scholarly journals Telomere Length Changes during Critical Illness: A Prospective, Observational Study

Genes ◽  
2019 ◽  
Vol 10 (10) ◽  
pp. 761 ◽  
Author(s):  
Zribi ◽  
Uziel ◽  
Lahav ◽  
Mesilati Stahy ◽  
Singer
Keyword(s):  
Observational Study ◽  
Telomere Length ◽  
Prospective Observational Study ◽  
Demographic Data ◽  
Admission Diagnosis ◽  
Telomere Shortening ◽  
Icu Stay ◽  
Icu Discharge ◽  
Length Changes ◽  
Wbc Count

: Objective: evaluation of telomere length change in acutely ill adult patients. Design: Blood samples were drawn on the first and seventh day of intensive care unit (ICU) stay to assess telomere length using a polymerase chain reaction (PCR)-based technique. Demographic data collected included age, weight, admission diagnosis, baseline laboratory values (pH, C- reactive protein (CRP), serum albumin level, white blood cell count (WBC) count, platelet count), and baseline SOFA and APACHE II scores. Additional data collected during the ICU stay included a repeated WBC count, the presence of positive blood cultures and outcome data, including death in the ICU or following discharge, whether ventilated or not at ICU discharge, and destination following discharge, i.e., medical ward or rehabilitation. Setting: General ICU in tertiary hospital. Patients: Forty patients admitted to the ICU within 72 h of hospital admission suffering from an acute illness were included in this prospective, observational study. Main results: Of the 40 patients studied, telomere shortening was noted in 21, telomere lengthening in 11, and no significant change in the other eight. The age of patients demonstrating telomere shortening was statistically significantly younger (45.4 vs. 61.5 years, p < 0.023) compared to those showing increased telomere length. In addition, a significant correlation was observed between the difference in telomere length and the corresponding difference in WBC count (telomere shortening was associated with a decreased WBC count and vice versa). A trend toward shortening was seen in patients with sepsis (p = 0.07). No significant correlations were found for any other demographic or outcome parameter and changes in telomere length. Conclusion: Changes in telomere length, both shortening and lengthening, were evident in the acute setting, but no associations between such changes with outcome were noted. Further studies in more homogeneous groups of patients appear to be warranted.

scholarly journals Oxidative Stress, Telomere Shortening, and Apoptosis Associated to Sarcopenia and Frailty in Patients with Multimorbidity

2020 ◽  
Vol 9 (8) ◽  
pp. 2669 ◽  
Author(s):  
Máximo Bernabeu-Wittel ◽  
Raquel Gómez-Díaz ◽  
Álvaro González-Molina ◽  
Sofía Vidal-Serrano ◽  
Jesús Díez-Manglano ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Telomere Length ◽  
Prospective Observational Study ◽  
Oxygen Species ◽  
Oxidative Stress Markers ◽  
Blood Leukocytes ◽  
Telomere Shortening ◽  
Blood Samples ◽  
Stress Markers ◽  
Total Antioxidant

Background: The presence of oxidative stress, telomere shortening, and apoptosis in polypathological patients (PP) with sarcopenia and frailty remains unknown. Methods: Multicentric prospective observational study in order to assess oxidative stress markers (catalase, glutathione reductase (GR), total antioxidant capacity to reactive oxygen species (TAC-ROS), and superoxide dismutase (SOD)), absolute telomere length (aTL), and apoptosis (DNA fragmentation) in peripheral blood samples of a hospital-based population of PP. Associations of these biomarkers to sarcopenia, frailty, functional status, and 12-month mortality were analyzed. Results: Of the 444 recruited patients, 97 (21.8%), 278 (62.6%), and 80 (18%) were sarcopenic, frail, or both, respectively. Oxidative stress markers (lower TAC-ROS and higher SOD) were significantly enhanced and aTL significantly shortened in patients with sarcopenia, frailty or both syndromes. No evidence of apoptosis was detected in blood leukocytes of any of the patients. Both oxidative stress markers (GR, p = 0.04) and telomere shortening (p = 0.001) were associated to death risk and to less survival days. Conclusions: Oxidative stress markers and telomere length were enhanced and shortened, respectively, in blood samples of polypathological patients with sarcopenia and/or frailty. Both were associated to decreased survival. They could be useful in the clinical practice to assess vulnerable populations with multimorbidity and of potential interest as therapeutic targets.

scholarly journals Rupture uterus: a prospective observational study of 25 consecutive cases in a tertiary referral centre in South India

2017 ◽  
Vol 6 (6) ◽  
pp. 2601 ◽  
Author(s):  
Rashmi S Desai ◽  
Amitha V Kamat
Keyword(s):  
Observational Study ◽  
Perinatal Mortality ◽  
Uterine Rupture ◽  
Maternal Morbidity ◽  
Prospective Observational Study ◽  
Demographic Data ◽  
Referral Centre ◽  
Tertiary Referral Centre ◽  
Predisposing Factor ◽  
Artery Ligation

Background: Uterine rupture in pregnancy is a rare though catastrophic complication with a high incidence of foetal and maternal morbidity. It appeared to be on the decline in recent times, prompting us to analyse the clinical picture now. The objective of the study was to study the risk factors, clinical profile and consequences of uterine rupture on maternal and perinatal outcome.Methods: A prospective observational study of 25 consecutive cases of uterine rupture was carried out between July 2013 and October 2015. All the cases of rupture uterus either referred or diagnosed after admission were included. Detailed demographic data, past and present obstetric events, time taken to reach the referral centre, the reasons for any delay, mode of presentation, type of rupture, management and maternal and foetal outcomes were analysed.Results: The incidence of rupture was 1 in 915 deliveries. Seventy-two per cent of them were referred cases. Average time to reach from referral centre was 4.3 hours, the common reasons for delay being patient factors (33%), transport problems (38%) and delayed referrals (22%). Previous caesarean section was the most common predisposing factor (56%). Sixty-four per cent of the ruptures were diagnosed clinically. Eighty-four per cent of the ruptures were complete. Sub-total hysterectomy was carried out in 14 (56%) patients. Internal iliac artery ligation (20%) and bladder repair (8%) were sometimes required. All women required blood transfusion.  Perinatal mortality was seen in 76%. There was no maternal mortality.Conclusions: Uterine rupture is a cause of severe acute maternal morbidity and very high perinatal mortality.  Delay in referral and diagnosis can lead to significant maternal morbidity and hysterectomy.

scholarly journals Butyrylcholinesterase as a perioperative complication marker in patients after transcatheter aortic valve implantation: a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e042857
Author(s):  
Bernhard Michels ◽  
Andreas Holzamer ◽  
Bernhard M Graf ◽  
Andre Bredthauer ◽  
Walter Petermichl ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Aortic Valve ◽  
Observational Study ◽  
Postoperative Period ◽  
Prospective Observational Study ◽  
Point Of Care ◽  
Demographic Data ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

ObjectivesTranscatheter aortic valve implantation (TAVI) is performed in elderly patients with severe aortic valve stenosis and increased operative risks. We tested the hypothesis that acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) have a predictive value for prevalent complications after TAVI and could serve as indicators of systemic inflammation in the early postoperative period.DesignProspective observational study.SettingThis study is a secondary analysis of multicentre CESARO- study.Participants48 patients with TAVI were included and 43 obtained the complete assessment.Primary and secondary outcome measuresPatients’ clinical parameters, demographic data, peripheral AChE and BChE activities and routine blood markers were assessed throughout the perioperative period using bedside point-of-care measurements for AChE and BChE. Postoperative complication screening was conducted up to the third postoperative day and included infections, delirium and heart-rhythm disturbances. After assessment, the patients were divided into complication and noncomplication group.ResultsOf 43 patients, 24 developed postsurgical complications (55.8%). Preoperative assessment showed no significant differences regarding demographic data and laboratory markers, but preoperative BChE levels were significantly lower in patients who developed postoperative complications (complication group 2589.2±556.4 vs noncomplication group 3295.7±628.0, Cohen’s r=0.514, p<0.001). In complication group, we observed an early, sustained reduction in BChE activity from preoperative to postoperative period. In complication group, BChE levels were significantly lower at each time point compared with noncomplication group. AChE activity showed no significant difference between both groups. Complication group also had longer stay in hospital overall.ConclusionBChE could be a useful perioperative biomarker to identify patients with a higher risk for postoperative complications after TAVI. By using point-of-care measurements, the levels of BChE are fast available and can lead to an early targeted therapy. Predicting the length of the hospital stay might play an important role in staff and resource management for these patients.Trial registration numberNCT01964274; Post-results.

scholarly journals Variation in the practice of discontinuing mechanical ventilation in critically ill adults: study protocol for an international prospective observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031775 ◽  
Author(s):  
Karen E A Burns ◽  
Leena Rizvi ◽  
Deborah J Cook ◽  
Peter Dodek ◽  
Arthur S Slutsky ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Observational Study ◽  
Research Ethics ◽  
Critically Ill ◽  
Prospective Observational Study ◽  
Demographic Data ◽  
Spontaneous Breathing Trial ◽  
Primary Objective ◽  
Critically Ill Adults ◽  
Ill Adults

IntroductionResearch supports the use of specific strategies to discontinue mechanical ventilation (MV) in critically ill patients. Little is known about how clinicians actually wean and discontinue MV in practice or the association between different discontinuation strategies and outcomes. The primary objective of this study is to describe international practices in the use of (1) daily screening for readiness to discontinue MV, (2) modes of MV used before initial discontinuation attempts, (3) weaning and spontaneous breathing trial (SBT) protocols, (4) SBT techniques and (5) sedation and mobilisation practices to facilitate weaning and discontinuation. The secondary objectives are to identify patient characteristics and time-dependent factors associated with use of selected strategies, investigate associations between SBT outcome (failure vs success) and outcomes, explore differences between patients who undergo an SBT early versus later in their intensive care unit (ICU) stay, and investigate the associations between different SBT techniques and humidification strategies on outcomes.Methods and analysisWe will conduct an international, prospective, observational study of MV discontinuation practices among critically ill adults who receive invasive MV for at least 24 hours at approximately 150 ICUs in six geographic regions (Canada, USA, UK, Europe, India and Australia/New Zealand). Research personnel at participating ICUs will collect demographic data, data to characterise the initial strategy or event that facilitated discontinuation of MV (direct extubation, direct tracheostomy, initial successful SBT, initial failed SBT or death before any attempt could be made), clinical outcomes and site information. We aim to collect data on at least 10 non-death discontinuation events in each ICU (at least 1500 non-death discontinuation events).Ethics and disseminationThis study received Research Ethics Approval from St. Michael’s Hospital (11-024) Research ethics approval will be sought from all participating sites. The results will be disseminated through publications in peer-reviewed journals.Trial registration numberNCT03955874.

scholarly journals A prospective observational study on prescribing pattern of antimicrobial agents in the post-operative general surgery ward of a tertiary care teaching hospital

2020 ◽  
Vol 9 (10) ◽  
pp. 1513
Author(s):  
Velvizhy R. ◽  
Johan J. Pandian
Keyword(s):  
Observational Study ◽  
General Surgery ◽  
Prospective Observational Study ◽  
Antimicrobial Agents ◽  
Generic Drugs ◽  
Demographic Data ◽  
Tertiary Care ◽  
Essential Medicine ◽  
Fixed Dose ◽  
Care Teaching

Background: This prospective observational study was done to know the current prescription trend of antimicrobial agents in the post-operative ward. To evaluate the current pattern of antimicrobial agents in the post-operative surgical cases of a tertiary care teaching hospital.Methods: The study was carried out in collaboration with the Department of General Surgery and Department of Pharmacology during April 2013 to March 2014. All parameters like demographic data, antimicrobials agents prescribed by surgeons, dose, frequency, duration, route, formulation, brand or generic drugs, adverse events were collected in the specially structured case proforma. Descriptive statistics was applied using SPSS version 17.0.Results: During the study period, 513 patient case records were analysed in which males are higher than females. A total of 816 drugs were used in 484 patients during the study period. 162 were on a single drug, 190 were on two drugs, 42 were on three drugs and 90 were on fixed dose combination. Brand name of the drugs and parenteral route of administration were preferred in the study. Cephalosporins (52.32%) and metronidazole (34.38%) were the most commonly prescribed group of antimicrobials followed by penicillin (0.9%), aminoglycosides (6.58%), quinolones (5.23%), macrolides (0.45%) and tetracycline (0.14%). Totally 135 (27.89%) patients received drugs which are not included in the essential medicine list of WHO and 112 (23.14%) patients received drugs which are not from national EML.Conclusions: The maximum prescribed antimicrobial agent in the post-operative ward was third generation cephalosporins.

scholarly journals Incidence of peripheral intravenous catheter phlebitis and its associated factors among patients admitted to University of Gondar hospital, Northwest Ethiopia: a prospective, observational study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Mulugeta Lulie ◽  
Abilo Tadesse ◽  
Tewodros Tsegaye ◽  
Tesfaye Yesuf ◽  
Mezgebu Silamsaw
Keyword(s):  
Observational Study ◽  
Associated Factors ◽  
Prospective Observational Study ◽  
Health Care Cost ◽  
Blood Stream Infection ◽  
Demographic Data ◽  
Northwest Ethiopia ◽  
Hospitalized Patients ◽  
Adverse Outcomes ◽  
P Value

Abstract Background Phlebitis, inflammation of tunica intima of venous wall, occurred in 13–56% of hospitalized patients. It is characterized by pain, erythema, swelling, palpable venous cord, and pussy discharge at catheter site. Cannula-related blood stream infection (CRBSI) is recognized complication of phlebitis. Adverse outcomes of phlebitis embrace patient discomfort, longer hospital stay and higher health care cost. This study aimed to determine the incidence and associated factors of peripheral vein phlebitis among hospitalized patients. Methods A hospital-based prospective, observational study was conducted between April 1 and August 31, 2020 at University of Gondar hospital, Northwest Ethiopia. A consecutive sampling method was used to recruit 384 patients. Patients were interviewed to obtain socio-demographic data. Relevant medical history and laboratory parameters were obtained from patients’ records. Presence and severity of phlebitis was identified by Jackson’s Visual Infusion Phlebitis (VIP) Scoring System. The Data were entered into EPI Info version 4.4.1 and transported to SPSS version 20 for analysis. Logistic regression analysis was used to identify associated factors with occurrence of phlebitis. P-value < 0.05 was used to declare significant association. Result A total of 384 study subjects were included in the study. The mean age of study subjects was 46 years, with a range of 19 to 96 years. The incidence of phlebitis was 70% among study subjects. Mid-stage (grade 3) and advanced-stage (grade 4) phlebitis were noticed in 136/268 (51%) and 89/268 (33%) respectively. Odds of developing phlebitis were twofold higher in patients with catheter-in situ > 96 h (AOR = 2.261, 95% CI 1.087–4.702, P-value = 0.029) as compared to those with catheter dwell time < 72 h. Female patients were 70% (AOR = 0.293, 95% CI 0.031–0.626, P-value = 0.002) lower than male patients with risk of developing phlebitis. Patients who use infusates were 53% (AOR = 0.472, 95% CI 0.280–0.796, P-value = 0.005) less likely to develop phlebitis as compared to those who didn’t use infusates. Conclusion The cannula must be reviewed on daily basis, and it should be removed if it stayed later than 96 h.

scholarly journals Suppression of Alternative Lengthening of Telomeres by Sp100-Mediated Sequestration of the MRE11/RAD50/NBS1 Complex

2005 ◽  
Vol 25 (7) ◽  
pp. 2708-2721 ◽  
Author(s):  
Wei-Qin Jiang ◽  
Ze-Huai Zhong ◽  
Jeremy D. Henson ◽  
Axel A. Neumann ◽  
Andy C.-M. Chang ◽  
...  
Keyword(s):  
Dna Replication ◽  
Telomere Length ◽  
Promyelocytic Leukemia ◽  
Nuclear Bodies ◽  
Population Doubling ◽  
Telomeric Dna ◽  
Alternative Lengthening Of Telomeres ◽  
Telomere Shortening ◽  
Alternative Lengthening ◽  
Length Changes

ABSTRACT Approximately 10% of cancers overall use alternative lengthening of telomeres (ALT) instead of telomerase to prevent telomere shortening, and ALT is especially common in astrocytomas and various types of sarcomas. The hallmarks of ALT in telomerase-negative cancer cells include a unique pattern of telomere length heterogeneity, rapid changes in individual telomere lengths, and the presence of ALT-associated promyelocytic leukemia bodies (APBs) containing telomeric DNA and proteins involved in telomere binding, DNA replication, and recombination. The ALT mechanism appears to involve recombination-mediated DNA replication, but the molecular details are largely unknown. In telomerase-null Saccharomyces cerevisiae, an analogous survivor mechanism is dependent on the RAD50 gene. We demonstrate here that overexpression of Sp100, a constituent of promyelocytic leukemia nuclear bodies, sequestered the MRE11, RAD50, and NBS1 recombination proteins away from APBs. This resulted in repression of the ALT mechanism, as evidenced by progressive telomere shortening at 121 bp per population doubling, a rate within the range found in telomerase-negative normal cells, suppression of rapid telomere length changes, and suppression of APB formation. Spontaneously generated C-terminally truncated Sp100 that did not sequester the MRE11, RAD50, and NBS1 proteins failed to inhibit ALT. These findings identify for the first time proteins that are required for the ALT mechanism.

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