scholarly journals Outcomes of the New COVID-19 Coronavirus Infection in 68 Patients with Inflammatory Bowel Diseases

2020 ◽  
Vol 75 (5S) ◽  
pp. 406-413
Author(s):  
Anna V. Kagramanova ◽  
Oleg V. Knyazev ◽  
Alexei V. Veselov ◽  
Tatyana V. Shkurko ◽  
Irina A. Li ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Statistical Significance ◽  
Blood Analysis ◽  
Lung Damage ◽  
Negative Consequences ◽  
Wide Range ◽  
Significant Difference ◽  
Inflammatory Bowel ◽  
Coronavirus Infection ◽  
Severe Lung

Background. COVID-19 is an infectious respiratory syndrome with a wide range of manifestations and outcomes. Patients with inflammatory bowel disease (IBD) generally have a higher risk of infection, especially if they receive immunosuppressive therapy. Aim to describe the manifestations of COVID-19 in patients with IBD and to determine the risk factors for severe COVID-19. Methods. The analysis included 68 patients with an established diagnosis of Crohns disease (CD) or ulcerative colitis and a confirmed new coronavirus infection. The diagnosis of coronavirus infection was established when SARS-CoV-2 was detected by PCR using nasopharyngeal smears, and computer tomography (CT) of the chest revealed inflammatory changes characteristic of coronavirus lung damage or high IgG and IgM titers based on the results of immunological blood analysis. Results. 68 patients with IBD and COVID-19 were observed in the Department of IBD, including 27 (39.7%) patients with CD, 41 (60.3%) patients with UC. Among patients diagnosed with pneumonia, 100 % of patients received therapy with thiopurines and infliximab. 8 (11.8%) patients were diagnosed with COVID-19 during hospitalization for a severe IBD attack. There was no statistically significant difference between UC and CD patients in terms of disease activity (p = 0.13) during the period of coronavirus infection. In 37 patients (26 UC, 11 BC) with pneumonia (100%), there was an exacerbation of IBD. Statistical significance was found between the development of more severe lung damage (CT 34) and IBD activity at the time of diagnosis of COVID-19 (p 0.001), the presence of comorbidities (p 0.001) and taking GCS (p 0.001) at the time of detection of COVID-19. However, the use of biological and immunosuppressive therapy was not associated with a higher risk of severe lung damage and the need for a ventilator. It was shown that the age of patients over 65 years was statistically correlated with the need for a ventilator (p = 0.02). Conclusion. The exacerbation of the disease, especially in elderly patients with comorbidities, the use of glucocorticosteroids was associated with negative consequences of COVID-19, while biological and immunosuppressant drugs used for the treatment of IBD did not have such a negative effect.

REACTIVATION OF HEPATITIS B IN PATIENTS RECOVERING FROM COVID-19

Vestnik ◽  
2021 ◽  
pp. 151-155
Author(s):  
Ж.С. Шерияздан ◽  
Н.Б. Байжигитова ◽  
У.А. Тургынбаева ◽  
Г.М. Курманова ◽  
Ш.А. Танкаева ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Cytopathic Effect ◽  
Gastrointestinal Disease ◽  
Lung Damage ◽  
Persistent Infections ◽  
Immune Mediated ◽  
Coronavirus Infection ◽  
The Moment ◽  
Severe Lung

Пандемия новой короновирусной инфекции, вызванной вирусом SARS-CoV-2, явилась вызовом системе здравоохранения во всем мире. На данный момент мы обладаем большей информацией об этом заболевании, проявляющемся в основном симптомами респираторной инфекции, от легких проявлении ОРВИ до тяжелого поражения легких. Также коронавирусная инфекция проявляется симптомами поражения ЖКТ чаще всего в виде рвоты, диареи и боли в животе. Кроме того, за год наблюдении, начиная с самого начала пандемии в Китае, описаны нарушения функции печени различного генеза у пациентов с коронавирусной инфекцией. Среди возможных причин называются прямое цитопатическое действие вируса, способного связываться с AПФ2β рецепторам гепато-билиарной системы, иммуноопосредованное повреждение гепатоцитов, в том числе при «цитокиновом шторме» и гепатотоксичности препаратов, применяемых при коронавирусной инфекции. Кроме этих механизмов повреждения печени есть еще реактивация хронических персистирующих инфекции. В частности, речь идет о реактивации хронического гепатита В. Статей, описывающих такие случаи, значительно меньше, чем тех, которые практически детально описывают различные изменения ферментов печени у пациентов, наблюдавшихся с коронавирусной инфекцией. Кроме бремени инфекции в манифестный период, есть не менее тяжелые последствия у реконвалесцентов или у тех, кто перенес заболевание в легкой форме, о чем мы и должны помнить, чтобы принимать необходимые меры в ближайшем и отдаленном периоде выздоровления после COVID-19. В данной статье мы приводим собственные наблюдения реактивации хронического гепатита В у 4 пациентов, перенесших COVID-19 в манифестной форме. The pandemic of the new coronavirus infection caused by the SARS-CoV-2 virus is a challenge to the health system around the world. At the moment, we have more information about this disease, which is manifested mainly by symptoms of a respiratory infection, from mild manifestations of ARVI to severe lung damage. Also, coronavirus infection often manifests itself as symptoms of a gastrointestinal disease, in the form of vomiting, diarrhea and abdominal pain. In addition, over a year of observation, starting from the very beginning of the pandemic in China, liver dysfunctions of various origins have been described in patients with coronavirus infection. Possible reasons include the direct cytopathic effect of the virus capable of binding to ACE2β receptors of the hepato-biliary system, immune-mediated damage to hepatocytes, including during a "cytokine storm" and hepatotoxicity of drugs used in coronavirus infection. In addition to these mechanisms of liver damage, there is also a reactivation of chronic persistent infections. In particular, we are talking about the reactivation of chronic hepatitis B. In addition to the burden of infection in the manifest period, there are no less severe consequences for convalescents or those who have suffered a mild illness, which we must remember in order to take the necessary measures in the near and distant period of recovery after COVID -19. In this article, we present our own observations of the reactivation of chronic hepatitis in 4 patients who underwent manifest COVID-19.

Hematological indicators for lung damage caused by COVID-19 infection

2020 ◽  
Vol 65 (11) ◽  
pp. 676-682
Author(s):  
E. A. Borodulina ◽  
Zh. P. Vasneva ◽  
B. E. Borodulin ◽  
E. S. Vdoushkina ◽  
L. V. Povalyaeva ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Blood Analysis ◽  
Lung Damage ◽  
Pcr Analysis ◽  
Coronavirus Infection ◽  
Ct Data ◽  
Group 2 ◽  
Hematological Indicators ◽  
Lung Tissue Damage ◽  
Damage Characteristic

During the pandemic of a new coronavirus infection one of the most serious complications is pneumonia. When entering a specialized pulmonology Department, the presence of pneumonia is confirmed by computed tomography (CT), the etiology is confirmed by the detection of SARS-CoV-2 RNA by PCR, the article analyzes the indicators of blood analysis when patients are admitted to the hospital. All admitted patients were divided into 2 groups. Group 1 of the study - with a new coronavirus infection Covid-19, confirmed by the detection of PCR-RNA SARS-CoV-2 (n=27). Group 2 consisted of 65 patients (70.7%) with lung tissue damage characteristic of Covid-19 according to CT, who had a negative analysis of PCR-RNA SARS-CoV-2. Statistically significant deviations were shown in a decrease in the percentage and absolute content of lymphocytes, monocytes and platelets, and an increase in neutrophils. The comparative analysis in the groups with positive and negative PCR analysis for the detection of SARS-CoV-2 RNA showed no statistically significant differences. It can be assumed that with the similarity of clinical manifestations and CT-data, a negative result of PCR-RNA SARS-CoV-2 can be diagnosed as «lung damage caused by COVID-19 infection».

scholarly journals Proinflammatory status of oral fluid in COVID-19

2021 ◽  
Vol 23 (5) ◽  
pp. 1171-1176
Author(s):  
I. A. Borodina ◽  
O. A. Gusyakova ◽  
I. A. Selezneva ◽  
F. N. Gilmiyarova ◽  
A. A. Ereshchenko ◽  
...  
Keyword(s):  
Respiratory Insufficiency ◽  
Inflammatory Process ◽  
Oral Fluid ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Elisa Testing ◽  
Wide Range ◽  
Significant Difference ◽  
Coronavirus Infection

At present, a search for promising ways to diagnose infection caused by SARS-CoV-2 is quite relevant. Oral fluid is not commonly used for assessment of COVID-19 risk. Its molecular profile reflects both local state of the oral cavity, and individual organs and systems, thus suggesting a reliable diagnostic platform. Systemic inflammatory response is known to play a crucial role in development of the coronavirus infection; the “cytokine storm” determines severity of the disease. The saliva-based diagnostics of clinical course in COVID-19 patients includes determination of IL-6, IL-8, C-reactive protein in oral fluid, in order to assess severity of the inflammatory process. The present study was carried out at the Department of Fundamental and Clinical Biochemistry with Laboratory Diagnostics, and Department of Pediatric Infections at the Samara State Medical University. The study involved 122 persons: 67 clinically healthy individuals comprised the control group, and the group of comparison included 55 inpatients with moderate or severe coronavirus infection (COVID-19) caused by SARS-CoV-2 virus as confirmed by PCR and/or ELISA testing. Development of the disease was accompanied by drastically increased contents of IL-6 and IL-8 in oral fluid of the patients relative to the indexes in healthy persons, i.e., several-fold for IL-6 (+ 650%) and even higher elevation of IL-8 levels (+ 26513%), as well as a 2-fold increase of C-reactive protein (+115%). When comparing the immune indexes of oral fluid in presence versus absence of respiratory insufficiency, a significant difference was found for salivary IL-6 (+173%) in the patients with grade 1-2 respiratory insufficiency as compared with patients free of respiratory disorders. Determination of these proinflammatory markers in patients with COVID-19 is of important prognostic significance when assessing development of the disease and its severity. Direct detection of their content in the oral fluid makes this method relevant, and potentially demanded for the outpatient diagnostics, being highly important during pandemics of coronavirus infection and limited medical resources. Examination of oral fluid at the pre-hospital stage is a resource-saving technology, since it does not require additional medical staff to take biomaterial, is non-invasive to the patient, and suggesting a wide range of research items, it can resolve a number of diagnostic issues, e.c., presence of specific genetic material or antibodies to SARS-CoV-2, severity of the inflammatory process and the risk of respiratory failure in the patient.

scholarly journals A Retrospective Study on 1587 Exotic Pets Presented to The Small Animal Veterinary Hospital, University of Tehran

2021 ◽  
Vol 44 ((E0)) ◽  
pp. 1-6
Author(s):  
Naqa S. M Tamimi ◽  
Bahare T. ◽  
Shahram J ◽  
Amir R.
Keyword(s):  
Statistical Significance ◽  
Small Animal ◽  
Disease Diagnosis ◽  
Health Problems ◽  
Common Diagnosis ◽  
Wide Range ◽  
Significant Difference ◽  
Gender Based ◽  
Veterinary Hospital ◽  
Exotic Pets

In recent decades, exotic pets are increasingly invited to homes with a wide range of variation in species and requirements that are more specialized. During a one-year period, 2408 exotic animals admitted to the Small Animal Veterinary Hospital, University of Tehran were assessed. Rabbits, hamsters, squirrels, turtles/tortoises, guinea pigs, lizards, hedgehogs, reindeer, monkeys, and snakes were referred, respectively. Owner referral cause and their gender in addition to the disease diagnosis were analyzed. While no statistical significance (P>0.05) was observed in the total number of men and women presenting these animals, gender-based preferences were spotted for owning specific types of animal species in this study (P<0.05). Furthermore, analysis showed that snakes and rabbits were more commonly (P<0.05) presented for checkup; while chelonians, lizards, hedgehogs, and monkeys were more presented with health problems (P<0.05). Other animals’ results did not show statistically significant difference for admission reasons (P>0.05). The health record assessment included 1587 animals with complete health files. The most common diseases diagnosed in most of these animals were metabolic bone disease/musculoskeletal problems and dental problems. In addition, eye problems in chelonians and urinary problems in hedgehogs were the most common diagnosis of those species. In conclusion, since the most common health problems of most participating animals were associated with mismanagement and inappropriate diet, it is highly recommended that owners be thoroughly educated by veterinarians to reduce the possibility of such conditions in exotic captive animals

scholarly journals The Stanford stereotactic radiosurgery experience on 7000 patients over 2 decades (1999–2018): looking far beyond the scalpel

2021 ◽  
pp. 1-17
Author(s):  
Nida Fatima ◽  
Antonio Meola ◽  
Victoria Y. Ding ◽  
Erqi Pollom ◽  
Scott G. Soltys ◽  
...  
Keyword(s):  
Treatment Modality ◽  
Linear Trend ◽  
Statistical Significance ◽  
Coefficient Of Determination ◽  
Benign Tumors ◽  
Spine Metastases ◽  
Spinal Lesions ◽  
Wide Range ◽  
Significant Difference ◽  
Spinal Arteriovenous Malformations

OBJECTIVE The CyberKnife (CK) has emerged as an effective frameless and noninvasive method for treating a myriad of neurosurgical conditions. Here, the authors conducted an extensive retrospective analysis and review of the literature to elucidate the trend for CK use in the management paradigm for common neurosurgical diseases at their institution. METHODS A literature review (January 1990–June 2019) and clinical review (January 1999–December 2018) were performed using, respectively, online research databases and the Stanford Research Repository of patients with intracranial and spinal lesions treated with CK at Stanford. For each disease considered, the coefficient of determination (r2) was estimated as a measure of CK utilization over time. A change in treatment modality was assessed using a t-test, with statistical significance assessed at the 0.05 alpha level. RESULTS In over 7000 patients treated with CK for various brain and spinal lesions over the past 20 years, a positive linear trend (r2 = 0.80) in the system's use was observed. CK gained prominence in the management of intracranial and spinal arteriovenous malformations (AVMs; r2 = 0.89 and 0.95, respectively); brain and spine metastases (r2 = 0.97 and 0.79, respectively); benign tumors such as meningioma (r2 = 0.85), vestibular schwannoma (r2 = 0.76), and glomus jugulare tumor (r2 = 0.89); glioblastoma (r2 = 0.54); and trigeminal neuralgia (r2 = 0.81). A statistically significant difference in the change in treatment modality to CK was observed in the management of intracranial and spinal AVMs (p < 0.05), and while the treatment of brain and spine metastases, meningioma, and glioblastoma trended toward the use of CK, the change in treatment modality for these lesions was not statistically significant. CONCLUSIONS Evidence suggests the robust use of CK for treating a wide range of neurological conditions.

scholarly journals Course of severe coronavirus (COVID-19) in a patient at risk

2020 ◽  
Vol 24 (3) ◽  
pp. 21-26
Author(s):  
Nikolai I. Kuznetsov ◽  
Valery V. Vasiliev ◽  
Elena S. Romanova ◽  
Galina Yu. Startseva
Keyword(s):  
At Risk ◽  
Patient Management ◽  
Severe Form ◽  
Lung Damage ◽  
Patients At Risk ◽  
Risk Patients ◽  
Coronavirus Infection ◽  
Patient At Risk ◽  
Tomography Data ◽  
Severe Lung

The article is devoted to the peculiarities of the clinical course of severe coronavirus infection in a 59-year-old woman at risk for comorbidities. Data on the pathogenesis of the severe form of COVID-19 are presented. Prognostic laboratory signs of an unfavorable outcome of coronavirus infection in people at risk are considered. The patient management tactics are described in accordance with the protocol for the treatment of new coronavirus infection. The assessment of patient management at the outpatient stage is given. A new coronavirus infection in at-risk patients can quickly lead to a worsening of the condition, which is manifested by severe lung damage not only according to computed tomography data, but also by the clinical symptom of ARDS. The severity of the condition in this category of patients is due to severe viral aggression, the development of a cytokine storm. The use of the recommended protocol for the treatment of new coronavirus infection in patients at risk does not always give the expected positive result.

Comparative study of Clinical Characteristics in Patients with Mild and Severe Reflux Esophagitis

2020 ◽  
Vol 66 (1) ◽  
pp. 19-22
Author(s):  
Melania Macarie ◽  
Simona Maria Bataga ◽  
Monica Pantea ◽  
Razvan Opaschi ◽  
Simona Mocan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sex Ratio ◽  
Hiatal Hernia ◽  
Statistical Significance ◽  
Erosive Esophagitis ◽  
Male Gender ◽  
Consecutive Series ◽  
Study Group ◽  
Entire Study ◽  
Significant Difference

AbstractObjective: This study aims to determine the correlation between risk factors and erosive esophagitis development.Methods: We conducted a retrospective observational study on a consecutive series of 19.672 patients who underwent upper gastrointestinal endoscopy between 01.01.2011-31.12.2017. A total of 3005 patients, diagnosed with erosive esophagitis, were included in the present study and stratified according to Los Angeles classification.Results: During the studied period we found 3005 patients with erosive esophagitis, sex ratio male to female was 1.3/1, the most common forms of esophagitis being grade A and B: 74.54% patients with esophagitis grade A, 14.80% patients with grade B; 5.29% patients were with grade C and 5.35% patients with esophagitis grade D. In severe esophagitis the male predominance was more prevalent (249 males, 71 female), with a sex ratio 3.50/1. The correlation of male gender with severe esophagitis was highly statistically significant (p < 0.0001, OR 2.97; 95% CI 2.25-3.91). Hiatal hernia was diagnosed in 1171 patients, the presence of large hiatal hernias, being an important predictor, with statistical significance (p < 0.0001, OR 3.41; 95% CI 2.22-5.21), for severe esophagitis development. Incidence of Helicobacter pylori infection was 11.51%, in the entire study group, with no statistical significant difference between patients with mild or severe esophagitis (12.02% vs 7.18%).Conclusion: Erosive esophagitis is a frequent disease, the most common forms being grade A and B. Male gender and the presence of hiatal hernia are the most important risk factors for erosive esophagitis development, in our study group.

Criteria positive and criteria negative anaphylaxis, with a focus on undifferentiated somatoform idiopathic anaphylaxis: A review and case series

2020 ◽  
Vol 41 (6) ◽  
pp. 436-441 ◽  
Author(s):  
Daniel A. Rosloff ◽  
Kunal Patel ◽  
Paul J. Feustel ◽  
Jocelyn Celestin
Keyword(s):  
Diagnostic Criteria ◽  
Statistical Significance ◽  
Case Series ◽  
Poor Response ◽  
Response To Treatment ◽  
Fisher Exact Test ◽  
Subjective Symptoms ◽  
Significant Difference ◽  
Physical Findings ◽  
Idiopathic Anaphylaxis

Background: Undifferentiated somatoform (US) idiopathic anaphylaxis (IA) is considered a psychogenic disorder characterized by a lack of observable physical findings and poor response to treatment. Although failure to diagnose true anaphylaxis can have disastrous consequences, identification of US-IA is crucial to limit unnecessary expenses and use of health care resources. Objective: To better define the presentation and understand the potential relationship between US-IA and underlying psychiatric comorbidities. Methods: We retrospectively reviewed 110 visits by 107 patients to our institution for evaluation and management of anaphylaxis over a 1-year period. The patients were classified as having either criteria positive (CP) or criteria negative (CN) anaphylaxis based on whether they met Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium criteria for the clinical diagnosis of anaphylaxis. Patient characteristics, including objective and subjective signs and symptoms, and the presence of psychiatric diagnoses were collected and analyzed. Statistical significance was assessed by using the Fisher exact test. A literature review of US-IA and other psychogenic forms of anaphylaxis was performed. Results: Patients with CP anaphylaxis were more likely to present with hypotension, wheezing, urticaria, and vomiting than were patients with CN anaphylaxis. The patients with CN anaphylaxis were more likely to present with subjective symptoms of sensory throat tightness or swelling compared with patients with CP anaphylaxis. No significant difference was detected in the prevalence of psychiatric conditions between the two groups. Conclusion: Patients who met previously established diagnostic criteria for anaphylaxis were more likely to present with objective physical findings than those who did not meet criteria for true anaphylaxis. CN patients who presented for treatment of anaphylaxis were more likely to present with subjective symptoms. Formal diagnostic criteria should be used by clinicians when evaluating patients with suspected anaphylaxis.

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