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Evaluation Value of Portable Color Doppler Ultrasound for Arteriovenous Fistula Stenosis in Patients with Maintenance Hemodialysis
Sujuan Wu,
Lingjun Shen,
Wenyu Gong
Issue:
Volume 8, Issue 4, July 2020
Pages:
143-147
Received:
23 April 2020
Accepted:
15 May 2020
Published:
28 May 2020
Abstract: Objective: By comparing the evaluation effect of traditional physical examination (PE) and portable color Doppler ultrasound on arteriovenous fistula (AVF), to explore the value of portable ultrasound in the diagnosis of abnormal fistula lesions in patients with maintenance hemodialysis (HD). Methods: 57 patients with maintenance HD from Dongpu HD center, the first affiliated hospital of Jinan university from September 2019 to March 2020 were selected. The PE was performed by specialist nurses, and AVF was evaluated by portable ultrasound, and the general data of the patients were collected. Results: The average age of the HD patients was 58.98 years, including 31 males (54.39%). The median of HD duration was 56 months, and 22 patients (28.60%) had diabetes mellitus. The prevalence of fistula stenosis was 17.54%. 50% PE was abnormal in fistula stenosis group, which was higher than that in non-fistula stenosis group (10.64%, P=0.012). The κ index was 0.394 in the consistency assessment between PE and portable ultrasound for evaluating the fistula stenosis (P=0.003). The incidence of fistula sound reduction, blood flow less than 200mL/min during treatment and abnormal arm lifting test in patients with fistula stenosis were all higher than those without fistula stenosis (all P<0.05). The results of multivariate logistic regression analysis showed that abnormal PE was closely related to fistula stenosis (OR=8.400, 95% confidence interval (CI)=1.786-39.498, P=0.007). Conclusion: Portable color Doppler ultrasound could effectively diagnose AVF stenosis in maintenance HD patients, especially when the traditional PE was abnormal, timely portable ultrasound evaluation was conducive to early intervention and extend the life of AVF.
Abstract: Objective: By comparing the evaluation effect of traditional physical examination (PE) and portable color Doppler ultrasound on arteriovenous fistula (AVF), to explore the value of portable ultrasound in the diagnosis of abnormal fistula lesions in patients with maintenance hemodialysis (HD). Methods: 57 patients with maintenance HD from Dongpu HD ...
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Clinical Case with Negative Polymerase Chain Reaction (PCR) and Suspicious Chest Computed Tomography (CT) Images SARS-CoV-2 Infection or Not
Adjagba Philippe Mahouna,
Adjadohoun Sonia,
Hounkponou Murielle,
Sonou Arnaud,
Codjo Léopold,
Soho Edson,
Dahito Mickaella,
Avocèvou Géraud,
Djoh Ingrid,
Sissinto Yolande,
Yèkpè Patricia,
Biaou Olivier,
Houenassi Dèdonougbo Martin
Issue:
Volume 8, Issue 4, July 2020
Pages:
148-152
Received:
12 May 2020
Accepted:
28 May 2020
Published:
4 June 2020
Abstract: Background: The SARS-CoV-2 infection has polymorphic clinical presentations. The real time PCR is the reference diagnostic test; however, it can only detect presence of virus for a specific window of time. Case: We report a clinical case in a patient aged 66 years. His clinical history included known hypertension for 10 years and ischemic stroke. He had no known contact with infected persons. He initially presented with a productive cough, fever, shortness of breath on exertion, intense asthenia and palpitations. The real time PCR with upper airway samples was conducted on days 18 and 20 of the onset of symptoms and was negative. Despite chest CT abnormalities, the patient was not considered to be infected SARS-CoV-2 according to national recommendations for diagnosis and treatment in Benin. He was discharged from the treatment centre. Readmitted 7 days later to the emergency room for respiratory distress, the patient died. Conclusion. Diagnosis of SARS-CoV-2 infection can be difficult. In the context of typical clinical presentation, chest CT features of viral pneumonia may be strongly suspicious for SARS-CoV-2 despite negative real time PCR results. In order to improve the diagnostic and therapeutic strategy for SARS-CoV-2 infection in Benin, chest CT and other diagnostic tests/ criteria should be adopted.
Abstract: Background: The SARS-CoV-2 infection has polymorphic clinical presentations. The real time PCR is the reference diagnostic test; however, it can only detect presence of virus for a specific window of time. Case: We report a clinical case in a patient aged 66 years. His clinical history included known hypertension for 10 years and ischemic stroke. H...
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Controversial Impact of Hepcidin Metabolism in the Pathogenesis of Anemia in Myelofibrosis
Stela Dimitrova,
Liana Gercheva,
Daniela Gerova,
Ilina Micheva
Issue:
Volume 8, Issue 4, July 2020
Pages:
153-158
Received:
22 May 2020
Accepted:
18 June 2020
Published:
6 July 2020
Abstract: Anemia in myelofibrosis (MF) is a result of a multifactorial process, which is incompletely understood. The central pathogenetic mechanism is a replacement of normal hemopoietic tissue by fibrotic stroma. However, ineffective erythropoiesis, inflammation and iron overload have an additional impact on anemia development, suggesting the role of dysregulated iron homeostasis and hepcidin. The aim of the study was to analyze parameters of iron metabolism and inflammation in patients with different forms and stages of myelofibrosis. Thirty-six patients with primary MF, post-polycythemia vera and post-essential thrombocythemia MF and fourteen healthy controls were included in the study. In the patient group, serum ferritin, Fe, TIBC and parameters of CBC were measured as a part of routine clinical assessment. Plasma total hepcidin levels and concentrations of Interleukin-6 (IL6) and Interleukin-8 (IL8) were measured in duplicate by ELISA (My BioSource, San Diego, USA) in patients and healthy controls. The hepcidin level in the patient group was found statistically lower compared to healthy controls (27,64±41,56 ng/ml; 111,13±49,56 ng/ml; F=2,81, p<0,001). Patients with newly diagnosed MF had significantly higher levels of hepcidin compared to those with prolonged evolution: between 1 and 5 years (p=0,005) and >5 years (p=0,038). Transfusion dependent patients presented with lower hepcidin compared to transfusions independent (10,10±6,67 ng/ml; 31,15±44,37 ng/ml; p=0,026). In patients receiving cytoreductive or target treatment hepcidin level was significantly lower compared to patients on best supportive care (17,74±21,99 ng/ml; 43,05±58,46 ng/ml; p=0,037). No difference was found in hepcidin level within the risk groups according to DIPSS, neither between the subtypes of disease (primary MF and secondary MF). Higher hepcidin positively correlated with leukocytosis (R=0,665, p=0,009) and age (R=0,392, p=0,0081). By multivariate analysis, a significant highly positive correlation was found between hepcidin and IL-6 (R=0,535, p=0,002) and weaker between hepcidin and IL-8 (R=0,413, p=0,21) A significant straight correlation was demonstrated between IL-6 and IL-8 (R=0,464, p=0,009) and a negative between serum iron and IL-6 (R=-0,367, p=0,42) and IL-8 (R=-0,438, p=0,14), respectively. The hepcidin regulation is complex and multifactorial. Its role in pathogenesis of anemia in myelofibrosis is controversary. Probably it has a higher impact in early stages of the disease and depends on treatment and transfusions.
Abstract: Anemia in myelofibrosis (MF) is a result of a multifactorial process, which is incompletely understood. The central pathogenetic mechanism is a replacement of normal hemopoietic tissue by fibrotic stroma. However, ineffective erythropoiesis, inflammation and iron overload have an additional impact on anemia development, suggesting the role of dysre...
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Corona Virus (SARS-COV-2) Induced Inflammatory Lung Disease a Review on the Role of Renin–Angiotensin System and the Angiotensin Converting Enzyme-2
Sanjeev Arya,
David Maskill,
Avinash Sharma,
Ankit Khanduri,
Prashant Kumar,
Dushyant Gaur,
Haider Abbas,
Sheetal Verma,
Vinita Singh
Issue:
Volume 8, Issue 4, July 2020
Pages:
159-171
Received:
20 June 2020
Accepted:
10 July 2020
Published:
17 July 2020
Abstract: In December 2019, a novel infectious disease, caused by Severe Acute Respiratory Syndrome-coronavirus 2 (SARS-CoV-2), was identified in Wuhan, China, now declared as a pandemic. The Renin–Angiotensin system (RAS) and angiotensin-converting enzyme 2 (ACE2) have drawn special attention, as ACE2 acts as a receptor for SARS-CoV2. No specific therapy against SARS-COV2 has been invented yet. There is a constant need towards understanding of the underlying pathophysiology to aid the pharmacological research. We have looked at the current evidence on the relationship between SARS-COV-2 and RAS and ACE2. Articles in English language published between 1st January 2003 and 15th June 2020 were searched using keywords and MeSH (Medical Subject Heading). We used Google Scholar and Pubmed as search engines. Conclusion: Bats serve as primary reservoir for SARS-CoV2, but its intermediate host has not been identified yet. ‘Hot spots’ on ACE2, serve as receptors for SARS-COV2. Imbalance in the activity of ACE/ACE2 is an important contribution towards the pathogenesis of coronavirus related diseases. ACE2 also has protective role and recombinant ACE2 has been shown to improve lung injury and it is a potential therapeutic agent.
Abstract: In December 2019, a novel infectious disease, caused by Severe Acute Respiratory Syndrome-coronavirus 2 (SARS-CoV-2), was identified in Wuhan, China, now declared as a pandemic. The Renin–Angiotensin system (RAS) and angiotensin-converting enzyme 2 (ACE2) have drawn special attention, as ACE2 acts as a receptor for SARS-CoV2. No specific therapy ag...
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The Relationship Between Resting Heart Rate and Age in Adult Nigerians
Peter Ekpunobi Chime,
Wilfred Okwudili Okenwa,
Bibiana Oti
Issue:
Volume 8, Issue 4, July 2020
Pages:
172-176
Received:
24 June 2020
Accepted:
10 July 2020
Published:
17 July 2020
Abstract: Background: Resting heart rate is related to cardiovascular mortality as well as to all-cause mortality. It is therefore important to know whether resting heart rate changes with age in adults. The aim of this study was to determine the relationship between heart rate and age in adult Nigerians. Methods: It was a retrospective study on adult Nigerians attending a University Teaching Hospital in Nigeria. All the needed data were retrieved from the medical records. Heart rate was calculated from the electrocardiogram and correlated with age. Results: There were 99 cases aged between 20 and 54 years and comprised of 60 males and 39 females. The mean heart rate was 73.40±13.16 beats/minute. Across the various decades, the mean heart rate in beats per minute was 73.46±10.70 in the third decade, 75.52±12.16 in the fourth decade, 72.38±13.91 in the fifth decade, and 71.60±18.77 in the sixth decade of life (p=0.770). Heart rate correlated negatively and weakly with age (r=- 0.034, p=0.736). There were more cases of sinus bradycardia than sinus tachycardia, but the proportion of cases with heart rate outside 60 beats per minute to 100 beats per minute was small. Conclusion: This study showed that resting heart rate did not change with age in young adult and middle-aged Nigerians who had no clinical evidence of heart disease. A greater proportion of them were in normal sinus rhythm.
Abstract: Background: Resting heart rate is related to cardiovascular mortality as well as to all-cause mortality. It is therefore important to know whether resting heart rate changes with age in adults. The aim of this study was to determine the relationship between heart rate and age in adult Nigerians. Methods: It was a retrospective study on adult Nigeri...
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Neurocognitive Disorders in People Living with Human Immunodeficiency Virus Aged 50 Years Old and More in Yalgado Ouédraogo Teaching Hospital
Guira Oumar,
Zombre Yacine,
Tieno Herve,
Drabo Youssouf Joseph
Issue:
Volume 8, Issue 4, July 2020
Pages:
177-181
Received:
8 June 2020
Accepted:
7 July 2020
Published:
23 July 2020
Abstract: A screening of neurocognitive disorders is required in people living with HIV (PLHIV) to improve their care. We aimed to determine their prevalence, their clinical features and identify their associated factors and their nosology in PLHIV aged 50 years old and more. This cross- sectional study from prospective data was carried out in Yalgado Ouédraogo Teaching Hospital, from February to April, 2019. PLHIV aged 50 years old and more were concerned. Those on antiretroviral therapy for at least 6 months were included. Those having a mental dysfunction that did not allow the use of the questionnaire were not included. Baseline data, those relating to HIV, cognitive and daily living capacities assessment, and the nosology of neurocognitive disorders were collected. Daily living capacities were assessed by the Instrumental Activities of Daily Living score, and the cognitive functions by the Mini Mental State Examination. The Chi-square’s or the Fisher’s test and the Student’s test were used to compare respectively the proportions and the means. The factors for which the p-value was less than 0.20 in a bivariate analysis were included into a logistic regression model for a multivariate analysis with a significance of p set at < 0.05. One hundred and two patients were studied: 46 males (45.1%), 56 females (54.9%). The mean age was 57±5.6 years. The main antecedent was alcohol consumption (34.3%). Fifty-nine patients had a nadir of CD4 below 200 cel/µl. Eighty one HIV1 patients had an undetectable updated viral load. The mean duration since HIV diagnosis was 147±62.0 and that of antiretroviral therapy 130±50.0 months. Twenty four (23.5%) patients had neurocognitive disorders, particularly in the fields of attention (100%) and memory (87.5%). A simultaneous disorder in attention, memory and language was the common phenotype (33.3%). It was Asymptomatic Neurocognitive Impairment (66.6%), Minor Neurocognitive Disorders (33.3%). The nosological groups were: “Possible HIV Associated Neurocognitive Disorders (HAND)” (95.83%), “Probable HAND” (4.17%), “Certain HAND” and Secondary neurocognitive disorders (0%). In a bivariate analysis, age ≥ 65, male gender, socio-cultural status 3 (NSC3), opportunistic infection, the nadir of CD4 were the factors with a p-value ≤ 0.20. In a multivariate analysis, age (OR=4.55) and NSC3 (OR=2.55) were associated with neurocognitive disorders with respective p-values 0.03 and 0.04. Neurocognitive disorders are not rare in PLHIV aged 50 years old and more in Burkina Faso. However, appropriate assessment tools have to be developed in accordance with the population’s socio-cultural specifities.
Abstract: A screening of neurocognitive disorders is required in people living with HIV (PLHIV) to improve their care. We aimed to determine their prevalence, their clinical features and identify their associated factors and their nosology in PLHIV aged 50 years old and more. This cross- sectional study from prospective data was carried out in Yalgado Ouédra...
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Models of Gen-gene Interaction in Determining the Severity of Bronchial Asthma in Children
Оlena Rechkina,
Nataliia Gorovenko,
Vira Stryzh,
Zoia Rossokha,
Svitlana Kyriachenko,
Serhii Rudenko
Issue:
Volume 8, Issue 4, July 2020
Pages:
182-191
Received:
14 February 2020
Accepted:
22 April 2020
Published:
4 August 2020
Abstract: Bronchial asthma (BA) has a polygenic nature, and the onset of its manifestation and features course is realized due to the influence of genetic factors. This study aimed to investigate the effect of polymorphisms of the genes of the phase II detoxification system and genes of the cardiovascular tone on the severity of asthma in children. The study included 163 children aged 5–18 years: 38 with severe asthma, 69 with moderate asthma, and 56 with mild asthma. A molecular genetic study was conducted to determine the frequency of gene propagation and gen-gene interaction by GSTT1, GSTM1, GSTP1, ACE, eNOS, AT2R1, NAT2 genes at different severity of bronchial asthma. Found that in the prediction of the severity of asthma special place belongs to the analysis of the combination of genotypes. Independent effects were found for AT2R1 and ACE gene polymorphisms. The ACE (I / D) / AT2R1 (A1166C) / eNOS (T786C) / eNOS (4b / 4a) four-locus model was developed to predict the severe BA course and the need for additional analysis of the interaction of AT2R1 (A1166C) and eNOS (T786C), eNOS (T786C) genes was demonstrated (4b4a) and GSTT1. The risk of developing severe BA has been demonstrated for the combination of 1166SS + 786TT, 1166CC + 786TC genotypes by AT2R1 (A1166C) and eNOS (T786C) genes, and the reduction of this risk for combinations of eNOS (4b4a) 4b4b + GSTT1 genotypes. In moderate asthma, combinations of ACE genotypes DD + AT2R1 1166SS and AT2R1 313AA + GSTP1 1166SS were reliable risk markers for severe asthma. AT2R1 gene polymorphism was the leading marker in more severe asthma. A marker of severe BA was also found for the heterozygous 857GA polymorphism of the NAT2 gene (G857A). Conclusions. The influence of ACE (I / D), AT2R1 (A1166C), eNOS (T-786C), NAT2 (G857A), GSTT1, and GSTP1 gene polymorphisms on the severity of asthma in children has been established.
Abstract: Bronchial asthma (BA) has a polygenic nature, and the onset of its manifestation and features course is realized due to the influence of genetic factors. This study aimed to investigate the effect of polymorphisms of the genes of the phase II detoxification system and genes of the cardiovascular tone on the severity of asthma in children. The study...
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Reducing Further Spread of COVID-19 in Taiwan by Containment of Overseas Immigration, Hospital Cluster Infection Control, and Mass Gathering Warnings
Yang Chih-Ching,
Wei Cheng-Yu
Issue:
Volume 8, Issue 4, July 2020
Pages:
192-196
Received:
1 June 2020
Accepted:
18 June 2020
Published:
10 August 2020
Abstract: The experience that Taiwan gained from the Severe Acute Respiratory Syndrome (SARS) epidemic in 2003 helped in the development of early preparation and response to COVID-19 outbreak. Measures including isolation, quarantine, and social distancing have been promptly taken to flatten the epidemic progress curve in the first 50 days since Dec. 31, 2019. In the second stage, the focus of epidemic prevention in Taiwan has shifted gradually from “containment” to “disaster reduction”. “Social distancing” is now a strategy for reducing transmission and “flattening the curve” with respect to cases entering the health care system. The further spread of COVID-19 in Taiwan was alleviated by control of movement in and out of the country, hospital clustering infection control, and the prevention of mass gatherings successfully. We already delayed the peak, therefore exports has become easier and we could help other countries with the necessary supply of materials. Overall, the performance of Taiwan's COVID-19 epidemic infection control was ranked first place among the 23 OECD countries. Most of the confirmed patients were aged among 20 to 40 years old, which accounted for 60% of total confirmed cases, with a total mortality rate of about 1.4%. The median time from the onset of symptoms to the release from isolation was 30 days. Due to this severe economic impact from COVID-19 epidemic, Taiwan government quickly responded with the three major principles of "epidemic prevention, bail-out, and revitalization", in order to reduce negative impact on many industries and corporations.
Abstract: The experience that Taiwan gained from the Severe Acute Respiratory Syndrome (SARS) epidemic in 2003 helped in the development of early preparation and response to COVID-19 outbreak. Measures including isolation, quarantine, and social distancing have been promptly taken to flatten the epidemic progress curve in the first 50 days since Dec. 31, 201...
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