scholarly journals Rapid increase of SpO2 on room air for 34 severe COVID-19 patients after ivermectin-based combination treatment: 55-62% normalization within 12-24 hours

2021 ◽  
Author(s):  
Jacqueline C Stone ◽  
Pisirai Ndarukwa ◽  
David E Scheim ◽  
Barry M Dancis ◽  
Jerry Dancis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Combination Treatment ◽  
Standard Care ◽  
Mortality Rates ◽  
Post Treatment ◽  
Nobel Committee ◽  
Combination Treatments ◽  
Medical Facilities ◽  
The Usa ◽  
The Mean

Abstract Background. The emergence of COVID-19 in March 2020 challenged Zimbabwe to mount a response with limited medical facilities and therapeutic options. Ivermectin (IVM) had by then been safely used to treat a variety of human diseases affecting millions, as noted by the Nobel Committee in awarding its 2015 prize for medicine. Based upon early clinical indications of efficacy against COVID-19, IVM-based combination treatments were deployed to treat this infection in Zimbabwe.Methods. Data were retrospectively analyzed for 34 severe COVID-19 patients treated with IVM-based combination therapy between August 2020 and May 2021, for whom pre- and post-treatment SpO2 values were all recorded on room air. Mortality and deterioration outcomes were also analyzed for a larger set of 92 severe COVID-19 patients receiving IVM-based treatment.Results: For the 34-patient SpO2 tracking series, all but two patients had significantly increased SpO2 values after the first IVM dose, and all patients recovered. Mean increases in SpO2 as percentages of full normalization to SpO2=97 were 55.1% at +12 hours and 62.3% at +24 hours post-treatment. These results paralleled similar sharp increases in SpO2, all on room air, for a series of 24 RT-qPCR confirmed, mostly severe COVID-19 patients in the USA (California) who were given IVM combination treatment, all of whom recovered. For 19 of those patients having SpO2 ≤ 90 prior to IVM, the mean SpO2 normalization at +24 hours post-treatment was 65.2% as calculated from the SpO2 values reported. For our larger series of 92 severe COVID-19 patients in Zimbabwe, median age 53, only two died and two more deteriorated prior to recovery, far less than a predicted 7 deaths and 17 deteriorations for the demographics and risk factors of these patients.Conclusions. The rapid, marked increases in SpO2 for both the Zimbabwe and California patients stand in sharp contrast to the decline in SpO2 and associated pulmonary function following onset of moderate or severe COVID-19 symptoms under standard care. These rapid SpO2 increases and low mortality rates support extended deployment of IVM treatment for COVID-19, complementary to immunizations for prevention.

scholarly journals Multiple drug resistance in hookworms infecting greyhound dogs in the USA

2021 ◽  
Author(s):  
Pablo D. Jimenez Castro ◽  
Abhinaya Venkatesan ◽  
Elizabeth Redman ◽  
Rebecca Chen ◽  
Abigail Malatesta ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Multiple Drug Resistance ◽  
Infection Intensity ◽  
The United States ◽  
Post Treatment ◽  
Multiple Drug ◽  
Fecal Samples ◽  
The Usa ◽  
The Mean ◽  
Β Tubulin

AbstractThe hookworm Ancylostoma caninum is the most prevalent nematode parasite of dogs. Recently, we confirmed multiple-drug resistance (MDR) in several A. caninum isolates to all anthelmintic drug classes approved for the treatment of hookworms in dogs in the United States (USA). Cases of MDR hookworms appear to be highly overrepresented in greyhounds, suggesting that the MDR worms evolved on racing greyhound farms/kennels. The aims of this study were to evaluate the range of drug-resistant phenotypes and genotypes of the A. caninum infecting greyhounds. Fecal samples from recently retired greyhounds originating from geographically diverse areas of the USA were acquired from two greyhound adoption kennels, one active greyhound racing kennel, and three veterinary practices that work with adoption kennels. Fecal egg counts (FECs) were performed on fecal samples from 219 greyhounds, and despite almost all the dogs having been treated with one or more anthelmintics in the previous two to four weeks, the mean FEC was 822.4 eggs per gram (EPG). Resistance to benzimidazoles and macrocyclic lactones were measured using the egg hatch assay (EHA) and the larval development assay (LDA) respectively. We performed 23 EHA and 22 LDA on either individual or pooled feces, representing 81 animals. Mean and median IC50 and IC95 values for the EHA were 5.3 uM, 3.6 uM, and 24.5 uM, 23.4 uM respectively. For the LDA, mean and median IC50 values were 749.8 nM, >1000 nM respectively. These values range from 62 to 68 times higher than those we measured in our susceptible laboratory isolates. Pre-treatment fecal samples could not be obtained, however, post-treatment samples representing 219 greyhounds were collected. For samples collected <10 days post-treatment with albendazole, moxidectin, or a combination of febantel-pyrantel-moxidectin, the mean FEC were 349, 333, and 835 EPG, respectively. Samples collected 10-21 days post-treatment with albendazole, moxidectin, or pyrantel, yielded mean FEC of 1874, 335, and 600 EPG, respectively. Samples collected >21 days post-treatment with albendazole or moxidectin yielded mean FEC of 1819 and 1117 EPG, respectively. We obtained DNA from hookworm eggs isolated from 70 fecal samples, comprised of 60 individual dogs and 10 pools from multiple dogs. Deep sequencing of the isotype 1 β-tubulin gene revealed the presence of the F167Y (TTC>TAC) resistance polymorphism in 99% of these samples, with 69% having ≥75% resistant allele frequency. No resistance-associated polymorphisms were seen at any of the other β-tubulin codons previously reported as associated with benzimidazole resistance in Strongylid nematodes. These clinical, in vitro, and genetic data provide strong evidence that racing and recently retired greyhound dogs in the USA are infected with MDR A. caninum at very high levels in terms of both prevalence and infection intensity.

scholarly journals Exogenous isoleucine and phenylalanine interact with abscisic acid-mediated anthocyanin accumulation in grape

2019 ◽  
Vol 31 (1) ◽  
pp. 147-157
Author(s):  
Tomoki Hattori ◽  
Yang Chen ◽  
Shinichi Enoki ◽  
Daisuke Igarashi ◽  
Shunji Suzuki
Keyword(s):  
Amino Acids ◽  
Combination Treatment ◽  
Growing Season ◽  
Grape Berry ◽  
Post Treatment ◽  
Anthocyanin Accumulation ◽  
Low Concentration ◽  
Combination Treatments ◽  
Berry Quality ◽  
Berry Skins

AbstractBerry skin colour is a crucial determinant of red/black grape berry quality. We investigated the effects of combination treatments with amino acids and a low concentration of ABA on anthocyanin accumulation in grapes. Among the amino acids tested, isoleucine and phenylalanine resulted in high anthocyanin contents in grape cell cultures. The combination treatments with isoleucine or phenylalanine, and a low concentration of ABA enhanced anthocyanin accumulation in grape cells and detached grape berries. The combination treatment with isoleucine, but not with phenylalanine, and ABA upregulated MybA1 expression. Field-grown grapevines received combination treatments with isoleucine or phenylalanine, and ABA in two growing seasons. In the 2015 growing season, the combination treatments with isoleucine or phenylalanine, and a low concentration of ABA accelerated anthocyanin accumulation in grape berry skins of field-grown grapevines on days 10 and 31 post treatment. The effects on anthocyanin accumulation became negligible at harvest. The effect of the combination treatment with phenylalanine and a low concentration of ABA on anthocyanin accumulation was masked in the 2017 growing season due to the unexpected stimulation of anthocyanin accumulation by the low concentration of ABA, although the combination treatment accelerated anthocyanin accumulation on days 3 and 10 post treatment. Taken together, the results suggested that exogenous isoleucine and phenylalanine interacted with ABA-mediated anthocyanin accumulation in grape berry skins of field-grown grapevines when the activity of ABA used to treat the grapevines was inadequate.

scholarly journals Emphysematous cystitis: mortality, risk factors, and pathogens of a rare disease

2017 ◽  
Vol 7 (2) ◽  
Author(s):  
Andreas Schicho ◽  
Christian Stroszczynski ◽  
Philipp Wiggermann
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Mortality Rate ◽  
Mortality Risk ◽  
Conservative Management ◽  
Mortality Rates ◽  
Emphysematous Pyelonephritis ◽  
Emphysematous Cystitis ◽  
The Mean ◽  
High Degree

Although high mortality rates have been reported for emphysematous pyelonephritis (EP), information on emphysematous cystitis (EC), which is less common, is sparse. Here, we report one new case of severe EC and 136 cases of EC that occurred between 2007 and 2016, and review information about the characteristics, diagnosis, treatment and mortality of these patients, and the pathogens found in these patients. The mean age of the 136 patients was 67.9±14.2 years. Concurrent emphysematous infections of other organs were found in 21 patients (15.4%), with emphysematous pyelonephritis being the most common of these infections. The primary pathogen identified was <em>Escherichia coli</em> (54.4%). Patients were mainly treated by conservative management that included antibiotics (n=105; 77.2%). Ten of the 136 patients with EC died, yielding a mortality rate of 7.4%. Despite the relatively low mortality rate of EC compared with that of EP, a high degree of suspicion must be maintained to facilitate successful and conservative management.

scholarly journals Behavioural Risk Factors Associated With Prostate Cancer: The Prostate Cancer Transatlantic Consortium (CaPTC) Cohort Study

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 5s-5s
Author(s):  
C.A. Oladoyinbo ◽  
O.O. Akinbule ◽  
A.A. Sobo ◽  
O.O. Bolajoko ◽  
I.E. Bassey ◽  
...  
Keyword(s):  
Physical Activity ◽  
Prostate Cancer ◽  
Risk Factors ◽  
Alcohol Consumption ◽  
West African ◽  
Activity Level ◽  
Factors Associated ◽  
The Usa ◽  
History Of ◽  
The Mean

Background: Studies have linked genetic susceptibility to prostate cancer (CaP) to African heritage and familial disease. Also, lifestyle factors, general and central obesity have been identified as risk factors for CaP. Aim: To assess the behavioral risk factors associated with CaP among West-African men and US West African immigrants. Methods: The cross-sectional study was conducted among 480 respondents recruited from Nigeria, Cameroon and the United States. The CaPTC Familial Project study instrument was used to collect data on the background information of respondents, country specific residence information, physical activity level, smoking and alcohol consumption pattern, family and personal history of cancer and other types of cancers and knowledge of CaP. Anthropometric measurements were taken. Data were analyzed using SPSS version 20. Results: Majority (85.6%) were recruited from Nigeria, 5.5% from Cameroon and 8.9% from the USA and the mean age is 48.2±9.9. About three quarters (74.4%) have been married only once while 10.8% have been married for about 2-5 times. Few (3.3%) of the respondent's wives had cancer and 0.2% had cervical cancer. Less than 1% of respondent's daughters had cancer, 4.6% of their uncles had cancer. Among the respondent's full brothers and sisters, 0.4% had cancer and 1.5% of their birth mothers had cancer. Also a few (2.3%) of respondent's fathers had cancer and 11.9% of their paternal grandparents had one type of cancer. About 17.2% of respondents have been diagnosed of a prostate condition and 5.9% were diagnosed of CaP with 47.1% of those with CaP are from Nigeria, 49.6% from the USA and 3.3% from Cameroon. One-quarter (25.6%) have smoked at least once in their lifetime, 2.5% smoke daily and the mean age at which smoking commenced is 26.6±19.4. More than half (55.4%) had consumed alcohol at least once in their lifetime and the mean age at which alcohol consumption started is 9.9±11.9. Only 9.8% had adequate knowledge about CaP and 61.0% poor knowledge. About a quarter (25.5%) were obese with 3.3% being morbidly obese. One-third (32.3%) are involved in moderate physical activity and 17.9% in rigorous physical activity. No significant difference ( P = 0.492) was observed in the physical activity level from the different locations. However, a significant relationship was observed between alcohol consumption, smoking, body mass index and country of residence ( P = 0.001, 0.035 and 0.001 respectively). Cigarette smoking and alcohol consumption (frequency and quantity) was significantly higher among respondents from the USA. Obesity was also significantly higher among the respondents from Nigeria and the USA. Although not statistically significant, family history of cancer was more among respondents from Nigeria and the USA. Conclusion: Obesity, smoking, alcohol consumption seems to be a common practice among respondents from Nigeria and USA.

scholarly journals Assessment of Predictors of Mortality in Neonatal Intestinal Obstruction

2018 ◽  
Vol 7 (1) ◽  
pp. 2 ◽  
Author(s):  
Imran Ali ◽  
Gowhar N Mufti ◽  
Nisar A Bhat ◽  
Aejaz A Baba ◽  
Khurshid A Sheikh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intestinal Obstruction ◽  
High Mortality ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Mortality Rates ◽  
Duration Of Symptoms ◽  
Duration Of Stay ◽  
Neonatal Intestinal Obstruction ◽  
The Mean

Background: Neonatal intestinal obstruction (NIO) continues to be a life-threatening condition with high mortality rates especially in developing countries. Highly skilled specialized care and facilities are required for survival. This study was conducted to assess various factors responsible for outcome in such neonates, so that extra attention is paid to the ones at high risk, with the idea to bring down the mortality rates in neonates admitted with intestinal obstruction.Materials and Methods: This study was a prospective observational study conducted on all neonates admitted with features of intestinal obstruction in our hospital from February 2014 to August 2016. The patients were followed up for a minimum of 1 month. Data was collected on prescribed proforma and analyzed for age, sex, prematurity, birth weight, clinical features, duration of symptoms, diagnosis, lab investigations, surgical procedure performed, complications etc. using the Statistical Package for Social Sciences (SPSS).Results: There were 120 neonates with intestinal obstruction, of which 92 neonates survived and 28 died. The mortality rate was 23.33%. There were 74 males and 46 females. The mean gestational age was 38.2±1.77 wks with a range between 32 to 41 wks. The mean age at presentation was 5.58 days with a range between 5 hrs to 26 days. The mean weight at presentation was 2510g. Mean duration of symptoms was 3.40 days. Gross congenital anomaly was seen in 22 neonates. Sepsis on admission was noted in 51 patients out of whom 23 died. Twenty-two patients presented with perforation peritonitis, of which 14 expired. Fifty-four neonates experienced significant in-hospital delay in surgery. The mean duration of stay in the hospital was 8.40 days. Overall, 92 neonates were discharged from the hospital.Conclusion: Neonatal intestinal obstruction is still associated with high mortality. After analyzing various factors we conclude, that increased age at presentation, delay in seeking treatment after the onset of symptoms, CRP/ blood culture positive sepsis on arrival, thrombocytopenia, acute kidney injury (raised urea and creatinine), acidosis and coagulopathy on admission, bowel perforation with peritonitis and the need for continued mechanical ventilation after surgery were the statistically significant risk factors for mortality in neonates with NIO in our series. However, sex, mode of delivery, gestational age, weight at presentation, hypothermia on arrival, associated gross congenital anomalies, delay in surgery after admission (in-hospital delay) and duration of stay in hospital were found to be statistically insignificant risk factors for mortality in our series.

scholarly journals FETAL DEATHS IN MARANHÃO STATE (BRAZIL), IN THE YEARS OF 2000, 2010 AND 2014

2017 ◽  
Vol 2 (3) ◽  
pp. 33
Author(s):  
Mayanna Karlla Lima Costa ◽  
Vilena Aparecida Ribeiro Silva ◽  
Raimunda Alves Silva
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Mortality Rate ◽  
Fetal Death ◽  
Mortality Rates ◽  
Descriptive Statistics ◽  
Fetal Mortality ◽  
Distribution Map ◽  
The World ◽  
The Mean

The occurrence of a high number of fetal deaths is present throughout the world. It is estimated that more than 2 million fetal deaths occur each year on the globe, where 98% predominate in developing countries. This research aimed to carry out the survey of the fetal deaths number in Maranhão state, as a way to bring contributions to theprevention and health care actions. Data from DATASUS were used for the survey of fetal deaths occurring in the 217 municipalities in Maranhão state in the years 2000, 2010 and 2014, as well as the fetal mortality rate. The program SURFER® version 11.0 were usedfor descriptive statistics analysis and construction of the mean distribution map of cases. The fetal mortality rate in Maranhão has increased over the years, not following the national trend of reduction of intrauterine mortality rates, being required greater investment in public policies to analyze the main risk factors in the state.Key words: fetal death, public health, fetal mortality rate.

scholarly journals Designing COVID-19 mortality predictions to advance clinical outcomes: Evidence from the Department of Veterans Affairs

2021 ◽  
Vol 28 (1) ◽  
pp. e100312
Author(s):  
Christos A Makridis ◽  
Tim Strebel ◽  
Vincent Marconi ◽  
Gil Alterovitz
Keyword(s):  
Artificial Intelligence ◽  
Risk Factors ◽  
Medical History ◽  
Clinical Outcomes ◽  
Mortality Rates ◽  
Veterans Affairs ◽  
Department Of Veterans Affairs ◽  
The Usa ◽  
Precision Recall Curve ◽  
Recall Curve

Using administrative data on all Veterans who enter Department of Veterans Affairs (VA) medical centres throughout the USA, this paper uses artificial intelligence (AI) to predict mortality rates for patients with COVID-19 between March and August 2020. First, using comprehensive data on over 10 000 Veterans’ medical history, demographics and lab results, we estimate five AI models. Our XGBoost model performs the best, producing an area under the receive operator characteristics curve (AUROC) and area under the precision-recall curve of 0.87 and 0.41, respectively. We show how focusing on the performance of the AUROC alone can lead to unreliable models. Second, through a unique collaboration with the Washington D.C. VA medical centre, we develop a dashboard that incorporates these risk factors and the contributing sources of risk, which we deploy across local VA medical centres throughout the country. Our results provide a concrete example of how AI recommendations can be made explainable and practical for clinicians and their interactions with patients.

scholarly journals Monotherapy versus beta-lactam-aminoglycoside combination treatment for gram-negative bacteremia: a prospective, observational study.

1997 ◽  
Vol 41 (5) ◽  
pp. 1127-1133 ◽  
Author(s):  
L Leibovici ◽  
M Paul ◽  
O Poznanski ◽  
M Drucker ◽  
Z Samra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Antibiotic Treatment ◽  
Combination Treatment ◽  
Mortality Rates ◽  
Beta Lactam ◽  
Gram Negative ◽  
Empirical Antibiotic Treatment ◽  
Gram Negative Bacteremia ◽  
Neutropenic Patients

The aim of the present study was to test whether the combination of a beta-lactam drug plus an aminoglycoside has advantage over monotherapy for severe gram-negative infections. Of 2,124 patients with gram-negative bacteremia surveyed prospectively, 670 were given inappropriate empirical antibiotic treatment and the mortality rate in this group was 34%, whereas the mortality rate was 18% for 1,454 patients given appropriate empirical antibiotic treatment (P = 0.0001). The mortality rates for patients given appropriate empirical antibiotic treatment were 17% for 789 patients given a single beta-lactam drug, 19% for 327 patients given combination treatment, 24% for 249 patients given a single aminoglycoside, and 29% for 89 patients given other antibiotics (P = 0.0001). When patients were stratified according to risk factors for mortality other than antibiotic treatment, combination therapy showed no advantage over treatment with a single beta-lactam drug except for neutropenic patients (odds ratio [OR] for mortality, 0.5; 95% confidence interval [95% CI], 0.2 to 1.3) and patients with Pseudomonas aeruginosa bacteremia (OR, 0.7; 95% CI, 0.3 to 1.8). On multivariable logistic regression analysis including all risk factors for mortality, combination therapy had no advantage over therapy with a single beta-lactam drug. The mortality rate for patients treated with a single appropriate aminoglycoside was higher than that for patients given a beta-lactam drug in all strata except for patients with urinary tract infections. When the results of blood cultures were known, 1,878 patients were available for follow-up. Of these, 816 patients were given a single beta-lactam drug, 442 were given combination treatment, and 193 were given a single aminoglycoside. The mortality rates were 13, 15, and 23%, respectively (P = 0.0001). Both on stratified and on multivariable logistic regression analyses, combination treatment showed a benefit over treatment with a single beta-lactam drug only for neutropenic patients (OR, 0.2; 95% CI, 0.05 to 0.7). In summary, combination treatment showed no advantage over treatment with an appropriate beta-lactam drug in nonneutropenic patients with gram-negative bacteremia.

scholarly journals The Influence of Socioeconomic Status on the Prognosis and Profile of Patients Admitted for Acute Heart Failure during COVID-19 Pandemic: Overestimated Aspects or a Multifaceted Hydra of Cardiovascular Risk Factors?

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1700
Author(s):  
Radu-Stefan Miftode ◽  
Irina-Iuliana Costache ◽  
Petru Cianga ◽  
Antoniu Octavian Petris ◽  
Corina-Maria Cianga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Socioeconomic Status ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Mortality Rates ◽  
Clinical Aspects ◽  
Direct Impact ◽  
The Mean ◽  
The Individual

Background: Heart failure (HF) is a complex clinical syndrome that represents a great burden on public health systems due to its increased prevalence, disability and mortality rates. There are multiple triggers that can induce or aggravate a preexisting HF, socioeconomic status (SES) emerging as one of the most common modifiable risk factors. Our study aimed to analyze the influence of certain SES indicators on the outcome, clinical aspects and laboratory parameters of patients with HF in North-Eastern Romania, as well as their relationship with other traditional cardiovascular risk factors. Methods: We conducted a prospective, single-center study comprising 120 consecutively enrolled patients admitted for acute HF. The evaluation of individual SES was based upon a standard questionnaire and evidence from official documents. Results: the patients’ age ranged between 18 and 94 years; Out of 120 patients, 49 (40.8%) were women and 71 (59.2%) were men, residing in rural 59 (49.2%) or urban 61 (50.8%) areas. 14.2% were university graduates, while 15.8% had only attended primary school. The majority of the patients are or were employed in the service sector (54.5%), followed by industry (29.2%) and agriculture (20%). The mean monthly income was 306.1 ± 177.4 euro, while the mean hospitalization cost was 2471.8 ± 2073.8 euro per patient. The individual income level was positively correlated with urban area of residence, adequate household sanitation facilities and healthcare access, and negatively associated with advanced age and previous hospitalizations due to HF. However, the individual financial situation was also positively correlated with the increased prevalence of certain cardiovascular risk factors, such as arterial hypertension, anemia or obesity, but not with total cholesterol or male gender. Concerning the direct impact of a poor economic status upon prognosis in the setting of acute HF, our results showed no statistically significant differences concerning the in-hospital or at 1-month follow-up mortality rates. Rather than inducing a direct impact on the short-term outcome, these findings concerning SES indicators are meant to enhance the implementation of policies aimed to provide adequate healthcare for people from all social layers, with a primary focus on modifiable cardiovascular risk factors.

Effect of Growth Regulators on Rooting of Magnolia grandifloraCultivars

HortScience ◽  
1998 ◽  
Vol 33 (3) ◽  
pp. 503d-503
Author(s):  
Ning Jiang ◽  
Donglin Zhang ◽  
Michael A. Dirr
Keyword(s):  
Growth Regulators ◽  
Combination Treatment ◽  
Similar Response ◽  
Combination Treatments ◽  
Rooting Of Cuttings ◽  
Root Quality

Cuttings from three southern magnolia cultivars, `Claudia Wannamaker', `Greenback™', and `Little Gem', were treated with KIBA, KNAA, and Hormodin #3, separately and in combination, at varying concentrations. The rooting of cuttings was cultivar-dependent, with `Greenback™' responding significantly to all the treatments. Only the high KNAA and combination treatments were effective with `Little Gem' and `Claudia Wannamaker'. The effect of KNAA on rooting with increasing concentration was significant. No similar response was observed with KIBA. The combination treatment with quick dip plus the talc formation produced the greatest rooting and root quality with the three cultivars. With this treatment, the average rooting rate of three cultivars was 67.4%, whereas the rooting rate of control plants was only 11.8%.

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