Severe COVID-19 elicits a hyperimmune response frequently amenable to steroids, which in turn increase the risk for opportunistic infections. COVID-19 associated pulmonary aspergillosis (CAPA) is a ...complication known to be associated with immunomodulatory treatment. The role of cumulative steroid dose in the development of CAPA is unclear. This study evaluates the relationship between cumulative steroid dose in hospitalized individuals with COVID-19 pneumonia and the risk for CAPA.
This retrospective cohort study includes 135 hospitalized patients with PCR-confirmed COVID-19 pneumonia at a tertiary centre in north Mexico. Patients who developed CAPA were matched by age and gender to two controls with COVID-19 pneumonia who did not develop CAPA defined and classified as possible, probable, or proven according to 2020 ECMM/ISHAM criteria. Cumulative steroid dose in dexamethasone equivalents was obtained from admission until death, discharge, or diagnosis of CAPA (whichever occurred first). The risk of CAPA by the continuous cumulative steroid dose was assessed using a logistic regression model.
Forty-five patients were diagnosed with CAPA and matched to 90 controls. Mean age was 61 ± 14 years, and 72% were male. Mean cumulative steroid dose was 66 ± 75 mg in patients without CAPA vs 195 ± 226 mg in patients with CAPA (P<0.001). The risk for CAPA increased with higher cumulative dose of steroids (OR 1.0075, 95% CI: 1.0033–1.0116).
Patients who developed CAPA had a history of higher cumulative steroid dose during hospitalization. The risk for CAPA increases ∼8% for every 10 mg of dexamethasone used.
In this paper, the bioreduction of Au(III) to Au(0) using biomass of the brown alga
Fucus vesiculosus was investigated. The recovery and reduction process took place in two stages with an optimum pH ...range of 4–9 with a maximum uptake obtained at pH 7. In the first stage, an induction period previous to gold reduction, the variation of pH, redox potential and gold concentration in solution was practically negligible and no color change was observed. In the second stage, the gold reduction was followed by a sharp decrease of gold concentration, pH and redox potential of solution and a color change from yellow to reddish purple. Hydroxyl groups present in the algal polysaccharides were involved in the gold bioreduction. Metallic gold was detected as microprecipitates on the biomass surface and in colloidal form as nanoparticles in the solution. Bioreduction with
F. vesiculosus could be an alternative and environmentally friendly process that can be used for recovering gold from dilute hydrometallurgical solutions and leachates of electronic scraps, and for the synthesis of gold nanoparticles of different size and shape.
This paper determines the effect of immobilized brown alga
Fucus vesiculosus in the biosorption of heavy metals with alginate xerogels. Immobilization increased the kinetic uptakes and intraparticle ...diffusion rates of the three metals. The Langmuir maximum biosorption capacity increased twofold for cadmium, 10 times for lead, and decreased by half for copper. According to this model, the affinity of the metals for the biomass was as follows: Cu
>
Pb
>
Cd without alga and Pb
>
Cu
>
Cd with alga. FITR confirmed that carboxyl groups were the main groups involved in the metal uptake. Calcium in the gels was displaced by heavy metals from solution according to the “egg-box” model. The restructured gel matrix became more uniform and organized as shown by scanning electron microscopy (SEM) characterization.
F. vesiculosus immobilized in alginate xerogels constitutes an excellent biosorbent for cadmium, lead and copper, sometimes surpassing the biosorption performance of alginate alone and even the free alga.
In the present work a novel pyrazole based chitosan Schiff base material was prepared using 5-azido-3-methyl-1-phenyl-1H-pyrazole-4-carbaldehyde and functionalized using Fe3O4-MoS2, where the ...nanoparticles get embedded within the gel matrix. The composite material was characterized using various techniques such as XRD, SEM, FTIR, EDS and TGA. The adsorbent material was analysed for the adsorptive take up process from the aqueous solutions of metal ion concentration ranging 20–100 mgL−1. The maximum adsorption capacity obtained for the material was 200.00 and 125.00 mg/g for Cr(VI) and Cu(II) respectively. Adsorptive mechanism was found to have pseudo second order kinetics and the adsorption isotherm followed Langmuir adsorption model following the monolayer adsorptive process. Further the evaluated thermodynamic parameter showed the adsorption process to be spontaneous and endothermic in nature. Reusability of the composite material was achieved using suitable stripping solutions.
The recovery of cadmium, lead and copper with the brown alga
Fucus vesiculosus was characterized and quantified. The biosorption data fitted the pseudo-second order and Langmuir isotherm models, but ...did not adjust to the intraparticle diffusion model. The metal uptakes deduced from the pseudo-second order kinetic model and the Langmuir isotherm model followed a similar sequence: Cu
>
Cd
≈
Pb. The Langmuir maximum metal uptakes were: 0.9626
mmol/g, Pb 1.02
mmol/g, and Cu 1.66
mmol/g. According to the equilibrium constants of this isotherm model, the affinity of metals for the biomass followed this order: Pb
>
Cu
>
Cd. Biosorption was accomplished by ion exchange between metals in solution and algal protons, calcium and other light metals, and by complexation of the adsorbed metals with algal carboxyl groups. FTIR spectra showed a shift in the bands of carboxyl, hydroxyl and sulfonate groups.
Abstract Aim To determine the effect of the type of mutation in low-density lipoprotein receptor gene and the risk factors associated with the development of premature cardiovascular disease (PCVD) ...in a large cohort of heterozygous familial hypercholesterolemia (hFH) subjects with genetic diagnosis in Spain. Methods and results A cross-sectional study was conducted on 811 non-related FH patients (mean age 47.1 ± 14 years, 383 males and 428 females) with a molecular defect in the low-density lipoprotein receptor ( LDLR ) gene from the Spanish National FH Register. Prevalence of PCVD was 21.9% (30.2% in males and 14.5% in women, P < 0.001). Mean age of onset of cardiovascular event was 42.1 years in males and 50.8 years in females. Of those patients with PCVD, 59.5% of males and 27% of females suffered a second cardiovascular (CV) event. In multivariate analysis male gender, age, tobacco consumption (ever), and total cholesterol/HDL-cholesterol (TC/HDL-C) ratio were significantly associated with PCVD. Two hundred and twenty different mutations were found with a large heterogeneity. Patients carrying null-mutations had significantly higher frequency of PCVD and recurrence of CV events. No relationship with Lp(a) levels and genotype of Apo E were found. Conclusions This study confirms the importance of identifying some classic risk factors such as smoking and TC/HDL-C ratio, and also the type of mutation in LDLR gene in order to implement early detection and intensive treatment for the prevention of cardiovascular disease in FH patients.
The present work reports the feasibility of using sugar-beet pectin gels for the removal of heavy metals from aqueous solutions. Sugar-beet pectin hydro- and xerogels were tested in the batch ...biosorption and desorption of cadmium, lead and copper. Pectins were successfully extracted and demethylated from the sugar-beet pulp, an agricultural residue, and gelled in the presence of CaCl
2. The stability of the hydro- and xerogel pectin beads made them suitable for biosorption of heavy metals in different conditions. Biosorption data were fitted to the pseudo-second order kinetic model and the Langmuir isotherm model, obtaining the corresponding parameters. Treated and untreated beads were characterized using FTIR and SEM to determine possible binding mechanisms. The main mechanisms involved were ion exchange with calcium of gel structure and chelation or complexation with carboxyl groups. After biosorption, calcium in the gels was substituted by metal cations reorganizing the structure of the gel matrix in a way that was visible using scanning electron microscopy. HNO
3 0.1
M was the best eluant for the reutilization of the gels and recovered all the adsorbed metal unlike HCl and H
2SO
4. Sugar-beet pectins could be used as an efficient biosorbent for the treatment and recovery of Cu, Pb and Cd from wastewater.
Calcium alginate beads were investigated for their biosorption performance in the removal of gold and silver from aqueous solutions. It was found that uptake capacities were significantly affected by ...the solution pH, with optimum pH values of 2 and 4 for gold and silver, respectively. Kinetic and isotherm experiments were carried out at the optimum pH. The maximum uptake capacities were 290 mg/g for Au and 52 mg/g for Ag. FTIR analysis indicated that both carboxylic and hydroxylic functional groups in alginate beads are involved in the metal binding and later reduction of gold (+3) and silver (+1) to gold (0) and silver (0). SEM and X-ray diffraction confirmed the formation of gold and silver nanoparticles.
Objective
To offer a practical guide for the presurgical and anesthetic management of pheochromocytomas and sympathetic paragangliomas (PGLs).
Methods
This protocol was based on a comprehensive ...review of the literature and on our own multidisciplinary team’s experience from managing pheochromocytoma and sympathetic PGLs at a referral center.
Results
Patients with pheochromocytomas and sympathetic paragangliomas (PGLs) may develop potentially life-threatening complications, especially during surgical procedures. A complete biochemical, radiological, genetic, and cardiological assessment is recommended in the preoperative stage as it provides an evaluation of the risk of surgical complications and malignancy, allowing individualization of the presurgical treatment. Treatment with α-blockade and proper volume expansion in the preoperative stage significantly reduces the perioperative morbidity. During surgery, the anesthesiologist should look for a deep anesthetic level that inhibits the cardiovascular effects of catecholamines to minimize the risk of intraoperative complications.
Conclusions
An optimal presurgical evaluation of pheochromocytomas/ sympathetic PGL requires a multidisciplinary approach, including a complete hormonal, radiological, cardiac, genetic, and functioning evaluation in most cases. A proper preoperative evaluation in combination with strict blood pressure and heart rate control, and blood volume status optimization, will significantly reduce the risk of intraoperative and perioperative complications. In those patients who unfortunately develop intraoperative complications, the role of the anesthesiologist is essential since the selection of the appropriate management has a direct impact on morbimortality reduction.
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