scholarly journals Neonatal HDL Counteracts Placental Vascular Inflammation via S1P–S1PR1 Axis

2020 ◽  
Vol 21 (3) ◽  
pp. 789
Author(s):  
Ilaria Del Gaudio ◽  
Sebastian Hendrix ◽  
Christina Christoffersen ◽  
Christian Wadsack
Keyword(s):  
Vascular Inflammation ◽  
Density Lipoprotein ◽  
Adverse Outcomes ◽  
Vascular Protection ◽  
Protective Function ◽  
Arterial Endothelial Cell ◽  
Sphingosine 1 Phosphate ◽  
Placental Inflammation ◽  
Short And Long Term

Placental inflammation and dysfunction during pregnancy are associated with short- and long-term adverse outcomes for the offspring. However, the mechanisms of vascular protection at the feto-placental interface are still poorly investigated. The high-density lipoprotein (HDL) associated sphingosine-1-phosphate (S1P) has been described as a powerful anti-inflammatory complex. This study aimed to elucidate the role of cord blood-derived HDL (nHDL) in feto-placental endothelial dysfunction. Here, we report that the exposure of primary fetal placental arterial endothelial cell (fPAEC) to healthy nHDL-S1P attenuated the ability of TNFα to activate NF-κB signaling and increase the expression of pro-inflammatory markers. Moreover, the angiotensin II (AngII)-induced reactive oxygen species (ROS) production was blunted in the presence of nHDL, whereas it was preserved when the cells were preincubated with S1P receptor antagonists, suggesting that S1P accounts for the vascular protective function of nHDL at the feto-placental unit. These results highlight the importance of HDL and S1P metabolism and signaling in pregnancy pathophysiology.

Glucocorticosteroids effects on brain development in the preterm infants: a role for microglia?

2021 ◽  
Vol 19 ◽  
Author(s):  
Zinni Manuela ◽  
Pansiot Julien ◽  
Elodie Billion ◽  
Baud Olivier ◽  
Mairesse Jérôme
Keyword(s):  
Brain Development ◽  
Preterm Infants ◽  
Adverse Outcomes ◽  
Mortality And Morbidity ◽  
Respiratory Problems ◽  
Neurodevelopmental Impairment ◽  
Short And Long Term ◽  
Abnormal Brain

: Prematurity, observed in 15 million births worldwide each year, is a clinical condition that is a major cause of neonatal mortality and morbidity in short and long term. Preterm infants are at high risk for developing respiratory problems, sepsis, and other morbidities leading to neurodevelopmental impairment and neurobehavioral disorders. Perinatal glucocorticosteroids have been widely used for the prevention and treatment of adverse outcomes linked to prematurity. However, despite their shortterm benefits due to their maturational properties, some clinical trials have shown an association between steroids exposure and abnormal brain development in infants born preterm. Neuroinflammation has emerged as a preeminent factor for brain injury in preterm infants, and the major role of microglia, the brain resident immune cells, has been recently highlighted. Considering the role of microglia in the modulation of brain development, the aim of this review is to summarize the effects of endogenous and exogenous glucocorticosteroids on brain development and discuss the possible role of microglia as a mediator of these effects.

Renal Protection in Critically Ill Patients

2019 ◽  
pp. 163-174
Author(s):  
Ryan W. Haines ◽  
John R. Prowle
Keyword(s):  
Chronic Kidney Disease ◽  
Intensive Care Unit ◽  
Kidney Injury ◽  
Adverse Outcomes ◽  
Renal Protection ◽  
High Quality ◽  
Hemodynamic Stability ◽  
Secondary Sources ◽  
Short And Long Term

Acute kidney injury complicates over 50% of critical care admissions and is associated with both increased short and long-term mortality and the development or acceleration of chronic kidney disease. While in certain settings, such as cardiac surgery, primary prevention of AKI is possible, in most cases AKI is present or evolving at intensive care unit admission and the main clinical focus is secondary prevention of further kidney injury. In the absence of evidence for specific AKI-targeted therapies, high quality supportive care to maximize hemodynamic stability and avoidance of secondary sources of kidney injury are the cornerstones of renal protection. Fluid overload is particularly associated with adverse outcomes in critical illness complicated by AKI. Continuous methods of renal replacement therapy may promote hemodynamic stability and have been associated with better longer term renal outcomes.

scholarly journals PS118. Extent of COPD Is Associated with Short and Long-term Adverse Outcomes in Patients Undergoing Elective AAA Repair

2012 ◽  
Vol 55 (6) ◽  
pp. 57S
Author(s):  
David H. Stone ◽  
Philip P. Goodney ◽  
Andres Schanzer ◽  
Jeffrey Kalish ◽  
Jeffrey Indes ◽  
...  
Keyword(s):  
Adverse Outcomes ◽  
Short And Long Term

scholarly journals Recent Insights on Prevalence and Corelations of Hypoactive Delirium

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Vaios Peritogiannis ◽  
Maria Bolosi ◽  
Charalampos Lixouriotis ◽  
Dimitrios V. Rizos
Keyword(s):  
Adverse Outcomes ◽  
Future Research ◽  
Clinical Settings ◽  
Symptom Presentation ◽  
Treatment Interventions ◽  
Benzodiazepine Use ◽  
Short And Long Term ◽  
Hypoactive Delirium ◽  
Long Term Mortality

Delirium is a complex neuropsychiatric syndrome which is common in all medical settings. It often goes unrecognized due to difficulties in the detection of its hypoactive variant. This review aims to provide an up-to-date account on recent research on hypoactive delirium (HD). Thirty-eight studies, which were conducted in various clinical settings, including the Intensive Care Unit (ICU), were included in this review. Those studies involved recent research that has been published during the last 6 years. Prevalence of HD was found to vary considerably among different settings. HD seems to be more common in critically ill patients and less common in patients examined by consultation-liaison psychiatric services and in mixed patient populations. The presence of HD in ICU patients was associated with higher short- and long-term mortality and other adverse outcomes, but no such association was reported in other settings. Research on other possible associations of HD with clinical variables and on symptom presentation yielded inconclusive results, although there is some evidence for a possible association of HD with benzodiazepine use. There are several methodological issues that need to be addressed by future research. Future studies should examine HD in the primary care setting; treatment interventions should also be the objective of future research.

scholarly journals Automated lung sound analysis using the LungPass platform: A sensitive and specific tool for identifying lower respiratory tract involvement in COVID-19.

2021 ◽  
Author(s):  
Elena A Lapteva ◽  
Olga N Kharevich ◽  
Victoria V. Khatsko ◽  
Natalia A. Voronova ◽  
Maksim V. Chamko ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Adverse Outcomes ◽  
Lung Sound ◽  
Sound Analysis ◽  
Abnormal Sound ◽  
Tract Involvement ◽  
Short And Long Term ◽  
Analysis Platform

Background: Lower respiratory tract (LRT) involvement, observed in about 20% of patients suffering from coronavirus disease 2019 (COVID-19) is associated with a more severe clinical course, adverse outcomes and long-term sequelae. Early identification of LRT involvement could facilitated targeted and timely interventions that could alter the short- and long-term disease outcomes. The LungPass is an automated lung sound analysis platform developed using neural network technology and previously trained. We hypothesised that the LungPass could be used as a screening tool for LRT involvement in patients with COVID-19. Methods: In a prospective observational study involving 282 individuals with presenting in the emergency department with a strong clinical suspicion of COVID-19 and imaging findings consistent with COVID-19 LRT involvement (25.5% had concomitant hypoxia), and 32 healthy controls, we assessed the sensitivity and specificity of the LungPass in identifying LRT involvement in COVID-19. We also compared the auscultatory findings of the LungPass compared to a chest physician using a traditional, high-quality stethoscope. Results: Among individuals with COVID-19 LRT involvement, the LungPass identified crackles in at least one auscultation site in 93.6% and in two or more points in 84%. Moreover, the LungPass identified any abnormal lung sound (crackles or wheeze) in at least one auscultation site in 98.6% and in at least two points in 94% of the participants. The respective percentages for the respiratory physicians were lower. Considering the presence of any added abnormal sound (crackles or wheeze) in at least two auscultation points as evidence of LRT involvement, LungPass demonstrated a sensitivity of 98.6% (95% confidence intervals [CI]: 96.4%-99.6%) and a specificity of 96.9% (95% CI: 83.8%-99.9%) in identifying COVID-19 LRT involvement. Conclusion: This exploratory study suggests the LungPass is a sensitive and specific platform for identifying LRT involvement due to COVID-19, even before the development of hypoxia.

scholarly journals Nutrition in pregnancy: Basic principles and recommendations

2014 ◽  
Vol 142 (1-2) ◽  
pp. 125-130 ◽  
Author(s):  
Draga Plecas ◽  
Snezana Plesinac ◽  
Olivera Kontic-Vucinic
Keyword(s):  
Adult Life ◽  
Adverse Outcomes ◽  
Adaptive Responses ◽  
Normal Ranges ◽  
Energy Needs ◽  
Wide Range ◽  
Short And Long Term ◽  
Adverse Pregnancy ◽  
In Pregnancy

Healthy diet in pregnancy should guarantee proper fetal growth and development, maintain (and promote) maternal health and enable lactation. Nutritional counseling and interventions need to be an integral part of antenatal care and continue during pregnancy in order to reduce the risk of maternal, fetal and neonatal complications, as well as the short- and long-term adverse outcomes. Adverse pregnancy outcomes are more common in women who begin the gestation as undernourished or obese in comparison to pregnant women whose weight is within normal ranges. Increased nutritional and energy needs in pregnancy are met through numerous metabolic adaptations; pregnancy is successfully achieved within wide range of variations in energy supply and weight gain. However, if nutrient restriction exceeds the limits of adaptive responses, evidence indicates that fetus will develop the alternative metabolic competence that might emerge as a disease (type 2 diabetes, hypertension, coronary heart disease and stroke) in adult life.

scholarly journals Biomarkers of acute kidney injury and associations with short- and long-term outcomes

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 986 ◽  
Author(s):  
Jennifer A. Schaub ◽  
Chirag R. Parikh
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Adverse Outcomes ◽  
Future Research ◽  
Long Term Outcomes ◽  
Medical Researchers ◽  
Novel Biomarkers ◽  
Short And Long Term

Acute kidney injury is strongly associated with increased mortality and other adverse outcomes. Medical researchers have intensively investigated novel biomarkers to predict short- and long-term outcomes of acute kidney injury in many patient care settings, such as cardiac surgery, intensive care units, heart failure, and transplant. Future research should focus on leveraging this relationship to improve enrollment for clinical trials of acute kidney injury.

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