scholarly journals COVID-19-Associated Pulmonary Aspergillosis in Russia

2021 ◽  
Vol 7 (12) ◽  
pp. 1059
Author(s):  
Olga Shadrivova ◽  
Denis Gusev ◽  
Maria Vashukova ◽  
Dmitriy Lobzin ◽  
Vitaliy Gusarov ◽  
...  

We studied the risk factors, etiology, clinical features and the effectiveness of therapy of COVID-19-associated pulmonary aspergillosis (CAPA) in adult patients. In this retrospective study, we included 45 patients with proven (7%) and probable (93%) CAPA. The ECMM/ISHAM, 2020 criteria were used to diagnose CAPA. A case-control study was conducted to study the risk factors of CAPA; the control group included 90 adult COVID-19 patients without IA. In CAPA patients, the main underlying diseases were diabetes mellitus (33%), and hematological and oncological diseases (31%). The probability of CAPA developing significantly increased with lymphocytopenia >10 days (OR = 8.156 (3.056–21.771), p = 0.001), decompensated diabetes mellitus (29% vs. 7%, (OR = 5.688 (1.991–16.246), p = 0.001)), use of glucocorticosteroids (GCS) in prednisolone-equivalent dose > 60 mg/day (OR = 4.493 (1.896–10.647), p = 0.001) and monoclonal antibodies to IL-1ß and IL-6 (OR = 2.880 (1.272–6.518), p = 0.01). The main area of localization of CAPA was the lungs (100%). The clinical features of CAPA were fever (98% vs. 85%, p = 0.007), cough (89% vs. 72%, p = 0.002) and hemoptysis (36% vs. 3%, p = 0.0001). Overall, 71% of patients were in intensive care units (ICU) (median—15.5 (5–60) days), mechanical ventilation was used in 52% of cases, and acute respiratory distress syndrome (ARDS) occurred at a rate of 31%. The lung CT scan features of CAPA were bilateral (93%) lung tissue consolidation (89% vs. 59%, p = 0.004) and destruction (47% vs. 1%, p = 0.00001), and hydrothorax (26% vs. 11%, p = 0.03). The main pathogens were A. fumigatus (44%) and A. niger (31%). The overall survival rate after 12 weeks was 47.2%.

Author(s):  
Satomi Ueno ◽  
Myo Nyein Aung ◽  
Motoyuki Yuasa ◽  
Ahmad Ishtiaq ◽  
Ei Thinzar Khin ◽  
...  

In Myanmar, the escalating prevalence of type 2 diabetes mellitus (T2DM) and impaired glucose tolerance among adults was recently reported, with the highest prevalence in the Yangon Region. The aim of the present study was to identify the risk factors in dietary habits and their relationship with T2DM in urban Myanmar residents. We conducted a case–control study recruiting 300 individuals aged 25–74 years living in the Yangon Region, consisting of 150 newly diagnosed cases attending a diabetes clinic, and 150 controls, who were community residents and free of diabetes. The case group had a significantly higher consumption of noodles, fish, beans, fermented food and pickles, dried food, topping seasonings, and non-dairy milk products than the control group, whereas they had a lower vegetable intake (more than three servings/day) and fruit intake (more than three servings/day) than the control group. Furthermore, the case group exhibited a higher frequency of some dietary behaviors than the control group, such as (1) having meals with family, (2) skipping breakfast, and (3) eating out. The final model showed that topping seasonings (adjusted odds ratio (aOR) 11.23, 95% confidence interval (CI) 3.08–40.90), more than three servings/day of vegetable intake (aOR 0.18, 95% CI 0.05–0.67), and having meals with family (aOR 2.23, 95% CI 1.05–4.71) were associated with diabetes. The study suggests that Myanmar’s characteristic dietary culture of topping their meals with salty seasonings and sauces and eating multiple dishes together as a family are risk factors associated with T2DM. Our findings may contribute recommendations and opportunities for the primary prevention of T2DM in urban Myanmar.


2021 ◽  
Vol 7 (4) ◽  
pp. 298
Author(s):  
Teny M. John ◽  
Ceena N. Jacob ◽  
Dimitrios P. Kontoyiannis

Mucormycosis (MCR) has been increasingly described in patients with coronavirus disease 2019 (COVID-19) but the epidemiological factors, presentation, diagnostic certainty, and outcome of such patients are not well described. We review the published COVID-19-associated mucormycosis (CAMCR) cases (total 41) to identify risk factors, clinical features, and outcomes. CAMCR was typically seen in patients with diabetes mellitus (DM) (94%) especially the ones with poorly controlled DM (67%) and severe or critical COVID-19 (95%). Its presentation was typical of MCR seen in diabetic patients (mostly rhino-orbital and rhino-orbital-cerebral presentation). In sharp contrast to reported COVID-associated aspergillosis (CAPA) cases, nearly all CAMCR infections were proven (93%). Treating physicians should have a high suspicion for CAMCR in patients with uncontrolled diabetes mellitus and severe COVID-19 presenting with rhino-orbital or rhino-cerebral syndromes. CAMR is the convergence of two storms, one of DM and the other of COVID-19.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1551.1-1552
Author(s):  
V. Mazurov ◽  
O. Shadrivova ◽  
M. Shostak ◽  
L. Martynova ◽  
M. Tonkoshkur ◽  
...  

Background:Invasive aspergillosis (IA) is a severe opportunistic infection that is not well understood in rheumatological patients.Objectives:To study risk factors, etiology, clinical manifestations and results of treatment of IA in adult rheumatological patients.Methods:Retrospective analysis of 830 patients (1998-2019) with “proven” and “probable” IA (EORTC / MSG, 2019), adults - 699 (84%). The main group included 18 (3%) adult rheumatological patients with IA, a control group included 610 (87%) adult hematological patients. Rheumatological patients were older, the average age was 59 years (21–75) vs 45 years (18–79), p = 0.005, and among them there were more women – 56% vs 42%, p = 0.01.Results:In rheumatological patients with IA, underlying diseases were ANCA-associated vasculitis (28%), granulomatosis with polyangiitis (22%), periarteritis (11%), systemic lupus erythematosus (22%), rheumatic heart disease (11%) and ankylosing spondylitis (6%). In the control group, underlying diseases were acute leukemia (45%), lymphomas (34%), chronic leukemia (9%), multiple myeloma (7%), myelodysplastic syndrome (3%), and other hematological diseases (2%).The main risk factors for IA development in rheumatological patients were: systemic steroids use (89% vs 69%), prolonged lymphocytopenia (76% vs 65%, median - 14 vs 12 days), treatment in ICU (44% vs 18%, p = 0.01), acute or chronic renal failure (39% vs 1%, p = 0.0008) and immunosuppressive therapy (28% vs 25%). Severe neutropenia was noted significantly less frequently (18% vs 83%, p = 0.0001). Additional risk factors were decompensated diabetes mellitus (17% vs 2%, p = 0.004), previous surgery (17% vs 1%, p = 0.001) and organ transplantation (6% vs 0%). In rheumatological patients, lung (83% vs 98%, p = 0.0001) and ≥2 organs (6% vs 8%) involvement were less common. Heart (11% vs 0%), sinuses (6% vs 5%) and central nervous system (6% vs 4%) involvement more often developed. In rheumatological patients, respiratory failure (61 vs 37%, p = 0.03), hemoptysis (28% vs 7%, p = 0.0001) and chest pain (17% vs 7%, p = 0, 04) were noted more often, less often - fever ≥380С (67% vs 85%, p = 0.01) and cough (61% vs 70%). CT signs of lung damage were similar in both groups, but rheumatologic patients were more likely to show an «air crescent» sign and / or destruction cavity (44% vs 10%, p = 0.0001). In rheumatologic patients, IA was more often confirmed by isolation ofAspergillusspp. from BAL (80% vs 45%, p = 0.005) and by histological examination (22% vs 7%, p = 0.01). The main pathogens wereA. fumigatus(50% vs 43%),A. niger(29% vs 32%), andA. flavus(14% vs 17%).Rheumatological patients were less likely to receive antifungal therapy 89% vs 99%, p = 0,0003. The main drug in both groups was voriconazole. The overall 12-week survival did not significantly differ between groups, but was lower in rheumatological patients with IA (69% vs 81%).Conclusion:In rheumatological patients, invasive aspergillosis more often developed at an older age, mainly in women. The main background diseases were ANCA-associated vasculitis, granulomatosis with polyangiitis, and systemic lupus erythematosus. Typical risk factors were steroids and immunosuppressants use, prolonged lymphocytopenia, ICU stay, and renal failure. The main causative agents wereA. fumigatus,A. niger, andA. flavus. The main localization of infection were lungs. Respiratory failure, hemoptysis and heart involvement were typical. The overall 12-week survival of rheumatological patients with invasive aspergillosis was 69%.Disclosure of Interests:None declared


2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Freda Lalrohlui ◽  
Souvik Ghatak ◽  
John Zohmingthanga ◽  
Vanlal Hruaii ◽  
Nachimuthu Senthil Kumar

AbstractOver the last few decades, Mizoram has shown an increase in cases of type 2 diabetes mellitus; however, no in-depth scientific records are available to understand the occurrence of the disease. In this study, 500 patients and 500 healthy controls were recruited to understand the possible influence of their dietary and lifestyle habits in relation with type 2 diabetes mellitus. A multivariate analysis using Cox regression was carried out to find the influence of dietary and lifestyle factors, and an unpaired t test was performed to find the difference in the levels of biochemical tests. Out of 500 diabetic patients, 261 (52.3%) were males and 239 (47.7%) were females, and among the control group, 238 (47.7%) were males and 262 (52.3%) were females. Fermented pork fat, Sa-um (odds ratio (OR) 18.98), was observed to be a potential risk factor along with tuibur (OR 0.1243) for both males and females. Creatinine level was found to be differentially regulated between the male and female diabetic patients. This is the first report of fermented pork fat and tobacco (in a water form) to be the risk factors for diabetes. The unique traditional foods like Sa-um and local lifestyle habits like tuibur of the Mizo population may trigger the risk for the prevalence of the disease, and this may serve as a model to study other populations with similar traditional practices.


2015 ◽  
Vol 43 (6) ◽  
Author(s):  
Katarina Jeremic ◽  
Aleksandar Stefanovic ◽  
Jelena Dotlic ◽  
Jelena Stojnic ◽  
Sasa Kadija ◽  
...  

AbstractThe study aim was to evaluate pregnancy outcomes in patients with antiphospholipid syndrome (APS) and to determine which clinical parameters present risk factors for adverse pregnancy outcomes in these patients.The study included 55 patients with APS treated at the Clinic for Ob/Gyn, Clinical Center of Serbia, from 2006 to 2012. The control group consisted of 55 healthy pregnant women. Data regarding previous pregnancies and conception method were registered. Immunological and laboratory tests were performed. Pregnancy outcomes, including miscarriage, intrauterine fetal death, hypertensive disorders, diabetes mellitus, phlebothrombosis, fetal growth restriction, premature delivery, delivery method, perinatal asphyxia, respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis were followed.The premature delivery rate in APS patients was 31.8%, and pregnancy loss was 18.2%. Significantly more patients with APS had thrombocytopenia, pregnancy losses, intrauterine growth restriction, and perinatal asphyxia compared with the control group. More miscarriages, preterm delivery, lower birth weight, preeclampsia, and IgM anticardiolipin antibody levels significantly correlated with adverse pregnancy outcomes. Although rare, respiratory distress syndrome can also worsen neonatal health status. According to ROC analysis, previous miscarriages correctly explained 66.3% of adverse pregnancy outcome cases. We generated four equations of adverse pregnancy outcome risk factors.The most important prognostic factor for pregnancy outcome in APS patients is the number of previous miscarriages. Using appropriate current therapeutic protocol can enable live birth of a healthy newborn in most cases.


1997 ◽  
Vol 119 (3) ◽  
pp. 307-311 ◽  
Author(s):  
K. R. NEAL ◽  
R. C. B. SLACK

The epidemiology of notified cases of campylobacter gastroenteritis in adults in Nottingham Health District was investigated using a case-control study with a postal questionnaire to ascertain data on risk factors. Over a 14-month period 531 cases (a 73% response rate of all laboratory confirmed cases) and 512 controls replied.Conditional logistic regression analysis was used to determine independent associations with infection. These included foreign travel (odds ratio (OR) 3·4; 95% confidence intervals (CI) 2·0–5·7), diabetes mellitus (OR 4·1, CI 1·1–17), medication with omeprazole (OR 3·5, CI 1·1–12) and H2 and H2 antagonists (OR 3·7, CI 1·3–15), contact with puppies (OR11·3, CI1·2–105), eating chicken (OR 1·4, CI 1·1–1·8) and drinking milk from bottles with tops damaged by a bird (OR 3·3, CI 1·0–11). Preparing main meals (OR 0·9, CI 0·8–1·0) and drinking delivered milk (OR 0·6, CI 0·4–0·9) were associated with a reduced risk of campylobacter infection.Foreign travel was reported in 25% of cases and another 15% had significant associations with other risk factors. The majority of cases, 60%, remained unexplained, indicating the need for further evolution of sporadic cases.


2016 ◽  
Vol 31 (2) ◽  
pp. 83
Author(s):  
Marina De Deus Moura Lima ◽  
Zacarias Soares Brito-Neto ◽  
Heylane Oliveira Amaral ◽  
Cacilda Castelo Branco Lima ◽  
Marcoeli Silva de Moura ◽  
...  

Objective: The aim of this study was to determine the risk factors associated with early childhood caries (ECC).Methods: It was an observational retrospective case-control study. The case group consisted of all patients diagnosed with ECC in the records of an active program of maternal and child care. The control group was composed of an equal number of children, matched for gender and age, who attended the program and did not have ECC. The process of data collection consisted of completing a pre-established schedule to analyse variables related to the mother/caregiver and child.Statisticalanalysis was performed using the chi-squared and odds ratio (OR), with alpha (α) = 0.05.Results: History of caries in the mother (OR=2.61; CI 95%=1.45-4.67) and father (OR=1.72; CI 95%=1.02-2.89) were key determinants in the child being diagnosed with ECC.Conclusions: The risk factors associated with ECC were the following: no oral hygiene acceptance, nocturnal feeding duration of more than 16 months, a daily intake of sugar greater than 4 times a day, a Baume type II maxillary arch, fewer than 3 consultations with the program, and a history of decay in the parents.


2015 ◽  
Vol 40 (3) ◽  
pp. 113-117 ◽  
Author(s):  
A Jahan ◽  
SZR Rezina Parvin ◽  
D Bugum

This case-control study was done to identify the correlation between the familial, social and environmental risk factors and autism. This hospital and specialized centre based study done from January 2002 to November, 2004. Thirty two children from the autism group and 14 children from the control group were enrolled. Mean age were 3.75 yrs. and 2.83 yrs. respectively. Significant proportion of children were in the highest birth orders, 68.8% in autism and 78.6% in the control group. Full term children were 96.9% and 92.9% respectively. 53.1% children in the autism and 57.1% in the normal speech delay group were born by cesarean sections. Higher education of parents in autism group was statistically significant (p<0.05). Too much watching TV, inadequate opportunity to mix with peers and inadequate interactive relationship with the family members in the early childhood were significantly (p= 0.001) related to the development of autism.Bangladesh Med Res Counc Bull 2014; 40 (3): 113-117


2018 ◽  
Vol 4 (2) ◽  
pp. 227-232 ◽  
Author(s):  
Muayad A Merza ◽  
Abdul Aziz Sulaiman Savo ◽  
Muhammad Jaafer

Diabetes can be linked with impaired host immunity that subsequently increases the rate of various infections including tuberculosis (TB), particularly in developing countries where TB is endemic. The objectives of this case control study were to determine the prevalence and the risk of LTBI among diabetic patients. It is a prospective case control study conducted in Azadi Teaching Hospital from September 2017 until May 2018. The diabetic patients included in this study were randomly selected. The diagnosis of diabetes mellitus (DM) was made according to the American Diabetes Association (ADA). Diabetes mellitus patients and the control participants were offered a voluntary tuberculin skin test (TST). The TST ≥10 mm was considered positive. The results were analyzed by entering the data in SPSS (statistical package for the social sciences, version 16; SPSS Inc., Chicago, Illinois, USA). Two hundred DM patients and 208 control individuals participated in this study. Collectively, 28 patients had positive TST results. Based on the sputum smear microscopy and CXR, none of these patients showed active TB disease. The differences between the DM patients and the control group had no statistical significance apart from previous hospitalization. The prevalence of LTBI was 23.53% in the diabetic group, whereas, it was 9.62% in the control group. The frequency of LTBI in diabetic patients was significantly higher than the control group. When the diabetic group was compared with the control group in terms of diabetic control and the duration of diabetes disease, there was a statistically significant association of diabetes duration ≥ 10 years and TST positivity. In conclusion, the previous hospitalization was a significant risk factor for diabetic patients to acquire TB bacilli. Latent TB infection was more common in diabetics than non diabetics and there was an increased likelihood of having LTBI with the duration of diabetes ≥ 10 years. To avoid the threatening of TB control program, prophylactic treatment of LTBI in diabetic patients is paramount.Asian J. Med. Biol. Res. June 2018, 4(2): 227-232


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