Evidence-based case report: Coinfection of COVID-19 in children and administration of antibiotics

A B S T R A C TBackground. COVID-19 in childrenalthoughmostly mild,but can also cause seriousillness and even death. Coinfection, especially bacterialcan increase the severity of thedisease. There is yet sufficient evidence about the role of antibiotics in childhoodCOVID-19 with coinfection.Objective. To review the available evidence on thecoinfection in childhood COVID-19 and the role of antibiotic administration.Method.Online literature search using Pubmed database, google scholar dan Cohcranelibrary Results.No study was found that directly evaluate the efficacy of antibiotic inchildhood COVID-19 with coinfection. Three meta-analyses found rates of coinfectionof 5.6%-14% and one case series identified a very high rate (94.2%). Most frequentpathogens included Mycoplasma pneumonia, Streptococcus pneumonia,andinfluenza/parainfluenza viruses. Two RCTsandone case series on antibioticadministration, but all three studies did not address coinfection status.All threestudies evaluated the combination of azithromycin and hydroxychloroquine. Nochanges in illness severity or mortality attributed to the medications, one studyindicated more rapid viral load clearance associated with azithromycin. ConclusionThere is a lack of evidence on the role of antibiotics in the management of childhoodCOVID-19with coinfection. Azithromycin can be considered in some cases.

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Vasculitis induced by biological agents used in rheumatology practice: A systematic review

Archives of Rheumatology ◽

10.46497/archrheumatol.2022.9049 ◽

2021 ◽

Author(s):

Camila da Silva Cendon Duran ◽

Adriane Souza da Paz ◽

Mittermayer Barreto Santiago

Keyword(s):

Systematic Review ◽

Leukocytoclastic Vasculitis ◽

Case Reports ◽

Case Series ◽

Final Analysis ◽

Infusion Reaction ◽

Biological Agents ◽

Necrosis Factor Alpha ◽

Pubmed Database ◽

Meta Analyses

Objectives: Biological medications have been used with an increasing frequency to treat rheumatological diseases. Autoimmune events can be induced by these drugs, such as psoriasiform lesions, alopecia, lupus and, vasculitis, which more often affects the skin (small-sized vessels) and eventually other organs. In this review, we describe the clinical profile of patients with vasculitis induced by the main biological agents used in rheumatology. Patients and methods: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The PubMed database was used for searching eligible articles. We included case reports, case series, and letter to the editor of patients on anti-tumor necrosis factor-alpha (anti-TNF-a) molecules, as well as tocilizumab, ustekinumab, secukinumab, rituximab, and abatacept, who had vasculitis induced by these agents. Results: Eighty-one articles were included for final analysis (n=89). Twenty-seven patients were using infliximab, 20 adalimumab, 18 etanercept, seven secukinumab, four certolizumab, four rituximab, three golimumab, three ustekinumab, two abatacept, and one tocilizumab. Unspecific leukocytoclastic vasculitis (LCV) was the most common type of vasculitis (n=37), followed by anti-neutrophil cytoplasmic antibody (ANCA)- associated vasculitis (n=16). The medication was replaced with another biological molecule in 23 cases, with only four relapses. In six cases, the biological was maintained, but vasculitis worsened/persisted in one case, being necessary drug removal. Conclusion: Infections, infusion reaction, cancer, and autoimmune events are well-known side effects of biological therapy. This review demonstrates that vasculitis is another adverse effect of this type of therapy, particularly the anti-TNF-a molecules, and LCV the most reported type of vasculitis.

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Chemerin and Cancer

International Journal of Molecular Sciences ◽

10.3390/ijms20153750 ◽

2019 ◽

Vol 20 (15) ◽

pp. 3750 ◽

Cited By ~ 14

Author(s):

Oliver Treeck ◽

Christa Buechler ◽

Olaf Ortmann

Keyword(s):

Review Article ◽

Innate Immune ◽

Original Research ◽

Cellular Receptors ◽

Dna Microarray Data ◽

Tumor Tissues ◽

Pubmed Database ◽

Meta Analyses ◽

G Protein Coupled

Chemerin is a multifunctional adipokine with established roles in inflammation, adipogenesis and glucose homeostasis. Increasing evidence suggest an important function of chemerin in cancer. Chemerin’s main cellular receptors, chemokine-like receptor 1 (CMKLR1), G-protein coupled receptor 1 (GPR1) and C-C chemokine receptor-like 2 (CCRL2) are expressed in most normal and tumor tissues. Chemerin’s role in cancer is considered controversial, since it is able to exert both anti-tumoral and tumor-promoting effects, which are mediated by different mechanisms like recruiting innate immune defenses or activation of endothelial angiogenesis. For this review article, original research articles on the role of chemerin and its receptors in cancer were considered, which are listed in the PubMed database. Additionally, we included meta-analyses of publicly accessible DNA microarray data to elucidate the association of expression of chemerin and its receptors in tumor tissues with patients’ survival.

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Systematic analysis of direct antiglobulin test results in post-artesunate delayed haemolysis

Malaria Journal ◽

10.1186/s12936-021-03735-w ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Tommaso Ascoli Bartoli ◽

Luciana Lepore ◽

Alessandra D’Abramo ◽

Giovanna Adamo ◽

Angela Corpolongo ◽

...

Keyword(s):

Univariate Analysis ◽

Case Series ◽

Direct Antiglobulin Test ◽

Systematic Analysis ◽

Immune Mediated ◽

Pubmed Database ◽

Antiglobulin Test ◽

Delayed Haemolysis ◽

Erythrocyte Clearance

Abstract Background Post-artesunate delayed haemolysis (PADH) is common after severe malaria episodes. PADH is related to the “pitting” phenomenon and the synchronous delayed clearance of once-infected erythrocytes, initially spared during treatment. However, direct antiglobulin test (DAT) positivity has been reported in several PADH cases, suggesting a contribution of immune-mediated erythrocyte clearance. The aim of the present study was to compare clinical features of cases presenting a positive or negative DAT. Methods Articles reporting clinical data of patients diagnosed with PADH, for whom DAT had been performed, were collected from PubMed database. Data retrieved from single patients were extracted and univariate analysis was performed in order to identify features potentially related to DAT results and steroids use. Results Twenty-two studies reporting 39 PADH cases were included: median baseline parasitaemia was 20.8% (IQR: 11.2–30) and DAT was positive in 17 cases (45.5%). Compared to DAT-negative individuals, DAT-positive patients were older (49.5 vs 31; p = 0.01), had a higher baseline parasitaemia (27% vs 17%; p = 0.03) and were more commonly treated with systemic steroids (11 vs 3 patients, p = 0.002). Depth and kinetics of delayed anaemia were not associated with DAT positivity. Conclusions In this case series, almost half of the patients affected by PADH had a positive DAT. An obvious difference between the clinical courses of patients presenting with a positive or negative DAT was lacking. This observation suggests that DAT result may not be indicative of a pathogenic role of anti-erythrocytes antibodies in patients affected by PADH, but it may be rather a marker of immune activation.

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Lack of influence of low temperature, light and growth substances on phytochrome resynthesis in coleoptiles of irradiated oat seedlings

Acta Societatis Botanicorum Poloniae ◽

10.5586/asbp.1984.025 ◽

2014 ◽

Vol 53 (2) ◽

pp. 271-278

Author(s):

Jan Kopcewicz ◽

Mariusz Cymerski ◽

Kazimierz Madela

Keyword(s):

Low Temperature ◽

Large Fraction ◽

Elongation Growth ◽

The Other ◽

High Rate ◽

Growth Substances ◽

Etiolated Seedlings ◽

High Level ◽

Very High

The photoconversion of phytochrome P<sub>R</sub> into the P<sub>FR</sub> form causes at the same time the destruction of the initial large fraction of phytochrome found in the coleoptiles of etiolated oat seedlings. Factors such as low temperature, light of different wavelengths or growth substances are not capable of preventing the progressive destruction and restore the synthesis of phytochrome. Thus an abnormally high level of phytochrome is found only in etiolated seedlings. Such seedlings, on the other hand, are characterized by a very high rate of elongation growth. The role of phytochrome in the control of deetiolation of seedlings is discussed.

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MANAGEMENT OF ILEOCECAL CROHN’S DISEASE DURING SURGICAL TREATMENT FOR ACUTE APPENDICITIS: A SYSTEMATIC REVIEW

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.202100000-98 ◽

2021 ◽

Vol 58 (4) ◽

pp. 560-565

Author(s):

Abel Botelho QUARESMA ◽

Eron Fabio MIRANDA ◽

Paulo Gustavo KOTZE

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Acute Appendicitis ◽

Meta Analysis ◽

Case Series ◽

High Rate ◽

Qualitative Assessment ◽

Randomized Studies ◽

Pubmed Database ◽

Increased Risk

ABSTRACT BACKGROUND In many patients, the diagnosis of Crohn’s disease (CD) is made during surgery for appendicitis in urgent settings. Intraoperative diagnosis can be challenging in certain cases, especially for less experienced surgeons. OBJECTIVE: Review of the literature searching for scientific evidence that can guide surgeons through optimal management of ileocecal CD found incidentally in surgery for acute appendicitis (AA). METHODS: Included studies were identified by electronic search in the PubMed database according to the Preferred Items of Reports for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The quality and bias assessments were performed by Methodological Index for Non-Randomized Studies (MINORS) criteria for non-randomized studies. RESULTS: A total of 313 studies were initially identified, six of which were selected (all retrospective) for qualitative assessment (two studies were comparative and four only descriptive case series). Four studies identified a high rate of complications when appendectomy or ileocolectomy were performed and in only one, there was no increased risk of postoperative complications with appendectomy. In the sixth study, diarrhea, previous abdominal pain, preoperative anemia and thrombocytopenia were independent predictors for CD in patients previously operated for suspected AA. CONCLUSION: Despite the paucity of data and low quality of evidence, a macroscopically normal appendix should be preserved in the absence of complicated disease when CD is suspected in surgery for AA. Ileocecal resections should be reserved for complicated disease (inflammatory mass, ischemia, perforation or obstruction). Further prospective studies are needed to confirm these claims.

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Bullous pemphigoid and radiotherapy: case report and literature review update

Dermatology Reports ◽

10.4081/dr.2021.9170 ◽

2021 ◽

Author(s):

Antonio Piras ◽

Bruno Fionda ◽

Antonella Sanfratello ◽

Andrea D'Aviero ◽

Giovanni Sortino ◽

...

Keyword(s):

Case Report ◽

Bullous Pemphigoid ◽

Large Scale ◽

Case Reports ◽

Normal Skin ◽

Disease Onset ◽

Case Series ◽

Characteristics Analysis ◽

Meta Analyses

INTROUDCTION Bullous pemphigoid (BP) is a common autoimmune bullous disease generally occurring in elderly patients. Itchy and tense blisters on normal skin or erythematous and edematous lesions on the trunk and extremities usually characterize BP. Trigger factors are still unclear while several case reports suggest a potential role of radiotherapy (RT) as BP trigger for disease onset or recrudescence. A review was performed in order to provide an update of literature. A case report of a patient affected by BP undergoing two radiotherapy courses for a primary breast cancer was also reported. MATERIALS AND METHODS A comprehensive review of the published literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. The review included studies describing BP and its relationships with RT treatments. RESULTS A total of 13 articles were reviewed. Studies characteristics analysis resulted in eleven case reports, one case series and one large-scale case–control study. CONCLUSIONS Literature update confirms the existence of a reasonable connection between RT and BP. Case report showed that a multidisciplinary management seems to assure the feasibility of RT in patients affected by BP, not depriving them of standard therapeutic opportunities.

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Investigating Cohesive Devices in Wordsworth Poetry

10.31235/osf.io/jfsnv ◽

2019 ◽

Author(s):

Mohamed Jabraddar Mahil Abd Allah

Keyword(s):

Content Analysis ◽

High Rate ◽

Literary Texts ◽

Stylistic Analysis ◽

Main Function ◽

Lexical Cohesion ◽

Cohesive Devices ◽

Analysis Technique ◽

Very High

This study has attempted to investigate the use of cohesive devices in Wordsworth poetry. It has aimed to understand the role of stylistics analysis in shaping the meanings of literary texts. In addition to explain how cohesion can contribute to interpreting and understanding poetry. The significant of the study is based on the fact that it contributes to the understanding of how linguistic and stylistic analysis of a text can be used, extensively, to clarify features and meanings in texts. Nine poems were selected to represent Wordsworth poetry. The poems were selected randomly. Cohesive devices were identified in the poems and analyzed using the content analysis technique. They were analyzed quantitatively. The analysis revealed a number of interesting results, namely: All types of cohesive devices were used in the poems selected for the purpose of the study (reference, substitution, ellipsis, conjunction and lexical cohesion). There were some variations in the use of some devices; in that certain devices were used at a very high rate of frequency compared to others. The main function of the use of cohesive devices within the poems was to help the poet express romantic values. Based on the results obtained, the study suggests the following: First, it would be interesting, for further studies to conduct more studies on the coherence of English literary discourse. Second, it is worth to investigate cohesive devices of the sociolinguistic aspects within poetry, as poetry is an important area whose genre contains impressive socio-cultural meaning.

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The dimer (HCl)2: Stationary points on the SCF 4-31G energy hypersurface and the role of entropy in the dimer formation

Collection of Czechoslovak Chemical Communications ◽

10.1135/cccc19793458 ◽

1979 ◽

Vol 44 (12) ◽

pp. 3458-3463 ◽

Cited By ~ 36

Author(s):

Pavel Hobza ◽

Petr Čársky ◽

Rudolf Zahradník

Keyword(s):

Energy Difference ◽

High Rate ◽

Stationary Points ◽

Heat Of Reaction ◽

Dimer Formation ◽

Small Energy ◽

Common Features ◽

Energy Hypersurface ◽

Very High

Two stationary points have been investigated on the 4-31G SCF energy hypersurface of (HCl)2. It has been shown, in agreement with experiment, that only the quasilinear structure satisfies all criteria required for a real minimum. Small heat of reaction and the crucial role of entropy in the (HCl)2 formation suggest that the dimer (HCl)2, in contrast to (HF)2, represents a true van der Waals molecule. A very small energy difference between the two stationary points (minimum and saddle point) suggests a very high rate of interconversion between two possible structures of the quasilinear form. Common features of and differences between (HCl)2 and (HF)2 are pointed out.

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Systematic Analysis of Direct Antiglobulin Test Results in Post-artesunate Delayed Hemolysis

10.21203/rs.3.rs-63635/v1 ◽

2020 ◽

Author(s):

Tommaso Ascoli Bartoli ◽

Luciana Lepore ◽

Alessandra D'Abramo ◽

Giovanna Adamo ◽

Angela Corpolongo ◽

...

Keyword(s):

Univariate Analysis ◽

Case Series ◽

Direct Antiglobulin Test ◽

Systematic Analysis ◽

Immune Mediated ◽

Pubmed Database ◽

Antiglobulin Test ◽

Erythrocyte Clearance ◽

Kinetics Of

Abstract Background: “Post-Artesunate Delayed Hemolysis” (PADH) is common after severe malaria episodes. PADH is related to the “pitting” phenomenon and the synchronous delayed clearance of once-infected erythrocytes, initially spared during treatment. However, direct antiglobulin test (DAT) positivity has been reported in several PADH cases, suggesting a contribution of immune-mediated erythrocyte clearance. The aim of the present study was to compare clinical features of cases presenting a positive or negative DAT.Method: Articles reporting clinical data of patients diagnosed with PADH, for whom DAT had been performed, were collected from PubMed database. Data retrieved from single patients were extracted and univariate analysis was performed in order to identify features potentially related to DAT results and steroids use.Results: Twenty-two studies reporting 39 PADH cases were included: median baseline parasitemia was 20.8% (IQR: 11.2-30) and DAT was positive in 17 cases (45.5%). Compared to DAT-negative individuals, DAT-positive patients were older (49.5 vs 31; p=0.01), had a higher baseline parasitemia (27% vs 17%; p=0.03) and were more commonly treated with systemic steroids (11 vs 3 patients, p=0.002). Depth and kinetics of delayed anemia were not associated with DAT positivity.Conclusions: In this case series, almost half of the patients affected by PADH had a positive DAT. An obvious difference between the clinical courses of patients presenting with a positive or negative DAT was lacking. This observation strongly suggests that DAT result is not indicative of a pathogenic role of anti-erythrocytes antibodies in patients affected by PADH, but is rather a marker of immune activation.

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COVID-19 and intracranial hemorrhage: a multicenter case series, systematic review and pooled analysis

10.21203/rs.3.rs-546639/v1 ◽

2021 ◽

Author(s):

Moritz L Schmidbauer ◽

Caroline Ferse ◽

Farid Salih ◽

Carsten Klingner ◽

Rita Musleh ◽

...

Keyword(s):

Systematic Review ◽

Intracranial Hemorrhage ◽

Selection Process ◽

Case Series ◽

Pooled Analysis ◽

Review Of Literature ◽

Neurologic Disorders ◽

Pubmed Database ◽

Hemorrhagic Complications ◽

Meta Analyses

Abstract Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) profoundly impacts on hemostasis and microvasculature. Correspondingly, antithrombotic therapy is frequently used for prophylaxis or treatment of thromboembolic complications as well as in the context of extracorporeal membrane oxygenation (ECMO). However, reports of intracranial hemorrhage (ICH) associated with Coronavirus disease 2019 (COVID-19) have also emerged. In the light of the dilemma between thromboembolic and hemorrhagic complications, we sought to systematically investigate incidence, mortality, radiological subtypes and clinical characteristics of ICH in COVID-19 patients.Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a systematic review of literature by screening the PubMed database and included patients diagnosed with COVID-19 and concomitant ICH. Furthermore, we performed a pooled analysis including a prospectively collected cohort of critically ill COVID-19 patients with ICH as part of the PANDEMIC registry (Pooled Analysis of Neurologic Disorders Manifesting in Intensive care of COVID-19).Results: Our literature review revealed a total of 217 citations. After selection process, 79 studies and a total of 477 patients were included. Median age was 58.8 years (95% CI 54.8 years-62.9 years; I2 = 85,6%). 23.3% patients experienced critical stage of COVID-19 (95% CI 8.9% − 61.2%, I2 = 53.8%). 62.7% patients were on anticoagulation (95% CI 38.2% − 103.0%, I2 = 82,6%), and 27.5% patients received ECMO (95% CI 5.8% − 130.2%, I2 = 92.7%). Microbleeds (51.1%, 95% CI 31.1% − 84.2%, I2 = 85.1%), subarachnoid hemorrhage (SAH) (26.6%, 95% CI 16.8% − 42.0%, I2 = 61.2%) and intraparenchymal hemorrhage (IPH) (33.7%, 95% CI 23.3% − 48.8%, I2 = 63.7%) were most frequently documented as ICH subtypes. Incidence was at 0.85% (95% CI 0.36%-1.99%; I2 = 97.5%) and mortality at 52.18% (95% CI 40.40%-67.39%; I2 = 51.7%), respectively.Conclusion: ICH in COVID-19 patients is rare, but has a very poor prognosis. Different subtypes of ICH seen in COVID-19 support the assumption of heterogenous and multifactorial pathomechanisms contributing to ICH in COVID-19. Further data and pathophysiological insights are warranted to resolve the conflict between thromboembolic and hemorrhagic complications in the future.

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