scholarly journals Virchow’s Triad and the Role of Thrombosis in COVID-Related Stroke

2021 ◽  
Vol 12 ◽  
Author(s):  
Francisco J. Gonzalez-Gonzalez ◽  
Mary Rodriguez Ziccardi ◽  
Mark D. McCauley

In December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as a virally transmitted disease. Three months later, SARS-CoV-2 became one of the largest pandemics in recent times, causing more than 235 million cases globally, and accounting for at least 4.8 million deaths to date. SARS-COV-2 infection was initially classified as a respiratory tract infection, but later was recognized as a multisystemic disease compromising gastrointestinal, hematological, cardiac, and neurological systems. With this Review, we aim to describe the epidemiology, risk factors, mechanisms, and management of cerebrovascular events in patients infected with COVID-19. Neurological manifestations related to thromboembolic cerebrovascular events in patients infected with COVID-19 have been frequent and associated with poor prognosis in the majority of cases. A better understanding of the mechanisms of thrombosis and etiologies of this new disease process are necessary to determine how to prevent and treat patients to reduce their length of stay, morbidity, and mortality.

2021 ◽  
Vol 11 ◽  
Author(s):  
Chien-Chin Chen ◽  
Pei-Chun Chiang ◽  
Tsung-Hsien Chen

The recent outbreak of coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2, has become a global threat. Due to neurological manifestations presented throughout the coronavirus disease process, the potential involvement of COVID-19 in central nervous system has attracted considerable attention. Notably, the neurologic system could be widely affected, with various complications such as acute cerebrovascular events, encephalitis, Guillain-Barré syndrome, and acute necrotizing hemorrhagic encephalopathy. However, the risk assessment of exposure to potential biohazards in the context of the COVID-19 pandemic has not been clearly clarified regarding the sampling, preparation, and processing neurological specimens. Further risk managements and implantations are seldom discussed either. This article aims to provide current recommendations and evidence-based reviews on biosafety issues of preparation and processing of cerebrospinal fluid and neurological specimens with potential coronavirus infection from the bedside to the laboratory.


2021 ◽  
pp. 178-184
Author(s):  
N. V. Sturov ◽  
S. V. Popov ◽  
I. Yu. Shmelkov

The role of fungi as causative agents of infections is growing. In in-patients, especially at intensive care units, fungal infections might cause serious problems. Studies conducted over recent years shows an increase of fungi detection in urine in in-patients from 5,01 up to 10,63%. Most often, the appearance of fungi in the urine connected with contamination or colonization of the urinary tract. However, in immunocompromised patients, this could be the part of urinary tract infection and even of disseminated fungal process. Candida is the most common cause of fungal urinary tract infections. At the same time, the presence of Candida in urine (candiduria) not always comes with clinical signs of urethritis, cystitis and pyelonephritis. Detection of noCandida albicans agents in urine is increasing, new Candida species revealed are resistant to antifungal drugs so risk of complications is increasing. Recent researches reveal new mechanisms of how Candida interacts with the bacteria that cause urinary infections. The main mechanisms of Candida virulence factors are dimorphism, adhesion proteins — Als1-7,9 and Gls, invasion enzymes — phospholipase, Als3 and Ssa1, as well as enzymes that neutralize reactive oxygen species. The most significant risk factors of fungal urinary tract infection are the presence of a urinary catheter, diabetes mellitus, immunosuppression and previous antibiotic intake. The study of the formation process of the cellular and immune response to Candida makes it possible to identify the main links in the pathogenesis of urinary tract candidiasis, as well as the main role of immunosuppression in the development of the disease.


2008 ◽  
Vol 37 (2) ◽  
pp. 162-165
Author(s):  
Mirjana Vidovic ◽  
Dzevdet Smajlovic ◽  
Osman Sinanovic

Introduction: Subarachnoid haemorrhage presents urgent state in neurology, with dramatic clinical picture and high mortality. Aim of this study was to analize role of the risk factors in prognosis of patients with spontaneous subarachnoidal haemorrhage. Patients and Methods: It was analyzed 48 patients with spontaneous subarachnoidal haemorrhage which are cured on Neurological clinic in Tuzla in period from January 1. 2001 till December 31. 2002. Mean age of patients was 57.6 +/-12. years. Results: It was shown that the most frequent risk factors were hypertension (72.9%), heart diseases (54.1%) and smoking (39.6%). From all 48, 21 (43.7%) patients died. At survived patients, one month from begining of disease, cases. Survived had significant lower mean age (p= .009) and Hunt Hess score (p=0.001) at admission than the died. Patients with complexity find by computed tomography had bad prognosis. Conclusion: Older age of patients, higher number of risk factors, higher Hunt Hess score at admission, and blood in the ventricular system on CT are risk factors for poor prognosis of patients with subarachnoidal haemorrhage.


2001 ◽  
Vol 120 (5) ◽  
pp. A282-A282
Author(s):  
I KOUTROUBAKIS ◽  
A SFIRIDAKI ◽  
A THEODOROPOULOU ◽  
A LIVADIOTAKI ◽  
P DIMOULIOS ◽  
...  

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.


Crisis ◽  
2012 ◽  
Vol 33 (2) ◽  
pp. 80-86 ◽  
Author(s):  
Sami Hamdan ◽  
Nadine Melhem ◽  
Israel Orbach ◽  
Ilana Farbstein ◽  
Mohammad El-Haib ◽  
...  

Background: Relatively little is known about the role of protective factors in an Arab population in the presence of suicidal risk factors. Aims: To examine the role of protective factors in a subsample of in large Arab Kindred participants in the presence of suicidal risk factors. Methods: We assessed protective and risk factors in a sample of 64 participants (16 suicidal and 48 nonsuicidal) between 15 and 55 years of age, using a comprehensive structured psychiatric interview, the Composite International Diagnostic Interview (CIDI), self-reported depression, anxiety, hopelessness, impulsivity, hostility, and suicidal behavior in first-degree and second-relatives. We also used the Religiosity Questionnaire and suicide attitude (SUIATT) and multidimensional perceived support scale. Results: Suicidal as opposed to nonsuicidal participants were more likely to have a lifetime history of major depressive disorder (MDD) (68.8% vs. 22.9% χ2 = 11.17, p = .001), an anxiety disorder (87.5% vs. 22.9, χ2 = 21.02, p < .001), or posttraumatic stress disorder (PTSD) (25% vs. 0.0%, Fisher’s, p = .003). Individuals who are otherwise at high risk for suicidality have a much lower risk when they experience higher perceived social support (3.31 ± 1.36 vs. 4.96 ± 1.40, t = 4.10, df = 62, p < .001), and they have the view that suicide is somehow unacceptable (1.83 ± .10 vs. 1.89 ± .07, t = 2.76, df = 60, p = .008). Conclusions: Taken together with other studies, these data suggest that the augmentation of protective factors could play a very important role in the prevention of incidental and recurrent suicidal behavior in Arab populations, where suicidal behavior in increasing rapidly.


2014 ◽  
Author(s):  
Whitney A. Leboeuf ◽  
Benjamin Brumley ◽  
John W. Fantuzzo ◽  
Cody A. Hostutler

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