scholarly journals A Visual and Comprehensive Review on COVID-19-Associated Pulmonary Aspergillosis (CAPA)

2021 ◽  
Vol 7 (12) ◽  
pp. 1067
Author(s):  
Simon Feys ◽  
Maria Panagiota Almyroudi ◽  
Reinout Braspenning ◽  
Katrien Lagrou ◽  
Isabel Spriet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fungal Infection ◽  
Prospective Studies ◽  
Interleukin 6 ◽  
Great Variability ◽  
Pulmonary Aspergillosis ◽  
Comprehensive Review ◽  
Multiple Factors ◽  
Work Up ◽  
Conclusive Data

Coronavirus disease 19 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a severe fungal infection complicating critically ill COVID-19 patients. Numerous retrospective and prospective studies have been performed to get a better grasp on this lethal co-infection. We performed a qualitative review and summarized data from 48 studies in which 7047 patients had been included, of whom 820 had CAPA. The pooled incidence of proven, probable or putative CAPA was 15.1% among 2953 ICU-admitted COVID-19 patients included in 18 prospective studies. Incidences showed great variability due to multiple factors such as discrepancies in the rate and depth of the fungal work-up. The pathophysiology and risk factors for CAPA are ill-defined, but therapy with corticosteroids and anti-interleukin-6 therapy potentially confer the biggest risk. Sampling for mycological work-up using bronchoscopy is the cornerstone for diagnosis, as imaging is often aspecific. CAPA is associated with an increased mortality, but we do not have conclusive data whether therapy contributes to an increased survival in these patients. We conclude our review with a comparison between influenza-associated pulmonary aspergillosis (IAPA) and CAPA.

'Mucormycosis' A Fungal Infection Threatening India During COVID-19' - A Review

2021 ◽  
Vol 19 ◽  
Author(s):  
Sumel Ashique
Keyword(s):  
Risk Factors ◽  
Fungal Infection ◽  
Invasive Pulmonary Aspergillosis ◽  
Background Risk ◽  
Pulmonary Aspergillosis ◽  
Second Wave

: During the second wave of Covid-19 in India, doctors recently reported a outbreak of cases involving a rare infection - called the "black fungus" - among recovering and recovered Covid-19 patients. The frequency of bacterial and fungal coinfections has been continuously rising. At the same time, invasive pulmonary aspergillosis is increasingly being recognized in association with nCOVID-19. Currently, India is suffering from a newly maiming disease associated with nCOVID-19 infected patients; at the time of the treatment, it can be developed into rhino-orbital mucormycosis. There are some approved antifungal therapies for treating this fungal infection. The background, risk factors, and associated reports about the infection are described in this review.

Incidence of depression and its influencing factors in 387 patients with asthma from Xinjiang, China

2020 ◽  
Vol 41 (2) ◽  
pp. e45-e53 ◽  
Author(s):  
Dilinuer Wufuer ◽  
Haidiya Aierken ◽  
Yan Fang ◽  
Mihereguli Simayi ◽  
Kelibiena Tuerxun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Depression Scale ◽  
High Morbidity ◽  
Hamilton Depression Scale ◽  
Multiple Factors ◽  
Asthma Symptoms ◽  
Depression Status ◽  
Treatment Of Depression ◽  
Quality Life

Background: Our study aimed to investigate the incidence of depression in 387 patients with asthma. Methods: The Zung self-rating depression scale and the Hamilton depression scale were used to evaluate the depression status in patients with asthma. Results: Results of logistic regression analysis indicated that, severity of asthma symptoms, taking medicine, frequency of asthma onset, and lack of education were the major risk factors for depression in patients with asthma. Conclusion: Depression is a complication with high morbidity in patients with asthma. It largely affects disease control of asthma and the quality life in patients. Multiple factors are relevant for depression in the patient with asthma. This study provided a comprehensive horizon for clinical management and treatment of depression in patients with asthma.

scholarly journals 1147. Short Course of Voriconazole Therapy as a Risk Factor for Relapse of Invasive Pulmonary Aspergillosis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S600-S601
Author(s):  
Dong Hoon Shin ◽  
Seung-Jin Yoo ◽  
Jongtak Jung ◽  
Kang Il Jun ◽  
Hyungjin Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Tertiary Care ◽  
Invasive Pulmonary Aspergillosis ◽  
Care Hospital ◽  
Pulmonary Aspergillosis ◽  
Treatment Termination ◽  
Duration Of Therapy ◽  
Short Course ◽  
Life Threatening

Abstract Background Invasive pulmonary aspergillosis (IPA) is a life-threatening opportunistic infection which usually occurs in immunocompromised patients. Recommended duration of voriconazole therapy is a minimum of 6-12 weeks for IPA, despite the lack of any firm evidence. In addition, risk factors for relapse of IPA are still unclear. Here, we explored risk factors for IPA relapse after initial treatment. Methods All patients with proven or probable IPA who had finished voriconazole treatment between 2005 and 2019 in a tertiary-care hospital were reviewed. IPA relapse was defined as re-diagnosis of proven or probable IPA at the same site within 1 year after treatment termination. Short course of voriconazole treatment was defined as a treatment less than 9 weeks, which is a median of the recommended minimum duration of therapy from the Infectious Disease Society of America. The radiological response was defined as a reduction in IPA burden by more than 50% on chest computed tomography (CT). Results Of 87 patients who had completed voriconazole treatment, 14 (16.1%) experienced IPA relapse. Multivariable Cox regression identified that short voriconazole treatment duration (adjusted hazard ratio [aHR], 3.7; 95% confidence interval [CI], 1.1–12.3; P=0.033) and radiological non-response (aHR, 4.6; 95% CI, 1.2–17.5; P=0.026) were independently associated with relapse of IPA after adjusting for several clinical risk factors. Conclusion Less improvement in CT, and short duration of voriconazole therapy were the independent risk factors for relapse after treatment of IPA. Longer duration of therapy should be considered for those at higher risk of relapse. Disclosures All Authors: No reported disclosures

Interleukin-6 G-174C gene polymorphism and serum resistin levels in North Indian women: Potential risk of metabolic syndrome

2010 ◽  
Vol 30 (10) ◽  
pp. 1445-1453 ◽  
Author(s):  
A Gupta ◽  
V Gupta ◽  
AK Singh ◽  
S Tiwari ◽  
S Agrawal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Genetic Polymorphism ◽  
Interleukin 6 ◽  
Metabolic Risk Factors ◽  
Metabolic Risk ◽  
Obese Women ◽  
Resistin Level ◽  
Indian Women ◽  
Mutant Genotype

The present investigations were aimed to identify the possible association between genetic polymorphism in interleukin-6 (IL-6) G-174C gene, which confers susceptibility to metabolic syndrome, and serum level of resistin in North Indian women. The study population comprised 370 unrelated Indian women (192 having abdominal obesity and 178 controls). Polymorphism in genotype (CC+GC) of IL-6 G-174C gene was determined using a combination of polymerase chain reaction (PCR) and sequence-specific primer with restriction fragment length polymorphism (RFLP) technology. Insulin resistance (IR) and serum resistin level were also analyzed along with metabolic risk factors. Of 192 abdominal obese women, 147 (76.56%) were found to have mutant CC+GC ( p = 0.001) genotype and allele frequency ( p = 0.001), which was significantly higher 45 (23.44%) than non-obese and their respective wild type. The mutant genotype (CC+GC) of IL-6 gene was found to be associated significantly with high triglyceride ( p = 0.025) and resistin level ( p < 0.001), when compared with respective wild genotype (GG) in obese women. Non-obese women with no signs of metabolic risk factors were found to have significantly low level of serum resistin and IR in comparison to obese women having genetic polymorphism for IL-6 G-174C gene. Study suggests that IL-6 G-174C gene is one among the susceptibility loci for metabolic syndrome in North Indian women. Genotype for this polymorphism may prove informative for prediction of genetic risk for metabolic syndrome. Further, high level of serum resistin molecules may be targeted to correlate with metabolic syndrome risk factors and could be used as early prediction marker.

scholarly journals FRI0549 RISK OF INVASIVE FUNGAL INFECTION IN SYSTEMIC LUPUS ERYTHEMATOSUS: A NATIONWIDE POPULATION-BASED STUDY IN TAIWAN

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 876.1-876
Author(s):  
C. F. Su ◽  
C. C. Lai ◽  
T. H. LI ◽  
Y. F. Chang ◽  
Y. T. Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Mortality Rate ◽  
Fungal Infection ◽  
Incidence Rate ◽  
Invasive Fungal Infection ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Intravenous Steroid ◽  
Independent Risk Factors

Background:Infectious disease is one of the leading causes of mortality in systemic lupus erythematosus (SLE). Among these infections, invasive fungal infection (IFI) carries high mortality rate (25-70%), but the literature of IFI in SLE is limited.Objectives:To investigate the epidemiology and risk factors of invasive fungal infection and its subtypes, including candidiasis, aspergillosis, and cryptococcosis, in SLE patients.Methods:All patients with newly diagnosed SLE between 1997-2012 were enrolled from Taiwan National Health Insurance Research Database, with an age- and sex-matched non-SLE control group in a ratio of 1:10. IFI was identified by ICD9 codes1from discharge record and validated by use of systemic anti-fungal agents. The incidence rate (IR), incidence rate ratio (IRR), cause mortality rate of IFI and its subtypes were compared. A Cox multivariate model with time-dependent covariates was applied to analyse the independent risk factors of IFI.Results:A total of 269 951 subjects (24 541 SLE and 245 410 control) were included. There were 445 episodes of IFI in SLE group. Candida was the most common pathogen (52.8%), followed by cryptococcus and aspergillus. The IR of IFI in SLE was 20.83 per 10,000 person-years with an IRR of 11.1 (95% CI 9.8-12.6) compared to the control (figure 1). Kaplan-Meier curve also disclosed a lower IFI-free survival in SLE (figure 2). The all-cause mortality rate was similar between SLE and the control (26.7 vs 25.7%). In SLE, treatment with mycophenolate mofetil (HR=2.24, 95% CI 1.48-3.37), cyclosporin (HR=1.65, 95% CI 1.10-1.75), cyclophosphamide (HR=1.37, 95% CI 1.07-1.75), oral daily dose of steroid>5 mg prednisolone (HR=1.26, 95% CI 1.01-1.58), and intravenous steroid therapy (HR=29.11, 95% CI 23.30-36.37) were identified as independent risk factors of IFI. Similar analyses were performed for subtypes of IFI. Distinctive risk factors were found between different subtypes of IFI (table 1).Conclusion:SLE patients have a higher risk of IFI. Intravenous steroid therapy is the most important risk factor of IFI. This study provides crucial information for risk stratification of IFI in SLE.References:[1] Winthrop KL, Novosad SA, Baddley JW, et al. Opportunistic infections and biologic therapies in immune-mediated inflammatory diseases: consensus recommendations for infection reporting during clinical trials and postmarketing surveillance. Ann Rheum Dis. 2015 Dec; 74(12):2107-2116.Disclosure of Interests:None declared

scholarly journals Uncommon case of pericardial effusion

2017 ◽  
Vol 11 (3) ◽  
pp. 331
Author(s):  
Andrea D'Amato ◽  
Costantino Mancusi ◽  
Maria Viviana Carlino ◽  
Veronica Lio ◽  
Federica De Pisapia ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Pericardial Effusion ◽  
Poor Prognosis ◽  
Severe Aortic Stenosis ◽  
Uncommon Case ◽  
Inflammatory Drugs ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

We present the case of a 59-year-old patient with severe aortic stenosis, asymptomatic mild to moderate pericardial effusion and no major risk factors for poor prognosis. He underwent four-week course of non-steroidal anti-inflammatory drugs (ibuprofen 600 mg TID) with no improvement of the effusion. After complete diagnostic work-up and examination, we discovered that he had a prostate cancer with bone metastasis. On the bone scintigraphy, there was particular involvement of ribs and sternum. We decided to treat our patient with an association of docetaxel and hormone therapy, after six months we observed a reduction in the pericardial effusion. Even in the presence of a patient without risk factor of poor prognosis, pericardial effusion can be the first sign of occult neoplasia.

scholarly journals Metabolic and endocrinological factors related to nephrolithiasis pre and post multiple techniques of bariatric surgery: a sistematic review

2014 ◽  
Vol 27 (suppl 1) ◽  
pp. 69-72
Author(s):  
Marcos Vinicius Ribeiro dos SANTOS ◽  
Gustavo Enrique Correia FERREIRA ◽  
Eduardo Cirne Pedrosa de OLIVEIRA ◽  
Flavio KREIMER ◽  
Josemberg Marins CAMPOS ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bariatric Surgery ◽  
Obesity Surgery ◽  
Prospective Studies ◽  
Retrospective Studies ◽  
Obesity Treatment ◽  
Large Percentage ◽  
Surgery For Obesity

INTRODUCTION: Despite of benefits of bariatric surgery for obesity treatment, the procedure may be related to some complications. AIM: Analyze studies to address the relation between nephrolithiasis and bariatric surgery. METHODS: Ten papers about this theme were selected from 2005-2013 in Pubmed, describing the relation of nephrolithiasis or their risk factors with several types of bariatric surgery. RESULTS: Retrospective studies with minimal follow-up of three years demonstrated 7,65% in surgery patients and 4,63% non-surgery with nephrolithiasis (p<0,05). Prospective studies (8 of 10) revealed large percentage of calculi appearing and significant increase in oxaluria. CONCLUSION: There is correlation between obesity surgery and nephrolithiasis.

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