Macro-TSH in Covid-19 Patients with an Underlying Thyroid Condition: A Case Series and Literature Review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Picazo Perea MP ◽  
◽  
Ruiz Gines MA ◽  
Ruiz Gines JA ◽  
Sastre Marcos J ◽  
...  
Keyword(s):  
Case Series ◽  
Underlying Disease ◽  
World Health ◽  
Response To Treatment ◽  
Reference Ranges ◽  
False Detection ◽  
Euthyroid Sick Syndrome ◽  
High Concentrations ◽  
Health Organization ◽  
First Time

Introduction: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that began in Wuhan (China), that spread rapidly worldwide, seriously affecting the population leading to a public health emergency declared by the World Health Organization. It is unknown how SARS-CoV-2 infection can affect thyroid function. In this study, we describe the characteristics of an unusual analytical interference that may explain the false detection of hypothyroidism in patients with SARS-CoV-2 infection. This is the first time that a phenomenon of this nature has been described in patients with COVID-19 and underlying thyroid dysfunction. Material and Methods: Observational study of patients admitted for severe COVID-19 infection and underlying thyroid disease. Results: TSH levels presented an atypical pattern different from that of Euthyroid Sick Syndrome (ESS), confirmed by the lack of response to substitution treatment. We develop different studies to confirm or eliminate potential interferences, being diagnosed of a possible macro-TSH. Conclusion: It is important to consider that in patients with COVID-19 and high concentrations of TSH and thyroid hormones within reference ranges with lack of response to treatment, one of the possible causes to consider is the presence of macro-TSH. The presence of macro-TSH interference in COVID-19 patients requires extreme precautions to avoid errors in diagnosis or treatment (replacement dose adjustment) in patients with hypothyroidism secondary to an underlying disease.

scholarly journals Programme for Harmonization to the International Scale in Latin America for BCR-ABL1 quantification in CML patients: findings and recommendations

2020 ◽  
Vol 58 (12) ◽  
pp. 2025-2035
Author(s):  
María Sol Ruiz ◽  
María Belén Sánchez ◽  
Yuly Masiel Vera Contreras ◽  
Evangelina Agrielo ◽  
Marta Alonso ◽  
...  
Keyword(s):  
Latin America ◽  
Myeloid Leukemia ◽  
World Health ◽  
Molecular Response ◽  
Limit Of Quantification ◽  
International Scale ◽  
Deep Molecular Response ◽  
Health Organization ◽  
First Time

AbstractObjectivesThe quantitation of BCR-ABL1 mRNA is mandatory for chronic myeloid leukemia (CML) patients, and RT-qPCR is the most extensively used method in testing laboratories worldwide. Nevertheless, substantial variation in RT-qPCR results makes inter-laboratory comparability hard. To facilitate inter-laboratory comparative assessment, an international scale (IS) for BCR-ABL1 was proposed.MethodsThe laboratory-specific conversion factor (CF) to the IS can be derived from the World Health Organization (WHO) genetic reference panel; however, this material is limited to the manufacturers to produce and calibrate secondary reference reagents. Therefore, we developed secondary reference calibrators, as lyophilized cellular material, aligned to the IS. Our purpose was both to re-evaluate the CF in 18 previously harmonized laboratories and to propagate the IS to new laboratories.ResultsOur field trial including 30 laboratories across Latin America showed that, after correction of raw BCR-ABL1/ABL1 ratios using CF, the relative mean bias was significantly reduced. We also performed a follow-up of participating laboratories by annually revalidating the process; our results support the need for continuous revalidation of CFs. All participating laboratories also received a calibrator to determine the limit of quantification (LOQ); 90% of them could reproducibly detect BCR-ABL1, indicating that these laboratories can report a consistent deep molecular response. In addition, aiming to investigate the variability of BCR-ABL1 measurements across different RNA inputs, we calculated PCR efficiency for each individual assay by using different amounts of RNA.ConclusionsIn conclusion, for the first time in Latin America, we have successfully organized a harmonization platform for BCR-ABL1 measurement that could be of immediate clinical benefit for monitoring the molecular response of patients in low-resource regions.

Indeterminate Chagas’ disease: Trypanosoma cruzi strain and re-infection are factors involved in the progression of cardiopathy

2003 ◽  
Vol 104 (4) ◽  
pp. 415-420 ◽  
Author(s):  
Juan M. BUSTAMANTE ◽  
Héctor W. RIVAROLA ◽  
Alicia R. FERNÁNDEZ ◽  
Julio E. ENDERS ◽  
Ricardo FRETES ◽  
...  
Keyword(s):  
Survival Rate ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Infected Group ◽  
World Health ◽  
Cardiac Lesions ◽  
Health Organization ◽  
Host Parasite ◽  
Β Adrenergic Receptors ◽  
First Time

Chagas' disease is caused by Trypanosoma cruzi, which is transmitted by reduviid bugs. The World Health Organization has estimated that about 16–18 million people in the Americas are infected, and that more than 100 million are at risk. In the present study we have used a murine model to analyse if particular T. cruzi strains (Tulahuen strain and SGO-Z12 isolate from a chronic patient) and/or re-infection may determine, during the indeterminate phase of experimental Chagas' disease, changes that could explain the different evolution of cardiac lesions. Re-infected mice reached higher parasitaemias than those infected for the first time. The survival in the indeterminate phase of mice infected with Tulahuen strain was 50.0%, while the SGO-Z12-infected group presented a significantly higher survival rate (77.1%; P<0.01). The SGO-Z12-re-infected group showed a survival rate (70.9%) significantly higher than that of the Tulahuen-re-infected group (37.0%; P<0.01). Electrocardiographic abnormalities were found in 66% of Tulahuen-infected mice, while in SGO-Z12-infected group such abnormalities were found in only 36% of animals (P<0.01). The two groups exhibited similar percentages of electrocardiographic dysfunction on re-infection, although intraventricular blocks were more frequent in Tulahuen-re-infected mice (P<0.01). Hearts from infected or re-infected mice with either parasite showed mononuclear infiltrates. The SGO-Z12-re-infected and Tulahuen-re-infected groups exhibited a significantly diminished affinity (P<0.05) and a significantly increased density (P<0.05) of cardiac β-adrenergic receptors compared with the infected and non-infected groups. The indeterminate phase of Chagas' disease is defined as a prolonged period that is clinically silent, but the present findings show that different T. cruzi strains and re-infection are able to alter the host–parasite equilibrium, and these factors may be responsible for inducing progressive cardiopathy.

scholarly journals Magnesium Sulphate For Tetanus, review of two cases

Medicinus ◽  
2020 ◽  
Vol 7 (4) ◽  
pp. 112
Author(s):  
Tirta Darmawan Susanto
Keyword(s):  
Intensive Care ◽  
Autonomic Dysfunction ◽  
Magnesium Sulphate ◽  
Case Series ◽  
Clinical Findings ◽  
Muscle Spasm ◽  
World Health ◽  
Control Muscle ◽  
Hospitalization Period ◽  
Health Organization

<div class="WordSection1"><p><strong>Introduction</strong><strong>: </strong>Tetanus is critically ill disease with long term hospitalization period. It need to be carefully monitored, usually in intensive care unit and involves critical care physicians. Benzodiazepine is preferred by World Health Organization (WHO) for muscle spasm control in tetanus, but it will be less costly if magnesium sulphate can be used alone to control spasm and autonomic dysfunction in tetanus. We report a series of 2 tetanus cases that were treated using magnesium sulphate to provide a brief clinical description about the use of magnesium sulphate in tetanus. We also give a brief review on epidemiology, pathophysiology, clinical findings, diagnosis, and treatment of tetanus to provide implications for intensive care physicians. Methods : Case series report</p><p><strong>Results : </strong>Two patients with tetanus was given magnesium sulphate infusion to control muscle spasm and autonomic dysfunction with good results as expected. Both of them were survive and discharged home in healthy condition.</p><p><strong>Conclusions :</strong></p><p>Magnesium sulphate can also be used to control muscle spasm and autonomic dysfunction although WHO recommend benzodiazepines for controlling muscle spasm. Intensive care physicians should have enough knowledge about tetanus and how it should be managed adequately to ensure survival from tetanus.</p></div>

scholarly journals Therapeutic Effectiveness and Safety of Repurposing Drugs for the Treatment of COVID-19: Position Standing in 2021

2021 ◽  
Vol 12 ◽  
Author(s):  
Safaet Alam ◽  
Taslima Binte Kamal ◽  
Md. Moklesur Rahman Sarker ◽  
Jin-Rong Zhou ◽  
S. M. Abdur Rahman ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Case Series ◽  
Basic Knowledge ◽  
World Health ◽  
Current Status ◽  
Drug Candidates ◽  
Health Organization ◽  
Meta Analyses

COVID-19, transmitted by SARS-CoV-2, is one of the most serious pandemic situations in the history of mankind, and has already infected a huge population across the globe. This horrendously contagious viral outbreak was first identified in China and within a very short time it affected the world's health, transport, economic, and academic sectors. Despite the recent approval of a few anti-COVID-19 vaccines, their unavailability and insufficiency along with the lack of other potential therapeutic options are continuing to worsen the situation, with valuable lives continuing to be lost. In this situation, researchers across the globe are focusing on repurposing prospective drugs and prophylaxis such as favipiravir, remdesivir, chloroquine, hydroxychloroquine, ivermectin, lopinavir-ritonavir, azithromycin, doxycycline, ACEIs/ARBs, rivaroxaban, and protease inhibitors, which were preliminarily based on in vitro and in vivo pharmacological and toxicological study reports followed by clinical applications. Based on available preliminary data derived from limited clinical trials, the US National Institute of Health (NIH) and USFDA also recommended a few drugs to be repurposed i.e., hydroxychloroquine, remdesivir, and favipiravir. However, World Health Organization later recommended against the use of chloroquine, hydroxychloroquine, remdesivir, and lopinavir/ritonavir in the treatment of COVID-19 infections. Combining basic knowledge of viral pathogenesis and pharmacodynamics of drug molecules as well as in silico approaches, many drug candidates have been investigated in clinical trials, some of which have been proven to be partially effective against COVID-19, and many of the other drugs are currently under extensive screening. The repurposing of prospective drug candidates from different stages of evaluation can be a handy wellspring in COVID-19 management and treatment along with approved anti-COVID-19 vaccines. This review article combined the information from completed clinical trials, case series, cohort studies, meta-analyses, and retrospective studies to focus on the current status of repurposing drugs in 2021.

scholarly journals Radon Gas in the City of Alicante. High Risk of Low Indoor Air Quality in Poorly Ventilated Buildings

2020 ◽  
Vol 17 (23) ◽  
pp. 8762
Author(s):  
Carlos Rizo-Maestre ◽  
Víctor Echarri-Iribarren
Keyword(s):  
World Health ◽  
Santa Barbara ◽  
Buried Structures ◽  
Gaseous State ◽  
Major Health ◽  
Radon Gas ◽  
Health Organization ◽  
Measurement Location ◽  
First Time ◽  
The City

In December 2019, Spain considered for the first time the presence of radon to the Technical Building Code (Basic Document HS 6: Radon Exposure Protection), although it only mentions minimum presences and the need for ventilation. This research shows that in buried structures or in places with little ventilation, even in soils with a low probability of granite, a high content of radon gas can be found. The city of Alicante has been used as a measurement location for different architectural sites; here, the level of 100 Bq/m3 is the first threshold where the gas must be monitored, and the level of 300 Bq/m3 is the maximum threshold above which corrective ventilation measures must be taken. The research conducted during the years 2015 and 2016 shows that it is necessary to account for also the areas considered to be “low presence of radon gas” to achieve healthy constructions. The renewal of air in the different places will be tested for the presence of radon, i.e., the greater the accumulation is, the less ventilation and the greater the risk of accumulation of radon gas. This study is located in the city of Alicante, where the seven civil constructions are located: two Civil War shelters, the Santa Barbara Castle, the Ereta Powder Keg, the Luceros-Marq and Serra Grossa railway tunnels and the Británica underground deposits. Radon gas is currently a concern for major health and medical agencies because it is considered to be a chemical element that is very harmful to people. The World Health Organization is one of the organisations that has the objective of studying and researching this element, to develop solutions. Radon gas is normally found in a gaseous state and is highly radioactive. It is present in many terrains and it is mostly found in those with granite; although the presence of this element is very low, there is always a minimum presence. In the past, in nongranite soils, the dose of radon was considered to be so low that it was insignificant. Therefore, in this research, the aim is to consider the high presence of radon gas in nongranite soils as long as the conditions for its accumulation are present.

scholarly journals Covid-19 and Pregnancy: An Overview

2020 ◽  
Vol 42 (07) ◽  
pp. 420-426
Author(s):  
Pedro Castro ◽  
Ana Paula Matos ◽  
Heron Werner ◽  
Flávia Paiva Lopes ◽  
Gabriele Tonni ◽  
...  
Keyword(s):  
Public Health ◽  
Pregnant Women ◽  
World Health Organization ◽  
Case Series ◽  
Public Health Emergency ◽  
Present Review ◽  
World Health ◽  
The World ◽  
Coronavirus Infection ◽  
Health Organization

AbstractSince the World Health Organization (WHO) declared coronavirus infection (COVID-19) a Public Health Emergency of International Concern in January 2020, there have been many concerns about pregnant women and the possible effects of this emergency with catastrophic outcomes in many countries. Information on COVID-19 and pregnancy are scarce and spread throughout a few case series, with no more than 50 cases in total. The present review provides a brief analysis of COVID-19, pregnancy in the COVID-19 era, and the effects of COVID-19 on pregnancy.

scholarly journals Multimodal neuroimaging of gliomatosis cerebri: a case series of four patients

2020 ◽  
Vol 9 (8) ◽  
pp. 205846012094278
Author(s):  
Robin Bonomi ◽  
Flora John ◽  
Suketu Patel ◽  
Geoffery Barger ◽  
Natasha Robinette ◽  
...  
Keyword(s):  
Amino Acid ◽  
Disease Progression ◽  
Imaging Modality ◽  
Case Series ◽  
Gliomatosis Cerebri ◽  
Added Value ◽  
World Health ◽  
Response To Treatment ◽  
Amino Acid Pet ◽  
Clinical Mri

In the latest World Health Organization classification of brain tumors, gliomatosis cerebri has been redefined to varying subsets of diffuse gliomas; however, the term is still used to describe gliomas with infiltrative growth into three or more cerebral lobes. These tumors are frequently misdiagnosed and difficult to treat due to their atypical presentation using structural imaging modalities including computed tomography and T1/T2-weighted magnetic resonance imaging (MRI). In this retrospective case series, we compared clinical MRI to amino acid positron emission tomography (PET) to assess the potential value of PET in the assessment of the extent of tumor involvement and in monitoring disease progression. We report the clinical course and serial multimodal imaging findings of four patients. Each patient presented at varying points in disease progression with widespread glioma brain involvement and was evaluated at least once by amino acid PET using alpha-[11C]methyl-L-tryptophan ([11C]-AMT). Increased uptake of [11C]-AMT was detected in a subset of non-enhancing brain lesions and detected tumor invasion before MRI signs of tumor in some regions. Increased uptake of [11C]-AMT was also detected in tumorous regions not detected by perfusion MRI or MR spectroscopy. Metabolic response to treatment was also observed in two patients. Overall, these data are consistent with and expand upon previous reports using other amino acid PET tracers in gliomatosis and show the potential added value of this imaging modality to clinical MRI in the detection and monitoring of these diffusely infiltrative tumors.

scholarly journals 119. Prospective Validation of a 3-Gene Signature for Tuberculosis Diagnosis, Predicting Progression and Evaluating Treatment Response

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S5-S5
Author(s):  
Hayley Warsinske ◽  
Aditya Rao ◽  
Flora Martinez Figueira Moreira ◽  
Paulo Cesar Pereira Dos Santos ◽  
Andrew Liu ◽  
...  
Keyword(s):  
Treatment Response ◽  
Disease Onset ◽  
Disease Status ◽  
Gene Signature ◽  
Case Control ◽  
World Health ◽  
Response To Treatment ◽  
Screening Study ◽  
Health Organization ◽  
Triage Test

Abstract Background The World Health Organization (WHO) has identified the need for a nonsputum-based triage test for tuberculosis (TB) that can be used to identify those who need further testing to identify active disease. We investigated whether our previously described 3-gene TB score could identify individuals with active tuberculosis (ATB) prior to seeking care (“active case detection”) and how the 3-gene TB score correlated with the timing of disease onset, disease severity, and response to treatment. Methods This study consisted of a prospective nested case–control trial, Brazil Active Screening Study (BASS; 2016), and re-analysis of data from 2 prospective cohort studies, the Adolescent Cohort Study (ACS; 2005–2007), and the Catalysis Treatment Response Cohort (CTRC; 2010–2013). The BASS case–control subcohort contained 81 adults (ages 20–72 years, 33 ATB, 48 controls). The ACS contained 153 adolescents (ages 12–18 years, 46 ATB, 107 LTBI). The CTRC-contained 138 adults (ages 17–67 years, 100 ATB, 17 other lung disease patients, 21 healthy controls). Results The 3-gene TB score diagnosed ATB patients with high accuracy: BASS cohort AUC = 0.87 (95% CI = 0.82–0.91, Figure 1A), ACS cohort AUC = 0.86 (95% CI = 0.76–0.97, Figure 1B), and CTRC AUC = 0.93 (95% CI = 0.88–0.97). In the ACS, the 3-gene TB score predicted progression from LTBI to ATB 6 months prior to positive sputum test (AUC = 0.86; 95% CI = 0.79–0.92, Figure 1B). In the CTRC, the 3-gene TB score correlated with glycolytic activity ratio of PET-CT at baseline (correlation = 0.54, P = 3.98 × 10−8, Figure 1C) and at the end of treatment (correlation = −0.408, P = 3.72 × 10−5). In the CTRC, the 3-gene TB score at baseline predicted the likelihood of prolonged sputum positivity following treatment initiation and treatment response at 6 months (P = 3.6 × 10−5). Collectively, across all cohorts, the 3-gene TB score identified ATB patients with 90% sensitivity and 70% specificity, and had 99% negative predictive value (NPV) at 5% prevalence. Conclusion Across 3 independent prospective cohorts, the 3-gene TB score closely approaches the WHO target product profile benchmarks for non-sputum–based triage test at high NPV. These performance characteristics make it a potential test for ruling out ATB and for monitoring disease status. Disclosures T. E. Sweeney, Inflammatix, Inc.: Employee and Shareholder, Salary. P. Khatri, Inflammatix Inc.: Board Member, Equity

scholarly journals Rosette-forming Glioneuronal Tumors in the Posterior Third Ventricle

2013 ◽  
Vol 40 (6) ◽  
pp. 885-888 ◽  
Author(s):  
Ibrahim Alnaami ◽  
Keith Aronyk ◽  
Jian-Qiang Lu ◽  
Edward S. Johnson ◽  
Cian O'Kelly
Keyword(s):  
Third Ventricle ◽  
Case Series ◽  
Neurofibromatosis Type ◽  
Pineal Region ◽  
World Health ◽  
Glioneuronal Tumor ◽  
First Case ◽  
The Central Nervous System ◽  
Health Organization ◽  
Glioneuronal Tumors

Rosette-forming glioneuronal tumor (RGNT) is a rare brain tumor found almost exclusively within the fourth ventricle. These grade I tumors were first included in the World Health Organization (WHO) Classification for the central nervous system in 20071. Since then, approximately 49 cases have been published.There are no reported cases of RGNT within the third ventricle, although this tumor has also been described in the pineal region, the tectum and within the aqueduct. Supratentorial localization is quite rare, with only three published: one was found in the septum pellucidum, another within the optic nerve in neurofibromatosis type 1 (NF1) patient and one in a patient with multiple RGNT in the lateral ventricle. The authors report the first case series in the literature of RGNT occurring within the posterior third ventricle.

scholarly journals Total mercury in the night shark, Carcharhinus signatus in the western equatorial Atlantic Ocean

2004 ◽  
Vol 47 (4) ◽  
pp. 629-634 ◽  
Author(s):  
Alexandre Gomes Ferreira ◽  
Vicente Vieira Faria ◽  
Carlos Euardo Veiga de Carvalho ◽  
Rosangela Paula Teixeira Lessa ◽  
Francisco Marcante Santana da Silva
Keyword(s):  
Atlantic Ocean ◽  
Total Mercury ◽  
Atomic Emission ◽  
World Health ◽  
Human Consumption ◽  
Equatorial Atlantic ◽  
Daily Ingestion ◽  
Equatorial Atlantic Ocean ◽  
High Concentrations ◽  
Health Organization

Mercury is the only element capable to biomagnificate along the food chain, and carnivorous fish tend to accumulate high concentrations of this element. Total mercury in muscle tissue of Carcharhinus signatus sampled along the western equatorial Atlantic Ocean was measured by atomic emission spectrophotometry with ICP/AES. The average total mercury concentrations were consistently greater than the maximum limit for human consumption established by the Brazilian Health Ministry for carnivorous fishes (1000 µg. kg-1 w.w.). Therefore, an average consumption of 0.1 kg/day of C. signatus would result in an average daily ingestion of 174.2 µg of Hg, more than five times the 30 µg/day intake established by the World Health Organization. In the range of lengths studied, body length could not be used as an indicator of the Hg contamination degree for C. signatus. Also, sex cannot be considered a determining factor in the total mercury accumulation in C. signatus.

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