scholarly journals Clinical characterization of dysautonomia in long COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nicolas Barizien ◽  
Morgan Le Guen ◽  
Stéphanie Russel ◽  
Pauline Touche ◽  
Florent Huang ◽  
...  
Keyword(s):  
Mixed Models ◽  
Repeated Measures ◽  
Physical Medicine ◽  
Persistent Symptoms ◽  
Index Changes ◽  
Changes Over Time ◽  
And Control ◽  
Testing Group ◽  
Over Time

AbstractIncreasing numbers of COVID-19 patients, continue to experience symptoms months after recovering from mild cases of COVID-19. Amongst these symptoms, several are related to neurological manifestations, including fatigue, anosmia, hypogeusia, headaches and hypoxia. However, the involvement of the autonomic nervous system, expressed by a dysautonomia, which can aggregate all these neurological symptoms has not been prominently reported. Here, we hypothesize that dysautonomia, could occur in secondary COVID-19 infection, also referred to as “long COVID” infection. 39 participants were included from December 2020 to January 2021 for assessment by the Department of physical medicine to enhance their physical capabilities: 12 participants with COVID-19 diagnosis and fatigue, 15 participants with COVID-19 diagnosis without fatigue and 12 control participants without COVID-19 diagnosis and without fatigue. Heart rate variability (HRV) during a change in position is commonly measured to diagnose autonomic dysregulation. In this cohort, to reflect HRV, parasympathetic/sympathetic balance was estimated using the NOL index, a multiparameter artificial intelligence-driven index calculated from extracted physiological signals by the PMD-200 pain monitoring system. Repeated-measures mixed-models testing group effect were performed to analyze NOL index changes over time between groups. A significant NOL index dissociation over time between long COVID-19 participants with fatigue and control participants was observed (p = 0.046). A trend towards significant NOL index dissociation over time was observed between long COVID-19 participants without fatigue and control participants (p = 0.109). No difference over time was observed between the two groups of long COVID-19 participants (p = 0.904). Long COVID-19 participants with fatigue may exhibit a dysautonomia characterized by dysregulation of the HRV, that is reflected by the NOL index measurements, compared to control participants. Dysautonomia may explain the persistent symptoms observed in long COVID-19 patients, such as fatigue and hypoxia. Trial registration: The study was approved by the Foch IRB: IRB00012437 (Approval Number: 20-12-02) on December 16, 2020.

scholarly journals Dysautonomia in post-COVID-19 patients: new insights

2021 ◽  
Author(s):  
Nicolas Barizien ◽  
Morgan Le Guen ◽  
Stéphanie Russel ◽  
Pauline Touche ◽  
Florent Huang ◽  
...  
Keyword(s):  
Mixed Models ◽  
Repeated Measures ◽  
Physical Medicine ◽  
Autonomic Dysregulation ◽  
Persistent Symptoms ◽  
Index Changes ◽  
Changes Over Time ◽  
And Control ◽  
Testing Group ◽  
Over Time

Abstract Background: Increasing numbers of COVID-19 patients, continue to experience symptoms months after recovering from mild cases of COVID-19. Amongst these symptoms, several are related to neurological manifestations, including fatigue, anosmia, hypogeusia, headaches and hypoxia. However, the involvement of the autonomic nervous system, expressed by a dysautonomia, which can aggregate all these neurological symptoms has not been prominently reported. Here, we hypothesize that dysautonomia, could occur in secondary COVID-19 infection, also referred to as “long COVID” infection. Methods: 39 participants were included from December 2020 to January 2021for assessment by the Department of physical medicine to enhance their physical capabilities: 12 participants with COVID-19 diagnosis and fatigue, 15 participants with COVID-19 diagnosis without fatigue and 12 control participants without COVID-19 diagnosis and without fatigue. Heart rate variability (HRV) during a change in position is commonly measured to diagnose autonomic dysregulation. In this cohort, to reflect HRV, parasympathetic/sympathetic balance was estimated using the NOL™ index, a multiparameter artificial intelligence-driven index calculated from extracted physiological signals by the PMD-200TM pain monitoring system. Repeated-measures mixed-models testing group effect were performed to analyze NOL index changes over time between groups. Results: A significant NOL index dissociation over time between post-COVID-19 participants with fatigue and control participants was observed (p=0.046). A trend towards significant NOL index dissociation over time was observed between post-COVID-19 participants without fatigue and control participants (p=0.109). No difference over time was observed between the two groups of post-COVID-19 participants (p=0.904). Conclusions: Post-COVID-19 participants with fatigue may exhibit a dysautonomia characterized by dysregulation of the HRV, that is reflected by the NOL index measurements, compared to control participants. Dysautonomia may explain the persistent symptoms observed in post-COVID-19 patients, such as fatigue and hypoxia.

scholarly journals Provincial and Temporal Variation in Macrolide and Lincosamide Antimicrobial Use by Outpatients in Canada, 1995 to 2010

2014 ◽  
Vol 25 (2) ◽  
pp. 103-106 ◽  
Author(s):  
Shiona K Glass-Kaastra ◽  
Rita Finley ◽  
Jim Hutchinson ◽  
David M Patrick ◽  
Karl Weiss ◽  
...  
Keyword(s):  
Mixed Models ◽  
Repeated Measures ◽  
Secular Trend ◽  
Time Frame ◽  
Antimicrobial Use ◽  
Patterns Of Use ◽  
Defined Daily Doses ◽  
The Mean ◽  
Canadian Provinces ◽  
Over Time

INTRODUCTION: Because antimicrobial use is commonly associated with the development of antimicrobial resistance, monitoring the volume and patterns of use of these agents is very important.OBJECTIVE: To assess the use of macrolide and lincosamide (ML) antimicrobials within Canadian provinces over time, and to compare use rates with those reported by European countries.METHODS: Antimicrobial prescribing data were used to develop two yearly metrics: prescriptions per 1000 inhabitant-days (PrIDs) and the mean defined daily doses (DDDs) per prescription, which were then used to build linear mixed models to assess differences among provinces over time.RESULTS: After accounting for repeated measures over time, prescribing rates (PrIDs) varied significantly according to province and year (P<0.001). However, little change occurred within each province over the time frame studied; from 1995 to 2010, each province had a PrID change <0.01. Quebec and British Columbia had significantly lower prescribing rates than all other provinces. No overall secular trend was apparent. In contrast, the DDDs per prescription did not vary significantly according to province, but showed a significant year-to-year increase.DISCUSSION: ML prescribing varied among provinces in Canada between 1995 and 2010, but remained relatively stable within each province. The average DDDs per ML prescription did not vary according to province, but increased linearly over time. These increases are likely to indicate that fewer prescriptions are being written for children over time, a practice supported by good antimicrobial stewardship principles.

scholarly journals Impacts of rTMS on Refractory Depression and Comorbid PTSD Symptoms at a Military Treatment Facility

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1420-e1427
Author(s):  
Sean Wilkes ◽  
Celia Ona ◽  
Michael Yang ◽  
Pingyang Liu ◽  
Amber Benton ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Active Duty ◽  
Ptsd Symptoms ◽  
Refractory Depression ◽  
Antidepressant Medications ◽  
Treatment Of Depression ◽  
Changes Over Time ◽  
Over Time

Abstract Introduction Repetitive transcranial magnetic stimulation (rTMS) as a treatment for depression has been studied for over two decades. Repetitive TMS was approved by the Food and Drug Administration in 2008 for the treatment of depression after at least one failed trial of an antidepressant medication of adequate dose and duration. This study evaluated whether rTMS treatments may be associated with measurable improvements in depression and post-traumatic stress disorder (PTSD) symptoms for treated military beneficiaries in Hawaii suffering from depression. It also examined the number of failed medication trials that patients underwent before rTMS treatment. Materials and Methods A retrospective chart review of 77 rTMS patients who received and completed treatment between January 1, 2010 and October 31, 2016 was performed. Under a typical treatment regimen, patients receive rTMS for 6 weeks as well as weekly psychiatric assessments, which included completion of Beck’s Depression Inventory (BDI) and PTSD Checklist (PCL). A mixed model repeated measures analysis was done assuming an autoregressive order one covariance structure to evaluate changes over time. Adjusted analyses were done to assess whether changes over time differed by age, prior diagnosis of PTSD, active duty status, and gender. Results The majority of patients were from the army (74%) and 56% were on active duty. Just over half (53%) were male. Most patients (52%) had completed trials of three or more different antidepressant medications before initiation of treatment with rTMS. The mean number of antidepressant trials was 2.7. BDI and PCL scores were significantly lower at end of treatment on average compared to the pretreatment baseline scores. Mean differences for BDI and PCL were significant with P &lt; 0.001 15, 30, and 45 days after TMS treatment was initiated. Overall, 44% of patients experienced a reduction ≥10 points on BDI, and 38% experienced a reduction ≥10 points on PCL. Additionally, scores fell similarly regardless of whether or not patients had a comorbid diagnosis of PTSD. Conclusions Our research suggests that rTMS treatments may produce a reduction in symptoms of both depression and PTSD in patients with refractory depression and comorbid PTSD. It may be a useful alternative to antidepressants in the treatment of depression in the military population, including those with comorbid PTSD. Broader implementation of this treatment modality may prove beneficial for the purposes of military readiness, given current policies and restrictions on service members who are initiated on antidepressant medications.

scholarly journals T189. FREE THYROXIN CONCENTRATIONS MODERATE THE RESPONSE TO A COGNITIVE REMEDIATION THERAPY IN PEOPLE WITH EARLY PSYCHOSIS: PRELIMINARY FINDINGS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S303-S304
Author(s):  
Francesc Estrada ◽  
Josep Maria Crosas ◽  
Maribel Ahuir ◽  
Sara Pérez ◽  
Wanda Zabala ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Cognitive Remediation ◽  
Early Psychosis ◽  
Cognitive Tasks ◽  
First Episode ◽  
Cognitive Changes ◽  
Cognitive Domains ◽  
Episode Psychosis ◽  
Changes Over Time ◽  
Over Time

Abstract Background Cognitive deficits are a common cause of functional disability in people with psychotic disorders. Cognitive remediation produces moderate improvements in cognitive performance in people with schizophrenia, although there is variability in the responses between patients. As previous longitudinal studies suggest that free thyroxin (FT4) levels influence attention cognitive tasks in patients with early psychosis, we aimed to conduct a pilot study to explore whether thyroid hormones might predict the response to cognitive remediation therapy (CRT) in patients with first-episode psychosis. Methods 27 patients (8 women; 19 men) with first-episode psychosis aged between 18 and 35 years old were randomized to receive a computerized CRT for three months (2 sessions/week) (N=14) or treatment as usual (TAU) (N=13). A full cognitive battery (CANTAB Schizophrenia) was administered at baseline and follow-up (3 months later, after the CRT/TAU period). Plasma levels of thyroid-stimulating hormone (TSH) and FT4 were measured. Data were analyzed on an intention-to-treat basis. Correlation analyses were conducted to explore the association between TSH and FT4 levels and cognitive changes over time. An ANOVA for repeated measures was used to compare longitudinal changes over time by the experimental group while adjusting for TSH and FT4 levels. Significance was defined as p&lt;0.05. Results TSH concentrations were not associated with cognitive changes over time. FT4 concentrations were associated with cognitive worsening over time in cognitive tasks dealing with reaction time (simple median movement time [r= 0.60, p= 0.003]; simple median reaction time [r= 0.44, p= 0.039]), sustained attention (signal detection for the rapid visual processing task [r= -0.46, p= 0.028]) and verbal memory (immediate recognition [r= -0.54, p= 0.008]; delayed recognition [r= -0.48, p= 0.019]). The ANOVA for repeated measures did not show time by group effects although a time by FT4 significant effect was found for cognitive tasks dealing with these cognitive domains (p&lt;0.05 for all). Discussion Although a direct effect of the CRT on cognitive improvement was not found, baseline FT4 concentrations appeared to predict the response to CRT in people with early psychosis. Significant associations were found for cognitive domains dealing with attention processes, which are in accordance with previous studies exploring the association between thyroid function and cognitive functioning in early psychotic patients. Our preliminary findings suggest that the determination of thyroid function status might be important for establishing which patients could show cognitive improvements over time. If these results are replicated in larger studies, the determination of thyroid status might help identify those individuals more prone for showing cognitive improvements, and allowing the implementation of a personalized medicine approach in the field of cognitive rehabilitation in psychosis.

87 VARIATION IN HEMATOLOGICAL PROFILES BETWEEN BOVINE SOMATIC CELL NUCLEAR TRANSFER CLONES AND CONTEMPORARIES FROM BIRTH TO ADULTHOOD

2009 ◽  
Vol 21 (1) ◽  
pp. 144 ◽  
Author(s):  
M. P. Green ◽  
C. Couldrey ◽  
M. C. Berg ◽  
D. N. Wells ◽  
R. S. F. Lee
Keyword(s):  
Somatic Cell ◽  
Cell Lines ◽  
Repeated Measures ◽  
Somatic Cell Nuclear Transfer ◽  
Nuclear Transfer ◽  
Hematological Parameters ◽  
Cell Counts ◽  
Normal Ranges ◽  
And Control ◽  
Over Time

The hematological characterization of clones derived by somatic cell nuclear transfer (SCNT) has not been extensively reported. Studies show that, generally, hematological parameters are within normal ranges, although distinct divergence between specific cohorts of clones and contemporaries exist. The aim of this study was to identify similarities and differences between cohorts of bovine clones and control animals and analyze the variations over time as the collective cohorts mature. Hematological profiles of 47 clones derived from 4 cell lines and 23 of their age- and sex-matched contemporary controls were compared. These donor cell lines were from 2 beef (male, n = 30) and 2 dairy (1 male, n = 9 and 1 female, n = 8) breeds and derived from myogenic cells, skin fibroblasts, and granulosa cells. Matched contemporaries, analyzed as one group, were produced via natural mating (n = 5) and AI (n = 14), with an additional in vitro-produced (IVP) group (n = 4) in the female cohort. All animals were subjected to similar management, nutrition, and environmental conditions. Serial samples were collected from birth until 15 months. Samples were assessed for the standard hematological parameters and cell morphology by a commercial clinical lab. Parameters were analyzed by one-way or as repeated measures ANOVA. The mean values for erythroid, myeloid, and lymphoid parameters were within normal ranges for both SCNT and controls, indicative of normal physiology. Red blood cells (RBC) from SCNT and control calves showed anisocytosis, poikilocytosis, cell fragmentation, and stippling, with a greater prevalence found in SCNT than in the controls. These abnormal morphologies were still evident in SCNT animals at 15 months of age, suggestive of delayed or incomplete erythroid maturation. Numbers of RBC, mean corpuscular volume (MCV), and hemoglobin (MCH) were different (P < 0.0001) between the collective SCNT cohorts and control animals over time, irrespective of genetics, sex, or breed. Taken together, these data suggest that erythropoiesis is generally perturbed in SCNT animals. In beef SCNT lines, platelet numbers were consistently different (P < 0.0001) from controls. White blood cell counts (WBC) were greater (P < 0.05) collectively in SCNT, although within the normal range, and the differential WBC changed with age (P < 0.05). Lymphocyte counts were greater (P < 0.05) in the collective SCNT cohorts. Further differences were seen in myeloid counts between specific SCNT and control cohorts. The greater variance evident in the myeloid parameters of SCNT animals was presumably because of an increased incidence of transient infections or inflammation in these animals. In summary, although most parameters were within the normal ranges over time, SCNT animals commonly display altered RBC, MCV, MCH, WBC, and lymphocyte parameters, which may be linked to cloning per se. This could partially explain the greater susceptibility of SCNT animals to external stressors. Supported by FRST contract C10X0311 and NRCGD.

scholarly journals PSIV-2 Changes in free glutamine and glutamate in mare milk during early lactation

2020 ◽  
Vol 98 (Supplement_4) ◽  
pp. 276-276
Author(s):  
Morgan B Pyles ◽  
Susan Hayes ◽  
Andrea Crum ◽  
Elizabeth Radomski ◽  
Miranda Kunes ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Early Lactation ◽  
Gut Health ◽  
Milk Samples ◽  
Major Energy Source ◽  
Amine Carrier ◽  
Daily Milk Yield ◽  
Changes Over Time ◽  
Over Time

Abstract Glutamine plays an important role in neonatal health. This amino acid serves as a nitrogen and amine carrier between tissues, as a major energy source and as a precursor for nucleic acids and proteins in rapidly proliferating intestinal cells. This study aimed to evaluate changes over time in free Gln and Glu concentrations in mare milk in early lactation and their relationship with foal gut health. Thirteen Thoroughbred mare and foal pairs were studied. Milk samples were collected at 12 h, 3, 5, 7, 10, 14, and 21 d after parturition and daily milk yield was estimated at 7 and 14 d postpartum. Milk samples were centrifuged (10 min, 3500 x g, 4 °C) to remove fat, then centrifuged twice (5 min, 10,000 x g, 22 °C) to remove protein. Free Glu and Gln were analyzed in triplicate using a membrane-based glutaminase and glutamate oxidase method (YSI 2700 Analyzer, YSI Life Sciences, OH). Daily fecal scores were recorded to monitor foal diarrhea and body weights were recorded weekly. Mixed model ANOVA with repeated measures (SAS 9.4) were used to evaluate changes over time in free Gln and Glu. Relationships between variables were assessed using regression analyses and Pearson’s correlation coefficient. Free Gln and Glu changed over time (P &lt; 0.0001). Glutamine increased from 12 h to 5 d, (0.24±0.11 mmol/L and 1.09±.11 mmol/L, respectively; P &lt; 0.05) then decreased to 0.90±0.11 mmol/L by 21 d postpartum. In contrast, free Gln was the lowest at 12 h (0.36±0.04 mmol/L) and continued increasing through 21 d postpartum (0.80±0.04 mmol/L; P &lt; 0.05). Bouts of diarrhea were negatively related to milk Gln (P &lt; 0.05) and foal ADG was positively related to milk Glu (P &lt; 0.05). These results suggest that Gln may have a role in foal gut health while Glu may influence foal growth.

scholarly journals Changes in fruit, vegetable and juice consumption after the diagnosis of type 2 diabetes: a prospective study in men

2016 ◽  
Vol 117 (5) ◽  
pp. 712-719 ◽  
Author(s):  
Camilla Olofsson ◽  
Andrea Discacciati ◽  
Agneta Åkesson ◽  
Nicola Orsini ◽  
Kerstin Brismar ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Prospective Study ◽  
Mixed Models ◽  
Prospective Cohort ◽  
Fruits And Vegetables ◽  
Vegetables And Fruits ◽  
A Prospective Study ◽  
Changes Over Time ◽  
Over Time

AbstractGiven the importance of prevention of complications in type 2 diabetes (T2D), we aimed to examine changes over time in consumption of fruits, vegetables and juice among men who were diagnosed with T2D in comparison with men without diabetes. The prospective Cohort of Swedish Men, aged 45–79 years in 1997, was used to examine changes in diet after diagnosis of T2D. Dietary intake was assessed using FFQ in 1997 and 2009. In all, 23 953 men who were diabetes free at baseline (1997) and completed both FFQ were eligible to participate in the study. Diagnosis of T2D was reported by subjects and ascertained through registers. Multivariable linear mixed models were used to examine changes in mean servings/week over time. In total, 1741 men developed T2D during the study period. Increased consumption of vegetables and fruits was observed among those who developed T2D (equivalent to 1·6 servings/week, 95 % CI 1·08, 2·03) and men who remained diabetes free (0·7 servings/week, 95 % CI 0·54, 0·84). Consumption of juice decreased by 0·6 servings/week (95 % CI −0·71, −0·39) among those who developed T2D and increased by 0·1 servings/week (95 % CI 0·05, 0·15) in those who were diabetes free. Changes over time and between groups were statistically significant. Although improvements in diet were observed, only 36 % of those with T2D and 35 % of those without diabetes consumed ≥5 servings of fruits and vegetables/d in 2009.

F-18 FDG PET/CT Characterization of Talc Pleurodesis-Induced Pleural Changes Over Time

2009 ◽  
Vol 34 (12) ◽  
pp. 886-890 ◽  
Author(s):  
Nghi C. Nguyen ◽  
Isaac Tran ◽  
Christopher N. Hueser ◽  
Dana Oliver ◽  
Hussein R. Farghaly ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Talc Pleurodesis ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Changes Over Time ◽  
Over Time
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