scholarly journals HMGB1, NLRP3, IL-6 and ACE2 Levels Are Elevated in COVID-19 with Headache: A Window to the Infection-Related Headache Mechanism

2021 ◽  
Author(s):  
Hayrunnisa Bolay ◽  
Ömer Karadaş ◽  
Bilgin Öztürk ◽  
Rıza Sonkaya ◽  
Bahar Taşdelen ◽  
...  
Keyword(s):  
Weight Loss ◽  
Angiotensin Ii ◽  
Serum Levels ◽  
Pulmonary Involvement ◽  
Sectional Study ◽  
Trigeminal Neurons ◽  
Moderate Disease ◽  
The Mean ◽  
Second Wave ◽  
D Dimer

Abstract BACKGROUND AND AIM: Pathogenesis of COVID-19 -related headache is unknown, though the induction ofthe trigeminal neurons throughinflammation is proposed. Weaimed to investigatekey systemic circulating inflammatory moleculesand their clinical relations in COVID-19 patients with headache. METHODS: Thiscross-sectional study enrolled 88COVID-19 patients,hospitalized on a regular ward during the second wave of the pandemic.Clinical characteristics of COVID-19 patients were recorded,and laboratory testswere studied.RESULTS: The mean agesof 48 COVID-19 patients with headache (47.71±10.8) and 40 COVID-19 patients without headache (45.70±12.72) were comparable. COVID-19 patients suffered from headache had significantly higher serum levels of HMGB1, NLRP3, ACE2, and IL-6 than COVID-19 patients without headache, whereasCGRP and IL-10 levels were similar in the groups. Angiotensin II level was significantly decreased in the headache group.COVID-19 patients with headache showedan increased frequency of pulmonary involvement and increased D- dimer levels. Furthermore, COVID-19 was more frequently associated with weight loss, nausea, and diarrhea in patients with headache. The frequency of anosmia and ageusia did not reach significant levelsbetween the two groups. Serum NLRP3 levels were correlated with headache duration and hospital stay, while headache response to paracetamol was negatively correlated with HMGB1 and positively associated with IL-10 levels. CONCLUSION: Stronger inflammatory response is associated with headache in hospitalized COVID-19 patients with moderate disease severity.Increased levels of the circulating inflammatory and/or nociceptive molecules like HMGB1, NLRP3, and IL-6 may play a role in the potential induction of the trigeminalsystem and manifestation of headache secondary to SARS-CoV-2 infection.

scholarly journals HMGB1, NLRP3, IL-6 and ACE2 levels are elevated in COVID-19 with headache: a window to the infection-related headache mechanism

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hayrunnisa Bolay ◽  
Ömer Karadas ◽  
Bilgin Oztürk ◽  
Riza Sonkaya ◽  
Bahar Tasdelen ◽  
...  
Keyword(s):  
Serum Levels ◽  
Pulmonary Involvement ◽  
Cross Sectional Study ◽  
Trigeminal System ◽  
Cross Sectional ◽  
Trigeminal Neurons ◽  
Moderate Disease ◽  
The Mean ◽  
Inflammatory Molecules ◽  
Second Wave

Abstract Background and aim Pathogenesis of COVID-19 -related headache is unknown, though the induction of the trigeminal neurons through inflammation is proposed. We aimed to investigate key systemic circulating inflammatory molecules and their clinical relations in COVID-19 patients with headache. Methods This cross-sectional study enrolled 88 COVID-19 patients, hospitalized on a regular ward during the second wave of the pandemic. Clinical characteristics of COVID-19 patients were recorded, and laboratory tests were studied. Results The mean ages of 48 COVID-19 patients with headache (47.71 ± 10.8) and 40 COVID-19 patients without headache (45.70 ± 12.72) were comparable. COVID-19 patients suffered from headache had significantly higher serum levels of HMGB1, NLRP3, ACE2, and IL-6 than COVID-19 patients without headache, whereas CGRP and IL-10 levels were similar in the groups. Angiotensin II level was significantly decreased in the headache group. COVID-19 patients with headache showed an increased frequency of pulmonary involvement and increased D- dimer levels. Furthermore, COVID-19 was more frequently associated with weight loss, nausea, and diarrhea in patients with headache. Serum NLRP3 levels were correlated with headache duration and hospital stay, while headache response to paracetamol was negatively correlated with HMGB1 and positively associated with IL-10 levels. Conclusion Stronger inflammatory response is associated with headache in hospitalized COVID-19 patients with moderate disease severity. Increased levels of the circulating inflammatory and/or nociceptive molecules like HMGB1, NLRP3, and IL-6 may play a role in the potential induction of the trigeminal system and manifestation of headache secondary to SARS-CoV-2 infection.

Relative value of serum cytokines and clinical factors in predicting weight loss in advanced pancreatic cancer (PC).

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 208-208
Author(s):  
D. R. Fogelman ◽  
X. S. Wang ◽  
M. Hassan ◽  
D. Li ◽  
M. M. Javle ◽  
...  
Keyword(s):  
Weight Loss ◽  
High Risk ◽  
Clinical Symptoms ◽  
Advanced Pancreatic Cancer ◽  
Serum Levels ◽  
Baseline Serum ◽  
Mean Values ◽  
Cytokine Analysis ◽  
Predict Weight Loss ◽  
The Mean

208 Background: The identification of PC patients at high risk for cachexia may allow for early intervention to prevent this outcome. Symptoms such as pain, nausea, and anorexia might predict weight loss. Likewise, inflammatory cytokines are also associated with cachexia. We evaluated the ability of each to predict weight loss in patients beginning treatment for PC. Methods: We evaluated 44 newly diagnosed advanced or metastatic PC patients for baseline symptomatology via the M. D. Anderson Symptom Inventory (MDASI). This survey assesses symptom severity, such as nausea, vomiting, fatigue, pain, diarrhea, and constipation, on a 1-10 scale. Baseline serum levels of IL-1a, IL-1b, IGF-1, CXCL-12, CXCL-16, CRP, IL-6, IL-8, VEGF, CEA, and CA 19-9 were assessed. Logistic regression analysis was performed to determine the odds ratio (OR) and confidence interval (CI) for the association of different parameters with 10% weight loss at 60 days from treatment initiation. Student t-test was used to compare the mean values across different strata. Results: A weight loss of >10% was observed in 15 patients (34%). Only the use of mild (but not strong) opioids was associated with weight loss; estimated OR = 6.2 (C.I. 1.2-31.9, p=.03). No association was observed for the MDASI parameters. Baseline levels of cytokines were available for 23 patients. We observed significant differences in the mean values of CXCL-16 (p=.05) and IL-6 (p=.045) in patients with weight loss as compared to those without weight loss. Moreover, serum level of erythropoietin may be negatively associated with weight loss (p=0.06). Conclusions: Alterations in serum cytokine levels may correlate more strongly with cachexia than clinical symptoms and underscore the importance of cytokine analysis in identifying PC patients at high risk for cachexia. [Table: see text]

scholarly journals Clinical and Immunopathologic Profile of Mexican Patients with IgG4 Autoimmune Pancreatitis

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
María T. Bourlon ◽  
Christianne Bourlon ◽  
Yemil Atisha-Fregoso ◽  
Fredy Chable-Montero ◽  
Marco A. Teliz ◽  
...  
Keyword(s):  
Weight Loss ◽  
Autoimmune Pancreatitis ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Serum Levels ◽  
Current Data ◽  
Histological Subtypes ◽  
Sclerosing Pancreatitis ◽  
The Mean ◽  
Mexican Patients

Autoimmune pancreatitis is part of the spectrum of IgG4-associated diseases. Its diagnostic criteria and histological subtypes have been formally proposed recently and although based on current data it has been suggested that there are differences in clinical presentation among populations, more research is needed to properly establish if this heterogeneity exists. In this paper, we describe 15 cases of autoimmune pancreatitis diagnosed at a Mexican centre of reference, all of them associated to the lymphoplasmocytic sclerosing pancreatitis variant. The mean age at the onset of symptoms was 47.5 ± 14.4 years, and 53% of patients were male. The main manifestations were weight loss (87%), obstructive jaundice (53%), and acute (27%) and chronic (27%) pancreatitis. Only 20% of patients had high IgG4 serum levels at the time of diagnosis. All patients receiving prednisone responded favourably, both in their pancreatic and extrapancreatic manifestations. Clinical manifestations of Mexican patients showed certain differences with respect to those usually reported.

scholarly journals Vitamin D and Lung Outcomes in Elderly COVID-19 Patients

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 717
Author(s):  
Alberto Sulli ◽  
Emanuele Gotelli ◽  
Andrea Casabella ◽  
Sabrina Paolino ◽  
Carmen Pizzorni ◽  
...  
Keyword(s):  
Vitamin D ◽  
Negative Correlation ◽  
Serum Levels ◽  
Pulmonary Involvement ◽  
Clinical Parameters ◽  
Lung Involvement ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Lower Vitamin ◽  
D Dimer

Background and aim: Vitamin D deficiency is frequently reported in patients with SARS-CoV-2 infection. The aim of this study was to correlate the 25OH-Vitamin D serum concentrations with clinical parameters of lung involvement, in elderly patients hospitalized for SARS-CoV-2 infection. Methods: Sixty-five consecutive COVID-19 patients (mean age 76 ± 13 years) and sixty-five sex- and age-matched control subjects (CNT) were analyzed. The following clinical parameters, including comorbidities, were collected at admission: type of pulmonary involvement, respiratory parameters (PaO2, SO2, PaCO2, PaO2/FiO2), laboratory parameters (including 25OH-vitamin D, D-dimer, C-reactive protein). Results: Significantly lower vitamin D serum levels were found in COVID-19 patients than in CNT (median 7.9 vs 16.3 ng/mL, p = 0.001). Interestingly, a statistically significant positive correlation was observed between vitamin D serum levels and PaO2 (p = 0.03), SO2 (p = 0.05), PaO2/FiO2 (p = 0.02), while a statistically significant negative correlation was found between vitamin D serum levels and D-dimer (p = 0.04), C-reactive protein (p = 0.04) and percentage of O2 in a venturi mask (p = 0.04). A negative correlation was also observed between vitamin D serum levels and severity of radiologic pulmonary involvement, evaluated by computed tomography: in particular, vitamin D was found significantly lower in COVID-19 patients with either multiple lung consolidations (p = 0.0001) or diffuse/severe interstitial lung involvement than in those with mild involvement (p = 0.05). Finally, significantly lower vitamin D serum levels were found in the elderly COVID-19 patients who died during hospitalization, compared to those who survived (median 3.0 vs 8.4 ng/mL, p = 0.046). Conclusions: This study confirms that 25OH-vitamin D serum deficiency is associated with more severe lung involvement, longer disease duration and risk of death, in elderly COVID-19 patients. The detection of low vitamin D levels also in younger COVID-19 patients with less comorbidities further suggests vitamin D deficiency as crucial risk factor at any age.

Modeling Within-Person Variance in Reaction Time Data of Older Adults

GeroPsych ◽  
2011 ◽  
Vol 24 (4) ◽  
pp. 169-176 ◽  
Author(s):  
Philippe Rast ◽  
Daniel Zimprich
Keyword(s):  
Reaction Time ◽  
Cognitive Aging ◽  
Reaction Times ◽  
Reaction Time Task ◽  
Reaction Time Data ◽  
Scale Model ◽  
Time Data ◽  
Time Task ◽  
The Mean ◽  
Second Wave

In order to model within-person (WP) variance in a reaction time task, we applied a mixed location scale model using 335 participants from the second wave of the Zurich Longitudinal Study on Cognitive Aging. The age of the respondents and the performance in another reaction time task were used to explain individual differences in the WP variance. To account for larger variances due to slower reaction times, we also used the average of the predicted individual reaction time (RT) as a predictor for the WP variability. Here, the WP variability was a function of the mean. At the same time, older participants were more variable and those with better performance in another RT task were more consistent in their responses.

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

scholarly journals Prospective Analysis of Coagulopathy Associated with Isolated Traumatic Brain Injury and Clinical Outcome

2021 ◽  
Author(s):  
Gopal Krishna ◽  
Varun Aggarwal ◽  
Ishwar Singh
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Clinical Outcome ◽  
Road Traffic ◽  
Statistical Significance ◽  
Platelet Counts ◽  
Coagulation Abnormalities ◽  
The Mean ◽  
D Dimer

Abstract Introduction Traumatic brain injury (TBI) affects the coagulation pathway in a distinct way than does extracranial trauma. The extent of coagulation abnormalities varies from bleeding diathesis to disseminated thrombosis. Design Prospective study. Methods The study included 50 patients of isolated TBI with cohorts of moderate (MHI) and severe head injury (SHI). Coagulopathy was graded according to the values of parameters in single laboratory. The incidence of coagulopathy according to the severity of TBI and correlation with disseminated intravascular coagulation (DIC) score, platelets, prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, and fibrinogen was observed. The comparison was also made between expired and discharged patients within each group. It also compared coagulation derailments with clinical presentation (Glasgow Coma Scale [GCS]) and outcome (Glasgow Outcome Scale [GOS]). Results Road traffic accident was the primary (72%) mode of injury. Fifty-two percent had MHI and rest had SHI. Eighty-four percent of cases were managed conservatively. The mean GCS was 12.23 and 5.75 in MHI and SHI, respectively. Sixty-two percent of MHI and 96% of the patients with SHI had coagulation abnormalities. On statistical analysis, DIC score (p < 0.001) strongly correlated with the severity of head injury and GOS. PT and APTT were also significantly associated with the severity of TBI. In patients with moderate TBI, D-dimer and platelet counts showed association with clinical outcome. Fibrinogen levels did not show any statistical significance. The mean platelet counts remained normal in both the groups of TBI. The mean GOS was 1.54 and 4.62 in SHI and MHI, respectively. Conclusion Coagulopathy is common in isolated TBI. The basic laboratory parameters are reliable predictors of coagulation abnormalities in TBI. Coagulopathy is directly associated with the severity of TBI, GCS, and poor outcome.

Effect of Medialization of the Trochlear Groove and Lateralization of the Tibial Tubercle on TT-TG Distance: A Cross-sectional Study of Dysplastic and Nondysplastic Knees

2021 ◽  
pp. 036354652098781
Author(s):  
Mathias Paiva ◽  
Lars Blønd ◽  
Per Hölmich ◽  
Kristoffer Weisskirchner Barfod
Keyword(s):  
Trochlear Dysplasia ◽  
Cross Sectional Study ◽  
Magnetic Resonance Images ◽  
Tibial Tubercle ◽  
Control Group ◽  
Trochlear Groove ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mean Values ◽  
The Mean

Background: Tibial tubercle–trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning. Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 84 knees (28 normal [NK], 28 with trochlear dysplasia [TD], and 28 with patellar dislocation without TD [PD]) were examined. The medial border of the posterior cruciate ligament (PCL) was chosen as the central anatomic landmark. The distance from the TT to PCL (TT-PCL) was measured to examine the lateralization of the TT. The distance from the TG to the PCL (TG-PCL) was measured to examine the medialization of the TG. Between-group differences were investigated by use of 1-way analysis of variance. Results: The mean values for TT-TG distance were 8.7 ± 3.6 mm for NK, 12.1 ± 6.0 mm for PD, and 16.7 ± 4.3 mm in the TD group ( P < .01). The mean values for TT-PCL distance were 18.5 ± 3.6 mm for NK, 18.5 ± 4.5 mm for PD, and 21.2 ± 4.2 mm in the TD group ( P = .03). The mean values for TG-PCL distance were 9.6 ± 3.0 mm for NK, 7.1 ± 3.4 mm for PD, and 5.1 ± 3.3 mm in the dysplastic group ( P < .01). Conclusion: The present results indicate that increased TT-TG distance is due to medialization of the TG and not lateralization of the TT. Knees with TD had increased TT-TG distance compared with the knees of the control group and the knees with PD. The TT-PCL distance did not differ significantly between groups, whereas the TG-PCL distance declined with increased TT-TG.

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