Role of immune mediators in predicting hospitalization of SARS-CoV-2 positive patients.

BACKGROUND: Several immune mediators (IM) including cytokines, chemokines, and their receptors have been suggested to play a role in COVID-19 pathophysiology and severity. AIM: To determine if early IM profiles are predictive of clinical outcome and which of the IMs tested possess the most clinical utility. METHODS: A custom bead-based multiplex assay was used to measure IM concentrations in a cohort of SARS-CoV-2 PCR positive patients (n = 326) with varying disease severities as determined by hospitalization status, length of hospital stay, and survival. Patient groups were compared, and clinical utility was assessed. Correlation plots were constructed to determine if significant relationships exist between the IMs in the setting of COVID-19. RESULTS: In PCR positive SARS-CoV-2 patients, IL-6 was the best predictor of the need for hospitalization and length of stay. Additionally, MCP-1 and sIL-2Rα were moderate predictors of the need for hospitalization. Hospitalized PCR positive SARS-CoV-2 patients displayed a notable correlation between sIL-2Rα and IL-18 (Spearman's ρ = 0.48, P=<0.0001). CONCLUSIONS: IM profiles between non-hospitalized and hospitalized patients were distinct. IL-6 was the best predictor of COVID-19 severity among all the IMs tested.

Pectus excavatum em uma ninhada de Buldogue Francês: relato de caso / Pectus excavatum in a French Bulldog Litter: case report

RESUMO O pectus excavatum é considerado uma patologia da parede torácica, onde há convexidade no aspecto ventral do esterno, o que gera complicações secundárias, como alongamento ventrodorsal do tórax e aumento da pressão intratorácica, entre outras. No presente caso, o corpo de um cachorro Buldogue Francês nasceu com sinais prévios de decaimento e baixo consumo de leito materno, além de uma avaliação médica forense. De acordo com a avaliação patológica, foi encontrada uma fenda no peito esternal relacionada às esternas caudais próximas à cartilagem xifóide, conteúdo espumoso na cartilagem epiglótica da laringe e sinais graves de enfisema nos lobos caudal, craniano e médio pulmonar. Na avaliação cardiológica, foi observada assimetria morfológica invaginante no septo interventricular na mesma área em que a fenda esternal ocorre, por sua vez, na avaliação radiográfica, evidencia uma depressão dorsal do terço caudal do esterno com alterações consideráveis na silhueta cardíaca. Na Colômbia não há relatos de ninhadas completas que apresentem esta alteração, portanto, pretende-se que este seja o primeiro relatório anatomopatológico e de imagem que descreva a patologia em caninos.

ABSTRACT Pectus excavatum is considered a pathology of the chest wall where there is convexity in the ventral aspect of the sternum, which generates secondary complications, such as ventrodorsal stretching of the chest and increased intrathoracic pressure, among others. In the present case, the body of a French bulldog dog was born with previous signs of decay and low consumption of maternal waste, in addition to a forensic medical evaluation. According to the pathological evaluation, a crack was found in the sternal chest related to the caudal sternum close to the xiphoid cartilage, frothy content in the laryngeal epiglottis cartilage and severe signs of emphysema in the caudal, cranial and middle lung lobes. In the cardiological evaluation, an invaginating morphological asymmetry was observed in the interventricular septum in the same area in which the sternal cleft occurs, in turn, in the radiographic evaluation, it shows a dorsal depression of the caudal third of the sternum with considerable changes in the cardiac silhouette. In Colombia there are no reports of complete litters that present this alteration, so it is intended that this is the first anatomopathological and imaging report that describes the pathology in canines.

Reduction of respiratory infections in asthma patients supplemented with vitamin D is related to increased serum IL-10 and IFNγ levels and cathelicidin expression.

BACKGROUND: Vitamin D is a molecule that modulates the immune response and shows anti-inflammatory effects that are beneficial for the control of chronic diseases such as asthma. The trial aim was to explore the effect of vitamin D supplementation on the colonization of pathogenic bacteria in the upper respiratory tract of allergic asthmatic patients. METHODS: This study was conducted in 86 patients between 18 and 50 years of age who were randomly divided into two groups. Both groups received the treatment recommended by the Global Initiative for Asthma (GINA). One group also received calcitriol (1,25-(OH)2D3), and the other group received a placebo. At baseline and 6 months, skin prick tests were conducted, pharyngeal bacterial cultures were performed, and cathelicidin LL-37 was measured in sputum. Serum levels of IgE, eosinophils, IL-5, IL-9, IL-10, IL-13, and IFNγ were quantified at the beginning and the end of the study. RESULTS: Serum levels of IL-10 and IFNγ increased significantly in the group of patients with vitamin D supplementation, while IL-5, IL-9, and IL-13 decreased significantly. At the end of the trial, IgE and eosinophil levels significantly decreased but allergen sensitivity did not show any changes from baseline. Respiratory infections were drastically reduced, and this decrease was related to the number of patients who had high serum levels of IL-10 and IFNγ and expressed LL-37 in their sputum. CONCLUSION: Treatment of asthma patients with vitamin D reduced respiratory infections, and this effect was related to the increase of cathelicidin LL-37.

[Plasma concentrations of beta-endorphins in the children of alcoholic patients]. / Niveles de beta-endorfinas en hijos de padres alcohólicos.

BACKGROUND: Of the factors identified in different studies as the possible causes of alcoholism, heredity appears to be the most important. However, environmental factors can increase or decrease the risk of an individual developing alcohol dependence. METHOD: To clarify the possible influence of heredity on alcoholism, we studied the plasma concentration of beta-endorphins in 25 families with alcoholic members: 27 children whose father was alcoholic and 7 whose father and mother were both alcoholics. The results were compared with finding in an age-matched control group of no-drinking adults and normal children in non-drinking families. RESULTS: The children of alcoholic parents had significantly lower beta-endorphin levels (p < 0.001) than control individuals, and concentrations were especially low when both parents were alcoholics. CONCLUSION: We conclude that plasma beta-endorphin concentration may have predictive value in identifying persons likely to become alcoholics.

Niveles de beta-endorfinas en hijos de padres alcohólicos / Plasma concentrations of beta-endorphins in the children of alcoholic parents

Introducción: En los últimos años son numerosos los trabajos acerca de las posibles causas del alcoholismo, donde parece intervenir varios factores, siendo la herencia uno de los más implicados, aunque se han destacado otros, como factores ambientales, que contribuirían a aumentar o disminuir el riesgo individual para desarrollar una dependencia alcohólica. Método: Para intentar aclarar la posible influencia de la herencia en el alcoholismo, hemos estudiado los niveles de beta-endorfinas (β-E) en 25 familias de alcohólicos, en las cuales había 27 hijos con un padre alcohólico y 7 hijos con los dos, así como en dichos padres alcohólicos, y comparado los resultados con unos grupos control: uno de adultos no bebedores y otro de niños normales en familias de no-bebedores, con edades similares. Resultados: Se ha encontrado que los hijos de alcohólicos tienen unos niveles de Beta-E significativamente más bajos (p < 0,001) que los controles, y estos niveles eran aún más bajos en los hijos cuyos dos padres eran alcohólicos. Conclusión: Se concluye que la determinación de β-E podía tener un valor predictivo a la hora de determinar quién es más propenso a ser alcohólico en el futuro

Background: Of the factors identified in different studies as the possible causes of alcoholism, heredity appears to be the most important. However, environmental factors can increase or decrease the risk of an individual developing alcohol dependence. Method: To clarify the possible influence of heredity on alcoholism, we studied the plasma concentration of beta-endorphins in 25 families with alcoholic members: 27 children whose father was alcoholic and 7 whose father and mother were both alcoholics. The results were compared with finding in an age-matched control group of no-drinking adults and normal children in non-drinking families. Results: The children of alcoholic parents had significantly lower beta-endorphin levels (p < 0.001) than control individuals, and concentrations were especially low when both parents were alcoholics. Conclusion: We conclude that plasma beta-endorphin concentration may have predictive value in identifying persons likely to become alcoholics

Plasma concentrations of beta-endorphin in smokers who consume different numbers of cigarettes per day.

The harmful effects of smoking on health have been widely documented, although it is as yet unclear whether tobacco dependence is only psychological in nature, or both psychological and physical. We studied plasma concentrations of beta-endorphin, cortisol, and adrenocorticotropic hormone (ACTH) in healthy persons who consumed different numbers of cigarettes per day, and compared the findings with those in a control group of nonsmokers. Beta-endorphin levels were significantly higher than in controls only in persons who smoked fewer than 10 cigarettes per day. Cortisol levels were significantly higher in smokers who consumed more than 20 cigarettes per day. There were no significant differences between any of the groups in plasma ACTH concentrations.

Classification of alcoholics on the basis of plasma beta-endorphin concentration.

Recent findings suggest that a genetic deficit in opioid may be a biological marker of alcoholism. In other words, decreased plasma concentrations of opioids may be a predisposing factor, rather than a consequence, of alcohol consumption. We attempted to classify 88 randomly chosen individuals as alcoholics or nonalcoholics on the basis of plasma concentration of beta-endorphins. This criterion had a sensitivity of 73.30% and a specificity of 79.45%. Its positive predictive value was 42.30%, and its negative predictive value was 93.55%.

Plasma concentrations of beta-endorphin, adrenocorticotropic hormone, and cortisol in drinking and abstinent chronic alcoholics.

Previous studies of the relationship between the endogenous opioid system and alcohol consumption have reported contradictory results. To shed light on this connection, we compared plasma concentrations of beta-endorphin, adrenocorticotropic hormone, and cortisol in 70 alcoholic persons after different periods of abstinence and a group of 80 control subjects. Plasma beta-endorphin was decreased in alcoholics (18.61 +/- 1.38 vs. 39.31 +/- 3.44 pg/ml), even after more than 10 years' abstinence. This effect may mediated by the tetrahydroisoquinoline system, and may thus result from chronic alcohol consumption. On the other hand, lowered circulating concentrations of beta-endorphin may be a cause, rather than an effect, of alcoholism. Plasma levels of adrenocorticotropic hormone and cortisol did not differ in alcoholics and controls (19.29 +/- 1.66 vs. 13.27 +/- 1.85 pg/ml for ACTH, 20.37 +/- 0.78 vs. 17.22 +/- 0.64 ng/ml for cortisol), and thus appear to have no relation with chronic alcohol consumption.

Effect of acute alcohol intoxication on the opioid system in humans.

We investigated the possible relations between the endogenous opioid system and acute alcoholic intoxication in 21 subjects, of whom 13 were drinkers who came to the emergency service with evident symptoms of drunkenness, and 8 were nondrinkers who consumed 1 g alcohol per kg body weight over a short period. Different patterns of changes were found in the two groups for plasma concentrations of beta-endorphin and adrenocorticotropic hormone. In drinkers, plasma levels of both substances increased, whereas in nondrinkers both concentrations decreased, the declines being especially notable 15, 30, and 45 min after ingestion. We found no differences between the two groups in plasma cortisol concentrations. The different levels of these substances may reflect differences in drinking behavior between the two groups.

[Evaluation of nutritional status in patients admitted to an internal medicine department. Study of 100 cases]. / Valoración del estado nutricional en pacientes ingresados en un servicio de Medicina Interna. Estudio de 100 casos.

We have confirmed that malnutrition is very frequent in hospitalized patients. There is no agreement about which are the indexes or criteria agreement about which are the indexes or criteria that can be used to define malnutrition, specially in early stages. In the present work, we have studied 100 patients randomly chosen amongst the admissions that occurred in the Internal Medicine Department over a period of one year. The patients were submitted to a protocol which included the following: anthropometric measurements, seric proteins and routine determinations (sugar level, cholesterol, uric acid, etc.) It has been considered as malnourished those patients who presented some marker with a value lower than 90% of the standard value. According to these criteria, 25 of them had a caloric-protein malnutrition, 24 had a proteic malnutrition and 25 of them had mixed malnutrition. The most sensible parameters had been the triceps skin fold and retinal transporting protein.

Plasma beta-endorphin levels in chronic alcoholics.

In order to test the possible relationship between the chronic consumption of alcohol and the opioid system, we have measured the plasma levels of beta-endorphin in a group of 31 alcoholic patients and compared the results with those of a control group of 16 subjects. Our results show that chronic consumption of alcohol induces a significant decrease in beta-endorphin (beta-end) plasma levels regardless of either the disease suffered by the alcoholic patient or of the time of abstinence studied (one month maximum). Thus we believe that the beta-end decrease may well be due to the patients' alcoholism and that it might be mediated by the tetrahydroisoquinoline system, or be a cause of alcoholism rather than a consequence.