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1.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(5): 1433-1439, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33067933

RESUMO

OBJECTIVE: To study the difference of long non coding RNA (lncRNA) expression profile in bone marrow specimens of children with acute leukemia (AL) and other hematological disease children with normal bone marrows as controls, to screen the lncRNA related with childhood hematological diseases, and to explore the expression of lncRNA AC002454.1 and its clinical significance in AL children. METHODS: The microarray gene chip technology was used to statistically analyze the lncRNA in bone marrow cells of newly diagnose AL children and control children. Ninty-seren differentially expressed lncRNAs were selected. The bone marrow specimens of ALL children (21 cases), AML children (22 cases) and control children (21 cases) were verified and compared by using qRT-PCR; then the lncRNA with maximum differential expression-lncRNA AC002454.1 was selected and used to analyze the relation of relative expression level with clinical indicators. RESULTS: The microarray gene chip detection showed that 1 884 differentially expressed lncRNA were found in ALL children, and 4 289 differentically expressed lncRNA were found in AML children. The results confirming these differentically expressed lncRNA by qRT-PCR showed that 9 lncRNA expression were significantly up-regulated in ALL children, and 12 lncRNA expression were significantly up-regulated in AML children. Among these up-regulated lncRNA, the difference of AC002454.1 expression was most significant in ALL and AML children (P<0.05, P<0.01). The detection showed that there was a significant difference, in AC002454.1 relative expression level of newly diagnosed T-ALL and B-ALL children (P<0.01), moreover, this difference also was found in ALL and AML children (P<0.05). The detection analysis showed that there was no statistical difference in AC002454.1 relative expression level among the different sex, age, WBC count at initial diagnosis, chromosome, fusion gene, and risk stratification (P>0.05 for all). CONCLUSION: The lncRNA expression profile of AL children has been gained by using the lncRNA microarray gene chip technicology. AC002454.1 the significantly high expression exist in AL children, which relates with immunotyping and prognosis of AL children in a certain degree.


Assuntos
Leucemia Mieloide Aguda , RNA Longo não Codificante , Doença Aguda , Criança , Humanos , Leucemia Mieloide Aguda/genética , Análise de Sequência com Séries de Oligonucleotídeos , Prognóstico , RNA Longo não Codificante/genética
2.
BMC Infect Dis ; 20(1): 740, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33036575

RESUMO

BACKGROUND: From 2016, the Government of India introduced the oral rotavirus vaccine into the national immunization schedule. Currently, two indigenously developed vaccines (ROTAVAC, Bharat Biotech; ROTASIIL, Serum Institute of India) are included in the Indian immunization program. We report the rotavirus disease burden and the diversity of rotavirus genotypes from 2005 to 2016 in a multi-centric surveillance study before the introduction of vaccines. METHODS: A total of 29,561 stool samples collected from 2005 to 2016 (7 sites during 2005-2009, 3 sites from 2009 to 2012, and 28 sites during 2012-2016) were included in the analysis. Stools were tested for rotavirus antigen using enzyme immunoassay (EIA). Genotyping was performed on 65.8% of the EIA positive samples using reverse transcription- polymerase chain reaction (RT-PCR) to identify the G (VP7) and P (VP4) types. Multinomial logistic regression was used to quantify the odds of detecting genotypes across the surveillance period and in particular age groups. RESULTS: Of the 29,561 samples tested, 10,959 (37.1%) were positive for rotavirus. There was a peak in rotavirus positivity during December to February across all sites. Of the 7215 genotyped samples, G1P[8] (38.7%) was the most common, followed by G2P[4] (12.3%), G9P[4] (5.8%), G12P[6] (4.2%), G9P[8] (4%), and G12P[8] (2.4%). Globally, G9P[4] and G12P[6] are less common genotypes, although these genotypes have been reported from India and few other countries. There was a variation in the geographic and temporal distribution of genotypes, and the emergence or re-emergence of new genotypes such as G3P[8] was seen. Over the surveillance period, there was a decline in the proportion of G2P[4], and an increase in the proportion of G9P[4]. A higher proportion of mixed and partially typed/untyped samples was also seen more in the age group 0-11 months. CONCLUSIONS: This 11 years surveillance highlights the high burden of severe rotavirus gastroenteritis in Indian children < 5 years of age before inclusion of rotavirus vaccines in the national programme. Regional variations in rotavirus epidemiology were seen, including the emergence of G3P[8] in the latter part of the surveillance. Having pre-introduction data is important to track changing epidemiology of rotaviruses, particularly following vaccine introduction.


Assuntos
Gastroenterite/epidemiologia , Genótipo , Hospitalização , Infecções por Rotavirus/epidemiologia , Rotavirus/genética , Doença Aguda , Antígenos Virais/imunologia , Pré-Escolar , Fezes/virologia , Feminino , Gastroenterite/prevenção & controle , Gastroenterite/virologia , Técnicas de Genotipagem , Humanos , Programas de Imunização , Esquemas de Imunização , Técnicas Imunoenzimáticas , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Prevalência , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Rotavirus/imunologia , Infecções por Rotavirus/prevenção & controle , Infecções por Rotavirus/virologia , Vacinas contra Rotavirus/imunologia
3.
Cochrane Database Syst Rev ; 10: CD008359, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33001448

RESUMO

This Cochrane review has been withdrawn. The Cochrane review is out of date and included a retracted article in the analysis. Withdrawn by Cochrane Colorectal Group. A new update is expected. The editorial group responsible for this previously published document have withdrawn it from publication.


Assuntos
Antibacterianos/uso terapêutico , Apendicectomia/métodos , Apendicite/tratamento farmacológico , Apendicite/cirurgia , Doença Aguda , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
Medicine (Baltimore) ; 99(40): e22616, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019482

RESUMO

RATIONALE: Neuromyelitis optica spectrum disorders (NMOSDs) are inflammatory demyelinating disorders of the central nervous system; they are characterized by severe optic neuritis and transverse myelitis. Intravenous methylprednisolone pulse (IVMP) therapy is an effective treatment that is administered to patients in the acute phase of NMOSD; this therapy has achieved remarkable results in clinical practice. However, there are no reports on NMOSD patients who have experienced an acute bilateral cerebral infarction while undergoing IVMP treatment. PATIENT CONCERNS: We report on a 62-yr-old woman who was undergoing IVMP therapy for the primary diagnosis of NMOSD. Unexpectedly, the patient's existing limb weakness worsened, and she developed motor aphasia on the second day of IVMP treatment. Additionally, brain magnetic resonance imaging revealed acute bilateral cerebral infarction. DIAGNOSIS: The patient's clinical manifestations, medical imaging results, and laboratory test results were taken into consideration; the final diagnosis was acute bilateral cerebral infarction in the presence of NMOSD. INTERVENTIONS: Subsequent to the onset of acute cerebral infarction, the patient was immediately treated with oral aspirin, atorvastatin, and intravenous butylphthalide. The hormone dose was adjusted to an oral 60-mg/d dose for maintenance; this was followed by immunoadsorption plasmapheresis for 3 days, and double-filtration plasmapheresis for 2 days. OUTCOMES: Following treatment onset, the patient's ocular symptoms significantly improved, and her limb muscle strength gradually recovered. Two months after discharge, the patient's husband reported that she was able to walk with the help of others and take care of herself, and that there was no recurrence. LESSONS: Medical professionals must be aware of the possibility of NMOSD patients with cerebrovascular risk factors suffering an acute cerebral infarction while undergoing high-dose IVMP therapy, as this therapy can exacerbate existing problems.


Assuntos
Infarto Cerebral/diagnóstico por imagem , Infarto Cerebral/etiologia , Neuromielite Óptica/complicações , Neuromielite Óptica/tratamento farmacológico , Doença Aguda , Administração Intravenosa , Administração Oral , Anticolesterolemiantes/uso terapêutico , Afasia de Broca/induzido quimicamente , Aspirina/administração & dosagem , Aspirina/uso terapêutico , Atorvastatina/uso terapêutico , Benzofuranos/administração & dosagem , Benzofuranos/uso terapêutico , Infarto Cerebral/tratamento farmacológico , Feminino , Humanos , Imagem por Ressonância Magnética , Metilprednisolona/administração & dosagem , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Fármacos Neuroprotetores/administração & dosagem , Fármacos Neuroprotetores/uso terapêutico , Plasmaferese/métodos , Inibidores da Agregação de Plaquetas/administração & dosagem , Inibidores da Agregação de Plaquetas/uso terapêutico , Resultado do Tratamento
5.
Medicine (Baltimore) ; 99(40): e22641, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019489

RESUMO

RATIONALE: Rotavirus is routinely diagnosed by the detection of antigens or the viral genome. However, these tests have limitations, in that they do not detect all rotavirus strains. PATIENT CONCERNS: We present a case of a 27-month-old girl who was hospitalized for 4 days with severe gastroenteritis, including high fever, vomiting, diarrhea, mild dehydration, and periumbilical pain. Notably, the patient previously received the Rotarix vaccine. DIAGNOSES: The laboratory tests were negative for rotavirus, astrovirus, adenovirus, and norovirus as well as common diarrhea-causing bacteria. Human-bovine recombinant rotavirus was detected by MinION sequencing. INTERVENTIONS: To investigate the cause agents from the unexplained severe gastroenteritis infant, the stool sample was prepared by random amplification for Nanopore MinION sequencing. OUTCOMES: Treatment through the administration of ORS solution and galtase powder with probiotics was successful after the diagnosis of unusual rotavirus infection. LESSONS: This case report is the first detection of an unusual human-bovine recombinant rotavirus in an idiopathic gastroenteritis using Nanopore MinION sequencing.


Assuntos
Gastroenterite/virologia , Sequenciamento por Nanoporos/métodos , Infecções por Rotavirus/diagnóstico , Vacinas contra Rotavirus/efeitos adversos , Rotavirus/genética , Dor Abdominal , Doença Aguda , Pré-Escolar , Desidratação/etiologia , Diarreia/etiologia , Fezes/virologia , Feminino , Febre/etiologia , Hidratação/métodos , Gastroenterite/patologia , Gastroenterite/terapia , Humanos , Probióticos/uso terapêutico , Rotavirus/isolamento & purificação , Infecções por Rotavirus/complicações , Infecções por Rotavirus/virologia , Índice de Gravidade de Doença , Resultado do Tratamento , Vacinação/efeitos adversos , Vacinas Atenuadas/efeitos adversos , Vômito/etiologia
6.
Medicine (Baltimore) ; 99(41): e22482, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031280

RESUMO

RATIONALE: Acute pancreatitis (AP) is one of the most common diseases of gastroenterological emergency with a highly variable clinical course and the incidence being on the rise in recent years. Posttraumatic diaphragmatic hernia is an uncommon disease and may manifest immediately or several years after the incident. Delayed presentation of traumatic diaphragmatic hernia associated with AP is relatively rare. PATIENT CONCERNS: A 26-year-old male with history of left chest knife injury 10 years ago, had AP due to delayed traumatic diaphragmatic hernia 5 days after Dragon Boat Race. DIAGNOSES: Thoracoabdominal computerized tomography detected left diaphragmatic hernia with pancreatic head displacement. Emergency surgery confirmed the diagnosis. INTERVENTIONS: Emergency surgery to reduce and repair the hernia. OUTCOMES: The patient was discharged from the hospital on the sixth postoperative day and no recurrence of pancreatitis during follow-up. LESSONS: For patients without obvious etiology of AP, clinicians should be highly vigilant and inquire the history in detail. For patients with trauma, the relevant examination should be improved, and the pancreatitis caused by traumatic diaphragmatic hernia should be treated with emergency operation immediately.


Assuntos
Hérnia Diafragmática Traumática/complicações , Pancreatite/etiologia , Doença Aguda , Adulto , Hérnia Diafragmática Traumática/diagnóstico por imagem , Hérnia Diafragmática Traumática/cirurgia , Humanos , Masculino , Fatores de Tempo , Tomografia Computadorizada por Raios X , Ferimentos Perfurantes/complicações
7.
J Investig Med High Impact Case Rep ; 8: 2324709620963635, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33019829

RESUMO

As COVID-19 (coronavirus disease 2019) spreads across the world multiple therapeutic interventions have been tried to reduce morbidity and mortality. We describe a case of collapsing focal sclerosing glomerulosclerosis (FSGS) and acute oxalate nephropathy in a patient treated with high-dose intravenous vitamin C for severe COVID-19 infection. Collapsing FSGS has been described in patients with COVID-19 infection associated with APOL-1; however, this case had collapsing FSGS developing in low-risk heterozygous APOL-1 variant, and we postulate that the intensity of the COVID-19 cytokine storm overwhelmed the protective state of APOL-1 heterozygosity. This case illustrates the importance of assessing the risk and benefit of planned therapeutic interventions on a case-by-case basis especially when there are still so many unknowns in the management of COVID-19 infection. Strong consideration should be given for performing a renal biopsy in patients who develop multifactorial acute kidney injury.


Assuntos
Ácido Ascórbico/efeitos adversos , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Glomerulosclerose Segmentar e Focal/induzido quimicamente , Hiperoxalúria/induzido quimicamente , Glomérulos Renais/patologia , Oxalatos/metabolismo , Pneumonia Viral/tratamento farmacológico , Doença Aguda , Lesão Renal Aguda/diagnóstico , Lesão Renal Aguda/etiologia , Ácido Ascórbico/administração & dosagem , Biópsia , Infecções por Coronavirus/epidemiologia , Progressão da Doença , Glomerulosclerose Segmentar e Focal/diagnóstico , Humanos , Hiperoxalúria/diagnóstico , Hiperoxalúria/metabolismo , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Vitaminas/administração & dosagem , Vitaminas/efeitos adversos
8.
J Hematol Oncol ; 13(1): 131, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008453

RESUMO

SARS-CoV-2 has infected millions of people worldwide, but little is known at this time about second infections or reactivation. Here, we report a case of a 55-year-old female undergoing treatment for CD20+ B cell acute lymphoblastic leukemia who experienced a viral reactivation after receiving rituximab, cytarabine, and dasatinib. She was initially hospitalized with COVID-19 in April and developed a high antibody titer with two negative nasal polymerase chain reaction (PCR) swabs for SARS-CoV-2 on discharge. After recovery, she resumed treatment in June for her leukemia, which included rituximab, cytarabine, and dasatinib. She promptly lost her COVID-19 antibodies, and her nasal PCR turned positive in June. She developed a severe COVID-19 pneumonia with lymphopenia, high inflammatory markers, and characteristic bilateral ground-glass opacities on chest CT, requiring high-flow nasal cannula and transfer to the intensive care unit. She received steroids, anticoagulation, and convalescent plasma, and within 48 h she was off oxygen. She was discharged home in stable condition several days later. Given the short time frame from leukemia treatment to PCR positivity and the low case rate in mid-June in New York City, reinfection appears to have been unlikely and SARS-CoV-2 reactivation is a possible explanation. This case illustrates the risks of treating recently recovered COVID-19 patients with immunosuppressive therapy, particularly lymphocyte- and antibody-depleting therapy, and raises new questions about the potential of SARS-CoV-2 reactivation.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/imunologia , Citarabina/uso terapêutico , Imunossupressores/uso terapêutico , Pneumonia Viral/imunologia , Leucemia-Linfoma Linfoblástico de Células Precursoras B/tratamento farmacológico , Rituximab/uso terapêutico , Doença Aguda , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Anticoagulantes/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/terapia , Infecções por Coronavirus/virologia , Citarabina/efeitos adversos , Feminino , Humanos , Imunização Passiva , Imunossupressores/efeitos adversos , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase , Recidiva , Rituximab/efeitos adversos , Esteroides/uso terapêutico , Resultado do Tratamento
9.
J Cardiothorac Surg ; 15(1): 295, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008478

RESUMO

BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (ECMO) is increasingly being utilized in patients with massive pulmonary embolism (PE). However, the efficacy and the safety remain uncertain. This study aimed to investigate clinical courses and outcomes in ECMO-treated patients with acute PE. METHODS: Twenty-one patients with acute PE rescued by ECMO from January 2012 to December 2019 were retrospectively analysed. Clinical features, laboratory biomarkers, and imaging findings of these patients were reviewed, and the relationship with immediate outcome and clinical course was investigated. RESULTS: Sixteen patients (76.2%) experienced refractory circulatory collapse requiring cardiopulmonary resuscitation (CPR) or ECMO support within 2 h after the onset of cardiogenic shock, and none could receive definitive reperfusion therapy before ECMO initiation. Before or during ECMO support, more than 90% of patients had imaging signs of right ventricular (RV) dysfunction. In normotension patients, the computed tomography (CT) value was a valuable predictor of rapid disease progression compared with cardiac troponin I level. Ultimately, in-hospital death occurred in ten patients (47.6%) and 90% of them died of prolonged CPR-related brain death. Cardiac arrest was a significant predictor of poor prognosis (p = 0.001). CONCLUSIONS: ECMO appears to be a safe and effective circulatory support in patients with massive PE. Close monitoring in intensive care unit is recommended in patients with RV dysfunction and aggressive use of ECMO may reduce the risk of sudden cardiac arrest and improve clinical outcome.


Assuntos
Oxigenação por Membrana Extracorpórea , Embolia Pulmonar/terapia , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Morte Encefálica , Reanimação Cardiopulmonar , Feminino , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/complicações , Reperfusão , Estudos Retrospectivos , Choque Cardiogênico/terapia , Tomografia Computadorizada por Raios X , Disfunção Ventricular Direita/etiologia
10.
J Hematol Oncol ; 13(1): 131, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: covidwho-810348

RESUMO

SARS-CoV-2 has infected millions of people worldwide, but little is known at this time about second infections or reactivation. Here, we report a case of a 55-year-old female undergoing treatment for CD20+ B cell acute lymphoblastic leukemia who experienced a viral reactivation after receiving rituximab, cytarabine, and dasatinib. She was initially hospitalized with COVID-19 in April and developed a high antibody titer with two negative nasal polymerase chain reaction (PCR) swabs for SARS-CoV-2 on discharge. After recovery, she resumed treatment in June for her leukemia, which included rituximab, cytarabine, and dasatinib. She promptly lost her COVID-19 antibodies, and her nasal PCR turned positive in June. She developed a severe COVID-19 pneumonia with lymphopenia, high inflammatory markers, and characteristic bilateral ground-glass opacities on chest CT, requiring high-flow nasal cannula and transfer to the intensive care unit. She received steroids, anticoagulation, and convalescent plasma, and within 48 h she was off oxygen. She was discharged home in stable condition several days later. Given the short time frame from leukemia treatment to PCR positivity and the low case rate in mid-June in New York City, reinfection appears to have been unlikely and SARS-CoV-2 reactivation is a possible explanation. This case illustrates the risks of treating recently recovered COVID-19 patients with immunosuppressive therapy, particularly lymphocyte- and antibody-depleting therapy, and raises new questions about the potential of SARS-CoV-2 reactivation.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/imunologia , Citarabina/uso terapêutico , Imunossupressores/uso terapêutico , Pneumonia Viral/imunologia , Leucemia-Linfoma Linfoblástico de Células Precursoras B/tratamento farmacológico , Rituximab/uso terapêutico , Doença Aguda , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Anticoagulantes/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/terapia , Infecções por Coronavirus/virologia , Citarabina/efeitos adversos , Feminino , Humanos , Imunização Passiva , Imunossupressores/efeitos adversos , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase , Recidiva , Rituximab/efeitos adversos , Esteroides/uso terapêutico , Resultado do Tratamento
11.
J Investig Med High Impact Case Rep ; 8: 2324709620963635, 2020.
Artigo em Inglês | MEDLINE | ID: covidwho-835773

RESUMO

As COVID-19 (coronavirus disease 2019) spreads across the world multiple therapeutic interventions have been tried to reduce morbidity and mortality. We describe a case of collapsing focal sclerosing glomerulosclerosis (FSGS) and acute oxalate nephropathy in a patient treated with high-dose intravenous vitamin C for severe COVID-19 infection. Collapsing FSGS has been described in patients with COVID-19 infection associated with APOL-1; however, this case had collapsing FSGS developing in low-risk heterozygous APOL-1 variant, and we postulate that the intensity of the COVID-19 cytokine storm overwhelmed the protective state of APOL-1 heterozygosity. This case illustrates the importance of assessing the risk and benefit of planned therapeutic interventions on a case-by-case basis especially when there are still so many unknowns in the management of COVID-19 infection. Strong consideration should be given for performing a renal biopsy in patients who develop multifactorial acute kidney injury.


Assuntos
Ácido Ascórbico/efeitos adversos , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Glomerulosclerose Segmentar e Focal/induzido quimicamente , Hiperoxalúria/induzido quimicamente , Glomérulos Renais/patologia , Oxalatos/metabolismo , Pneumonia Viral/tratamento farmacológico , Doença Aguda , Lesão Renal Aguda/diagnóstico , Lesão Renal Aguda/etiologia , Ácido Ascórbico/administração & dosagem , Biópsia , Infecções por Coronavirus/epidemiologia , Progressão da Doença , Glomerulosclerose Segmentar e Focal/diagnóstico , Humanos , Hiperoxalúria/diagnóstico , Hiperoxalúria/metabolismo , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Vitaminas/administração & dosagem , Vitaminas/efeitos adversos
12.
Vestn Oftalmol ; 136(6): 70-77, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33084282

RESUMO

Anterior uveitis (AU) is one of the common extraskeletal manifestations of spondyloarthritis (SpA). The course of AU in patients with SpA is characterized by frequent relapses. The article considers the question of local and systemic use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment and prevention of SpA-associated uveitis exacerbations.


Assuntos
Espondilartrite , Uveíte Anterior , Uveíte , Doença Aguda , Anti-Inflamatórios não Esteroides , Humanos , Espondilartrite/complicações , Espondilartrite/diagnóstico , Espondilartrite/tratamento farmacológico , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte/etiologia , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico , Uveíte Anterior/etiologia
14.
BMJ Case Rep ; 13(9)2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32878841

RESUMO

We report the case of a 38-year-old man who presented to the emergency department with fever, myalgia, nausea, vomiting, dry cough, breathlessness and abdominal pain. He was admitted due to hypoxaemia and was diagnosed with SARS-CoV-2 and was subsequently referred to the intensive care unit for intubation and mechanical ventilation. Severe rhabdomyolysis and acute kidney injury developed 4 days later and were suspected after noticing discolouration of the urine and a marked increase in plasma myoglobin levels. Treatment included hydration, forced diuresis and continuous renal replacement therapy. In addition to the coronavirus disease acute respiratory distress syndrome, he was diagnosed with possible SARS-CoV-2-induced myositis with severe rhabdomyolysis and kidney failure. The patient survived and was discharged from intensive care after 12 days, returning home 23 days after hospitalisation, fully mobilised with a partially restored kidney function.


Assuntos
Lesão Renal Aguda/diagnóstico , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , Rabdomiólise/diagnóstico , Doença Aguda , Lesão Renal Aguda/etiologia , Lesão Renal Aguda/terapia , Adulto , Antibacterianos/uso terapêutico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Humanos , Masculino , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Terapia de Substituição Renal/métodos , Rabdomiólise/etiologia , Rabdomiólise/terapia , Resultado do Tratamento
15.
Kyobu Geka ; 73(8): 563-571, 2020 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-32879281

RESUMO

The fundamental treatment of Stanford type A acute aortic dissection is a lifesaving emergency surgery in our hospital. We perform hemiarch replacement with a focus on entry tear, but an extended surgery is also performed only when resection of the entry tear is difficult. The outcomes of current therapeutic policy, along with the short-term and the long-term outcomes of different sites of entry tear, were examined retrospectively. Three hundred and twenty surgery of Stanford type A acute aortic dissection were performed between 1991 and 2015 at our hospital. Their short-term and long-term outcomes were examined after dividing them into 7 groups according to their entry sites. We also investigated surgical methods and effects of presence/absence of residual entry tear. As a result, overall hospital mortality was 13.1%. There was no significant difference in either shortterm or long-term outcome among the groups. Likewise, no significant difference was observed in the surgical methods or the presence/absence of residual entry tear. Recently, minimally invasive procedures, such as stent-grafting, have been applied to manage the residual entry tear. Therefore, an aggressive extended surgery is no longer inevitable and our current therapeutic policy is considered reasonable.


Assuntos
Aneurisma Dissecante/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular , Doença Aguda , Humanos , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
16.
Vestn Otorinolaringol ; 85(4): 51-57, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32885638

RESUMO

Acute rhinosinusitis is one of the most common outpatient diseases. The duration of antibiotic therapy in practice can be a cause of disagreement. The latest European guideline for rhinosinusitis EPOS 2020 does not specify clear terms for antibacterial therapy for acute bacterial rhinosinusitis, which suggests that they are determined by the attending physician based on the rate of regression of clinical manifestations in each specific clinical case. OBJECTIVE: To analyze the treatment regimens of adult patients with acute rhinosinusitis in the system of the outpatient service of Administrative Directorate of the President of the Russian Federation in Moscow and compare these schemes with guidelines. MATERIAL AND METHODS: A retrospective analysis of 2267 outpatient disease histories of patients who were on outpatient treatment with a diagnosis of acute rhinosinusitis treated by otorhinolaryngologists from 7 ambulance clinics for the period from January 2016 to May 2018 was performed. Diagnostic methods and treatment regimens of these patients were evaluated. RESULTS: At the diagnostic stage, X-ray methods were recommended in 87% of cases, and ultrasound examination of the paranasal sinuses was performed in 4% of cases. Elimination and irrigation therapy was prescribed in 88.05% of cases (1996 people), maxillary sinus punctures were performed in 9.82% of cases, the average number of procedures was 2±1.3, treatment by displacement was performed in 31.8% of patients, the average number of procedures was 3±1.2. Antibiotic therapy was recommended in 77.4% of cases (1755 people), penicillin group drugs were prescribed in 41.5% of cases, macrolides in 30.5% of cases, cephalosporins in 20.7% of cases, and fluoroquinolones in 7.3% of cases. Intranasal glucocorticosteroids were submitted by 67.7% of patients (1535 people), mucolytics and mucoregulatory drugs - 41% of patients, decongestants for acute rhinosinusitis were recommended in 60.9% of cases, antihistamines - in 36.8% of cases. An average course of antibacterial therapy was 5.9±1.34 days, the recovery of the patients was observed on the background of complex treatment. CONCLUSIONS: In general, in the system of the outpatient service of Administrative Directorate of the President of the Russian Federation, diagnostic and therapeutic measures are carried out in accordance with current clinical recommendations. There is a fairly high percentage of prescribing macrolides (30.5%) and fluoroquinolones (7.3%) in starting therapy, which is a violation of the principles of starting antibacterial therapy.


Assuntos
Rinite/tratamento farmacológico , Doença Aguda , Adulto , Assistência Ambulatorial , Antibacterianos/uso terapêutico , Humanos , Moscou , Estudos Retrospectivos , Federação Russa
17.
BMC Infect Dis ; 20(1): 656, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32894071

RESUMO

BACKGROUND: Several studies have shown a substantial impact of Rotavirus (RV) vaccination on the burden of RV and all-cause acute gastroenteritis (AGE). However, the results of most impact studies could be confused by a dynamic and complex space-time process. Therefore, there is a need to analyse the impact of RV vaccination on RV and AGE hospitalisations in a space-time framework to detect geographical-time patterns while avoiding the potential confusion caused by population inequalities in the impact estimations. METHODS: A retrospective population-based study using real-world data from the Valencia Region was performed among children aged less than 3 years old in the period 2005-2016. A Bayesian spatio-temporal model was constructed to analyse RV and AGE hospitalisations and to estimate the vaccination impact measured in averted hospitalisations. RESULTS: We found important spatio-temporal patterns in RV and AGE hospitalisations, RV vaccination coverage and in their associated adverted hospitalisations. Overall, ~ 1866 hospital admissions for RV were averted by RV vaccination during 2007-2016. Despite the low-medium vaccine coverage (~ 50%) in 2015-2016, relevant 36 and 20% reductions were estimated in RV and AGE hospitalisations respectively. CONCLUSIONS: The introduction of the RV vaccines has substantially reduced the number of RV hospitalisations, averting ~ 1866 admissions during 2007-2016 which were space and time dependent. This study improves the methodologies commonly used to estimate the RV vaccine impact and their interpretation.


Assuntos
Gastroenterite/epidemiologia , Hospitalização , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/economia , Rotavirus/imunologia , Vacinação , Doença Aguda , Teorema de Bayes , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Vacinas contra Rotavirus/imunologia , Fatores Socioeconômicos , Espanha/epidemiologia , Fatores de Tempo , Cobertura Vacinal
18.
Georgian Med News ; (304-305): 13-19, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32965243

RESUMO

Objective - to present the rationale for the choice of surgical tactics for patients with acute pancreatitis by using the levels of transforming growth factor ß1 (TGF-ß1) in the diagnosis of severity and differential diagnosis of sterile and infected forms of pancreatic necrosis.; The data on the study of a comprehensive clinical and instrumental examination of 94 patients with acute pancreatitis of varying severity were analyzed: mild - 20; average - 12; severe - 62 (34 with the infected and 28 with the sterile form of pancreatic necrosis), some features of the content of TGF-ß1 in the blood serum depending on the severity of acute pancreatitis and the form of pancreatic necrosis. Morphological studies of the pancreas (45 cases) in those operated on with severe acute pancreatitis were carried out by immunohistochemistry. The algorithm for early differential diagnosis of sterile and infected forms of pancreatic necrosis was improved based on the use of the diagnostic coefficient (DK) and the informative (I) significance of indicators: TGF-ß1, ARACNE II, CT-index Balthazar, which made it possible to optimize approaches to the choice of surgical intervention. An immunohistochemical method in the autopsy material of the pancreas revealed an increase in the expression of TGF-ß1 in the tissue as the severity of destructive pancreatitis progresses from sterile to infected forms.; Taking into account the levels of TGF-ß1 in the diagnosis of the severity of acute pancreatitis, differential diagnosis of sterile and infected forms of pancreatic necrosis allows differentiated and timely changes in the strategy of surgical intervention - the choice between "closed", "half-open" and "open" types of surgical operations, reduce the number of repeated interventions and reduce postoperative mortality.


Assuntos
Pancreatite/diagnóstico , Pancreatite/cirurgia , Doença Aguda , Anti-Inflamatórios , Humanos , Pâncreas/cirurgia , Prognóstico , Fatores de Crescimento Transformadores
19.
Georgian Med News ; (304-305): 91-95, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965256

RESUMO

The aim of the study is to determine the clinical and laboratory characteristics of acute lymphadenitis in children.; The study was performed using retrograde analysis of diagnosis and treatment of 158 children with acute lymphadenides of nonspecific and specific etiology, different localization (submandibular, cervical, axillary, inguinal and other peripheral localization) who were treated at the inpatient department in the pediatric surgery of MHCF "Local oncologic dispensary of Kramatorsk" from 2015 to 2019. Among the inpatient children there were 86 (54.4%) boys and 72 (45.6%) girls. The age of the patients ranged from 2 months to 18 years. The average age of the patients was 5.8±0.61 years. The surgical procedures were performed in 131 patients (82.9%) while the non-specific nature of the inflammatory process was confirmed in 102 patients (77.9%) taking into account the clinical course of the disease and the results of microbiological analysis. A specific inflammatory process was found out in 29 patients (22.1%). It was clinically detected that 18 children (13.7%) had BCG-lymphadenitis (confirmed by histological examination) and 11 patients (8.4%) had benign lymphoreticulosis (felinosis) among them.; Due to the use of shear wave elastography 62.9% of the children were able to avoid any surgery, extra puncture and they were treated conservatively.


Assuntos
Doença da Arranhadura de Gato , Linfadenite/diagnóstico , Doença Aguda , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Pacientes Internados , Masculino , Pescoço/diagnóstico por imagem , Estudos Retrospectivos
20.
Zhongguo Zhong Yao Za Zhi ; 45(15): 3707-3712, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-32893562

RESUMO

Curcumin was used to interfere with acute pancreatitis model rats to explore its possible mechanism. One hundred and twenty rats were randomly divided into blank group, model group, model+curcumin group, model+mock+curcumin group, model+antagonist+curcumin group and model+curcumin+LY294002 group, with 20 rats in each group. The wet/dry weight ratio of pancreatic tissue was measured and the pathological changes of pancreas were observed by HE staining. The apoptosis was detected by TUNEL staining; the levels of serum amylase, lipase, Bcl-2 and Bax were detected by ELISA, and the levels of PI3 K, Akt and p-Akt in pancreatic tissue were measured by Western blot. HE staining showed that curcumin could improve the pathological changes of pancreas and reduce the pathological score of pancreas, while ELISA results showed that curcumin could decrease the levels of amylase, lipase and Bax in peripheral serum and increase the concentration of Bcl-2. Western blot results showed that the expression levels of PI3 K and p-Akt in pancreatic tissue of model rats were up-regulated after the intervention of curcumin, and the apoptosis rate of pancreatic cells decreased in TUNEL staining. The above effects could be weakened by miR-198 antagonist and PI3 K-Akt signal pathway inhibitor LY294002. In conclusion, curcumin has an ideal effect on acute pancreatitis, and its mechanism may be mediated by miR-198-PI3 K-Akt axis.


Assuntos
Curcumina , MicroRNAs , Pancreatite , Doença Aguda , Animais , Apoptose , Fosfatidilinositol 3-Quinases , Proteínas Proto-Oncogênicas c-akt , Ratos , Ratos Sprague-Dawley , Transdução de Sinais
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