD-fMRI assessment using the motor paradigm immediately before and after the same HD sessions. To assess the oxidative stress, the same patients underwent biological-assessment, including Malondialdehyde (MDA) and Total- Antioxidant-Activity (TAOA) reported in earlier papers. Results: BOLD-fMRI maps of motor areas obtained from HD-patients before and after HD sessions revealed a significant enhancement of activation volume of the studied motor cortex after HD reflecting brain plasticity. Results were correlated with OS assessed by the measurement of MDA and TAOA; this correlation was close to 1. Conclusion: Indeed, HD enhances the inflammatory state of brain tissues reflected by the increased OS. The functional brain reaction demonstrated a functional activity reorganization to overcome the inflammatory state and OS enhanced by HD process. This functional activity reorganization reveals brain plasticity induced by OS originated by HD.

Download Full-text

A Potential Role of Coenzyme Q10 Deficiency in Severe SARS-CoV2 Infection

10.21926/obm.icm.2004042 ◽

2020 ◽

Vol 5 (4) ◽

Author(s):

Vasilios M. Polymeropoulos ◽

Keyword(s):

Viral Entry ◽

Coenzyme Q10 ◽

Severe Infection ◽

The Body ◽

Therapeutic Options ◽

Severe Illness ◽

Infected People ◽

Inflammatory State ◽

Exogenous Compounds ◽

Obesity Hypertension

There is a dramatic need for extensive research into the predictors of severe infection with SARS-CoV2 and therapeutic options for infected people. People who suffer from severe illness and higher mortality display a pattern of having specific co-morbidities (diabetes, obesity, hypertension) and are of higher age. Recent research has described methods of viral entry via receptors (ACE2, TMPRSS2) and the hyper-inflammatory state often associated with severe illness (increase in interleukins, increase in TNF-alpha). These discoveries have led to the research of currently available and developing therapies, that are helpful to patients. Deficiencies of specific vitamins and other endogenous molecules of the body should be examined to understand if a pattern exists among the people most severely affected. Coenzyme Q10 (CoQ10) is a fat-soluble substance ubiquitously expressed throughout the body that is important for the generation of ATP and mediation of inflammatory disease. CoQ10 faces a decline with increasing age, genetic predispositions, and ingestion of exogenous compounds that could reduce the level of CoQ10. Deficiencies and subsequent supplementation with CoQ10 recently has displayed encouraging results for the improvement of a wide variety of diseases. This manuscript is significant as it points to a potential relationship of CoQ10 and the population suffering from severe illness of COVID-19, and further encourages the need for research into measuring the levels of CoQ10 and vitamins to understand if levels predict severe illness and mortality. This could offer new avenues into research in combating this pandemic and potentially future therapeutic options.

Download Full-text

SARS-CoV-2 and the Nervous System: From Clinical Features to Molecular Mechanisms

International Journal of Molecular Sciences ◽

10.3390/ijms21155475 ◽

2020 ◽

Vol 21 (15) ◽

pp. 5475 ◽

Cited By ~ 11

Author(s):

Manuela Pennisi ◽

Giuseppe Lanza ◽

Luca Falzone ◽

Francesco Fisicaro ◽

Raffaele Ferri ◽

...

Keyword(s):

Nervous System ◽

Molecular Mechanisms ◽

Neuronal Damage ◽

Neurological Complications ◽

Neurological Manifestations ◽

Wide Range ◽

Inflammatory State ◽

Acute Polyneuropathy ◽

The Central Nervous System ◽

The Impact

Increasing evidence suggests that Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) can also invade the central nervous system (CNS). However, findings available on its neurological manifestations and their pathogenic mechanisms have not yet been systematically addressed. A literature search on neurological complications reported in patients with COVID-19 until June 2020 produced a total of 23 studies. Overall, these papers report that patients may exhibit a wide range of neurological manifestations, including encephalopathy, encephalitis, seizures, cerebrovascular events, acute polyneuropathy, headache, hypogeusia, and hyposmia, as well as some non-specific symptoms. Whether these features can be an indirect and unspecific consequence of the pulmonary disease or a generalized inflammatory state on the CNS remains to be determined; also, they may rather reflect direct SARS-CoV-2-related neuronal damage. Hematogenous versus transsynaptic propagation, the role of the angiotensin II converting enzyme receptor-2, the spread across the blood-brain barrier, the impact of the hyperimmune response (the so-called “cytokine storm”), and the possibility of virus persistence within some CNS resident cells are still debated. The different levels and severity of neurotropism and neurovirulence in patients with COVID-19 might be explained by a combination of viral and host factors and by their interaction.

Download Full-text

Intravenous iron therapy and circulating biomarkers of inflammation in men with heart failure with reduced ejection fraction

European Heart Journal ◽

10.1093/ehjci/ehaa946.1167 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Drozd ◽

M Tkaczyszyn ◽

K Wegrzynowska-Teodorczyk ◽

M Kasztura ◽

M Dziegala ◽

...

Keyword(s):

Heart Failure ◽

Intravenous Iron ◽

Inflammatory Biomarkers ◽

Iron Therapy ◽

Reduced Ejection Fraction ◽

Tnf Α ◽

Inflammatory State ◽

Iv Iron ◽

Hs Crp ◽

Intravenous Iron Therapy

Abstract Background Large randomized clinical trials have demonstrated that intravenous (IV) iron therapy in iron-deficient patients with heart failure with reduced ejection fraction (HFrEF) brings clinical benefits related to symptoms of the disease and exercise capacity. Mechanisms underlying beneficial effects of such repletion are still the subject of interest as this is not solely related to improved haematopoiesis (IV iron works also in non-anaemic subjects). In patients with chronic heart failure iron deficiency (ID) is linked with inflammatory processess but data regarding the impact of IV iron on inflammation is scarce. Purposes We evaluated whether IV iron therapy affects circulating biomarkers of pro-inflammatory state in men with HFrEF and concomitant ID. Methods This is the sub-analysis of the study to investigate the effects of IV ferric carboxymaltose (FCM) on the functioning of skeletal muscles in men with HFrEF. For the purposes of current research we analyzed data of 20 men with HFrEF (median age 68 (62, 75 – in brackets interquartile ranges, respectively) years, LVEF: 30 (25, 35) %, ischaemic HF aetiology: 85%, NYHA class I/II/III: 30%/50%/20%) and ID (definition according to ESC guidelines - ferritin <100 ng/mL, or ferritin 100–299 ng/mL with transferrin saturation [TSAT] <20%) who were randomized in a 1:1 ratio to receive either the 24-week therapy with IV FCM (dosing scheme as in the CONFIRM-HF trial) or saline (controls). The study was double-blinded. We used ELISA to evaluate different circulating pro-inflammatory biomarkers (high-sensitivity C-reactive protein [hs-CRP], tumor necrosis factor alpha [TNF-α], interleukin 6 [IL-6], interleukin 1 beta [IL-1β], interleukin 22 [IL-22]) at baseline and week 24. Results IV FCM therapy repleted iron stores in men with HFrEF as reflected by an increase in serum ferritin and TSAT, which was not seen in a control group. IV FCM therapy (as well as the saline administration) affected neither haemoglobin concentration nor parameters reflecting iron stores in red cells. Baseline serum ferritin was not related to hs-CRP, TNF-α, IL-6, IL-1β, and IL-22 (all p>0.23). Baseline TSAT was related to hs-CRP (r=−0.47, p=0.02) but not other inflammatory biomarkers. Levels of hs-CRP, TNF-α, IL-6, IL-1β, and IL-22 at week 0 were similar in subjects who received IV iron and controls (all p>0.22). Change from week 0 to week 24 adjusted for baseline value (delta W24-W0 as the percentage of W0) regarding IL-22 was lower in an active treatment arm as compared with saline (p=0.049) and there was a trend towards lower delta TNF-α in FCM group compared to saline (p=0.067). These findings were not valid for other measured pro-inflammatory biomarkers. Conclusions In men with HFrEF and concomitant ID intravenous iron therapy with FCM affects biomarkers of pro-inflammatory state. Clinical relevance of this finding requires further translational research. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This research was funded by the National Science Centre (Poland) grant allocated on the basis of the decision number DEC-2012/05/E/NZ5/00590

Download Full-text

The Ability of Metabolomics to Discriminate Non-Small-Cell Lung Cancer Subtypes Depends on the Stage of the Disease and the Type of Material Studied

Cancers ◽

10.3390/cancers13133314 ◽

2021 ◽

Vol 13 (13) ◽

pp. 3314

Author(s):

Tomasz Kowalczyk ◽

Joanna Kisluk ◽

Karolina Pietrowska ◽

Joanna Godzien ◽

Miroslaw Kozlowski ◽

...

Keyword(s):

Metabolic Pathways ◽

Early Stage ◽

Chronic Obstructive ◽

Liquid Chromatography Mass Spectrometry ◽

Obstructive Pulmonary Disease ◽

Cell Lung Carcinoma ◽

Cancer Subtypes ◽

Inflammatory State ◽

Nsclc Patients

Identification of the NSCLC subtype at an early stage is still quite sophisticated. Metabolomics analysis of tissue and plasma of NSCLC patients may indicate new, and yet unknown, metabolic pathways active in the NSCLC. Our research characterized the metabolomics profile of tissue and plasma of patients with early and advanced NSCLC stage. Samples were subjected to thorough metabolomics analyses using liquid chromatography-mass spectrometry (LC-MS) technique. Tissue and/or plasma samples from 137 NSCLC patients were analyzed. Based on the early stage tissue analysis, more than 200 metabolites differentiating adenocarcinoma (ADC) and squamous cell lung carcinoma (SCC) subtypes as well as normal tissue, were identified. Most of the identified metabolites were amino acids, fatty acids, carnitines, lysoglycerophospholipids, sphingomyelins, plasmalogens and glycerophospholipids. Moreover, metabolites related to N-acyl ethanolamine (NAE) biosynthesis, namely glycerophospho (N-acyl) ethanolamines (GP-NAE), which discriminated early-stage SCC from ADC, have also been identified. On the other hand, the analysis of plasma of chronic obstructive pulmonary disease (COPD) and NSCLC patients allowed exclusion of the metabolites related to the inflammatory state in lungs and the identification of compounds (lysoglycerophospholipids, glycerophospholipids and sphingomyelins) truly characteristic to cancer. Our results, among already known, showed novel, thus far not described, metabolites discriminating NSCLC subtypes, especially in the early stage of cancer. Moreover, the presented results also indicated the activity of new metabolic pathways in NSCLC. Further investigations on the role of NAE biosynthesis pathways in the early stage of NSCLC may reveal new prognostic and diagnostic targets.

Download Full-text

Full recombinant flagellin B from Vibrio anguillarum (rFLA) and its recombinant D1 domain (rND1) promote a pro-inflammatory state and improve vaccination against P. salmonis in Atlantic salmon (S. salar)

Developmental & Comparative Immunology ◽

10.1016/j.dci.2020.103988 ◽

2021 ◽

Vol 117 ◽

pp. 103988

Author(s):

Roxana González-Stegmaier ◽

Andrea Peña ◽

Franz Villarroel-Espíndola ◽

Patricia Aguila ◽

Cristian Oliver ◽

...

Keyword(s):

Atlantic Salmon ◽

Vibrio Anguillarum ◽

Inflammatory State

Download Full-text

Crocodile blood supplementation protects vascular function in diabetic mice

Food Production, Processing and Nutrition ◽

10.1186/s43014-021-00066-w ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Chui Yiu Bamboo Chook ◽

Francis M. Chen ◽

Gary Tse ◽

Fung Ping Leung ◽

Wing Tak Wong

Keyword(s):

Endothelial Cells ◽

Vascular Function ◽

Quantitative Polymerase Chain Reaction ◽

Functional Study ◽

Diabetic Patients ◽

Diabetic Mice ◽

Gene Expressions ◽

Inflammatory State ◽

Crocodile Blood

Abstract Cardiovascular disease is a major cause of mortality in diabetic patients due to the heightened oxidative stress and pro-inflammatory state in vascular tissues. Effective approaches targeting cardiovascular health for diabetic patients are urgently needed. Crocodile blood, an emerging dietary supplement, was suggested to have anti-oxidative and anti-inflammatory effects in vitro, which have yet to be proven in animal models. This study thereby aimed to evaluate whether crocodile blood can protect vascular function in diabetic mice against oxidation and inflammation. Diabetic db/db mice and their counterparts db/m+ mice were treated daily with crocodile blood soluble fraction (CBSF) or vehicle via oral gavage for 4 weeks before their aortae were harvested for endothelium-dependent relaxation (EDR) quantification using wire myograph, which is a well-established functional study for vascular function indication. Organ culture experiments culturing mouse aortae from C57BL/6 J mice with or without IL-1β and CBSF were done to evaluate the direct effect of CBSF on endothelial function. Reactive oxygen species (ROS) levels in mouse aortae were assessed by dihydroethidium (DHE) staining with inflammatory markers in endothelial cells quantified by quantitative polymerase chain reaction (qPCR). CBSF significantly improved deteriorated EDR in db/db diabetic mice through both diet supplementation and direct culture, with suppression of ROS level in mouse aortae. CBSF also maintained EDR and reduced ROS levels in mouse aortae against the presence of pro-inflammatory IL-1β. Under the pro-inflammatory state induced by IL-1β, gene expressions of inflammatory cytokines were downregulated, while the protective transcripts UCP2 and SIRT6 were upregulated in endothelial cells. Our study suggests a novel beneficial effect of crocodile blood on vascular function in diabetic mice and that supplementation of diet with crocodile blood may act as a complementary approach to protect against vascular diseases through anti-oxidation and anti-inflammation in diabetic patients. Graphical abstract

Download Full-text

Nursing the uroabdomen patient

The Veterinary Nurse ◽

10.12968/vetn.2021.12.3.131 ◽

2021 ◽

Vol 12 (3) ◽

pp. 131-138

Author(s):

Sam McGaw

Keyword(s):

Metabolic Acidosis ◽

Urinary Tract ◽

Diagnostic Imaging ◽

Urinary Diversion ◽

Nursing Care ◽

Postoperative Care ◽

Surgical Intervention ◽

Urinary Catheter ◽

Abdominal Cavity ◽

Patient Presentation

Uroabdomen, the presence of urine in the abdominal cavity, commonly occurs in dogs and cats, particularly following a trauma. Initial stabilisation of the patient is essential to treat the multisystemic effects of electrolyte and metabolic derangements, including hyperkalaemia, azotaemia and metabolic acidosis. Diagnosis is confirmed by comparing laboratory analysis of abdominal fluid and serum. Urinary diversion is required, often via placement of a urinary catheter, to prevent continuing urine accumulation. Once haemodynamically stable, diagnostic imaging may be performed to confirm the location of the urinary tract rupture, with several modes of imaging available. Surgical intervention may be necessary to repair the urinary leak, this is dependent on the location and severity of the trauma to the urinary tract. Registered veterinary nurses play an important role in the management of the uroabdomen patient, from initial triage and stabilisation, to assisting with imaging, anaesthetic monitoring and postoperative care. This article will discuss the aetiology of the uroabdomen, patient presentation and how to effectively treat the critical patient. Nursing care is vital for ensuring patient welfare and identifying complications that may arise.

Download Full-text