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Probability of acute heart failure in chronic kidney disease

Rev Med Inst Mex Seguro Soc. 2021 Aug 2;59(4):322-329.

ABSTRACT

BACKGROUND: In Mexico 130,000 people live with chronic kidney disease (CKD). Heart conditions are the most frequent clinical problems; 45% of the deaths of patients in replacement therapy have a cardiac origin.

OBJECTIVE: To identify the probability of presenting acute heart failure (AHF) in patients with CKD in the Adult Emergency Department (AED) of a second-level hospital.

MATERIAL AND METHODS: Case-control study with 111 cases and 103 controls. Cases were defined as patients with CKD admitted to AED for AHF compared with controls: patients with CKD who were admitted for a different diagnosis. Binary logistic regression was performed and odds ratio (OR) and 95% confidence intervals (95% CI) were determined. A value of p ˂ 0.05 was considered significant.

RESULTS: Arterial hypertension (OR 7.12, 95% CI 2.3-22.06, p = 0.01), the use of 3 or more antihypertensive drugs (OR 2.903, 95% CI 1.19-7.11, p = 0.02), the use of inhibitors of angiotensin converting enzyme (ACE inhibitors) (OR 4.25, 95% CI 1.78-10.09, p = 0.01), angiotensin II receptor blockers (ARBs) (OR 2.41, 95% CI 1.19-4.89, p = 0.014), diuretics (OR 42.87, 95% CI 9.02-203.63, p = 0.00), peritoneal dialysis (OR 2.48, 95% CI 1.25-4.81, p = 0.009) and hemodialysis (OR 0.40, 95% CI 0.20-0.79, p = 0.009) had statistical significance.

CONCLUSIONS: CKD patients with arterial hypertension, use of ACE inhibitors, ARBs, diuretics and peritoneal dialysis were more likely to present AHF, while patients who were on hemodialysis were less likely to presenting it.

PMID:35023711

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Application of Non-Invasive Ventilator in Treatment of Severe COVID-19 Patients

Clin Lab. 2022 Jan 1;68(1). doi: 10.7754/Clin.Lab.2021.210416.

ABSTRACT

BACKGROUND: Since December 2019, there has been a global outbreak of COVID-19. As of the end of July 2020, more than 600,000 deaths had been reported globally. The purpose of this paper is to further explore the application of non-invasive ventilation in severe COVID-19 patients.

METHODS: A retrospective study was conducted to included 57 confirmed COVID-19 patients, among which 36 cases were severe. According to different oxygen inhalation methods, they were divided into non-invasive ventilator assisted ventilation group with 21 cases (group A) and 15 cases of nasal catheter oxygen inhalation group (group B). The data of respiration (RR), heart rate (HR), partial arterial pressure of oxygen (PaO2), partial arterial pressure of carbon dioxide (PaCO2), and oxygenation index (OI) before the treatment of noninvasive ventilator assisted ventilation or nasal catheter oxygen treatment at 24, 48, and 72 hours of treatment of the 2 groups were collected and analyzed to determine whether the above indicators were statistically different in each time period.

RESULTS: After 24 hours of treatment with noninvasive ventilator assisted ventilation in group A, RR gradually decreased, PaO2 and OI were significantly higher than before treatment, while after 24 hours of treatment, PaO2, RR, HR and other indexes in group B showed no significant improvement, and OI increased gradually after 48 hours of treatment, with statistically significant difference compared with that before treatment.

CONCLUSIONS: Early adoption of non-invasive ventilation can effectively improve the hypoxic state of patients with severe COVID-19. The combination of underlying diseases will not prolong the use of non-invasive ventilation.

PMID:35023696 | DOI:10.7754/Clin.Lab.2021.210416

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Asprosin and Oxidative Stress Level in COVID-19 Patients

Clin Lab. 2022 Jan 1;68(1). doi: 10.7754/Clin.Lab.2021.210423.

ABSTRACT

BACKGROUND: The global COVID-19 pandemic, caused by the SARS-CoV-2 virus, has created great problems in healthcare systems throughout the world. Although, just like other respiratory tract viral infections, it is a disease with pathophysiological processes associated in general with cytokine production, inflammation, cell death, and redox imbalance or oxidative stress, very little is known about the pathology. Also, in recent studies, the effect of asprosin, which has an important and complex role on metabolism, on COVID-19 is unknown. The aim of this study is to determine the level of asprosin, a new hormone that has the potential to affect many metabolic pathways such as glucose metabolism, in COVID-19 patients. In addition, it is to determine whether asprosin is associated with oxidative stress in COVID-19 patients.

METHODS: Blood samples were taken from 30 patients diagnosed with COVID-19 confirmed with RT-PCR test and 30 healthy control subjects. The serum asprosin level was analyzed with ELISA, and total antioxidant status (TAS) and total oxidant status (TOS) levels with colorimetric analysis.

RESULTS: The asprosin and TAS levels were determined to be statistically significantly decreased in the COVID-19 patients, and the TOS and OSI levels were significantly increased.

CONCLUSIONS: It can be thought that a decrease in asprosin level in COVID-19 patients causes a decrease in metabolic activity, prevents sufficient energy production in patients, and therefore oxidative stress increases in patients.

PMID:35023691 | DOI:10.7754/Clin.Lab.2021.210423

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Epidemiological Survey on Echinococcosis in Xinjiang Uygur Autonomous Region, People’s Republic of China

Clin Lab. 2022 Jan 1;68(1). doi: 10.7754/Clin.Lab.2021.210429.

ABSTRACT

BACKGROUND: According to the latest data, the detection rate of echinococcus in Hoboksar Mongol Autonomous County was 3.7%. The objective of this study is to further investigate the epidemiology of echinococcosis in Ho-boksar Mongol Autonomous County of Xinjiang Uygur Autonomous Region, People’s Republic of China and provide the scientific evidence for preventive and control measures.

METHODS: We performed ultrasound examination of 521 people in Hoboksar Mongol Autonomous County of Xinjiang Autonomous Region, and collected 508 serum samples, which were analyzed with enzyme-linked immunosorbent assay. Data were analyzed by t-test and multinomial logistic regression for risk factor analysis. We collected 126 pieces of herder’s dog feces and used double antibody sandwich method to detect the positive rate of fecal antigen.

RESULTS: The prevalence rate of human echinococcosis in this region was 4.4% (23/521), including 4.0% (21/521) for cystic echinococcosis (CE), 0.38% (2/521) for alveolar echinococcosis (AE). It was found that CE seropositivity was significantly different from gender, age, ethnic group, occupation, culture, area, income and awareness of this disease. The seroprevalence rate of people aged 41 – 65 (3.74%) was higher than of age 0 – 17 (0.197%) (p > 0.05); Female serological positive (4.921%) was higher than male (1.772%) (p > 0.005); Mongolian serological positive (5%) was higher than Han (0.197%) and Kazakhs (1.181%) (p > 0.05); The herdsmen serological positive (2.756% was higher than students (0.197%) (p > 0.05); The primary school students serological positive (2.559%) was higher than children before school 0% (p > 0.05); Chagankule serological positive (9.211%) was higher than Bayinaow (8.497%) (p > 0.05); The seroprevalence rate of people with income < 2,000 (3.74%) was higher than people with income over 5,000 (0.197%) (p > 0.05); The seroprevalence rate of people who had no disease awareness (4.724%) was higher than those who had awareness of Hydatid disease (1.969%) (p < 0.05). Multivariate logistic regression show age, ethic group and awareness of station are the influence factors of epidemiology of echinococcosis. Canine fecal antigen positive rate was 50% (p > 0.05). Narenhebuke (48.78%) was higher than chahet (20.00%), but there is no statistical difference (p > 0.05).

CONCLUSIONS: The surveillance data and our study results tend to be consistent that echinococcosis has an increasing trend in Hoboksar Mongol Autonomous County. Efforts should be continued, in both animals and humans by increasing training campaigns and public awareness.

PMID:35023682 | DOI:10.7754/Clin.Lab.2021.210429

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Exploration of Community Care Awareness about COVID-19 Sterilization

Clin Lab. 2022 Jan 1;68(1). doi: 10.7754/Clin.Lab.2021.210520.

ABSTRACT

BACKGROUND: COVID-19 affects millions of people worldwide so WHO declared the COVID-19 pandemic on 11 March 2020. Since the vaccine is in the early trial phase and until it proves its efficacy, the need of finding alternative methods, which can help to curb this pandemic is urgent, so its prevention depends on standard infection control measures. This study’s aim is to assess the knowledge, awareness, and practice level of Taif population towards Corona Virus disease – 2019 (COVID-19) sterilization.

METHODS: A cross sectional study was conducted on 504 participants by administering a well-structured questionnaire comprising three sections including demographics, knowledge, attitude, and practice among the general population in Taif governorate KSA, over a duration of three months from July until September 2020. The descriptive analysis was carried out for demographics and dependent variables using the statistical program for social sciences. The t-test was used to detect any relationship between knowledge and practice score percentage of the general population response with respect to their gender and level of education. A p-value of < 0.05 was considered statistically significant.

RESULTS: A total of 504 respondents willingly participated in the survey, there is a highly significant difference in the knowledge score percentage in respondents aged between 41 – 60 years old in comparison to the age group < 20 – 40 years old also between urban residence in comparison to rural residence, and a highly significant difference in the knowledge and practice score percentage in post graduate respondents in comparison to undergraduate. In addition, there was a significant difference in the practice score percentage in respondents aged between 41 – 60 years old in comparison to age group < 20 – 40, and a highly significant difference was seen in the practice score percentage in respondents living in urban areas in comparison to rural areas.

CONCLUSIONS: The suggestion of this study was that knowledge and practice gaps among population, especially in the young age group, had to be covered by holding training programs through workshops or to include courses in the curriculum of ministry of health.

PMID:35023673 | DOI:10.7754/Clin.Lab.2021.210520

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External Quality Assessment for Severe Acute Respiratory Syndrome Coronavirus 2 RNA Detection in Chongqing, China

Clin Lab. 2022 Jan 1;68(1). doi: 10.7754/Clin.Lab.2021.210517.

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a huge threat to public health. Therefore, clinical laboratories must have the ability to detect SARS-CoV-2 RNA. With the enhanced detection in Chongqing, many laboratories rapidly implemented assays for the molecular detection of SARS-CoV-2 based on real-time reverse transcription polymerase chain reaction (rRT-PCR) assays. This study aimed to improve the detection capabilities of clinical laboratories by evaluating their performance for SARS-CoV-2 RNA detection through the external quality assessment (EQA) programs of 2020 in Chongqing to contribute to the prevention of this epidemic.

METHODS: The EQA panels consist of eight positive samples with concentrations within 2.7 – 5.0 log10 copies/mL quantified by digital PCR and two negative samples with other human coronaviruses clinically validated by four commercial assays. All 21 samples from four rounds were distributed to the participating laboratories through cold-chain transportation. Depending on the results from each sample, laboratories were asked to use one or two assays to detect SARS-CoV-2 RNA. Test results and raw data were also required. All data were evaluated, and the testing performance of commercial assays was compared. For the rounds, all laboratories used commercial assays.

RESULTS: Four rounds of EQA programs were performed, and the percent agreements of participants were 97.5% (39/40), 97.5% (39/40), 98.9% (88/89), 100.0% (131/131). Only three false negative results and one false positive result were obtained. Statistical significance in the Ct values of the ORF region and N region of SARS-CoV-2-RNA was found by using one-step, one-step concentration, and magnetic bead methods (p < 0.05). The Ct values of the ORF region of SARS-CoV-2-RNA in P5 and P6 were significantly different in the different batches of reagent A (p < 0.05). The ORF region of SARS-CoV-2-RNA was not detected in a batch of reagent B.

CONCLUSIONS: The majority of laboratories in Chongqing have reliable diagnostic ability for SARS-CoV-2 detection. Our data emphasized the importance of EQA for monitoring the performance of clinical laboratories. However, clinical laboratories must first effectively evaluate the performance of reagents prior to their use.

PMID:35023672 | DOI:10.7754/Clin.Lab.2021.210517

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Evaluating the Bond Strength of a Polymer Infiltrated Ceramic Network to Zirconia Using the Crossbeam Push-Off Method

Eur J Prosthodont Restor Dent. 2021 Dec 22. doi: 10.1922/EJPRD_2348Bashary07. Online ahead of print.

ABSTRACT

Porcelains and glass-ceramics have been used to produce CAD-milled veneers and crowns for zirconia copings and implant-abutments. This study evaluated the bondstrength of a polymer-infiltrated-ceramic-network to zirconia using two adhesive cement systems: Panavia 21 and Multilink Automix. Lithium disilicate and feldspathic porcelain were also tested as reference CAD-On materials. Long beams (3x6x40 mm³) of zirconia and short beams (3x6x15 mm³) of the CAD-On materials were prepared. Zirconia and each CAD-On material were bonded in a crossbeam arrangement and subjected to a modified tensile bond-strength test. Half of the samples in each group (n=10) were tested 5 days after bonding (baseline) and the remaining (n=10) underwent aging (50,000 thermocycles at 5°C and 55°C) prior to bond-strength testing. The effects of material, cement, and aging on the tensile bond-strength were tested using a three-way ANOVA. The reference lithium disilicate/Multilink system showed no significant differences in bond strength compared to polymer-infiltrated-ceramic-network and porcelain. The long-term retention of polymer-infiltrated-ceramic-network was not statistically different compared to the baseline values and the two reference materials. With comparable bond strength between all materials, polymer-infiltrated-ceramic-network is the favorable choice for CAD-On to zirconia copings and implant-abutments due to its superior resistance to fatigue fracture relative to porcelain.

PMID:35023665 | DOI:10.1922/EJPRD_2348Bashary07

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Evaluation of the Diagnostic and Predictive Value of Glutamic Acid Decarboxylase, Zinc Transporter 8 Serum Levels in Alzheimer’s Disease

Clin Lab. 2022 Jan 1;68(1). doi: 10.7754/Clin.Lab.2021.210422.

ABSTRACT

BACKGROUND: Identification of validated peripheral biomarkers for Alzheimer’s Disease, leading to an early diagnosis of the disease, would be valuable for predicting progression and targeted therapeutics. In this regard, serum levels of GADA, ZnT8A, Zn, vitamin D, and leukocyte expression of brain-derived neurotrophic factor (BDNF) gene were investigated in Alzheimer’s patients and control group.

METHODS: Serum levels of GADA, ZnT8A, Zn, and vitamin D and leukocyte expression of the BDNF gene were evaluated in 40 AD patients and 40 control cases. The diagnostic value of investigated factors was examined with the receiver operating characteristic (ROC).

RESULTS: The results showed significant differences of p < 0.0001, p < 0.0001, and p = 0.0006 between AD patients and control individuals in GADA, Zn, and ZnT8A serum levels, respectively. No significant difference was observed in the serum concentration of vitamin D between AD patients and control cases (p = 0.2993). The expression level of the BDNF gene in AD patients was different from control cases, but it was not statistically significant (p > 0.05). Moreover, ROC curve analysis disclosed a diagnostic potency for serum levels of GADA, Zn, and ZnT8A for AD with an area under the ROC curve of > 0.7 (p < 0.0001, p < 0.0001, and p = 0.0007, respectively).

CONCLUSIONS: The results demonstrated the higher serum levels of GADA and ZnT8A and lower serum concentrations of Zn in the patient group. Therefore, these parameters can be discussed as possibly diagnostic in AD cases.

PMID:35023669 | DOI:10.7754/Clin.Lab.2021.210422

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Investigation of immunity against Bordetella pertussis in pregnant women and an overview of the vaccination schedule in Turkey

Turk J Pediatr. 2021;63(6):1020-1027. doi: 10.24953/turkjped.2021.06.010.

ABSTRACT

BACKGROUND: Pertussis caused by Bordetella pertussis, is a disease leading to significant morbidity and mortality in neonates and infants. Direct protection of the infant may be achieved by maternal and neonatal vaccination. Despite primary vaccination, infants under six months pose the greatest risk of infection with pertussis. Maternal immunization provides a high level of infant protection from birth until immunity is achieved by active vaccination. There is no routine Tdap vaccination recommendation for pregnant women in Turkey. This study was carried out to determine pertussis antibody levels in pregnant women and provide data for improving vaccine planning.

METHODS: The study was carried out with 133 pregnant women in Turkey. Antibody titers to pertussis toxin (anti-PT) and filamentous hemagglutinin (anti-FHA) were measured by the commercially available ELISA.

RESULTS: Among 133 participants, 93 (69.9%) were found to be immune according to anti-PT IgG antibody levels. According to anti-FHA IgG antibody levels, 123 (92.5%) participants were considered to be immune. A positive correlation was observed between PT and FHA and the findings were statistically significant (P < 0.001, r = 0.343). In the study group, the ages of the participants varied between 17 and 44 years. The mean age of those who were immune was 27.3±5.6, the mean age of non-immune patients was 29.1±6.2 and the difference was not statistically significant (P= 0.14).

CONCLUSIONS: Our results reveal that approximately one-third of pregnant women were not immune to pertussis, reflecting many young infants to be vulnerable to pertussis infection until the onset of primary vaccinations, although childhood pertussis vaccination coverage has been high for a long time. We conclude that Tdap vaccine recommendation for pregnant women regardless of previous immunization history may be beneficial for the protection of infants in their first six months.

PMID:35023652 | DOI:10.24953/turkjped.2021.06.010

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The relationship between immature platelet fraction and severity of acute bronchiolitis

Turk J Pediatr. 2021;63(6):1056-1063. doi: 10.24953/turkjped.2021.06.014.

ABSTRACT

BACKGROUND AND OBJECTIVES: Acute bronchiolitis is one of the most common reasons for hospitalization in infants. Although patients with acute bronchiolitis generally have a good prognosis, death can also occur. In this study, we evaluate the immature platelet fraction (IPF) as an indicator of the severity of acute bronchiolitis.

METHODS: In our study, 179 patients diagnosed with acute bronchiolitis were divided into three groups as mild (n: 48; 26.8%), moderate (n: 104; 58.10%) and severe (n: 27; 15.1%) bronchiolitis. There were 80 healthy children in the control group. The diagnostic capacity of IPF and hematological parameters (platelet distribution width (PDW), mean platelet volume (MPV), white blood cell count (WBC), and platelet count (PLT)) values to predict severity of acute bronchiolitis was evaluated using receiver operating characteristic (ROC) curves and their respective areas under the curves (AUCs) calculated with 95% confidence intervals.

RESULTS: The IPF value of patients with acute bronchiolitis was significantly higher than the healthy group (p < 0.001). In addition, a positive correlation was observed between clinical severity of bronchiolitis and IPF. The ROC curve analysis indicated that the IPF cut-off point for predicting severity of acute bronchiolitis was > 3.2% (Sensitivity of 84%, specificity of 97%). We found that the AUCs for IPF, MPV, PDW, WBC and PLT were statistically significant for bronchiolitis relative to the healthy control group. The parameter with the greatest AUC value was IPF.

CONCLUSION: The IPF may present for diagnosing and evaluating the clinical severity of acute bronchiolitis in children.

PMID:35023656 | DOI:10.24953/turkjped.2021.06.014