Peculiarities of the COVID-19 course and consequences in overweight and obese patients. Lessons from the current pandemic

Treatment difficulties of COVID-19 have determined the need to identify predictive risk factors for the development of a complicated disease course, critical conditions and death. Endocrine and metabolic abnormalities associated with obesity, including impaired insulin sensitivity, chronic inflammation and impaired lipid and fatty acid metabolism, increase immunological dysregulation and make these patients more susceptible to developing infectious diseases. Research data allows us to single out obesity as a risk factor for the aggravated course of COVID-19, as well as a longer period before the virus elimination, and, therefore, the risk of virus transmission. Potentiation of cardiovascular risk factors, an increase in the production of pro-inflammatory cytokines, coagulopathy are factors in the development of unfavorable outcomes in such patients.This review presents literature data on the features of the course and the mechanisms of development of complications in patients with new coronavirus infection and obesity. Taking into account the need to restore metabolic health to increase the adaptive and resistant capacities of the body in the face of the threat of a new increase in the prevalence of COVID-19, the possibilities of treating obesity using a combined preparation containing sibutramine and metformin in one tablet, are discussed.

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Endocrinopathies in the era of coronavirus infection

Public health of the Far East Peer-reviewed scientific and practical journal ◽

10.33454/1728-1261-2021-3-41-44 ◽

2021 ◽

Vol 3 (89) ◽

pp. 41-44

Author(s):

O.V. Ushakova ◽

◽

E.Yu. Pyankova ◽

N.N. Masalova ◽

O.V. Serebryakova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Risk Factor ◽

Fatty Acid ◽

Metabolic Disorders ◽

Acid Metabolism ◽

Critical Conditions ◽

Virus Elimination ◽

Coronavirus Infection ◽

Pro Inflammatory Cytokines

Difficulties in the treatment of COVID-19 have determined the need to systematize the factors for the development of complications, critical conditions and death. Endocrine and metabolic disorders associated with obesity, insulin resistance, chronic inflammation, and lipid and fatty acid metabolism disorders increase immunological dysregulation and make these patients vulnerable to infection. The data from the observations made it possible to single out diabetes mellitus, obesity as a risk factor aggravating the course of COVID-19, and to state the duration of the virus elimination period, potentiation of cardiovascular diseases, an increase in the production of pro-inflammatory cytokines, coagulopathy - factors in the development of unfavorable outcomes. The article presents generalized data on the organization of medical care for patients with endocrine pathology during the coronavirus pandemic

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Pediatric dog bites: a population-based profile

Injury Prevention ◽

10.1136/injuryprev-2017-042621 ◽

2018 ◽

Vol 25 (4) ◽

pp. 290-294 ◽

Cited By ~ 4

Author(s):

Jackson Fein ◽

David Bogumil ◽

Jeffrey S Upperman ◽

Rita V Burke

Keyword(s):

Risk Factors ◽

Data Bank ◽

Population Based ◽

The Body ◽

Body Region ◽

Cross Sectional ◽

Dog Bites ◽

Severity Of Injury ◽

The Face ◽

At Home

BackgroundPrevious studies have identified risk factors for dog bites in children, but use data from individual trauma centers, with limited generalizability. This study identifies a population risk profile for pediatric dog bites using the National Trauma Data Bank. We hypothesized that the population at risk was younger boys, that such bites occur at home, are moderately severe, and are on the face or neck.MethodsFor this retrospective cross-sectional study, a sample of 7912 children 17 years old and younger with International Classification of Diseases (ICD)-9 event code E906.0, for dog bites, were identified. Datasets from 2007 to 2014 were used. Data included patient’s gender, age, ICD-9 primary and location E-codes, AIS body region and AIS severity.ResultsMost children were 6–12 years old and female, but a similar number fell into the narrower range of 0–2 years old. Injuries in the younger group frequently occurred at home, on the face and head, and with minor severity. Age of the child predicts the location of incident (P<0.001), the severity of injury (P<0.001) and the body region of the injury (P<0.001). Body region of the injury predicted its severity (P<0.001).DiscussionYounger children are more likely to receive dog bites, and bites incurred are likely of greater severity. Children this young cannot yet be taught how to properly interact with a dog.ConclusionsDog bites are a significant source of morbidity for children. Based on the population risk factors profile generated, this study recommends targeting live dog education towards the parents of young children.

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Perianal Basal Cell Carcinoma

Case Reports in Dermatology ◽

10.1159/000380847 ◽

2015 ◽

Vol 7 (1) ◽

pp. 25-28 ◽

Cited By ~ 4

Author(s):

Isil Bulur ◽

Emine Boyuk ◽

Zeynep Nurhan Saracoglu ◽

Deniz Arik

Keyword(s):

Risk Factors ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

The Body ◽

Additional Risk ◽

Closed Area ◽

Non Melanoma Skin Cancer ◽

The Face ◽

Melanoma Skin

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. Exposure to ultraviolet light is an important risk factor for BCC development and the disorder therefore develops commonly on body areas that are more exposed to sunlight, such as the face and neck. It is uncommon in the closed area of the body and quite rare in the perianal and genital regions. Herein, we report a 34-year-old patient with perianal BCC who had no additional risk factors.

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Pathogenetic mechanisms of sensorineural hearing loss in patients with COVID-19 and methods for their correction

INTERNATIONAL NEUROLOGICAL JOURNAL ◽

10.22141/2224-0713.17.7.2021.245560 ◽

2021 ◽

Vol 17 (7) ◽

pp. 20-26

Author(s):

M.A. Trishinska ◽

O.Ye. Kononov

Keyword(s):

Risk Factors ◽

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Therapeutic Approach ◽

Brain Structures ◽

Sensorineural Hearing ◽

Pathogenetic Mechanisms ◽

Coronavirus Infection ◽

Mechanisms Of Development ◽

The Brain

The article describes the main pathogenetic mechanisms of acute sensorineural hearing loss, including that caused by infection. Possible risk factors and mechanisms of development of sensorineural hearing loss against the background of coronavirus infection caused by SARS-CoV-2 virus are consi-dered. Cases of hearing loss in patients with COVID-19 have been described. The pathogenetically substantiated therapeutic approach to the treatment of such patients is presented, it is based on the optimization of acetylcholine neurotransmission in the brain structures involved in the conduction and perception of the auditory impulse.

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The Effect of Nosocomial Infection on the Severity and Outcome of the Disease in Patients with Severe and Extremely Severe COVID-19

Messenger of Anesthesiology and Resuscitation ◽

10.21292/2078-5658-2021-18-6-15-21 ◽

2021 ◽

Vol 18 (6) ◽

pp. 15-21

Author(s):

L. M. Kalmanson ◽

I. V. Shlyk ◽

Yu. S. Polushin ◽

O. V. Stanevich ◽

A. A. Galkina

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Renal Replacement Therapy ◽

Kidney Disease ◽

Demographic Data ◽

Infectious Complications ◽

Disease Outcome ◽

Cardiovascular Pathology ◽

Coronavirus Infection ◽

Mechanisms Of Development

The mechanisms of development of nosocomial infectious complications in COVID-19 and the contribution of bacterial and mycotic superinfection to the formation of extremely high mortality among patients with severe and extremely severe course of this disease have not yet been fully revealed. The objective: to study epidemiology, risk factors for the development of nosocomial superinfection, and its effect on the severity and outcome of the disease in patients with COVID-19.Subjects and Methods. 383 cases of severe and extremely severe COVID-19 were retrospectively analyzed. Demographic data, the presence of concomitant diseases, community-acquired co-infection at the time of hospitalization, data on the methods used to treat new coronavirus infection, severity of the course of the disease, developed infectious complications and their etiology, and the disease outcome were studied. Risk factors for the development of secondary infectious complications and the contribution of nosocomial superinfection to the severity of COVID-19 and the disease outcome were evaluated.Results. Risk factors for the development of secondary infectious complications include age over 65 years (OR 1.04; 95% CI 1.03–1.06; p < 0.0001), concomitant cardiovascular pathology (OR 3.82; 95% CI 2.02‒7.19; p < 0.0001), chronic kidney disease, including requiring renal replacement therapy (OR 2.01; 95% CI 1.33–3.02; p = 0.0007), and glucocorticoid therapy (OR 1.62; 95% CI 1.02–2.69; p = 0.04). The development of nosocomial infectious complications in patients with COVID-19 is associated with a more severe course of the disease and unfavorable prognosis (OR 13.44; 95% CI 8.23‒21.92; p < 0.0001).Conclusion. Identification of risk factors for the development of secondary infectious complications in COVID-19 allows developing differentiated approaches to the pathogenetic treatment of patients with severe COVID-19, increasing alertness in terms of the development of nosocomial infections, ensuring their timely diagnosis and treatment.

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Scar Contractures

Textbook on Scar Management ◽

10.1007/978-3-030-44766-3_13 ◽

2020 ◽

pp. 117-122

Author(s):

Marguerite Guillot Masanovic ◽

Luc Téot

Keyword(s):

Risk Factors ◽

Wound Healing ◽

Horizontal Plane ◽

Functional Limitations ◽

Skin Grafting ◽

The Body ◽

The Matrix ◽

The Face ◽

Skin Retraction ◽

Extensive Burns

AbstractScar retractions occurring on mobile areas on the body surface, like the neck, the joints, the hand, and the face may induce functional limitations in skin availability during movements. Extensive burns, trauma, and infected wounds may be found as risk factors. The activation of populations of myofibroblasts may explain the occurrence of skin contracture, as they mechanically act on the matrix and induce skin retraction (Kwan and Tredget, Hand Clin 33(2):277–292, 2017). Pathological consequences of the contractures may vary from a moderate limitation of movement over a digital joint to a permanent neck contracture impairing eye vision in the horizontal plane. The shortage of skin capacity may vary from 2 to 10 cm. Most of the contractures respond to an active early treatment when there is an early diagnosis at 1 month after wound healing, but if diagnosed later specific surgical procedures are needed, like skin grafting, local or regional flaps, but also complex microsurgical flaps. Specific indications depend on the necessity to restore the function.

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Covid-19 and its relationship with kidney diseases: a scope review

Journal of Human Growth and Development ◽

10.36311/jhgd.v31.12782 ◽

2021 ◽

Vol 31 (3) ◽

pp. 533-548

Author(s):

Jennifer Soanno Marchiori ◽

Miguel Athos Da Silva De Oliveira ◽

Italla Maria Pinheiro Bezerra

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Kidney Diseases ◽

Renal Involvement ◽

Kidney Injury ◽

The Body ◽

Warning Signs ◽

Constant Attention ◽

Disease Evolution ◽

Coronavirus Infection

Background: COVID-19 is an acute respiratory disease originally from China that emerged in December 2019 and quickly spread around the world, affecting 230,418.415 people, and causing 4,724,876 deaths. Coming from the coronavirus family, SARS-CoV-2 is a new subtype of virus that affects the respiratory tract in different levels and can spread and affect other vital structures in the body. Objective: To identify the risk factors that lead patients infected by the new coronavirus to develop kidney disease. Methods: This is a systematic review of the Scoping Review type (scope review), according to the method proposed by the Joanna Briggs Institute, with the implementation of a checklist structured by PRISMA-ScR that contains 22 mandatory items. The following descriptors were used: coronavirus infection, acute kidney injury and risk factors in five databases, namely PudMed, Scopus, Embase, Virtual Health Library and Web of Science. Results: While reading the studies, it was concluded that Acute Kidney Injury was the main renal finding in patients contaminated by SARS-CoV-2. The risk factors for developing renal worsening in patients with COVID-19 were the extremes of age, race, sex, pre-existing diseases, and the disease evolution. Conclusion: It is assumed that renal involvement does not occur only for an exclusive reason, but as a set of factors. It is up to the health team to pay constant attention to the warning signs by monitoring the contaminated patient.

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Three cases of Pontine Ischemic Syndrome Analysis (Millard-Gubler)

10.5327/1516-3180.088 ◽

2021 ◽

Author(s):

Camila Maria Bezerra Holanda ◽

Maurus Marques de Almeida Holanda ◽

Maurus Marques de Almeida Holanda Filho ◽

Emílio Pires Diniz Neto ◽

Hannah Pereira Costa ◽

...

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Basilar Artery ◽

Abducens Nerve ◽

Nerve Fibers ◽

The Body ◽

Motor Deficit ◽

The Face ◽

Ischemic Syndrome

Background: Millard-Gubler syndrome is characterized by crossed paralysis affecting the members on one side of the body and the face on the opposite side. It results from the lesion of the medioinferior (base) region of the pons, compromising the corticospinal tract and the facial nerve fibers. This disorder can also be associated with abducens nerve palsy. The finding of this syndrome in patients with a diagnosis of Ischemic Stroke is uncommon. Objectives and Methods: Report the syndrome in 03 patients diagnosed with ischemic stroke in the territory of branches of the basilar artery due to involvement of the circumferential pontine artery that irrigates the tegumentary territory of the VI and VII nerves. Results: The patients presented with facial weakness with deviation of the labial commissure, with convergent strabismus of the eye bulb on the same side, in addition to contralateral motor deficit. A computed tomography revealed a hypodense lesion located anterior to the pons, suggesting ischemic stroke. In the evolution of the cases, one patient developed coma, with brainstem infarction due to thrombosis of the basilar artery, while the other 2 cases evolved without sequelae. The risk factors that led to this event will be discussed and compared. Conclusions: These cases reports have their importance justified by the unusual presentation of this pons stroke, and it reinforces the fundamental role of neurological semiology, assessment of risk factors and image, for correct early diagnostic suspicion and treatment.

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Questions on the role of biofilms for the adaptation of microorganisms to unfavorable environmental factors by the example of P. aeruginosa

Hygiene and Sanitation ◽

10.33029/0016-9900-2020-99-4-379-383 ◽

2020 ◽

Vol 99 (4) ◽

pp. 379-383

Author(s):

Vasily N. Afonyushkin ◽

N. A. Donchenko ◽

Ju. N. Kozlova ◽

N. A. Davidova ◽

V. Yu. Koptev ◽

...

Keyword(s):

Antibiotic Resistance ◽

Environmental Factors ◽

Barrier Function ◽

Infectious Agent ◽

Antagonistic Activity ◽

The Body ◽

Main Function ◽

Pathogenic Potential ◽

The Face

Pseudomonas aeruginosa is a widely represented species of bacteria possessing of a pathogenic potential. This infectious agent is causing wound infections, fibrotic cystitis, fibrosing pneumonia, bacterial sepsis, etc. The microorganism is highly resistant to antiseptics, disinfectants, immune system responses of the body. The responses of a quorum sense of this kind of bacteria ensure the inclusion of many pathogenicity factors. The analysis of the scientific literature made it possible to formulate four questions concerning the role of biofilms for the adaptation of P. aeruginosa to adverse environmental factors: Is another person appears to be predominantly of a source an etiological agent or the source of P. aeruginosa infection in the environment? Does the formation of biofilms influence on the antibiotic resistance? How the antagonistic activity of microorganisms is realized in biofilm form? What is the main function of biofilms in the functioning of bacteria? A hypothesis has been put forward the effect of biofilms on the increase of antibiotic resistance of bacteria and, in particular, P. aeruginosa to be secondary in charcter. It is more likely a biofilmboth to fulfill the function of storing nutrients and provide topical competition in the face of food scarcity. In connection with the incompatibility of the molecular radii of most antibiotics and pores in biofilm, biofilm is doubtful to be capable of performing a barrier function for protecting against antibiotics. However, with respect to antibodies and immunocompetent cells, the barrier function is beyond doubt. The biofilm is more likely to fulfill the function of storing nutrients and providing topical competition in conditions of scarcity of food resources.

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