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1.
Sensors (Basel) ; 21(7)2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33810301

RESUMO

Coronavirus disease 19 (COVID-19) is a virus that spreads through contact with the respiratory droplets of infected persons, so quarantine is mandatory to break the infection chain. This paper proposes a wearable device with the Internet of Things (IoT) integration for real-time monitoring of body temperature the indoor condition via an alert system to the person in quarantine. The alert is transferred when the body thermal exceeds the allowed threshold temperature. Moreover, an algorithm Repetition Spikes Counter (RSC) based on an accelerometer is employed in the role of human activity recognition to realize whether the quarantined person is doing physical exercise or not, for auto-adjustment of threshold temperature. The real-time warning and stored data analysis support the family members/doctors in following and updating the quarantined people's body temperature behavior in the tele-distance. The experiment includes an M5stickC wearable device, a Microelectromechanical system (MEMS) accelerometer, an infrared thermometer, and a digital temperature sensor equipped with the user's wrist. The indoor temperature and humidity are measured to restrict the virus spread and supervise the room condition of the person in quarantine. The information is transferred to the cloud via Wi-Fi with Message Queue Telemetry Transport (MQTT) broker. The Bluetooth is integrated as an option for the data transfer from the self-isolated person to the electronic device of a family member in the case of Wi-Fi failed connection. The tested result was obtained from a student in quarantine for 14 days. The designed system successfully monitored the body temperature, exercise activity, and indoor condition of the quarantined person that handy during the Covid-19 pandemic.


Assuntos
Acelerometria , Temperatura Corporal , Internet das Coisas , Sistemas Microeletromecânicos , Quarentena , Termometria , Humanos , Pandemias , Telemetria
2.
Medicine (Baltimore) ; 100(12): e25235, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33761716

RESUMO

BACKGROUND: This study aimed to evaluate the efficacy of peri-induction forced air warming to prevent inadvertent perioperative hypothermia, defined as a reduction in body temperature to <36.0°C during the perioperative period, in intraoperatively warmed patients receiving major surgery lasting >120 minutes. METHODS: In total, 130 patients scheduled for elective surgery under general anesthesia lasting >120 minutes were divided into 2 groups: peri-induction warming (n = 65) and control (n = 65). Patients in the peri-induction warming group were warmed during the anesthetic induction period using a forced-air warmer set at 47°C, whereas patients in the control group were covered passively with a cotton blanket. All patients were warmed with a forced-air warmer during surgery. Body temperature was measured using a tympanic membrane thermometer in the pre- and postoperative periods and using a nasopharyngeal temperature probe during surgery. Patients were evaluated for shivering scale score, thermal comfort scale score, and satisfaction score in the post-anesthesia care unit. RESULTS: The incidence rates of intraoperative and postoperative hypothermia were lower in the peri-induction warming group than in the control group (19.0% vs 57.1%, P < .001; 3.3% vs 16.9%, P = .013, respectively). Body temperature was higher in the peri-induction warming group (P < .001). However, intraoperative blood loss, as well as postoperative thermal comfort scale score, shivering scale score, and patient satisfaction score, were similar between groups. Post-anesthesia care unit duration was also similar between groups. CONCLUSIONS: Peri-induction active forced air warming is an effective, simple, and convenient method to prevent inadvertent perioperative hypothermia in intraoperatively warmed patients undergoing major surgery lasting >120 minutes.


Assuntos
Anestesia Geral , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Calefação/métodos , Hipotermia , Complicações Pós-Operatórias , Termometria/métodos , Anestesia Geral/efeitos adversos , Anestesia Geral/métodos , Temperatura Corporal , Procedimentos Cirúrgicos Eletivos/métodos , Feminino , Humanos , Hipotermia/etiologia , Hipotermia/prevenção & controle , Masculino , Pessoa de Meia-Idade , Assistência Perioperatória/métodos , Período Perioperatório/efeitos adversos , Período Perioperatório/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Resultado do Tratamento
3.
Anticancer Res ; 41(3): 1459-1469, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33788738

RESUMO

BACKGROUND/AIM: Although acute appendicitis (AA) in elderly patients is different from AA in younger patients, the accuracy of diagnostic scores (DSs) in detecting AA is rarely considered. PATIENTS AND METHODS: A cohort of 470 AAP (acute abdominal pain) patients older than 50 years, including 224 women (53.7%) and 193 men (46.3%), were included in the study. The most significant diagnostic predictors were used to construct DS formulas for AA diagnosis with (Tax+) and without body temperature (Tax-). Meta-analytical techniques were used to calculate the summary Se and Sp estimates for each data sets (history-taking, findings, and DS formulas). RESULTS: In SROC analysis, the AUC values for i) symptoms ii) signs and tests iii) DSTax- and iv) DSTax+ were as follows: i) AUC=0.658 (95%CI=0.601-0.709); ii) AUC=0.751 (95%CI=0.701-0.800), iii) AUC=0.977 (95%CI=0.942-1.000), and for iv) AUC=0.980 (95%CI=0.956-1.000). Using roccomp analysis for these AUC values, the differences were significant as follows: between i) and ii) p=0.0358; between i) and iii) p<0.0001; between i) and iv) p<0.0001; between ii) and iii) p<0.0001; between ii) and iv) p<0.0001; and between iii) and iv) p=0.682. CONCLUSION: Similar to younger AA patients, the DS formula was superior to both the clinical history-taking and findings, and therefore, the use of DS should be an important part of the diagnostic decision tree of AA also in the elderly patients presenting with AAP.


Assuntos
Dor Abdominal/diagnóstico , Apendicite/diagnóstico , Temperatura Corporal , Anamnese/métodos , Doença Aguda , Idoso , Apendicite/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC
5.
Int J Hyperthermia ; 38(1): 202-212, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33682604

RESUMO

Increased transmissibility of the pandemic severe acute respiratory coronavirus 2 (SARS-CoV-2) has been noted to occur at lower ambient temperatures. This is seemingly related to a better replication of most respiratory viruses, including SARS-CoV-2, at lower-than-core body temperatures (i.e., 33 °C vs 37 °C). Also, intrinsic characteristics of SARS-CoV-2 make it a heat-susceptible pathogen. Thermotherapy has successfully been used to combat viral infections in plants which could otherwise result in great economic losses; 90% of viruses causing infections in plants are positive-sense single-stranded ribonucleic acid (+ssRNA) viruses, a characteristic shared by SARS-CoV-2. Thus, it is possible to envision the use of heat-based interventions (thermotherapy or mild-temperature hyperthermia) in patients with COVID-19 for which moderate cycles (every 8-12 h) of mild-temperature hyperthermia (1-2 h) have been proposed. However, there are potential safety and mechanistic concerns which could limit the use of thermotherapy only to patients with mild-to-moderate COVID-19 to prevent disease progression rather than to treat patients who have already progressed to severe-to-critical COVID-19. Here, we review the characteristics of SARS-CoV-2 which make it a heat-susceptible virus, potential host mechanisms which could be enhanced at higher temperatures to aid viral clearance, and how thermotherapy could be investigated as a modality of treatment in patients with COVID-19 while taking into consideration potential risks.


Assuntos
/terapia , Hipertermia Induzida , Animais , Temperatura Corporal , Genes Virais , Humanos , Plantas/virologia , Interferência de RNA , /isolamento & purificação
6.
PLoS One ; 16(3): e0247635, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33770093

RESUMO

BACKGROUND: COVID-19 is characterized by a rapid change in the patient's condition, with major changes occurring over a few days. We aimed to develop and evaluate an emergency system for monitoring patients with COVID-19, which may be useful in hospitals where more severe patients stay in their homes. METHODOLOGY/PRINCIPAL FINDINGS: The system consists of the home-based patient unit, which is set up around the patient and the hospital unit, which enables the medical staff to telemonitor the patient's condition and help to send medical recommendations. The home unit allows the data transmission from the patient to the hospital, which is performed using a cell phone application. The hospital unit includes a virtual instrument developed in LabVIEW® environment that can provide a real-time monitoring of the oxygen saturation (SpO2), beats per minute (BPM), body temperature (BT), and peak expiratory flow (PEF). Abnormal events may be fast and automatically identified. After the design details are described, the system is validated by a 30-day home monitoring study in 12 controls and 12 patients with COVID-19 presenting asymptomatic to mild disease. Patients presented reduced SpO2 (p<0.0001) and increased BPM values (p<0.0001). Three patients (25%) presented PEF values between 50 and 80% of the predicted. Three of the 12 monitored patients presented events of desaturation (SpO2<92%). The experimental results were in close agreement with the involved pathophysiology, providing clear evidence that the proposed system can be a useful tool for the remote monitoring of patients with COVID-19. CONCLUSIONS: An emergency system for home monitoring of patients with COVID-19 was developed in the current study. The proposed system allowed us to quickly respond to early abnormalities in these patients. This system may contribute to conserving hospital resources for those most in need while simultaneously enabling early recognition of patients under acute deterioration, requiring urgent assessment.


Assuntos
/patologia , Serviços de Assistência Domiciliar , Monitorização Fisiológica/métodos , Adulto , Doenças Assintomáticas/enfermagem , Temperatura Corporal , Estudos de Casos e Controles , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis , Oximetria , Pico do Fluxo Expiratório/fisiologia , /isolamento & purificação
7.
J Biomed Opt ; 26(4)2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33715317

RESUMO

SIGNIFICANCE: The need for regulatory review of infrared thermographs (IRTs) used on humans was removed in response to the unique circumstances of the SARS-CoV-2 pandemic (a.k.a., COVID-19). The market for these devices has since expanded considerably. This evaluation of IRT performance may have significant implications for febrility screening worldwide. AIM: Perform controlled nonhuman trials of IRT devices to identify and quantify deviations in the human temperature range. APPROACH: We compared IRT readings of a temperature-controlled non-human subject with one FDA-cleared IRT and one FDA-cleared handheld NCIT. In individual trials for each device, the subject was measured between 35°C and 40°C at 0.25°C increments. RESULTS: The IRT device measurements were consistently normalized around the human mean (∼37 ° C). Temperatures were decremented as they approached the febrile range, and systematically reported as normal across all seven devices. This effect does not appear to be explained by a fixed offset or any known approach to estimating body temperature, or by random error. CONCLUSION: The IRTs in this study generated human temperature measurements that were systematically biased to the mean human temperature. Given that these devices are utilized for sentinel detection of possible infectious disease transmission, and are now globally employed, the implications for reduced detection of febrility are a widespread false sense of security. This vulnerability must be considered with respect to facility access control, clinical applications, and travel screening in the context of the ongoing COVID-19 pandemic response.


Assuntos
Temperatura Corporal , Febre/diagnóstico , Termografia/métodos , Febre/etiologia , Humanos , Programas de Rastreamento , Termografia/instrumentação
8.
Sensors (Basel) ; 21(5)2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33669012

RESUMO

In this paper, the key technology of interferometric microwave thermometer is studied, the research can be applied to the temperature measurement of human body and subcutaneous tissue. This paper proposes a hardware architecture of interferometric microwave thermometer with 2 GHz bandwidth, in which the phase shifter is used to correct phase error and the quadrature demodulator is used to realize autocorrelation detection function. The results show that when input power is 7 dBm, the detection sensitivity can reach 176.54 mV/dBm and the temperature resolution of the microwave radiometer can reach 0.4 K. Correction algorithm is designed to improve the accuracy of temperature measurement. After correction, the phase error is reduced from 40° to 1.4° and when temperature changes 0.1 °C, the voltage value changes obviously. Step-by-step calibration and overall calibration are used to calibrate the device. Inversion algorithm can determine the relationship between physical temperature and output voltage. The mean square error of water temperature inversion by multiple linear regression algorithm is 0.607 and that of BP neural network algorithm is 0.334. The inversion accuracy can be improved by reducing the temperature range. Our work provides a promising realization of accurate, rapid and non-contact detection device of human body temperature.


Assuntos
Temperatura Corporal , Micro-Ondas , Humanos , Radiometria , Temperatura , Termômetros
9.
Br J Nurs ; 30(5): 288-295, 2021 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-33733857

RESUMO

This article explores body temperature and the physiological process of thermoregulation. Normal body temperature and body temperature changes are discussed, including comorbidities associated with body temperature and signs of hyperthermia and hypothermia, and the factors that affect intraoperative temperature regulation. The evidence base behind thermometry is discussed and is applied to contemporary clinical conditions and symptoms, including: sepsis and suspected COVID-19. After discussing clinical considerations and regulations that encompass thermometry, three case studies present the use of the Genius 3 Tympanic Thermometer in clinical practice, with user feedback supporting its benefits, which include speed, accuracy and ease of use.


Assuntos
Temperatura Corporal/fisiologia , Termômetros , Membrana Timpânica/fisiologia , /diagnóstico , Terapias Complementares , Cuidados Críticos , Humanos , Monitorização Fisiológica/instrumentação , Reprodutibilidade dos Testes , Sepse/diagnóstico , Fatores de Tempo
10.
Artigo em Inglês | MEDLINE | ID: mdl-33530640

RESUMO

Thermography is widely used in the medical field, including in the detection of breast disorders. The aim of the research was to characterize the range of breast surface temperature values, taking into account the entire area of the mammary gland and, independently, the nipple, in healthy women. An additional aim was to assess the symmetry of the breast temperature distribution (using an IR camera) and the correlation of temperatures with the content of adipose tissue. Thermograms were made for the right and left breasts, each time delineating the area of the entire breast and a separate area of the nipple, chest, and abdomen. Analyzing the intergroup differences in temperature of selected body areas (Tmean), it was shown that, in all cases, they were significantly higher in younger women. Statistical analysis showed no significant differences between breast and nipple temperatures in relation to the body sides. The highest temperatures within the mammary gland were recorded for the nipple area. The use of the high-resolution digital infrared thermal imaging method in early and screening preventive diagnoses of changes in the mammary gland requires individual interpretation of the results, taking into account the assessment of the physiological pattern of temperature distribution in both breasts.


Assuntos
Neoplasias da Mama , Termografia , Temperatura Corporal , Mama , Feminino , Humanos , Temperatura
11.
Am J Hum Genet ; 108(3): 446-457, 2021 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-33600773

RESUMO

The protein α-actinin-3 expressed in fast-twitch skeletal muscle fiber is absent in 1.5 billion people worldwide due to homozygosity for a nonsense polymorphism in ACTN3 (R577X). The prevalence of the 577X allele increased as modern humans moved to colder climates, suggesting a link between α-actinin-3 deficiency and improved cold tolerance. Here, we show that humans lacking α-actinin-3 (XX) are superior in maintaining core body temperature during cold-water immersion due to changes in skeletal muscle thermogenesis. Muscles of XX individuals displayed a shift toward more slow-twitch isoforms of myosin heavy chain (MyHC) and sarcoplasmic reticulum (SR) proteins, accompanied by altered neuronal muscle activation resulting in increased tone rather than overt shivering. Experiments on Actn3 knockout mice showed no alterations in brown adipose tissue (BAT) properties that could explain the improved cold tolerance in XX individuals. Thus, this study provides a mechanism for the positive selection of the ACTN3 X-allele in cold climates and supports a key thermogenic role of skeletal muscle during cold exposure in humans.


Assuntos
Actinina/genética , Termogênese/genética , Tecido Adiposo Marrom/metabolismo , Animais , Temperatura Corporal/genética , Códon sem Sentido/genética , Evolução Molecular , Humanos , Masculino , Camundongos , Camundongos Knockout , Músculo Esquelético/metabolismo , Seleção Genética/genética
12.
J Wildl Dis ; 57(1): 238-241, 2021 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-33635981

RESUMO

The global SARS-CoV-2 pandemic and the role of bats in zoonotic spillover have renewed interest in the flight-as-fever hypothesis, which posits that high body temperatures experienced by bats during flight contribute to their high viral tolerance. We argue that flight-as-fever is unlikely to explain why bats harbor more viruses than other mammals on the basis of two lines of reasoning. First, flight temperatures reported in the literature overestimate true flight temperatures because of methodologic limitations. Second, body temperatures in bats are only high relative to humans, and not relative to many other mammals. We provide examples of mammals from diverse habitats to show that temperatures in excess of 40 C during activity are quite common in species with lower viral diversity than bats. We caution scientists against stating the flight-as-fever hypothesis as unquestioned truth, as has repeatedly occurred in the popular media in the wake of the SARS-CoV-2 pandemic.


Assuntos
Temperatura Corporal/fisiologia , Quirópteros/fisiologia , Quirópteros/virologia , /fisiologia , Animais , Portador Sadio/veterinária , Portador Sadio/virologia , Reservatórios de Doenças/virologia , Voo Animal/fisiologia , Zoonoses
13.
Int J Mol Sci ; 22(3)2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33530581

RESUMO

Many studies have shown both the CD28-D80/86 costimulatory pathway and the PD-1-PD-L1/L2 coinhibitory pathway to be important signals in modulating or decreasing the inflammatory profile in ischemia-reperfusion injury (IRI) or in a solid organ transplant setting. The importance of these two opposing pathways and their potential synergistic effect led our group to design a human fusion recombinant protein with CTLA4 and PD-L2 domains named HYBRI. The objective of our study was to determine the HYBRI binding to the postulated ligands of CTLA4 (CD80) and PD-L2 (PD-1) using the Surface Plasmon Resonance technique and to evaluate the in vivo HYBRI effects on two representative kidney inflammatory models-rat renal IRI and allogeneic kidney transplant. The Surface Plasmon Resonance assay demonstrated the avidity and binding of HYBRI to its targets. HYBRI treatment in the models exerted a high functional and morphological improvement. HYBRI produced a significant amelioration of renal function on day one and two after bilateral warm ischemia and on days seven and nine after transplant, clearly prolonging the animal survival in a life-sustaining renal allograft model. In both models, a significant reduction in histological damage and CD3 and CD68 infiltrating cells was observed. HYBRI decreased the circulating inflammatory cytokines and enriched the FoxP3 peripheral circulating, apart from reducing renal inflammation. In conclusion, the dual and opposite costimulatory targeting with that novel protein offers a good microenvironment profile to protect the ischemic process in the kidney and to prevent the kidney rejection, increasing the animal's chances of survival. HYBRI largely prevents the progression of inflammation in these rat models.


Assuntos
Rejeição de Enxerto/prevenção & controle , Transplante de Rim , Proteínas Recombinantes de Fusão/farmacologia , Traumatismo por Reperfusão/prevenção & controle , Transdução de Sinais/efeitos dos fármacos , Imunidade Adaptativa/efeitos dos fármacos , Aloenxertos , Animais , Biomarcadores , Temperatura Corporal , Modelos Animais de Doenças , Sobrevivência de Enxerto/efeitos dos fármacos , /metabolismo , Imunidade Inata/efeitos dos fármacos , Imuno-Histoquímica , Imunomodulação/efeitos dos fármacos , Testes de Função Renal , Transplante de Rim/efeitos adversos , Camundongos , Ratos
14.
Nurs Res ; 70(2): 142-149, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33630537

RESUMO

BACKGROUND: Neonatal sepsis causes morbidity and mortality in preterm infants. Clinicians need a predictive tool for the onset of neonatal infection to expedite treatment and prevent morbidity. Abnormal thermal gradients, a central-peripheral temperature difference (CPtd) of >2°C or <0°C, and elevated heart rate characteristic (HRC) scores are associated with infection. OBJECTIVE: This article presents the protocol for the Predictive Analysis Using Temperature and Heart Rate Study. METHODS: This observational trial will enroll 440 very preterm infants to measure abdominal temperature and foot temperature every minute and HRC scores hourly for 28 days to compare infection data. Time with abnormal thermal gradients (Model 1) and elevated HRC scores (Model 2) will be compared to the onset of infections. For data analysis, CPtd (abdominal temperature - foot temperature) will be investigated as two derived variables, high CPtd (number/percentage of minutes with CPtd of >2°C) and low CPtd (number/percentage of minutes with CPtd of <0°C). In the infant-level model, the outcome yi will be an indicator of whether the infant was diagnosed with an infection in the first 28 days of life, and the high CPtd and low CPtd variables will be the average over the entire observation period, logit(yi) = ß0 + xiß1 + ziγ. For the day-level model, the outcome yit will be an indicator of whether the ith infant was diagnosed with an infection on the tth day from t = 4 through t = 28 or the day that infection is diagnosed (25 possible repeated measures), logit(yit) = ß0 + xitß1 + zitγ. It will be determined whether a model with only high CPtd or only low CPtd is superior in predicting infection. Also, the correlation of abnormal HRC scores with high CPtd and low CPtd values will be assessed. DISCUSSION: Study results will inform the design of an interventional study using temperatures and/or heart rate as a predictive tool to alert clinicians of cardiac and autonomic instability present with infection.


Assuntos
Temperatura Corporal/fisiologia , Lactente Extremamente Prematuro/fisiologia , Doenças do Prematuro/diagnóstico , Sepse Neonatal/diagnóstico , Ensaios Clínicos como Assunto , Humanos , Recém-Nascido , Doenças do Prematuro/prevenção & controle , Unidades de Terapia Intensiva Neonatal , Monitorização Fisiológica/métodos , Sepse Neonatal/prevenção & controle , Estudos Observacionais como Assunto , Equilíbrio Hidroeletrolítico/fisiologia
15.
Eur J Med Res ; 26(1): 20, 2021 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-33573699

RESUMO

BACKGROUND: Vitamin C is an essential water-soluble nutrient that functions as a key antioxidant and has been proven to be effective for boosting immunity. In this study, we aimed to assess the efficacy of adding high-dose intravenous vitamin C (HDIVC) to the regimens for patients with severe COVID-19 disease. METHODS: An open-label, randomized, and controlled trial was conducted on patients with severe COVID-19 infection. The case and control treatment groups each consisted of 30 patients. The control group received lopinavir/ritonavir and hydroxychloroquine and the case group received HDIVC (6 g daily) added to the same regimen. RESULTS: There were no statistically significant differences between two groups with respect to age and gender, laboratory results, and underlying diseases. The mean body temperature was significantly lower in the case group on the 3rd day of hospitalization (p = 0.001). Peripheral capillary oxygen saturations (SpO2) measured at the 3rd day of hospitalization was also higher in the case group receiving HDIVC (p = 0.014). The median length of hospitalization in the case group was significantly longer than the control group (8.5 days vs. 6.5 days) (p = 0.028). There was no significant difference in SpO2 levels at discharge time, the length of intensive care unit (ICU) stay, and mortality between the two groups. CONCLUSIONS: We did not find significantly better outcomes in the group who were treated with HDIVC in addition to the main treatment regimen at discharge. Trial registration irct.ir (IRCT20200411047025N1), April 14, 2020.


Assuntos
Antivirais/uso terapêutico , Ácido Ascórbico/administração & dosagem , /tratamento farmacológico , Antivirais/administração & dosagem , Ácido Ascórbico/uso terapêutico , Temperatura Corporal , Feminino , Humanos , Hidroxicloroquina/uso terapêutico , Unidades de Terapia Intensiva , Tempo de Internação , Lopinavir/uso terapêutico , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , /virologia , Ritonavir/uso terapêutico , Resultado do Tratamento
16.
Nat Commun ; 12(1): 814, 2021 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-33547300

RESUMO

On the basis of Covid-19-induced pulmonary pathological and vascular changes, we hypothesize that the anti-vascular endothelial growth factor (VEGF) drug bevacizumab might be beneficial for treating Covid-19 patients. From Feb 15 to April 5, 2020, we conducted a single-arm trial (NCT04275414) and recruited 26 patients from 2-centers (China and Italy) with severe Covid-19, with respiratory rate ≥30 times/min, oxygen saturation ≤93% with ambient air, or partial arterial oxygen pressure to fraction of inspiration O2 ratio (PaO2/FiO2) >100 mmHg and ≤300 mmHg, and diffuse pneumonia confirmed by chest imaging. Followed up for 28 days. Among these, bevacizumab plus standard care markedly improves the PaO2/FiO2 ratios at days 1 and 7. By day 28, 24 (92%) patients show improvement in oxygen-support status, 17 (65%) patients are discharged, and none show worsen oxygen-support status nor die. Significant reduction of lesion areas/ratios are shown in chest computed tomography (CT) or X-ray within 7 days. Of 14 patients with fever, body temperature normalizes within 72 h in 13 (93%) patients. Relative to comparable controls, bevacizumab shows clinical efficacy by improving oxygenation and shortening oxygen-support duration. Our findings suggest bevacizumab plus standard care is highly beneficial for patients with severe Covid-19. Randomized controlled trial is warranted.


Assuntos
Bevacizumab/uso terapêutico , /efeitos dos fármacos , Idoso , Inibidores da Angiogênese/uso terapêutico , Temperatura Corporal/efeitos dos fármacos , China , Feminino , Febre/prevenção & controle , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
17.
PLoS One ; 16(2): e0246312, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33534829

RESUMO

OBJECTIVE: Understanding mild to moderate symptoms of coronavirus disease 2019 (Covid-19) is important in order to identify active cases early and thus counteract transmission. METHODS: In March 2020, Leipzig University Hospital established an outpatient clinic for patients potentially infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Confirmed cases with mild to moderate symptoms self-isolated at home and were followed-up by daily telephone calls for at least 14 days. Symptoms and course of illness of these patients are reported here. RESULTS: From March 20 to April 17, 2020, 1460 individuals were tested for SARS-CoV-2 by naso- or oropharyngeal swab for real-time polymerase chain reaction (RT-PCR). Covid-19 was confirmed in 91 (6.2%) patients, of which 87 were included in the final analysis. Patients presented for testing after a mean of 5.9 days (IQR = 2.0-8.5). The median age was 37.0 years (IQR = 28.5-53), and 48 (55.2%) were female. Five (5.7%) patients required hospital admission during the course of illness. Most frequently reported symptoms were fatigue (n = 64, 74%), cough (n = 58, 67%), and hyposmia/hypogeusia (n = 44, 51%). In contrast to previous reports, fever occurred in less than a third of patients (n = 25, 29%). By day 14, more than half of the patients had recovered completely (n = 37/70, 52.9%). CONCLUSIONS: Fever seems to be less common in patients of relatively young age diagnosed with mild to moderate Covid-19. This suggests that body temperature alone may be an insufficient indicator of SARS-CoV-2 infection.


Assuntos
Temperatura Corporal , /diagnóstico , Adulto , /complicações , Tosse/etiologia , Fadiga/etiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Nasofaringe/virologia , Pacientes Ambulatoriais , RNA Viral/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , /isolamento & purificação
18.
PLoS One ; 16(2): e0245257, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33534845

RESUMO

Despite the increasing personalization of medicine, surprisingly ~37.0°C (98.6°F) continues as the estimate of normal temperature. We investigated between-subject and within-subject thermal variability, whether a significant percentage of individuals have a low mean oral temperature, and whether these differ by sex, age, time of day, ethnicity, body mass index (BMI), or menstrual phase. Oral temperature was measured by Life Brand® Fast-Read Digital Oral Thermometers and sampled 14 times over two weeks, seven morning and seven evening readings. The volunteer sample consisted of 96 adults (42 men, 54 women; 27 couples, 42 singletons), ages 18-67 years. We found sizeable individual differences in body temperature and that the normal temperature of many individuals is considerably lower than 37.0°C (98.6°F). Mean temperatures ranged from 35.2°C (95.4°F) to 37.4°C (99.3°F). The mean temperature across all participants was 36.1°C (97.0°F)-lower than most studies have reported, consistent with recent evidence of temperature declining over decades. 77% had mean temperatures at least 0.55°C (1°F) lower than 37.0°C (98.6°F). Mean temperature did not differ by age, but women had higher temperatures than men, even within a couple with room temperature and warmth of clothing equated. Although oral temperature varied widely across individuals, it showed marked stability within individuals over days. Variability of temperature over days did not differ by sex, but was larger among younger adults. Using 37.0°C (98.6°F) as the assumed normal temperature for everyone can result in healthcare professionals failing to detect a serious fever in individuals with a low normal temperature or obtaining false negatives for those individuals when using temperature to screen for COVID-19, mistaking their elevated temperature as normal. Some have called for lowering the estimate of normal temperature slightly (e.g., 0.2°C [0.36°F]). That still seems an overly high estimate. More important, using any standardized "normal" temperature will lead to errors for many people. Individual differences are simply too great. Personalizing body temperature is needed. Temperature could be measured at yearly doctor visits, as blood pressure is now. That would be simple to implement. Since our results show marked thermal stability within an individual, sampling temperature only once yearly could provide an accurate indication of a person's normal temperature at that time of day. Such records over time would also provide a more accurate understanding of how temperature changes over the lifespan.


Assuntos
Temperatura Corporal , Adolescente , Adulto , Fatores Etários , Idoso , /virologia , Feminino , Febre/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Adulto Jovem
19.
Nat Commun ; 12(1): 843, 2021 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-33594062

RESUMO

Adaptive thermogenesis is essential for survival, and therefore is tightly regulated by a central neural circuit. Here, we show that microRNA (miR)-33 in the brain is indispensable for adaptive thermogenesis. Cold stress increases miR-33 levels in the hypothalamus and miR-33-/- mice are unable to maintain body temperature in cold environments due to reduced sympathetic nerve activity and impaired brown adipose tissue (BAT) thermogenesis. Analysis of miR-33f/f dopamine-ß-hydroxylase (DBH)-Cre mice indicates the importance of miR-33 in Dbh-positive cells. Mechanistically, miR-33 deficiency upregulates gamma-aminobutyric acid (GABA)A receptor subunit genes such as Gabrb2 and Gabra4. Knock-down of these genes in Dbh-positive neurons rescues the impaired cold-induced thermogenesis in miR-33f/f DBH-Cre mice. Conversely, increased gene dosage of miR-33 in mice enhances thermogenesis. Thus, miR-33 in the brain contributes to maintenance of BAT thermogenesis and whole-body metabolism via enhanced sympathetic nerve tone through suppressing GABAergic inhibitory neurotransmission. This miR-33-mediated neural mechanism may serve as a physiological adaptive defense mechanism for several stresses including cold stress.


Assuntos
MicroRNAs/metabolismo , Sistema Nervoso Simpático/fisiologia , Termogênese/genética , Tecido Adiposo Marrom/fisiologia , Animais , Temperatura Corporal/fisiologia , Peso Corporal , Encéfalo/metabolismo , Linhagem Celular , Temperatura Baixa , Dieta Hiperlipídica , Estresse do Retículo Endoplasmático , Humanos , Integrases/metabolismo , Masculino , Camundongos , Camundongos Obesos , MicroRNAs/genética , Consumo de Oxigênio/fisiologia , Fenótipo , Subunidades Proteicas/genética , Subunidades Proteicas/metabolismo , Receptores de GABA-A/genética , Receptores de GABA-A/metabolismo
20.
Sci Rep ; 11(1): 4660, 2021 02 25.
Artigo em Inglês | MEDLINE | ID: mdl-33633250

RESUMO

Coronavirus SARS-COV-2 infections continue to spread across the world, yet effective large-scale disease detection and prediction remain limited. COVID Control: A Johns Hopkins University Study, is a novel syndromic surveillance approach, which collects body temperature and COVID-like illness (CLI) symptoms across the US using a smartphone app and applies spatio-temporal clustering techniques and cross-correlation analysis to create maps of abnormal symptomatology incidence that are made publicly available. The results of the cross-correlation analysis identify optimal temporal lags between symptoms and a range of COVID-19 outcomes, with new taste/smell loss showing the highest correlations. We also identified temporal clusters of change in taste/smell entries and confirmed COVID-19 incidence in Baltimore City and County. Further, we utilized an extended simulated dataset to showcase our analytics in Maryland. The resulting clusters can serve as indicators of emerging COVID-19 outbreaks, and support syndromic surveillance as an early warning system for disease prevention and control.


Assuntos
/epidemiologia , Aplicativos Móveis , Vigilância de Evento Sentinela , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ageusia/epidemiologia , Temperatura Corporal , Análise por Conglomerados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Smartphone , Estados Unidos/epidemiologia , Adulto Jovem
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