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1.
Eur Rev Med Pharmacol Sci ; 25(3): 1743-1751, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33629344

RESUMO

OBJECTIVE: This study evaluated the ability of mid-regional proadrenomedullin (MR-proADM) to identify disease severity in Coronavirus disease 2019 (COVID-19) patients in comparison to conventional inflammatory biomarkers and clinical scores. PATIENTS AND METHODS: In an observational trial, COVID-19 acute respiratory distress syndrome (ARDS) patients were enrolled. MR-proADM, C-reactive protein (CRP), procalcitonin (PCT) and lactic acid (LA) were measured in all patients at admission (T0), at 24 hours (T1) and in the third (T3) and fifth day (T5) of hospitalization. The aims of this study were to determine the role of MR-proADM to detect patients with high risk of mortality and compare the prognostic value of MR-proADM with commonly used clinical scores (Sequential Organ Failure Assessment score - SOFA score, Acute Physiologic Assessment and Chronic Health Evaluation II score - APACHE II score, and Simplified Acute Physiological score II - SAPS II score). RESULTS: Twenty-one COVID-19 ARDS patients admitted to the Intermediate Care Unit (IMCU) were enrolled. The median MR-proADM values were 2.28, 2.41, 1.96 and 1.89 nmol/L at T0, T1, T3 and T5, respectively. The 30-day all-cause mortality rate was 52.4%. Mean MR-proADM T0 value was significantly higher in non-survivors compared with survivors (3.5 vs. 1.1 nmol/L, p < 0.05). No significant differences were found for the other inflammatory biomarkers. In terms of the area under the receiver-operating characteristic curve (AUC), MR-proADM showed a similar discriminatory power compared with APACHE II, SOFA and SAPS II score (0.81, 0.91, 0.70 and 0.78, respectively). The optimal MR-proADM cut-point cut-off point was 1.07 nmol/L, which corresponds to a sensitivity of 91% and a specificity of 71%. CONCLUSIONS: MR-proADM, in addition to the clinical scores, could be useful to predict outcome in COVID-19 ARDS patients.


Assuntos
Adrenomedulina/sangue , COVID-19/sangue , Precursores de Proteínas/sangue , SARS-CoV-2 , Síndrome Respiratória Aguda Grave/sangue , APACHE , Biomarcadores/sangue , Proteína C-Reativa/análise , COVID-19/mortalidade , Humanos , Itália , Escores de Disfunção Orgânica , Prognóstico , Curva ROC , Síndrome Respiratória Aguda Grave/mortalidade , Síndrome Respiratória Aguda Grave/virologia
2.
J Math Biol ; 50(6): 713-32, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15772823

RESUMO

A class of lumped parameter models to describe the local dynamics in a controlled environment of a two-trophic chain is considered. The class is characterized by a trophic function (functional response of predator to the abundance of prey) depending on the ratio of prey biomass x and a linear function of predator biomass y: f(qx/[(1-rho)k + rhoy]), where q is the efficiency of the predation process, k is a reference biomass, and rho (0 < or = rho < or = 1) specifies the predation model. The trophic function is defined only by some properties determining its shape. A stability analysis of the models has been performed by taking the parameters q and rho as bifurcation parameters: the regions in the (rho,q) plane of existence and stability of nonnegative equilibrium states and limit cycles are determined. This analysis shows that the behaviour of the models is qualitatively similar for 0 < or = rho < 1 (in particular the null state is always a saddle point), while the value rho=1 gives rise to some kind of structural instability of the system (in particular the null state becomes an attractor for sufficiently high predation efficiency).


Assuntos
Ecossistema , Modelos Biológicos , Comportamento Predatório , Animais , Insetos/crescimento & desenvolvimento , Controle Biológico de Vetores , Doenças das Plantas/parasitologia , Plantas
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