We report a confirmed case of Candidatus Neoehrlichia mikurensis infection in a woman in Spain who had a previous hematologic malignancy. Candidatus N. mikurensis infections should be especially ...suspected in immunocompromised patients who exhibit persistent fever and venous thrombosis, particularly if they live in environments where ticks are prevalent.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We evaluated whether the time between first respiratory support and intubation of patients receiving invasive mechanical ventilation (IMV) due to COVID-19 was associated with mortality or pulmonary ...sequelae.
Prospective cohort of critical COVID-19 patients on IMV. Patients were classified as early intubation if they were intubated within the first 48 h from the first respiratory support or delayed intubation if they were intubated later. Surviving patients were evaluated after hospital discharge.
We included 205 patients (140 with early IMV and 65 with delayed IMV). The median p
;p
age was 63 56.0; 70.0 years, and 74.1% were male. The survival analysis showed a significant increase in the risk of mortality in the delayed group with an adjusted hazard ratio (HR) of 2.45 (95% CI 1.29-4.65). The continuous predictor time to IMV showed a nonlinear association with the risk of in-hospital mortality. A multivariate mortality model showed that delay of IMV was a factor associated with mortality (HR of 2.40; 95% CI 1.42-4.1). During follow-up, patients in the delayed group showed a worse DLCO (mean difference of - 10.77 (95% CI - 18.40 to - 3.15), with a greater number of affected lobes (+ 1.51 95% CI 0.89-2.13) and a greater TSS (+ 4.35 95% CI 2.41-6.27) in the chest CT scan.
Among critically ill patients with COVID-19 who required IMV, the delay in intubation from the first respiratory support was associated with an increase in hospital mortality and worse pulmonary sequelae during follow-up.
La escuela se configura como un espacio para acciones de paz, vinculadas a las situaciones cotidianas que viven las niñas y los niños de la primera infancia; en este sentido, el objetivo general de ...este artículo de investigación apuntó a comprender el papel del potencial de la memoria y de la socialización política, para la reconfiguración de las formas de relacionamiento de las niñas y los niños para la construcción de paz en Centros de Desarrollo Infantil (cdi) e instituciones educativas en Bogotá, Apartadó y Manizales. Metodológicamente se trabajó desde un enfoque mixto: en términos cuantitativos se creó un instrumento ad hoc para medir, a través de múltiples variables e indicadores, la incidencia de estos potenciales; en términos cualitativos, se analizaron los relatos de las niñas y los niños. A modo de conclusión, la escuela es un espacio para la construcción de paz, desde el cual se tejen formas de relacionamiento con otras personas y con sus contextos. Los recuerdos permiten la reconfiguración del presente, y la escuela es uno de los escenarios para que dicha configuración se potencie. La paz se construye en la vida cotidiana en la escuela, donde las prácticas de participación y escucha posibilitan que las niñas y los niños sean constructores de la convivencia y el buen vivir.
Up to 80% of patients surviving acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 infection present persistent anomalies in pulmonary function after hospital discharge. There is a ...limited understanding of the mechanistic pathways linked to post-acute pulmonary sequelae.
To identify the molecular underpinnings associated with severe lung diffusion involvement in survivors of SARS-CoV-2-induced ARDS.
Survivors attended to a complete pulmonary evaluation 3 months after hospital discharge. RNA sequencing (RNA-seq) was performed using Illumina technology in whole-blood samples from 50 patients with moderate to severe diffusion impairment (DLCO<60%) and age- and sex-matched individuals with mild-normal lung function (DLCO≥60%). A transcriptomic signature for optimal classification was constructed using random forest. Transcriptomic data were analyzed for biological pathway enrichment, cellular deconvolution, cell/tissue-specific gene expression and candidate drugs.
RNA-seq identified 1357 differentially expressed transcripts. A model composed of 14 mRNAs allowed the optimal discrimination of survivors with severe diffusion impairment (AUC=0.979). Hallmarks of lung sequelae involved cell death signaling, cytoskeleton reorganization, cell growth and differentiation and the immune response. Resting natural killer (NK) cells were the most important immune cell subtype for the prediction of severe diffusion impairment. Components of the signature correlated with neutrophil, lymphocyte and monocyte counts. A variable expression profile of the transcripts was observed in lung cell subtypes and bodily tissues. One upregulated gene, TUBB4A, constitutes a target for FDA-approved drugs.
This work defines the transcriptional programme associated with post-acute pulmonary sequelae and provides novel insights for targeted interventions and biomarker development.
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•A distinct transcriptional program is associated with severe diffusion impairment.•Cell death and cytoskeletal architecture are implicated in pulmonary dysfunction.•TUBB4A emerges as a potential target to treat the respiratory functional sequelae.•A transcriptomic signature accurately identifies survivors with severe alterations.
More than 20% of hospitalized patients with COVID-19 demonstrate ARDS requiring ICU admission. The long-term respiratory sequelae in such patients remain unclear.
What are the major long-term ...pulmonary sequelae in critical patients who survive COVID-19?
Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated 3 months after hospitalization discharge. The follow-up comprised symptom and quality of life, anxiety and depression questionnaires, pulmonary function tests, exercise test (6-min walking test 6MWT), and chest CT imaging.
One hundred twenty-five patients admitted to the ICU with ARDS secondary to COVID-19 were recruited between March and June 2020. At the 3-month follow-up, 62 patients were available for pulmonary evaluation. The most frequent symptoms were dyspnea (46.7%) and cough (34.4%). Eighty-two percent of patients showed a lung diffusing capacity of less than 80%. The median distance in the 6MWT was 400 m (interquartile range, 362-440 m). CT scans showed abnormal results in 70.2% of patients, demonstrating reticular lesions in 49.1% and fibrotic patterns in 21.1%. Patients with more severe alterations on chest CT scan showed worse pulmonary function and presented more degrees of desaturation in the 6MWT. Factors associated with the severity of lung damage on chest CT scan were age and length of invasive mechanical ventilation during the ICU stay.
Three months after hospital discharge, pulmonary structural abnormalities and functional impairment are highly prevalent in patients with ARDS secondary to COVID-19 who required an ICU stay. Pulmonary evaluation should be considered for all critical COVID-19 survivors 3 months after discharge.
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The aim of this paper was to analyze the predictive effect of coping strategies on the risk for suicidal ideation and behavior in 309 adolescents between 11 and 18 years of age (M=13.51; SD=1.9). ...This was a quantitative study, with a cross-sectional-correlational design. The Suicide Orientation Scale (Iso-30) and the Coping Strategies Inventory (CSI) were used. Findings suggest that 12.9% of the sample reported high risk of suicide. Adolescents at low risk of suicide, compared with those reporting moderate and severe risk, had higher scores on problem solving, cognitive restructuring, social support, emotional expression, and problem avoidance, and lower scores on desiderative thinking, social withdrawal, and self-criticism. Suicidal ideation and behavior were found to correlate negatively with problem solving, cognitive restructuring, social support, emotional expression, problem avoidance, and positively with desiderative thinking, social withdrawal and self-criticism. Multinomial logistic regression analysis showed that coping strategies explained between 46 % and 56 % of the variance of the risk of suicidal ideation and behavior. Social withdrawal and self-criticism strategies contributed significant effects that increased the probability of high suicide risk. These findings can be used to help guide suicide prevention and intervention strategies in school settings.
There is a limited understanding of the pathophysiology of postacute pulmonary sequelae in severe COVID-19. The aim of current study was to define the circulating microRNA (miRNA) profiles associated ...with pulmonary function and radiologic features in survivors of SARS-CoV-2-induced ARDS. The study included patients who developed ARDS secondary to SARS-CoV-2 infection (n = 167) and a group of infected patients who did not develop ARDS (n = 33). Patients were evaluated 3 months after hospital discharge. The follow-up included a complete pulmonary evaluation and chest computed tomography. Plasma miRNA profiling was performed using RT-qPCR. Random forest was used to construct miRNA signatures associated with lung diffusing capacity for carbon monoxide (D
LCO
) and total severity score (TSS). Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses were conducted. D
LCO
< 80% predicted was observed in 81.8% of the patients. TSS showed a median P
25
;P
75
of 5 2;8. The miRNA model associated with D
LCO
comprised miR-17-5p, miR-27a-3p, miR-126-3p, miR-146a-5p and miR-495-3p. Concerning radiologic features, a miRNA signature composed by miR-9-5p, miR-21-5p, miR-24-3p and miR-221-3p correlated with TSS values. These associations were not observed in the non-ARDS group. KEGG pathway and GO enrichment analyses provided evidence of molecular mechanisms related not only to profibrotic or anti-inflammatory states but also to cell death, immune response, hypoxia, vascularization, coagulation and viral infection. In conclusion, diffusing capacity and radiological features in survivors from SARS-CoV-2-induced ARDS are associated with specific miRNA profiles. These findings provide novel insights into the possible molecular pathways underlying the pathogenesis of pulmonary sequelae.
Trial registration:
ClinicalTrials.gov identifier: NCT04457505.
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Trial registration:
ISRCTN.org identifier: ISRCTN16865246.
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L. is a tropical tree that is used in traditional medicine around the world. The high content of flavonoid, alkaloid, acetogenin, phenolic and lipophilic compounds of this tropical tree forms the ...basis of its traditional medical uses. Our objective was to study soursop leaf extracts to support their use as antiviral therapies and investigate their protective effects against oxidative damage. The aqueous extract (AE) and acidified ethanolic extract (AEE) of soursop leaves were characterized by ultra performance liquid chromatography (UPLC), and their effects on human erythrocytes and in vitro antioxidant capacity, as evaluated by 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid (ABTS) assays, were investigated. The antiviral effects were evaluated using a bacteriophage surrogate. AEE showed the highest phenolic content, with rutin as the predominant compound. This extract showed higher values in the DPPH and ABTS assays, with 23.61 ± 0.42 and 24.91 ± 0.16 mmol of Trolox equivalent per gram, respectively. Inhibition of hemolysis was 34% and 51% for AE and AEE, respectively. AEE was selected for the antiviral study because of its higher antioxidant activity. The viral reduction ranged from 5-6 log10 plaque-forming units/volume (PFU) at contact times of 15-360 min. Soursop leaves have a positive effect on reducing oxidative stress in human erythrocytes and viral infections.
A few studies showed that both adherence to Mediterranean diet (MedDiet) and physical activity practice have a positive impact on pulmonary function in subjects with lung disease. These associations ...are not well studied in subjects free from lung disease. In a cross-sectional study conducted in 3020 middle-aged subjects free of lung disease, adherence to the MedDiet using the Mediterranean Diet Adherence Screener, and physical activity practice using the International Physical Activity Questionnaire short form were recorded. Respiratory function was assessed using forced spirometry and the results were evaluated according to the Global initiative for Chronic Obstructive Lung Disease. Logistic regression models were used to analyze the associations between adherence to the MedDiet and physical activity practice with the presence of ventilatory defects. Participants with a high adherence to MedDiet, in comparison to those with low adherence, had both higher forced vital capacity (FVC; 100 (87⁻109) vs. 94 (82⁻105) % of predicted,
= 0.003) and forced expired volume in the first second (FEV1; 100 (89⁻112) vs. 93 (80⁻107) % of predicted,
< 0.001). According to their degree of physical activity, those subjects with a high adherence also had both higher FVC (100 (88⁻107) vs. 94 (83⁻105) % of predicted,
= 0.027) and FEV1 (100 (89⁻110) vs. 95 (84⁻108) % of predicted,
= 0.047) in comparison with those with low adherence. The multivariable logistic regression models showed a significant and independent association between both low adherence to MedDiet and low physical activity practice, and the presence of altered pulmonary patterns, with differences between men and women. However, no joint effect between adherence to MedDiet and physical activity practice on respiratory function values was observed. Low adherence to MedDiet and low physical activity practice were independently associated with pulmonary impairment. Therefore, the lung mechanics seem to benefit from heart-healthy lifestyle behaviors.
Objetivo: Evaluar el estado nutricional de estudiantes universitarios con proponer las recomendaciones adecuadas de alimentación.
Materiales y Métodos: Los alumnos participantes fueron evaluados ...mediante un estudio transversal, se diseñaron y aplicaron encuestas con la finalidad de obtener información relacionados con hábitos alimenticios y sintomatología; la evaluación antropométrica y la toma de muestras sanguíneas para la realización de hemograma se realizaron bajo la normatividad ética estandarizada. Para el análisis estadístico de los datos se aplicó un modelo de regresión logística multifactorial utilizando para ello el programa EPI INFOTM. Adicionalmente, se realizó una revisión de la literatura en base de datos en relación a los nutrientes adecuados y recomendados para prevenir la COVID-19.
Resultados : Se evaluó un grupo de 42 estudiantes universitarios (n=42) cuya edad oscila entre 18 y 22 años de edad. Más del 95% de los jóvenes declararon consumir carbohidratos como su mayor fuente de alimento; por otro lado, el 76% mostraron un IMC dentro de los parámetros normales (19-24.9 Kg/m2). Se estimaron recuentos bajos de hemoglobina con una prevalencia del 11.90% entre el grupo participante.
Conclusiones: La alimentación sigue siendo la clave para la salud y el bienestar del ser humano. Para mejorar el sistema inmunitario se recomienda el consumo de alimentos naturales, en lugar de alimentos con alto contenido de azucares, harinas y grasas. Dentro de los alimentos con mayor potencial para la prevención de la COVID-19 se encuentran los frutos secos, los huevos, el pescado, los vegetales de hoja verde y los granos enteros. El consumo de fitoquímicos y nutracéuticos puede prevenir e incluso tratar la infección por SARS- CoV-2.
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