scholarly journals Renal and hepatic  injury associated with COVID-19 infection; A prospective cohort analysis of  renal and hepatic injury in patients infected with COVID-19        

2021 ◽  
Author(s):  
Qutaiba Al Khames Aga ◽  
Kawthar Nassir ◽  
Hesham Al Mawla ◽  
Hassan Abbas ◽  
Jawad Rasheed ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hepatic Injury ◽  
Cohort Analysis ◽  
Kidney Injury ◽  
Stage Iv ◽  
Liver Function Tests ◽  
Total Serum ◽  
Liver Injuries ◽  
Function Test ◽  
Baseline Values

The current study evaluated the rate of progression of acute kidney and hepatic injury and its associated mortality rate in patients infected with COVID-19. For this study, a total of 397 COVID-19 positive adult patients were prospectively recruited. Routine medical examination, liver function tests (LFT) and renal function test (RFT) were performed at the time of hospitalization and this procedure was repeated for every two days until the hospital stay of the patient or till the death of the patient. The upper values (data obtained from the recovered patients or died patients during course of the disease) of LFT and RFT were compared to that of baseline values (recorded at the time of hospitalization) of recovered or died patients. The baseline values of both LFT and RFT values were not significantly varied between recovered 88.41% (n=351) and died patients 11.59% (n=46) at the time of hospitalization. However, the baseline values of total serum bilirubin were significantly (P = 0.001) higher in died patients at the time of hospitalization as compared to the recovered patients. Moreover, majority (52.17%) of the died patients progressed to stage III and stage IV acute kidney injury prior to death. Furthermore, both LFT and RFT were abnormally elevated as compared to their baseline values among the died patients.  COVID-19 patients possess high risk for the development of acute kidney and liver injuries, which can substantially enhance the mortality rate.

scholarly journals Acute kidney and liver injury could be the cause of death in patients with COVID-19

2021 ◽  
Author(s):  
Qutaiba Al Khames Aga ◽  
Kawthar Nassir ◽  
Hesham Al Mawla ◽  
Hassan Abbas ◽  
Jawad Rasheed ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Liver Injury ◽  
Poor Prognosis ◽  
Hepatic Injury ◽  
Total Bilirubin ◽  
Serum Bilirubin ◽  
Stage Iv ◽  
Liver Function Tests ◽  
Total Serum ◽  
Baseline Values

We evaluated the increase in the risk of developing acute kidney and hepatic injury. Moreover, we investigate the association between kidney and liver biomarkers with poor prognosis and mortality rate. Methods: This was a prospective cohort study of 397 adult patients with an average age of 48.03 ± 14.09 were diagnosed with COVID-19 of whom, 46 (11.59%) died in hospital. The upper values of the kidney and liver biomarkers were obtained from the recovered patients during the disease period and are compared to the data for dead patients at admission (Baseline) and one day before death. Results: At admission to the hospital, the baseline S.Cr, BUN, and eGFR were not significantly varied between recovered and dead patients. Furthermore, the baseline values for AST, ALT, and ALP were not significantly differed between both groups. Whereas, baseline value of total serum bilirubin was higher in died compared to the recovered patients. For dead patients, the day before death, 52.17% of the patients had progressed to stage III and stage IV AKI. S.Cr and BUN were significantly higher, and eGFR was lower compared to the recovered patients. All of the kidney and liver function tests were abnormally increased from baseline to the day before death. The AST, ALT, and total bilirubin one day before death were significantly higher compared to their baseline value. Conclusions: COVID-19 patients have a high risk for the development of AKI and liver injury that can be progressed to a chronic stage and increase the mortality rate.

scholarly journals Necrotising Otitis Externa Antibiotic therapy complications: A retrospective cohort analysis

2021 ◽  
Author(s):  
Ali Ijaz ◽  
Emma Williams ◽  
Joby Cole ◽  
Glen Watson
Keyword(s):  
Adverse Effects ◽  
Antibiotic Therapy ◽  
Otitis Externa ◽  
Cohort Analysis ◽  
Kidney Injury ◽  
Liver Function Tests ◽  
Surrounding Tissue ◽  
Duration Of Treatment ◽  
Intravenous Antibiotics ◽  
Cranial Nerve Palsies

Introduction: Necrotising otitis externa (NOE) is a serious, progressive infection of the external ear canal. If untreated, it can invade into temporal bone, skull-base and surrounding tissue resulting in cranial nerve palsies, neurological infections and death. Patients present with unremitting, severe otalgia, otorrhoea and oedematous ear canals containing granulation. Surgery has a limited role; the mainstay of treatment involves a long course of intravenous antibiotics. Currently, there is no data on the complications of antibiotic treatment for NOE. This project aims to provide evidence on the nature/frequency of severe treatment-related complications requiring a change in antibiotic regime. Methods: A retrospective 5-year cohort analysis was performed on 64 patients who were treated for confirmed NOE with intravenous antibiotic therapy. Clinical notes, blood results and antibiotic prescriptions were documented and analysed. Results: Average duration of treatment was 11 weeks (range=38 weeks). There was an average of 2.1 antibiotic regimes per patient with 10 cases requiring inpatient admission due to treatment-related complications. 63% of treatment changes were directly related to adverse effects of intravenous antibiotics. Drug allergy/intolerance (n=18) and clinical deterioration i.e. Lack of symptomatic improvement and/or worsening inflammatory markers (n=18), were the most common reasons for antibiotic change. Neutropenia, deranged liver function tests and acute kidney injury were also recognised adverse effects of treatment. Conclusion: This study provides the first evidence on the notable frequency of antibiotic-related complications in NOE patients. Larger, multicentre studies are required in the future to validate our findings and will better inform both clinicians and patients of the risks of treatment.

Effectiveness of a vancomycin dosing protocol guided by area under the concentration-time curve to minimal inhibitory concentration (AUC/MIC) with multidisciplinary team support to improve hospital-wide adherence to a vancomycin dosing protocol: A pilot study

2021 ◽  
pp. 1-6
Author(s):  
Panipak Katawethiwong ◽  
Anucha Apisarnthanarak ◽  
Kittiya Jantarathaneewat ◽  
David J. Weber ◽  
David K. Warren ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Multidisciplinary Team ◽  
Kidney Injury ◽  
University Hospital ◽  
Routine Practice ◽  
Post Intervention ◽  
Coagulase Negative Staphylococci ◽  
Time Curve ◽  
Concentration Time ◽  
Quasi Experimental

Abstract Background: Limited data are available on the implementation of an area under the concentration-time curve (AUC)–based dosing protocol with multidisciplinary team (MT) support to improve adherence with vancomycin dosing protocol. Objective: To evaluate the effectiveness of an AUC-based dosing protocol with MT support intervention with adherence to a hospital-wide vancomycin dosing protocol at Thammasat University Hospital. Method: We conducted a quasi-experimental study in patients who were prescribed intravenous vancomycin. The study was divided into 2 periods; (1) the preintervention period when the vancomycin dosing protocol was already applied in routine practice and (2) the post-intervention period when the implementation of an AUC-based dosing protocol with MT support was added to the existing vancomycin dosing protocol. The primary outcome was the rate of adherence, and the secondary outcomes included acute kidney injury events, vancomycin-related adverse events, and 30-day mortality rate. Results: In total, 240 patients were enrolled. The most common infections were skin and soft-tissue infections (24.6%) and bacteremia (24.6%). The most common pathogens were coagulase-negative staphylococci (19.6%) and Enterococcus spp (15.4%). Adherence with the vancomycin dosing protocol was significantly higher in the postintervention period (90.8% vs 55%; P ≤ .001). By multivariate analysis, an AUC-based dosing protocol with MT support was the sole predictor for adherence with the vancomycin dosing protocol (adjusted odds ratio, 10.31; 95% confidence interval, 4.54–23.45; P ≤ .001). The 30-day mortality rate was significantly lower during the postintervention period (8.3% vs 20%; P = .015). Conclusions: AUC-based dosing protocol with MT support significantly improved adherence with vancomycin dosing protocol and was associated with a lower 30-day mortality rate.

Virtual Population Analysis (VPA) Equations for Nonhomogeneous Populations, and a Family of Approximations Including Improvements on Pope's Cohort Analysis

1986 ◽  
Vol 43 (12) ◽  
pp. 2406-2409 ◽  
Author(s):  
Alec D. MacCall
Keyword(s):  
Mortality Rate ◽  
Population Analysis ◽  
Seasonal Pattern ◽  
Cohort Analysis ◽  
Natural Mortality ◽  
Close Approximation ◽  
Virtual Population Analysis ◽  
Virtual Population ◽  
Special Case

A set of "backward" virtual population analysis (VPA) equations relates catch (Ct) from continuous fishing between times t and t + 1 to population n size (Nt, Nt+1) when a portion of the stock is unavailable to fishing. The usual VPA equations become a special case where the entire stock is available (i.e. the stock is homogeneous). A close approximation to the VPA equations is Nt = Nt+1 exp(M) + CtM/(1 − exp(−M)), which has properties similar to Pope's "cohort analysis" and is somewhat more accurate in the case of a continuous fishery, especially if the natural mortality rate (M) is large. Much closer simple approximations are possible if the seasonal pattern of catches is known.

Evaluation Changes in Indicators of Oncological Service in Colorectal Cancer in East Kazakhstan Region

2021 ◽  
Vol 9-10 (219-220) ◽  
pp. 11-16
Author(s):  
Yerkezhan Zhadykova ◽  
◽  
Sauirbay Sakhanov ◽  
Dulat Turebayev ◽  
Dariyana Kulmirzayeva ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Mortality Rate ◽  
Early Diagnosis ◽  
Stage Iv ◽  
International Agency ◽  
Keywords Colorectal Cancer ◽  
Anti Cancer ◽  
East Kazakhstan ◽  
The Difference ◽  
The Republic

About 3.15 million new cases of colorectal cancer (CRC) are predicted and it is expected that about 1.62 million human will die from this pathology, according to the forecasts of the International Agency for Research on Cancer in 2040. To this aim, an analysis studying studying the indicators of the oncological service for CRC also makes it possible to evaluate the ongoing anti-cancer measures in East Kazakhstan region. Aim. Evaluate some indicators of the oncological service at CRC in East Kazakhstan region in 2009 to 2018. Materials and methods. The research material was data from the Ministry of Health of the Republic of Kazakhstan – annual form No. 7 and 35 regarding CRC (ICD 10 – C18-21) for 2009-2018 in East Kazakhstan region – incidence, mortality, early diagnosis, neglect, morphological verification. A retrospective study using descriptive and analytical methods of biomedical statistics was used as the main method. Results and discussion. For 2009-2018, 3,661 new cases of CRC were registered in East Kazakhstan region for the first time. The incidence of CRC was 25.30/0000 and in dynamics tended to increase from 21.90/0000 (2009) to 25.70/0000 in 2018, the difference was statistically significant (t=1.99 and p=0.047). The mortality rate from CRC tended to decrease from 15.50/0000 to 14.70/0000 (p=0.591), and the average annual mortality rate from CRC was 15.60/0000. The indicators of early diagnosis (the proportion of patients with stage I-II) improved from 58.8% (2009) to 62.3% in 2018, and, accordingly, the indicators of the proportion of neglected patients significantly decreased with stage III (from 25.5% to 20.8%), while with stage IV (from 15.7% to 16.9%) there is a slight increase. The indicators of morphological verification in CRC improved from 90.5% to 98.6% during the studied years. Conclusion. An improvement in the indicators of morphological verification and early diagnosis of CRC was found. The obtained results are recommended to be used for monitoring anti-cancer measures in the region. Keywords: colorectal cancer, incidence, mortality, early diagnosis, neglect, morphological verification.

THYROID CYTOLOGY AND IT'S INTERPRETATION WITH THYROID FUNCTION TEST

2021 ◽  
pp. 80-82
Author(s):  
Dipti Debbarma ◽  
Shipra Singh ◽  
Debarshi Jana ◽  
Chittaranjan Dutta
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Nodular Goiter ◽  
Thyroid Function Test ◽  
Total Serum ◽  
Endocrine Glands ◽  
Nodular Goitre ◽  
Medical College ◽  
Euthyroid State ◽  
Function Test

INTRODUCTION: The Thyroid gland is unique among the endocrine glands. It is the largest of all the endocrine glands and it is supercial in location. It is the only gland which is easily approachable to direct physical, cytological and histopathological examination. The thyroid gland is affected by a variety of pathological lesions that are manifested by various morphologies including developmental, inammatory, hyperplastic and neoplastic pathology which are quiet common in the clinical practice. AIM OFTHE STUDY:In this study, we aimed to assess the cytological ndings of palpable thyroid nodules in conjunction with thyroid hormonal prole of the patient. To study the incidence in relevance to age, sex in various categories of thyroid lesions. MATERIALS & METHODS: Study Design: Institutional based Cross-sectional Study. Duration of study: January 2019 to August 2020. Source of data: Patients presenting to the OPD and admitted in the In-patient ward at Darbhanga Medical College, Bihar. Place of study: Department of Pathology, Darbhanga Medical College and Hospital, Laheriasarai, Bihar. Sample Size: 60 patients of enlarged thyroid gland. RESULTS & OBSERVATIONS: We found that the 53.3% Patients are in euthyroid state. Nodular goitre is the most common nding. In the present study among 60 patients, Nodular goiter accounts for 83.3 % of all cases; 41.7% of them were in euthyroid state, 21.7 % in hypothyroid state , 8.3 % in subclinical hypothyroid and remaining 11.7 % in hyperthyroid state . SUMMARY AND CONCLUSION: FNAC together with thyroid function test (TFT) analysis leads to early and accurate diagnosis of various thyroid diseases and reduces surgical intervention. The study showed that FNAcytologic diagnosis cannot be used to predict thyroid function using total serum T4, T3 and TSH concentrations. Measurement of TSH, free T4, and free T3 would be preferable

Influence of errors in natural mortality estimates in cohort analysis

1997 ◽  
Vol 54 (7) ◽  
pp. 1608-1612 ◽  
Author(s):  
G Mertz ◽  
R A Myers
Keyword(s):  
Mortality Rate ◽  
Similar Pattern ◽  
Cohort Analysis ◽  
Transient Behavior ◽  
Natural Mortality ◽  
Exact Formulation ◽  
Fishing Mortality ◽  
Bias Factor ◽  
Special Case ◽  
Mortality Estimates

The accuracy of the estimation of cohort strength from catch data may be greatly degraded if a poor estimate of the natural mortality rate is entered into the calculation. A straightforward, exact formulation for the error in cohort reconstruction due to a misspecified natural mortality rate is presented. The special case of constant fishing mortality is particularly transparent, allowing the error to be segmented into easily interpreted terms. A change in the fishing mortality may result in a distinct hump in the transient behavior of the bias factor, rather than a simple monotonic adjustment. This implies a similar pattern in estimated cohort strength.

scholarly journals Evaluation of Reversed Administration Order of Busulfan (BU) and Cyclophosphamide (CY) as Conditioning on Liver Toxicity in Allogenic Hematopoietic Stem Cell Transplantation (ALLHSCT)

2020 ◽  
Author(s):  
Mani Ramzi ◽  
Nasrin Namdari ◽  
Shirin Haghighat ◽  
Hourvash Haghighinejad
Keyword(s):  
Stem Cell ◽  
Mortality Rate ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Acute Gvhd ◽  
Liver Toxicity ◽  
Conditioning Regimen ◽  
Liver Function Tests ◽  
Hematopoietic Stem ◽  
Transplantation Center

Background: Busulfan (BU) in combination with cyclophosphamide (CY) is used as an effective conditioning regimen in hematopoietic SCT. Busulfan, depletes glutathione level in liver and causes elevated levels of CY metabolites. Cyclophosphamide metabolites are highly toxic for sinusoidal endothelial cells and cause VOD/ SOS with high mortality rate. Materials and Methods: Between September 2013 and September 2015, all adult patients with acute leukemia who were candidates for myeloablative allogenic SCT and were admitted to Stem Cell Transplantation center were enrolled in this prospective randomized clinical trial. We tested the hypothesis that reverse administration from BU-CY (n=28) to CY-BU group (n=27) would reduce liver toxicity. Results: Liver function tests were significantly higher in the BU-CY group between day -1 and +4 (p<0.05), but VOD/SOS was not diagnosed in both groups. The incidence and severity of acute GVHD was higher in the BU-CY group, but not statistically significant. Engraftment and mortality rate were not different. Conclusion: These data support the concept that CY-BU is associated with less liver toxicity, suggesting CY-BU is superior to BU-CY as conditioning.

scholarly journals Hydroxyethyl Starch 130/0.42 Effect’s on Renal Function in Patients After Cardiac Surgery: A Retrospective Cohort Analysis

2020 ◽  
Author(s):  
Benedict Morath ◽  
Andreas Meid ◽  
Johannes Rickmann ◽  
Jasmin Soethoff ◽  
Markus Verch ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Cardiac Surgery ◽  
Kidney Function ◽  
Hydroxyethyl Starch ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Kidney Injury ◽  
Retrospective Cohort Analysis ◽  
The Impact

Abstract Background: Fluid management is an everyday challenge in intensive care units worldwide. Data from recent trials suggest that the use of hydroxyethyl starch leads to a higher rate of acute kidney injury and mortality in septic patients. Evidence on the safety of hydroxyethyl starch used in postoperative cardiac surgery patients is lacking Methods: The aim was to determine the impact of postoperatively administered hydroxyethylstarch 130/0.42 on renal function and 90-day mortality compared to with or without balanced crystalloids in patients after elective cardiac surgery. A retrospective cohort analysis was performed including 2245 patients undergoing elective coronary artery bypass grafting or, aortic valve replacement, or a combination of both between 2015 - 2019. Acute kidney injury was defined according to the ‘kidney disease improving global outcomes’ criteria. Multivariate logistic regression yielded adjusted associations of postoperative hydroxyethyl starch administration with acute kidney injury during hospital stay and 90-day mortality. Linear mixed-effects models predicted trajectories of estimated glomerular filtration rates over the postoperative period to explore the impact of dosage and timing of hydroxyethyl starch administration.Results: A total of 1009 patients (45.0 %) suffered from acute kidney injury. Significantly less acute kidney injury of any stage occurred in patients receiving hydroxyethyl starch compared to patients receiving only crystalloids for fluid resuscitation (43.7 % vs. 51.2 % p=0.008). In multivariate analysis, the administration of hydroxyethyl starch showed a protective effect (OR 0.89 95% confidence interval (CI) (0.82-0.96)) which was less prominent in patients receiving only crystalloids (OR 0.98, 95% CI (0.95-1.00)). No association between hydroxyethyl starch and 90-day mortality (OR 1.05 95% CI (0.88-1.25)) was detected. Renal function trajectories were dose-dependent and biphasic and hydroxyethyl starch could even slow down the late postoperative decline of kidney function.Conclusion: This study showed no association between hydroxyethyl starch and the postoperative occurrence of acute kidney injury and may add evidence to the discussion about the use of hydroxyethyl starch in cardiac surgery patients. In addition, hydroxyethyl starch administered early after surgery in adequate low doses might even prevent the decline of the kidney function after cardiac surgery.

Sign in / Sign up

Export Citation Format

Share Document