Development of novel antibodies to combat the novel SARS-CoV-2 virus is ongoing. Importantly, particular subgroups are more prone to severe disease, namely patients with poor immune responses. This ...includes cancer patients with solid and haematological disease, solid organ transplant (SOT) patients and those with congenital or acquired immunodeficiency. Outcomes for patients with poor immune responses receiving antibody therapy for underlying disease and SARS-CoV-2 severe infection are undergoing investigation. The objective of this study was to perform a search on patients with poor immune responses with severe SARS-CoV-2 infection, to assess if antibody therapy is beneficial in such populations. We performed searches using PubMED and medrXiv up to May 2021 of patients with solid and hematologic malignancy, SOT patients and acquired or congenital immunodeficiency. The primary outcome was to assess if antibody therapy was included during SARS-CoV-2 infection and the clinical outcomes of such treatment in this population. Here we find that there is a repurposing of monoclonal antibodies to target cytokine release syndrome, along with the use of convalescent plasma (CP). Despite CP demonstrating promising results, we reiterate evidence that CP forces mutational escape and subsequent variant development. Repurposing of antibody therapies (such as Tocilizumab) proved effective, especially in SOT patients. This also potentially opens an avenue for the use of anti-SARS-CoV-2 spike protein neutralizing monoclonal antibodies; however, studies have yet to focus on patients with poor immune responses as a subpopulation.
Ischemic heart disease (IHD) morbidity and mortality indices, along with medical intervention rates, were analyzed among Mediterranean countries, Croatia, Slovenia, Spain, Italy, and France, in the ...pre-COVID period. Standardized IHD incidence and prevalence rates from 1990 and mortality rates from 1985 were obtained from the Global Burden of Disease Study 2017 and Health for All databases. Coronary artery bypass graft (CABG) and transluminal coronary angioplasty (TCA) rates in the 2011–2019 period were obtained from Eurostat. Trends were estimated with Joinpoint regression analysis. IHD mortality rates range from 13.6 to 74.3 for females and from 37.8 to 126.03 for males. IHD mortality rates in Croatia were 5.6-fold higher among females and 3.3-fold higher among males compared to France. All countries decreased standardized IHD prevalence and incidence rates, although the magnitude varied. The high-to-low ratio, Croatia vs. Spain, was 3.5-fold for CABG and 3.2-fold for TCA. Slovenia, as opposed to Croatia, reduced the gap for all medical indicators except for relatively high prevalence rates. Despite a significant rise in medical interventions in Croatia, ineffective clinical and public health initiatives have led to only modest declines in IHD mortality rates over the past decade.
Rak dojke najčešća je novotvorina i peti uzrok smrti žena. Etiologija i patogeneza ovoga zloćudnog tumora su multifaktorske. Pojava neoplazma u primatelja solidnih organa liječenih imunosupresivnim ...lijekovima je 2 do 3 puta veća nego u općoj populaciji. U rizičnoj populaciji su i žene s presađenim bubregom. Cilj ovoga pregleda literature je istražiti povezanost pojavnosti karcinoma dojke u primatelja bubrežnog presatka i imunosupresivnih režima, opisati njihovu ulogu u tom procesu te istražiti trenutne preporuke probira za rano otkrivanje karcinoma dojke u toj populaciji. Kako bismo pristupili potrebnoj literaturi koristili smo bazu podataka PubMed-a. MeSH pojmovi uporabljeni za pretragu baze literature su bili: “breast cancer”; “risk factors”; “cancer screening”; “kidney transplantation”; “immunosuppression” i “cancer”. Nakon primjene kriterija isključenja ukupno je pregledano 409 članaka. Članci su uključivali randomizirana kontrolna istraživanja, preglede i sustavne preglede literature. Uporabljene su i reference s drugih pregleda literature kako bi se pribavile dodatne relevantne informacije koje potencijalno nisu bile dohvaćene pri inicijalnoj pretrazi. Karcinom dojke najdijagnosticiraniji je karcinom i ujedno peti vodeći uzrok smrti žena u svijetu. Karcinom dojke je na trećem mjestu liste malignih uzročnika smrti, odmah iza karcinoma pluća i kolorektalnog karcinoma. Karcinom dojke je uzrokovan kombinacijom hormonskih i genetskih
čimbenika te čimbenika vezanih uz starenje. Značajan čimbenik procesa kancerogeneze je imunosupresija, što potvrđuje dva do tri puta češća pojavnost malignih bolesti u populaciji primatelja transplantiranih organa. Kronična imunosupresivna terapija, okolišni čimbenici (izlaganje sunčevu zračenju) i genetički zapisi pojedinaca utječu na proces razvoja malignih bolesti u primatelja transplantiranih organa. Imunosupresivni lijekovi smanjuju imuni nadzor, što pospješuje proces virusne onkogeneze te opće karcinogeneze. Primatelji bubrežnog presatka skloniji su razvoju karcinoma upravo zbog doživotne imunosupresivne terapije pa je karcinom drugi uzročnik smrtnosti kod te populacije. Od iznimne važnosti je spomenuti da razlike u procijenjenom riziku razvoja karcinoma ovise upravo o vrsti karcinoma. Pokazalo se da imunosupresija ne utječe na određene maligne bolesti poput karcinoma dojke, jer je njihov relativni rizik usporediv s onim u općoj populaciji. Zbog ograničenog broja radova koji se bave tematikom karcinoma dojke nakon transplantacije bubrega ovom prigodom predstavljamo sveobuhvatan pregled dosadašnje literature, trenutnog razumijevanja patofi ziologije bolesti, uloge probira u- njenoj dijagnozi i liječenju. Opsežnim pregledom literature došli smo do zaključka da rizik razvoja karcinoma dojke nakon transplantacije u primatelja bubrežnog presatka nije povećan u usporedbi s općom populacijom. Iz pregledanih radova proizlazi zaključak da razvoj karcinoma dojke u primatelja bubrežnog presatka nije povezan s post-transplantacijskim imunosupresivnim režimom te je uglavnom povezan sa starenjem i neovisnim čimbenicima rizika koji sami po sebi mogu dovesti do transplantacije bubrega, kao što je dijabetes melitus. Zbog programa probira za rano otkrivanje karcinoma post-transplantacijski karcinom dojke obično se dijagnosticira rano. Međutim, ako ga se dijagnosticira u uznapredovalim
stadijima povezan je sa značajno lošijim ishodom i povećanom razinom smrtnosti u usporedbi s općom populacijom. Preporuka je da se probir bolesnika provodi zajedno s općom populacijom koja odgovara dobi i spolu bolesnika s presatkom, uz naglasak na individualni pristup svakom bolesniku. Iznimno je važno napomenuti da je ovo područje medicine koje zahtijeva daljnje istraživanje. Zbog rijetkosti post-transplantacijskog karcinoma dojke i oskudnih resursa na tu tematiku većina smjernica ekstrapolirana je iz opće populacije i ne odgovara minimalnom riziku od razvoja te bolesti. Slično tome, smjernice za liječenje izvedene su iz podataka opće populacije i ne uzimaju u obzir posebna razmatranja kod populacije pacijenata s bubrežnim presatkom kao: održavanje funkcionalnog presatka, odbacivanje presatka, nefrotoksične kemoterapijske lijekove i istodobnu primjenu imunosupresivnih lijekova. Potrebno je spomenuti da je heterogenost rezultata o kojima se raspravlja u našem pregledu literature posljedica različitih vrsta imunosupresivnih režima, transplantiranih organa, pridruženih bolesti, duljine praćenja bolesnika i programa probira. Kako bi se defi nirale jasne smjernice prilagođene ovoj populaciji, potrebno je daljnje istraživanje mehanizama nastanka bolesti, uz produljeno vrijeme praćenja pacijenata na različitim imunosupresivnim režimima kako bi se omogućila naknadna usporedba.
Salt is crucial for human health, but it`s excess is associated with the development of many diseases including arterial hypertension which is a major feature of hypertensive pregnancy disorders ...(HPDs). Maternal nutrition during pregnancy can affect cardiometabolic disease development during pregnancy and later in life, but it can also affect fetal growth and disease development in adulthood. Recent studies suggest that excessive salt intake often combined with low potassium intake throughout pregnancy, can suppress renin-angiotensin-aldosterone system (RAAS) with adverse effects on fetoplacental development and can increase the risk of HPDs. Although salt restriction has been considered potentially harmful in the non-pharmacological treatment of arterial hypertension in pregnancy and current guidelines do not recommend it during pregnancy to prevent HPDs, especially gestational hypertension and the development of preeclampsia, its role should be reconsidered in light of the recent evidence. However, one key question remains: How much salt, upper and lower limit of daily intake, in a balanced diet is not harmful in uncomplicated pregnancies as well as HPDs in general?
Rationale
The increasing demand to develop more efficient compounds to treat cognitive impairments in schizophrenia has led to the development of experimental model systems. One such model system ...combines the study of surrogate populations expressing high levels of schizotypy with oculomotor biomarkers.
Objectives
We aimed (1) to replicate oculomotor deficits in a psychometric schizotypy sample and (2) to investigate whether the expected deficits can be remedied by compounds shown to ameliorate impairments in schizophrenia.
Methods
In this randomized double-blind, placebo-controlled study 233 healthy participants performed prosaccade (PS), antisaccade (AS) and smooth pursuit eye movement (SPEM) tasks after being randomly assigned to one of four drug groups (nicotine, risperidone, amisulpride, placebo). Participants were classified into medium- and high-schizotypy groups based on their scores on the Schizotypal Personality Questionnaire (SPQ, Raine (Schizophr Bull 17:555–564,
1991
)).
Results
AS error rate showed a main effect of Drug (
p
< 0.01), with nicotine improving performance, and a Drug by Schizotypy interaction (
p
= 0.04), indicating higher error rates in medium schizotypes (
p
= 0.01) but not high schizotypes under risperidone compared to placebo. High schizotypes had higher error rates than medium schizotypes under placebo (
p
= 0.03). There was a main effect of Drug for saccadic peak velocity and SPEM velocity gain (both
p
≤ 0.01) indicating impaired performance with risperidone.
Conclusions
We replicate the observation of AS impairments in high schizotypy under placebo and show that nicotine enhances performance irrespective of group status. Caution should be exerted in applying this model as no beneficial effects of antipsychotics were seen in high schizotypes.
PDF
