ABSTRACT
BACKGROUND: The inflammatory response plays a significant role in the outcome of coronavirus disease (COVID-19). METHODS: We investigated plasma cytokine and chemokine concentrations in non-infected (NI), asymptomatic severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-infected blood donors (AS), and patients with severe COVID-19 (SC). RESULTS: The SC group showed significantly higher levels of interleukin 6 (IL-6), IL-10, and CCL5 than the AS and NI groups. The SC and AS groups had considerably greater CXCL9 and CXCL10 concentrations than the NI group. Only NI and infected people showed separate clusters in the principal component analysis. CONCLUSIONS: SC, as well as AS was characterized by an inflammatory profile.
Subject(s)
COVID-19 , Humans , SARS-CoV-2 , Interleukin-10 , Interleukin-6 , Blood Donors , Chemokines , CytokinesABSTRACT
ABSTRACT Background: The inflammatory response plays a significant role in the outcome of coronavirus disease (COVID-19). Methods: We investigated plasma cytokine and chemokine concentrations in non-infected (NI), asymptomatic severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-infected blood donors (AS), and patients with severe COVID-19 (SC). Results: The SC group showed significantly higher levels of interleukin 6 (IL-6), IL-10, and CCL5 than the AS and NI groups. The SC and AS groups had considerably greater CXCL9 and CXCL10 concentrations than the NI group. Only NI and infected people showed separate clusters in the principal component analysis. Conclusions: SC, as well as AS was characterized by an inflammatory profile.
ABSTRACT
BACKGROUND: Yellow fever (YF) is a viral hemorrhagic disease caused by an arbovirus from the Flaviviridae family. Data on the clinical profile of severe YF in intensive care units (ICUs) are scarce. This study aimed to evaluate factors associated with YF mortality in patients admitted to a Brazilian ICU during the YF outbreaks of 2017 and 2018. METHODS: This was a longitudinal cohort case series study that included YF patients admitted to the ICU. Demographics, clinical and laboratory data were analyzed. Cox regression identified independent predictors of death risk. RESULTS: A total of 114 patients were studied. The median age was 48 years, and 92.1% were males. In univariate analysis, jaundice, leukopenia, bradycardia, prothrombin time, expressed as a ratio to the international normalized ratio-(PT-INR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, lactate, arterial pH and bicarbonate, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score 3 (SAPS 3) severity scores, transfusion of fresh frozen plasma, acute renal failure (Acute Kidney Injury Network stage III (AKIN III)), hemodialysis, cumulative fluid balance at 72 h of ICU, vasopressor use, seizures and grade IV encephalopathy were significantly associated with mortality. In multivariate analysis, factors independently associated with YF mortality were PT-INR, APACHE II, and grade IV hepatic encephalopathy. CONCLUSIONS: In the large outbreak in Brazil, factors independently associated with death risk in YF were: PT-INR, APACHE II, and grade IV hepatic encephalopathy. Early identification of patients with YF mortality risk factors may be very useful. Once these patients with a poor prognosis have been identified, proper management should be promptly implemented.
Subject(s)
Intensive Care Units , Yellow Fever/mortality , APACHE , Acute Kidney Injury/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Disease Outbreaks , Female , Hepatic Encephalopathy/diagnosis , Humans , Longitudinal Studies , Male , Middle Aged , Risk Factors , Simplified Acute Physiology Score , Yellow Fever/diagnosis , Yellow Fever/epidemiology , Young AdultABSTRACT
Os médicos Alexandre Moura e Argus Leão Araújo discutem nesse vídeo sobre o Caso Gabriela do Curso Atualização do Manejo Clínico da Dengue. O diagnóstico diferencial e a atenção desprendida em casos com uma rápida evolução, onde o paciente, por exemplo, manifesta hemorragia, estado febril e outros quadros agudos, deve ser efetivado imediatamente com antibiótico venoso mesmo sem o diagnóstico, devido a rápida piora não permitir uma cultura de sangue ou outros exames.
Subject(s)
Dengue , Diagnosis, Differential , CeftriaxoneABSTRACT
Os médicos Alexandre Moura e Argus Leão Araújo discutem nesse vídeo sobre o Caso Geraldo do Curso Atualização do Manejo Clínico da Dengue. Elucidam que no Caso Geraldo a dor abdominal é um sinal frequentemente ignorado em pacientes com suspeitas de dengue. Para pacientes com sinal de alarme, encaixados no grupo C, aconselham a hidratação por pelo menos duas horas e a realização do hemograma, bem como outros procedimentos a serem realizados a fim de melhor conduzir o paciente e garantir sua recuperação.
Subject(s)
Dengue , Diagnosis, Differential , Health Knowledge, Attitudes, PracticeABSTRACT
Esse vídeo discorre sobre como deve ser realizada a prova do laço em pacientes com suspeitas de dengue. Primeiramente deve-se verificar a pressão arterial, somar com a sistólica e dividir por dois. O resultado é o valor pressórico médio. Em seguida, deve-se inflar o manguito até o valor médio encontrado e pelo tempo determinado em cada caso. Após esse tempo deve ser contada a quantidade de petéquias formadas para a constatação da dengue.
