MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN ASSOCIATED WITH COVID-19: RESULTS OF A MULTICENTER STUDY

2021 ◽  
Vol 100 (6) ◽  
pp. 23-31
Author(s):  
Yu.Yu. Novikova ◽  
◽  
D.Yu. Ovsyannikov ◽  
A.A. Glazyrina ◽  
N.N. Zvereva ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Intensive Therapy ◽  
Late Complication ◽  
Clinical Signs ◽  
Open Label ◽  
Atypical Form ◽  
Symptom Complex ◽  
Inflammatory Syndrome ◽  
Symptoms And Signs

Coronavirus disease 2019 (COVID-19) in children in most cases is asymptomatic or mild, and its most severe late complication is multisystem inflammatory syndrome in children (MIS-C). The aim of the study is to find clinical, laboratory and instrumental characteristics, description of therapeutic tactics, including determination of the profile of patients requiring Tocilizumab prescription and the outcomes of MIS-C associated with COVID-19. Materials and methods of research: 245 children aged 3 months – 17 years old were included in the pilot prospective multicenter open-label comparative study with MIS-C associated with COVID-19, verified based on CDC criteria (2020). Results: the median age of patients was 8 [5; 10] years, boys predominated among the patients (57.1%); MIS-C manifested itself as a combination of the symptom complex of Kawasaki disease (KD, 53.1% of patients), more often of atypical form, cardiovascular (66.1%), gastrointestinal (61.2%), neurological (27.3%) symptoms and signs of detection of the urinary (29.4%) and respiratory (19.6%) systems; macrophage activation syndrome (MAS) was diagnosed in 19.5% of patients. Therapy included glucocorticosteroids (97.6%), antibiotics (95.5%), anticoagulants (93.9%), intravenous immunoglobulin (34.7%), vasoactive/vasopressor support (31.8%), Tocilizumab (15.1%), mechanical ventilation (2.4%), extracorporeal membrane oxygenation (0.4%). Patients receiving Tocilizumab, statistically significantly more often compared with patients without this therapy, were in the intensive care unit (ICU, 86.5% versus 40.9%, p<0.001), more often required vasopressor therapy (70.3% versus 25%, p<0.001), had statistically significantly higher markers of laboratory inflammatory activity. Treatment in 47.8% of cases was carried out in an ICU; one child has died. In 4.1%, according to echocardiography, coronaritis, ectasia of the coronary arteries without the formation of persistent aneurysms were detected. Conclusion: MIS-C associated with COVID-19 has clinical signs of KD, often of the incomplete form, accompanied by arterial hypotension/shock, MAS, which requires intensive therapy, and the prescription of Tocilizumab.

CLINICAL, LABORATORY-INSTRUMENTAL CHARACTERISTICS, COURSE AND THERAPY OF PEDIATRIC MULTISYSTEM INFLAMMATORY SYNDROME ASSOCIATED WITH COVID-19

2020 ◽  
Vol 99 (6) ◽  
pp. 73-83
Author(s):  
Yu.Yu. Novikova ◽  
◽  
D.Yu. Ovsyannikov ◽  
A.A. Glazyrina ◽  
O.I. Zhdanova ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Intensive Therapy ◽  
Gastrointestinal Symptoms ◽  
Arterial Hypotension ◽  
Therapy Outcomes ◽  
Clinical Hospital ◽  
Severe Manifestation ◽  
Symptom Complex ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome

The most severe manifestation of the new coronavirus infection COVID-19 in children is the multisystem inflammatory syndrome in children (MIS-C). A systematic review of foreign publications as of July 25, 2020 contains an analysis of the disease course in 662 children with this syndrome and is used for comparison with the data obtained. Objective of the research: to characterize clinical manifestation, results of laboratory and instrumental studies, therapy, outcomes and consequences of the COVID-19- associated MIS-C, based on the observation of patients hospitalized to Morozov Children's City Clinical Hospital and Children’s clinical hospital of infectious diseases № 6 from May 1 to September 15, 2020. Materials and methods: the pilot study included 32 children aged 9 months – 15 years with COVID-19-associated MIS-C, verified based on WHO criteria (2020), including symptoms of Kawasaki disease (KD), arterial hypotension/shock, laboratory and instrumental signs of heart damage, signs of coagulopathy, gastrointestinal symptoms, increased inflammation markers, COVID-19 markers. Results: the median age of patients was 6 years, boys predominated among the patients (66%), all patients had antibodies to SARS-CoV-2 (31 children of the IgG class); MIS-C manifested itself as a combination of KD symptom complex (75% of patients) with arterial hypotension/shock (28%), neurological (50%), respiratory (41%), gastrointestinal (59%) symptoms; macrophage activation syndrome (MAS) was verified in 16% of patients. Therapy included intravenous immunoglobulin (75%), systemic glucocorticosteroids (88%), anticoagulants (91%), vasoactive/vasopressor support (31%). In 38% of cases treatment was performed in intensive care unit; one child died. According to echocardiography, 16% of patients had coronariitis, ectasia, and coronary arteries aneurysms. Conclusion: COVID-19-associated MIS-C is characterized by a severe course, cross-features with KD, shock syndrome with KD, MAS which requires intensive therapy and can cause acquired pathology of the cardiovascular system in children.

DETERMINATION OF WHITE BLOOD CELLS USING FOLDSCOPE WITH SMARTPHONE

2019 ◽  
pp. 10-13
Author(s):  
Ranu Kumar ◽  
Prasad Kapildeo
Keyword(s):  
Human Blood ◽  
Blood Cells ◽  
Blood Smear ◽  
Clinical Laboratory ◽  
White Blood Cells ◽  
Healthcare Services ◽  
Field Level ◽  
Morphology Analysis

We are traditionally used Microscope in clinical laboratory for determination of white blood cells of human blood smear. Now, in this study we were used Foldscope with Smartphone in the place of Microscope and examine many samples of human blood smear which was collected from local diagnostic centers. We were very easily quantity & morphology analysis of all types of WBC cells such as Neutrophils, Lymphocytes, Monocytes, Eosionophils, Basophils in blood smear with the help of Foldscope & image taken by Smartphone. The main objective of this study is to use Foldscope for quantity & morphology analysis of human WBCs at field level especially poor resource area where healthcare services or centers is not available & where carry of microscope is not possible.

scholarly journals The pathway through LC-MS method development: in-house or ready-to-use kit-based methods?

2020 ◽  
Vol 58 (6) ◽  
pp. 1002-1009 ◽  
Author(s):  
Caroline Le Goff ◽  
Jordi Farre-Segura ◽  
Violeta Stojkovic ◽  
Patrice Dufour ◽  
Stéphanie Peeters ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Liquid Chromatography ◽  
Tandem Mass Spectrometry ◽  
Method Development ◽  
Clinical Laboratory ◽  
Cross Reactivity ◽  
Tandem Mass ◽  
Chromatography Tandem Mass Spectrometry ◽  
Liquid Chromatography Tandem Mass

AbstractHistorically, the determination of low concentration analytes was initially made possible by the development of rapid and easy-to-perform immunoassays (IAs). Unfortunately, typical problems inherent to IA technologies rapidly appeared (e.g. elevated cost, cross-reactivity, lot-to-lot variability, etc.). In turn, liquid chromatography tandem mass spectrometry (LC-MS/MS) methods are sensitive and specific enough for such analyses. Therefore, they would seem to be the most promising candidates to replace IAs. There are two main choices when implementing a new LC-MS/MS method in a clinical laboratory: (1) Developing an in-house method or (2) purchasing ready-to-use kits. In this paper, we discuss some of the respective advantages, disadvantages and mandatory requirements of each choice. Additionally, we also share our experiences when developing an in-house method for cortisol determination and the implementation of an “ready-to-use” (RTU) kit for steroids analysis.

Determination of multidirectional myocardial deformations in cats with hypertrophic cardiomyopathy by using two-dimensional speckle-tracking echocardiography

2017 ◽  
Vol 19 (12) ◽  
pp. 1283-1289 ◽  
Author(s):  
Ryohei Suzuki ◽  
Yohei Mochizuki ◽  
Hiroki Yoshimatsu ◽  
Takahiro Teshima ◽  
Hirotaka Matsumoto ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Contractile Function ◽  
Radial Strain ◽  
Clinical Signs ◽  
Myocardial Deformation ◽  
Radial Deformation ◽  
Two Dimensional

Objectives Hypertrophic cardiomyopathy, a primary disorder of the myocardium, is the most common cardiac disease in cats. However, determination of myocardial deformation with two-dimensional speckle-tracking echocardiography in cats with various stages of hypertrophic cardiomyopathy has not yet been reported. This study was designed to measure quantitatively multidirectional myocardial deformations of cats with hypertrophic cardiomyopathy. Methods Thirty-two client-owned cats with hypertrophic cardiomyopathy and 14 healthy cats serving as controls were enrolled and underwent assessment of myocardial deformation (peak systolic strain and strain rate) in the longitudinal, radial and circumferential directions. Results Longitudinal and radial deformations were reduced in cats with hypertrophic cardiomyopathy, despite normal systolic function determined by conventional echocardiography. Cats with severely symptomatic hypertrophic cardiomyopathy also had lower peak systolic circumferential strain, in addition to longitudinal and radial strain. Conclusions and relevance Longitudinal and radial deformation may be helpful in the diagnosis of hypertrophic cardiomyopathy. Additionally, the lower circumferential deformation in cats with severe hypertrophic cardiomyopathy may contribute to clinical findings of decompensation, and seems to be related to severe cardiac clinical signs. Indices of multidirectional myocardial deformations by two-dimensional speckle-tracking echocardiography may be useful markers and help to distinguish between cats with hypertrophic cardiomyopathy and healthy cats. Additionally, they may provide more detailed assessment of contractile function in cats with hypertrophic cardiomyopathy.

Determination of the L-ascorbic acid requirements in Wistar osteogenic disorder Shionogi rats for prolonged carcinogenesis experiments

1996 ◽  
Vol 30 (4) ◽  
pp. 337-346 ◽  
Author(s):  
S. W. Y. Chan ◽  
P. C. Reade
Keyword(s):  
Animal Model ◽  
Ascorbic Acid ◽  
Drinking Water ◽  
Normal Level ◽  
Physical Condition ◽  
Wistar Rats ◽  
Clinical Signs ◽  
Supplement Group ◽  
Palatal Mucosa

Wistar Shionogi rats of the ( od/od) substrain with the osteogenic disorder are unable to synthesize L-ascorbic acid ( L-AA) and appear to be an appropriate animal model for studying the effect of L-AA in carcinogenesis. To determine the minimal L-AA requirements of these animals for prolonged survival in a satisfactory physical condition during experimentation, four concentrations of L-AA (0.33 g/l, 0.67 g/l, 1.67 g/l and 3.33 g/l) were administered via drinking water to four groups of animals ( n=2). Their water intake per cage was recorded three times weekly and the plasma L-AA levels were determined at the start, after 2, 4, 8 and 12 weeks and at the termination of the experiment. To simulate the procedures to be undertaken in oral mucosal carcinogenesis experiments, the animals were gently restrained and a designated amount of sterile NaCl was applied to the palatal mucosa three times a week for 26 weeks. The L-AA supplement group with the lowest concentration (0.33 g/l L-AA) achieved mean plasma levels of 7 ± 1.38 μM, approximately one-eighth that of the normal level (mean plasma L-AA level in outbred Wistar rats was found to be 58 ± 3 μM) whilst those in the higher supplement group (3.33 g/l L-AA) achieved a mean of 18 ± 1.25 μM. All of the animals employed in the present study survived for 26 weeks and showed no clinical signs of L-AA deficiency during this period.

Psychological factors of student youth‘s responsible behavior.

2020 ◽  
Vol 89-90 (4-5) ◽  
pp. 93-101
Author(s):  
Tatyana Fadeeva ◽  
Keyword(s):  
Social Responsibility ◽  
Self Esteem ◽  
Psychological Characteristics ◽  
Educational Organizations ◽  
Social Desirability Scale ◽  
Self Confidence ◽  
Responsible Behavior ◽  
Symptom Complex ◽  
Similarities And Differences

The article considers the problem of studying the determinants of the types of responsible behavior of young people. It is assumed that there are similarities and differences in the determination of the types of responsible behavior of the youth. The study involved 70 students (average age – 22 years old, SD = 2.19; men – 12%). We used the standardized methods "Questionnaire for the diagnosis of the personal symptom complex of responsibility" (Kocharyan I.A.), "Methods for the study of self-attitude" (Panteleev S.R.), the questionnaire "Determining the level of self-esteem" (Kovalev S.V.), "Social Desirability Scale" (D. Crown, D. Marlowe). We established that the most pronounced types of social behavior of youth are "ethics" and "self-sacrifice". It is shown that the severity of the type of social responsibility is determined by various combinations of psychological characteristics. The most complex regression equation characterizes the type of responsible behavior “Normalizations”. The least pronounced prediction of responsible behavior was revealed in relation to its types: "Fidelity to principle" and "Self-confidence". The results of this study can be useful for further study of the problems of social responsibility, as well as for the development of programs for the formation of youth's social responsibility in educational organizations.

scholarly journals Metabolomic Signature in Sera of Multiple Sclerosis Patients during Pregnancy

2018 ◽  
Vol 19 (11) ◽  
pp. 3589 ◽  
Author(s):  
Claudia Rossi ◽  
Ilaria Cicalini ◽  
Mirco Zucchelli ◽  
Maria di Ioia ◽  
Marco Onofrj ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Signs ◽  
Female Gender ◽  
Epidemiological Studies ◽  
Mass Spectrometry Analysis ◽  
Spectrometry Analysis ◽  
Hormonal Fluctuations ◽  
The Central Nervous System ◽  
Multiple Sclerosis Patients

Multiple sclerosis (MuS) is an autoimmune disease of the central nervous system characterized by neuroinflammation, neurodegeneration, and degradation of the myelin sheath. Epidemiological studies have shown that the female gender is more susceptible than the male gender to MuS development, with a female-to-male ratio of 2:1. Despite this high onset, women have a better prognosis than men, and the frequency of the relapsing phase decreases during pregnancy, while it increases soon after birth. Therefore, it is interesting to investigate hormonal fluctuations during pregnancy and whether they correlate with metabolic signatures. To gain a deeper inside into the biochemical mechanism of such a multifactorial disease, we adopted targeted metabolomics approaches for the determination of many serum metabolites in 12 pregnant women affected by MuS by mass spectrometry analysis. Our data show a characteristic hormonal fluctuation for estrogens and progesterone, as expected. They also highlight other interesting hormonal alterations for cortisol, corticosterone, 11-deoxycortisol, 4-androstene-3,17-dione, testosterone, and 17α-hydroxyprogesterone. Furthermore, a negative correlation with progesterone levels was observed for amino acids and for acylcarnitines, while an imbalance of different sphingolipids pathways was found during pregnancy. In conclusion, these data are in agreement with the characteristic clinical signs of MuS patients during pregnancy and, if confirmed, they may add an important tessera in the complex mosaic of maternal neuroprotection.

scholarly journals Enteroparasitic occurrence in fecal samples analyzed at the University of Western São Paulo-UNOESTE clinical laboratory, Presidente Prudente, São Paulo State, Brazil

2004 ◽  
Vol 46 (5) ◽  
pp. 243-248 ◽  
Author(s):  
Nair Toshiko Tashima ◽  
Maria Jacira Silva Simões
Keyword(s):  
Giardia Lamblia ◽  
Clinical Laboratory ◽  
Clinical Signs ◽  
Data Bank ◽  
Sao Paulo ◽  
São Paulo ◽  
Bank Structure ◽  
Stool Samples ◽  
Medical Attendance ◽  
The University

This study aims to analyze the enteroparasitic occurrence in children from 0 to 12 years old consulted at the University of western São Paulo Clinical Laboratory, Presidente Prudente, SP, Brazil, in relation to the socioeconomic profile of the attended children. Stool samples were examined and a questionnaire was applied with the objective of knowing the patient's age, sex, medical attendance, characteristic of the habitation, provisioning of water, dejection and domestic waste fates, use of footwear and clinical signs. The software EPI INFO 6 (Version 6.04b) was used for the elaboration of the data bank structure and analysis after previous data codification. Among 1,000 children analyzed, as many as 21.3% presented some kind of parasite. The most frequent protozoan was Giardia lamblia (7.3%) followed by Entamoeba coli (3.9%). The most frequent helminth was Enterobius vermicularis (1.9%) followed by Hymenolepis nana (0.5%). The most frequent protozoan association was Giardia lamblia / Entamoeba coli (0.9%).

scholarly journals CYP2E1-DEPENDENT VARIATIONS IN HEPATOCYTES DAMAGE DURING TREATMENT OF TUBERCULOSIS

2019 ◽  
Vol 16 (3) ◽  
pp. 20-26
Author(s):  
L.V. Natrus ◽  
L.V. Gayova ◽  
O.O. Gorkunenko ◽  
P.A. Chernovol ◽  
M.V. Zelinska
Keyword(s):  
Gene Polymorphism ◽  
Maintenance Therapy ◽  
Genomic Dna ◽  
Clinical Laboratory ◽  
Intensive Therapy ◽  
Venous Blood ◽  
Control Group ◽  
Drug Induced ◽  
Cyp2e1 Gene ◽  
Tb Treatment

Relevance. Investigation of polymorphism in a locus of CYP2E1 as the prognostic factor of drug-induced hepatotoxicity at anti-TB therapy is significant due to the influence of CYP2E1 on drug metabolism. The objective of the investigation is to analyze the association of rs2070676 СYP2E1 gene polymorphism with drug-induced hepatotoxicity by means of the clinical-laboratory values of serum transaminases at anti-TB treatment. Materials and methods. The study involved 47 patients with drug-susceptible tuberculosis first time discovered. 58 healthy volunteers comprised a control group. Laboratory indices were determined in venous blood three times: before the treatment as baseline; in 2 months of intensive therapy (isoniazid, rifampicin, ethambutol, pyrazinamide), then in 4 months of maintenance therapy (isoniazid, rifampicin). Serum activities of enzymes ALT, AST, and GGT were measured by standard algorithm on automatic analyzer BS-300. Analysis of rs2070676 polymorphism of CYP2E1 gene was performed by polymerase chain reaction using standard PureLink® Genomic DNA Kit for Purification of Genomic DNA; Manufacturer of INVITROGEN (USA). For statistical processing, IBM SPSS Statistics 23 was applied. Results. Investigation of serum ALT and AST in patients with major genotype CYP2E1 (C/C) showed the lower baseline ALT and AST levels comparing to the control group, which might be caused by suppression of hepatocytes functions at the development of the disease. Anti-TB treatment caused an increase in ALT and AST levels comparing to the baseline in patients with major CYP2E1 (C/C) genotype. In the group with C/G polymorphism, the baseline ALT level didn’t differ much from the baseline of the control group; it showed a decrease after intensive therapy and returned back to the initial level at maintenance therapy. This might be related to the certain protective property of СYP2E1 gene polymorphism. The AST level was increased after intensive therapy (to a smaller extent than for the patients with major C/C genotype) and remained on the same level at maintenance therapy. A study of GGT showed a gradual increase regardless of genotype. Conclusion. According to the data of the experiment, the status of hepatocytes in patients with tuberculosis at baseline and during treatment was different depending on the CYP2E1 genotype. The results of the experiment indicate that the CYP2E1 gene polymorphism has a certain protecting role. It reduces the level of drug metabolites and hepatotoxicity which causes mitochondrial dysfunction.

scholarly journals Determination of Bovine Rotavirus G and P Serotypes in Italy by PCR

1999 ◽  
Vol 37 (12) ◽  
pp. 3879-3882 ◽  
Author(s):  
E. Falcone ◽  
M. Tarantino ◽  
L. Di Trani ◽  
P. Cordioli ◽  
A. Lavazza ◽  
...  
Keyword(s):  
Reverse Transcription ◽  
Clinical Signs ◽  
Specific Primers ◽  
Bovine Rotavirus ◽  
Reverse Transcription Pcr ◽  
Rotavirus Vaccines ◽  
Intestinal Contents ◽  
Group A

Determination of the G and P serotypes of group A bovine rotaviruses from 149 samples of feces or intestinal contents collected from calves showing clinical signs of neonatal diarrhea was performed by a nested reverse transcription-PCR typing assay. The G6 serotype was the most prevalent, accounting for viruses in 55.7% of the samples; viruses of the G10 and G8 serotypes were found in 34.9 and 4.7% of the samples, respectively. The virus in one sample (0.7%) was not classified due to concomitant infection with G6 and G8 strains, whereas viruses in six samples (4.0%) could not be characterized with any of the three G serotype-specific primers selected for the present study. When examined for their P-serotype specificities, viruses in 55 and 42.3% of the samples were characterized as P[11] and P[5], respectively, no P[1] serotype was identified, and viruses in 2.7% of the samples could not be classified due to multiple reactivity with both P[5]- and P[11]-specific primers. Various combinations of G and P serotypes were observed, the most frequent being G6,P[5] (38.3%), G10,P[11] (31.5%), and G6,P[11] (15.4%). The results of the present study, while contributing to a better understanding of the epidemiology of bovine rotaviruses in Italy, address the relevance of serotype specificity with regard to the constancy of the quality of bovine rotavirus vaccines under different field conditions.

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