An Analysis on the Clinical Features of MHD Patients with Coronavirus Disease 2019: A Single Center Study

Abstract Background: In this study, we aimed to find out the features of the maintenance hemodialysis (MHD) patients infected with Coronavirus Disease 2019 (COVID-19) in the Blood Purification Center of Wuhan No.1 Hospital, Hubei Province, China, and provide evidences for clinical treatment.Methods: We collected the data of all the MHD patients in this hemodialysis center by February 20, 2020, including those infected with COVID-19. These patients were divided into three groups: the control group (537 cases), confirmed group (66 cases) and suspected group (24 cases). We compared the relevant data of the three groups and analyzed the factors that may affect the possibility of catching COVID-19.Results: 1. By February 20, 2020, there were 627 MHD patients in the Hemodialysis Center of Wuhan No.1 Hospital. The prevalence rate of the COVID-19 was 14.35% (90/627, including 66 confirmed cases and 24 suspected cases); the fatality rate 13.33% (12/90, including 12 death cases); the mortality rate 1.91% (12/627).2. The comparison between the three groups revealed the following results: weekly hemodialysis duration (WHD), ultrafiltration volume (UFV) and ultrafiltration rate (UFR) of the confirmed group were obviously lower than those of the control and suspected groups (P＜0.05); the neutrophil ratio (N%), neutrophil (N#), monocyte (M#) and total carbon dioxide (TCO2) were significantly higher than those of the control group while the lymphocyte ratio (L%) was much lower (P＜0.05).3. The lung CT scans found three common features: bilateral abnormalities (81.54%), multiple abnormalities (84.62%) and patchy opacity (61.54%).4. The binary logstic regression analysis showed that diabetes (OR=5.404,95% CI 1.950～14.976, P=0.001) and hypertension (OR=3.099,95% CI 1.380～6.963, P=0.006) are independent risk factors for MHD patients to be infected with COVID-19; WHD (OR=0.846,95% CI 0.737～0.970, P=0.017), UFR (OR=0.012,95% CI 0.002～0.058, P＜0.001) and serum ferritin (SF, OR=0.823,95% CI 0.748～0.906, P＜0.001) are independent protective factors.Conclusion: MHD patients with diabetes or hypertension are more likely to be infected with COVID-19. In clinical treatment, hemodialysis duration, UFR and SF levels should be controlled appropriately to reduce the risk of infection.

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SUPPORTIVE EDUCATIVE SYSTEM DALAM MENINGKATKAN KEMANDIRIAN MERAWAT KAKI PADA PASIEN DIABETES MELLITUS TIPE II

Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal ◽

10.32583/pskm.9.2.2019.63-72 ◽

2019 ◽

Vol 9 (2) ◽

pp. 63-72

Author(s):

Nova Nurwinda Sari ◽

Herlina Herlina

Keyword(s):

Diabetes Mellitus ◽

Health Center ◽

Intervention Group ◽

T Test ◽

Control Group ◽

P Value ◽

Type Ii ◽

Foot Care ◽

Control Group Design ◽

Patients With Diabetes

Diabetes mellitus dapat menyebabkan cukup banyak komplikasi seperti kelainan mata, kelainan ginjal, kelainan pembuluh darah dan kelainan pada kaki. Penderita diabetes mellitus yang mengalami komplikasi kronis perlu diberikan upaya preventif untuk mencegah komplikasi, salah satunya adalah kemampuan perawatan kaki. Penelitian ini dilakukan untuk menguji efektivitas supportive educative system dalam meningkatkan kemandirian perawatan kaki pada pasien dengan diabetes mellitus Tipe II di Puskesmas Permata Sukarame, Bandar Lampung. Penelitian ini menggunakan metode quasy eksperimen dengan desain pretest-posttest with control group dengan total masing-masing kelompok sebanyak 18 responden. Pengumpulan data dilakukan dengan menyebarkan kuesioner kepada responden yang memenuhi kriteria inklusi penelitian. Penelitian ini diuji menggunakan analisis univariat, bivariat dan uji T-test. Hasil penelitian menunjukkan bahwa terdapat perbedaan rata-rata dalam kemandirian perawatan kaki pada kelompok intervensi dan kelompok kontrol dengan p-value 0,000. Pendidikan dan praktik perawatan kaki harus diberikan sejak dini sebagai upaya pencegahan untuk komplikasi. Kata kunci : Supportive educative system, kemandirian perawatan kaki SUPPORTIVE EDUCATIVE SYSTEM IN IMPROVING INDEPENDENCE OF FOOT CARE IN PATIENTS WITH DIABETES MELLITUS TYPE II ABSTRACT Diabetes mellitus can cause quite a lot of complications such as eye disorders, kidney disorders, vascular disorders and abnormalities in the legs. Patients with diabetes mellitus who have chronic complications need to be given a preventive effort to prevent complications, one of which is foot care ability. This research was conducted to examine the effectiveness of supportive educative systems in increasing the independence of foot care in patients with Type II diabetes mellitus in the Permata Sukarame Health Center Bandar Lampung Working Area. This study used a quasi-experimental method with pretest-posttest with control group design with a total of 18 respondents each. Data collection is done by distributing questionnaires to respondents who meet the research inclusion criteria. This study was tested using univariate, bivariate, T-Test analysis. The results showed that the mean differences in the independence of foot care in the intervention group and the control group in the Permata Sukarame Community Health Center work area with a p-value of 0,000. Education and practice of foot care should be given early as a preventative effort for complications. Keywords: Supportive educative system, independence of foot care

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Particularities of nutritional status in patients with diabetes mellitus on maintenance hemodialysis

Nephrology and Dialysis ◽

10.28996/2618-9801-2020-2-189-197 ◽

2020 ◽

Vol 22 (2) ◽

pp. 189-197

Author(s):

N.A. Mikhaylova ◽

◽

S.V. Tishkina ◽

V.M. Ermolenko ◽

A.M. Kertsev ◽

...

Keyword(s):

Diabetes Mellitus ◽

Nutritional Status ◽

Maintenance Hemodialysis ◽

Patients With Diabetes

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Good Glycemic Control for a Low Cardiovascular Risk in Children Suffering from Diabets

Revista de Chimie ◽

10.37358/rc.17.2.5453 ◽

2017 ◽

Vol 68 (2) ◽

pp. 358-361

Author(s):

Camelia Busila ◽

Mariana Cretu Stuparu ◽

Aurel Nechita ◽

Camelia Ana Grigore ◽

Gabriela Balan

Keyword(s):

Glycosylated Hemoglobin ◽

Control Group ◽

Sex Distribution ◽

Good Glycemic Control ◽

Rural And Urban ◽

Lipid Panel ◽

Patients With Diabetes ◽

Kolmogorov Smirnov ◽

Low Cardiovascular Risk

The study is a prospective and operational one, ant its was conducted on 58 patients with diabetes type 1 and 2. The patients sex distribution was homogenious and they come from both rural and urban environment. The statistical analisys was carried out using the programme SPSS 17.0 for Windows. The distribution normality was cheked using the Kolmogorov - Smirnov Z test. he values of glycemia, glycosylated hemoglobin, lipid panel, blood pressure have been measured and compared to the ones belonging to the control group.

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Diabetes-induced Alterations in HDL Subfractions Distribution

Current Pharmaceutical Design ◽

10.2174/1381612825666190227224246 ◽

2020 ◽

Vol 26 (27) ◽

pp. 3341-3348 ◽

Cited By ~ 1

Author(s):

Marek Femlak ◽

Anna Gluba-Brzozka ◽

Beata Franczyk ◽

Jacek Rysz

Keyword(s):

Diabetes Mellitus ◽

Cardiovascular Risk ◽

Public Health Problem ◽

Statin Treatment ◽

Oxidative Modification ◽

Control Group ◽

Newly Diagnosed ◽

Hdl Subfractions ◽

Patients With Diabetes ◽

Healthy Control

Introduction: Diabetes mellitus (DM) due to its increasing prevalence and associated morbidity and mortality has become a serious public health problem. In DM, HDL may lose its beneficial features and become proatherogenic due to its altered biological activity thus increasing cardiovascular risk. The aim of this study was to assess the influence of the presence of diabetes mellitus type 2 and its duration on the distribution of HDL subfractions. Moreover, the effect of statin treatment on HDL subfraction share was analysed in this study. Methods: The study group consisted of 50 patients with newly diagnosed DM and 50 persons with DM for longer than 10 years while the control group consisted of 50 healthy volunteers. HDL subfractions were analysed with the use of Lipoprint. Results: We demonstrated progressive worsening of heart functioning and impairment of its structure in the course of diabetes mellitus. Moreover, we observed that HDL-6 subfraction and intermediate HDL fraction are lowest in the group with advanced DMt2 compared to the group with newly diagnosed DM and a healthy control group. Finally, the results of our study indicated the effect of statin treatment on HDL subfractions that seems not to be advantageous. Conclusion: It seems that in patients with diabetes mellitus compromised antiatherogenic properties of HDL, as a result of oxidative modification and glycation of the HDL protein as well as the transformation of the HDL proteome into a proinflammatory protein, increase cardiovascular risk.

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Evaluation of Salivary Antioxidants and Oxidative Stress Markers in Type 2 Diabetes Mellitus: A Retrospective Cohort Study

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530319666191016103222 ◽

2020 ◽

Vol 20 (4) ◽

pp. 584-590 ◽

Cited By ~ 1

Author(s):

Shima Fathi ◽

Shiva Borzouei ◽

Mohammad Taghi Goodarzi ◽

Jalal Poorolajal ◽

Fatemeh Ahmadi-Motamayel

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Control Group ◽

Oxidative Stress Markers ◽

Stress Markers ◽

Type 2 Dm ◽

Patients With Diabetes ◽

The Difference ◽

And Oxidative Stress

Background: Diabetes Mellitus (DM) is a progressive metabolic disorder. Objective: The aim of this study was to investigate the relationship between antioxidant and oxidative stress markers in the saliva of patients with type 2 DM and a healthy control group. Methods: In this study, 20 patients with diabetes and 20 healthy individuals were evaluated. Salivary antioxidants markers consisted of total antioxidant capacity (TAC), uric acid (UA), peroxidase and catalase. Oxidative stress markers included total oxidant status (TOS), malondealdehyde (MDA) and total thiol (SH). Sialochemical analysis was performed with spectrophotometric assay. All the statistical analyses were conducted using STATA software. Results: TAC decreased significantly in patients with diabetes. Although salivary UA and peroxidase were lower in patients with diabetes compared to the control group, the difference was not significant. Salivary catalase in patients with diabetes was significantly lower than that in the control group. MDA and TOS exhibited significantly higher levels in type 2 DM. SH levels were slightly higher in DM. Conclusions: According to the results of the present study, there were some changes in the salivary levels of some antioxidants and oxidative stress markers in patients with type 2 DM and could be measured as an indicator of serum changes..

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Epidemiology, Risk Factors, and Outcomes of Opportunistic Infections after Kidney Allograft Transplantation in the Era of Modern Immunosuppression: A Monocentric Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm8050594 ◽

2019 ◽

Vol 8 (5) ◽

pp. 594 ◽

Cited By ~ 4

Author(s):

Philippe Attias ◽

Giovanna Melica ◽

David Boutboul ◽

Nathalie De Castro ◽

Vincent Audard ◽

...

Keyword(s):

Risk Factors ◽

Protective Factor ◽

Opportunistic Infections ◽

Control Group ◽

Kidney Allograft ◽

Extended Criteria Donor ◽

Allograft Transplantation ◽

Kidney Recipients ◽

Independent Risk Factors ◽

Kidney Transplantations

Epidemiology of opportunistic infections (OI) after kidney allograft transplantation in the modern era of immunosuppression and the use of OI prevention strategies are poorly described. We retrospectively analyzed a single-center cohort on kidney allograft adult recipients transplanted between January 2008 and December 2013. The control group included all kidney recipients transplanted in the same period, but with no OI. We analyzed 538 kidney transplantations (538 patients). The proportion of OI was 15% (80 and 72 patients). OI occurred 12.8 (6.0–31.2) months after transplantation. Viruses were the leading cause (n = 54, (10%)), followed by fungal (n = 15 (3%)), parasitic (n = 6 (1%)), and bacterial (n = 5 (0.9%)) infections. Independent risk factors for OI were extended criteria donor (2.53 (1.48–4.31), p = 0.0007) and BK viremia (6.38 (3.62–11.23), p < 0.0001). High blood lymphocyte count at the time of transplantation was an independent protective factor (0.60 (0.38–0.94), p = 0.026). OI was an independent risk factor for allograft loss (2.53 (1.29–4.95), p = 0.007) but not for patient survival. Post-kidney transplantation OIs were mostly viral and occurred beyond one year after transplantation. Pre-transplantation lymphopenia and extended criteria donor are independent risk factors for OI, unlike induction therapy, hence the need to adjust immunosuppressive regimens to such transplant candidates.

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WoundClot® Hemostatic Gauze Reduces Bleeding Time after Arterial Venous Fistula Decannulation

Blood Purification ◽

10.1159/000514934 ◽

2021 ◽

pp. 1-7

Author(s):

Orit Kliuk-Ben Bassat ◽

Doron Schwartz ◽

Alexander Zubkov ◽

Amir Gal-Oz ◽

Alexander Gorevoy ◽

...

Keyword(s):

Bleeding Time ◽

Control Group ◽

Dialysis Adequacy ◽

Cotton Gauze ◽

Single Center Study ◽

Time Required ◽

Venous Fistula ◽

Thrombosis Rate

Introduction: Decannulation of the arteriovenous fistula (AVF) after each hemodialysis session requires a precise compression on the needle puncture site. The objective of our study was to evaluate the bleeding time (BT) needed to achieve hemostasis using WoundClot, an innovative hemostatic gauze, and to assess whether its long-term use can improve AVF preservation. Methods: This is a prospective single center study. Initially, the time to hemostasis after AVF decannulation was compared between WoundClot and cotton gauze in 24 prevalent hemodialysis patients. Thereafter, the patients continued to use WoundClot for 12 months and were compared to a control group consisting of 25 patients using regular cotton gauze. Follow-up data included parameters of dialysis adequacy, AVF interventions, and thrombotic events. Results: WoundClot use shortened significantly the time needed for hemostasis. Mean venous BT decreased by 3.99 (±4.6) min and mean arterial BT by 6.38 (±4.8) min when using WoundClot compared to cotton gauze (p < 0.001). At the end of the study, dialysis adequacy expressed by spKt/V was higher in the WoundClot group compared to control (1.73 vs. 1.53, respectively, p = 0.047). Although patients in WoundClot group had a higher baseline BT, arterial and venous pressures did not differ between the groups after a median follow up of 10.8 months. AVF thrombosis rate was similar between the groups. Conclusions: WoundClot hemostatic gauze significantly reduced the time required for hemostasis after AVF decannulation and may be associated with better AVF preservation. We suggest using WoundClot for arterial BT longer than 15 min and for venous BT longer than 12.5 min.

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Effect of Instruction on Preventing Delayed Bleeding after Colorectal Polypectomy and Endoscopic Mucosal Resection

Journal of Clinical Medicine ◽

10.3390/jcm10050928 ◽

2021 ◽

Vol 10 (5) ◽

pp. 928

Author(s):

Takuya Okugawa ◽

Tadayuki Oshima ◽

Keisuke Nakai ◽

Hirotsugu Eda ◽

Akio Tamura ◽

...

Keyword(s):

Risk Factors ◽

Medical Records ◽

Colorectal Polyp ◽

Control Group ◽

Single Center ◽

Antithrombotic Agents ◽

Delayed Bleeding ◽

Factors Associated ◽

Independent Risk Factors ◽

Continuous Use

Background: The frequency of delayed bleeding after colorectal polypectomy has been reported as 0.6–2.8%. With the increasing performance of polypectomy under continuous use of antithrombotic agents, care is required regarding delayed post-polypectomy bleeding (DPPB). Better instruction to educate endoscopists is therefore needed. We aimed to evaluate the effect of instruction and factors associated with delayed bleeding after endoscopic colorectal polyp resection. Methods: This single-center, retrospective study was performed to assess instruction in checking complete hemostasis and risk factors for onset of DPPB. The incidence of delayed bleeding, comorbidities, and medications were evaluated from medical records. Characteristics of historical control patients and patients after instruction were compared. Results: A total of 3318 polyps in 1002 patients were evaluated. The control group comprised 1479 polyps in 458 patients and the after-instruction group comprised 1839 polyps in 544 patients. DPPB occurred in 1.1% of polyps in control, and 0.4% in after-instruction. Instruction significantly decreased delayed bleeding, particularly in cases with antithrombotic agents. Hot polypectomy, clip placement, and use of antithrombotic agents were significant independent risk factors for DPPB even after instruction. Conclusion: The rate of delayed bleeding significantly decreased after instruction to check for complete hemostasis. Even after instruction, delayed bleeding can still occur in cases with antithrombotic agents or hot polypectomy.

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Correlation between white blood cell count at admission and mortality in COVID-19 patients: a retrospective study

BMC Infectious Diseases ◽

10.1186/s12879-021-06277-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bin Zhu ◽

Xiaokai Feng ◽

Chunguo Jiang ◽

Song Mi ◽

Liya Yang ◽

...

Keyword(s):

White Blood Cells ◽

Vital Role ◽

World Health ◽

Kaplan Meier ◽

Single Center Study ◽

Union Hospital ◽

Laboratory Examinations ◽

The Difference ◽

Wbc Count ◽

Death Cases

Abstract Background Coronavirus disease-19 (COVID-19) has become a world health threaten. Its risk factors with death were still not known. White blood cells (WBC) count as a reflection of inflammation has played a vital role in COVID-19, however its level with death is not yet investigated. Methods In this retrospective, single-center study, all confirmed patients with COVID-19 at West Branch of Union Hospital from Jan 29 to Feb 28, 2020 were collected and analyzed. Demographic and clinical data including laboratory examinations were analyzed and compared between recovery and death patients. Results A total of 163 patients including 33 death cases were included in this study. Significant association was found between WBC count and death (HR = 1.14, 95%CI: 1.09–1.20, p < 0.001). The regression analysis results showed there was a significant association between WBC count and death (HR = 5.72, 95%CI: 2.21–14.82, p < 0.001) when use the second quartile as a cutoff value (> 6.16 × 10^9/L). The difference was still exist after adjusting for confounding factors (HR = 6.26, 95%CI: 1.72–22.77, p = 0.005). In addition, Kaplan-meier survival analysis showed that there was a significant decline of the cumulative survival rate (p < 0.001) in those with WBC count ≥6.16 × 10^9/L. Conclusion WBC count at admission is significantly corelated with death in COVID-19 patients. Higher level of WBC count should be given more attention in the treatment of COVID-19.

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