scholarly journals Late reinfection with a different severe acute respiratory syndrome coronavirus-2 clade in a patient with refractory arterial hypertension: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Javier García-Abellán ◽  
Antonio Galiana ◽  
Marta Fernández-González ◽  
Nieves Gonzalo-Jiménez ◽  
Montserrat Ruiz-García ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Arterial Hypertension ◽  
Primary Infection ◽  
Individual Risk ◽  
Time Interval ◽  
Limited Information ◽  
Initial Infection ◽  
Viral Shedding ◽  
Complete Dataset ◽  
The Individual

Abstract Background Differentiating between persistent infection with intermittent viral shedding and reinfection with severe acute respiratory syndrome coronavirus 2 remains challenging. Although a small number of cases with genomic evidence of second infection have been reported, limited information exists on frequency and determinants of reinfection, time between infections, and duration of immunity after the primary infection. Case presentation We report a reinfection with severe acute respiratory syndrome coronavirus 2 in a 52-year-old caucasian male whose primary infection was diagnosed in May 2020, during the first wave of the pandemic in Spain, and the second occurred 8 months later, in January 2021. We present a complete dataset including results from real-time polymerase chain reaction, serology, and genome sequencing confirming reinfection with a different clade. Noteworthy was that the patient was immunocompetent but had multiple cardiometabolic comorbidities, including refractory arterial hypertension, that might increase the individual risk in coronavirus disease 2019. Conclusions This case of reinfection with severe acute respiratory syndrome coronavirus 2 occurring several months after the primary infection reports the longest time interval between reinfection and initial infection described to date. It raises concerns on the duration of protective immunity, suggesting that it may begin to wane in patients who acquired the initial infection during the first wave of the pandemic. The potential contributing role of arterial hypertension and cardiometabolic comorbidities as risk factors for reinfection deserves investigation.

scholarly journals Late Reinfection With a Different SARS-CoV-2 Clade in a Patient With Refractory Arterial Hypertension: a Case Report.

2021 ◽  
Author(s):  
Antonio Galiana ◽  
Javier García-Abellán ◽  
Marta Fernández-González ◽  
Nieves Gonzalo-Jiménez ◽  
Montserrat Ruiz-García ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Primary Infection ◽  
Individual Risk ◽  
Time Interval ◽  
Limited Information ◽  
Data Set ◽  
Initial Infection ◽  
Viral Shedding ◽  
The Individual

Abstract Background: Differentiating between persistent infection with intermittent viral shedding and reinfection with SARS-CoV-2 remains challenging. Although a small number of cases with genomic evidence of second infection have been reported, limited information exists on frequency and determinants of reinfection, time between infections, and duration of immunity after the primary infection. Case presentation: We report a reinfection with SARS-CoV-2 in a 52-year old male whose primary infection was diagnosed in May 2020, during the first wave of the pandemic in Spain, and the second occurred eight months later, in January 2021. We present a complete data set including results from real-time polymerase chain reaction, serology and genome sequencing confirming reinfection with a different clade. Noteworthy was that the patient was immunocompetent but had multiple cardiometabolic comorbidities, including refractory arterial hypertension, that might increase the individual risk in COVID-19.Conclusions: This case of reinfection with SARS CoV-2 occurring several months after the primary infection reports the longest time interval between reinfection and initial infection described to date. It raises concerns on the duration of protective immunity, suggesting that it may begin to wane in patients who acquired the initial infection during the first wave of the pandemic. The potential contributing role of arterial hypertension and cardiometabolic comorbidities as risk factors for reinfection deserves investigation.

Clinical Score and Machine Learning-Based Model to Predict Diagnosis of Primary Aldosteronism in Arterial Hypertension

Hypertension ◽  
2021 ◽  
Vol 78 (5) ◽  
pp. 1595-1604
Author(s):  
Fabrizio Buffolo ◽  
Jacopo Burrello ◽  
Alessio Burrello ◽  
Daniel Heinrich ◽  
Christian Adolf ◽  
...  
Keyword(s):  
Machine Learning ◽  
Arterial Hypertension ◽  
Primary Aldosteronism ◽  
Learning Algorithm ◽  
Area Under The Curve ◽  
Clinical Score ◽  
Machine Learning Algorithms ◽  
Supervised Machine Learning ◽  
Individual Risk ◽  
The Individual

Primary aldosteronism (PA) is the cause of arterial hypertension in 4% to 6% of patients, and 30% of patients with PA are affected by unilateral and surgically curable forms. Current guidelines recommend screening for PA ≈50% of patients with hypertension on the basis of individual factors, while some experts suggest screening all patients with hypertension. To define the risk of PA and tailor the diagnostic workup to the individual risk of each patient, we developed a conventional scoring system and supervised machine learning algorithms using a retrospective cohort of 4059 patients with hypertension. On the basis of 6 widely available parameters, we developed a numerical score and 308 machine learning-based models, selecting the one with the highest diagnostic performance. After validation, we obtained high predictive performance with our score (optimized sensitivity of 90.7% for PA and 92.3% for unilateral PA [UPA]). The machine learning-based model provided the highest performance, with an area under the curve of 0.834 for PA and 0.905 for diagnosis of UPA, with optimized sensitivity of 96.6% for PA, and 100.0% for UPA, at validation. The application of the predicting tools allowed the identification of a subgroup of patients with very low risk of PA (0.6% for both models) and null probability of having UPA. In conclusion, this score and the machine learning algorithm can accurately predict the individual pretest probability of PA in patients with hypertension and circumvent screening in up to 32.7% of patients using a machine learning-based model, without omitting patients with surgically curable UPA.

scholarly journals Spectrum and Clinical Characteristics of Symptomatic and Asymptomatic Coronavirus Disease 2019 (COVID-19) With and Without Pneumonia

2020 ◽  
Author(s):  
Huihui Zeng ◽  
Yiming Ma ◽  
Zhiguo Zhou ◽  
Wenlong Liu ◽  
Peng Huang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Renal Replacement Therapy ◽  
Severe Acute Respiratory Syndrome ◽  
Clinical Characteristics ◽  
Invasive Mechanical Ventilation ◽  
The Other ◽  
Limited Information ◽  
Viral Shedding ◽  
Radiologic Findings ◽  
Global Pandemic

Abstract BackgroundCoronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic. Based on symptoms, COVID-19 cases can be classified as symptomatic or asymptomatic. However, there is limited information about the differences between COVID-19 patients with and without pneumonia. Our study aimed to further discuss the spectrum and clinical characteristics of symptomatic and asymptomatic COVID-19 patients with and without pneumonia. MethodsIn China, all COVID-19 cases are hospitalized in designated hospitals until two continuous negative oropharyngeal swabs obtained, which allows the professional monitoring of symptoms and clinical characteristics. We stratified all COVID-19 cases in our database, and evaluated clinical characteristics in different COVID-19 subgroups (symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia and asymptomatic without pneumonia). ResultsAccording to symptoms and laboratory and radiologic findings, COVID-19 cases were defined as symptomatic with pneumonia, symptomatic without pneumonia, asymptomatic with pneumonia or asymptomatic without pneumonia. There were differences in the clinical characteristics and prognosis among the four groups. Both noninvasive (18, 4.2%) and invasive mechanical ventilation (11, 2.6%) were applied in only the symptomatic with pneumonia group. Likewise, extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) were applied in only the symptomatic with pneumonia group. There were no differences in the durations of viral shedding and hospitalization among the four groups.ConclusionWe have defined a comprehensive spectrum of COVID-19 with and without pneumonia. The symptomatic with pneumonia group consumed more medical resources than the other groups, and extra caution and monitoring should be applied in this group. The asymptomatic COVID-19 group had a similar viral shedding duration as the symptomatic COVID-19 group.Trial registrationNot available

scholarly journals Household transmissions of SARS-CoV-2 in the time of unprecedented travel lockdown in China

2020 ◽  
Author(s):  
Xiao-Ke Xu ◽  
Xiao-Fan Liu ◽  
Lin Wang ◽  
Sheikh Taslim Ali ◽  
Zhanwei Du ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Severe Acute Respiratory Syndrome ◽  
Age Groups ◽  
Hubei Province ◽  
Mitigation Strategies ◽  
Limited Information ◽  
Individual Level ◽  
Epidemiological Features ◽  
The Individual ◽  
Epidemiological Characteristics

AbstractImportanceSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in the city of Wuhan, China, in December 2019 and then spread globally. Limited information is available for characterizing epidemiological features and transmission patterns in the regions outside of Hubei Province. Detailed data on transmission at the individual level could be an asset to understand the transmission mechanisms and respective patterns in different settings.ObjectiveTo reconstruct infection events and transmission clusters of SARS-CoV-2 for estimating epidemiological characteristics at household and non-household settings, including super-spreading events, serial intervals, age- and gender-stratified risks of infection in China outside of Hubei Province.Design, Setting, and Participants9,120 confirmed cases reported online by 264 Chinese urban Health Commissions in 27 provinces from January 20 to February 19, 2020. A line-list database is established with detailed information on demographic, social and epidemiological characteristics. The infection events are categorized into the household and non-household settings.ExposuresConfirmed cases of SARS-CoV-2 infections.Main Outcomes and MeasuresInformation about demographic characteristics, social relationships, travel history, timelines of potential exposure, symptom onset, confirmation, and hospitalization were extracted from online public reports. 1,407 infection events formed 643 transmission clusters were reconstructed.ResultsIn total 34 primary cases were identified as super spreaders, and 5 household super-spreading events were observed. The mean serial interval is estimated to be 4.95 days (standard deviation: 5.24 days) and 5.19 days (standard deviation: 5.28 days) for households and non-household transmissions, respectively. The risk of being infected outside of households is higher for age groups between 18 and 64 years, whereas the hazard of being infected within households is higher for age groups of young (<18) and elderly (>65) people.Conclusions and RelevanceThe identification of super-spreading events, short serial intervals, and a higher risk of being infected outside of households for male people of age between 18 and 64 indicate a significant barrier to the case identification and management, which calls for intensive non-pharmaceutical interventions (e.g. cancellation of public gathering, limited access of public services) as the potential mitigation strategies.Key PointsQuestionWhat epidemiological characteristics and risk factors are associated with household and non-household transmissions of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China outside of Hubei Province?FindingsIn this epidemiological study analyzing 1,407 SARS-CoV-2 infection events reported between 20 January 2020 and 19 February 2020, 643 transmission clusters were reconstructed to demonstrate the non-negligible frequency of super-spreading events, short duration of serial intervals, and a higher risk of being infected outside of household for male people of age between 18 and 64 years.MeaningThese findings provide epidemiological features and risk estimates for both household and non-household transmissions of SARS-CoV-2 in China outside of Hubei Province.

Quantitative Pipeline Risk Assessment and Maintenance Optimization

2004 ◽  
Author(s):  
Patrick L. Wickenhauser ◽  
David K. Playdon
Keyword(s):  
Risk Assessment ◽  
Risk Ratio ◽  
Financial Risk ◽  
Minimum Cost ◽  
Quantitative Risk Assessment ◽  
Individual Risk ◽  
Optimal Time ◽  
Time Interval ◽  
Safety Risk ◽  
The Individual

The quantitative risk assessment tool was used to calculate the failure rates, failure consequences and risk levels along the pipeline. Safety risk was characterized by the individual risk ratio, which was defined as the maximum individual risk associated with a given segment divided by the tolerable individual risk. Tolerable individual risk values were defined as a function of population density following the approach developed by MIACC and the UK HSE. Financial risk was expressed in dollars per km-year and included a dollar equivalent for public perception. The recommended maintenance plan was defined as the minimum cost option that achieved a tolerable safety risk. The first step in developing the plan was to identify all segments that do not meet tolerable risk criteria (i.e., segments with an individual risk ratio greater than 1). For each of these segments a number of potential maintenance scenarios that address the dominant failure threats were selected. A cost optimization analysis was then carried out in which the total expected cost associated with each maintenance option was calculated as the sum of implementing the option plus the corresponding financial risk component, amortized over the inspection interval. This analysis was used to identify the minimum cost alternative that meets the individual risk constraint. Outcomes of the analysis included the best maintenance option (e.g., inline inspection, hydrostatic test) and the optimal time interval for segment re-evaluation.

scholarly journals Reinfection or Reactivation of Severe Acute Respiratory Syndrome Coronavirus 2: A Systematic Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Xiujuan Tang ◽  
Salihu S. Musa ◽  
Shi Zhao ◽  
Daihai He
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
General Population ◽  
Severe Acute Respiratory Syndrome ◽  
Lower Risk ◽  
Primary Infection ◽  
Recent Literature ◽  
Severe Infection ◽  
Health Concerns ◽  
Viral Shedding

As the pandemic continues, individuals with re-detectable positive (RP) SARS-CoV-2 viral RNA among recovered COVID-19 patients have raised public health concerns. It is imperative to investigate whether the cases with re-detectable positive (RP) SARS-CoV-2 might cause severe infection to the vulnerable population. In this work, we conducted a systematic review of recent literature to investigate reactivation and reinfection among the discharged COVID-19 patients that are found positive again. Our study, consisting more than a total of 113,715 patients, indicates that the RP-SARS-CoV-2 scenario occurs plausibly due to reactivation, reinfection, viral shedding, or testing errors. Nonetheless, we observe that previously infected individuals have significantly lower risk of being infected for the second time, indicating that reactivation or reinfection of SARS-CoV-2 likely have relatively less impact in the general population than the primary infection.

The importance and significance of gene polymorphisms in preeclampsia

2016 ◽  
pp. 45-49
Author(s):  
P.N. Veropotvelyan ◽  
◽  
I.S. Tsehmistrenko ◽  
N.P. Veropotvelyan ◽  
N.S. Rusak ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Systematic Review ◽  
Early Diagnosis ◽  
Gene Polymorphisms ◽  
Individual Risk ◽  
Extended Study ◽  
Stress Genes ◽  
Detoxification System ◽  
The Individual ◽  
The Relationship

Was to conduct a systematic review of data on the relationship between polymorphisms genes of detoxification system and development of preeclampsia (РЕ). Рresents the main genes of detoxification system (GSTPI, GSTМI, GSTТI, GРХI, ЕРНХI, SOD-2, SOD-3, CYPIAL, MTHЕR, MTR) and their functions. Of interest is the possibility of calculating the individual risk of PE based on the results about the presence of a combination of different polymorphisms in the genotype of the female. Question about early diagnosis of РЕ remains controversial and not fully understood. It is necessary to conduct further in-depth, extended study of this problem. Key words: preeclampsia, oxidative stress, genes of the detoxification system.

The relevance of dietetic approach of Ayurveda from the perspective of COVID-19 pandemic

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 748-752
Author(s):  
Swapnali Khabade ◽  
Bharat Rathi ◽  
Renu Rathi
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Healthy Person ◽  
World Health ◽  
Physical And Mental Health ◽  
Leading Role ◽  
Global Pandemic ◽  
The People ◽  
The World ◽  
Health Organization ◽  
The Individual

A novel, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes severe acute respiratory syndrome and spread globally from Wuhan, China. In March 2020 the World Health Organization declared the SARS-Cov-2 virus as a COVID- 19, a global pandemic. This pandemic happened to be followed by some restrictions, and specially lockdown playing the leading role for the people to get disassociated with their personal and social schedules. And now the food is the most necessary thing to take care of. It seems the new challenge for the individual is self-isolation to maintain themselves on the health basis and fight against the pandemic situation by boosting their immunity. Food organised by proper diet may maintain the physical and mental health of the individual. Ayurveda aims to promote and preserve the health, strength and the longevity of the healthy person and to cure the disease by properly channelling with and without Ahara. In Ayurveda, diet (Ahara) is considered as one of the critical pillars of life, and Langhana plays an important role too. This article will review the relevance of dietetic approach described in Ayurveda with and without food (Asthavidhi visheshaytana & Lanhgan) during COVID-19 like a pandemic.

Differentiation of endemic areas by incidence rates of tick-borne infectious diseases as the basis for choosing prevention strategy and tactics

2019 ◽  
pp. 56-61
Author(s):  
N.V. Rudakov ◽  
N.A. Penyevskaya ◽  
D.A. Saveliev ◽  
S.A. Rudakova ◽  
C.V. Shtrek ◽  
...  
Keyword(s):  
High Risk ◽  
Infectious Diseases ◽  
Population Based ◽  
Preventive Therapy ◽  
Incidence Rates ◽  
Prevention Strategy ◽  
Individual Risk ◽  
The Individual ◽  
Integral Assessment ◽  
Very High

Research objective. Differentiation of natural focal areas of Western Siberia by integral incidence rates of tick-borne infectious diseases for determination of the strategy and tactics of their comprehensive prevention. Materials and methods. A retrospective analysis of official statistics for the period 2002-2018 for eight sub-federal units in the context of administrative territories was carried out. The criteria of differentiation were determined by means of three evaluation scales, including long-term mean rates of tick-borne encephalitis, tick-borne borreliosis, and Siberian tick-borne typhus. As a scale gradation tool, we used the number of sample elements between the confidence boundaries of the median. The integral assessment was carried out by the sum of points corresponding to the incidence rates for each of the analyzed infections. Results. The areas of low, medium, above average, high and very high risk of tick-borne infectious diseases were determined. Recommendations on the choice of prevention strategy and tactics were given. In areas of very high and high incidence rates, a combination of population-based and individual prevention strategies is preferable while in other areas a combination of high-risk and individual strategies is recommended. Discussion. Epidemiologic zoning should be the basis of a risk-based approach to determining optimal volumes and directions of preventive measures against natural focal infections. It is necessary to improve the means and methods of determining the individual risk of getting infected and developing tick-borne infectious diseases in case of bites, in view of mixed infection of vectors, as well as methods of post-exposure disease prevention (preventive therapy).

scholarly journals A New Medical Record Proposal to the Prognostic Risk Assessment for MRONJ in Oncologic Patients: “Sapienza Head and Neck Unit” Proposal

2021 ◽  
Vol 18 (4) ◽  
pp. 1851
Author(s):  
Edoardo Brauner ◽  
Silvia Mezi ◽  
Alessandro Ciolfi ◽  
Chiara Ciolfi ◽  
Resi Pucci ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Bone Cancer ◽  
Osteonecrosis Of The Jaw ◽  
Individual Risk ◽  
Medical Report ◽  
Oncologic Patients ◽  
Antiangiogenic Drugs ◽  
Dental Screening ◽  
The Individual

Medication-related osteonecrosis of the jaw (MRONJ) is an adverse event associated with antiresorptive and antiangiogenic drugs. The use of these drugs in the treatment of cancer patients with bone metastasis is necessary and standardized in the literature. A multidisciplinary approach for the patient’s management is strongly recommended. Therefore, it should be necessary to integrate the path of these subjects with a dedicated dental screening in order to first assess the individual risk of developing a MRONJ, and then to plan dental treatments and oral hygiene sessions, and finally to schedule a follow-up to intercept and treat early osteonecrosis. The aim of this manuscript is to propose a new simple medical report to evaluate patients affected by metastatic bone cancer in order to reduce the risk of developing MRONJ.

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