Association of patient characteristics with clinical outcomes in a cohort of hospitalised patients with SARS-CoV-2 infection in a Greek referral centre for COVID-19.

Patient-important outcomes related to coronavirus disease 2019 (COVID-19) continue to drive the pandemic response across the globe. Various prognostic factors for COVID-19 severity have emerged and their replication across different clinical settings providing health services is ongoing. We aimed to describe the clinical characteristics and their association with outcomes in patients hospitalised with COVID-19 in the University Hospital of Ioannina. We assessed a cohort of 681 consecutively hospitalised patients with COVID-19 from January 2020 to December 2021. Demographic data, underlying comorbidities, clinical presentation, biochemical markers, radiologic findings, COVID-19 treatment and outcome data were collected at the first day of hospitalisation and up to 90 days. Multivariable Cox regression analyses were performed to investigate the associations between clinical characteristics (hazard ratios (HRs) per standard deviation (s.d.)) with intubation and/or mortality status. The participants' mean age was 62.8 (s.d., 16.9) years and 57% were males. The most common comorbidities were hypertension (45%), cardiovascular disease (19%) and diabetes mellitus (21%). Patients usually presented with fever (81%), cough (50%) and dyspnoea (27%), while lymphopenia and increased inflammatory markers were the most common laboratory abnormalities. Overall, 55 patients (8%) were intubated, and 86 patients (13%) died. There were statistically significant positive associations between intubation or death with age (HR: 2.59; 95% CI 1.52-4.40), lactate dehydrogenase (HR: 1.44; 95% CI 1.04-1.98), pO2/FiO2 ratio < 100 mmHg (HR: 3.52; 95% CI 1.14-10.84), and inverse association with absolute lymphocyte count (HR: 0.54; 95% CI 0.33-0.87). These data might help to identify points for improvement in the management of COVID-19 patients.

Effect of herbal feed additives on performance parameters, intestinal microbiota, intestinal morphology and meat lipid oxidation of broiler chickens.

1. This feeding trial investigated the effects of herbal feed additives on performance of broiler chickens, jejunal and caecal microbiota, jejunal morphology, meat chemical composition and oxidative stability during refrigerated storage. 2. In a 42 days trial, 320 one-day-old broiler chickens were randomly allocated to 4 groups with 4 replicate pens each containing 20 chicks. The control group was fed maize-soybean-based diets. The diets of the other three groups were supplemented with herbal feed additives: HRB1 with StresomixTM (0.5 g/kg feed); HRB2 with AyuceeTM (1.0 g/kg feed); HRB3 with Salcochek ProTM (1.0 g/kg feed). The GC/MS analysis of the feed additives showed that the major components of HRB1 were ß-caryophyllene (14.4%) and menthol (9.8%); HRB2 were n-hexadecanoic acid (14.22%) and ß-caryophyllene (14.4%); and HRB3 were menthol (69.6%) and clavicol methyl ether (13.9%). 3. Intestinal samples were taken at 42 day to determine bacterial populations (total aerobe counts, Lactobacilli, and Escherichia coli) and perform gut morphology analysis. Meat samples were analysed for chemical composition and oxidative stability under storage. 4. The HRB1 group had improved (P < 0.05) body weight gain and tended to have improved (0.05 ≤ P < 0.10) feed conversion ratio, compared to the control group. Jejunum lactic acid bacteria counts were increased (P < 0.001) in groups HRB1 and HRB3, compared to the control group, whereas caecal lactic acid bacteria counts tended to increase (0.05 ≤ P < 0.10) in group HRB1, compared to the control group. Breast meat fat content tended to be lower (0.05 ≤ P < 0.10) in group HRB1. Meat oxidative stability was improved (P < 0.001), and jejunum villus height, crypt depth and goblet cells numbers were increased (P < 0.001) in all three herbal supplemented groups, compared to the control. 5. In conclusion, herbal feed additives may be able to improve both growth performance and antioxidant activity of broiler chickens, based on their phenolic compound content.

The beginning of personalized medicine in sepsis: small steps to a bright future.

There is a growing recognition that there is a need for a more personalized approach towards sepsis care. In most clinical trials investigating novel therapeutic interventions against sepsis, patients have been considered a rather homogeneous population. However, there is probably more individual variability between septic patients than previously considered. The pathophysiology of sepsis is a complex and dynamic process that originates from the host immune response to infection and varies according to the genetic predisposition, immune status and co-morbid conditions of the host, the type of pathogen and the site and extent of infection. Until now, efforts to stratify septic patients according to their immune profile were hampered by the lack of specific biomarkers. Recent advances in molecular medicine have made it possible to develop tools that will facilitate a faster and more precise diagnosis of infection. Individual variability between each patient's responses to infection can assist in tailoring therapeutic interventions to the individual's disease profile and monitoring treatment response. In this review, we describe those recent advances in genomics and theragnostics, which are slowly entering clinical practice and which will make possible a more personalized approach to each septic patient in the next decade.

Stress management can facilitate weight loss in Greek overweight and obese women: a pilot study.

BACKGROUND: Stress and negative emotions have been shown to be critical factors in inducing overeating as a form of maladaptive coping in obese people. METHODS: The present study aimed to evaluate the efficacy of an 8-week stress management programme that includes progressive muscle relaxation (PMR) and diaphragmatic breathing on weight loss and eating behaviour in a sample of overweight and obese women who started a weight-loss programme. A total of 34 women with a mean (SD) body mass index of 38.17 (7.19) kg m(-) ² and mean (SD) age 47.35 (11.64) years were recruited from the outpatients Obesity Clinic of a public hospital in Athens. Participants were randomly assigned into a Stress Management (SM) and a control group. Anthropometric measurements were taken before and after the intervention, and the participants completed the following questionnaires: Dutch Eating Behaviour Questionnaire (DEBQ), Eating Attitudes Test (Eat-26), Health Locus of Control (HLC) and Perceived Stress Scale (PSS) before and after the intervention. RESULTS: The findings indicated a significant improvement in weight loss in the SM group [4.44 (0.83) kg] after intervention compared to the control group [1.38 (0.78) kg] (P < 0.05). A higher restrained eating behaviour was observed in the SM group after intervention compared to the control group, although there was no significant difference in perceived stress levels. CONCLUSIONS: The intervention group showed greater weight reduction, possibly because of the stress management programme, and a greater dietary restraint was demonstrated by them compared to the control group. It is likely that stress management could facilitate weight loss in obese women; however, more studies are needed to confirm this hypothesis.

An update on approaches to controlling coccidia in poultry using botanical extracts.

1. This paper reviews the use of botanical extracts in the control of coccidial infection in poultry. 2. Some plants and their respective volatile oils and extracts have the potential to alleviate coccidiosis and reduce its severity. 3. Most plant bioactives improve some, but not all, aspects of coccidiosis with variable effectiveness against different species of Eimeria. 4. Difficulties in comparing research findings have arisen from the use of different experimental models, different active components and infectious dose of Eimeria. 5. Current knowledge of their potential anti-coccidial effects may provide guidance for the use of botanical extracts in the control of the coccidiosis.

The effect of dietary oregano essential oil on microbial growth of rabbit carcasses during refrigerated storage.

The effect of dietary supplementation with oregano essential oil on microbial growth of rabbit carcasses during refrigerated storage was investigated. A total of 45 weaned rabbits were separated into three equal groups with three subgroups each. One group was given the basal diet and served as control and the other two groups were administered diets supplemented with oregano essential oil at levels of 100 and 200mg/kg diet, respectively (OR100 and OR200 groups). Total viable counts, Pseudomonas spp., lactic acid bacteria, Brochothrix thermosphacta, Enterobacteriaceae and yeast and mould counts, as well as off-odours and appearance of slime were all assessed on rabbit carcasses stored at 3±1°C for 12 days. The results showed that performance parameters were not affected (p>0.05) whereas the dietary supplementation with oregano essential oil resulted in lower (p<0.05) average microbial counts on the carcasses, compared to controls, throughout storage. Dietary supplementation with oregano essential oil at 200mg/kg was more effective in inhibiting microbial growth compared with 100mg/kg. Sensory evaluation scores indicated that the carcasses obtained from OR100 and OR200 groups gave a noticeable putrid odour after days 8 and 10, respectively, whereas the control carcasses developed off-odours after the 6th day of storage. Slime formation in the controls was observed after day 6, while the OR100 and OR200 groups were just beginning to show slime after days 8 and 10, respectively.

Daily dose of itraconazole 100 mg to treat allergic bronchopulmonary aspergillosis (ABPA) related eosinophilia: a case report.

BACKGROUND: Itraconazole can be used in the treatment of allergic bronchopulmonary aspergillosis (ABPA), as add-on therapy to antiasthmatic medications. Description of the case: The case of an 83-year-old male with asthma, newly diagnosed with ABPA, is presented. A daily itraconazole dose of 100 mg managed to efficiently control eosinophilia and reduce his total IgE count, while these laboratory findings relapsed three months after stopping itraconazole. When the dose was reduced to 100 mg of itraconazole every other day, it was proved insufficient to control eosinophilia. Moreover, one year later, he is being efficiently treated with 100 mg itraconazole daily. CONCLUSIONS: The dose of itraconazole 100 mg can effectively treat some cases of ABPA with asthma. HIPPOKRATIA 2017, 21(3): 144-146.

Effects of long-term feeding of a diet supplemented with clinoptilolite to dairy cows on the incidence of ketosis, milk yield and liver function.

Fifty-two clinically healthy Holstein cows were randomly assigned to one of three groups according to their age and parity. The first group (A) consisted of 17 cows that were fed a concentrate ration supplemented with 1.25 per cent clinoptilolite, the second group (B) consisted of 17 cows fed a ration supplemented with 2.5 per cent clinoptilolite, and the third group (C) consisted of 18 cows, which were fed the basal ration containing no clinoptilolite. The rations were fed from four weeks before the cows' expected parturition dates until the beginning of the next dry period. Blood samples were collected from each animal at the start of the experiment, on the day of calving and then monthly, and analysed for serum glucose, ketone bodies, liver enzymes, blood urea nitrogen (BUN) and total proteins. The milk yield of each cow was recorded monthly. The cows in group B had significantly fewer cases of clinical ketosis during the first month after calving and a higher total milk yield. Feeding the cows with clinoptilolite for a long period had no apparent adverse effects on their liver function, and did not significantly affect the concentrations of glucose, ketone bodies, BUN and total proteins in their serum.

The effect of dietary oregano essential oil on lipid oxidation in raw and cooked chicken during refrigerated storage.

The antioxidative effect of dietary supplementation with oregano essential oil on susceptibility of raw and cooked breast and thigh muscle meat of chickens to lipid oxidation during refrigerated storage for 9 days was investigated. Day-old chickens (n=80) were randomly divided into four groups and fed a basal diet containing 30 mg α-tocopheryl acetate kg(-1) feed as control, or basal diet plus 200 mg α-tocopheryl acetate kg(-1) feed, or basal diet plus 50 or 100 mg oregano essential oil kg(-1) for 38 days prior to slaughter. Lipid oxidation was assessed by monitoring malondialdehyde (MDA) formation in raw and cooked meat during 0, 3, 6 and 9 days of refrigerated storage, using the thiobarbituric acid (TBA) assay and third-order derivative spectrophotometry. Results showed that dietary oregano essential oil supplementation exerted antioxidative effects, the supplementation being most effective in retarding lipid oxidation in stored raw and cooked meat at the 100 mg oregano essential oil kg(-1) feed. However, dietary α-tocopheryl acetate supplementation at 200 mg kg(-1) feed displayed greater antioxidant activity than oregano treatments. Thigh muscle was more susceptible to oxidation compared to breast muscle in all treatments, although the former tissues contained α-tocopherol at markedly higher levels.

Effect of dried oregano leaves versus neomycin in treating newborn calves with colibacillosis.

Treatment with neomycin (as a positive control) and dried oregano leaves on mortality, number of days scouring and severity of scours due to Escherichia coli were examined in 30 Holstein calves. Calves were assigned to one of the treatments following clinical signs of diarrhoea (i.e. faecal score >2), and treated either with an oral solution of neomycin sulphate, to provide 10 mg neomycin sulphate per kg calf body weight per 24 h, or dried oregano leaves, to provide 10 mg oregano essential oil per kg calf body weight per 24 h. The number of scouring days, severity of scouring and mortality rates were similar between the treatments. This study indicates that dried oregano leaves administered as an oral solution to calves with diarrhoea may be as effective in the treatment of colibacillosis as neomycin.

Effects on blood concentrations of certain serum fat-soluble vitamins of long-term feeding of dairy cows on a diet supplemented with clinoptilolite.

The objective of the experiment was to investigate the effect of clinoptilolite (a natural zeolite) supplementation in the ration of dairy cows on serum beta-carotene, vitamins A and E concentrations. Fifty-two clinically healthy Holstein cows were randomly assigned to one of three groups according to their age and parity. The first group (group A, n = 17), was offered a concentrate feed supplemented with 1.25% clinoptilolite. The second group (group B, n = 17), was offered a concentrate feed supplemented with 2.5% clinoptilolite. The third group (group C, n = 18), which served as controls, was offered the same concentrate feed without clinoptilolite supplementation. All cows were fed the above concentrates continuously starting 30 days before the expected parturition up to the end of lactation. Blood samples from individual animals were collected just before the start of experiment, at the day of calving and, thereafter, at monthly intervals. All samples were tested for serum beta-carotene, vitamins A and E concentrations. The results showed that the 1.25 and 2.5% supplementation of clinoptilolite had no adverse effect on serum concentrations of beta-carotene, vitamins A and E.

Effect of dietary dried oregano leaves on growth performance, carcase characteristics and serum cholesterol of female early maturing turkeys.

1. A study was conducted with 120 female early maturing turkeys to test the effect of dietary dried oregano leaves (Origanum vulgare subsp. hirtum) on body weight (BW), feed intake (FI), feed conversion efficiency (FCE), carcase characteristics and serum cholesterol concentration. Dried oregano leaves had a content of 3.6 ml essential oils/100 g, while the carvacrol content was 855 g/kg of the total essential oils. 2. From 1 to 84 d of age, the turkeys were fed on 4 diets varying in oregano content (OR0, no oregano--control; OR45, 1.25 g oregano/kg; OR90, 2.5 g oregano/kg; OR135, 3.75 g oregano/kg). Birds were given feed and water ad libitum. 3. BW was unaffected by oregano throughout the experiment. FI and FCE were similar among all treatments until 42 d of age. From 43 to 84 d of age and for the overall experimental period, FI decreased linearly in treatment OR135 and FCE increased linearly with dietary oregano content. Body and carcase weights, carcase yield, and the relative weights of the heart and liver were not significantly affected by oregano content. The relative weights of the gizzard and small intestine decreased linearly with oregano content. Serum cholesterol content was similar among all treatments. 4. In the present study, dietary oregano (1.25, 2.5 and 3.75 g/kg) improved FCE in female early maturing turkeys between 43 and 84 d, with the lowest oregano inclusion (1.25 g/kg) giving the most cost effective diet. Thus, dried oregano leaves may be used as a natural herbal growth promoter for early maturing turkeys.

Effect of natural zeolite on yolk:albumen ratio in hen eggs.

1. The egg yolk: albumen (Y:A) ratio during the laying year was investigated in a commercial strain (Hisex) when natural zeolite was added to a layer's diet. 2. Dietary natural zeolite (NZ) increased both egg weight and albumen weight, while yolk weight was not significantly affected. 3. The Y:A ratio was less (more albumen) in eggs laid by hens on zeolite treatments. It was concluded that by feeding NZ it is possible to alter the Y:A ratio.

Effect of age and carcase composition on the onset of sexual maturity in quail under normal feeding regimens.

1. The effect of age and carcase composition on the onset of sexual maturity was investigated in Japanese quail (Coturnix coturnix japonica) reared under a normal feeding regimen. 2. At 42 d of age, when the quail had started to lay and hen day production was about 60%, layers were heavier and contained more carcase fat than those that were not laying. 3. The liver and the ovary weight were greater following the onset of sexual maturity than 1 or 2 weeks before (35 and 28 d respectively). 4. Carcase fat as well as age are critical requirements for the onset of sexual maturity in quail.

Effect of dietary oregano essential oil on performance of chickens and on iron-induced lipid oxidation of breast, thigh and abdominal fat tissues.

1. We studied the effect of dietary oregano essential oil (50 and 100 mg/kg of feed) on the performance of broilers, and determined the susceptibility of the resulting broiler meat to iron-induced lipid oxidation. 2. Performance of the birds was unaffected by the experimental diets. Therefore, dietary oregano oil exerted no growth-promoting effect on broilers. 3. Iron-induced lipid oxidation showed that as oregano oil increased in the diet, malondialdehyde values decreased in tissue samples, suggesting that the oil, particularly at 100 mg/kg of feed, exerted an antioxidant effect on chicken tissues. 4. Dietary alpha-tocopheryl acetate supplementation at 200 mg/kg of feed displayed greater antioxidant activity than oregano oil at either supplementation rate. 5. Thigh muscle was more susceptible to oxidation than breast muscle, although the former contained alpha-tocopherol at higher concentration. Muscle alpha-tocopherol is an important factor influencing lipid oxidation, but the influence of polyunsaturated fatty acids and content of pro-oxidants must be taken into consideration too.

Performance of rabbits and oxidative stability of muscle tissues as affected by dietary supplementation with oregano essential oil.

The effect of dietary supplementation with oregano essential oil on the performance of rabbits, and the susceptibility of the produced raw and thermally treated muscle tissue to lipid oxidation during refrigerated storage, were investigated. A total of 96 weaned rabbits were separated into four equal groups with three subgroups each. One group was given the basal diet and served as control, two groups were administered diets supplemented with oregano essential oil at levels of 100 and 200 mg/kg diet, whereas the remaining group was given a diet supplemented with alpha-tocopheryl acetate at 200 mg/kg. During the 42-day experimental period, body weight and feed intake were recorded weekly and the feed conversion ratio was calculated. Feeding the experimental diets to rabbits, performance parameters were not affected. Therefore, dietary oregano essential oil exerted no growth-promoting effect on rabbits. With increased supplementation of oregano essential oil, malondialdehyde values decreased in both raw and thermally treated muscles during refrigerated storage. This finding suggests that dietary oregano essential oil exerted a significant antioxidant effect. Dietary supplementation of oregano essential oil at the level of 200 mg/kg was more effective in delaying lipid oxidation compared with the level of 100 mg/kg, but inferior to dietary supplementation of 200 mg alpha-tocopheryl acetate per kg. This study indirectly provides evidence that antioxidant compounds occurring in oregano essential oil were absorbed by the rabbit and increased the antioxidative capacity of tissues.

Effect of dietary supplementation with oregano essential oil on performance of broilers after experimental infection with Eimeria tenella.

A study was carried out to examine the effect of dietary supplementation of oregano essential oil on performance of broiler chickens experimentally infected with Eimeria tenella at 14 days of age. A total of 120 day-old Cobb-500 chicks separated into 4 equal groups with three replicates each, were used in this study. Two groups, one infected with 5 x 10(4) sporulated oocysts of E. tenella and the other not, were given a basal diet and served as controls. The other two groups also infected with E. tenella were administered diets supplemented with oregano essential oil at a level of 300 mg/kg, or with the anticoccidial lasalocid at 75 mg/kg. Following this infection, survival rate, bloody diarrhoea and oocysts excretion as well as lesion score were determined. Throughout the experimental period of 42 days, body weight gain and feed intake were recorded weekly, and feed conversion ratios were calculated. Two weeks after the infection with E. tenella supplementation with dietary oregano oil resulted in body weight gains and feed conversion ratios not differing from the non-infected group, but higher than those of the infected control group and lower than those of the lasalocid group. These parameters correspond with the extent of bloody diarrhoea, survival rate, lesion score and oocyst numbers and indicated that oregano essential oil exerted an anticoccidial effect against E. tenella, which was, however, lower than that exhibited by lasalocid.