ACE Gene I/D Polymorphism and Acute Pulmonary Embolism in COVID19 Pneumonia: A Potential Predisposing Role

Most recent studies have stressed a high risk of thromboembolism in patients with SARS-CoV-2 infection, particularly in those with severe COVID-19 pneumonia. Counterbalance between angiotensin-converting-enzyme (ACE) and ACE2 activities in COVID-19 disease may be crucially involved in the thrombo-inflammatory process. Currently, no study has investigated ACE I/D polymorphism involvement in COVID-19 disease complicated by pulmonary embolism, hence the aim of the present pilot study. This is a retrospective, single-center observational case-control study, conducted at the Sub-Intensive Care Unit of A.O.R.N. Ospedali dei Colli, Cotugno Hospital, Naples (Italy). We included 68 subjects with severe/critical COVID-19 pneumonia. COVID-19 patients were divided according to occurrence of PE (PE+, n = 25) or absence of thromboembolic complications (PE−, n = 43). Assessment of ACE I/D polymorphisms showed a statistically significant difference between PE+ and PE− patients (p = 0.029). Particularly, prevalence of D/D homozygous polymorphism was significantly higher in PE+ COVID-19 patients than in PE− (72 vs. 46.5%; p = 0.048), while heterozygote I/D polymorphism was significantly lower expressed in PE+ patients than in PE− (16 vs. 48.8%; p = 0.009). Computed tomographic pulmonary angiography showed predominantly mono/bilateral sub-segmental embolisms. In conclusion, our findings let us hypothesize a genetic susceptibility to thromboembolism in COVID-19 disease. ACE D/D polymorphism might represent a genetic risk factor, although studies on larger populations are needed.

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The Predictive Value of Cell Blood Count Parameters to Diagnose Pulmonary Embolism in Patients with SARS-CoV-2 Infection: A Case Control Study

Antibiotics ◽

10.3390/antibiotics11010060 ◽

2022 ◽

Vol 11 (1) ◽

pp. 60

Author(s):

Alessio Strazzulla ◽

Sarra Abroug Ben Halima ◽

Ibrahim Chouchane ◽

Marwa Rezek ◽

Marcella Pinto Stiebler ◽

...

Keyword(s):

Pulmonary Embolism ◽

Blood Count ◽

Case Control Study ◽

Univariate Analysis ◽

Case Control ◽

Lymphocyte Ratio ◽

Pulmonary Scintigraphy ◽

Significant Difference ◽

Control Study

Introduction: Acute pulmonary embolism (aPE) is frequently associated with coronavirus infectious disease-2019 (COVID-19) with an incidence of more than 16%. Among the new promising biomarkers of aPE, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) showed correlations with aPE prognosis. The aim of this study was to conduct an exploratory analysis to check the possible role of cell blood count (CBC) parameters as diagnostic and prognostic biomarkers of aPE in COVID-19 patients. Materials and Methods: A case control study was conducted. Two populations were compared: (i) patients hospitalised from 31 January 2020 to 30 June 2021 with severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection and aPE confirmed at angio computed tomography (aCT) or pulmonary scintigraphy (COVID-19 aPE group); (ii) patients hospitalised from 31 January 2017 to 30 June 2021 without SARS-CoV-2 infection whose suspicion of aPE was excluded by aCT or pulmonary scintigraphy (no-aPE group). Results: Overall, 184 patients were included in the study, 83 in COVID-19 aPE group and 101 in no-aPE group. At the univariate analysis, COVID-19 patients with aPE had higher NLR, PLR, neutrophil and lymphocyte counts than patients without aPE (p < 0.05). No significant difference was found in mean platelet volume and platelet counts. No difference in mortality rate was detected. At the multivariate analysis, neutrophil and lymphocyte counts were both associated with diagnostic of aPE while no CBC parameters were associated with mortality at day#7. Conclusions: Neutrophiland lymphocyte counts could be predictors of the early detection of aPE in COVID-19 patients. The value of CBC indices as biomarkers of aPE in daily clinical practice needs to be investigated in further studies.

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Risk factors associated with subacromial pain in young athletes: A case control study

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-191683 ◽

2021 ◽

pp. 1-9

Author(s):

Zoran Z. Sarcevic ◽

Andreja P. Tepavcevic

Keyword(s):

Logistic Regression ◽

Case Control Study ◽

Case Control ◽

Sternoclavicular Joint ◽

Pectoralis Major ◽

Young Athletes ◽

Serratus Anterior ◽

Significant Difference ◽

Lower Trapezius ◽

Control Study

BACKGROUND: Subacromial pain (SAP) is a common complaint of young athletes, independently of the sport engaged. The prevalence of SAP in some sports is up to 50%. OBJECTIVE: The study was aimed to investigate some new factors possibly associated to subacromial pain in young athletes. The factors considered were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. METHODS: This case-control study included 82 young athletes 9–15 years, 41 with the symptoms of SAP and 41 controls. All participants self-reported whether they had subacromial pain. In addition, Hawkins–Kennedy Test was performed to all the participants to evaluate the subacromial pressure. Main outcome measures were the grade of tightness of the clavicular portion of the pectoralis major, dysfunction of the sternoclavicular joint, and serratus anterior and lower trapezius strength. The grade of tightness of the clavicular portion of the pectoralis major and the dysfunction of the sternoclavicular joint were measured with an inclinometer. Serratus anterior and lower trapezius strength were measured by a handheld dynamometer with external belt-fixation. The data were analyzed using t-test for independent samples, Mann-Whitney U test, contingency coefficients and a stepwise binary logistic regression. RESULTS: Significant statistical difference was observed in the grade of tightness of the clavicular portion of the pectoralis major and in the variable representing the physiological functioning of the sternoclavicular joint, between the cases and the controls. There was no significant difference in serratus anterior and lower trapezius strength between the cases and the controls. Logistic regression analysis showed that the variable representing the physiological functioning of the sternoclavicular joint and the grade of shortening of the clavicular portion of the pectoralis major were good predictors for presence of SAP. CONCLUSIONS: A strong association was determined between subacromial pain in young athletes, clavicular portion of pectoralis major tightness and the dysfunction of the sternoclavicular joint.

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Is computed tomographic pulmonary angiography justified in all patients with suspected pulmonary embolism – tertiary multidisciplinary hospital perspective

European Heart Journal ◽

10.1093/ehjci/ehaa946.2250 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

R Morawiec ◽

O Brycht ◽

M Nadel ◽

J Drozdz

Keyword(s):

Heart Failure ◽

Pulmonary Embolism ◽

Creatinine Level ◽

Pulmonary Angiography ◽

Hospital Death ◽

Contrast Induced Nephropathy ◽

Computed Tomographic ◽

Level Increase ◽

Computed Tomographic Pulmonary Angiography ◽

Egfr Decline

Abstract Background According to 2019 ESC guidelines for management in patients with the pulmonary embolism (PE), the computed tomographic pulmonary angiography (CTPA) is the diagnostic method of choice in suspected high-risk PE defined as patients with hemodynamic instability. In stable cases, it is recommended to assess the pre-test probability of the PE. However, CTPA with its great accuracy and wide availability in most medical centers is used as often to confirm as to exclude the diagnosis in PE suspected patients, despite the fact that it is linked with the risk of radiation and iodine-containing contrast exposure. Purpose The aim of the study was to assess the validity of CTPA use in patients with suspected PE form the perspective of multidisciplinary clinical center. Methods We retrospectively analyzed the data of from 52,474 hospitalized patients between 01.2018 and 12.2019. A total of 261 (0.5%) consecutive patients with suspected PE (in the emergency department or during hospitalization) were included into the study. Due to suspicion of PE all patients underwent the CTPA. In this group, we analyzed all available clinical data, results of laboratory and diagnostic tests (before and after CTPA) including estimated glomerular filtration rate (eGFR), creatinine level, transthoracic echocardiography (TTE) and planar ventilation/perfusion (lung scintigraphy) scan (V/Q SPECT) if performed. Results The CTPA confirmed PE in 28.9% of patients. The most common final diagnoses, established in the group with negative CTPA result, include heart failure (33.9%), pneumonia (14.4%) exacerbation of chronic obstructive pulmonary disease or asthma (9.3%) and acute coronary syndrome (5.9%). Acute PE was the cause of in-hospital death in 2.4% of patients and the rate of all cause in-hospital death was 11.4%. In 54.2% of patients we observed the eGFR decline and creatinine level increase, meeting the criteria of the acute contrast-induced nephropathy in 33 of them of them (19.8%). In the group with excluded PE, mean eGFR before CTPA was 70.9ml/min/1.73m2 with the decline to mean 60.4ml/min/1.73m2 during the hospitalization (p<0.01). In patients with negative CTPA result and the worsening of the renal function mean eGFR decline was 17.8ml/min/1.73m2 (p<0.01) and mean creatinine level increase was 38.6μmol/l (p<0.01). CONSLUSIONS The initial data collected show the overuse of CTPA in suspected PE, as the diagnosis was confirmed in less than one-third of them. Although CTPA allows to exclude or confirm PE unambiguously, its use is associated with risk of acute contrast-induced nephropathy. Additionally, in patients with exacerbation of heart failure established as final diagnosis after excluding PE, intensive diuretic treatment is crucial and may cause further accompanying renal function worsening. Therefore, optimizing the diagnostic pathway in patients with suspected PE into less aggravating procedures such as TTE or V/Q SPECT is justifiable. Funding Acknowledgement Type of funding source: None

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Association between the duration of physical restraint and pulmonary embolism in psychiatric patients: A nested case–control study using a Japanese nationwide database

Archives of Psychiatric Nursing ◽

10.1016/j.apnu.2021.07.009 ◽

2021 ◽

Author(s):

Naoki Hirose ◽

Kojiro Morita ◽

Mitsuhiro Nakamura ◽

Kiyohide Fushimi ◽

Hideo Yasunaga

Keyword(s):

Pulmonary Embolism ◽

Case Control Study ◽

Psychiatric Patients ◽

Physical Restraint ◽

Case Control ◽

Nationwide Database ◽

Nested Case Control ◽

Control Study

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First-trimester fetal growth discordance and development of preeclampsia in dichorionic twin pregnancies

Journal of Perinatal Medicine ◽

10.1515/jpm-2013-0260 ◽

2015 ◽

Vol 43 (6) ◽

Cited By ~ 1

Author(s):

Tanya Maric ◽

Natasha Singh ◽

Keith Duncan ◽

Guy J. Thorpe-Beeston ◽

Makrina D. Savvidou

Keyword(s):

Fetal Growth ◽

Case Control Study ◽

Subsequent Development ◽

First Trimester ◽

Case Control ◽

Retrospective Case ◽

Crown Rump Length ◽

Significant Difference ◽

Twin Pregnancies ◽

Control Study

AbstractTo investigate the relation between first-trimester fetal growth discrepancy, as assessed by crown-rump length (CRL) at 11+0 to 13+6 weeks of gestation, and subsequent development of preeclampsia (PE) in dichorionic diamniotic (DCDA) twin pregnancies. The association between inter-twin CRL and birth weight (BW) discrepancy was also investigated.This was a retrospective, case-control study of DCDA twin pregnancies. Inter-twin CRL discrepancy was calculated as 100×(larger CRL–smaller CRL)/larger CRL. BW discordance was calculated as 100×(larger BW–smaller BW)/larger BW.The study included 299 DCDA pregnancies that remained normotensive and 35 that subsequently developed PE. There was no significant difference in the inter-twin CRL discrepancy between pregnancies complicated by PE and those that were not [3.2%, interquartile range (IQR): 0.5–4.5% vs. 3.3%, IQR: 1.4–5.5%; P=0.17]. There was a positive correlation between inter-twin CRL and BW discrepancy but only in pregnancies that remained normotensive (P<0.001). In women that subsequently developed PE, there was no association between inter-twin CRL and BW discordance (P=0.54).In unselected DCDA twins, first-trimester CRL discrepancy is not different between pregnancies that subsequently develop PE and those that remain normotensive. Furthermore, in pregnancies that are complicated by PE, the association between inter-twin CRL and BW discrepancy appears to be lost.

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Risk Factors Associated with Bleeding After Alteplase Administration for Pulmonary Embolism: A Case-Control Study

Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy ◽

10.1002/phar.1440 ◽

2014 ◽

Vol 34 (8) ◽

pp. 818-825 ◽

Cited By ~ 13

Author(s):

Garrett M. Curtis ◽

Simon W. Lam ◽

Anita J. Reddy ◽

Seth R. Bauer

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Case Control Study ◽

Case Control ◽

Factors Associated ◽

Control Study

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The association of male infertility with telomere length: A case control study

Indian Journal of Clinical Anatomy and Physiology ◽

10.18231/j.ijcap.2021.070 ◽

2021 ◽

Vol 8 (4) ◽

pp. 325-332

Author(s):

Kate Deepali Rajesh ◽

Puranam Vatsalaswamy ◽

Manvikar Purshotam Rao

Keyword(s):

Male Infertility ◽

Telomere Length ◽

Real Time ◽

Real Time Pcr ◽

Case Control Study ◽

Case Control ◽

Control Group ◽

Significant Difference ◽

Control Study ◽

Sperm Telomere Length

To study the relevance of sperm telomere length and infertility in men. : Our case-control study included twenty-five males in couple with sub-fertility/infertility (test group) and twenty five healthy males (control group) with proven paternity in the age group 25 to 35 years. The Absolute Sperm Telomere length (aSTL) was measured by real-time PCR. We investigated whether any significant difference in the aSTL value existed between the groups and analysed the relationship between aSTL and other sperm parameters.The mean (SE) aSTL recorded in the infertile cases was significantly shorter than for the control group being 140.60 (6.66) Kb/genome and 239.63 (12.32) Kb/genome respectively (p <0.001) A weak correlation was eminent between aSTL kb/genome and the total sperm count mil/ml (rho= 0.04, p - 0.86), progressive sperm motility (rho= - 0.02, p=0.934) and sperm viability (rho= - 0.07 p=0.741) in the infertile group. The measurement of aSTL by real-time PCR is a simple and rapid method that offers further paramount information with respective to the quality of sperm. It is befitted for epidemiological studies, hence opening new perspectives in the evaluation of male infertility. Limitations - Our study was confined to men aged between 25 and 35 years. Further comparative studies are needed to explore the significance of STL and infertility in older males. Additional studies will help illumine the significance of aSTL as a prognostic biomarker in assisted reproduction.

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The Relationship between Serum Levels of Vitamin C, Uric Acid and Antioxidant Condition with Coronary Artery Diseases: a Case-Control Study

10.21203/rs.2.15439/v1 ◽

2019 ◽

Author(s):

Aida Torkzaban ◽

Seyed Amir Mansour Alavi Naeini ◽

Akbar Hassanzadeh ◽

Mehrdad Namdari

Keyword(s):

Uric Acid ◽

Vitamin C ◽

Case Control Study ◽

Demographic Data ◽

Systolic Pressure ◽

Case Control ◽

Control Group ◽

Case Group ◽

Significant Difference ◽

Control Study

Abstract Background Coronary hearth diseases are among the main causes of death in adults. Increase of oxidative stress and defects in antioxidant defense play a major role in endothelium performance and are an effective factor in progress of atherosclerosis. Some studies have also reported different malondialdehyde and total antioxidant capacity among the atherosclerosis patients.Methods In this case-control study, 44 atherosclerosis patients referring to Shahid Madani treatment-education center were considered as the case group; while 44 healthy peoples were placed in the control group. Demographic data and anthropometric indices were measured. Food frequency questionnaire and international physical activity questionnaires were also completed. After 12 hours of fasting, 10 ml blood was sampled from the participants. Uric acid, vitamin C, TAC and MDA were also measured. The data were finally analyzed by SPSS Ver 22 software.Results A significant difference was observed between the two groups in terms of uric acid (P<0.001) and vitamin C (P<0.03). However, mean MDA and TAC showed no significant difference between the two groups. The two groups’ difference in terms of vitamin A, E and beta carotene, zinc and selenium intake was not significant. A significant difference was however detected between the two groups in terms of vitamin C (P<0.047). A significant relationship was also observed between the systolic pressure and CHD (P<0.028).Conclusion Results of this study indicated that the uric acid and vitamin C levels of atherosclerosis patients had significant increase and decrease in comparison with the healthy subjects, respectively. Mean TAC and antioxidant levels of their diets (except for vitamin C) showed no significant difference. Systolic blood pressure of the patients was significantly higher than the controls.

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Interaction between serum FGF-23 and PTH in renal phosphate excretion, a case-control study in hypoparathyroid patients

10.21203/rs.2.12237/v2 ◽

2019 ◽

Author(s):

Forough Saki ◽

Seyed Reza Kassaee ◽

Azita Salehifar Salehifar ◽

gholamhossein Ranjbar omrani

Keyword(s):

Parathyroid Hormone ◽

Serum Calcium ◽

Case Control Study ◽

Fractional Excretion ◽

Case Control ◽

Control Group ◽

Phosphate Excretion ◽

Significant Difference ◽

Fgf 23 ◽

Control Study

Abstract Background:phosphate homeostasis is mediated through complex counter regulatory feed-back balance between parathyroid hormone, FGF-23 and 1,25(OH)2D. Both parathyroid hormone and FGF-23 regulate proximal tubular phosphate excretion through signaling on sodium- phosphate cotransporters II a and II c . However, the interaction between these hormones on phosphate excretion is not clearly understood. We performed the present study to evaluate whether the existence of sufficient parathyroid hormone is necessary for full phosphaturic function of FGF-23 or not. Methods:In this case-control study, 19 patients with hypoparathyroidism and their age- and gender-matched normal population were enrolled. Serum calcium, phosphate, alkaline phosphatase,parathyroid hormone, FGF-23, 25(OH)D, 1,25(OH)2D and Fractional excretion of phosphorous were assessed and compared between the two groups, using SPSS software. Results:The mean serum calcium and parathyroid hormone level was significantly lower in hypoparathyroid patients in comparison with the control group(P<0.001 and P<0.001, respectively). We found high serum level of phosphate and FGF-23 in hypoparathyroid patients compared to the control group (P<0.001 and P<0.001,respectively). However, there was no significant difference in Fractional excretion of phosphorous or 1,25OH2D level between the two groups. There was a positive correlation between serum FGF-23 and Fractional excretion of phosphorous just in the normal individuals (P <0.001, r = 0.79). Conclusions:Although the FGF-23 is a main regulator of urinary phosphate excretion but the existence of sufficient parathyroid hormone is necessary for the full phosphaturic effect of FGF-23.

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