scholarly journals Ruxolitinib for Severe COVID-19-Related Hyperinflammation in Nonresponders to Steroids

2021 ◽  
pp. 1-7
Author(s):  
Mauricio Sarmiento ◽  
Patricio Rojas ◽  
Joaquin Jerez ◽  
Pablo Bertín ◽  
James Campbell ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Severe Disease ◽  
Public Health Problem ◽  
Early Discharge ◽  
Complete Regression ◽  
Major Public Health Problem ◽  
Severe Respiratory Failure ◽  
Effective Strategies ◽  
Previously Treated ◽  
Slow Evolution

<b><i>Introduction:</i></b> Currently, severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection is a major public health problem worldwide. Although most patients present a mild infection, effective strategies are required for patients who develop the severe disease. Anti-inflammatory treatment with JAK inhibitors has been considered in SARS-CoV-2. <b><i>Methods:</i></b> In this study, we presented our experience in a group of severe SARS-CoV-2 Chilean patients. This prospective study was performed on consecutive patients presenting severe respiratory failure owing to COVID-19 or high-risk clinical condition associated with SARS-CoV-2, and who were treated with ruxolitinib for management of associated inflammation. Overall, 18 patients presenting SARS-CoV-2 viral-induced hyperinflammation were treated with ruxolitinib, with 16 patients previously treated with steroids, 4 with tocilizumab, and 3 with both treatments. <b><i>Results:</i></b> Ten patients evolved with favorable response, including 7 patients admitted with severe respiratory failure (PaFi less than 200 mm Hg in high-flow nasal cannula), presenting complete regression of hyperinflammation, regression of the lung lesions, and subsequent discharge. In the remaining 8 patients, 25% showed reduced inflammation, but early discharge was not achieved owing to the slow evolution of respiratory failure. Unfortunately, 3 patients demonstrated a severe respiratory failure. The early initiation of ruxolitinib was found to be associated with better clinical evolution (<i>p</i> &#x3c; 0.005). <b><i>Conclusion:</i></b> In this study, ruxolitinib resolved hyperinflammatory state in 55% of the patients, regardless of the previous steroid or tocilizumab therapy. Unfortunately, few patients demonstrated severe evolution despite ruxolitinib therapy. Notably, the treatment starting time appears to play an important role in achieving good outcomes. Further validation in randomized controlled trials is crucial.

scholarly journals The Long Noncoding RNA MEG3 Is Downregulated and Inversely Associated with VEGF Levels in Osteoarthritis

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Wei Su ◽  
Wen Xie ◽  
Qingkun Shang ◽  
Bing Su
Keyword(s):  
Noncoding Rna ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Rt Pcr ◽  
Average Life Expectancy ◽  
Vegf Mrna ◽  
Normal Cartilage ◽  
Effective Strategies ◽  
Inhibition Of Angiogenesis ◽  
Bone And Cartilage Development

Osteoarthritis (OA) is becoming a major public health problem in China, especially considering the increase in average life expectancy of the population. Thus, enhanced understanding of the molecular changes associated with OA is urgently needed to develop more effective strategies for the diagnosis and treatment of this debilitating disease. LncRNAs play an important role in the processes of bone and cartilage development. Maternally expressed gene 3 (MEG3) is a maternally expressed lncRNA and may function as a tumor suppressor by inhibiting angiogenesis. OA is closely associated with angiogenesis and the inhibition of angiogenesis presents a novel therapeutic approach to reduce inflammation and pain in OA. In this study, we detected the mRNA expression of MEG3 and VEGF in articular cartilage samples from 20 OA patients and 10 healthy volunteers by real-time RT-PCR. VEGF protein is detected by ELISA in cartilage samples. The results show that human MEG3 is significantly downregulated in OA patients compared to normal cartilage samples. However, higher levels of VEGF mRNA and protein are found in OA compared to the control. Moreover, MEG3 levels are inversely associated with VEGF levels, suggesting that MEG3 may be involved in OA development through the regulation of angiogenesis.

scholarly journals Sodium taurocholate cotransporting polypeptide is a functional receptor for human hepatitis B and D virus

eLife ◽  
2012 ◽  
Vol 1 ◽  
Author(s):  
Huan Yan ◽  
Guocai Zhong ◽  
Guangwei Xu ◽  
Wenhui He ◽  
Zhiyi Jing ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Viral Infections ◽  
Affinity Purification ◽  
Severe Disease ◽  
Sodium Taurocholate ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Hepatitis D ◽  
Human Hepatitis ◽  
Functional Receptor

Human hepatitis B virus (HBV) infection and HBV-related diseases remain a major public health problem. Individuals coinfected with its satellite hepatitis D virus (HDV) have more severe disease. Cellular entry of both viruses is mediated by HBV envelope proteins. The pre-S1 domain of the large envelope protein is a key determinant for receptor(s) binding. However, the identity of the receptor(s) is unknown. Here, by using near zero distance photo-cross-linking and tandem affinity purification, we revealed that the receptor-binding region of pre-S1 specifically interacts with sodium taurocholate cotransporting polypeptide (NTCP), a multiple transmembrane transporter predominantly expressed in the liver. Silencing NTCP inhibited HBV and HDV infection, while exogenous NTCP expression rendered nonsusceptible hepatocarcinoma cells susceptible to these viral infections. Moreover, replacing amino acids 157–165 of nonfunctional monkey NTCP with the human counterpart conferred its ability in supporting both viral infections. Our results demonstrate that NTCP is a functional receptor for HBV and HDV.

scholarly journals Risk for Severe Pulmonary Tuberculosis among Alcoholics and Diabetics

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Balachandran J ◽  
Sreekumar B
Keyword(s):  
Diabetes Mellitus ◽  
Pulmonary Tuberculosis ◽  
Severe Disease ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Public Health Problem ◽  
Significant Risk Factor ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Minimal Disease

Tuberculosis is a major public health problem. Some patients present with minimal lesions where as others present with advanced lesions. Patients with advanced or severe disease have high morbidity and mortality. Their infectiousness is also high. This is a Case control study to identify the strength of associations between two important factors, namely alcoholism and diabetes mellitus, and severity of disease. There were 80 cases and 80 controls. Cases were patients with severe disease and controls were patients with minimal disease. Severity of tuberculosis was assessed by chest radiographic criteria as per American Thoracic Society recommendation. The study was done over a period of 18 months. Both inclusion and exclusion criteria were applied in the selection of cases and controls. 46.25% of cases and 23.75% of controls were alcoholic. 15% of cases were suffering from diabetes mellitus whereas only 5% of controls were diabetic. Univariate analysis showed that both alcoholism and diabetes mellitus were significant risk factors. When the confounding effect of age was also taken into account, diabetes mellitus was not found to be a significant risk factor in causing severe pulmonary tuberculosis. Therefore preventive measures may be targeted to alcoholics for the early identification of severe pulmonary tuberculosis.

scholarly journals Hydroxychloroquine for the treatment of severe respiratory infection by COVID-19: A randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257238
Author(s):  
Carmen Hernandez-Cardenas ◽  
Ireri Thirion-Romero ◽  
Sebastián Rodríguez-Llamazares ◽  
Norma E. Rivera-Martinez ◽  
Patricia Meza-Meneses ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Severe Disease ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Serious Adverse Events ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Secondary Outcomes

Introduction The novel coronavirus pandemic (COVID–19) represents a major public health problem and it is key to find a treatment that reduces mortality. Our objective was to estimate whether treatment with 400 mg/day of Hydroxychloroquine for 10 days reduces in-hospital mortality in subjects with severe respiratory disease due to COVID-19 compared with placebo. Material and methods A double-blind, randomized, placebo-controlled trial to evaluate the safety and efficacy of Hydroxychloroquine for the treatment of severe disease by COVID-19 through an intention-to-treat analysis. Eligible for the study were adults aged more than 18 years with COVID-19 confirmed by RT-PCR and lung injury requiring hospitalization with or without mechanical ventilation. Primary outcome was 30-day mortality. Secondary outcomes: days of mechanical ventilation, days of hospitalization and cumulative incidence of serious adverse events. Results A total of 214 patients with COVID-19 were recruited, randomized and analyzed. They were hypoxemic with a mean SpO2 of 65% ± 20, tachycardic (pulse rate 108±17 min-1) and tachypneic (32 ±10 min-1); 162 were under mechanical ventilation at randomization. Thirty-day mortality was similar in both groups (38% in Hydroxychloroquine vs. 41% in placebo, hazard ratio [HR] 0.88, 95% Confidence Interval [95%CI] 0.51–1.53). In the surviving participants, no significant difference was found in secondary outcomes. Conclusion No beneficial effect or significant harm could be demonstrated in our randomized controlled trial including 214 patients, using relatively low doses of Hydroxychloroquine compared with placebo in hospitalized patients with severe COVID-19.

scholarly journals TETANUS;

2013 ◽  
Vol 20 (06) ◽  
pp. 1026-1034
Author(s):  
MUHAMMAD MUAZZAM ◽  
SHEHZAD ADIL MANSOOR ◽  
SUMERA BADAR ◽  
Asif Nadeem ◽  
Bilal Anwar ◽  
...  
Keyword(s):  
Medical Records ◽  
Severe Disease ◽  
Immunization Coverage ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Common Cause ◽  
Moderate Disease ◽  
Tetanus Immunization ◽  
Age And Sex ◽  
Overall Mortality

Background: Tetanus still remains a major public health problem in Pakistan like in most other developing countries, with ahigh morbidity and mortality. Objectives: To study the demographic profile the clinical profile, the outcome of the tetanus patients andeffectiveness of tetanus immunization coverage in district Faisalabad. Design: Retrospective record based study. Place and Duration:Surgical unit-5 DHQ Hospital, Faisalabad from January 2010 to December 2012. Subjects and Methods: All data of 198 patients oftetanus of any age and sex, diagnosed clinically was collected, compiled and analyzed from the Medical Records Department of theHospital. Results: Out of 198 patients of tetanus,138(69.7%) were males and 60(30.3%) were females. Their ages ranged from 1 to 85years with a mean and a standard deviation respectively of 29.36 and 17.48 years.162 (81.8%) were from rural and36(18.2%) were fromurban areas. 47(23.7%) patients were having prior immunization and151(76.3%) were not immunized. The most common presentingsymptoms were trismus (47.5%), body stiffness(24.2%),fits(19.2%) and respiratory distress(9.1%). 23(11.6%) patients were havingmild disease,71(35.9%) patients were having moderate disease,71(35.9%) patients were having severe disease and 33(16.7%) werehaving very severe disease. Overall mortality rate was 41.4%. Respiratory failure was the most common cause of death and there wasstatistically significant association between mortality and increasing grades of disease. Conclusions: By making expanded programmeof immunization(EPI) more effective and removing flaws from out-dated vaccination through incomplete vaccination. By improvingawareness in public and complete vaccination through EPI program, we can reduce the incidence of tetanus.

scholarly journals Risk for Severe Pulmonary Tuberculosis among Alcoholics and Diabetics

2013 ◽  
Vol 1 (1) ◽  
pp. 14-16
Author(s):  
Balachandran J ◽  
Sreekumar B
Keyword(s):  
Diabetes Mellitus ◽  
Pulmonary Tuberculosis ◽  
Severe Disease ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Public Health Problem ◽  
Significant Risk Factor ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Minimal Disease

Tuberculosis is a major public health problem. Some patients present with minimal lesions where as others present with advanced lesions. Patients with advanced or severe disease have high morbidity and mortality. Their infectiousness is also high. This is a Case control study to identify the strength of associations between two important factors, namely alcoholism and diabetes mellitus, and severity of disease. There were 80 cases and 80 controls. Cases were patients with severe disease and controls were patients with minimal disease. Severity of tuberculosis was assessed by chest radiographic criteria as per American Thoracic Society recommendation. The study was done over a period of 18 months. Both inclusion and exclusion criteria were applied in the selection of cases and controls. 46.25% of cases and 23.75% of controls were alcoholic. 15% of cases were suffering from diabetes mellitus whereas only 5% of controls were diabetic. Univariate analysis showed that both alcoholism and diabetes mellitus were significant risk factors. When the confounding effect of age was also taken into account, diabetes mellitus was not found to be a significant risk factor in causing severe pulmonary tuberculosis. Therefore preventive measures may be targeted to alcoholics for the early identification of severe pulmonary tuberculosis.

scholarly journals Awareness of Cancer-Related Malnutrition and Its Management: Analysis of the Results From a Survey Conducted Among Medical Oncologists

2021 ◽  
Vol 11 ◽  
Author(s):  
Maurizio Muscaritoli ◽  
Emanuele Corsaro ◽  
Alessio Molfino
Keyword(s):  
Cancer Patients ◽  
Public Health Problem ◽  
Multidisciplinary Teams ◽  
Major Public Health Problem ◽  
Negative Consequences ◽  
Treatment Optimization ◽  
Nutritional Interventions ◽  
Effective Strategies ◽  
Medical Oncologists ◽  
Survey Results

Cancer is a global major public health problem, particularly in Western countries, where it represents the second leading cause of death after cardiovascular disease. Malnutrition is common in cancer patients and differs from starvation-related malnutrition, as it results from a combination of anorexia and metabolic dysregulation, caused by the tumor itself or by its treatment, and causing cachexia. Cancer-associated malnutrition can lead to several negative consequences, including poor prognosis, reduced survival, increased therapy toxicity, reduced tolerance and compliance to treatments, and diminished response to antineoplastic drugs. Guidelines issued by the Ministry of Health in 2017, the most recent ESPEN guidelines and the PreMiO study highlighted an inadequate nutritional support in cancer patients since their first visit, and recommended an optimization of the quality of life of cancer patients in each stage of the disease, also through specific nutritional interventions by multidisciplinary teams. Based on the evidences summarized above, a survey has been carried out on a sample of 300 Italian hospital medical oncologists to evaluate their level of awareness and perception of cancer-related malnutrition and their proposals to implement effective strategies to improve nutritional care in the setting of hospital oncology departments in Italy. The survey results indicate that, despite high levels of awareness among Italian oncologists, malnutrition in cancer patients remains, at least in part, an unmet medical need, and additional efforts are necessary in terms of increased training and hiring of personnel, and of creation of organizational pathways aimed at treatment optimization based on available evidences.

scholarly journals HYDROXYCHLOROQUINE FOR THE TREATMENT OF SEVERE RESPIRATORY INFECTION BY COVID-19: A RANDOMIZED CONTROLLED TRIAL

2021 ◽  
Author(s):  
Carmen Hernandez-Cardenas ◽  
Ireri Thirion-Romero ◽  
Norma E. Rivera-Martinez ◽  
Patricia Meza-Meneses ◽  
Arantxa Remigio-Luna ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Severe Disease ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Serious Adverse Events ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Secondary Outcomes

ABSTRACTThe novel coronavirus pandemic (COVID–19) represents a major public health problem due to its rapid spread and its ability to generate severe pneumonia. Thus, it is essential to find a treatment that reduces mortality. Our objective was to estimate whether treatment with 400 mg/day of Hydroxychloroquine for 10 days reduces in-hospital mortality in subjects with severe respiratory disease due to COVID-19 compared with placebo.Material and methodsA double-blind, randomized, placebo-controlled trial to evaluate the safety and efficacy of Hydroxychloroquine for the treatment of severe disease by COVID-19 through an intention-to-treat analysis. Eligible for the study were adults aged more than 18 years with COVID-19 confirmed by RT-PCR and lung injury requiring hospitalization with or without mechanical ventilation. Primary outcome was 30-day mortality. Secondary outcomes: days of mechanical ventilation, days of hospitalization and cumulative incidence of serious adverse events.ResultsA total of 214 patients with COVID-19 were recruited, randomized and analyzed. They were hypoxemic with a mean SpO2 of 65% ± 20, tachycardic (pulse rate 108±17 min-1) and tachypneic (32 ±10 min-1); 162 were under mechanical ventilation at randomization. Thirty-day mortality was similar in both groups (38% in Hydroxychloroquine vs. 41% in placebo, hazard ratio [HR] 0.88, 95% Confidence Interval [95%CI] 0.51-1.53). In the surviving participants, no significant difference was found in secondary outcomes.ConclusionNo beneficial effect or significant harm could be demonstrated in our randomized controlled trial including 214 patients, using relatively low doses of Hydroxychloroquine compared with placebo in hospitalized patients with severe COVID-19.CONSORT GUIDELINES

Substance Abuse and Drug-Related Death, Suicidal Ideation, and Suicide: A Review

Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Annie Mino ◽  
Arnaud Bousquet ◽  
Barbara Broers
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Substance Abuse ◽  
Suicidal Ideation ◽  
Family Support ◽  
Drug Users ◽  
Suicide Attempts ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Hiv Epidemic

The high mortality rate among drug users, which is partly due to the HIV epidemic and partly due to drug-related accidental deaths and suicides, presents a major public health problem. Knowing more about prevalence, incidence, and risk factors is important for the development of rational preventive and therapeutic programs. This article attempts to give an overview of studies of the relations between substance abuse, suicidal ideation, suicide, and drug-related death. Research in this field is hampered by the absence of clear definitions, and results of studies are rarely comparable. There is, however, consensus about suicidal ideation being a risk factor for suicide attempts and suicide. Suicidal ideation is also a predictor of suicide, especially among drug users. It is correlated with an absence of family support, with the severity of the psychosocial dysfunctioning, and with multi-drug abuse, but also with requests for treatment. Every clinical examination of a drug user, not only of those who are depressed, should address the possible presence of suicidal ideation, as well as its intensity and duration.

MEASLES OUTBREAK IN A RURAL AREA OF A DEVELOPING COUNTRY: A CASE CONTROL STUDY

2018 ◽  
Vol 7 (4) ◽  
pp. 197-201
Author(s):  
Mir M Hassan Bullo ◽  
Mirza Amir Baig ◽  
Jawad Faisal Malik ◽  
Ejaz Ahmad Khan ◽  
Muazam Abbas Ranjha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vaccine Coverage ◽  
Significant Risk ◽  
Public Health Problem ◽  
Maculopapular Rash ◽  
Healthcare Facility ◽  
Control Measures ◽  
Major Public Health Problem ◽  
District Health ◽  
Active Case

Background: Measles is highly contagious vaccine preventable disease (VPD), and a major public health problem considered as leading cause of morbidity and mortality in developing countries like Pakistan. An outbreak of measles was reported in Sharifabad Islamabad on 15th of April 2017, and an investigation was launched to assess the magnitude of outbreak, evaluate risk factors and recommend control measures. Methods: A comprehensive house to house active case search along with vaccine coverage survey was conducted from April 19-22, 2017. A case was defined as "onset of maculopapular rash with fever in a resident of Sharifabad with at least one of the following signs/ symptoms, Coryza, Conjunctivitis, Cough, Otitis media or Pneumonia present in between 19 March to 22nd April 2017". Four age & sex matched controls were selected from the neighborhood. Data was collected through interview method using structured questionnaire and vaccination coverage was determined by using Epi survey form. Blood samples were sent for laboratory confirmation. Results: A total of eight cases were identified through active case finding while three were reported by local practitioner. Mean age of cases were 20 months (range 8-36 months). Severely affected age-group was 1-2 years with attack rate of 46%. Around two-third (64%) of cases and a few (16%) of controls were unvaccinated against measles. Contact with measles patient [OR 25.2, CI 3.9-160.1, P=0.00], unvaccinated children [OR 9.2 CI 2.12-40.4, P=0.000], social misconception regarding vaccination [OR 7.8 CI 1.42-42.6, P=0.00], and distance from healthcare facility [OR 5.7 CI 1.15-28.35, P=0.02] were significant risk factors. Vaccine efficacy was 90%. Conclusion: Main reasons of the outbreak were contact with the cases, and low vaccination status. We recommended comprehensive measles vaccination and community awareness sessions. On our recommendations district health authority Islamabad carried out mop up of whole area.

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