scholarly journals Increased serum catalytic iron may mediate tissue injury and death in patients with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vipul Chakurkar ◽  
Mohan Rajapurkar ◽  
Suhas Lele ◽  
Banibrata Mukhopadhyay ◽  
Valentine Lobo ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Mortality ◽  
Active Form ◽  
Joint Model ◽  
Adverse Outcomes ◽  
Composite Outcome ◽  
Age And Gender ◽  
And Gender ◽  
Primary Composite Outcome

AbstractThe pathophysiology and the factors determining disease severity in COVID-19 are not yet clear, with current data indicating a possible role of altered iron metabolism. Previous studies of iron parameters in COVID-19 are cross-sectional and have not studied catalytic iron, the biologically most active form of iron. The study was done to determine the role of catalytic iron in the adverse outcomes in COVID-19. We enrolled adult patients hospitalized with a clinical diagnosis of COVID-19 and measured serum iron, transferrin saturation, ferritin, hepcidin and serum catalytic iron daily. Primary outcome was a composite of in-hospital mortality, need for mechanical ventilation, and kidney replacement therapy. Associations between longitudinal iron parameter measurements and time-to-event outcomes were examined using a joint model. We enrolled 120 patients (70 males) with median age 50 years. The primary composite outcome was observed in 25 (20.8%) patients—mechanical ventilation was needed in 21 (17.5%) patients and in-hospital mortality occurred in 21 (17.5%) patients. Baseline levels of ferritin and hepcidin were significantly associated with the primary composite outcome. The joint model analysis showed that ferritin levels were significantly associated with primary composite outcome [HR (95% CI) = 2.63 (1.62, 4.24) after adjusting for age and gender]. Both ferritin and serum catalytic iron levels were positively associated with in-hospital mortality [HR (95% CI) = 3.22 (2.05, 5.07) and 1.73 (1.21, 2.47), respectively], after adjusting for age and gender. The study shows an association of ferritin and catalytic iron with adverse outcomes in COVID-19. This suggests new pathophysiologic pathways in this disease, also raising the possibility of considering iron chelation therapy.

scholarly journals The role of premorbid transthoracic echocardiogram in identifying adverse clinical outcomes in patients admitted with COVID-19

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C Lee ◽  
N Patel ◽  
L Panepinto ◽  
M Byers ◽  
M Ambrosino ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Diastolic Function ◽  
Odds Ratio ◽  
The United States ◽  
Adverse Outcomes ◽  
Transthoracic Echocardiogram ◽  
Composite Outcome ◽  
Lateral Velocity ◽  
Initiation Of Dialysis

Abstract Background/Introduction The novel coronavirus disease (COVID-19) inpatient mortality rate is approximately 20% in the United States. Reports have described a wide pattern of abnormalities in echocardiograms performed in patients admitted with COVID-19. The role of premorbid transthoracic echocardiogram (TTE) in the prediction of COVID-19 severity and mortality is yet to be fully assessed. Purpose To assess whether a pre-COVID TTE can identify patients at high risk of adverse outcomes who are admitted with COVID-19. Methods All patients who underwent a TTE from one year to one month prior to an index inpatient admission for COVID-19 were retrospectively enrolled across five clinical sites. Demographic information, medical history, and laboratory data were included for analysis. Echocardiograms were analyzed by an observer blinded to clinical data. Linear and logistic regressions were performed to detect the association of variables with death, invasive mechanical ventilation, initiation of dialysis, and a composite of these endpoints during the COVID-19 admission. Outcomes were then adjusted for a risk score using inverse propensity weighting incorporating age, sex, diabetes, hypertension, obstructive sleep apnea, history of atherosclerotic cardiovascular disease, atrial fibrillation, diuretic use, and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use. Results There were 104 patients (68±15 years old, 49% male, BMI 31.4±9.1kg/m2) who met inclusion criteria (baseline characteristics in Table 1). Mean time from TTE to positive SARS-CoV-2 PCR test was 139±91 days. Twenty-nine (28%) participants died during the index COVID-19 admission. There was no association of pre-COVID echocardiographic measures of systolic ventricular function with any endpoint. Diastolic function, as assessed by LV e', was associated with mortality (Table 2). There were 25 patients (24%) with a normal lateral e' (≥10cm/s); none died. There were 35 (34%) patients with LV e' lateral velocity <8 cm/s, of whom 15 (43%) died. LV e' lateral velocity <8 cm/s was associated with an unadjusted odds ratio of 7.69 (95% confidence interval [CI] 2.26–26.19) for death and 3.25 (95% CI 1.11–9.54) for the composite outcome. The odds ratio for death was 4.76 (95% CI 1.10–20.61) and 3.78 (95% CI 0.98–14.6) for the composite outcome after adjustment for clinical risk factors (Table 2). Conclusion In patients with an echocardiogram prior to COVID-19, impaired diastolic function as represented by an abnormal LV e' lateral velocity was associated with both inpatient COVID-19 mortality and a composite outcome of death, mechanical ventilation, and initiation of dialysis, even after adjustment for multiple co-morbidities and medication use. Knowledge of the pre-COVID TTE results may help clinicians identify patients at higher risk of adverse outcomes during an admission for COVID-19. FUNDunding Acknowledgement Type of funding sources: None.

Empirical Analysis of Clinical Evaluations on Children Involved in the Child Protection System: The Role of Age and Gender

2000 ◽  
Author(s):  
Erika Felix ◽  
Anjali T. Naik-Polan ◽  
Christine Sloss ◽  
Lashaunda Poindexter ◽  
Karen S. Budd
Keyword(s):  
Empirical Analysis ◽  
Child Protection ◽  
Protection System ◽  
Age And Gender ◽  
Clinical Evaluations ◽  
And Gender

Children’s Lives and Deaths in Merovingian Gaul

2020 ◽  
pp. 185-213
Author(s):  
Émilie Perez
Keyword(s):  
Social Identity ◽  
Age Groups ◽  
New Method ◽  
Recent Analysis ◽  
Age And Gender ◽  
The Past ◽  
And Gender ◽  
Grave Goods

The role of children in Merovingian society has long been downplayed, and the study of their graves and bones has long been neglected. However, during the past fifteen years, archaeologists have shown growing interest in the place of children in Merovingian society. Nonetheless, this research has not been without challenges linked to the nature of the biological and material remains. Recent analysis of 315 children’s graves from four Merovingian cemeteries in northern Gaul (sixth to seventh centuries) allows us to understand the modalities of burial ritual for children. A new method for classifying children into social age groups shows that the type, quality, quantity, and diversity of grave goods were directly correlated with the age of the deceased. They increased from the age of eight and particularly around the time of puberty. This study discusses the role of age and gender in the construction and expression of social identity during childhood in the Merovingian period.

Do They Really Mean It? Children’s Inference of Speaker Intentions and the Role of Age and Gender

2019 ◽  
Vol 63 (4) ◽  
pp. 689-712
Author(s):  
K. Rothermich ◽  
O. Caivano ◽  
L.J. Knoll ◽  
V. Talwar
Keyword(s):  
Gender Differences ◽  
Young Adults ◽  
Video Clip ◽  
Age And Gender ◽  
Video Clips ◽  
Age And Gender Differences ◽  
Speaker Intentions ◽  
And Gender

Interpreting other people’s intentions during communication represents a remarkable challenge for children. Although many studies have examined children’s understanding of, for example, sarcasm, less is known about their interpretation. Using realistic audiovisual scenes, we invited 124 children between 8 and 12 years old to watch video clips of young adults using different speaker intentions. After watching each video clip, children answered questions about the characters and their beliefs, and the perceived friendliness of the speaker. Children’s responses reveal age and gender differences in the ability to interpret speaker belief and social intentions, especially for scenarios conveying teasing and prosocial lies. We found that the ability to infer speaker belief of prosocial lies and to interpret social intentions increases with age. Our results suggest that children at the age of 8 years already show adult-like abilities to understand literal statements, whereas the ability to infer specific social intentions, such as teasing and prosocial lies, is still developing between the age of 8 and 12 years. Moreover, girls performed better in classifying prosocial lies and sarcasm as insincere than boys. The outcomes expand our understanding of how children observe speaker intentions and suggest further research into the development of teasing and prosocial lie interpretation.

scholarly journals Association between the level of plasma B-type natriuretic peptide and in-hospital mortality in patients with acute exacerbation of COPD without a history of coronary ischemic heart disease: a retrospective study

2021 ◽  
Author(s):  
Jiyun Cui ◽  
Jie Liu ◽  
Jing Wang ◽  
Meng Lv ◽  
Chunyan Xing ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Heart Disease ◽  
Hospital Mortality ◽  
Ischemic Heart Disease ◽  
Natriuretic Peptide ◽  
Invasive Mechanical Ventilation ◽  
Ischemic Heart ◽  
Composite Outcome ◽  
History Of ◽  
Secondary Outcomes

Abstract Background: Previous studies suggested that plasma B-type natriuretic peptide (BNP) level was often elevated in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and was associated with increased mortality. However, most studies did not consider the fact that conditions such as coronary ischemic heart disease can also increase BNP level. Therefore, we aimed to explore the association between BNP level and in-hospital mortality in patients with AECOPD without a history of coronary ischemic heart disease.Methods: In this retrospective cohort study, patients who were diagnosed with AECOPD using International Statistical Classification of Diseases and Related Health Problems, Nineth Revision (ICD-9 codes) between January 2017 and December 2019. All data were obtained from electronic patient files and medical data intelligence platform of Jinan Central Hospital. BNP level was determined within 24 hours after admission, and the value was log2 transformed. The primary outcome was in-hospital mortality, and the secondary outcome was a composite outcome of in-hospital mortality or invasive mechanical ventilation.Results: A total of 300 patients were included in this study. Univariate cox regression analysis showed that the unadjusted HRs of the primary and secondary outcomes were 1.85 (95% CI, 1.39-2.47) and 1.45 (95% CI, 1.20-1.75), respectively. After adjustment for age, sex, past medical history, smoking status, drinking status, CURB65 (Confusion, Urea > 7mmol/L, Respiratory rate≥30/min, Blood pressure systolic < 90 mmHg or diastolic <60 mmHg and age > 65 years), arterial partial pressure of O2(PaO2), the adjusted HRs of the primary and secondary outcomes were 3.65 (95% CI, 2.54-5.26) and 1.43 (95% CI, 1.14-1.97), respectively. The results of subgroup analysis by age, sex, and lung function were robust. This study was retrospective, so there was no clinical trial registration.Conclusions: The plasma log2BNP level was significantly associated with in-hospital mortality and a composite outcome of in-hospital mortality or invasive mechanical ventilation.

scholarly journals Pathomorphological evaluation of hepatobiliary lesions in dogs and cats of Ankara region

2021 ◽  
Vol 91 (4) ◽  
pp. 359-378
Author(s):  
Yanad Abou Monsef ◽  
◽  
Osman Kutsal
Keyword(s):  
Liver Fibrosis ◽  
Post Mortem ◽  
Reference Standard ◽  
Age And Gender ◽  
Immunohistochemical Methods ◽  
And Gender ◽  
Hepatic Lesions ◽  
Histopathological Studies ◽  
Passive Congestion

The objective of this study was to investigate pathological disorders of the hepatobiliary system in dogs and cats in Ankara using pathomorphological methods, and to determine the types and frequency of the observed lesions. Furthermore, we aimed to evaluate hepatic reparation as a reaction of the liver to injury with different hepatobiliary lesions using immunohistochemical methods. Livers obtained from 56 cats and 74 dogs submitted for post-mortem investigation were examined macroscopically and microscopically. Samples with hepatic fibrosis were stained immunohistochemically with an α-SMA antibody. Lesions were found in 98% of the livers of the examined dogs and cats. The most common histopathological diagnoses were hepatitis (39.28%), hepatocellular lipidosis (16.07%), and cholangitis/cholangiohepatitis (14.28%) in cats. In dogs they were hepatitis (28.38%), passive congestion (25.68%) and proliferative lesions (21.62%). For some hepatobiliary lesions, breed, age and gender predispositions were observed. Immunohistochemically, the α-SMA antibody positively stained parenchymal, portal and septal myofibroblasts. A positive correlation was verified between immunohistochemical α-SMA scores and histochemical fibrosis scores. This is the first study in Turkey documenting both the incidence of hepatobiliary lesions among feline and canine species, and their pathomorphological features. In terms of reparation, the major role of the hepatic myofibroblasts in liver fibrosis was observed. There were variations in the intensity and location of positively stained cells according to the type of lesion. The conclusion of this research indicates the need to pay attention to certain hepatic lesions in dogs and cats, and provides a reference standard for further clinical and histopathological studies.

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