scholarly journals A distinct metabolic profile associated with a fatal outcome in COVID-19 patients during early epidemic in Italy

2021 ◽  
Author(s):  
Elisa Saccon ◽  
Alessandra Bandera ◽  
Mariarita Sciumè ◽  
Flora Mikeloff ◽  
Abid Ali Lashari ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Diagnostic Tool ◽  
Clinical Setting ◽  
Metabolic Profile ◽  
Fatal Outcome ◽  
Predictive Biomarkers ◽  
Biological Resource ◽  
Disease Prognosis

AbstractLeveraging the unique biological resource based upon the initial COVID-19 patients in Policlinico di Milano (Italy), our study provides the first metabolic profile associated with a fatal outcome. The identification of potential predictive biomarkers offers a vital opportunity to employ metabolomics in a clinical setting as diagnostic tool of disease prognosis upon hospital admission.

scholarly journals Distinct Metabolic Profile Associated with a Fatal Outcome in COVID-19 Patients during the Early Epidemic in Italy

2021 ◽  
Author(s):  
Elisa Saccon ◽  
Alessandra Bandera ◽  
Mariarita Sciumè ◽  
Flora Mikaeloff ◽  
Abid A. Lashari ◽  
...  
Keyword(s):  
High Throughput ◽  
Metabolic Profile ◽  
Fatal Outcome ◽  
Oxygen Demand ◽  
Diagnostic Tools ◽  
Metabolomics Data ◽  
Metabolic Alterations ◽  
Disease Prognosis ◽  
The Moment ◽  
Clinical Conditions

Understanding the metabolic alterations occurring during an infection is a key element for identifying potential indicators of the disease prognosis, which are fundamental for developing efficient diagnostic tools and offering the best therapeutic treatment to the patient. Here, exploiting high-throughput metabolomics data, we identified the first metabolic profile associated with a fatal outcome, not correlated with preexisting clinical conditions or the oxygen demand at the moment of diagnosis.

scholarly journals Continuous Infusion of Flumazenil in the Management of Benzodiazepines Detoxification

2021 ◽  
Vol 12 ◽  
Author(s):  
Anna Benini ◽  
Rossella Gottardo ◽  
Cristiano Chiamulera ◽  
Anna Bertoldi ◽  
Lorenzo Zamboni ◽  
...  
Keyword(s):  
Plasma Level ◽  
Hospital Admission ◽  
Continuous Infusion ◽  
Clinical Setting ◽  
Withdrawal Syndrome ◽  
Withdrawal Symptoms ◽  
High Dose ◽  
End Of Treatment ◽  
Before And After ◽  
Treatment Changes

An effective approach in the treatment of benzodiazepine (BZD) overdosing and detoxification is flumazenil (FLU). Studies in chronic users who discontinued BZD in a clinical setting suggested that multiple slow bolus infusions of FLU reduce BZD withdrawal symptoms. The aim of this study was to confirm FLU efficacy for reducing BZD withdrawal syndrome by means of continuous elastomeric infusion, correlated to drugs plasma level and patients' compliance.Methods: Seven-day FLU 1 mg/day subcutaneously injected through an elastomeric pump and BZDs lormetazepam, clonazepam, and lorazepam were assessed by HPLC-MS/MS in serum of patients before and after 4 and 7 days of FLU continuous infusion treatment. Changes in withdrawal severity were assessed by using the BZD Withdrawal Scale (BWS).Results: Fourteen patients (mean age ± SD 42.5 ± 8.0 years, 5 male and 9 female), admitted to the hospital for high-dose BZD detoxification, were enrolled in the study. Serum FLU concentrations significantly decreased from 0.54 ± 0.33 ng/ml (mean ± SD) after 4 days of treatment to 0.1 ± 0.2 ng/ml at the end of infusion. Lormetazepam concentrations were 502.5 ± 610.0 ng/ml at hospital admission, 26.2 ± 26.8 ng/ml after 4 days, and 0 at the end of treatment. BWS values decreased during FLU treatment temporal period. FLU was well-tolerated by patients.Conclusions: Elastomeric FLU infusion for BZD detoxification is a feasible administration device to maintain adequate, constant, and tolerated FLU concentrations for reducing BZD withdrawal symptoms.

Saliva Analysis in the Clinical Setting: Revisiting an Underused Diagnostic Tool

2002 ◽  
Vol 50 (3) ◽  
pp. 214-225 ◽  
Author(s):  
Rafael M. Nagler ◽  
Oded Hershkovich ◽  
Sophie Lischinsky ◽  
Eric Diamond ◽  
Abraham Z. Reznick
Keyword(s):  
Diagnostic Tool ◽  
Clinical Setting ◽  
Saliva Analysis

scholarly journals Characterization of epidemiological distribution and outcome of COVID-19 in patients with hereditary hemorrhagic telangiectasia: a nationwide retrospective multi-centre study during first wave in Italy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Patrizia Suppressa ◽  
Fabio Pagella ◽  
Gennaro Mariano Lenato ◽  
Eleonora Gaetani ◽  
Ilaria Serio ◽  
...  
Keyword(s):  
Intensive Care ◽  
General Population ◽  
Hospital Admission ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Fatal Outcome ◽  
Structured Interview ◽  
Infection Risk ◽  
Multi Centre Study ◽  
The Impact ◽  
Pandemic Wave

Abstract Background Coronavirus Disease 2019 (COVID-19) continues to have a devastating impact across the world. A number of pre-existing common clinical conditions were reported to represent risk factors for more severe COVID-19 outcomes. Hereditary Hemorrhagic Telangiectasia (HHT) is a rare vascular heritable disorders, characterized by complications secondary to visceral Arterio-Venous Malformations. The impact of HHT, as well as for many Rare Diseases (RDs) on infection susceptibility profile and clinical adverse outcome risk is an unresolved issue. Objectives The main objectives were: to assess the clinical features and outcomes of HHT patients infected with COVID-19; to compare the relative infection risk in these patients with the Italian general population throughout the first pandemic wave; to investigate the factors potentially associated with severe COVID-19 outcome in HHT patients, and the possible impact of COVID-19 infection on HHT-related symptoms/complications. Finally, we aimed to estimate how the lockdown-associated wearing of personal protective equipment/individual protection devices could affect HHT-related telangiectasia bleeding frequency. Methods The study is a nation-wide questionnaire-based survey, with a multi-Center retrospective cross-sectional design, addressed to the whole Italian HHT population. COVID-19 cases, occurring throughout the first pandemic wave, were collected by a questionnaire-based semi-structured interview. Only the cases ascertained by laboratory confirmation (molecular/serological) were included for epidemiological estimates. Information concerning eventual SarS-Cov-2 infection, as well as regarding HHT-related manifestations and HHT-unrelated co-morbidities were collected by the questionnaire. Prevalence data were compared to Italian general population in the same period. Results The survey disclosed 9/296 (3.04%) COVID-19 cases, 8/9 of them being resident in Lombardy, the main epidemic epicenter. Pneumonia was reported by 4/9 patients, which prompted hospital admission and intensive care management in 2 cases. No fatal outcome was recorded. After careful refinement of epidemiological analysis, the survey evidenced overlapping infection risk in HHT compared to general population. Conclusions COVID-19 infection profile parallels geographical distribution of epidemic foci. COVID-19 in HHT patients can lead to highly variable clinical profile, likely overlapping with that of general population. The HHT disease does not seem to involve a different approach in terms of hospital admission and access to intensive care with respect to general population.

scholarly journals Glutathione Reductase Is Associated with the Clinical Outcome of Septic Shock in the Patients Treated Using Continuous Veno-Venous Haemofiltration

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 689
Author(s):  
Georgijs Moisejevs ◽  
Eva Bormane ◽  
Dace Trumpika ◽  
Regina Baufale ◽  
Inara Busmane ◽  
...  
Keyword(s):  
Septic Shock ◽  
Hospital Admission ◽  
Glutathione Reductase ◽  
Prospective Observational Study ◽  
Fatal Outcome ◽  
Binary Logistic Regression ◽  
Favourable Outcome ◽  
Failure Assessment ◽  
Total Antioxidant ◽  
Multivariable Regression

Background and objectives: At present, there is insufficient evidence to support the use of continuous veno-venous haemofiltration (CVVH) in the early treatment of septic shock. This study focuses on the association between survival and different parameters of oxidative stress (RedOx). Thereby, we evaluated whether RedOx markers are associated with the outcome of septic shock in patients under early-initiated CVVH treatment. Materials and Methods: We conducted a prospective observational study of 65 patients with septic shock who started CVVH within 12 h after hospital admission. Blood samples were taken from each patient prior to the start of CVVH. The following RedOx markers were measured: glutathione peroxidase, glutathione reductase (GR), total antioxidant capacity, superoxide dismutase, nitric oxide, malondialdehyde and 4-hydroxynonenal. The odds ratio (OR) was calculated using binary logistic regression and stepwise multivariable regression. Results: The 65 patients had a median age of 66 years and 39 were male. Based on the outcome, the patients were divided into two groups—non-survivors (n = 29) and survivors (n = 36)—and the levels of RedOx markers were compared between them. Of all the markers, only higher GR activity was found to be significantly associated with the fatal outcome; 100.3 U/L versus 60.5 U/L, OR = 1.027 (95% CI, 1.010–1.044). Following adjustment for the sequential organ failure assessment score and other parameters, GR activity still presented a significant association with the fatal outcome, OR = 1.020 (95% CI, 1.002–1.038). Conclusions: GR activity is associated with in-hospital fatal outcomes among septic shock patients under early-initiated CVVH treatment. Septic shock patients who have a lower GR activity at hospital admission may have a favourable outcome of the early initiation of CVVH.

scholarly journals Respiratory rates observed over 15 seconds compared with rates measured using the RRate app. Practice-based evidence from an observational study of acutely ill adult medical patients during their hospital admission

2020 ◽  
Vol 19 (1) ◽  
pp. 15-20
Author(s):  
Immaculate Nakitende ◽  
◽  
Teopista Namujwiga ◽  
Dustin Dunsmuir ◽  
J. Mark Ansermino ◽  
...  
Keyword(s):  
Observational Study ◽  
Hospital Admission ◽  
Early Warning ◽  
Clinical Setting ◽  
Computer Algorithm ◽  
Early Warning Score ◽  
Medical Patients ◽  
National Early Warning Score ◽  
Busy Clinical Setting ◽  
Background Counting

Background: counting respiratory rate over 60 seconds can be impractical in a busy clinical setting. Methods: 870 respiratory rates of 272 acutely ill medical patients estimated from observations over 15 seconds and those calculated by a computer algorithm were compared. Results: The bias of 15 seconds of observations was 1.85 breaths per minute and 0.11 breaths per minute for the algorithm derived rate, which took 16.2 SD 8.1 seconds. The algorithm assigned 88% of respiratory rates their correct National Early Warning Score points, compared with 80% for rates from 15 seconds of observation. Conclusion: The respiratory rates of acutely ill patients are measured nearly as quickly and more reliably by a computer algorithm than by observations over 15 seconds.

Assessment of metabolic profile in a clinical setting

2006 ◽  
Vol 9 (5) ◽  
pp. 589-595 ◽  
Author(s):  
Panagiota Pervanidou ◽  
Christina Kanaka-Gantenbein ◽  
George P Chrousos
Keyword(s):  
Clinical Setting ◽  
Metabolic Profile

scholarly journals Primary Analysis of the Risk Factors for Severity and Mortality in COVID-19 Patients in Uzbekistan

2021 ◽  
Vol 53 (03) ◽  
pp. 104-111
Author(s):  
Azamat Alimov ◽  
Keyword(s):  
Risk Factors ◽  
Hospital Admission ◽  
Retrospective Analysis ◽  
Old Age ◽  
Severe Disease ◽  
Fatal Outcome ◽  
Male Gender ◽  
Primary Analysis ◽  
Moderate Disease ◽  
D Dimer

A retrospective analysis of 561 patients with confirmed COVID-19 was performed to determine the risk factors for severity and mortality which could predict the disease outcome in early stages. Patients were divided into 4 groups in accordance with disease severity: mild, moderate, severe and critical. And initial clinical and laboratory parameters of patients at admission were studied. The age of severe and deceased patients was significantly higher than patients with mild and moderate course (р=0.003). Patiens with severe disease and fatal outcome had higher incidence of concomitant diseases compared to patients with mild and moderate course (p=0.01). The time passed from onset of first symptoms and hospital admission was shorter in patients with mild and moderate disease than patients with severe and critical disease (р=0.0001). The leukocytosis, significant lymphopenia (р=0.0001), high D-dimer and ferritin levels were associated with severe disease. Male gender, old age, presence of concomitant diseases should be considered as risk factors for severe course and death at COVID-19.

scholarly journals P.044 Prospective clinical detection of 2-hydroxyglutarate to predict IDH-mutant gliomas using magnetic resonance spectroscopy: preliminary results

2017 ◽  
Vol 44 (S2) ◽  
pp. S25-S25
Author(s):  
MS Taccone ◽  
TB Nguyen ◽  
J Woulfe ◽  
I Moldovan ◽  
G Melkus ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Diagnostic Tool ◽  
Clinical Setting ◽  
Who Classification ◽  
Resonance Spectroscopy ◽  
Idh Mutation ◽  
Clinical Detection ◽  
Higher Sensitivity

Background: With the advent of the 2016 WHO classification of tumours, prognostically distinct subclasses of glioma have been revealed. A subset of gliomas which harbor the isocitrate dehydrogenase (IDH) mutation have a survival advantage. 2-Hydroxyglutarate (2-HG) is a byproduct of faulty IDH metabolism in IDH mutants making it an ideal tumour biomarker. Since pre-operative detection of this metabolite using magnetic resonance spectroscopy (MRS) may yield valuable information for the neurosurgeon, we undertook the first Canadian utility study to detect 2-HG via MRS. Methods: We will recruit 150 patients presenting with a newly suspected glioma. All patients will undergo MRS scans for 2-HG pre-operatively and the neuropathologist will determine IDH status post-operatively based on immunohistochemistry and DNA sequencing. Pre-operative detection of 2-HG will be compared to post-operative IDH status. Results: To date, of 34 eligible subjects, 29 have glioma determined by pathology. Seven of these were IDH-mutant positive by pathology, of which 3 were detected by MRS. One glioma positive for 2-HG on MRS turned out to be IDH mutant negative on pathology. Conclusions: Prospective detection of 2-HG via MRS is feasible in the clinical setting. Additional subjects as well as refinement of our MRS protocol may yield higher sensitivity and specificity of this novel and clinically relevant diagnostic tool.

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