scholarly journals The Seasonality, Steroid and the Lower Ratio of Neutrophil to Lymphocyte Associated With Listeriosis in Japan

2021 ◽  
Author(s):  
Yusuke Watanabe ◽  
Itaru Nakamura ◽  
Yuri Miura ◽  
Hidehiro Watanabe
Keyword(s):  
Mortality Rate ◽  
Clinical Symptoms ◽  
Warm Season ◽  
Underlying Disease ◽  
University Hospital ◽  
Control Group ◽  
Case Group ◽  
Steroid Use ◽  
Lower Ratio ◽  
Tokyo Medical

Abstract Background: Although listeriosis is a foodborne infection with a high mortality rate, studies of listeriosis from Asia are limited. We aimed to compare the characteristics of listeriosis and non-listeriosis (defined as bacteremia without Listeria monocytegenes infection) in Japan.Methods: We conducted a case–control study of adults with listeriosis or with bacteremia without L. monocytegenes infection from January 1, 2010, to December 31, 2019, at Tokyo Medical University Hospital in Japan. We recorded the incidence of admissions and the clinical characteristics, including age and sex; underlying disease; clinical symptoms; onset month; whether listeriosis was community-associated or health care–associated; medicine; blood count; biochemical findings; antibiotics use; admission to the intensive care unit; and outcome.Results: A total of 12 patients were included in the case group and 28 patients were included in the control group. Most cases of listeriosis were present in patients of an advanced age, with underlying disease, and/or on immunosuppressant therapy. Two patients died within 30 days and one developed a brain abscess. Listeriosis onset was associated with the warm season (90.9% vs. 53.8%; P = 0.033), steroid use (54.5% vs. 19.2%; P = 0.042), and a lower ratio of neutrophils to lymphocytes (9.46 vs. 18.44; P = 0.015).Conclusion: The incidence of listeriosis in this study was similar to that in other Asian countries and the 30-day mortality rate was 18.2%. We observed that listeriosis onset was associated with the warm season, steroid use, and a lower ratio of neutrophils to lymphocytes.

scholarly journals The seasonality, steroid use, and lower ratio of neutrophil to lymphocyte associated with bacteremia of Listeria monocytogenes in Japan from 2010 to 2019: a case–control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yusuke Watanabe ◽  
Itaru Nakamura ◽  
Yuri Miura ◽  
Hidehiro Watanabe
Keyword(s):  
Mortality Rate ◽  
Case Control Study ◽  
Warm Season ◽  
Case Control ◽  
University Hospital ◽  
Control Group ◽  
P Value ◽  
Steroid Use ◽  
Lower Ratio ◽  
Control Study

Abstract Background Despite having a high mortality rate, Asian studies about the characteristics of adult listeriosis are limited. We investigated the incidence of listeriosis per admissions, associated factors, and rate of mortality in listeriosis, compared with non-listeriosis. Methods We recorded the incidence of listeriosis per 10,000 admissions and conducted a case–control study from January 1, 2010, to December 31, 2019, at Tokyo Medical University Hospital (TMUH) in Japan. Cases were defined as adult with listeriosis that was bacteremia due to L. monocytogenes. Controls, defined as adult with non-listeriosis bacteremia due to other pathogens, were matched by age and clinical department to cases. We analyzed differences in seasonality, including warm season (defined as the period from May to October), medication including steroids, laboratory findings, and mortality. The odds ratio and p value between the cases group and control group were calculated using a chi-square test and Fisher’s exact test. Results The incidence of listeriosis per 10,000 admissions to TMUH was 0.51. Eleven patients, excluding one neonate, were included in the case group. Twenty-six patients, excluding one patient because of contamination and one patient because of insufficient medical record, were included in the control group. Listeriosis onset was associated with the warm season (90.9% vs. 53.8%; p = 0.033), steroid use (54.5% vs. 19.2%; p = 0.042), and a lower ratio of neutrophils to lymphocytes (9.46 vs. 18.44; p = 0.015). The 30-day mortality rate of listeriosis was similar to non-listeriosis (18.3% vs. 19.2%; p = 0.619). Conclusion The incidence of listeriosis per admissions in this study was similar to that in other Asian countries. Factors associated with listeriosis were the warm season, steroid use, and a lower ratio of neutrophils to lymphocytes. Additionally, the 30-day mortality rate was similarly high in both the listeriosis and non-listeriosis groups.

scholarly journals Obesity in Pregnancy – Implications on Pregnancy Events

2020 ◽  
Vol 8 (B) ◽  
pp. 1157-1161
Author(s):  
Lilia Koleva ◽  
Victoria Spasova ◽  
Marieta Popova ◽  
Valentina Petkova ◽  
Milen Dimitrov
Keyword(s):  
Pregnant Women ◽  
Preterm Births ◽  
Developed Countries ◽  
Overweight And Obesity ◽  
University Hospital ◽  
Control Group ◽  
Case Group ◽  
Normal Limits ◽  
The University ◽  
Maternal Overweight

BACKGROUND: Overweight and obesity are serious health problems in most developed countries. The percentage of young women with excessive weight who get pregnant continues to grow every year. This raises a concern about the risks of the mother and the baby during pregnancy and after birth. AIM: This study aims to determine health risk for overweight mothers and especially the risk for preterm birth. MATERIALS AND METHODS: This is a prospective and retrospective study taking place in the outpatient clinic of the University Hospital “Maichin Dom”. Our study included 105 pregnant women with BMI ≥25 kg/m2 as a case group and 91 pregnant women with BMI within normal limits as a control group. RESULTS: Mean BMI in the case group was 34.79 ± 3.71 kg/m2 and 20.20 ± 2.24 kg/m2 in the control group. Among 105 women in the case group, we registered 24.8% (n = 26) who gave birth before term. Preterm births among 91 women in the control group were registered in 17.6% (n = 16) patients. We found a significant correlation between increased BMI and the risk of increased systolic and diastolic blood pressure. Moreover, we found comorbidities in 43.8% of cases and 24.2% of controls. CONCLUSION: Maternal overweight and obesity during pregnancy are associated with increased risks of preterm delivery and complications of pregnancy. Extra efforts should be made to help women lose weight before this important period of life.

scholarly journals Increasing frequency of Pseudomonas aeruginosa infections during tigecycline use

2015 ◽  
Vol 9 (03) ◽  
pp. 309-312 ◽  
Author(s):  
Aysegul Ulu-Kilic ◽  
Emine Alp ◽  
Dilek Altun ◽  
Fatma Cevahir ◽  
Gamze Kalın ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Tertiary Care ◽  
Care Facility ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Control Group ◽  
Case Group ◽  
Icu Patients ◽  
Thoracic Drainage ◽  
Tertiary Care Facility

Introduction: The widespread use of tigecycline raises the question of increasing infection rates of Pseudomonas aeruginosa (PA) in ICUs which are not affected by this antibiotic. Objective:  The aim of this study was to determine if treatment with tigecycline is a risk factor for PA infection in ICU patients. Methodology: A retrospective and observational study was conducted at Erciyes University Hospital, Turkey, between 2008 and 2010. The Erciyes University Hospital is a 1300-bed tertiary care facility. The patients included in this study were hospitalized in four adult ICUs. Patients with PA infections (case group) were compared with patients with nosocomial infection other than PA (control group). Results: A total of 1,167 patients with any nosocomial infections were included in the study. Two hundred and seventy eight (23.8%) of the patients had PA infection during their ICU stay. Fifty nine patients (21.2%) in the case group received tigecycline before developing PA infections, which were found to be significantly more frequent than in the controls (p < 0.01). Multivariate analysis showed that risk factors for PA infection were previous tigecycline use (4 times), external ventricular shunt (4.2 times), thoracic drainage catheter (2.5 times) and tracheostomy (1.6 times). Conclusion: Our results contribute to the need for new studies to determine the safety of tigecycline use, especially for the treatment of critically ill patients. Since tigecycline seems to be an alternative for the treatment of multidrug resistant (MDR) microorganisms, rational use of this antibiotic in ICU patients is essential.

Differentiation of acute pyelonephritis from other febrile states in children using urinary neutrophil gelatinase-associated lipocalin (uNGAL)

2016 ◽  
Vol 54 (1) ◽  
Author(s):  
Jadranka Arambašić ◽  
Sanja Mandić ◽  
Željko Debeljak ◽  
Dario Mandić ◽  
Vesna Horvat ◽  
...  
Keyword(s):  
Acute Pyelonephritis ◽  
Clinical Symptoms ◽  
Characteristic Curve ◽  
Severe Disease ◽  
White Blood Cells ◽  
Diagnostic Value ◽  
University Hospital ◽  
Control Group ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

AbstractAcute pyelonephritis is a severe disease which is sometimes difficult to recognize based on clinical symptoms and routinely available diagnostic tests, especially in young children. The aim of this study was to assess the diagnostic value of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a biomarker of acute pyelonephritis.In this case-control study we analyzed 134 children (median age 2.5 years) who were admitted to the Pediatric Clinic of University Hospital Centre Osijek, Croatia. Eighty of them had acute pyelonephritis, while 54 children had febrile state of different etiology including cystitis and they represented the control group. uNGAL, white blood cells, C-reactive protein, urinanalysis, urine culture, kidney ultrasound and a dimercaptosuccinic acid scintigraphic scan were done for each child. uNGAL was measured using chemiluminiscent microparticle immunoassay on ARHITECT i1000SR (Abbott Diagnostics, IL, USA).uNGAL values were significantly higher in children with acute pyelonephritis compared to the control groups (113.6 ng/mL vs. 10.2 ng/mL, p<0.001). A receiver operating characteristic curve comparison was done for tested parameters and encouraging results were obtained for uNGAL (AUC=0.952). A cut-off value of 29.4 ng/mL had 92.5% sensitivity and 90.7% specificity. We showed that uNGAL can also serve in differentiating acute pyelonephritis from cystitis (cut-off 38.5 ng/mL), and for differentiation of cystitis from febrile states with etiology other than urinary tract infection (UTI) (cut-off 20.4 ng/mL).uNGAL can be a useful diagnostic biomarker in acute pyelonephritis in children, but also in differentiating cystitis from febrile states other than UTI.

scholarly journals Arterial and Venous Thrombosis Complicated in COVID-19: A Retrospective Single Center Analysis in Japan

2021 ◽  
Vol 8 ◽  
Author(s):  
Seiya Oba ◽  
Tadashi Hosoya ◽  
Miki Amamiya ◽  
Takahiro Mitsumura ◽  
Daisuke Kawata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Clinical Symptoms ◽  
Epidemiological Data ◽  
Japanese Patients ◽  
University Hospital ◽  
Bleeding Complications ◽  
Protein Mutants ◽  
Tokyo Medical ◽  
D Dimer

Background: Thrombosis is a characteristic complication in coronavirus disease 2019 (COVID-19). Since coagulopathy has been observed over the entire clinical course, thrombosis might be a clue to understanding the specific pathology in COVID-19. Currently, there is limited epidemiological data of COVID-19-associated thrombosis in the Japanese population and none regarding variant strains of SARS-CoV-2. Here, we elucidate the risk factors and the pattern of thrombosis in COVID-19 patients.Methods: The patients consecutively admitted to Tokyo Medical and Dental University Hospital with COVID-19 were retrospectively analyzed. SARS-CoV-2 variants of concern/interest (VOC/VOI) carrying the spike protein mutants E484K, N501Y, or L452R were identified by PCR-based analysis. All thrombotic events were diagnosed by clinical symptoms, ultrasonography, and/or radiological tests.Results: Among the 516 patients, 32 patients experienced 42 thromboembolic events. Advanced age, severe respiratory conditions, and several abnormal laboratory markers were associated with the development of thrombosis. While thrombotic events occurred in 13% of the patients with a severe respiratory condition, those events still occurred in 2.5% of the patients who did not require oxygen therapy. Elevated D-dimer and ferritin levels on admission were independent risk factors of thrombosis (adjusted odds ratio 9.39 and 3.11, 95% confidence interval 2.08–42.3, and 1.06–9.17, respectively). Of the thrombotic events, 22 were venous, whereas 20 were arterial. While patients with thrombosis received anticoagulation and antiinflammatory therapies with a higher proportion, the mortality rate, organ dysfunctions, and bleeding complications in these patients were higher than those without thrombosis. The incidence of thrombosis in COVID-19 became less frequent over time, such as during the replacement of the earlier strains of SARS-CoV-2 by VOC/VOI and during increased use of anticoagulatory therapeutics.Conclusion: This study elucidated that elevated D-dimer and ferritin levels are useful biomarkers of thrombosis in COVID-19 patients. The comparable incidence of arterial thrombosis with venous thrombosis and the development of thrombosis in less severe patients required further considerations for the management of Japanese patients with COVID-19. Further studies would be required to identify high-risk populations and establish appropriate interventions for thrombotic complications in COVID-19.

scholarly journals The use of a metronome during cardiopulmonary resuscitation in the emergency room of a university hospital

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Renata Maria de Oliveira Botelho ◽  
Cássia Regina Vancini Campanharo ◽  
Maria Carolina Barbosa Teixeira Lopes ◽  
Meiry Fernanda Pinto Okuno ◽  
Aécio Flávio Teixeira de Góis ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Survival Rates ◽  
Spontaneous Circulation ◽  
University Hospital ◽  
Control Group ◽  
Case Group ◽  
Chi Square ◽  
Significant Difference ◽  
Service Data

ABSTRACT Objective: to compare the rate of return of spontaneous circulation (ROSC) and death after cardiac arrest, with and without the use of a metronome during cardiopulmonary resuscitation (CPR). Method: case-control study nested in a cohort study including 285 adults who experienced cardiac arrest and received CPR in an emergency service. Data were collected using In-hospital Utstein Style. The control group (n=60) was selected by matching patients considering their neurological condition before cardiac arrest, the immediate cause, initial arrest rhythm, whether epinephrine was used, and the duration of CPR. The case group (n=51) received conventional CPR guided by a metronome set at 110 beats/min. Chi-square and likelihood ratio were used to compare ROSC rates considering p≤0.05. Results: ROSC occurred in 57.7% of the cases, though 92.8% of these patients died in the following 24 hours. No statistically significant difference was found between groups in regard to ROSC (p=0.2017) or the occurrence of death (p=0.8112). Conclusion: the outcomes of patients after cardiac arrest with and without the use of a metronome during CPR were similar and no differences were found between groups in regard to survival rates and ROSC.

Antinuclear Antibodies and Lupus-like Manifestations in Rheumatoid Arthritis and Ankylosing Spondylitis Patients at 4 Months' Follow-up After Treatment with Infliximab and Etanercept

2020 ◽  
Vol 16 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Mir Amir Aghdashi ◽  
Mohsen Khadir ◽  
Roshan Dinparasti-Saleh
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Treatment Regimen ◽  
Antinuclear Antibodies ◽  
Clinical Symptoms ◽  
Underlying Disease ◽  
Case Group ◽  
Tnf Α ◽  
The Relationship

Background: Up to 44% of patients treated with infliximab and 7% of patients treated with etanercept reported to have anti-drug antibodies within the first 6 months of treatment. Recently, anti-TNF-α therapies have been reported to be employed in the induction of the druginduced lupus erythematous. Objective: The aim of the present study was to investigate the relationship between anti-TNFα antibodies and various manifestations of lupus erythematous. Methods: We enrolled a total of 56 cases divided into 28 known cases of rheumatoid arthritis and 28 cases of ankylosing spondylitis patients and 56 controls. The case group was divided into 4 groups according to the underlying disease (RA or AS) and treatment regimen (infliximab or etanercept). ANA and anti-dsDNA levels and lupus criteria were assessed at the beginning of the study and 4 months after the initiation of anti-TNFα. Results: 36% and 21% of RA patients treated with infliximab, were ANA and anti-dsDNA positive after 4 months (P=0.003, P=0.025). 28% and 7% of RA patients treated with etanercept, were ANA and anti-dsDNA positive after 4 months (P=0.009, P=0.15). 21% and 7% of AS patients treated with infliximab, were ANA and anti-dsDNA positive, respectively (P=0.025, P=0.15). 14% and 7% of AS patients treated with etanercept, were ANA and anti-dsDNA positive, respectively (P=0.63, P=0.15). Three patients who were positive for auto-antibodies developed three criteria for SLE. Conclusions: Infliximab potentially may increase both ANA and anti-dsDNA levels in rheumatoid arthritis, but only ANA in ankylosing spondylitis patients. In general, clinicians should consider different clinical symptoms of ATIL, which may be present as a lupus-like syndrome similar to idiopathic SLE or classical DIL.

THE DNA METHYLATION STATUS IN PRESENT DAY POPULATIONS LIVING IN AREAS OF VIETNAM SUBJECTED TO AGENT ORANGE SPRAYING DURING THE WAR IN NAM DONG AND A LUOI, THUA THIEN HUE PROVINCE

2018 ◽  
pp. 59-66
Author(s):  
Thanh Tin Nguyen ◽  
Phan Minh Triet Le ◽  
Viet Nhan Nguyen ◽  
Cristina Giuliani ◽  
Donata Luiselli ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Methylation Status ◽  
University Hospital ◽  
Agent Orange ◽  
Control Group ◽  
Case Group ◽  
Veterans Health ◽  
Dna Hypomethylation ◽  
Cross Sectional ◽  
Cyp1a1 Gene

Introduction: Agent Orange was the most extensively used among herbicides sprayed on Vietnam territory during the Vietnam War. Its by-product, 2,3,7,8-tetrachlorodibenzo-paradioxin (Dioxin), is an extremely toxic and persistent chemical. The effects of this spraying on both Vietnamese and United States Veterans health has been reported in many publications. However, there wasn’t any study of the effects at the molecular level of the residual Dioxin in the environment on present Vietnamese civilians living in contaminated areas. Objective: To investigate the association between residual Agent Orange/Dioxin in the environment and the alterations of DNA methylation in the peripheral blood of the present day Vietnamese population living in spraying areas. Methods: Cross-sectional study. The subjects were 188 individuals who came to Hue University Hospital for health care: 94 individuals for case group from sprayed areas (A Luoi and Nam Dong, Thua Thien Hue Province), and 94 individuals for the control group from non-sprayed areas (Quang Binh to North Vietnam). MALDI-TOF MS technique was used to detect the alterations of DNA methylation of CYP1A1 gene. Results: Among 22 CpG position of CYP1A1 gene were investigated, there were the DNA hypomethylation at CpG_2.3.4, CpG_5, CpG_12.13 in case group compared to the control (p<0.05). After dividing case group into 2 subgroups, we found the significant DNA hypomethylation at CpG_2.3.4, CpG_5, CpG_9, CpG_10, CpG_11, CpG_12.13, CpG_17, CpG_18.19 in subgroup CASES_F_P compared to CASES_NON_F_P also control group (p< 0.05). Conclusions: Individuals living in A Luoi and Nam Dong– the Dioxin contaminated areas– had DNA hypomethylation in CYP1A1 gene. The DNA hypomethylation seem not due to the effects of residual Dioxin in the environment in present day, it was likely to be inherited by epigenetic way from the DNA methylation alterations on their parents who had directly exposure to that spraying. This theory should be verified through extensive studies with CASES_F_P family and more genes will be investigated. Key words: Agent Orange, Dioxin, DNA methylation, CYP1A1

scholarly journals The effect of heparin prescription before primary PCI on long-term and short-term clinical and para clinical results and the mortality of patients with acute coronary syndrome

2018 ◽  
Vol 7 (4) ◽  
pp. 748
Author(s):  
Bijan Zamani ◽  
Asghar Abdollahi ◽  
Afrooz Mardi
Keyword(s):  
Mortality Rate ◽  
Left Ventricle ◽  
Anticoagulation Therapy ◽  
Control Group ◽  
Case Group ◽  
Primary Pci ◽  
Left Ventricle Function ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Ventricle Function

Background: Primary PCI (PPCI) is the main reperfusion treatment for ST-segment elevation myocardial infarction (STEMI). Anticoagulation therapy should be administered in patients undergoing PCI in order to limit the ischemic complications. In this study, we evaluated the effect of bolus unfractionated heparin (UFH) before PPCI on clinical outcome of patients with STEMI.Methods: In this randomized clinical trial, 196 patients (72.4% male with mean age of 63.02±13.37 years) with STEMI undergoing PPCI were randomly assigned to receive bolus UFH 60-90 U/kg in emergency room (case group) or during PCI (control group). Clinical outcomes, 30 day mortality, hematoma, left ventricle function improvement during follow-up were compared between groups.Results: In both groups there was good flow in the involved coronary artery after PCI. Case group compared to control group had significantly more cases with improved LVEF (28.1% vs. 9.7%, p=0.005). Also, case group compared to control group had more hematoma (3.1% vs. 0%, p=0.24) and higher mortality rate (6% vs. 4.2%, p=0.56) which had no significant difference between groups.Conclusions: PPCI in patients with STEMI accompanies with acceptable coronary flow irrespective of receiving bolus heparin. Receiving bolus heparin in these patients may have improved left ventricle function by increasing the rate of reflow. However, using bolus heparin did not accompany with increased rate of bleeding and had no effect on 30 day mortality rate.

scholarly journals Prospective, observational, single-centre cohort study with an independent control group matched for age and sex aimed at investigating the significance of cholinergic activity in patients with schizophrenia: study protocol of the CLASH-study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e050501
Author(s):  
Benedikt Schick ◽  
Eberhard Barth ◽  
Benjamin Mayer ◽  
Claire-Louise Weber ◽  
Theresa Hagemeyer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Symptoms ◽  
Point Of Care ◽  
Acetylcholinesterase Activity ◽  
Primary Objective ◽  
University Hospital ◽  
Control Group ◽  
Independent Control ◽  
Data Set ◽  
Butyrylcholinesterase Activity

IntroductionAlterations in the cholinergic metabolism may cause various clinical symptoms of schizophrenia. In addition to the ‘monoamine hypothesis,’ neuroinflammation is also discussed as a cause of schizophrenia. To date, there has been no evidence of alterations in the central cholinergic transmitter balance in patients with schizophrenia under clinical conditions. By contrast, studies in critically ill patients have established the measurement of acetylcholinesterase activity as a suitable surrogate parameter of central cholinergic transmitter balance/possible pathophysiological changes. Butyrylcholinesterase activity has been established as a parameter indicating possible (neuro)inflammatory processes. Both parameters can now be measured using a point-of-care approach. Therefore, the primary objective of this study is to investigate whether acetylcholinesterase and butyrylcholinesterase activity differs in patients with various forms of schizophrenia. Secondary objectives address the possible association between acetylcholinesterase and butyrylcholinesterase activity and (1) schizophrenic symptoms using the Positive and Negative Syndrome Scale, (2) the quantity of antipsychotics taken and (3) the duration of illness.Methods and analysisThe study is designed as a prospective, observational cohort study with one independent control group. It is being carried out at the Department of Psychiatry and Psychotherapy III, Ulm University Hospital, Germany. Patient enrolment started in October 2020, and the anticipated end of the study is in January 2022. The enrolment period was set from October 2020 to December 2021 (extension required due to SARS-CoV-2 pandemic). The sample size is calculated at 50 patients in each group. Esterase activity is measured on hospital admission (acute symptomatology) and after referral to a postacute ward over a period of three consecutive days. The matched control group will be created after reaching 50 patients with schizophrenia. This will be followed by a comprehensive statistical analysis of the data set.Ethics and disseminationThe study was registered prospectively in the German Clinical Trials Register (DRKS-ID: DRKS00023143,URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023143) after approval by the ethics committee of the University of Ulm, Germany Trial Code No. 280/20.Trial registration numberDRKS00023143; Pre-results.

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