scholarly journals Survival and 30-days hospital outcome in hospitalized COVID-19 patients in Upper Egypt: Multi-center study

2020 ◽  
Author(s):  
Aliae Mohamed-Hussein ◽  
Islam Galal ◽  
Mohammed Mustafa Abdel Rasik Mohamed ◽  
Mohamed Eltaher AA Ibrahim ◽  
Shazly Baghdady Ahmed
Keyword(s):  
Demographic Data ◽  
Invasive Mechanical Ventilation ◽  
Clinical Manifestations ◽  
Related Factors ◽  
Upper Egypt ◽  
Cumulative Survival ◽  
Icu Admission ◽  
Hospital Outcome ◽  
Multi Center Study ◽  
Qsofa Score

Background: Determining the clinical features and outcomes of patients diagnosed with COVID-19 is fundamental to improve the understanding and adequate management of the novel illness. This study aims to identify the basic demography, underlying comorbidities and the mortality related factors of hospitalized patients with COVID-19 in Upper Egypt. Patients and methods: 1064 cases consecutively admitted to isolation hospitals in Upper Egypt. All cases had confirmed COVID-19 infection. The electronic records of the patients were retrospectively revised and the demographic data, clinical manifestations, qSOFA score on admission and 30 days-outcome (ICU admission, death, recovery, referral or still in hospital) were analyzed. Overall cumulative survival in all patients and those > or < 50 years were calculated. Results 49.2% of the study population were males while 50.8% females with mean age 49.4 years-old. On admission, 83.9% were stable with qSOFA score < 1, 3% required non- invasive mechanical ventilation, and 2.1% required O2 therapy. Within 30 days, 203 cases (19.1%) required admission to ICU. Death was recorded in 11.7% of cases, 28.7% recovered, 40.5% referred and 19.2% were still under treatment. Determinants of ICU admission and survival in the current study were age > 50, respiratory rate > 24/minute, SaO2 < 89%, qSOFA >1 and need for O2 therapy or NIV. The cumulative survival was 75.3% with the mean survival was 28.1, and 95.2% overall survival was recorded in those aged < 50 years. Conclusions Age older than 50 years old, those with pre-existing DM, initial qSOFA score, requirement for O2 therapy and NIV from the first day of hospital admission may be associated with unfavorable 30 days- in hospital outcome of COVID- 19.

Progression of carotid near-occlusion to complete occlusion: related factors and clinical implications

2020 ◽  
pp. neurintsurg-2019-015638
Author(s):  
Andrés García-Pastor ◽  
Antonio Gil-Núñez ◽  
José María Ramírez-Moreno ◽  
Noelia González-Nafría ◽  
Javier Tejada ◽  
...  
Keyword(s):  
Collateral Circulation ◽  
Demographic Data ◽  
Clinical Manifestations ◽  
Treatment Modalities ◽  
Clinical Implications ◽  
Related Factors ◽  
Complete Occlusion ◽  
Clinical Consequences ◽  
Near Occlusion

BackgroundThe clinical consequences and factors related to the progression from a carotid near-occlusion (CNO) to a complete occlusion are not well established. Our aim is to describe the rate, predictive factors and clinical implications of the progression to complete carotid occlusion (PCCO) in a population of patients with symptomatic CNO.MethodsWe conducted a multicenter, nationwide, prospective study from January 2010 to May 2016. Patients with angiography-confirmed CNO were included. We collected information on demographic data, clinical manifestations, radiological and hemodynamic findings, and treatment modalities. A 24 month carotid-imaging follow-up of the CNO was performed.Results141 patients were included in the study, and carotid-imaging follow-up was performed in 122 patients. PCCO occurred in 40 patients (32.8%), and was more frequent in medically-treated patients (34 out of 61; 55.7%) compared with patients treated with revascularization (6 out of 61; 9.8%) (p<0.001). 7 of the 40 patients with PCCO (17.5%) suffered ipsilateral symptoms. Factors independently related with PCCO in the multivariate analysis were: age ≥75 years (OR 2.93, 95% CI 1.05 to 8.13), revascularization (OR 0.07, 95% CI 0.02 to 0.20), and collateral circulation through the ipsilateral ophthalmic artery (OR 3.25, 95% CI 1.01 to 10.48).ConclusionsPCCO occurred within 24 months in more than half of the patients under medical treatment. Most episodes of PCCO were not associated with ipsilateral symptoms. Revascularization reduces the risk of PCCO.

Cystic echinococcosis in children: high frequency of multiple organ involvement in North of Iran

2020 ◽  
Vol 20 ◽  
Author(s):  
Mohsen Mohammadi ◽  
Setareh Mamishi ◽  
Babak Pourakbari ◽  
Zahra Faraz ◽  
Mahmoud Khodabandeh ◽  
...  
Keyword(s):  
Cystic Echinococcosis ◽  
Demographic Data ◽  
Clinical Manifestations ◽  
Control Program ◽  
Multiple Organ ◽  
The Body ◽  
Related Factors ◽  
Northern Iran ◽  
Worldwide Distribution ◽  
Kidney Involvement

Introduction: Echinococcosis as an important zoonotic infection has a major worldwide distribution. Pediatric echinococcosis has still become a health concerning issue in developing countries specifically in the Middle East and Iran. The aim of this study was to investigate the human echinococcosis in children in the northern Iran. Material and methods: Patients admitted to the pediatric subspecialty hospital of Amir Kala, Babol, Iran from 2011 to 2016 with a confirmed diagnosis of echinococcosis were reviewed. Records of the patients including demographic data, clinical manifestations of the disease, type of cysts and other related factors were collected. Results: Sixteen pediatric patients, twelve (75%) male and four (25%) female were evaluated. All cases had cystic echinococcosis. The results showed that fever (75%) following vomiting, nausea, and coughing (44%) were the most common clinical manifestations. The most common localizations of cases were determined as liver (n=10, 62.5%) and lung (n=9, 56%). The frequency of involvement of more than one organ was 31% (5 cases). The co-occurrence of liver and lung was seen in 2 (12.5%) cases and in one case co-occurrence of liver and spleen was reported. In one case lung, liver and, the pelvis was involved, while in another case liver, sub diaphragm and kidney involvement were observed. Conclusion: Cystic echinococcosis should be kept in mind when a cystic lesion is encountered anywhere in the body, particularly in patients lining in the endemic regions. Since cystic echinococcosis has a considerable economic impact in Iran, the implementation of a control program as well as the surveillance system are highly recommended to reduce the economic burden of this disease.

scholarly journals Comparison of host endothelial, epithelial and inflammatory response in ICU patients with and without COVID-19: a prospective observational cohort study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Pavan K. Bhatraju ◽  
Eric D. Morrell ◽  
Leila Zelnick ◽  
Neha A. Sathe ◽  
Xin-Ya Chai ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Epithelial Cell ◽  
Acute Phase ◽  
Cell Injury ◽  
Acute Phase Proteins ◽  
Invasive Mechanical Ventilation ◽  
Icu Patients ◽  
Icu Admission ◽  
Amyloid A ◽  
Epithelial Cell Injury

Abstract Background Analyses of blood biomarkers involved in the host response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection can reveal distinct biological pathways and inform development and testing of therapeutics for COVID-19. Our objective was to evaluate host endothelial, epithelial and inflammatory biomarkers in COVID-19. Methods We prospectively enrolled 171 ICU patients, including 78 (46%) patients positive and 93 (54%) negative for SARS-CoV-2 infection from April to September, 2020. We compared 22 plasma biomarkers in blood collected within 24 h and 3 days after ICU admission. Results In critically ill COVID-19 and non-COVID-19 patients, the most common ICU admission diagnoses were respiratory failure or pneumonia, followed by sepsis and other diagnoses. Similar proportions of patients in both groups received invasive mechanical ventilation at the time of study enrollment. COVID-19 and non-COVID-19 patients had similar rates of acute respiratory distress syndrome, severe acute kidney injury, and in-hospital mortality. While concentrations of interleukin 6 and 8 were not different between groups, markers of epithelial cell injury (soluble receptor for advanced glycation end products, sRAGE) and acute phase proteins (serum amyloid A, SAA) were significantly higher in COVID-19 compared to non-COVID-19, adjusting for demographics and APACHE III scores. In contrast, angiopoietin 2:1 (Ang-2:1 ratio) and soluble tumor necrosis factor receptor 1 (sTNFR-1), markers of endothelial dysfunction and inflammation, were significantly lower in COVID-19 (p < 0.002). Ang-2:1 ratio and SAA were associated with mortality only in non-COVID-19 patients. Conclusions These studies demonstrate that, unlike other well-studied causes of critical illness, endothelial dysfunction may not be characteristic of severe COVID-19 early after ICU admission. Pathways resulting in elaboration of acute phase proteins and inducing epithelial cell injury may be promising targets for therapeutics in COVID-19.

scholarly journals Sofosbuvir with daclatasvir and the outcomes of patients with COVID-19: a systematic review and meta-analysis with GRADE assessment

2021 ◽  
pp. postgradmedj-2021-140287
Author(s):  
Ahmad Fariz Malvi Zamzam Zein ◽  
Catur Setiya Sulistiyana ◽  
Wilson Matthew Raffaello ◽  
Arief Wibowo ◽  
Raymond Pranata
Keyword(s):  
Systematic Review ◽  
Absolute Risk ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Invasive Mechanical Ventilation ◽  
Intervention Group ◽  
Control Group ◽  
Reduce Mortality Rate ◽  
Icu Admission ◽  
Clinical Recovery

PurposeThis systematic review and meta-analysis aimed to evaluate the effect of sofosbuvir/daclatasvir (SOF/DCV) on mortality, the need for intensive care unit (ICU) admission or invasive mechanical ventilation (IMV) and clinical recovery in patients with COVID-19.MethodsWe performed a systematic literature search through the PubMed, Scopus and Embase from the inception of databases until 6 April 2021. The intervention group was SOF/DCV, and the control group was standard of care. The primary outcome was mortality, defined as clinically validated death. The secondary outcomes were (1) the need for ICU admission or IMV and (2) clinical recovery. The pooled effect estimates were reported as risk ratios (RRs).ResultsThere were four studies with a total of 231 patients in this meta-analysis. Three studies were randomised controlled trial, and one study was non-randomised. SOF/DCV was associated with lower mortality (RR: 0.31 (0.12, 0.78); p=0.013; I2: 0%) and reduced need for ICU admission or IMV (RR: 0.35 (0.18, 0.69); p=0.002; I2: 0%). Clinical recovery was achieved more frequently in the SOF/DCV (RR: 1.20 (1.04, 1.37); p=0.011; I2: 21.1%). There was a moderate certainty of evidence for mortality and need for ICU/IMV outcome, and a low certainty of evidence for clinical recovery. The absolute risk reductions were 140 fewer per 1000 for mortality and 186 fewer per 1000 for the need for ICU/IMV. The increase in clinical recovery was 146 more per 1000.ConclusionSOF/DCV may reduce mortality rate and need for ICU/IMV in patients with COVID-19 while increasing the chance for clinical recovery.Protocol registrationPROSPERO: CRD42021247510.

scholarly journals Evaluation of changes in shoulder balance and prediction of final shoulder imbalance during growing-rod treatment for early-onset scoliosis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ziyang Liu ◽  
Tie Liu ◽  
Yong Hai ◽  
Lingyun Wu ◽  
Junrui Jonathan Hai ◽  
...  
Keyword(s):  
Early Onset ◽  
Demographic Data ◽  
Potential Effect ◽  
Early Onset Scoliosis ◽  
Shoulder Balance ◽  
Related Factors ◽  
Growing Rod ◽  
Shoulder Imbalance ◽  
Entire Treatment

Abstract Background Obtaining and maintaining final shoulder balance after the entire treatment course is essential for early-onset scoliosis (EOS) patients. The relatively small number of growing-rod (GR) graduates who complete final fusion has resulted in an overall paucity of research on the GR treatment of EOS and a lack of research on the shoulder balance of EOS patients during GR treatment. Methods Twenty-four consecutive patients who underwent GR treatment until final fusion were included. Radiographic shoulder balance parameters, including the radiographic shoulder height (RSH), clavicle angle (CA), and T1 tilt angle (T1T), before and after each step of the entire treatment were measured. Shoulder balance changes from GR implantation to the last follow-up after final fusion were depicted and analysed. Demographic data, surgical-related factors, and radiographic parameters were analysed to identify risk factors for final shoulder imbalance. The shoulder balance of patients at different time points was further analysed to explore the potential effect of the series of GR treatment steps on shoulder balance. Results The RSH showed substantial improvement after GR implantation (P = 0.036), during the follow-up period after final fusion (P = 0.021) and throughout the entire treatment (P = 0.011). The trend of change in the CA was similar to that of the RSH, and the T1T improved immediately after GR implantation (P = 0.037). Further analysis indicated that patients with shoulder imbalance before final fusion showed significantly improved shoulder balance after fusion (P = 0.045), and their RSH values at early postfusion and the final follow-up did not show statistically significant differences from those in the prefusion shoulder balance group (P > 0.05). Early postfusion shoulder imbalance (odds ratio (OR): 19.500; 95% confidence interval (CI) = 1.777–213.949; P = 0.015) was identified as an independent risk factor for final shoulder imbalance. Conclusions Shoulder balance could be improved by GR implantation but often changes during the multistep lengthening process, and the final result is relatively unpredictable. Final fusion could further adjust the prefusion shoulder imbalance. Focusing on the prefusion shoulder balance of GR graduates and providing patients with early shoulder balance after fusion might be necessary.

scholarly journals Infrastructural and Human Factors Affecting Safety Outcomes of Cyclists

2018 ◽  
Vol 10 (2) ◽  
pp. 299 ◽  
Author(s):  
Sergio Useche ◽  
Luis Montoro ◽  
Francisco Alonso ◽  
Oscar Oviedo-Trespalacios
Keyword(s):  
Human Factors ◽  
Online Survey ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
User Characteristics ◽  
Severe Injuries ◽  
Related Factors ◽  
Cross Sectional ◽  
Road Crashes ◽  
Safety Outcomes

The increasing number of registered road crashes involving cyclists during the last decade and the high proportion of road crashes resulting in severe injuries and fatalities among cyclists constitutes a global issue for community health, urban development and sustainability. Nowadays, the incidence of many risk factors for road crashes of cyclists remains largely unexplained. Given the importance of this issue, the present study has been conducted with the aim of determining relationships between infrastructural, human factors and safety outcomes of cyclists. Objectives: This study aimed, first, to examine the relationship between key infrastructural and human factors present in cycling, bicycle-user characteristics and their self-reported experience with road crashes. And second, to determine whether a set of key infrastructural and human factors may predict their self-reported road crashes. Methods: For this cross-sectional study, a total of 1064 cyclists (38.8% women, 61.2% men; M = 32.8 years of age) from 20 different countries across Europe, South America and North America, participated in an online survey composed of four sections: demographic data and cycling-related factors, human factors, perceptions on infrastructural factors and road crashes suffered. Results: The results of this study showed significant associations between human factors, infrastructural conditions and self-reported road crashes. Also, a logistic regression model found that self-reported road crashes of cyclists could be predicted through variables such as age, riding intensity, risky behaviours and problematic user/infrastructure interactions. Conclusions: The results of this study suggest that self-reported road crashes of cyclists are influenced by features related to the user and their interaction with infrastructural characteristics of the road.

scholarly journals Exploiting an early warning Nomogram for predicting the risk of ICU admission in patients with COVID-19: a multi-center study in China

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Yiwu Zhou ◽  
Yanqi He ◽  
Huan Yang ◽  
He Yu ◽  
Ting Wang ◽  
...  
Keyword(s):  
Community Health Centers ◽  
Smoking Status ◽  
External Validation ◽  
Individual Risk ◽  
Global Public Health ◽  
Discriminative Ability ◽  
Icu Admission ◽  
Novel Coronavirus ◽  
Individualized Prediction ◽  
Multi Center Study

Abstract Background Novel coronavirus disease 2019 (COVID-19) is a global public health emergency. Here, we developed and validated a practical model based on the data from a multi-center cohort in China for early identification and prediction of which patients will be admitted to the intensive care unit (ICU). Methods Data of 1087 patients with laboratory-confirmed COVID-19 were collected from 49 sites between January 2 and February 28, 2020, in Sichuan and Wuhan. Patients were randomly categorized into the training and validation cohorts (7:3). The least absolute shrinkage and selection operator and logistic regression analyzes were used to develop the nomogram. The performance of the nomogram was evaluated for the C-index, calibration, discrimination, and clinical usefulness. Further, the nomogram was externally validated in a different cohort. Results The individualized prediction nomogram included 6 predictors: age, respiratory rate, systolic blood pressure, smoking status, fever, and chronic kidney disease. The model demonstrated a high discriminative ability in the training cohort (C-index = 0.829), which was confirmed in the external validation cohort (C-index = 0.776). In addition, the calibration plots confirmed good concordance for predicting the risk of ICU admission. Decision curve analysis revealed that the prediction nomogram was clinically useful. Conclusion We established an early prediction model incorporating clinical characteristics that could be quickly obtained on hospital admission, even in community health centers. This model can be conveniently used to predict the individual risk for ICU admission of patients with COVID-19 and optimize the use of limited resources.

scholarly journals The clinical features of COVID-19 patients with positive viral RNA stool test results and possibility of fecal-oral transmission : A Systematic Review

2021 ◽  
Vol 22 (1) ◽  
pp. 42-51
Author(s):  
Selina Natalia ◽  
Felicia Imanuella Thorion ◽  
Luky Adlino ◽  
Clifford Eltin John ◽  
Andree Kurniawan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gastrointestinal Tract ◽  
Demographic Data ◽  
Clinical Manifestations ◽  
Viral Rna ◽  
World Health ◽  
Test Results ◽  
Oral Transmission ◽  
Positive Stool ◽  
Health Organization

Objective : Coronavirus disease 2019 (COVID-19) has been declared as an international public health emergency by the World Health Organization (WHO), with outbreaks in over 200 countries and causing over 390,000 deaths globally. ACE-2 receptors are highly expressed in the upper and lower gastrointestinal system, providing a prerequisite for SARS-CoV-2 infection in the gastrointestinal tract. In addition, over half of the COVID-19 patients have viral nucleic acid detected in their feces and almost one-quarter of the cases, the stool samples test positive even when respiratory samples are negative. The aim of this systematic review is to summarize literature and to evaluate the clinical characteristics of patients with positive viral RNA stool test for COVID-19 and if there is a possibility of fecal-oral transmission of SARS-CoV-2 virus.Method : This systematic review has been registered in PROSPERO (CRD42020183049). A systematic search of the literature for observational study and randomized control trial was conducted in PubMed central and Google Scholar through May 5th, 2020. Three reviewers independently searched and selected. The risk of bias was evaluated using Newcastle-Ottawa Quality assessment tool.Results : 340 articles were screened, then from which eight articles were selected. Of eight articles that were included in this study, we sought for three main categories of the clinical manifestation; gastrointestinal, respiratory, and others. Each study was reviewed systematically to gain demographic data and evidence regarding the possibility of fecal oral transmission in SARS-CoV-2. Two studies reported prolongation of positive stool test results after the respiratory specimen conversion to negative which support the theory of fecal oral transmission.Conclusion : In conclusion, diarrhea, cough, and fever are the most common clinical manifestations in COVID-19 patients with positive RNA stool test results. Fecal oral transmission may be possible due to the ACE-2 receptors in the lining of the gastrointestinal tract. RNA stool test should be used as addition in discharging COVID-19 patients.

scholarly journals Comparison of Quantiferon-TB Gold and TST tests in the diagnosis of latent tuberculosis infection among HIV infected patients in Hamadan, west of Iran

2020 ◽  
Vol 14 (04) ◽  
pp. 360-365
Author(s):  
Fariba Keramat ◽  
Benyamin Bagheri Delavar ◽  
Alireza Zamani ◽  
Jalal Poorolajal ◽  
Elham Lajevardi ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Latent Tuberculosis Infection ◽  
Demographic Data ◽  
Clinical Manifestations ◽  
Latent Tuberculosis ◽  
Cd4 Count ◽  
Tuberculosis Infection ◽  
Percent Agreement ◽  
Immunodeficiency Virus ◽  
The Mean

Introduction: Human immunodeficiency virus (HIV) infection increases the susceptibility of patients for latent tuberculosis infection (LTBI) and reactivtion tuberculosis. This study aimed to compare the Quantiferon-TB gold-in tube test (QFT) with tuberculin skin test (TST) in the diagnosis of LTBI in HIV infected patients. Methodology: This comparative study of 89 patients with HIV in the Behavioral Diseases Counseling Center in Hamadan was carried out from July 2015 to November 2016. After obtaining consent from the patients, all demographic data, clinical manifestations, and laboratory results (CD4 count, TST and QFT) were entered into the questionnaires. The CD4 count is usually routinely performed using flow cytometry at the Behavioral Counselling Center. Quantiferon-TB test was done by using Qiagen – Quantiferon-2 plate kit ELISA. Results: Totally, 89 HIV infected patients with the mean age of 39.55 ± 10.31 years old were enrolled in the study. Sixty patients (67.42%) were male. The mean duration of HIV infection was 4.44 ± 3.88 years and the mean of CD4 count was 388.65 ± 260.66 cells/µL . Twenty patients had LTBI based on TST. Considering the QFT intermediate results as a positive test, the percent agreement of QFT and TST was 59.55%, which was not statistically significant (P = 0.2387). Conclusions: According to the results, there was no significant percent agreement between QFT and TST for detecting LTBI in HIV infected patients. However, by decreasing CD4 counts, there was a significant relation between TST positive and LTBI in HIV patients.

scholarly journals Comorbidities and related factors in rheumatoid arthritis patients of south India- Karnataka Rheumatoid Arthritis Comorbidity (KRAC) study

Reumatismo ◽  
2017 ◽  
Vol 69 (2) ◽  
pp. 47 ◽  
Author(s):  
S. Chandrashekara ◽  
V. Shobha ◽  
B.G. Dharmanand ◽  
R. Jois ◽  
S. Kumar ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Thyroid Disease ◽  
South India ◽  
South Indian Population ◽  
Related Factors ◽  
Female Ratio ◽  
South Indian ◽  
Clinical Research Associates ◽  
Multi Center Study

The aim was to study the prevalence of comorbidities in rheumatoid arthritis (RA) patients in everyday clinical practice and their association with disease-specific and demographic factors. The multi-center study recruited 3,247 (at 14 centers, and 265) were excluded due to incomplete data. The number of subjects considered for the analysis was 2982. The mean (±standard deviation) age was 48.98±12.64 years and the male-to-female ratio was 1:5. The data was collected based on a pre-structured pro forma by trained clinical research associates through interview and verification of charts and reports available in the patient records. The following comorbidities were studied: cardiovascular disease, hypertension, diabetes mellitus, hypercholesterolemia, thyroid disease, psychiatric diseases like depression, and pulmonary disease. Hypertension (20.7%), diabetes mellitus (14.4%) and thyroid disease (18.3%) were the most prevalent comorbidities. Hypercholesterolemia (5.3%), pulmonary diseases (2.1%), cardiovascular diseases (0.2%) and depression (0.03%) were prevalent in ≤5% of the study population. The overall presence of comorbidity increased with age and reduced with the duration of illness prior (DOIP). The age, gender, and DOIP differed significantly between groups with and without hypercholesterolemia. Females had a statistically increased prevalence of thyroid disease. The prevalence of comorbidities in RA patients from south India is around 40% and the incidence of comorbidity increased with age. As per the literature evidence, the prevalence in the current study subjects was higher when compared to prevalence of similar diseases occurring in the general south Indian population.

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