Analysis of Risk Factors in COVID-19 Adult Mortality in Russia.

BACKGROUND AND OBJECTIVE: Epidemiological data obtained during the ongoing SARS-CoV-2 pandemic suggests that COVID-19 mortality has specific age and gender associations. However, limited epidemiological studies explored specific populational risk factors, including comorbidities, and patient clinical characteristics. The main aim of our retrospective cohort study was to analyze associations between age, gender, and comorbidities in deceased COVID-19 patients. MATERIALS AND METHODS: A retrospective cohort analysis was performed to assess significant risk factors in adult patients deceased from COVID-19 infection by evaluating Electronic Medical Records and post-mortem analysis in COVID-19 patients deceased between April 2020 to October 2020. All patients underwent post-mortem evaluation along with medical history analysis, including data on disease duration, hospitalization, and clinical peculiarities. RESULTS: Medical records of 1487 COVID-19 patients revealed that the prevalence of males was higher (by 23%) than females; the median age for males was 71 years of age whereas for females it was 78. The most prevalent comorbid pathologies were: hypertension, obesity, diabetes, and cancer. Males are at significantly increased risk of lethal outcome, even in younger age groups, with comorbid conditions. CONCLUSION: The study concluded that comorbidities, such as hypertension, obesity, diabetes, cancer are the most important risk factors for comorbid mortality in COVID-19 patients. In addition to lung damage, multiple organ dysfunctions may be a crucial reason for COVID-19 induced death. Special precautions, such as early hospitalization, increased monitoring, and preventative tactics should be taken for at-risk patients.

The Role of Mitochondria in Piperine Mediated Cardioprotection in Isoproterenol Induced Myocardial Ischemia.

BACKGROUND: Several pharmacological therapeutic interventions are being used as therapeutic agents against myocardial infarction/ischemia (MI) but their usage is constrained by toxicity and nonselective pharmacological actions. Our preliminary report depicted the cardioprotective effect of piperine against isoproterenol (ISO)-induced MI. AIM: Current study determined the protective efficacy of piperine by modulating mitochondrial function in rat models of isoproterenol (ISO)-induced myocardial ischemia. METHODS: The above aim was achieved by analyzing mitochondrial antioxidant status, mitochondrial calcium, mitochondrial enzyme activity, ATP level, and apoptosis. Ultra-structural alterations in heart tissue were determined by TEM analysis. RT-PCR studies and Western blotting were executed to determine apoptotic and proapoptotic gene expression, and apoptotic protein expression, respectively. RESULTS: The results elucidate that piperine pre-treatment prevents ISO induced alterations in the mitochondrial antioxidant status, Krebs cycle as well as mitochondrial respiratory chain enzyme activities (MRCEs). ISO induced ultrastructural changes of heart mitochondria were significantly reduced in the group that received piperine pretreatment followed by ISO injection. Piperine maintains mitochondrial calcium homeostasis and inhibits ISO-induced myocardial apoptosis. A significant increase in the expression levels of proapoptotic genes such as Bax, caspases (caspase 9, caspase 3), and cytochrome-c with a concomitant decrease in Bcl-2 expression (anti-apoptotic gene) was observed in ISO injected group compared to the control group. The group that received the piperine pretreatment followed by ISO administration showed a significant decrease in the expression profile of proapoptotic genes with a concomitant increase in the anti-apoptotic gene expression than the ISO injected group. Apoptotic protein expressions including Bax, cytochrome-c, caspase-3, and cleaved PARP were upregulated & Bcl-2 was downregulated with ISO treatment, whereas piperine pre-treatment prevented these changes in apoptotic protein expressions during ISO-induced myocardial cell damage. CONCLUSION: Current results demonstrate the efficacy of piperine for attenuating ISO-induced myocardial ischemia by enhancing mitochondria function. This study described that piperine could be used as a nutritional intervention against ISO-induced myocardial ischemia.

The Posterior Perforated Substance: A Brain Mystery Wrapped in an Enigma.

BACKGROUND: There is a dearth of published information on the posterior perforated substance as compared to the anterior perforated substance. We managed to glean facts about the posterior perforated substance that can serve as a landmark for surgical operations in the adjacent regions of the midbrain and the vessels passing through it. Moreover, the posterior perforated substance contains the interpeduncular nucleus responsible for the mental state of the individual. OBJECTIVES: 1) To describe the topography of the blood vessels supplying the posterior perforated substance area from the surgical point of view; 2) to investigate the functions of the interpeduncular nucleus. METHODS: We assembled and analyzed results from source databases by Elsevier, NCBI MedLine, Scopus, Scholar. Google and Embase. Each article was studied in detail for practically useful information about the posterior perforated substance. RESULTS: The P1-segment perforating branches of the posterior cerebral artery supply the posterior perforated substance. This area is especially vulnerable in the case of vascular pathologies. The posterior communicating artery can block the surgeon's view and impede maneuverability of the tool in the area of the posterior perforated substance, which may be addressed using the separation technique, which can lead to positive results. In addition, the medial habenula-interpeduncular nucleus in the posterior perforated substance is associated with various addictions and psychiatric conditions. CONCLUSION: The posterior perforated substance area is of great interest for surgical interventions. Future studies of the interpeduncular nucleus anticipate the development of drugs to affect different types of dependencies and some mental diseases.