ABSTRACT
Background: With wide clinical spectrum, multisystem inflammatory syndrome associated with coronavirus disease 2019 (COVID-19) in children (MIS-C) is a relatively novel condition occurring weeks to months’ post SARS-CoV-2 infection. The aim was to systematically review data on clinical features, laboratory parameters and therapeutics of MIS-C from India. Methods: This systematic review was done as per the PRISMA guidelines, and quality assessment was done using NIH tool for case-series. A systematic search through databases yielded studies whose data was pooled to calculate the mean frequencies with standard deviation using GraphPad software. Results: Screening of 2548 articles published till December, 2021, yielded 11 case-series. World Health Organization case definition was used widely. There was a slight preponderance of males (57%), median (IQR) age was 7 (6,7) years, 63% (n=305) required intensive care unit admissions, and mortality rate was 10% (n=261). Clinical features included fever, mucocutaneous features (72%), and gastrointestinal problems (62%) in majority. Widely used treatment was corticosteroids (76%) and intravenous immunoglobulin (62%) with other options depending on patient’s state. An increased level of inflammatory markers and derangement in other parameters corroborated with disease status. Kawasaki disease like features, not reported in many studies, ranged from 4-76% of patients. Conclusion: MIS-C presents with a wide spectrum clinical features, increased inflammatory markers and managed as per the disease course and presentation. Future studies monitoring the long-term effects of MIS-C are recommended.
ABSTRACT
BACKGROUND/OBJECTIVES: This study addressed the question whether the composition of supposedly 'healthy' or 'unhealthy' dietary regimes has a calorie-independent short-term effect on biomarkers of metabolic stress and vascular risk in healthy individuals. SUBJECTS/METHODS: Healthy male volunteers (age 29.5 +/- 5.9 years, n = 39) were given a standardized baseline diet for two weeks before randomization into three groups of different dietary regimes: fast food, Mediterranean and German cooking style. Importantly, the amount of calories consumed per day was identical in all three groups. Blood samples were analyzed for biomarkers of cardiovascular risk and metabolic stress after two weeks of the baseline diet and after two weeks of the assigned dietary regime. RESULTS: No dietary intervention affected the metabolic or cardiovascular risk profile when compared in-between groups or compared to baseline. Subjects applied to the Mediterranean diet showed a statistically significant increase of uric acid compared to baseline and compared to the German diet group. Plasma concentrations of urea were significantly higher in both the fast food group and the Mediterranean group, when compared to baseline and compared to the German diet group. No significant differences were detected for the levels of vitamins, trace elements or metabolic stress markers (8-hydroxy-2-deoxyguanosine, malondialdehyde and methylglyoxal, a potent glycating agent). Established parameters of vascular risk (e.g. LDL-cholesterol, lipoprotein(a), homocysteine) were not significantly changed in-between groups or compared to baseline during the intervention period. CONCLUSIONS: The calorie-controlled dietary intervention caused neither protective nor harmful short-term effects regarding established biomarkers of vascular or metabolic risk. When avoiding the noxious effects of overfeeding, healthy individuals can possess the metabolic capacity to compensate for a potentially disadvantageous composition of a certain diet.
Subject(s)
Humans , Male , Biomarkers , Cooking , Diet , Diet, Mediterranean , Fast Foods , Lipoprotein(a) , Malondialdehyde , Oxidative Stress , Plasma , Pyruvaldehyde , Random Allocation , Stress, Physiological , Trace Elements , Urea , Uric Acid , Vitamins , VolunteersABSTRACT
BACKGROUND/OBJECTIVES: This study addressed the question whether the composition of supposedly 'healthy' or 'unhealthy' dietary regimes has a calorie-independent short-term effect on biomarkers of metabolic stress and vascular risk in healthy individuals. SUBJECTS/METHODS: Healthy male volunteers (age 29.5 +/- 5.9 years, n = 39) were given a standardized baseline diet for two weeks before randomization into three groups of different dietary regimes: fast food, Mediterranean and German cooking style. Importantly, the amount of calories consumed per day was identical in all three groups. Blood samples were analyzed for biomarkers of cardiovascular risk and metabolic stress after two weeks of the baseline diet and after two weeks of the assigned dietary regime. RESULTS: No dietary intervention affected the metabolic or cardiovascular risk profile when compared in-between groups or compared to baseline. Subjects applied to the Mediterranean diet showed a statistically significant increase of uric acid compared to baseline and compared to the German diet group. Plasma concentrations of urea were significantly higher in both the fast food group and the Mediterranean group, when compared to baseline and compared to the German diet group. No significant differences were detected for the levels of vitamins, trace elements or metabolic stress markers (8-hydroxy-2-deoxyguanosine, malondialdehyde and methylglyoxal, a potent glycating agent). Established parameters of vascular risk (e.g. LDL-cholesterol, lipoprotein(a), homocysteine) were not significantly changed in-between groups or compared to baseline during the intervention period. CONCLUSIONS: The calorie-controlled dietary intervention caused neither protective nor harmful short-term effects regarding established biomarkers of vascular or metabolic risk. When avoiding the noxious effects of overfeeding, healthy individuals can possess the metabolic capacity to compensate for a potentially disadvantageous composition of a certain diet.
Subject(s)
Humans , Male , Biomarkers , Cooking , Diet , Diet, Mediterranean , Fast Foods , Lipoprotein(a) , Malondialdehyde , Oxidative Stress , Plasma , Pyruvaldehyde , Random Allocation , Stress, Physiological , Trace Elements , Urea , Uric Acid , Vitamins , VolunteersABSTRACT
O diagnóstico da artrite reumatoide é estabelecido considerando-se uma associação de achados clínicos. Nenhum teste laboratorial, achado histológico ou característica radiológica isoladamente confirma o diagnóstico. A avaliação na fase precoce da doença, contudo, é especialmente difícil, já que alterações sorológicas e radiológicas características muitas vezes estão ausentes. Alguns exames recentemente descritos, como a investigação dos anticorpos contra proteínas e peptídeos citrulinados, são especialmente úteis para o diagnóstico nas fases iniciais da doença. Outros marcadores, como exames genéticos, dosagem de marcadores do metabolismo ósseo e cartilaginoso, lecitina ligadora de manose, selectina E, leptina, interleucina 6 e marcadores de ativação do endotélio vascular, embora promissores, ainda não fazem parte dos recursos de investigação da rotina clínica.
The diagnosis of rheumatoid arthritis is established considering a combination of clinical findings. No laboratory test, histological finding or radiological feature alone confirm the diagnosis. The evaluation at the early phase of the disease, however, is especially difficult, since serological changes and radiological features are often absent. Some tests recently described, such as the investigation of antibodies against proteins and citrullinated peptides are particularly useful for diagnosing the early stages of the disease. Other markers, such as genetic tests, dosages of markers of the bone and cartilage metabolism, mannose-binding lecithin, E-selectin, leptin, interleukin 6 and activation markers of the vascular endothelium, although promising, are not yet part of the clinical investigation routine arsenal.