scholarly journals Integrative parameter of platelet aggregation in intensive care of COVID-19 patients

2021 ◽  
Vol 18 (4) ◽  
pp. 99-107
Author(s):  
A. V. Marochkov ◽  
A. L. Lipnitski ◽  
A. G. Starovoitov ◽  
V. U. Dazortsava ◽  
V. A. Livinskaya

Objective. To conduct a comparative analysis of changes in platelet aggregation parameters in COVID-19 patients which are related to anticoagulant therapy and to determine the effectiveness of the integrative parameter of platelet aggregation.Materials and methods. 34 patients with confirmed COVID-19 (group 1) were included into the study. To compare the obtained results, healthy females were included into group 2 (n = 30). The following parameters of aggregation were determined: degree, time, rate and area of aggregation (until its maximum degree).Results. The area of aggregation is the best among all the parameters of platelet aggregation to diagnose COVID-19 in patients according to the Hosmer-Lemeshow test: with an ADP inducer — 0.3 μg/ml (Chi-square = 9.481, p = 0.303); ADP — 1.25 μg/ml (Chi square = 12.577, p = 0.127); ADP — 2.5 μg/ml (Chi-square = 6.226, p = 0.622); adrenaline — 2.5 μM (Chi-square = 7.367, p = 0.498); adrenaline — 5 μM (Chi-square = 6.824, p = 0.556).Conclusion. The area of aggregation is an informative integrative parameter that allows to quantify the degree of aggregation in the treatment of hypercoagulation syndrome in COVID-19 patients.

2021 ◽  
Vol 20 (3) ◽  
pp. 16-24
Author(s):  
A.V. Marochkov ◽  
◽  
◽  
A.L. Lipnitski ◽  
A.G. Starovoitov ◽  
...  

The change in platelet function that occurs in patients during treatment for a new coronavirus infection can be determined using the platelet aggregation method. Objectives. To determine optimal inducer of platelet aggregation and to assess its prognostic significance in intensive therapy of patients with COVID-19 infection. Material and methods. 34 patients with new coronavirus infection were included in group 1, and 30 healthy women were included in group 2. The study of platelet aggregation was carried out by the turbidimetric method with AP2110 analyzer (SOLAR, Results. The area under the aggregation curve was statistically significantly greater in patients in group 1 when using an ADP inducer at a dose of 0.3 μg/ml (69.1 (27.3; 164.4) unit in comparison with 55.3 (31.5; 68.2) units in group 2, p<0.001). When using an ADP inducer in high concentrations of 1.25 and 2.5 μg/ml and an adrenaline inducer in concentrations of 2.5 and 5 μM, the area under the curve in patients with COVID-19 infection was statistically significantly lower compared to group 2. The area under the aggregation curve according to the Hosmer-Lemeshov criterion has been found to be an independent predictor of death in the intensive care unit (Chi-square=5.074, p=0.06 for ADP 0.3 μg/ml and Chi square=15.121, p=0.057 for ADP 0.6 μg/ml). Conclusions. A comparative analysis of platelet aggregation using inducers of ADP, adrenaline and collagen has shown that in patients with new coronavirus infection, the degree of coagulation imbalance should be determined according to the indications obtained with an ADP inducer at a dose of 0.3 and 0.6 μg/ml.


Animals ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 480
Author(s):  
Martina Zappaterra ◽  
Laura Menchetti ◽  
Leonardo Nanni Costa ◽  
Barbara Padalino

This study aimed at documenting whether dromedary camels have a preference for shade and how their behavior would change depending on the presence of shade and variable space allowance. A total of 421 animals kept in 76 pens (66 with shelter (Group 1), and 10 without shelter (Group 2)) at the camel market in Doha (Qatar) were recorded for 1 min around 11:00 a.m. when the temperature was above 40 °C. The number of animals in the sun and shade and their behaviors were analyzed using an ad libitum sampling method and an ad hoc ethogram. The results of a chi-square test indicated that camels in Group 1 had a clear preference for shade (p < 0.001). The majority of Group 1 camels were indeed observed in the shade (312/421; 74.11%). These camels spent more time in recumbency and ruminating, while standing, walking, and self-grooming were more commonly expressed by the camels in the sun (p < 0.001). Moreover, locomotory stereotypic behaviors (i.e., pacing) increased as space allowance decreased (p = 0.002). Based on the findings of this pilot study, camels demonstrated a preference for shade; shade seemed to promote positive welfare, while overcrowding seemed to trigger stereotypy and poor welfare. Overall, our preliminary results are novel and provide evidence that shaded areas are of paramount importance for camel welfare. Further research, involving designed studies at multiple locations is needed to confirm these results.


2013 ◽  
Vol 53 (3) ◽  
pp. 125
Author(s):  
Marlisye Marpaung ◽  
Supriatmo Supriatmo ◽  
Atan Baas Sinuhaji

Background Vitamin A deficiency may increase the risk or bea cause of diarrhea. Many studies have been conducted on theefficacy of vitamin A in the management of acute diarrhea, butthe outcomes remain inconclusive.Objective To determine the effectiveness of vitamin A in reducingthe severity of acute diarrhea in children.Methods We performed a single􀁈blind􀁈randomized controlledtrial in the Secanggang District, Langkat Regency, North ofSumatera, from August 2009 to January 2010 in children aged6 months to 5 years, who had diarrheas. Subjects were dividedinto two groups. Group 1 received a single dose of vitamin A(100,000 IU for subjects aged 6 to 11 month old or with bodyweights :s 10 kg, or 200,000 IU for subjects aged 2: 12 month oldor with body weights> 10 kg). Group 2 received a single doseof placebo. The establishment of severity was based on changesin diarrheal frequency, stool consistency, volume and durationof diarrhea after treatment. We performed independent T􀁈testand Chi square tests for statistical analyses. The study was anintention􀁈to􀁈treat analysis.Results We enrolled 120 children who were randomized intotwo groups of 60 subjects each. Group 1, received vitamin Aand group 2 received a placebo. The results showed significantdifferences between the two groups in stool volume starting onthe first day (95%CI 192.30 to 3237.51; P􀁉O.OOI), as well asdiarrheal frequency (P=O.OOl) and stool consistency (P=O.OOl)on the second day observation and duration of diarrhea followingtreatment (95%CI - 40.60 to - 25.79; P􀁉O.OOI;).Conclusions Vitamin A supplementation is effective in reducingthe severity of acute diarrhea in children under five years of age.[Paediatr lndones. 2013;53:125-31.]


Author(s):  
Daming Zhu ◽  
Yuanyuan Zhang ◽  
Nowwar Mustafa ◽  
Angela Hoban ◽  
Dan Murphy ◽  
...  

Background: We have had a “one call activation system” for primary PCI at our regional academic center since 1999. The ED physician initiated the system with the decision for primary PCI made by cardiologist (interventional or non-interventional) on call. But since July 1, 2009, only interventional cardiologists are involved in the decision making process. Otherwise, the comprehensive strategy remained the same. As we have reported previously, this new strategy resulted in a shortened door-to-balloon (D2B) time. In the present study, we analyzed the D2B timeline intervals to determine where the major gains were achieved. Methods: We conducted a retrospective analysis of 665 consecutive patients presenting to our institution with suspicion of acute STEMI during a 30-month period. Group 1 consisted of patients in the 12 months (July 1 2008-June 30 2009) before and Group 2 consisted of patients in the 18 months (July 1 2009-Dec. 31 2010) after the system change was instituted. Mann-Whitney U test and chi-square test were used for statistical analysis. Results: 218 patients in group 1 were taken to the cath lab of which 180 received primary PCI. 349 patients in group 2 were taken to the cath lab of which 275 received primary PCI. The results were presented in the table. Conclusions: Comprehensive strategy with exclusive involvement of interventional cardiologist resulted in a significant decrement in decision-to-balloon time. The EKG-to-decision time did not decrease, contrary to our expectation.


Author(s):  
Panagis Galiatsatos ◽  
Tiffany Powell-Wiley ◽  
Xiaobai Li ◽  
Sameer Kadri ◽  
Dorothea McAreavey ◽  
...  

Introduction: Cardiac intensive care involves delivery of comprehensive critical care using advanced therapies for high-risk conditions. It is unclear if the outcomes such patients experience are evenly distributed throughout all care settings and what patient- and hospital-level factors impact these health outcomes. We evaluated the distribution of case-mix, acuity and processes of care from a nationally reflective convenience sample of intensive care units (ICUs). Methods: The Cerner Healthfacts Database was used to identify critically ill cardiac encounters (CICE). The sample consisted of inpatients hospitalized between January 2009 and December 2014 coded with a cardiac principal diagnosis and requiring direct admission or transfer to an ICU within 48 hours of hospital admission. Hospitals were dichotomized into those with a single undifferentiated ICU (Group 1) and those with a multidisciplinary ICU framework (≥1 ICU including at least 1 cardiac type; Group 2). Results: There were a total of 44012 individual hospital encounters in 68 hospitals, including 18001 patients in Group 1 and 26011 in Group 2. The majority of hospitals in Group 2 were teaching. There were no difference in admission SOFA score for cardiac patients admitted to the ICU, and no difference in the unadjusted in-hospital death rates. Further hospital-level factors are in Table 1. Acute myocardial infarction was the leading diagnosis in Group 1 (6429 encounters; 35.7% of total encounters) and Group 2 (11394 encounters; 43.8% of total encounters). Conclusion: Critically ill patients with cardiac diagnoses demonstrated equivalent baseline severity of illness, in-hospital mortality and lengths of stay when admitted to hospitals with single of multiple ICU care settings. However, hospitals with a multi-ICU setting tended to be teaching hospitals.


2019 ◽  
Vol 5 (2) ◽  
pp. 118-122
Author(s):  
Uzzwal Kumar Mallick ◽  
Mohammad Shah Jahirul Hoque Chowdhury ◽  
Mohammad Enayet Hussain ◽  
Mohammad Asaduzzaman ◽  
Md Sirajul Islam ◽  
...  

Background: The management of Guillain-Barré Syndrome is very crucial for the outcome of the patient. Objective: The aim of the study was to compare efficacy of IvIg(Intravenous Immunoglobulin) versus PE(Plasmaexchange) in treatment of mechanically ventilation adults with GBS in neuro-intensive care unit of Bangladesh. Methodology: Thiswas a prospective, observationalcohort study, in a Neuro-ICU from 2017 to 2018. We included all patients with GBS who required mechanical ventilation (MV). We defined two groups: group 1 (group treated by IvIg: 0.4 g/kg/day for 5 days) and group 2 (group treated by PE: 5 PE during 10days, every alternate day). We collectedclinical and therapeutic aspects and outcome. Results: A total number of 49 patients (34 in group 1 and 15 in group 2) were enrolled. The mean age was 37.4±9.2 years, with a male predominance (65.3%). on electrophysiological findings, in 4(32.7%) patients had acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy (AMAN) in 26 (53.1%) patients and acute motor-sensory axonal neuropathy (AMSAN) was 3(6.1%)and NCS was not done in 4(8.2%) cases. The mean length of ICU stay was 20±19.10 days and 46.60±30.02 days in IVIG and PE group respectively. The ICU stay was significantly shorter (p = 0.001) in the IvIg group than PE group. Patients receiving IvIg were early weaned of MV (p = 0.002) compared to those receiving PE with a statistical significance. Also, duration of M/V (P=.002), Need of tracheostomy (p=.005) and over all surval rate (p=.007) was significantly in favoue of IvIg group than PE group. Out of 49 patients, total 3 patients were died and they all were AMAN variety. Conclusion: Our work reveals a meaningful difference for the MV duration, ICU stay, weaning and excellent recovery in IvIg group compared to PE group in terms of less complcations. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 118-122


2015 ◽  
Vol 27 (1) ◽  
pp. 263 ◽  
Author(s):  
R. H. Alvarez ◽  
F. L. N. Natal ◽  
R. M. L. Pires ◽  
K. M. R. Duarte ◽  
C. A. Oliveira

The injection of a low dose of eCG has the potential to induce multiple ovulation and pregnancies in cattle. The present study aimed to evaluate the ovarian response, conception rate and incidence of twin pregnancies of cyclic cows receiving 1 of 2 low doses of eCG. Multiparous Nellore (Bos t. indicus) cows with plasma progesterone levels >1 ng∙mL–1 on at least one of 2 blood samples collected at 10-day intervals (Day –10 and Day 0) received an intramuscular (IM) injection of 2 mg of oestradiol benzoate (EB; Estrogin®, AUSA, São Paulo, Brazil) and a vaginal device (DIP) containing 1 g of progesterone (Primer®, Tecnopec, São Paulo, SP, Brazil) on Day 0. On Day 8, the DIP was removed and cows received an IM injection of 150 μg of cloprostenol (Veteglan®, Hertape Calier, Juatuba, MG, Brazil). At this time, the animals were randomly distributed into 3 groups. Group 1 (n = 30) received an IM injection of 2 mL of saline, whereas groups 2 (n = 41) and 3 (n = 23) received 600 IU and 900 IU of eCG (Novormon® MSD Saude Animal, São Paulo, Brazil), respectively. Twenty-four hours later (Day 9), all groups received 1 mg of EB and were submitted to fixed-time artificial insemination (FTAI) 30 h later (i.e. 54 h after DIP removal). Oestrus observation was performed daily from the time of the withdrawal of the DIP until the day of FTAI. Ovaries were examined ultrasonically at the time of FTAI, the following day and 7 days after FTAI. Pregnancy diagnosis was done by ultrasonography 30 days after FTAI and the incidence of twin or single calves was recorded at birth. Data were analysed by chi-square test. The rate of expression of oestrus was 70.0% (group 1), 82.9% (group 2), and 78.2% (group 3; P = 0.25). Cows that had 2 or more large follicles at the time of FTAI was 0% (group 1), 14.6% (group 2), and 34.8% (group 3; P < 0.05). The ovulation rate of cows in group 1 (80.0%) was higher than cows in groups 2 (48.8%) and 3 (52.2%; P < 0.05). The conception rates for groups 1, 2, and 3 were 50.0, 26.8, and 39.1%, respectively (P < 0.05). Two animals in group 3, one in group 2, and none of group 1 had twin pregnancies on Day 30 after FTAI. Only one of these cows (group 3) had a twin calving. It was concluded that the injection of 600 or 900 IU eCG, in an oestradiol/progestogen FTAI protocol does not result in an increase in the rate of twin calvings, but may negatively affect pregnancy rates of cyclic Nellore cows.Financial support was provided by FAPESP (proc. 2011/13096–0).


2016 ◽  
Vol 8 (1) ◽  
pp. 68-73 ◽  
Author(s):  
Thomas J. Caruso ◽  
Diane H. Steinberg ◽  
Nancy Piro ◽  
Kimberly Walker ◽  
Rebecca Blankenburg ◽  
...  

ABSTRACT Background Mentors influence medical trainees' experiences through career enhancement and psychosocial support, yet some trainees never receive benefits from involved mentors. Objective Our goals were to examine the effectiveness of 2 interventions aimed at increasing the number of mentors in training programs, and to assess group differences in mentor effectiveness, the relationship between trainees' satisfaction with their programs given the presence of mentors, and the relationship between the number of trainees with mentors and postgraduate year (PGY). Methods In group 1, a physician adviser funded by the graduate medical education department implemented mentorships in 6 residency programs, while group 2 involved a training program with funded physician mentoring time. The remaining 89 training programs served as controls. Chi-square tests were used to determine differences. Results Survey responses from group 1, group 2, and controls were 47 of 84 (56%), 34 of 78 (44%), and 471 of 981 (48%, P = .38), respectively. The percentages of trainees reporting a mentor in group 1, group 2, and the control group were 89%, 97%, and 79%, respectively (P = .01). There were no differences in mentor effectiveness between groups. Mentored trainees were more likely to be satisfied with their programs (P = .01) and to report that faculty supported their professional aspirations (P = .001). Across all programs, fewer first-year trainees (59%) identified a mentor compared to PGY-2 through PGY-8 trainees (84%, P &lt; .001). Conclusions A supported mentorship program is an effective way to create an educational environment that maximizes trainees' perceptions of mentorship and satisfaction with their training programs.


Author(s):  
Meltem Bor ◽  
Ozkan Ilhan

Abstract Aim The aim of our study was to determine the factors associated with mortality in neonates with carbapenem-resistant Klebsiella pneumoniae (CRKP). Material and methods This retrospective, single-center study was conducted in the Neonatal Intensive Care Unit of Harran University Faculty of Medicine between January 2017 and July 2018 who had CRKP growth in their blood, urine or cerebrospinal fluid cultures. The discharged group was designated as the control group (Group 1), whereas the group that faced mortality was classified as the case group (Group 2). The demographic data, clinical findings and laboratory and microbiological results of the two groups were compared to identify risk factors. Results A total of 58 patients (36 in Group 1 and 22 in Group 2) exhibited CRKP growth during the study period. Low birth weight (p = 0.039), previous antifungal (p = 0.002) or amikacin use (p = 0.040), congenital anomalies (p = 0.002), total parenteral nutrition (TPN) administration (p = 0.002), surgery (p = 0.035), thrombocytopenia (p = 0.007), low platelet mass index (p = 0.011), elevated C-reactive protein (p = 0.004), high carbapenem minimum inhibitory concentration (MIC) (p = 0.029) and high amikacin MIC (p = 0.019) were associated with mortality. In a multivariate regression analysis, previous antifungal use (p = 0.028), congenital anomalies (p = 0.032) and TPN use (p = 0.013) were independent factors in predicting mortality. Conclusion Previous antifungal use, congenital anomalies and TPN use were found to be independent risk factors for mortality in neonates with CRKP infection.


2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0012
Author(s):  
Mehmet Hasan Tatari ◽  
Vugar Guliyev

Objectives: Anterior cruciate ligament (ACL) injury is a common disorder in athletes and in most cases, meniscal tears accompany. These meniscal tears can be the result of the initial trauma or the consecutive injuries in the unoperated patients. The aim of the study was to compare the incidence of meniscal tears in the patients operated because of ACL defficiency in the early or late period after the initial trauma. The age of the patient and meniscal tear pattern were the other subjects compared. Methods: The groups included 42, 72 and 129 patients respectively. Among all groups, it was shown that in 125 cases (% 51.4), a meniscal tear accompanied the ACL tear. In Group 1, 18 cases (% 42.8) had meniscal tears while 29 patients (% 37) in Group 2 and 78 patients (% 60.4) in Group 3 had any kind of meniscal tear. Bucket handle tears constituted 38 % of all tears in Group 1, 53 % in Group 2 and 56 % in Group 3. There was a significant statistical difference between the groups among the presence of meniscal tear and the period between the initial trauma and operation time. When the patients accepted the operation in the first six months after the initial trauma, the incidence of the meniscal injury decreased significantly (chi-square test) (p <0,01). There was no statistical difference between three groups among the percentage of bucket handle tears (variance analysis: p=0,196). The statistical difference was not important between the groups among the age of the patients in relation with the pattern of the meniscal tears (variance analysis: p=0,236). Results: The groups included 42, 72 and 129 patients respectively. Among all groups, it was shown that in 125 cases (% 51.4), a meniscal tear accompanied the ACL tear. In Group 1, 18 cases (% 42.8) had meniscal tears while 29 patients (% 37) in Group 2 and 78 patients (% 60.4) in Group 3 had any kind of meniscal tear. Bucket handle tears constituted 38 % of all tears in Group 1, 53 % in Group 2 and 56 % in Group 3. There was a significant statistical difference between the groups among the presence of meniscal tear and the period between the initial trauma and operation time. When the patients accepted the operation in the first six months after the initial trauma, the incidence of the meniscal injury decreased significantly (chi-square test) (p <0,01). There was no statistical difference between three groups among the percentage of bucket handle tears (variance analysis: p=0,196). The statistical difference was not important between the groups among the age of the patients in relation with the pattern of the meniscal tears (variance analysis: p=0,236) Conclusion: We can say that the incidence of meniscal tears can be decreased if the patients with ACL injury are operated early after the initial trauma. Earlier ACL reconstruction means less meniscal tear.


Sign in / Sign up

Export Citation Format

Share Document