Characterization of Patients With Type 2 Diabetes Mellitus and COVID-19

Abstract The coronavirus is a pathogen that mainly attacks the human respiratory system Previous coronavirus outbreaks (CoV) include severe acute respiratory syndrome (SARS), the clinical spectrum of COVID19 is very broad ranging from mild symptoms to ARDS to multiple organ failure and death. A history of DM2, advanced age and other comorbidities are considered predictors of higher morbidity and mortality, it is also known that blood glucose and DM levels are independent predictors of morbidity and mortality in patients with SARS. It should be remembered that patients with DM2 suffer from a chronic low grade inflammation that could facilitate the cytokine storm which in turn would be the cause of severe cases of COVID 19 pneumonia and the eventual death of many patients. Glucocorticoids have a stimulating and inhibitory effect on the immune response according to the moment in which it is administered and its circulating levels insulin therapy has been shown to decrease inflammation. For the control of glycemia the objectives must be individualized. Glycemic and individualized targets for non critical hospitalized patients have been established by different scientific societies such as ADA and AACE and Endocrine Society. In Honduras the protocol for the clinical management of adult patients with COVID 19 was developed to establish and standardize timely treatment in patients with suspected or confirmed COVID 19 which consists of the MAIZ scheme and the MAIZ scheme AAA. A retrospective longitudinal descriptive study was carried out with a review of the data obtained from 32 patients diagnosed with DM2 and COVID19 during the months of June through September 2020 at the CAMI Comprehensive Medical Care Clinic located in the city of Tegucigalpa Honduras collecting epidemiological and clinical data. The results of the research show that of the 32 patients with DM2 and COVID 19, 59% (19) belong to the male gender and 41% (13) to the female gender, with an average age of 60 years. In the COVID19 severity classification the evaluated patients presented in the following condition mild 25% (8), moderate 69% (22) and severe 6% (2). The diagnostic method used was detection of anti SARS CoV2 antibodies 56% (17) and TR-PCR 43% (14). 75% (24) received steroids, 8.69% (2) of the patients who used steroids in their management had hyperglycemia and required management with regular insulin. 100% (32) of the patients who were treated recovered without registering any death. Conclusions: are that the pathophysiological factors of DM2 in relation to the immune system of patients can be a determining factor to present a degree of severity greater than that presented by the general population that falls ill with COVID19. Adequate glycemic control can determine a better prognosis in the evolution of the disease despite its degree of severity.

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Potential for transmission of Elizabethkingia anophelis by Aedes albopictus and the role of microbial interactions in Zika virus competence

10.1101/702464 ◽

2019 ◽

Author(s):

MG Onyango ◽

AF Payne ◽

J Stout ◽

C Dieme ◽

L Kuo ◽

...

Keyword(s):

Zika Virus ◽

Inhibitory Effect ◽

Microbial Interactions ◽

Morbidity And Mortality ◽

Source Of Infection ◽

Vector Borne ◽

Complex Relationships ◽

The Impact ◽

First Time ◽

Transmission Barrier

AbstractElizabethkingia anophelis has been the cause of four outbreaks with significant morbidity and mortality. Its transmission routes remain unknown and no point source of infection has been identified. Here we show that E. anophelis can be found in the saliva of Aedes mosquitoes, suggesting the novel possibility of vector-borne transmission of this bacterium. We additionally characterized diverse microbial communities in Aedes midguts, salivary glands and saliva. To the best of our knowledge, this represents the first description of the microbiome of Aedes saliva. Further, we demonstrate that increased abundance of E. anophelis is associated with decreased susceptibility and replication of Zika virus (ZIKV) in the midgut of Aedes mosquitoes, suggesting a novel transmission barrier for arboviruses transmitted by Aedes mosquitoes. Together, these results demonstrate the complex relationships between the mosquito, the midgut microbial community and arboviruses and offer insights into the epidemiology and control of emerging bacterial and viral pathogens.Author SummaryElizabethkingia anophelis has in the recent past caused outbreaks different parts of the world resulting both in morbidity and mortality. Until now, to the best of our knowledge, no study has been able to demonstrate that this bacterium can be transmitted by mosquitoes. We have demonstrated for the first time that Elizabethkingia anophelis is present in the saliva of both infected and non-infected Aedes mosquitoes. Further, we have shown that it confers an inhibitory effect on Zika virus establishment in the midguts of Aedes mosquitoes. Together, these results potentially display the potential for vector borne transmission of E. anophelis as well as a novel transmission barrier of ZIKV. Lastly, we have for the first time characterized salivary microbes of Aedes mosquitoes necessitating the investigation of the impact of salivary microbes in severity of disease in vertebrate hosts.

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Determination of Neuromuscular Control of the Upper Limbs in Children - Case Study

BRAIN. BROAD RESEARCH IN ARTIFICIAL INTELLIGENCE AND NEUROSCIENCE ◽

10.18662/brain/11.4sup1/155 ◽

2020 ◽

Vol 11 (4Sup1) ◽

pp. 46-61

Author(s):

Carmen-Magdalena Camenidis ◽

◽

Irina Băițel ◽

Amalia Oatu ◽

Octavian Amzulescu ◽

...

Keyword(s):

Kinematic Chain ◽

Neuromuscular Control ◽

Female Gender ◽

Upper Limbs ◽

Motor Action ◽

Muscle Groups ◽

The Moment ◽

The Right

The objective of this case study is to observe the existence of an anticipation mechanism at the muscle groups level of the upper limbs. We tried to highlighted this anticipation process by measuring the potential of surface electric for some muscle groups representing the kinematic chain on the right side, involved in the motor action of catching a basketball and a 3kg medicine ball with two hands to the chest. We conducted a case study of a 13-year-old child, female gender. As a measurement method, we used surface electromyography signals of the EMG Trigno Delsys wireless system with 16 electrodes. We determined the moment when the muscles come into action by increasing the potential of surface electric and the moment when the action of catching the ball takes place, using the information provided by the accelerometers incorporated in the sensors of the Delsys equipment used. Therefore, we obtained information about how different muscle groups come into action which helped us to get an idea of how the child's movement is structured. Based on results of accelerations and EMG signals acquired we have formulated conclusions regarding the neuromuscular control of the tested subject. We also planned for the future to test a larger group of participants in the study research of anticipation mechanism in children who do not practice any performance sports.

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Separate Consent for Anesthetic Practice: Need of the Moment

Journal of Institute of Medicine ◽

10.3126/jiom.v42i3.37571 ◽

2020 ◽

Vol 42 (3) ◽

pp. 1-6

Author(s):

Anil Shrestha ◽

Gentle S Shrestha ◽

Saurabh Pradhan ◽

Pankaj Joshi

Keyword(s):

Critical Care ◽

Pain Management ◽

Older Patients ◽

Morbidity And Mortality ◽

Daily Routine ◽

Anaesthetic Practice ◽

Patient Morbidity ◽

Enormous Amount ◽

Primary Physicians ◽

The Moment

Decades of refinement and modifications have led the modern anaesthetic practice to be conducted so smoothly and safely, that sometimes we take for granted the enormous amount of risks involved with it. Furthermore, with the evolution of monitoring techniques, and discovery of safer drugs, anesthesia has facilitated the conduction of complex surgeries on sicker patients, and older patients. The expansion to critical care and pain management services has added another dimension to this field, with anesthesiologists not just working as facilitators for another procedure, but acting as primary physicians. Anesthesiologists are among the few clinicians, who are involved in patient morbidity and mortality in their daily routine. With the ever-changing ethical and legal background, the significance of obtaining a separate consent for anesthesia needs to be timely evaluated. In this review, we have discussed the significance of a separate consent for anesthesia and highlight its various aspects.

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The Relevance of a Physical Active Lifestyle and Physical Fitness on Immune Defense: Mitigating Disease Burden, With Focus on COVID-19 Consequences

Frontiers in Immunology ◽

10.3389/fimmu.2021.587146 ◽

2021 ◽

Vol 12 ◽

Author(s):

Tayrine Ordonio Filgueira ◽

Angela Castoldi ◽

Lucas Eduardo R. Santos ◽

Geraldo José de Amorim ◽

Matheus Santos de Sousa Fernandes ◽

...

Keyword(s):

Physical Activity ◽

Physical Exercise ◽

Physical Fitness ◽

Bed Rest ◽

Multiple Organ ◽

Immune Defense ◽

Sitting Time ◽

Low Grade ◽

Home Based ◽

Effective Therapeutic Strategy

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a fast spreading virus leading to the development of Coronavirus Disease-2019 (COVID-19). Severe and critical cases are characterized by damage to the respiratory system, endothelial inflammation, and multiple organ failure triggered by an excessive production of proinflammatory cytokines, culminating in the high number of deaths all over the world. Sedentarism induces worse, continuous, and progressive consequences to health. On the other hand, physical activity provides benefits to health and improves low-grade systemic inflammation. The aim of this review is to elucidate the effects of physical activity in physical fitness, immune defense, and its contribution to mitigate the severe inflammatory response mediated by SARS-CoV-2. Physical exercise is an effective therapeutic strategy to mitigate the consequences of SARS-CoV-2 infection. In this sense, studies have shown that acute physical exercise induces the production of myokines that are secreted in tissues and into the bloodstream, supporting its systemic modulatory effect. Therefore, maintaining physical activity influence balance the immune system and increases immune vigilance, and also might promote potent effects against the consequences of infectious diseases and chronic diseases associated with the development of severe forms of COVID-19. Protocols to maintain exercise practice are suggested and have been strongly established, such as home-based exercise (HBE) and outdoor-based exercise (OBE). In this regard, HBE might help to reduce levels of physical inactivity, bed rest, and sitting time, impacting on adherence to physical activity, promoting all the benefits related to exercise, and attracting patients in different stages of treatment for COVID-19. In parallel, OBE must improve health, but also prevent and mitigate COVID-19 severe outcomes in all populations. In conclusion, HBE or OBE models can be a potent strategy to mitigate the progress of infection, and a coadjutant therapy for COVID-19 at all ages and different chronic conditions.

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Aktywność kobiet w wyborach na urząd prezydenta miasta Rzeszowa w latach 2002–2018

Polityka i Społeczeństwo ◽

10.15584/polispol.2020.2.9 ◽

2020 ◽

Vol 18 (2) ◽

pp. 124-145

Author(s):

Małgorzata Niewiadomska-Cudak ◽

Keyword(s):

Local Government ◽

Local Politics ◽

Female Gender ◽

The Political ◽

Representation Of Women ◽

Direct Election ◽

Participation Of Women ◽

Enforcement Authority ◽

The Moment ◽

The City

The article deals with the activity of women in the elections to the enforcement authority in Rzeszów over the period of 16 years, i.e. from the moment the act on the direct election of a commune head, town mayor and president came into force. An attempt was made to analyze the women's electoral participation in the candidacy for the position of mayor or president from the political science perspective. The choice of the place of this city is not without significance, as the feminization rate (the women’s involvement in local government authorities in cities with poviat status), indicates that Rzeszów came 62 out of 66 cities (Swianiewicz, Łukomska, 2020, s. 9). Examining the representation of female voters in five elections not only gauges the phenomenon of female gender participation, but also helps to understand the problem of under-representation of women among presidents at the city level with poviat rights. The article complements the discussions on the participation of women in local government authorities, but also fills a significant cognitive gap in research on the representation of women in local politics.

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Cessation of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation

Heart ◽

10.1136/heartjnl-2020-317418 ◽

2020 ◽

pp. heartjnl-2020-317418

Author(s):

Melissa E Middeldorp ◽

Aashray Gupta ◽

Adrian Elliott ◽

Kadhim Kadhim ◽

Anand Thiyagarajah ◽

...

Keyword(s):

Atrial Fibrillation ◽

Adverse Events ◽

Vitamin K ◽

Oral Anticoagulants ◽

Female Gender ◽

Vitamin K Antagonist ◽

Serious Adverse Events ◽

Care Clinic ◽

Multivariable Analyses

ObjectiveTo characterise the rate, causes and predictors of cessation of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF).Patients and methodsConsecutive patients with AF with a long-term anticoagulation indication treated with NOACs (dabigatran, apixaban and rivaroxaban) in our centre from September 2010 through December 2016 were included. Prospectively collected data with baseline characteristics, causes of cessation, mean duration-to-cessation and predictors of cessation were analysed.ResultsThe study comprised 1415 consecutive patients with AF, of whom 439 had a CHA2DS2-VASc≥1 and were on a NOAC. Mean age was 71.9±8.7 years and 37% were females. Over a median follow-up of 3.6 years (IQR=2.7–5.3), 147 (33.5%) patients ceased their index-NOAC (113 switched to a different form of OAC), at a rate of 8.8 per 100 patient-years. Serious adverse events warranting NOAC cessation occurred in 28 patients (6.4%) at a rate of 1.6 events per 100 patient-years. The mean duration-to-cessation was 4.9 years (95% CI 4.6 to 5.1) and apixaban had the longest duration-to-cessation with (5.1, 95% CI 4.8 to 5.4) years, compared with dabigatran (4.6, 95% CI 4.2 to 4.9) and rivaroxaban (4.5, 95% CI 3.9 to 5.1), pairwise log-rank p=0.002 and 0.025, respectively. In multivariable analyses, age was an independent predictor of index-NOAC cessation (HR 1.03, 95% CI 1.01 to 1.05; p=0.006). Female gender (HR 2.2, 95% CI 1.04 to 4.64; p=0.04) independently predicted serious adverse events.ConclusionIn this ‘real world’ cohort, NOAC use is safe and well-tolerated when prescribed in an integrated care clinic. Whether apixaban is better tolerated compared with other NOACs warrants further study.

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Duns Scotus on the Female Gender

10.1093/oxfordhb/9780199664153.013.009 ◽

2014 ◽

Author(s):

Marilyn McCord Adams

Keyword(s):

Female Gender ◽

Original Sin ◽

Gender Justice ◽

Duns Scotus ◽

Immaculate Conception ◽

Marriage Contract ◽

Right Reason ◽

The Moment

Scotus’ estimate of the female gender is shaped by his view that Mary is pre-eminent among merely human saints. Because Mary must be a real mother, he rejects the Aristotelian view that mothers are merely passive causes in reproduction. Christ’s most perfect saving act preserves Mary for immaculate conception, freedom from original sin, not just from birth but from the moment of foetal animation. Gender-justice is important in the marriage contract, even though God never dispenses from life-long indissoluble monogamy to allow polyandry or to permit women to divorce. The Franciscan distinction between dominion and use allows Mary and Joseph to be really married even though both vowed chastity. Gender-justice means that right reason would never permit merely human institutions from restricting ordination to men. The command must come from Christ himself.

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Inflammatory Microenvironment and Adipogenic Differentiation in Obesity: The Inhibitory Effect of Theobromine in a Model of Human Obesity In Vitro

Mediators of Inflammation ◽

10.1155/2019/1515621 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 12

Author(s):

Maria Pia Fuggetta ◽

Manuela Zonfrillo ◽

Cristina Villivà ◽

Enzo Bonmassar ◽

Giampiero Ravagnan

Keyword(s):

Adipose Tissue ◽

Proinflammatory Cytokines ◽

Adipogenic Differentiation ◽

Inhibitory Effect ◽

Low Grade ◽

Tissue Inflammation ◽

Inflammatory Microenvironment ◽

Adipocyte Cell ◽

Inflammatory State

Objective. Obesity is considered a clinic condition characterized by a state of chronic low-grade inflammation. The role of macrophages and adipocytokines in adipose tissue inflammation is in growing investigation. The physiopathological mechanisms involved in inflammatory state in obesity are not fully understood though the adipocytokines seem to characterize the biochemical link between obesity and inflammation. The aim of this work is to analyze the effect of theobromine, a methylxanthine present in the cocoa, on adipogenesis and on proinflammatory cytokines evaluated in a model of fat tissue inflammation in vitro. Methods. In order to mimic in vitro this inflammatory condition, we investigated the interactions between human-like macrophages U937 and human adipocyte cell lines SGBS. The effect of theobromine on in vitro cell growth, cell cycle, adipogenesis, and cytokines release in the supernatants has been evaluated. Results. Theobromine significantly inhibits the differentiation of preadipocytes in mature adipocytes and reduces the levels of proinflammatory cytokines as MCP-1 and IL-1β in the supernatants obtained by the mature adipocytes and macrophages interaction. Conclusion. Theobromine reduces adipogenesis and proinflammatory cytokines; these data suggest its potential therapeutic effect for treating obesity by control of macrophages infiltration in adipose tissue and inflammation.

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Vascular inflammation in hypertension and diabetes: molecular mechanisms and therapeutic interventions

Clinical Science ◽

10.1042/cs20060247 ◽

2007 ◽

Vol 112 (7) ◽

pp. 375-384 ◽

Cited By ~ 217

Author(s):

Carmine Savoia ◽

Ernesto L. Schiffrin

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Metabolic Disorders ◽

Molecular Mechanisms ◽

Vascular Inflammation ◽

Cardiovascular Morbidity ◽

Morbidity And Mortality ◽

Low Grade ◽

Cardiovascular Morbidity And Mortality

More than 80% of patients with type 2 diabetes mellitus develop hypertension, and approx. 20% of patients with hypertension develop diabetes. This combination of cardiovascular risk factors will account for a large proportion of cardiovascular morbidity and mortality. Lowering elevated blood pressure in diabetic hypertensive individuals decreases cardiovascular events. In patients with hypertension and diabetes, the pathophysiology of cardiovascular disease is multifactorial, but recent evidence points toward the presence of an important component dependent on a low-grade inflammatory process. Angiotensin II may be to a large degree responsible for triggering vascular inflammation by inducing oxidative stress, resulting in up-regulation of pro-inflammatory transcription factors such as NF-κB (nuclear factor κB). These, in turn, regulate the generation of inflammatory mediators that lead to endothelial dysfunction and vascular injury. Inflammatory markers (e.g. C-reactive protein, chemokines and adhesion molecules) are increased in patients with hypertension and metabolic disorders, and predict the development of cardiovascular disease. Lifestyle modification and pharmacological approaches (such as drugs that target the renin–angiotensin system) may reduce blood pressure and inflammation in patients with hypertension and metabolic disorders, which will reduce cardiovascular risk, development of diabetes and cardiovascular morbidity and mortality.

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Characterization of the Quorum Sensing Regulon in Acidithiobacillus ferrooxidans

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.825.129 ◽

2013 ◽

Vol 825 ◽

pp. 129-132 ◽

Cited By ~ 1

Author(s):

Sigde Mamani ◽

Yan Denis ◽

Danielle Moinier ◽

Mohamad Sabbah ◽

Laurent Soulère ◽

...

Keyword(s):

Cell Adhesion ◽

Quorum Sensing ◽

Acidithiobacillus Ferrooxidans ◽

Operating Cost ◽

Second Step ◽

Low Grade ◽

Mineral Surface ◽

Homoserine Lactones ◽

The Moment

Bioleaching is the solubilization of metals from ores by microorganisms. This process is more efficient than conventional methods in the metal recovery from low grade ores while decreasing the operating cost and the environmental impact. Among the bioleaching bacteria, the Gram-negative chemolithoautotrophic acidophilic Acidithiobacillus ferrooxidans has the ability to adhere to mineral surface and to form biofilm. The genes involved in the production of this biofilm are controlled by a cellular communication system called Quorum Sensing (QS). The QS occurs mainly through the production of acyl homoserine lactones (AHLs). A functional QS system has been identified in At. ferrooxidans with an acyl synthase (AfeI) and a transcriptional regulator (AfeR). Here, our purpose is to characterize the quorum sensing regulon and particularly the genes involved in biofilm formation in At. ferrooxidans. This has been done by cell adhesion experiments comparing At. ferrooxidans grown with or without Tetrazol, an AHL analogue that activates the cell adhesion to mineral surface. The second step has been to compare the expression of some genes predicted to be involved in the QS regulon in At. ferrooxidans grown in the presence/absence of Tetrazol using real-time PCR. These two different strategies are expected to give insight on the moment at which the At. ferrooxidans QS regulon is switched on. The formation of biofilm could improve the bioleaching operation and therefore the understanding of the QS regulon is of primordial importance.

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