Systemic Complications
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2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Kátia Nunes da Silva ◽  
André Luiz Nunes Gobatto ◽  
Zaquer Suzana Munhoz Costa-Ferro ◽  
Bruno Raphael Ribeiro Cavalcante ◽  
Alex Cleber Improta Caria ◽  
...  

AbstractThe COVID-19 pandemic, caused by the rapid global spread of the novel coronavirus (SARS-CoV-2), has caused healthcare systems to collapse and led to hundreds of thousands of deaths. The clinical spectrum of COVID-19 is not only limited to local pneumonia but also represents multiple organ involvement, with potential for systemic complications. One year after the pandemic, pathophysiological knowledge has evolved, and many therapeutic advances have occurred, but mortality rates are still elevated in severe/critical COVID-19 cases. Mesenchymal stromal cells (MSCs) can exert immunomodulatory, antiviral, and pro-regenerative paracrine/endocrine actions and are therefore promising candidates for MSC-based therapies. In this review, we discuss the rationale for MSC-based therapies based on currently available preclinical and clinical evidence of safety, potential efficacy, and mechanisms of action. Finally, we present a critical analysis of the risks, limitations, challenges, and opportunities that place MSC-based products as a therapeutic strategy that may complement the current arsenal against COVID-19 and reduce the pandemic’s unmet medical needs.


2021 ◽  
Author(s):  
Qionglei Zhong ◽  
Shaoli Wang ◽  
Siying Chen ◽  
Xingyue Chen ◽  
Lizhen Han ◽  
...  

Abstract Objective: To compare the recurrence rate of retinopathy of prematurity (ROP) after treatment with 0.3 mg vs. 0.25 mg ranibizumab. Subjects: All patients with ROP who underwent intravitreal injection of ranibizumab in Hainan General Hospital between January 2014 and May 2020 were included in this study. Methods: 82 cases (146 eyes) who received intravitreal injection of 0.25 mg ranibizumab were included in the conventional-dose group, and 59 cases (108 eyes) who received intravitreal injection of 0.3 mg ranibizumab were included in the high-dose group. The two groups were further divided into the 25-28-week, 29-31-week, 32-34-week, and 35-36-week GA subgroups. The differences between the conventional-dose group and the high-dose group in gestational age (GA), birth weight(BW), age at initial injection(weeks), incidence of systemic diseases, the recurrence rate of ROP, and age at retinal vascularization completed(weeks) were analyzed. Results: GA, BW, age at initial injection, and the incidence of systemic diseases were not significantly different between the conventional-dose group and the high-dose group (p>0.05). The recurrence rates of ROP were significantly lower in the 25-28-week, 29-31-week, and 32-34-week subgroups of the high-dose group than in the same subgroups of the conventional-dose group (p<0.05). Within the conventional-dose group, the recurrence rate of ROP was significantly lower in the 32-34-week and 35-36-week subgroups than in the 25-28-week and 29-31-week subgroups (p<0.05). Within the high-dose group, the recurrence rate of ROP was not significantly different between the four subgroups (p>0.05). Retinal vascularization was completed at a later age in the 32-34-week subgroup of the high-dose group than in the 32-34-week subgroup of the conventional-dose group (p<0.05) but was not significantly different between the two groups at any other GA range (p>0.05). No severe ocular or systemic complications occurred in any patient. Conclusion: Treatment with 0.3 mg ranibizumab can reduce the recurrence rate of ROP without prolonging retinal vascularization or causing serious systemic complications. Therefore, this dose may be an appropriate therapeutic dose for ROP.


2021 ◽  
pp. 153857442110287
Author(s):  
Ottavia Borghese ◽  
Maria Porzia Ganimede ◽  
Alessandra Briatico Vangosa ◽  
Angelo Pisani ◽  
Sofia Vidali ◽  
...  

Objective The objective is to report a single centre experience in the embolization of visceral artery pseudoaneurysms with N-butyl-cyanoacrylate-methacryloxy sulfolane (NBCA-MS). Methods A retrospective observational cohort study was conducted on data about all consecutive patients treated for visceral artery pseudoaneurysms in the Interventional Radiology Unit of SS Annunziata Hospital, in Taranto (Italy) between January 2016 and July 2020. Only patients treated with NBCA-MS embolization were included. Clinical and technical outcomes were evaluated during in-hospital stay and at 3-month follow-up by computed angiotomography (CTA). Results Among 89 patients undergoing treatment for visceral artery pseudoaneurysm, a total of 58 (65.2%) patients (n = 32, 55.2% men; median age 45.8 years, range: 35–81) treated with NBCA-MS only were enrolled. Pseudoaneurysms were located in the renal artery (n = 18 cases, 31%), in the splenic artery (n = 27, 46.6%), in the intra-parenchymal hepatic artery (n = 3, 5.2%), in the common hepatic artery (n = 4, 6.9%) or in the pancreatic artery (n = 6, 10.3%). N-butyl-cyanoacrylate was diluted 1:1 with Lipiodol ultra-fluid, and mean volume injected was 0.6 ± 0.3 mL (range: 0.2–2.8 mL). Embolization was technically and clinically successful in all patients (n = 58, 100%) with an immediate total thrombosis of the pseudoaneurysm at the completion angiography. No systemic complications were noted in all cases. Five cases (8.6%) of non-target vessel embolization occurred without any clinical complication. No pseudoaneurysm recurrence was detected at the CTA control 1 day postoperatively. In one case (1.7%), a recurrence was detected 4 days after the initial treatment and successfully managed by a repeated NBCA-MS embolization. During the hospital stay, 56 patients recovered well but 2 (3.4%) died from multi-organ failure not related to the embolization. No recurrences were detected at the 3-month postoperative CTA in the remaining patients. Conclusions In properly selected patients affected with visceral artery pseudoaneurysms, NBCA-MS represents a definitive and safe embolization agent.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xiaowu Dong ◽  
Wenjian Mao ◽  
Lu Ke ◽  
Lin Gao ◽  
Jing Zhou ◽  
...  

Background. The optimal management strategy in acute necrotizing pancreatitis (ANP) is debated, and compliance with current guidelines in China is not known. In this study, we performed a national survey on this topic in China. Methods. An online questionnaire about the diagnosis and treatment of local complications of ANP was distributed through a national collaborative network. The local and systemic complications were defined according to the Revised Atlanta Classification. Results. There were 321 survey respondents from the 394 who opened the link (response rate 81%) from 208 hospitals located in 30/34 provinces across China. There was a lack of consensus in terms of early diagnosis of infected pancreatic necrosis (IPN) as the respondents chose to depend on clinical symptoms (70/321, 22%), organ failure (82/321, 26%), imaging changes (84/321, 26%), and fine needle aspiration (51/321, 16%), respectively. A “step-up” approach has been widely adopted in patients with IPN (294/321, 92%). The decision for initial intervention (without confirmed/suspected infection) was based on clinical condition, CT imaging, or laboratory indicators for most respondents (229/321, 71%). Conclusion. While the “step-up” approach has been widely adopted, there is still significant variation in regard to the diagnosis of infection, the best timing for drainage, and the indications for early intervention.


2021 ◽  
Vol 7 (6) ◽  
pp. 64377-64393
Author(s):  
Helena Pinto Ferreira de Miranda ◽  
Isabela Neves de Camargo ◽  
Isabella de Almeida Cunha ◽  
Jacqueline Bonfim Freitas ◽  
Juliana Mota Silva ◽  
...  

2021 ◽  
Vol 11 (13) ◽  
pp. 5984
Author(s):  
Diana Cristala Kappenberg Niţescu ◽  
Liliana Păsărin ◽  
Silvia Mârţu ◽  
Cornelia Teodorescu ◽  
Bogdan Vasiliu ◽  
...  

Background: The aim of this study is to quantify chemotherapy agents in the saliva of oncology patients undergoing intravenous chemotherapy treatment, and evaluate the oral and periodontal clinical modifications and possible correlations between them. Materials and Methods: The study was conducted on 29 patients undergoing chemotherapy treatment with cisplatin, oxaliplatin or gemcitabine. Three total saliva samples were gathered from each patient in three key points regarding chemotherapy. The samples were then analyzed through methods of mass spectrometry and liquid chromatography. Results: Cisplatin and gemcitabine were only found in saliva at 30 min and 2 h after chemotherapy administration, however oxaliplatin was determined in all three samples. Clinically, the most accentuated clinical attachment loss and CPITN scores were observed on mandibular teeth, whereas the highest values for the Sillness and Loe gingival index and gingival bleeding index were in the lateral maxillary areas. We found no statistically significant correlation between the periodontal parameters and chemotherapy concentration in saliva. Conclusion: A fraction of systemically administered chemotherapy can also be found in the saliva of oncology patients and have the potential to exacerbate oral infections and cause local and systemic complications throughout the oncology treatment. Further research is required in order to fully understand how chemotherapy can influence the development of periodontal disease.


Antioxidants ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 971
Author(s):  
Noemí Cárdenas-Rodríguez ◽  
Cindy Bandala ◽  
América Vanoye-Carlo ◽  
Iván Ignacio-Mejía ◽  
Saúl Gómez-Manzo ◽  
...  

Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is an emergent infectious disease that has caused millions of deaths throughout the world. COVID-19 infection’s main symptoms are fever, cough, fatigue, and neurological manifestations such as headache, myalgias, anosmia, ageusia, impaired consciousness, seizures, and even neuromuscular junctions’ disorders. In addition, it is known that this disease causes a series of systemic complications such as adverse respiratory distress syndrome, cardiac injury, acute kidney injury, and liver dysfunction. Due to the neurological symptoms associated with COVID-19, damage in the central nervous system has been suggested as well as the neuroinvasive potential of SARS-CoV-2. It is known that CoV infections are associated with an inflammation process related to the imbalance of the antioxidant system; cellular changes caused by oxidative stress contribute to brain tissue damage. Although anti-COVID-19 vaccines are under development, there is no specific treatment for COVID-19 and its clinical manifestations and complications; only supportive treatments with immunomodulators, anti-vascular endothelial growth factors, modulating drugs, statins, or nutritional supplements have been used. In the present work, we analyzed the potential of antioxidants as adjuvants for the treatment of COVID-19 and specifically their possible role in preventing or decreasing the neurological manifestations and neurological complications present in the disease.


2021 ◽  
Author(s):  
Sidra Sarwat ◽  
Ambreen Akhtar ◽  
Syeda Fizza Abdud Dayan ◽  
Najma Shaheen ◽  
Humna Shahid Durrani ◽  
...  

Abstract Background: Safety protocols are usually neglected among most of the TNT exposed population, therefore, rendering the community prone to various occupational hazards. The current study highlights ring shaped cataract and urinary metabolites of TNT among TNT exposed population (n=26) against a control group (n=20).Methods: An observational case-control study was carried out in two groups: 300 subjects exposed to TNT in Dir and Bajour Agency, Pakistan and a control group from the base hospital. We determined the presence of ring shaped cataract and urine metabolites of TNT using slit lamp biomicroscope and gas chromatography mass spectrometric analysis respectively.Results: Results substantiate a high level of urine metabolites for exposed subjects compared to the control group (p<0.001). Age had no significant effect on (p>0.05) on presence of ring shaped cataract and the level of urinary metabolites of TNT, while duration of exposure showed significant effect (p<0.001). Females showed high incidence of ring shaped cataract and urinary metabolites of TNT than men ( p<0.001). The mean age of the exposed subjects was 51±14.38 (Mean+SD) years. The mean year of exposure was 49±5 (Mean+SD) years,Conclusion: This study showed TNT as a risk factor for the presence of ring-shaped cataract among TNT exposed group in Pakistan. It is important to screen exposed community for the presence of ring-shaped cataract, and pre-clinical identification of TNT adducts to prevent systemic complications.


Author(s):  
Fabian Heinrich ◽  
Carina Romich ◽  
Tamara Zimmermann ◽  
Inga Kniep ◽  
Antonia Fitzek ◽  
...  

AbstractThe current pandemic with Severe acute respiratory syndrome-coronavirus-2 has been taking on new dynamics since the emergence of new variants last fall, some of them spreading more rapidly. Many countries currently find themselves in a race to ramp up vaccination strategies that have been initiated and a possible third wave of the pandemic from new variants, such as the Variant of Concern-202012/01 from the B.1.1.7 lineage. Until today, many investigations in death cases of Coronavirus-disease-19 have been conducted, revealing pulmonary damage to be the predominant feature of the disease. Thereby, different degrees of macroscopic and microscopic lung damage have been reported, most of them resembling an Acute Respiratory Distress Syndrome. Far more, systemic complications of the disease such as pulmonary embolisms have been described. However, neither morphologic nor virologic findings of patients dying of the new variants have yet been reported. Here, we report on a comprehensive analysis of radiologic, morphologic, and virologic findings in a fatal case of this variant.


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