scholarly journals Endocrine Flawed In COVID-19 Era

2021 ◽  
pp. 49-64
Author(s):  
Farhana Akter ◽  
Rahnuma Ahmad ◽  
Mainul Haque
Keyword(s):  
Adrenal Insufficiency ◽  
Negative Impact ◽  
Medical Science ◽  
Endocrine System ◽  
Clinical Expertise ◽  
Angiotensin Converting Enzyme 2 ◽  
Global Pandemic ◽  
History Of ◽  
Hypothalamic Pituitary Axis ◽  
Adequate Management

The clinical practice and social relationships have been changed since the emergence of COVID-19. It is declared a global pandemic affecting millions of people across the world. SARS-CoV-2 virus while infecting human has been noted to affect several vital organs and biological systems. This can occur directly through virus-induced damage or indirectly due to the host response after virus entry, which produce a negative impact on body systems. Human endocrine system similar fatal effect. Thereafter, the knowledge and clinical expertise about the management of the endocrine pathological consequences of COVID-19 is essential in the current pandemic situation. The need of such clinical proficiency is increasing more demanding as SARS-CoV-2 pandemic is growing towards more devastating phase. The coronavirus enters the human body by using the angiotensin converting enzyme 2 (ACE-2). Other than the pneumocytes, ACE-2 is expressed by several endocrine glands like the pancreas, pituitary gland, adrenal glands, thyroid, ovary, and testes. Diabetes has a significant impact on covid 19. Diabetes Mellitus is one of the comorbidities most frequently linked to severity and mortality resulting from COVID-19 infection. Thus, careful management that includes modification of treatment may be needed to protect from the most dangerous outcomes of the virus infection or hospitalization with COVID-19, not only for patients with a known history of diabetes but also those suffering SARS-CoV-2 induced new-onset diabetes. Those suffering from obesity are more susceptible to SARS-CoV-2 as well as to adverse effects. In order to limit the susceptibility and severity of SARS-CoV-2 infection, there needs to be adequate management of nutrition of obese and undernourished patients. Hypothalamic-pituitary axis suppression, adrenal insufficiency, thyroid dysfunction, hypocalcemia, vitamin D lack, and vertebral fractures have also been reported as frequent findings in COVID-19 infected individuals who needed to be hospitalized and often associated with fatal clinical outcomes. Prompt glucocorticoid adjustment is also required in patients with COVID-19 having adrenal insufficiency. Addressing hormonal status may limit further treatment burden for a COVID-19 infected patient. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.49-64

scholarly journals Chronic Heroin Dependence Leading to Adrenal Insufficiency

2014 ◽  
Vol 2014 ◽  
pp. 1-2 ◽  
Author(s):  
Gautam Das
Keyword(s):  
Pain Relief ◽  
Adrenal Insufficiency ◽  
Hpa Axis ◽  
Negative Impact ◽  
Endocrine System ◽  
Multiple Organ ◽  
Drug Addicts ◽  
Secondary Adrenal Insufficiency ◽  
Long Period ◽  
Organ Systems

Opioids have been the mainstay for pain relief and palliation over a long period of time. They are commonly abused by drug addicts and such dependence usually imparts severe physiologic effects on multiple organ systems. The negative impact of opioids on the endocrine system is poorly understood and often underestimated. We describe a patient who developed severe suppression of the hypothalamic-pituitary adrenal (HPA) axis leading to secondary adrenal insufficiency due to long standing abuse of opioids.

Examining the entry of Walmart into South Africa: A stakeholder management perspective

2019 ◽  
Vol 38 (2) ◽  
pp. 78-89
Author(s):  
Tembinkosi Bonakele ◽  
Dave Beaty ◽  
Fathima Rasool ◽  
Drikus Kriek
Keyword(s):  
South Africa ◽  
Trade Unions ◽  
Negative Impact ◽  
Stakeholder Management ◽  
Sources Of Information ◽  
Key Stakeholders ◽  
Management Perspective ◽  
Labour Standards ◽  
History Of ◽  
Primary Focus

The recent entry of the US multinational Walmart into South Africa has proved to be a source of controversy. Key stakeholders in South Africa objected to the merger and attempted to block it unless certain conditions were met. The aim of this study was to examine the controversy and the conditions surrounding the merger. The research employed a qualitative archival analysis to examine publicly available sources of information with regard to the merger. The findings revealed key stakeholders’ concerns that Walmart’s entry would lead to an increase in imports which would displace local producers, increase unemployment, marginalise trade unions and lower labour standards unless certain conditions were met. The results also revealed problems relating to the firm’s primary focus on “business” while neglecting “public interest” issues, naively relying on their “local retailer” to manage key stakeholders, and assuming that their perceived controversial reputation regarding treatment of trade unions and their views about unemployment as well as the controversies surrounding their history of entry into other global markets would not have the major negative impact it did on stakeholders in South Africa.

scholarly journals Predicting COVID-19 mortality with electronic medical records

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Hossein Estiri ◽  
Zachary H. Strasser ◽  
Jeffy G. Klann ◽  
Pourandokht Naseri ◽  
Kavishwar B. Wagholikar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Information ◽  
Age Groups ◽  
Prognostic Models ◽  
Smoking History ◽  
Risk Scores ◽  
Gradient Boosting ◽  
Chronic Obstructive ◽  
Clinical Expertise ◽  
History Of

AbstractThis study aims to predict death after COVID-19 using only the past medical information routinely collected in electronic health records (EHRs) and to understand the differences in risk factors across age groups. Combining computational methods and clinical expertise, we curated clusters that represent 46 clinical conditions as potential risk factors for death after a COVID-19 infection. We trained age-stratified generalized linear models (GLMs) with component-wise gradient boosting to predict the probability of death based on what we know from the patients before they contracted the virus. Despite only relying on previously documented demographics and comorbidities, our models demonstrated similar performance to other prognostic models that require an assortment of symptoms, laboratory values, and images at the time of diagnosis or during the course of the illness. In general, we found age as the most important predictor of mortality in COVID-19 patients. A history of pneumonia, which is rarely asked in typical epidemiology studies, was one of the most important risk factors for predicting COVID-19 mortality. A history of diabetes with complications and cancer (breast and prostate) were notable risk factors for patients between the ages of 45 and 65 years. In patients aged 65–85 years, diseases that affect the pulmonary system, including interstitial lung disease, chronic obstructive pulmonary disease, lung cancer, and a smoking history, were important for predicting mortality. The ability to compute precise individual-level risk scores exclusively based on the EHR is crucial for effectively allocating and distributing resources, such as prioritizing vaccination among the general population.

Amidst pandemic and racial upheaval: Where Asian Americans Fit

2020 ◽  
pp. 1-17
Author(s):  
Whitney Hua ◽  
Jane Junn
Keyword(s):  
United States ◽  
Asian Americans ◽  
Racial Inequality ◽  
White Supremacy ◽  
The United States ◽  
Structural Racism ◽  
Global Pandemic ◽  
American Capitalism ◽  
Racial History ◽  
History Of

Abstract As racial tensions flare amidst a global pandemic and national social justice upheaval, the centrality of structural racism has renewed old questions and raised new ones about where Asian Americans fit in U.S. politics. This paper provides an overview of the unique racial history of Asians in the United States and analyzes the implications of dynamic racialization and status for Asian Americans. In particular, we examine the dynamism of Asian Americans' racial positionality relative to historical shifts in economic-based conceptions of their desirability as workers in American capitalism. Taking history, power, and institutions of white supremacy into account, we analyze where Asian Americans fit in contemporary U.S. politics, presenting a better understanding of the persistent structures underlying racial inequality and developing a foundation from which Asian Americans can work to enhance equality.

scholarly journals Assessment of the Sexual Violence Situation in a Regional Hospital in Guatemala: The Need for a Multidisciplinary Clinic

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S105-S105
Author(s):  
Blanca Soto ◽  
Miriam Canet ◽  
Diego Erdmenger
Keyword(s):  
Sexual Violence ◽  
Physical Violence ◽  
Negative Impact ◽  
Epidemiological Data ◽  
Depth Analysis ◽  
Significant Negative Impact ◽  
Comprehensive Health ◽  
History Of ◽  
Hepatitis B Testing

Abstract Background Sexual violence is a global health problem, in terms of age and sex, showing a significant negative impact on health. Incidence in Guatemala is among the highest of the region reaching an average of 23 cases reported daily nationally per statistics from the Ministry of Health in 2015. Methods Retrospective analysis of the database of all sexual violence cases reported from a secondary -level national hospital in Guatemala from January 2005 to September 2015 (period A) and in-depth analysis on demographic and epidemiological data along with information of the follow-up of cases between January 2012 and September 2015 (period B) was performed. Results Period A: 500 cases; female (96%; 481/500). Assault occurred between 16–20 years (34%; 163/481) 11–15 years (22.25%; 107/481), and 21–30 years (22.04%; 106/481). From all reported male cases, 73.68% (14/19) occurred under 15 years. Period B: 154/217 (70.96%) cases included; female (95.45%; 147/154), mean age: 17.87 years. Assault occurred in public spaces (57.14%; 88/154) and victim’s home (29.87%; 46/154). Almost 13% of victims reported history of previous assault, 5.84% by the same aggressor. More than one aggressor participated in 36.37% of assaults. Physical violence was associated in 57.79% of cases. Most victims (92.76%; 141/152) consulted within 72 hours of the assault. HIV, VDRL, and Hepatitis B testing performed in 100, 52, and 33.77%, respectively, were negative. Follow-up visits at 3, 6, and 12 months after the aggression were attended by 20.78% (30/154), 1.95% (3/154), and 1.95% (3/154) of victims, respectively. Psychology support was completed only in 18.18% (28/154). Emergency contraception was provided when indicated; pregnancy as result of the aggression was reported in nine cases (5.84%). Conclusion The study shows that young women were the most vulnerable group for sexual violence. There is a lack of multidisciplinary approach and follow-up. Interventions on infectious diseases screening have to be optimized to reduce the risk of ETS transmission. This evidence supports the need for a specialized clinic to ensure access to comprehensive health services for victims. Disclosures All authors: No reported disclosures.

scholarly journals Foreign Body in abdomen

2015 ◽  
Vol 14 (2) ◽  
pp. 210-212
Author(s):  
Md Zakirul Alam ◽  
Mohibul Aziz
Keyword(s):  
Abdominal Pain ◽  
Foreign Body ◽  
Medical Science ◽  
X Ray ◽  
Diagnostic Center ◽  
History Of ◽  
Upper Abdominal ◽  
Married Female

A 19 years old married female presented with severe upper abdominal pain, repeated vomiting having history of swallowing a knife 7 months ago was admitted in Mordern Clinic and Diagnostic center, Joypurhat, Bangladesh. USG abdomen & X-ray (fig-1) abdomen were done when presence of a large foreign body (knife fig-3) in abdomen was made which latter on confirmed by Endoscopy of upper GIT (fig-2). Surprisingly the patient kept it in her abdomen for 7 months without any symptoms until the symptoms got worse and compelled her to seek medical help. The knife was removed by laparotomy, gastrotomy with uneventful recovery.Bangladesh Journal of Medical Science Vol.14(2) 2015 p.210-212

scholarly journals The Effects of Aβ1-42 Binding to the SARS-CoV-2 Spike Protein S1 Subunit and Angiotensin-Converting Enzyme 2

2021 ◽  
Vol 22 (15) ◽  
pp. 8226
Author(s):  
John Tsu-An Hsu ◽  
Chih-Feng Tien ◽  
Guann-Yi Yu ◽  
Santai Shen ◽  
Yi-Hsuan Lee ◽  
...  
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Viral Entry ◽  
Negative Impact ◽  
Spike Protein ◽  
Infection Model ◽  
Converting Enzyme ◽  
Viral Receptor ◽  
Angiotensin Converting Enzyme 2 ◽  
People With Dementia ◽  
The Impact

Increasing evidence suggests that elderly people with dementia are vulnerable to the development of severe coronavirus disease 2019 (COVID-19). In Alzheimer’s disease (AD), the major form of dementia, β-amyloid (Aβ) levels in the blood are increased; however, the impact of elevated Aβ levels on the progression of COVID-19 remains largely unknown. Here, our findings demonstrate that Aβ1-42, but not Aβ1-40, bound to various viral proteins with a preferentially high affinity for the spike protein S1 subunit (S1) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the viral receptor, angiotensin-converting enzyme 2 (ACE2). These bindings were mainly through the C-terminal residues of Aβ1-42. Furthermore, Aβ1-42 strengthened the binding of the S1 of SARS-CoV-2 to ACE2 and increased the viral entry and production of IL-6 in a SARS-CoV-2 pseudovirus infection model. Intriguingly, data from a surrogate mouse model with intravenous inoculation of Aβ1-42 show that the clearance of Aβ1-42 in the blood was dampened in the presence of the extracellular domain of the spike protein trimers of SARS-CoV-2, whose effects can be prevented by a novel anti-Aβ antibody. In conclusion, these findings suggest that the binding of Aβ1-42 to the S1 of SARS-CoV-2 and ACE2 may have a negative impact on the course and severity of SARS-CoV-2 infection. Further investigations are warranted to elucidate the underlying mechanisms and examine whether reducing the level of Aβ1-42 in the blood is beneficial to the fight against COVID-19 and AD.

Abstract TP207: Sex Differences in Cardiovascular Risk Profiles of Patients with Diabetes in the Greater Cincinnati/ Northern Kentucky Stroke Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Tracy E Madsen ◽  
Jane C Khoury ◽  
Kathleen Alwell ◽  
Charles J Moomaw ◽  
Stacie L Demel ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Stroke Risk ◽  
Negative Impact ◽  
Age Difference ◽  
Risk Profiles ◽  
Chi Square ◽  
Adult Age ◽  
Stroke Study ◽  
Patients With Diabetes ◽  
History Of

Introduction: Diabetes mellitus (DM) carries a greater stroke risk for females than males, possibly because of a difference in cardiovascular risk profiles between females and males with DM. Our aim was to compare the sex-specific risk factor profiles for patients with DM with those without DM among patients with acute ischemic stroke (AIS) in the Greater Cincinnati/ Northern Kentucky Stroke Study (GCNKSS). Methods: The GCNKSS ascertained cases of AIS in 2005 and 2010 among adult (age ≥20 years) residents of a biracial population of 1.3 million. Past and current stroke risk factors, obtained via chart review, were compared between those with and without DM using chi-square to examine bivariate differences and multiple logistic regression to examine sex-specific profiles. P < 0.05 was considered statistically significant. Results: There were 3515 patients with incident AIS; 1919 (55%) were female, 697 (20%) were black, and 1146 (33%) had DM. A lower proportion of females with DM were over 65 years old compared with those without DM. The proportion of males >65 with DM was not significantly different from that of males without DM. Among both females and males with DM, significantly more were Black, obese, and had histories of hypertension, high cholesterol, CAD and myocardial infarction compared to those without DM. In sex-specific adjusted analyses, women with DM were significantly less likely to be over 65 and more likely to have CAD than women without DM, whereas age and CAD were not significant factors in differentiating the profiles of men with and without DM. Conclusions: The result that females had their strokes at a younger age if they had a history of DM, and that no such age difference existed in males, suggests that DM is more severe and has a greater negative impact on females than males. As opposed to males, females with DM were also more likely to have CAD compared to those without DM, consistent with a possible sex difference in the association between DM and vascular disease.

Fear, history, stigma, and bias in the COVID-19 pandemic

2020 ◽  
Vol 18 (7) ◽  
pp. 177-182
Author(s):  
Kevin Kupietz, PhD ◽  
Lesley Gray, MPH
Keyword(s):  
Emergency Management ◽  
Disease Outbreaks ◽  
Social Effects ◽  
Evidence Based ◽  
Stigma And Discrimination ◽  
Emergency Managers ◽  
Global Pandemic ◽  
New Concepts ◽  
History Of ◽  
The Relationship

Introduction: The greatest enemy of a global pandemic is not the virus itself, but the fear, rumor, and stigma that envelopes people. This article explores the context and history of fear and stigma relating to pandemic, summarizing key actions to mitigate the harms during an active pandemic.Method: Our article draws from accounts in literature and journalist accounts documenting the relationship between infectious diseases and major disease outbreaks that have garnered fear and stigmatization. Results: Fear, stigma, and discrimination are not new concepts for pandemics. These social effects run the risk of diverting attention from the presenting disease and government responses. Reactions to fear, stigma, and discrimination risk sabotaging effective efforts to contain, manage, and eradicate the disease.Conclusion: Emergency managers have an important role in dispelling myths, disseminating appropriate and evidence-based information without exacerbating fears. Knowledge about the roots of fear and bias along with a good understanding of historical plagues and pandemics is vital to ensure those in the field of emergency management can effectively manage irrational fears.

Atypical presentation of autoimmune polyglandular syndrome type 1 in the fifth decade

2021 ◽  
Vol 14 (4) ◽  
pp. e241680
Author(s):  
Aditya Sanjeevi ◽  
Adlyne Reena Asirvatham ◽  
Karthik Balachandran ◽  
Shriraam Mahadevan
Keyword(s):  
Adrenal Insufficiency ◽  
Vitamin D Supplementation ◽  
Chronic Mucocutaneous Candidiasis ◽  
Syndrome Type ◽  
Primary Amenorrhoea ◽  
Autoimmune Polyglandular Syndrome ◽  
Nail Changes ◽  
History Of ◽  
Autoimmune Polyglandular Syndrome Type

A 45-year-old woman presented to us with a short-term history of nausea, vomiting and giddiness. On arrival at our hospital, examination revealed postural hypotension. Fluid resuscitation with intravenous normal saline was commenced. She also had chronic mucocutaneous candidiasis and nail changes suggestive of ectodermal dystrophy. Detailed history taking revealed that she had never attained menarche. Serum biochemistries showed hyponatraemia, hyperkalaemia, and hypocalcaemia (sodium, 127 mEq/L; potassium, 6 mEq/L; and albumin-corrected calcium, 6 mg/dL). Adrenocorticotropic hormone-stimulated cortisol (16.7 mcg/dL) was suboptimal favouring adrenal insufficiency. She was started on hydrocortisone and fludrocortisone supplementation. Additionally, the parathyroid hormone was inappropriately low (3.8 pg/mL) confirming hypoparathyroidism. Oral calcium and active vitamin D supplementation were added. With the above clinical and biochemical picture, namely, clustering of primary amenorrhoea, adrenal insufficiency and hypoparathyroidism, the diagnosis pointed towards autoimmune polyglandular syndrome. Genetic workup revealed a deletion in exon 8 of the autoimmune regulator gene confirming the diagnosis of autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy/autoimmune polyglandular syndrome type 1 .

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