Prevalence and clinical significance of antiphospholipid antibodies in patients with coronavirus disease 2019 admitted to intensive care units: a prospective observational study.

Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19-induced coagulopathy, its clinical significance remains uncertain. Therefore, this study aimed to evaluate the prevalence and clinical significance of aPLs among critically ill patients with COVID-19. This prospective observational study included 60 patients with COVID-19 admitted to intensive care units (ICU). The study outcomes included prevalence of aPLs, and a primary composite outcome of all-cause mortality and arterial or venous thrombosis between antiphospholipid-positive and antiphospholipid-negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. A total of 60 critically ill patients were enrolled. Among them, 57 (95%) were men, with a mean age of 52.8 ± 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found be antiphospholipid-positive; 21 of them were positive for lupus anticoagulant, whereas one patient was positive for anti-ß2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during their ICU stay did not differ between antiphospholipid-positive and antiphospholipid-negative patients (4 [18%] vs. 6 [16%], adjusted odds ratio 0.98, 95% confidence interval 0.1-6.7; p value = 0.986). The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.

Clinical outcomes of intravenous immunoglobulin therapy in COVID-19 related acute respiratory distress syndrome: a retrospective cohort study.

BACKGROUND: Intravenous immunoglobulin (IVIG) has been used as an immunomodulatory therapy to counteract severe systemic inflammation in coronavirus disease 2019 (COVID-19). But its use in COVID-19 related acute respiratory distress syndrome (ARDS) is not well established. METHODS: We conducted a retrospective analysis of electronic health records of COVID-19 patients admitted to intensive care units (ICUs) at Hazm Mebaireek General Hospital, Qatar, between March 7, 2020 and September 9, 2020. Patients receiving invasive mechanical ventilation for moderate-to-severe ARDS were divided into two groups based on whether they received IVIG therapy or not. The primary outcome was all-cause ICU mortality. Secondary outcomes studied were ventilator-free days and ICU-free days at day-28, and incidence of acute kidney injury (AKI). Propensity score matching was used to adjust for confounders, and the primary outcome was compared using competing-risks survival analysis. RESULTS: Among 590 patients included in the study, 400 received routine care, and 190 received IVIG therapy in addition to routine care. One hundred eighteen pairs were created after propensity score matching with no statistically significant differences between the groups. Overall ICU mortality in the study population was 27.1%, and in the matched cohort, it was 25.8%. Mortality was higher among IVIG-treated patients (36.4% vs. 15.3%; sHR 3.5; 95% CI 1.98-6.19; P < 0.001). Ventilator-free days and ICU-free days at day-28 were lower (P < 0.001 for both), and incidence of AKI was significantly higher (85.6% vs. 67.8%; P = 0.001) in the IVIG group. CONCLUSION: IVIG therapy in mechanically ventilated patients with COVID-19 related moderate-to-severe ARDS was associated with higher ICU mortality. A randomized clinical trial is needed to confirm this observation further.

Clinical evaluation of pregnant women with SARS-COV2 pneumonia: a real-life study from Egypt.

BACKGROUND: Knowledge about the outcome of COVID-19 on pregnant women is so important. The published literature on the outcomes of pregnant women with COVID-19 is confusing. The aim of this study was to report our clinical experience about the effect of COVID-19 on pregnant women and to determine whether it was associated with increased mortality or an increase in the need for mechanical ventilation in this special category of patients. METHODS: This was a cohort study from some isolation hospitals of the Ministry of Health and Population, in eleven governorates, Egypt. The clinical data from the first 64 pregnant women with COVID-19 whose care was managed at some of the Egyptian hospitals from 14 March to 14 June 2020 as well as 114 non-pregnant women with COVID-19 was reviewed. RESULTS: The two groups did not show any significant difference regarding the main outcomes of the disease. Two cases in each group needed mechanical ventilation (p 0.617). Three cases (4.7%) died among the pregnant women and two (1.8%) died among the non-pregnant women (p 0.352). CONCLUSIONS: The main clinical outcomes of COVID-19 were not different between pregnant and non-pregnant women with COVID-19. Based on our findings, pregnancy did not exacerbate the course or mortality of COVID-19 pneumonia.

Optimal design of one-dimensional photonic crystal filters using minimax optimization approach.

In this paper, we introduce a simulation-driven optimization approach for achieving the optimal design of electromagnetic wave (EMW) filters consisting of one-dimensional (1D) multilayer photonic crystal (PC) structures. The PC layers' thicknesses and/or material types are considered as designable parameters. The optimal design problem is formulated as a minimax optimization problem that is entirely solved by making use of readily available software tools. The proposed approach allows for the consideration of problems of higher dimension than usually treated before. In addition, it can proceed starting from bad initial design points. The validity, flexibility, and efficiency of the proposed approach is demonstrated by applying it to obtain the optimal design of two practical examples. The first is (SiC/Ag/SiO(2))(N) wide bandpass optical filter operating in the visible range. Contrarily, the second example is (Ag/SiO(2))(N) EMW low pass spectral filter, working in the infrared range, which is used for enhancing the efficiency of thermophotovoltaic systems. The approach shows a good ability to converge to the optimal solution, for different design specifications, regardless of the starting design point. This ensures that the approach is robust and general enough to be applied for obtaining the optimal design of all 1D photonic crystals promising applications.

Atlantoaxial rotatory subluxation in children.

Atlantoaxial rotatory subluxation is a rare condition in which patients present with the acute onset of torticollis. Atlantoaxial rotatory subluxation represents a spectrum of disease from muscle spasm to a fixed mechanical block to reduction of the atlantoaxial complex. If left untreated, some cases may resolve spontaneously; however, other cases may result in the development of secondary changes in the bony anatomy of the atlantoaxial joint, leading to persistent deformity. Diagnosis of the condition is largely clinical but can be aided by various imaging modalities, including radiographs, dynamic CT scanning, three-dimensional CT reconstructions, or MRI. Consideration should always be given to infection or other inflammatory disease as an underlying, precipitating cause. Treatments include observation, the use a cervical collar and analgesics, halter or skeletal traction, and posterior fusion of C1-C2. The most important factor for success of conservative treatment is the time from the onset of symptoms to recognition and the initiation of treatment.

Influence of Back Pain on Patient Satisfaction Scores.

OBJECTIVES: Patient satisfaction scores are increasing in importance. Although the influence of selected patient and physician characteristics on satisfaction scores has been identified, the impact of different pediatric diagnoses is unknown. The purpose of this study was to compare patient satisfaction scores in visits for mechanical back pain with visits for clubfoot or scoliosis. METHODS: A retrospective analysis of patient satisfaction scores from pediatric visits for back pain, clubfoot, and scoliosis at three tertiary centers was performed. Satisfaction data were obtained from survey questions that used a 5-point scale ranging from very poor (1) to very good (5). Statistical analysis was performed using χ(2) and Fisher exact tests. RESULTS: Data from 565 visits for scoliosis, 81 for clubfoot, and 57 for mechanical back pain were used. The mean scores in back pain visits for the likelihood of recommending the care provider, confidence in the care provider, and explanation by the care provider were 4.87, 4.79, and 4.70, respectively. These scores were not lower than visits for scoliosis and clubfoot (P < 0.05). The mean score for likelihood to recommend the practice after back pain visits was 4.73, with more scores of 3 or higher than clubfoot or scoliosis (P < 0.05). CONCLUSIONS: Satisfaction scores in pediatric patients with back pain were not lower than visits for scoliosis or clubfoot. Future research can be directed toward identifying common goals in visits for pediatric mechanical back pain to further improve the patient experience.

Posterior fixation without debridement for vertebral body osteomyelitis and discitis.

OBJECT: The authors evaluated the efficacy of posterior instrumentation for the management of spontaneous spinal infections. Standard surgical management of spontaneous spinal infection is based on debridement of the infected tissue. However, this can be very challenging as most of these patients are medically debilitated and the surgical debridement requires a more aggressive approach to the spine either anteriorly or via an expanded posterior approach. The authors present their results using an alternative treatment method of posterior-only neuro-decompression and stabilization without formal debridement of anterior tissue for treating spontaneous spinal infection. METHODS: Fifteen consecutive patients were treated surgically by 2 of the authors. All patients had osteomyelitis and discitis and were treated postoperatively with intravenous antibiotics for at least 6 weeks. The indications for surgery were failed medical management, progressive deformity with ongoing persistent spinal infection, or neurological deficit. Patients with simple epidural abscess without bony instability were treated with laminectomy and were not included in this series. Fourteen patients were treated with posterior-only decompression and long-segment rigid fixation, without formal debridement of the infected area. One patient was treated with staged anterior and posterior surgery due to delay in treatment related to medical comorbidities. The authors examined as their outcome the ambulatory status and recurrence of deep infection requiring additional surgery or medical treatment. RESULTS: Of the initial 15 patients, 10 (66%) had a minimum 2-year follow-up and 14 patients had at least 1 year of followup. There were no recurrent spinal infections. There were 3 unplanned reoperations (1 for loss of fixation, 1 for early superficial wound infection, and 1 for epidural hematoma). Nine (60%) of 15 patients were nonambulatory at presentation. At final followup, 8 of 15 patients were independently ambulatory, 6 required an assistive device, and 1 remained nonambulatory. CONCLUSIONS: Long-segment fixation, without formal debridement, resulted in resolution of spinal infection in all cases and in significant neurological recovery in almost all cases. This surgical technique, when combined with aggressive antibiotic therapy and a multidisciplinary team approach, is an effective way of managing serious spinal infections in a challenging patient population.

Short-term starvation at different feeding regimes on appetite responses, feeding utilization and physiological indices, of red hybrid tilapia (Oreochromis mossambicus × Oreochromis niloticus) fingerlings reared in brackish water.

A 42 day factorial trial (3x2) was designed to evaluate the effect of short-term starvation with different feeding frequencies on performance, feed utilization, physiological status and appetite responses of red hybrid tilapia fingerlings. Eighteen plastic tanks with a capacity of (55 L) were used to accomplish this work. Fingerlings with an average initial weight of 23 g ± 0.2 (SE) were randomly stocked at a rate of 8 fingerlings/aquarium. Six groups were designated as the following: II/ED: fish was fed twice every day; IV/ED: fish fed four times every day; II/EOD: fish fed twice every other day (alternate-day feeding or one day of feeding followed by another of fasting); IV/EOD: was fed four times every other day; II/EO3D: fish fed twice every other three days (three day of feeding followed by another of fasting) and IV/EO3D: fish fed four times every other three days. Fish were fed on commercial diets 30 % protein (4 % of biomass). Results showed insignificant differences between fish fed every other day and those fed every day in some growth indicators. In the same trend, the interaction between feed deprivation and feeding frequency cleared that fingerlings of IV/EOD did not significantly differ with those fed every day in growth indices. Moreover this treatment was the best in feed conversion efficiency and several physiological indicators.

Brain-Inspired Reservoir Computing Using Memristors with Tunable Dynamics and Short-Term Plasticity.

Recent advancements in reservoir computing (RC) research have created a demand for analogue devices with dynamics that can facilitate the physical implementation of reservoirs, promising faster information processing while consuming less energy and occupying a smaller area footprint. Studies have demonstrated that dynamic memristors, with nonlinear and short-term memory dynamics, are excellent candidates as information-processing devices or reservoirs for temporal classification and prediction tasks. Previous implementations relied on nominally identical memristors that applied the same nonlinear transformation to the input data, which is not enough to achieve a rich state space. To address this limitation, researchers either diversified the data encoding across multiple memristors or harnessed the stochastic device-to-device variability among the memristors. However, this approach requires additional preprocessing steps and leads to synchronization issues. Instead, it is preferable to encode the data once and pass them through a reservoir layer consisting of memristors with distinct dynamics. Here, we demonstrate that ion-channel-based memristors with voltage-dependent dynamics can be controllably and predictively tuned through the voltage or adjustment of the ion channel concentration to exhibit diverse dynamic properties. We show, through experiments and simulations, that reservoir layers constructed with a small number of distinct memristors exhibit significantly higher predictive and classification accuracies with a single data encoding. We found that for a second-order nonlinear dynamical system prediction task, the varied memristor reservoir experimentally achieved an impressive normalized mean square error of 1.5 × 10-3, using only five distinct memristors. Moreover, in a neural activity classification task, a reservoir of just three distinct memristors experimentally attained an accuracy of 96.5%. This work lays the foundation for next-generation physical RC systems that can exploit the complex dynamics of their diverse building blocks to achieve increased signal processing capabilities.

Applying the improved stratigraphic modified Lorenz technique for dividing the highly heterogeneous clastic reservoirs into hydraulic flow units.

The present study applies the improved stratigraphic modified Lorenz (ISML) technique to divide the Matulla Formation in Muzhil Oil Field in the Gulf of Suez into some hydraulic flow units (HFUs) and to check the flow efficiency contribution of each hydraulic flow unit (HFU) to the total bulk flow capacity of the reservoir in 3 wells (Muzhil-4, 7, and 8). The output of the ISML plot is applied in integration with the vertical plot of the porosity (∅), permeability (k), and effective pore radius (R35) against depth to measure the efficiency of each HFU contribution to the total flow capacity of the Matulla reservoir, and to delineate the main attributor to the flow capacity. It is indicated that the Matulla sandstone reservoirs can be subdivided into 7 HFUs to the NW of the field, while it is subdivided into four and five HFUs in the center and to the SE of the field; i.e., its heterogeneity increases to the NW at Muzhil-7 well. On the other side, the best reservoir quality is assigned to the southeast at Muzhil-4 well (av. ∅ = 20.8%, av. k = 596.6 md, and R35 = 12.1 µm). The efficiency of the obtained HFUs was estimated and described both mathematically and graphically. Also, the measured porosity and permeability values indicate relatively low reservoir properties to the NW of the field. The reservoir heterogeneity is also measured using the Dykstra-Parsons technique which indicates extremely high heterogeneity (0.89 ≤ V ≤ 0.98).

Comparative antisickling and antioxidant activities of Pseudobombax ellipticum cultivars in relation to their metabolite profiling using LC/MS.

Pseudobombax ellipticum is native to South America and is cultivated worldwide mostly for its medicinal benefits. The plant is used traditionally in respiratory disorders such as dry cough, in the treatment of fever and stomach pain, and as an antimicrobial and analgesic. The antisickling and antioxidant effects of the flowers of P. ellipticum (Kunth) Dugand (red) and P. ellipticum cultivar alba (white) were compared using an in vitro assay in 2% sodium metabisulfite sickling induction model, DPPH, and metal chelation assays. Both red and white flowers exhibited antioxidant and antisickling activities. In DPPH assay, lower IC50 (34.89 ± 0.98 and 53.28 ± 1.14 µg mL-1) in red and white flowers respectively were detected relative to Trolox as a positive control (56.82 ± 0.87 µg mL-1). Comparable metal chelation activity (81.4 and 77.8 µM EDTA equivalent/mg) was detected in red and white flowers of both cultivars respectively. The average readings of the "reversal of sickling test "revealed a decrease in sickling percent from 49% to 15% in red flowers and to 18% in white flowers. Also, polymerization inhibition rate was increased from 0.34 to 1 and to 0.92 in red and white flowers respectively. Total phenolics, flavonoids and anthocyanins were quantified in red and white flowers as (163.9, 43.13 mg gallic acid equivalent/g extract), (71.92, 34.5 mg rutin equivalent/g extract) and (127.0, 85.9 mg pelargonidine-3-mono glucoside equivalent/kg extract), respectively. Liquid chromatography mass spectrometry (LC-MS) analysis was further employed for detection and identification of anthocyanins in flower extracts. Eight new anthocyanins were identified for the first time in genus Pseudobombax. These results reveal the potential role for both red and white flower extracts as possible antisickling agents in sickle cell anemia management.

The safety, health, and well-being of healthcare workers during COVID-19: A scoping review.

The outbreak of the COVID-19 pandemic has affected the safety and well-being of healthcare workers. A scoping review was conducted to highlight the impact of COVID-19 on the safety, health, and well-being of healthcare workers and to shed light on the concerns about their perceived safety and support systems. A literature search was conducted in three different databases from December 1, 2019, through July 20, 2022, to find publications that meet the aim of this review. Using search engines, 3087 articles were identified, and after a rigorous assessment by two reviewers, 30 articles were chosen for further analysis. Two themes emerged during the analysis: safety and health and well-being. The primary safety concern of the staff was mostly about contracting COVID-19, infecting family members, and caring for patients with COVID-19. During the pandemic, the health care workers appeared to have anxiety, stress, uncertainty, burnout, and a lack of sleep. Additionally, the review focused on the suggestions of health care providers to improve the safety and well-being of workers through fair organizational policies and practices and timely, individualized mental health care.

An insight into synthesis and antitumor activity of citrate and gallate stabilizing gold nanospheres.

Both gallic and citrate are well-established antioxidants that show promise as new selective anti-cancer drugs. Gold nanoparticles (AuNPs) as well can be developed as flexible and nontoxic nano-carriers for anti-cancer drugs. This article evaluating the efficiency and biocompatibility of gallic acid and citrate capping gold nanoparticles to be used as anti-cancer drug. The biosafety and therapeutic efficiency of prepared nano-formulations were tested on Hela and normal BHK cell line. Gold nanospheres coated with citrate and gallate were synthesized via wet chemical reduction method. The prepared nano-formulations, citrate and gallate coated gold nanospheres (Cit-AuNPs and Ga-AuNPs), were characterized with respect to their morphology, FTIR spectra, and physical properties. In addition, to assess their cytotoxicity, cell cycle arrest and flow cytometry to measure biological response were performed. Cit-Au NPs and Ga-Au NPs were shown to significantly reduce the viability of Hela cancer cells. Both G0/G cell cycle arrest and comet assay results showed that genotoxic effect was induced in Hela cells by Cit-Au NPs and Ga-Au NPs. The results of this study showed that Cit-Au NPs and Ga-AuNPs inhibit the growth of metastatic cervical cancer cells, which could have therapeutic implications.

Neutrophil-to-lymphocyte ratio as a predictor of clinical outcomes in critically ill COVID-19 patients: A retrospective observational study.

Background: Timely identification of patients at risk of worse clinical outcomes is vital in managing coronavirus disease 2019 (COVID-19). The neutrophil-to-lymphocyte ratio (NLR) calculated from complete blood count can predict the degree of systemic inflammation and guide therapy accordingly. Hence, we did a study to investigate the role of NLR value on intensive care unit (ICU) admission in predicting clinical outcomes of critically ill COVID-19 patients. Methods: We conducted a retrospective analysis of electronic health records of COVID-19 patients admitted to ICUs at Hazm Mebaireek General Hospital, Qatar, from March 7, 2020 to July 18, 2020. Patients with an NLR equal to or higher than the cut-off value derived from the receiver operating characteristic curve were compared to those with an NLR value below the cut-off. The primary outcome studied was all-cause ICU mortality. The secondary outcomes evaluated were the requirement of mechanical ventilation and ICU length of stay (LOS). Results: Five hundred and nineteen patients were admitted to ICUs with severe COVID-19 infection during the study period. Overall, ICU mortality in the study population was 14.6% (76/519). NLR on ICU admission of ≥6.55 was obtained using Youden's index to predict ICU mortality, with a sensitivity of 81% and specificity of 41%. Mortality was significantly higher in patients with age ≥60 years (p < 0.001), chronic kidney disease (p = 0.03), malignancy (p < 0.002), and NLR ≥ 6.55 (p < 0.003). There was also a significant association between the requirement of mechanical ventilation (34.7% vs. 51.8%, p < 0.001) and increased ICU LOS (8 vs. 10 days, p < 0.01) in patients with ICU admission NLR ≥ 6.55. Conclusion: Higher NLR values on ICU admission are associated with worse clinical outcomes in critically ill COVID-19 patients.

Characteristics and clinical outcomes of COVID-19 patients with pulmonary disorders: A single-center, retrospective observational study.

INTRODUCTION: Mortality rates and clinical characteristics of patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU) vary significantly. OBJECTIVES: To describe the data of patients with pulmonary comorbidities who were admitted to the ICU with COVID-19 in Qatar in terms of demographic characteristics, coexisting conditions, imaging findings, and outcomes. METHODS: We conducted a retrospective study of the outcomes with regard to mortality and requirement of invasive ventilation, demographic characteristics, coexisting conditions, secondary infections, and imaging findings for critical care patients with COVID-19 in Qatar who had pulmonary comorbidities between March and June 2020. RESULTS: A total of 923 patients were included, 29 (3.14%) were found to have pulmonary disease. All these 29 patients' respiratory disease was noted to be asthma. Among these, three patients (10.3%) died in the ICU within 28 days of ICU admission. They were all above 50 years old. Nineteen (66%) patients required intubation and mechanical ventilation. Twenty-one (72.4%) patients were males. The most common comorbidities included diabetes mellitus (55.1%) and hypertension (62%). Eighteen (62%) patients developed secondary infections in the ICU. Five (17.24%) patients developed renal impairment. Twenty (69%) patients received tocilizumab as part of their COVID-19 management, and out of these 16 (80%) patients developed a coinfection. CONCLUSION: Patients with pulmonary disorders had higher mortality rates than other patients admitted to ICU during the same time frame with similar comorbidities; these patients require extra consideration and care to avoid disease progression and death.

Nebulized fentanyl for respiratory symptoms in patients with COVID-19 (ventanyl trial).

ABSTRACT: Patients with coronavirus disease (COVID-19) commonly experience distressing and challenging respiratory symptoms. Interventions such as oxygen therapy, oral opiates, and traditional nebulizers like ipratropium bromide and salbutamol are variable in their efficacy, and therapy responses in patients are difficult to predict. The purpose of this study is to investigate the efficacy of nebulized fentanyl citrate on dyspnea, cough, and throat pain in patients with COVID-19 and evaluate the safety with any potential adverse events.In COVID-19, about 59% of patients will exhibit cough, 35% generalized body ache and sore throat, and 31% dyspnea. Some methods such as nebulized lidocaine, magnesium sulfate, and systemic opioids have been used to manage the respiratory symptoms. It has been previously shown that fentanyl nebulizer has beneficial effect in improving shortness of breath in patients with chronic obstructive pulmonary disease. The proposed theory behind that was that fentanyl decreased the rate of spontaneous respiratory rate, diminished the brain stem chemoreceptor response to hypoxia and hypercarbia, in addition to exhibiting a modulating effect on the brain stem. Therefore, we hypothesize that nebulized fentanyl has superior effect in improving shortness of breath and relieving cough compared to normal saline, in addition to its advantageous throat pain relief, while exhibiting fewer side effects in patients with COVID 19 infection. Therefore, this phase-III, randomized, comparative, parallel assignment, single-blinded clinical trial aims at assessing the efficacy and safety of nebulized fentanyl to suppress cough, improve breathlessness, and relieve throat pain in patients with COVID-19.

Predictors of mortality and morbidity in critically ill COVID-19 patients: An experience from a low mortality country.

Background and Aims: Clinical characteristics and factors associated with mortality in patients admitted to the intensive care unit (ICU) in countries with low case fatality rates (CFR) are unknown. We sought to determine these in a large cohort of critically ill COVID-19 patients in Qatar and explore the early mortality predictors. Methods: We retrospectively studied the clinical characteristics and outcomes in patients admitted to the ICU at the national referral hospital for COVID-19 patients in Qatar. Logistic regression analysis was used to determine factors associated with mortality. Results: Between March 7 and July 16, 2020, a total of 1079 patients with COVID-19 were admitted to the ICU. The median (IQR) age of patients was 50 (41-59) years. Diabetes (47.3%) and hypertension (42.6%) were the most common comorbidities. In-hospital mortality was 12.6% overall and 25.9% among those requiring mechanical ventilation. Factors independently associated with mortality included older age ([OR]; 2.3 [95% CI; 1.92-2.75] for each 10-year increase in age, p < 0.001), chronic kidney disease (OR; 1.9 [95% CI; 1.02-3.54], p = 0.04), active malignancy (OR; 6.15 [95% CI; 1.79-21.12], p = 0.004), lower platelet count at ICU admission (OR; 1.41 [95% CI; 1.13-1.75] for each 100 × 103/µl decrease, p = 0.002), higher neutrophil-to-lymphocyte ratio at admission (OR; 1.01 [95% CI; 1-1.02] for each 1- point increase, p = 0.016), higher serum ferritin level at admission (OR; 1.05 [(95% CI; 1.02-1.08] for each 500 µg/L increase, p = 0.002), and higher serum bilirubin level at admission (OR; 1.19 [95% CI; 1.04-1.36] for each 10 µmol/L increase, p = 0.01). Conclusions: The mortality rate among critically ill COVID-19 patients is low in Qatar compared to other countries. Older age, chronic kidney disease, active malignancy, higher neutrophil-to-lymphocyte ratios, lower platelet counts, higher serum ferritin levels, and higher serum bilirubin levels are independent predictors of in-hospital mortality.

Effect of eyelid manipulation and manual jugular compression on intraocular pressure measurement in dogs.

OBJECTIVE: To determine the effect of eyelid manipulation and manual jugular compression on intraocular pressure (IOP) measurement in clinically normal dogs. DESIGN: Randomized clinical trial. ANIMALS: 30 dogs (57 eyes) without diseases or medications that affect IOP. PROCEDURES: An applanation tonometer was used to measure IOP during eyelid manipulation or jugular compression. Six manipulations were used in each eye, including minimal eyelid manipulation, maximal dorsoventral extension of the eyelids, lateral eyelid extension, manual compression of the ipsilateral jugular vein, manual compression of both jugular veins, and lateral eyelid extension with manual compression of both jugular veins. Skull type and position of globe in the orbit were recorded. RESULTS: The 2 manipulations that caused the greatest significant increase in mean IOP were lateral eyelid extension with compression of both jugular veins (difference from baseline IOP, 17.6 mm Hg; 95% confidence interval [CI], 15.7 to 19.5 mm Hg) and lateral eyelid extension alone (16.5 mm Hg; 95% CI, 14.6 to 18.4 mm Hg). Dorsoventral eyelid extension (6.42 mm Hg; 95% CI, 4.5 to 8.3 mm Hg) and compression of both jugular veins alone (3.0 mm Hg; 95% CI, 1.1 to 5.0 mm Hg) significantly increased mean IOP, compared with baseline. Compression of the ipsilateral jugular vein increased mean IOP (0.3 mm Hg; 95% CI, -1.6 to 2.2 mm Hg) from baseline, but not significantly. CONCLUSIONS AND CLINICAL RELEVANCE: Traction on the eyelids or pressure on both jugular veins can significantly increase IOP values as measured by use of applanation tonometry in clinically normal dogs.

Colchicine-induced rhabdomyolysis: a review of 83 cases.

A 74-year-old man with medical history significant for atrial fibrillation, hyperlipidaemia and coronary artery disease on atorvastatin presented to the emergency department with profound weakness. The patient reports he first noticed his weakness 4 weeks after starting colchicine, prescribed for recurrent pericarditis with pericardial effusion, a complication following recent coronary artery bypass grafting. The patient was also on prednisone therapy for presumed post-pericardiotomy syndrome. The weakness involved all four limbs but was more notable in the lower extremities, with preserved sensation and tenderness to palpation. Labs showed an elevated creatinine phosphokinase and serum creatinine consistent with rhabdomyolysis. Discontinuation of the offending medications, including colchicine and atorvastatin, as well as intravenous fluid resuscitation with physical rehabilitation, led to improvement in the patient's symptoms. He was eventually discharged to a rehabilitation facility to continue physical therapy.

Cryptococcemia in a patient with COVID-19: A case report.

The authors urge clinicians to balance the use of Immunosuppressant drugs and tocilizumab for COVID-19 patients to avoid the development of infections like Cryptococcemia, leading to death within 30 days.